title: The incremental value of internet-based instruction as an adjunct to classroom instruction: a prospective randomized study.
abstract: OBJECTIVE
  Computer-based methods of instruction offer the possibility of helping medical students to learn clinical skills and professionalism. Without rigorous documentation of its pedagogic advantages, the utility of Internet-based teaching is not solidly grounded. The authors carried out a prospective, randomized study of educational outcomes, comparing a traditional classroom course in clinical ethics with the same course supplemented by Internet-based discussion.
  
  
  METHODS
  Introduction to Clinical Ethics is a sophomore medical school course that teaches a specific method for analyzing clinical ethical problems. One sophomore class was randomly assigned to either classroom teaching alone (traditional group; n = 65) or classroom teaching supplemented with Internet-based discussions of cases illustrating ethical issues (Internet component group; n = 62). A final case analysis comprehensively evaluated students' understanding of the analytic method taught in the course. Grades for both groups on the final case analyses, which were rated by two external reviewers, were compared.
  
  
  RESULTS
  The students' understanding of ethical analysis, as measured by grades of external reviewers on the final paper, was significantly higher for those in the course with the Internet component than it was for those in the traditional course (3.0 +/- 0.6 and 2.6 +/- 0.7, respectively; p <.005).
  
  
  CONCLUSIONS
  The study documents the incremental value of Internet-based teaching of clinical ethics to sophomore medical students.
authors.affiliation: Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Lipman
authors.forename: R M
authors.initials: RM
authors.lastname: Sade
authors.forename: A L
authors.initials: AL
authors.lastname: Glotzbach
authors.forename: C J
authors.initials: CJ
authors.lastname: Lancaster
authors.forename: M F
authors.initials: MF
authors.lastname: Marshall
mesh_terms: D003194:Computer-Assisted Instruction; D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D020407:Internet; D011446:Prospective Studies; D014481:United States