A randomized controlled trial of two different types of web-based instructional methods: One with case-based scenarios and one without

Abstract

Background: Computer-based learning (CBL) is an effective form of medical education. Educators have developed recommendations for instructional design but there is only minimal research that evaluates these recommendations.

Aim: To evaluate the effect of case-based questions contained in computer modules on learning efficacy.

Methods: The authors conducted a randomized controlled trial in 124 medical students of two CBL PowerPoint modules-based on Medicare. The modules were identical except one contained 11 case-based scenarios followed by multiple choice questions. The primary outcome measurement was a previously validated, 11-item knowledge test taken at the end of the module and at the end of the academic year to test retention.

Results: The students who studied the module with case-based questions answered one more item correctly in the first test (8.9 vs. 10.00 correct answers, p = 0.001). This difference had disappeared by the time of the second test (4.2 vs. 4.7, p = 0.095).

Conclusions: This study shows that computer modules with case-based questions enhance learning in the short-term but at the expense of increased time and so decreased learning efficiency. This learning benefit was not maintained.