title: Computer-based programmed instruction did not improve the knowledge retention of medication instructions of individuals with type 2 diabetes mellitus.
abstract: The purpose of this study was to investigate whether computer-based programmed instruction (CPI) with a dynamic avatar (DA) improves retention of medication information better than text (controls) or better than CPI with text (T-CPI), CPI with voice (V-CPI), or CPI with static avatar with text (SA-CPI).
  
  
  
  Participants with type 2 diabetes mellitus were enrolled in a randomized controlled trial comparing TDS with CPI in 4 conditions (T-CPI, V-CPI, SA-CPI, and DA-CPI). CPI sequentially delivers segmented information in text or voice followed by a multiple-choice question. Immediately after the user selects an option, CPI delivers elaborated feedback. Satisfaction was measured immediately after the interventions, and medication knowledge was measured at 2 weeks.
  
  
  
  One-hundred fifty individuals (30 per group) with a mean age 62 years (standard deviation [SD] 7.99 years) participated. There were no baseline differences in race, body mass index, education, and health literacy. Medication knowledge retention at 2 weeks was not significantly different between the groups, df(4), F = 0.17, P = .95 (TDS, mean = 25.43, SD = 5.11; T-CPI, mean = 25.07, SD = 4.98; V-CPI, mean = 25.77, SD = 4.89; SA-CPI, mean = 25.83, SD = 5.31; and DA-CPI, mean = 24.93, SD = 6.25). Satisfaction scores were significantly lower for TDS, df(4), F = 3.11, P = .01.
  
  
  
  CPI did not improve medication knowledge retention at 2 weeks. CPI led to higher patient satisfaction compared with controls.
authors.affiliation: The Laboratory of E-learning and Multimedia Research (LEMUR), Bruce W. Carter Miami VA Geriatric Research Education and Clinical
  Center (GRECC), Miami, Florida (Dr Ruiz, Dr Andrade, Dr Anam, Dr Lisigurski, Dr Karanam, Dr Sharit)|University of Miami Miller School of Medicine, Miami, Florida (Dr Ruiz, Dr Andrade, Dr Sharit)
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Ruiz
authors.affiliation: The Laboratory of E-learning and Multimedia Research (LEMUR), Bruce W. Carter Miami VA Geriatric Research Education and Clinical
  Center (GRECC), Miami, Florida (Dr Ruiz, Dr Andrade, Dr Anam, Dr Lisigurski, Dr Karanam, Dr Sharit)|University of Miami Miller School of Medicine, Miami, Florida (Dr Ruiz, Dr Andrade, Dr Sharit)
authors.forename: Allen D
authors.initials: AD
authors.lastname: Andrade
authors.affiliation: The Laboratory of E-learning and Multimedia Research (LEMUR), Bruce W. Carter Miami VA Geriatric Research Education and Clinical
  Center (GRECC), Miami, Florida (Dr Ruiz, Dr Andrade, Dr Anam, Dr Lisigurski, Dr Karanam, Dr Sharit)
authors.forename: Ramanakumar
authors.initials: R
authors.lastname: Anam
authors.affiliation: The Laboratory of E-learning and Multimedia Research (LEMUR), Bruce W. Carter Miami VA Geriatric Research Education and Clinical
  Center (GRECC), Miami, Florida (Dr Ruiz, Dr Andrade, Dr Anam, Dr Lisigurski, Dr Karanam, Dr Sharit)
authors.forename: Miriam
authors.initials: M
authors.lastname: Lisigurski
authors.affiliation: The Laboratory of E-learning and Multimedia Research (LEMUR), Bruce W. Carter Miami VA Geriatric Research Education and Clinical
  Center (GRECC), Miami, Florida (Dr Ruiz, Dr Andrade, Dr Anam, Dr Lisigurski, Dr Karanam, Dr Sharit)
authors.forename: Chandana
authors.initials: C
authors.lastname: Karanam
authors.affiliation: The Laboratory of E-learning and Multimedia Research (LEMUR), Bruce W. Carter Miami VA Geriatric Research Education and Clinical
  Center (GRECC), Miami, Florida (Dr Ruiz, Dr Andrade, Dr Anam, Dr Lisigurski, Dr Karanam, Dr Sharit)|University of Miami Miller School of Medicine, Miami, Florida (Dr Ruiz, Dr Andrade, Dr Sharit)|University of Miami College of Engineering, Miami, Florida (Dr Sharit)
authors.forename: Joseph
authors.initials: J
authors.lastname: Sharit
mesh_terms: D000328:Adult; D003194:Computer-Assisted Instruction; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015397:Program Evaluation; D012153:Retention, Psychology; D012648:Self Care / Q000523:psychology*; D011795:Surveys and Questionnaires; D060145:Text Messaging; D014584:User-Computer Interface; D014728:Veterans