Test-enhanced learning in Neuroanesthesia for the First Year anesthetic residents: a randomized controlled trial.

BACKGROUND: Test enhancing learning (TEL) had shown a significant effect in promoting the learning of many learning contents. However, its effect on the postgraduate medical level was unclear. This study aimed to investigate the effect of TEL in 1st year anesthesiology residents learning neuroanesthesia. METHOD: The residents were randomized to either group A, which was assigned to do the intervention exam (exam A) for two times during learning in neuroanesthesia, or group B, which studied in the same environment without doing the exam. All participants were assigned to do the assessment exam (exam B) at one month after the end of the rotation. All of the exams were ten multiple choice questions (MCQ). Since the anesthesia residents rotated to neuroanesthesia for two weeks twice during the first year, we conducted the experiments twice, using exams that covered both basic science (BS) and clinical science (CS) topics. RESULTS: There was no significant difference in mean ± SD of the scores for assessment exams asking about the basic science topic (BS_B) [group A (5.25 ± 2.05) VS group B (4.90 ± 1.80); p = 0.570] and the clinical science topic (CS_B) [group A (6.30 ± 1.26) VS group B (5.95 ± 1.61); p = 0.448]. CONCLUSION: This study showed null findings on the effect of TEL on learning in residents of the first year of anesthesiology. More studies on TEL were required to confirm the effect of TEL and find the appropriate test format that could enhance learning for post-graduate medical trainees.

A randomized controlled, non-inferiority trial of Moodle online learning for basic life support training on learning outcomes among dental students.

OBJECTIVES: Dental students require basic life support (BLS) training to build their competency in cardiac arrest response. Online learning differs from the types of learning commonly practiced in Asia. We compared online learning and didactic lecture for BLS training in Thai dental students on knowledge, skill, and satisfaction. METHODS: This was a randomized controlled, single-blinded, non-inferiority trial in fifth-year students from Khon Kaen University's Faculty of Dentistry from August 2015 to February 2016. Online learning was conducted using Modular Object-Oriented Dynamic Learning Environment (Moodle) 2.9 and required 90 min. Those in the didactic lecture group received a 90-min lecture covering similar content. Both groups received 2 h of skill training. After training, we evaluated their ability to pass a skills test, knowledge scores (immediately after training and 3 months later), and course satisfaction (5-point Likert scale). RESULTS: We included 78 students and randomized them to online learning (39) or didactic lecture (39). The difference in proportion (95% confidence interval [CI]) of students passing the skills test on their first attempt was -1.5 (-20.8, 23.8), and all passed on their second attempt. The mean differences (95% CI) between the groups' immediate and 3 months knowledge scores were -2.5 (-6.2, 1.2), and -1.3 (-4.9, 2.3), respectively. The mean difference (95% CI) in satisfaction score was 0.02 (-0.28, 0.32). CONCLUSION: Online learning and didactic lectures yielded comparable knowledge and skills, including satisfaction in Thai dental students. Online BLS training may alternatively aim for self-paced learning and increase flexibility. The recommendation is to increase online BLS learning in Thai culture.

Effects of Intraoperative Dexamethasone and Ondansetron on Postoperative Nausea and Vomiting in Microvascular Decompression Surgery: A Randomized Controlled Study.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a common problem and may lead to catastrophic complications, especially in neurosurgical cases. The aim of this study was to evaluate the effects of dexamethasone and ondansetron for preventing PONV in patients who underwent microvascular decompression (MVD) surgery. METHODS: A prospective, double-blinded, randomized control trial was conducted with 54 patients who underwent MVD. Patients were allocated into two groups. The study group (Gr. D) received intraoperative dexamethasone 4 mg iv and ondansetron 4 mg iv, whereas the control group (Gr. N) received placebo (0.9% normal saline 1 ml iv and 0.9% normal saline 2 ml iv). The incidence and severity of PONV were observed at 1, 2, 4, and 24 hr postsurgery. RESULTS: At 1, 2, 4, and 24 hr postsurgery, Gr. D had a lower incidence (7.4%, 11.1%, 29.6%, and 66.7%) and lower severity of PONV than Gr. N (18.5%, 29.6%, 37.0%, and 81.5% at 1, 2, 4, and 24 hr; p > 0.05). The requirement for antiemetic drugs was not significantly different between the groups (p > 0.05). CONCLUSION: Administration of dexamethasone and ondansetron 4 mg seemed to decrease the incidence of PONV in the first 24 hours but not significantly. Therefore, further studies are to be carried out by escalating either dexamethasone dose or the dose of ondansetron or both.