title: Online learning in thoracic surgical training: promising results of multi-institutional pilot study.
abstract: BACKGROUND
  Cardiothoracic surgical education faces numerous challenges, including reduced duty hours and diminishing prioritization of teaching, in the setting of rapidly advancing knowledge, skills, and case complexity. Pass rates on the American Board of Thoracic Surgery exam remain suboptimal, and new training formats are being evaluated. We hypothesize that Internet-based courses can be developed and implemented to supplement learning of basic topics in cardiothoracic surgery.
  
  
  METHODS
  After a needs assessment, 4 online self-study courses were developed by content experts using a Moodle [modular object-oriented dynamic learning environment] platform. As a pilot cohort, students from 4 thoracic surgery training programs participated, accessing courses at their own pace. Each course included general and detailed readings, multimedia content, discussion forum, and a question-bank supported quiz (90% required to pass, multiple attempts allowed). Utilization and exam data were tracked electronically. The t tests were used to compare first versus final-year traditional track trainees. Post-course surveys collected data on trainee attitudes.
  
  
  RESULTS
  Nineteen students completed 4 courses on tracheal disease. Mean time spent per course and quiz attempts to pass were 1.35 hours and 2.86, respectively. Scores improved with successive attempts. Senior trainees showed a trend toward less time per course and fewer quiz attempts. Post-course surveys uniformly demonstrated perceived benefits from the content and quizzes in an easy-to-navigate format.
  
  
  CONCLUSIONS
  Online courses can be developed and integrated within cardiothoracic training programs. This pilot demonstrates evidence of active learning as shown through the embedded assessments. Internet-based courses may serve as a means of supplementing modern thoracic surgical training. Further development and evaluation are warranted.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Washington University, St. Louis, Missouri. Electronic address: antonoffm@wudosis.wustl.edu.
authors.forename: Mara B
authors.initials: MB
authors.lastname: Antonoff
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of Washington, Seattle, Washington.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Verrier
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Yang
authors.affiliation: Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Jules
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Texas.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: DeArmond
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Allen
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of Washington, Seattle, Washington.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Varghese
authors.affiliation: Joint Council on Thoracic Surgery Education, Chicago, Illinois.
authors.forename: Darcy
authors.initials: D
authors.lastname: Sengewald
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ara A
authors.initials: AA
authors.lastname: Vaporciyan
mesh_terms: D020375:Education, Distance; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010865:Pilot Projects; D011380:Programmed Instructions as Topic; D013903:Thoracic Surgery / Q000193:education*