title: Comparison of a web-based package with tutor-based methods of teaching respiratory medicine: subjective and objective evaluations.
abstract: BACKGROUND
  Respiratory disease is a major cause of morbidity and mortality not only in the United Kingdom, but globally. A good understanding of respiratory disease and its treatment is essential for all medical graduates. As a result of changes in clinical practice, patients with some common respiratory illnesses are less often admitted to hospital, restricting the experience available to undergraduate students. Combined with a potential shortage of clinical teachers, this means that new methods of teaching need to be developed and appraised. The aim of this study was to establish whether a web-based package on the diagnosis of respiratory disease would be as effective and as acceptable to final year medical students as tutor-led methods of teaching the same material.
  
  
  METHODS
  137 out of 315 final year undergraduate students in a single medical school volunteered to take part. Each received up to two hours of tutor-lead interactive, tutor-lead didactic or electronic, Web-based teaching on the accurate diagnosis and management of respiratory disease. Post teaching performance was assessed by multiple true/false questions and data interpretation exercises, whilst students' teaching preferences were assessed by questionnaire.
  
  
  RESULTS
  Despite a high knowledge baseline before the study, there was a small, but statistically significant increase in knowledge score after all forms of teaching. Similarly, data interpretation skills improved in all groups, irrespective of teaching format, Although paradoxically most students expressed a preference for interactive tutor-lead teaching, spirometry interpretation in those receiving web-based teaching improved significantly more [p = 0.041] than in those in the interactive group.
  
  
  CONCLUSIONS
  Web-based teaching is at least as good as other teaching formats, but we need to overcome students' reluctance to engage with this teaching method.
authors.affiliation: Respiratory Medicine, Imperial College London, NHLI at Charing Cross Campus, Fulham Palace Road, London W6 8RP, UK. sue.smith@imperial.ac.uk
authors.forename: Susan F
authors.initials: SF
authors.lastname: Smith
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Roberts
authors.forename: Martyn R
authors.initials: MR
authors.lastname: Partridge
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015510:Clinical Medicine / Q000193:education; D003194:Computer-Assisted Instruction; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D011336:Probability; D018794:Problem-Based Learning / Q000458:organization & administration*; D015397:Program Evaluation; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000628:therapy; D012680:Sensitivity and Specificity; D013337:Students, Medical; D013664:Teaching Materials