title: Assessment of Durability of Online and Multisensory Learning Using an Ophthalmology Model.
abstract: OBJECTIVE
  To explore the impact of online learning and multisensory small-group teaching on acquisition and retention of specialty knowledge and diagnostic skills during a third-year family medicine rotation.
  
  
  METHODS
  Exploratory, observational, longitudinal, and multiple-skill measures.
  
  
  METHODS
  Two medical school classes (n = 199) at a public medical school in California.
  
  
  METHODS
  Students engaged in online self-study, small-group interactive diagnostic sessions, picture identification of critical pathologic features, and funduscopic simulator examinations. The authors compared performance on testing immediately after online learning with testing at end-rotation, as well as picture identification versus simulator diagnostic ability in students with (n = 94) and without (n = 105) practice tracing contours on whiteboard projections of those same slides depicting fundus pathologic features of common systemic diseases.
  
  
  METHODS
  Picture identification, accuracy of funduscopic descriptions, online module post-tests, and end-rotation tests.
  
  
  RESULTS
  Proprioceptive reinforcement of fundus pattern recognition significantly reduced the need for remediation for misdiagnosing optic disc edema during end-rotation funduscopic simulator testing, but it had no effect on fundus pattern recognition or diagnostic ability overall. Near-perfect immediate online post-test scores contrasted sharply with poor end-rotation scores on an in-house test (average, 59.4%). Rotation timing was not a factor because the patterns remained consistent throughout the academic school year.
  
  
  CONCLUSIONS
  Neither multisensory teaching nor online self-study significantly improved retention of ophthalmic knowledge and diagnostic skills by the end of a month-long third-year rotation. Timing such training closer to internship when application is imminent may enhance students' appreciation for its value and perhaps may improve retention. Pulsed quizzes over time also may be necessary to motivate students to retain the knowledge gained.
authors.affiliation: Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, Irvine, California. Electronic address: llippa@uci.edu.
authors.forename: Linda Mottow
authors.initials: LM
authors.lastname: Lippa
authors.affiliation: Department of Emergency Medicine, University of California, Irvine, Irvine, California.
authors.forename: Craig L
authors.initials: CL
authors.lastname: Anderson
mesh_terms: D001245:Association Learning; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005194:Family Practice / Q000193:education; D005500:Follow-Up Studies; D006801:Humans; D017145:Models, Educational; D009862:Online Systems; D009885:Ophthalmology / Q000193:education*; D011434:Proprioception; D012164:Retinal Diseases / Q000175:diagnosis; D012189:Retrospective Studies; D012577:Schools, Medical; D013663:Teaching