Does peer learning or higher levels of e-learning improve learning abilities? A randomized controlled trial

Figures & data

Table 1 Proposed levels in modern e-learning

Course level
Level 1	Text, images, audio, simple interactivities for content presentation. Template layout
Level 2	Level 1+video and simple animations. Fewer pages with template layout
Level 3	Complex animation, high-fidelity/3D graphics, complex multilevel, and multivariable interaction

Table 2 Correct answers in pre-tests and post-tests

Group	Pre-test	Post-test	Improvement	Cohen's d
1a (eCases, level 1)	22% (21–23%)	88% (86–91%)	66% (63–69%)	14.23
1b (eCases, level 2)	22% (20–23%)	92% (91–94%)	70% (68–73%)	19.78
1c (eCases, level 2+)	22% (21–23%)	94% (92–95%)	71% (68–73%)	18.24
2a (eTextbook, level1)	23% (21–24%)	66% (64–68%)	43% (41–45%)	10.51
2b (eTextbook, level 2)	22% (21–24%)	70% (68–73%)	48% (46–50%)	10.76
2c (eTextbook, level 2+)	22% (20–23%)	71% (68–74%)	49% (46–53%)	9.71

Values are relative numbers of correct answers for each type of educational content in each group, with 95% confidence intervals in brackets. p <0.05 for all of the following comparisons: 1a (eCases) vs. 2a (eTextbook); 1b (eCases) vs. 2b (eTextbook); 1c (eCases) vs. 2c (eTextbook). Mann–Whitney U test for all comparisons. N=20 in each group. Cohen's effect size value (d): high (>0.8), moderate (0.5–0.8), or small (0.2–0.5) practical significance.

Table 3 Between-level comparisons in test result improvements

Level comparisons	Results	p	Cohen's d
Group 1 (eCases)
Level 1 vs. level 2	66% vs. 70%	0.03	0.86
Level 2 vs. level 2+	70% vs. 71%	0.73	0.07
Group 2 (eTextbook)
Level 1 vs. level 2	43% vs. 48%	0.002	0.94
Level 2 vs. level 2+	48% vs. 49%	0.81	0.12

Mann–Whitney U test for all comparisons. N=20 in each group. Cohen's effect size value (d): high (>0.8), moderate (0.5–0.8), or small (0.2–0.5) practical significance.

Table 4 Student's satisfaction with the e-learning material and social aspects (score 1–10)

Level comparisons	Group 1	p	Cohen's d	Group 2	p	Cohen's d
Satisfaction with material
Level 1 vs. level 2	4.2 vs. 6.9	<0.001	3.19	3.8 vs. 5.5	0.002	1.39
Level 2 vs. level 2+	6.9 vs. 7.0	0.94	0.06	5.5 vs. 5.7	0.76	0.08
Satisfaction with social aspect
Level 1 vs. level 2	4.7 vs. 4.9	0.52	0.25	4.5 vs. 4.2	0.40	0.26
Level 2 vs. level 2+	4.9 vs. 6.9	<0.001	2.80	4.2 vs. 5.0	0.04	0.72

Arithmetic averages for each group displayed. Mann–Whitney U test for all comparisons. N=20 in each group. Cohen's effect size value (d): high (>0.8), moderate (0.5–0.8), or small (0.2–0.5) practical significance.