title: Blended learning in radiology: is self-determined learning really more effective?
abstract: OBJECTIVE
  To investigate whether there are differences in learning outcomes after the application of self-determined (intrinsic motivation) or mandatory (extrinsic motivation) use of e-learning units in an undergraduate radiology internship.
  
  
  METHODS
  96 medical students undergoing a one-week radiology internship were included in this study. Ten electronic cases (e-cases) were created for a blended learning approach. The e-learning environment was accessed on a self-determined (group B; n=32) or a mandatory basis (group C; n=32). A group without access to the e-learning environment served as control group (group A; n=32). Usage parameters of the e-cases were recorded. Results of a pre- and post-course assessment were used to quantitatively analyze learning outcomes.
  
  
  RESULTS
  In group B 19/32 (59%) students processed at least one e-case, while in group C all students processed at least one e-case. There was a trend towards a higher improvement in knowledge in students exposed to a blended learning approach (group B: 13.7%; group C: 15.4%) than in the control group (group A: 8.5%; p=0.5356). Group C processed (p=0.0093) and passed (p=0.0078) significantly more e-cases, than with group B. There were no significant differences in the mean time per e-case and the total time on e-cases between both groups.
  
  
  CONCLUSIONS
  Extrinsic motivation results in a more extensive use of e-learning units in an undergraduate radiology internship when compared with intrinsic motivation. The choice of the teaching strategy has a bigger influence on learning outcomes than the type of motivation, highlighting the need for qualified medical teachers.
authors.affiliation: Department of Diagnostic and Interventional Radiology, RWTH Aachen University, Aachen, Germany. mahnken@rad.rwth-aachen.de
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Mahnken
authors.forename: Martin
authors.initials: M
authors.lastname: Baumann
authors.forename: Michael
authors.initials: M
authors.lastname: Meister
authors.forename: Verena
authors.initials: V
authors.lastname: Schmitt
authors.forename: Martin R
authors.initials: MR
authors.lastname: Fischer
mesh_terms: D016022:Case-Control Studies; D003194:Computer-Assisted Instruction / Q000706:statistics & numerical data*; D003479:Curriculum / Q000706:statistics & numerical data*; D004521:Educational Measurement / Q000706:statistics & numerical data*; D005858:Germany; D026684:Personal Autonomy; D011871:Radiology / Q000193:education* / Q000706:statistics & numerical data; D013337:Students, Medical / Q000706:statistics & numerical data*; D013663:Teaching / Q000706:statistics & numerical data*