The Effect of Multimedia Replacing Text in Resident Clinical Decision-Making Assessment

Autor/inn/en	Chang, Todd P.; Schrager, Sheree M.; Rake, Alyssa J.; Chan, Michael W.; Pham, Phung K.; Christman, Grant
Titel	The Effect of Multimedia Replacing Text in Resident Clinical Decision-Making Assessment
Quelle	In: Advances in Health Sciences Education, 22 (2017) 4, S.901-914 (14 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Chang, Todd P.)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1382-4996
DOI	10.1007/s10459-016-9719-0
Schlagwörter	Medical Students; Pediatrics; Multimedia Materials; Clinical Diagnosis; Decision Making; Trainees; Hypothesis Testing; Scores; Low Achievement; Vignettes; Computer Assisted Testing; Statistical Analysis; Correlation; Clinical Experience; Electronic Learning; Graduate Students + Suchen Sie Ihr Suchwort? Klinische Sozialpädiatrie; Decision-making; Entscheidungsfindung; Auszubildender; Weibliche Auszubildende; Hypothesenprüfung; Hypothesentest; Unterdurchschnittliche Leistung; Statistische Analyse; Korrelation; Graduate Study; Student; Students; Aufbaustudium; Graduiertenstudium; Hauptstudium; Studentin
Abstract	Multimedia in assessing clinical decision-making skills (CDMS) has been poorly studied, particularly in comparison to traditional text-based assessments. The literature suggests multimedia is more difficult for trainees. We hypothesize that pediatric residents score lower in diagnostic skill when clinical vignettes use multimedia rather than text for patient findings. A standardized method was developed to write text-based questions from 60 high-resolution, quality multimedia; a series of expert panels selected 40 questions with both a multimedia and text-based counterpart, and two online tests were developed. Each test featured 40 identical questions with reciprocal and alternating modality (multimedia vs. text). Pediatric residents and rising 4th year medical students (MS-IV) at a single residency were randomized to complete either test stratified by postgraduate training year (PGY). A mixed between-within subjects ANOVA analyzed differences in score due to modality and PGY. Secondary analyses ascertained modality effect in dermatology and respiratory questions using Mann-Whitney U tests, and correlations on test performance to In-service Training Exam (ITE) scores using Spearman rank. Eighty-eight residents and rising interns completed the study. Overall multimedia scores were lower than text-based scores (p = 0.047, ?[subscript p, superscript 2] = 0.04), with highest disparity in rising interns (MS-IV); however, PGY had a greater effect on scores (p = 0.001, ?[subscript p, superscript 2] = 0.16). Respiratory questions were not significantly lower with multimedia (n = 9, median 0.71 vs. 0.86, p = 0.09) nor dermatology questions (n = 13, p = 0.41). ITEs correlated significantly with text-based scores (? = 0.23-0.25, p = 0.04-0.06) but not with multimedia scores. In physician trainees with less clinical experience, multimedia-based case vignettes are associated with significantly lower scores. These results help shed light on the role of multimedia versus text-based information in CDMS, particularly in less experienced clinicians. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2020/1/01