Experiences with using e-learning tools in orthopedics in an uncontrolled field study application.

BACKGROUND: E-learning is widely used in undergraduate medical education and often in blended learning settings for students learning at home. This study should assess the educative value of e-learning tools in orthopedics and traumatology when used under "field" conditions, in comparison with a controlled laboratory-like setting. MATERIALS AND METHODS: Medical students were invited for their voluntary online participation in an uncontrolled study (UCS). They were randomly exposed to digital book chapters or podcasts on four different orthopedic diseases, and then filled in pre-/post-tests and evaluations. Test results indicating insufficient study participation were not included in the subsequent analysis. Results in a gain of knowledge and student's satisfaction were compared to existing data of a randomized controlled trial with the same tools in a laboratory environment (RCT). RESULTS: Among 84 included UCS students and 130 RCT students, podcast learners showed a significantly higher gain of knowledge compared to text learners independent of the learning setting (UCS p<0.011; RCT p<0.001). There were no significant differences in the gain of knowledge for the two different learning tools when comparing each the UCS and RCT settings. Evaluations showed positive ratings for both tools, while podcasts were on the average rated higher than texts were. Significantly more UCS participants (n=46) compared to the RCT (n=34) showed signs of disengagement with the study (p<0.05). DISCUSSION: The findings suggest that it is possible to achieve a similar gain of knowledge with e-learning tools in uncontrolled settings and in RCTs. The role of e-learning materials in voluntary and formative learning settings is of value and should be explored in future studies. LEVEL OF EVIDENCE: III, case-control study.

Superior Gain in Knowledge by Podcasts Versus Text-Based Learning in Teaching Orthopedics: A Randomized Controlled Trial.

OBJECTIVE: Digital learning (e-learning) has become a firm part of surgical undergraduate education. However, there is still a lack in analyzing e-learning tools in experimental settings without potentially biasing curricular influences. This study should compare students' learning outcome with podcasts versus book texts under laboratory conditions in the field of orthopedics. METHODS: Voluntary medical students were randomly assigned for learning either with a book chapter or a podcast about common orthopedic diseases in an isolated computer room. Before and after intervention, students answered multiple-choice tests and questionnaires about their attitudes and satisfaction. The study was conducted from November 2012 to February 2013. RESULTS: Totally, 130 students were included (55 text users and 75 podcast users, 52 males and 78 females). There was a significant increase in the overall knowledge for both groups (p < 0.001). Podcast users scored significantly better in the posttests (p < 0.021) and achieved a significantly higher gain of knowledge compared to text users (p < 0.001). The evaluation also showed a significantly higher approval of podcasts regarding comprehensibility, teaching efficacy, or fun learning with it (p < 0.05). Females gained significantly more knowledge by the use of texts than males did (p = 0.04), without any sex difference when using podcasts. CONCLUSIONS: This study showed a significantly higher gain of knowledge and higher satisfaction from learning with podcasts compared to book texts among students. Podcasts seem to be beneficial when teaching defined orthopedic topics to medical students. Sex plays an additional independent role in the impact of e-learning tools on students' learning outcome.