Enhanced Web-Based Otitis Study Case vs Simple Paper-Case: Impact on Medical Student Objec-tive Structured Clinical Exam (OSCE) Performance

Abstract

Background: Distance education methods have taken on greater importance as medi-cal student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. Objective: To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed bet-ter on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Design/Methods: Students were randomized by community site to receive either the enhanced (E) or simple otitis study case (S). Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: http://www.aap.org/otitismedia/www/vc/ear/index.cfm (American Academy of Pediatrics Otitis Web Site). They were then to select "Case 1" which was a continuation of the case scenario pre-sent on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiv-ing the S-case viewed the same case scenario and objectives, but were not instructed to go to the web-page. All students rotated through two OSCE otitis stations. In the first station they inter-viewed a simulated patient(OSCE-SP) and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR). Scores on the two sta-tions were compared by group. Results: There were 198 students who took the OSCE. 178 (90%) responded to a survey that in-dicated they had opened and read the e-mailed case. There were 87 students in the E-group and 91 in the S-group. The mean ?s.d. OSCE-SP station score for the E-group was 72.6 ?12.0 vs 75.4 ?9.8 for the S-group, p=0.09. For the otitis presentation station the scores for the E-group and S-group were respectively, 82.9 ?9.6 and 83.7 ?9.4, p=0.55. Conclusions: These data suggest that enhanced visual distance education cases may offer no dis-tinct advantage over simple paper-type case study guides. Keywords: Distance education, medical education, web-based education.