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Ann Thorac Surg 2006;82:1790-1795
© 2006 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Comparative Evaluation of Multimedia Driven, Interactive, and Case-Based Teaching in Heart Surgery

Reinhard Friedl, MDa,*, Helmut Höppler, MDa, Karl Ecarda, Wilfried Scholz, MDa, Andreas Hannekum, MD, PhDa, Wolfgang Oechsner, MDb, Sylvia Stracke, MDc

a Department of Heart Surgery, University Hospital of Ulm, Ulm, Germany
b Department of Cardiac Anesthesiology, University Hospital of Ulm, Ulm, Germany
c Division of Nephrology, University Hospital of Ulm, Ulm, Germany

Accepted for publication May 31, 2006.

* Address correspondence to Dr Friedl, University Hospital of Ulm, Dept. of Heart Surgery, Steinhövelstr. 9, 89073 Ulm, Germany (Email: reinhard.friedl{at}medizin.uni-ulm.de).

BACKGROUND: Multimedia-augmented instruction with various approaches is used in heart surgery. There is little evidence which instructional techniques and media are of advantage to impart knowledge more effectively and lead to better application of knowledge in the operation room.

METHODS: Sixty-nine students learned with an interactive, case-based teaching (ICBT) course about aortic valve replacement. They were compared with historic controls exposed to identical information provided by a multimedia module presenting content systematically (SMM; n = 69) and a print medium (PM; n = 57). Motivation, computer knowledge, and didactic quality were evaluated with psychometric tests. All groups performed multiple choice pretests and posttests and participated in live surgery during which their performance was assessed.

RESULTS: All groups had equal computer knowledge, but the ICBT group felt significantly less-motivated and more challenged. Multiple choice posttest results were comparable (ICBT 80.2% ± 10.9%, SMM 76.7% ± 13.3%, PM 76.9% ± 11.1). During surgery, the ICBT (79.2% ± 16%) and SMM groups (82.9% ± 10%) performed significantly better than the PM group (64.7% ± 12%; both p < 0.0001). Overall didactic assessment was significantly worse in the ICBT group when compared with the SMM and PM groups.

CONCLUSIONS: For novices in heart surgery, ICBT was less motivating than traditionally structured content (SMM and PM). The ICBT did not improve performance in the operation room. However, both multimedia groups could better apply their knowledge during live surgery. The PM is as effective as multimedia when factual knowledge has to be retained.






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