title: Evidence of knowledge acquisition in a cognitive flexibility-based computer learning environment.
abstract: BACKGROUND
  A computer-based learning experience was developed using cognitive flexibility theory to overcome the pitfalls often encountered in existing medical education. An earlier study (not published) showed significant pretest-posttest increase in scores, as well as a significant positive correlation between choosing to complete the module individually or in pairs.
  
  
  METHODS
  This experience was presented as part of a second-year course in medical school with randomized assignment for students to complete the program as pairs or individuals.
  
  
  RESULTS
  Sixty-six scores of 101 medical students (31 from students working as singles and 35 from 70 working in pairs) were analyzed. Out of 47 possible points, the mean pretest score was 15.1 (SD = 6.4, range 13.7-15.9). The mean posttest score was 22.9 (SD = 5.2, range 21.1-24.2). Posttest scores were statistically significantly higher than pretest scores (p<.001, Cohen's d = 1.17, average gain 7.8 points). Both pairs and singles showed pre-to-post test score gains, but the score gains of pairs and singles were not significantly different.
  
  
  CONCLUSIONS
  This learning module served as an effective instructional intervention. However, the effect of collaboration, measured by score gains for pairs, was not significantly different from score gains of students completing the assignment individually.
authors.affiliation: Bonfils Blood Center, Denver, Colorado, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Heath
authors.forename: John
authors.initials: J
authors.lastname: Higgs
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Ambruso