title: E-learning optimization: the relative and combined effects of mental practice and modeling on enhanced podcast-based learning-a randomized controlled trial.
abstract: Enhanced podcasts increase learning, but evidence is lacking on how they should be designed to optimize their effectiveness. This study assessed the impact two learning instructional design methods (mental practice and modeling), either on their own or in combination, for teaching complex cognitive medical content when incorporated into enhanced podcasts. Sixty-three medical students were randomised to one of four versions of an airway management enhanced podcast: (1) control: narrated presentation; (2) modeling: narration with video demonstration of skills; (3) mental practice: narrated presentation with guided mental practice; (4) combined: modeling and mental practice. One week later, students managed a manikin-based simulated airway crisis. Knowledge acquisition was assessed by baseline and retention multiple-choice quizzes. Two blinded raters assessed all videos obtained from simulated crises to measure the students' skills using a key-elements scale, critical error checklist, and the Ottawa global rating scale (GRS). Baseline knowledge was not different between all four groups (p = 0.65). One week later, knowledge retention was significantly higher for (1) both the mental practice and modeling group than the control group (p = 0.01; p = 0.01, respectively) and (2) the combined mental practice and modeling group compared to all other groups (all ps = 0.01). Regarding skills acquisition, the control group significantly under-performed in comparison to all other groups on the key-events scale (all ps ≤ 0.05), the critical error checklist (all ps ≤ 0.05), and the Ottawa GRS (all ps ≤ 0.05). The combination of mental practice and modeling led to greater improvement on the key events checklist (p = 0.01) compared to either strategy alone. However, the combination of the two strategies did not result in any further learning gains on the two other measures of clinical performance (all ps > 0.05). The effectiveness of enhanced podcasts for knowledge retention and clinical skill acquisition is increased with either mental practice or modeling. The combination of mental practice and modeling had synergistic effects on knowledge retention, but conveyed less clear advantages in its application through clinical skills.
authors: Department of Anaesthesia, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room M3200, Toronto, ON, M4N 3M5, Canada. fahad.alam@sunnybrook.ca.|The Wilson Centre for Research in Education, 200 Elizabeth Street, 1ES-565, Toronto, ON, M5G 2C4, Canada. fahad.alam@sunnybrook.ca.
authors: Fahad
authors: F
authors: Alam
authors: Department of Anaesthesia and Department of Innovation in Medical Innovation, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
authors: Sylvain
authors: S
authors: Boet
authors: Department of Critical Care, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.|The Wilson Centre for Research in Education, 200 Elizabeth Street, 1ES-565, Toronto, ON, M5G 2C4, Canada.
authors: Dominique
authors: D
authors: Piquette
authors: Department of Emergency Medicine, The Ottawa Hospital, University of Ottawa, 1053 Carling Avenue, E-Main, Room EM-206, Box 227, Ottawa, ON, K1Y 4E9, Canada.
authors: Anita
authors: A
authors: Lai
authors: Belleville General Hospital, 265 Dundas Street East, Belleville, ON, K8N 5A9, Canada.
authors: Christopher P
authors: CP
authors: Perkes
authors: Department of Innovation in Medical Education and University of Ottawa Skills and Simulation Centre, The Ottawa Hospital, University of Ottawa, 451 Smyth Road, RGN 2211, Ottawa, ON, K1H 8M5, Canada.
authors: Vicki R
authors: VR
authors: LeBlanc
mesh_terms: D058109:Airway Management; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D017145:Models, Educational; D009864:Ontario; D000066908:Simulation Training / Q000379:methods; D013850:Thinking; D014741:Video Recording; D057211:Webcasts as Topic; D055815:Young Adult
keywords: Curriculum design; E-learning; Instructional design; Learning strategies; Medical education; Mental practice; Mobile learning; Modeling; Podcasts; Simulation