title: Adaptive Tutorials Versus Web-Based Resources in Radiology: A Mixed Methods Comparison of Efficacy and Student Engagement.
abstract: OBJECTIVE
  Diagnostic imaging is under-represented in medical curricula globally. Adaptive tutorials, online intelligent tutoring systems that provide a personalized learning experience, have the potential to bridge this gap. However, there is limited evidence of their effectiveness for learning about diagnostic imaging.
  
  
  METHODS
  We performed a randomized mixed methods crossover trial to determine the impact of adaptive tutorials on perceived engagement and understanding of the appropriate use and interpretation of common diagnostic imaging investigations. Although concurrently engaged in disparate blocks of study, 99 volunteer medical students (from years 1-4 of the 6-year program) were randomly allocated to one of two groups. In the first arm of the trial on chest X-rays, one group received access to an adaptive tutorial, whereas the other received links to an existing peer-reviewed Web resource. These two groups crossed over in the second arm of the trial, which focused on computed tomography scans of the head, chest, and abdomen. At the conclusion of each arm of the trial, both groups completed an examination-style assessment, comprising questions both related and unrelated to the topics covered by the relevant adaptive tutorial. Online questionnaires were used to evaluate student perceptions of both learning resources.
  
  
  RESULTS
  In both arms of the trial, the group using adaptive tutorials obtained significantly higher assessment scores than controls. This was because of higher assessment scores by senior students in the adaptive tutorial group when answering questions related to topics covered in those tutorials. Furthermore, students indicated significantly better engagement with adaptive tutorials than the Web resource and rated the tutorials as a significantly more valuable tool for learning.
  
  
  CONCLUSIONS
  Medical students overwhelmingly accept adaptive tutorials for diagnostic imaging. The tutorials significantly improve the understanding of diagnostic imaging by senior students.
authors: School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
authors: Vincent
authors: V
authors: Wong
authors: School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
authors: Ariella J
authors: AJ
authors: Smith
authors: School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
authors: Nicholas J
authors: NJ
authors: Hawkins
authors: School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
authors: Rakesh K
authors: RK
authors: Kumar
authors: Department of Radiology, Westmead Hospital, Sydney, Australia.
authors: Noel
authors: N
authors: Young
authors: Department of Radiology, Westmead Hospital, Sydney, Australia.
authors: Merribel
authors: M
authors: Kyaw
authors: School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Sydney, Australia. Electronic address: g.velan@unsw.edu.au.
authors: Gary M
authors: GM
authors: Velan
mesh_terms: D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D018592:Cross-Over Studies; D003479:Curriculum; D006801:Humans; D020407:Internet; D018794:Problem-Based Learning; D011871:Radiology / Q000193:education*; D011795:Surveys and Questionnaires
keywords: adaptive tutorials; diagnostic imaging; eLearning; engagement; medical education; radiology