Computational protocol: Mobile Technology in E-Learning for Undergraduate Medical Education on Emergent Otorhinolaryngology–Head and Neck Surgery Disorders: Pilot Randomized Controlled Trial

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Protocol publication

[…] Emergent ORL-HNS disorders are sensitive and acute and require many consultations for the patients to receive appropriate point-of-care service and follow-up []. We selected the 10 most common emergent ORL-HNS disorders, including foreign body, epistaxis, ear trauma, acute otitis externa, deep neck infection, head and neck cancer and associated complications, acute otitis media, nasal trauma, acute pharyngotonsillitis, and sudden deafness (in descending order based on consultation frequency) among 300 consecutive patients who visited an otolaryngologist in 2004 at our Department of Emergency.To design effective instructional material, we analyzed our tasks and topics and needs of 10 undergraduate students after traditional ORL-HNS lectures []. We then developed the instructional content using a two-round modified Delphi method. The first round included 10 academic physicians including 2 emergency physicians and 2 ORL-HNS department chiefs who designed the learning objectives and developed the instructional content according to the needs assessment. In the second round, 10 junior residents rated the relative importance of each item. We then developed a storyboard and courseware using an instructional system design model including five phases (analysis, design, development, implementation, and evaluation) [].Subsequently, the content was translated into an e-learning app including a novel gamified IM module and a conventional visual-auditory text-image PPS module. We created an 80-min storyboard for each module, and both modules had the same design of user interface (). We also created a learning map to allow the learners to assess their progress in each session or their overall progress. Moreover, both modules contained simple slides for review purposes after completing the brief sessions (). The PowerPoint Show (PPS) Module In the PPS module, we used video lectures to present the visual-auditory text-image context (multimedia learning) that was intended to reduce the cognitive load []. We recorded the PPS presentations with audio narrations and ink gestures using Camtasia Studio software version 8 (TechSmith, Okemos, MI, USA). Each mini video (6-8 min) contained seven voice and text-image slides for each disorder. We created a playback application to allow the learners to seek the videos (). The Interactive Multimedia (IM) Module The content for the novel IM module was derived from and corresponded to the textbook-based learning material of the conventional PPS module. In the IM module, we used a game-based learning method to implement the instruction, in which the learners operated a character to run, jump, and interact with other characters (in a parkour style) to obtain learning materials (7 text-image slides per disorder) in the four domains of the 10 disorders (). The instructional materials were briefly explained using scrolling text. After they had read the material for 2 disorders or completed 10 disorders, they had to complete small game-based quizzes that were designed to emphasize the key points and enhance their working memory []. Notably, contexts of the game-based quizzes were different from those of the multiple-choice questionnaires (MCQs) and multimedia situational tests (MSTs).Two investigators from the study team reviewed the instructional content of each module using the Software Evaluation Checklist []. This checklist includes 7 items (curriculum connections, age/grade appreciates, investment justification, layout, support materials, instructional content, graphics/multimedia) with two (yes, no) scales (a total of 28 questions). The overall items were confirmed to be significantly correlated after computing the correlation between the 2 investigators’ reviews (Spearman correlation test, r=.91, P<.001). Major bug fixes were performed before the pilot study. [...] Due to the relatively small sample size in the pilot study, we analyzed all variables using a nonparametric approach. Descriptive statistics were expressed as median and 95% CI. Percentage (%) changes ([after value-before value]/[before value] × 100) in the MCQ and MST were calculated. Differences between groups were analyzed using the Wilcoxon signed-rank test or the Mann-Whitney U test as appropriate. Categorical variables were analyzed using Fisher exact test. Effect size and 95% CI were estimated using the Hodges-Lehmann method for Mann-Whitney U test and Wilcoxon signed rank test and odds ratio calculation Fisher exact test to improve the quality of the reporting of our results. Statistical analyses were performed using G*Power software (Heinrich-Heine University, Dusseldorf, Germany), Graph Pad Prism 7.00 for Windows (Graph Pad Software Inc., San Diego, CA, USA), and IBM SPSS Statistics 23.0 (IBM Corporation, Armonk, NY, USA). […]

Pipeline specifications

Software tools Parkour LIMS, G*Power, SPSS
Application Miscellaneous
Organisms Homo sapiens
Diseases Feline Panleukopenia