E-learning and deliberate practice for oral case presentation skills: A randomized trial

Figures & data

Table

Practice points

On-line learning combined with coached deliberate practice improves students’ abilities to present patient cases in an organized, succinct, and well-reasoned manner. Reliable checklists for specific cases can be created, allowing for standardized assessment to address student concerns about haphazard faculty expectations.

Table 1  Northwestern oral presentations checklist.^a

Content-specific items
Opening statement
• Age and gender/occupation
• Relevant historical information
• Chief concern
History of present illness
• Cardinal features of symptoms
• Significance
• Pertinent positives
• Pertinent negatives
Additional medical history
• Pertinent past history
• Important medications/allergies
• Focused family history
• Focused social history
• Avoid separate review of systems here
Physical exam
• Vital signs
• General appearance
• Organized head-to-toe
• All pertinent organ systems described
• Irrelevant systems excluded
Assessment and plan
• Synthesis statement
• Accurate differential diagnosis with at least three items
• Accurate argument for and against items on differential
General items
Overall
• Timing under five minutes
• In order
Style
• No extraneous commentary
• No mispronunciations
• Minimal prompting from notes
• Avoids vocal tics (e.g., “um.”)

Note: ^aStyle items were included in the curriculum but excluded from the assessment scores due to poor inter-rater agreement.

Figure 1. Flow diagram from waitlist control study.

Figure 2. Overall scores for intervention, waitlist control, and historical comparison groups at three time points. Notes: *p<0.01 for difference in improvement between waitlist control and intervention from baseline to midpoint evaluation. **p<0.0001 for difference between historical comparison and implementation class at final evaluation.

Table 2  Intervention students’ ratings of e-learning module and deliberate practice

Question	Mean rating^a (SD)
Survey after e-learning module (n = 77):
I feel more prepared to do an oral case presentation after completing this curriculum	4.0 (0.75)
This curriculum teaches the most important points about oral presentations	4.2 (0.62)
This curriculum will help me avoid common mistakes made in oral presentations	4.1 (0.59)
The interactive portions of the curriculum added to my learning	3.8 (0.99)
Oral presentation skills are an essential part of my professional skill set	4.5 (0.62)
Survey after deliberate practice (n = 75):
I feel more prepared to do an oral case presentation after completing this curriculum	4.3 (0.49)
The on-line module helped me do better presentations to the M4 coaches than I would have without it	3.9 (1.0)
This curriculum will help me become a better doctor	4.3 (0.58)
The M4 coaching helped me improve my second presentation	4.1 (0.66)
I used the time between my first and second presentations to reflect and to improve my second presentation	4.1 (0.56)
Rate the educational quality of the following:
• On-line module	3.5 (1.2)
• M4 coaching	4.1 (0.79)
• Overall curriculum (module + coaching combined)	4.0 (0.81)

Notes: SD = standard deviation.

^aLikert scales are 1 = strongly disagree, 3 = uncertain, 5 = strongly agree, except the final three items on educational quality, where 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.