Same Content, Different Methods: Comparing Lecture, Engaged Classroom, and Simulation.

BACKGROUND AND OBJECTIVES: There is a push to use classroom technology and active teaching methods to replace didactic lectures as the most prevalent format for resident education. This multisite collaborative cohort study involving nine residency programs across the United States compared a standard slide-based didactic lecture, a facilitated group discussion via an engaged classroom, and a high-fidelity, hands-on simulation scenario for teaching the topic of acute dyspnea. The primary outcome was knowledge retention at 2 to 4 weeks. METHODS: Each teaching method was assigned to three different residency programs in the collaborative according to local resources. Learning objectives were determined by faculty. Pre- and posttest questions were validated and utilized as a measurement of knowledge retention. Each site administered the pretest, taught the topic of acute dyspnea utilizing their assigned method, and administered a posttest 2 to 4 weeks later. Differences between the groups were compared using paired t-tests. RESULTS: A total of 146 residents completed the posttest, and scores increased from baseline across all groups. The average score increased 6% in the standard lecture group (n=47), 11% in the engaged classroom (n=53), and 9% in the simulation group (n=56). The differences in improvement between engaged classroom and simulation were not statistically significant. CONCLUSIONS: Compared to standard lecture, both engaged classroom and high-fidelity simulation were associated with a statistically significant improvement in knowledge retention. Knowledge retention after engaged classroom and high-fidelity simulation did not significantly differ. More research is necessary to determine if different teaching methods result in different levels of comfort and skill with actual patient care.

Text messaging to improve resident knowledge: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: Advances in technology present opportunities to develop and test innovative teaching methods. We sought to evaluate whether text messaging could improve medical resident knowledge in musculoskeletal medicine. METHODS: Eleven U.S. family medicine residency programs with a total of 269 residents participated in this randomized, controlled trial. Residents were invited to complete a pretest to assess musculoskeletal medicine knowledge. The residents randomized to the intervention group were then offered to receive text messages termed electronically Generated Educational Messages (eGEMs) three times per week during a 12-week period. The primary outcome was change in pretest and posttest scores among residents in an intervention group (those who received text messages) as compared to a control group (those who did not receive the text messages). Focus groups were conducted to assess resident acceptability and usefulness of text messaging as a teaching tool. RESULTS: Sixty-three residents completed the pretests and posttests. The intervention group's score improved from 55% of questions answered correctly to 64%; the control group improved from 56% to 61%. While these pretest/posttest changes each were statistically significant, the difference in improvement between the two groups was not. Focus groups revealed that participants liked the intervention, but suggestions for improvement included ability to tailor the eGEMs. CONCLUSIONS: The use of eGEMs as initially developed did not increase resident knowledge based on exam scores. Further study is needed to determine if a more tailored intervention is effective.