title: Are live instructors replaceable? Computer vs. classroom lectures for EFAST training.
abstract: BACKGROUND
  The EFAST (extended focused assessment with sonography for trauma) is part of the recommended curriculum for Emergency Medicine and Surgery residents. Computer-based lectures may represent a time-efficient alternative to traditional lectures.
  
  
  OBJECTIVE
  Our hypothesis was that computer lectures in basic ultrasound and the EFAST are not inferior to classroom lectures in test score improvement for residents with or without prior training.
  
  
  METHODS
  First-year Emergency Medicine and Surgery residents were enrolled and completed a pre-test. Subjects were then randomized into a classroom group, which attended traditional lectures, and a computer group, which listened to narrated lectures on computers. After the didactic training, all subjects completed a post-test.
  
  
  RESULTS
  Forty-four subjects completed the study: 64% were General Surgery residents, 66% were male. Overall, mean test score improvements were higher in the classroom than in the computer group (28.0% vs. 18.4%). In 25 residents without prior training, mean improvements in the computer and classroom groups were 25% and 27%, respectively. The 95% confidence limit around the difference was 9%, falling within the a priori non-inferiority range of 10%, and consistent with non-inferiority of computer-based lectures. In 19 residents with prior training, mean test score improvements for the computer and classroom groups were 13% and 29%, respectively. The 95% confidence limit of 24% exceeded the non-inferiority range, consistent with inferiority of computer-based lectures.
  
  
  CONCLUSIONS
  Computer-based lectures are not inferior to classroom lectures and may represent a worthwhile substitution in subjects without prior ultrasound education. Our data suggest that didactic ultrasound training through classroom lectures is more effective than computer-based lectures in individuals with prior training.
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: Elke
authors.initials: E
authors.lastname: Platz
authors.forename: Andrew
authors.initials: A
authors.lastname: Liteplo
authors.forename: Shelley
authors.initials: S
authors.lastname: Hurwitz
authors.forename: James
authors.initials: J
authors.lastname: Hwang
mesh_terms: D000328:Adult; D003194:Computer-Assisted Instruction / Q000379:methods*; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D013502:General Surgery / Q000193:education*; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D008297:Male; D013663:Teaching / Q000379:methods*; D014463:Ultrasonography