title: Comparative evaluation of multimedia driven, interactive, and case-based teaching in heart surgery.
abstract: 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.
authors.affiliation: Department of Heart Surgery, University Hospital of Ulm, Ulm, Germany. reinhard.friedl@medizin.uni-ulm.de
authors.forename: Reinhard
authors.initials: R
authors.lastname: Friedl
authors.forename: Helmut
authors.initials: H
authors.lastname: Höppler
authors.forename: Karl
authors.initials: K
authors.lastname: Ecard
authors.forename: Wilfried
authors.initials: W
authors.lastname: Scholz
authors.forename: Andreas
authors.initials: A
authors.lastname: Hannekum
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Oechsner
authors.forename: Sylvia
authors.initials: S
authors.lastname: Stracke
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D003194:Computer-Assisted Instruction; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D019918:Heart Valve Prosthesis Implantation / Q000193:education*; D006801:Humans; D009042:Motivation; D019212:Multimedia; D013663:Teaching / Q000379:methods*