title: Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training.
abstract: OBJECTIVE
  Web-based learning has several potential advantages over lectures, such as anytime-anywhere access, rich multimedia, and nonlinear navigation. While known to be an effective method for learning facts, few studies have examined the effectiveness of Web-based formats for learning procedural skills. The authors sought to determine whether a Web-based tutorial is at least as effective as a didactic lecture for learning ultrasound-guided vascular access (UGVA).
  
  
  METHODS
  Participating staff emergency physicians (EPs) and junior emergency medicine (EM) residents with no UGVA experience completed a precourse test and were randomized to either a Web-based or a didactic group. The Web-based group was instructed to use an online tutorial and the didactic group attended a lecture. Participants then practiced on simulators and live models without any further instruction. Following a rest period, participants completed a four-station objective structured clinical examination (OSCE), a written examination, and a postcourse questionnaire. Examination results were compared using a noninferiority data analysis with a 10% margin of difference.
  
  
  RESULTS
  Twenty-one residents and EPs participated in the study. There were no significant differences in mean OSCE scores (absolute difference = -2.8%; 95% confidence interval [CI] = -9.3% to 3.8%) or written test scores (absolute difference = -1.4%; 95% CI = -7.8% to 5.0%) between the Web group and the didactic group. Both groups demonstrated similar improvements in written test scores (26.1% vs. 25.8%; p = 0.95). Ninety-one percent (10/11) of the Web group and 80% (8/10) of the didactic group participants found the teaching format to be effective (p = 0.59).
  
  
  CONCLUSIONS
  Our Web-based tutorial was at least as effective as a traditional didactic lecture for teaching the knowledge and skills essential for UGVA. Participants expressed high satisfaction with this teaching technology. Web-based teaching may be a useful alternative to didactic teaching for learning procedural skills.
authors.affiliation: Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jordan
authors.initials: J
authors.lastname: Chenkin
authors.forename: Shirley
authors.initials: S
authors.lastname: Lee
authors.forename: Thien
authors.initials: T
authors.lastname: Huynh
authors.forename: Glen
authors.initials: G
authors.lastname: Bandiera
mesh_terms: D000328:Adult; D003194:Computer-Assisted Instruction / Q000379:methods*; D004502:Education, Medical, Continuing / Q000379:methods*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D008297:Male; D018084:Ultrasonography, Interventional; D014656:Vascular Surgical Procedures / Q000193:education*