Online Learning Efficacy Research Database

Objective: The purpose of this study was to examine the effects of course delivery methods on examination grades and student perceptions in a sonography course. Materials and Methods: The participant included all sonography students (n = 103), enrolled at a Midwestern university, during the academic years (AY) of 2010–2021. A retrospective, convergent mixed-methods design was used to collect and analyze data, related to the course delivery method. Results: The highest overall mean examination score and course satisfaction rating resulted from the blended learning format and the lowest mean examination scores and course satisfaction resulted from the flipped learning format. Conclusion: Health professions students are a diverse group of learners. Pedagogical practices should include course design and delivery methods which educate all learners. Courses that balance both face-to-face learning with opportunities for self-directed learning improve student satisfaction which could lead to improved student outcomes and provide the foundation for students to become competent health care professionals. 
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Traditional lectures continue to be one of the common ways of teaching practiced in medical schools across India. However, there are many other effective ways of teaching in large groups and lately e-learning modules, which can be synchronous, asynchronous, or blended, have been used to complement face-to-face interactions. E-assignments have been effectively used to engage students into meaningful learning. Aim: The aim of the study is to compare asynchronous teaching with traditional teaching in terms of student perspectives and learning. Materials and Methods: After taking ethical clearance from the Institutional Ethics Committee, the study was conducted involving 66 student volunteers from MBBS 2nd year. All the students were subjected to a pretest on the topic – “low backache” prior to the intervention. The students were then divided into two groups: Group A and Group B of 33 students each. Group A was taught by traditional lecture method, while Group B was given an e-assignment on the topic for which no face-to-face interaction was done earlier. The students from both the groups were then subjected to a posttest followed by feedback. Results: Analysis of covariance, considering the pretest score as a covariate, revealed that the two groups were comparable to begin with P = 0.632. After the intervention, posttest mean scores improved significantly (P < 0.001) within each group, for both the groups, but there was no significant difference in posttest scores on intergroup comparison (P = 0.507). Student feedback brought to light that 85% of the students felt that the traditional lecture method followed by e-learning would be of a great benefit to them. Conclusion: Although no single method emerged as superior over the other, student feedback revealed that 90% of the students graded e-module as either satisfactory to good. Most felt that lecture followed by e-modules will help them to learn better. 
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Objective
Online education is effective for knowledge acquisition, but its effect on clinical skill development is not well characterized. Weaimed to compare communication skills of 50 first-year medical students who learned to assess and treat patients through an online learning module vs an in-class lecture.
Methods
Twenty-six students were randomized to learn about antidepressant-induced sexual dysfunction in class and 24 learned the same content through an online module. Students were individually observed conducting an interview with a standardized patient with antidepressant-induced sexual dysfunction. Students were assessed by faculty raters blinded to the student’s learning mode. Standardized patients were asked about their willingness to have the student as their physician.
Results
More students who learned in class vs online demonstrated appropriate verbal empathy (18 [69%] vs 8 [33%]; P = 0.01), defined as completing each task in the “verbal empathy” assessment domain, as measured by a faculty rater. Other assessed variables were not significantly different. Standardized patients’ willingness (vs unwillingness; P = 0.01) to have the student as their physician was associated with the demonstration (by faculty appraisal) of a number of basic skills: using open-ended questions, asking one question at a time, using gender-neutral terminology when asking about the patient’s relationship, and using appropriate sexual-health terminology.
Conclusions
This study, although limited by a single-site design and the small number of participants, offers preliminary evidence that, if confirmed, may suggest that in-class learning from a psychiatrist (vs from an online module) is associated with greater verbal empathy in the assessment of SSRI-related sexual dysfunction 
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Electronic learning introduces a teaching device for deeper and more efficient learning. A study was conducted by the Pathology Department of Tehran University of Medical Sciences, Tehran, Iran. The topic of practical pathology was selected earlier based on the curriculum. High-quality digital images of the slides were presented in the form of an e-file. The medical students were asked to register for participation in conventional or virtual groups. The first group underwent traditional education and members of the virtual group were given the website address to click into the website where the materials were uploaded. At the end of the semester, both groups were scientifically evaluated. The mean final pathology exam grade in the virtual group was higher than that of the control group; however, the difference between groups was not statistically significant (P=0.658). In conclusion, it was observed that in teaching practical pathology, virtual education may be as effective as conventional method. 
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Objective:
Student satisfaction and student performance are of primary concern when classroom pedagogy is changed. We determine the equivalence of two teaching methodologies in a clinical microbiology course using test scores as the measure of student performance.
Methods:
The two teaching methodologies examined were a traditional lecture-based method face-to-face (F2F) method and an inverted classroom method (ICM). Student perceptions of the ICM method were measured using a course survey in which students were asked to compare their experiences in the ICM class with experiences in a traditional F2F class. Classroom exams were administered in the same way in the traditional F2F lecture and ICM courses. Student test averages obtained in both pedagogies were compared for equivalence using an independent samples t-test. A six-question survey was developed to assess student perception of the ICM classroom compared to that for the traditional lecture-based classroom.
Results:
Test performance of students in the ICM was equivalent to that of students receiving traditional F2F lectures. Mean difference between test scores for the ICM and traditional F2F groups was 1.9 points (95% confidence interval [CI],4.0–0.14). Survey responses indicated that respondents feel positively about self-learning in ICM and prefer the flexibility provided by ICM.
Conclusion:
This study provides evidence that the ICM method of teaching clinical microbiology can replace the traditional F2F method without loss of student performance. Respondent perceptions of the inverted classroom were positive, with students favoring the flexibility. 
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Background
Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The ‘Introduction to Information and Communication Technology and eHealth’ course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach.

Methods
Two questionnaires were developed and tested for face validity and reliability in a pilot course with 20 CHWs. Those were designed to measure CHWs’ knowledge of and attitudes towards the use of ICT, before and after each course, as well as their satisfaction with each learning approach. Following validation, a randomised controlled trial was conducted to assess the effectiveness of the two learning approaches. A total of 40 CHWs were recruited, stratified by position, gender and computer experience, and allocated to the traditional or blended learning group using block randomisation. Participants completed the baseline and follow-up questionnaires before and after each course to assess the impact of each learning approach on their knowledge, attitudes, and satisfaction. Per-item, pre-post and between-group, mean differences for each approach were calculated using paired and unpaired t-tests, respectively. Per-item, between-group, satisfaction scores were compared using unpaired t-tests.

Results
Scores across all scales improved after attending the traditional and blended learning courses. Self-rated ICT knowledge was significantly improved in both groups with significant differences between groups in seven domains. However, actual ICT knowledge scores were similar across groups. There were no significant differences between groups in attitudinal gains. Satisfaction with the course was generally high in both groups. However, participants in the blended learning group found it more difficult to follow the content of the course.

Conclusions
This study shows that there is no difference between blended and traditional learning in the acquisition of actual ICT knowledge among community healthcare workers in developing countries. Given the human resource constraints in remote resource-poor areas, the blended learning approach may present an advantageous alternative to traditional learning. 
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Aim
To compare ophthalmology teaching delivered by eLearning with traditional lectures, in terms of undergraduate performance and satisfaction.
Methods
Randomised controlled crossover study at King’s College London Medical School with 245 third year medical students. The ophthalmology syllabus was divided into ten topics. Five topics were randomised to be taught by traditional lectures and five by electronic learning (eLearning). For the second rotation of students the topics were crossed over, so that those topics taught by traditional lectures were taught by eLearning and vice versa. At the end of each rotation the students sat an optional online mock examination containing 100 questions (ten on each topic). Students’ examination performance was compared between the two teaching methods. Student satisfaction was assessed using an online satisfaction survey. Outcome measures were the mean percentage of correct answers across all ten topics, student satisfaction and self-assessed knowledge.
Results
The mean examination score for questions taught by eLearning was 58% (95% CI, 55.7–59.6), versus 55% (95% CI 53.1–56.8) for traditional lectures (P = 0.047). Across all topics students were more satisfied with eLearning than traditional lectures, with 87% (95% CI 84.5–88.4) rating eLearning as ‘excellent’ or ‘good’ versus 65% (95% CI 62.0–67.4) for lectures (p < 0.0001). Overall 180 (75.6%) preferred eLearning compared to traditional lectures, with 166 (69.7%) rating eLearning ‘much better’ or ‘better,’ 61 (25.6%) ‘neutral’ and 11 (4.6%) ‘worse’ or ‘much worse.’
Conclusions
Student satisfaction and examination performance are both enhanced by ophthalmology eLearning. Similar eLearning modules may be suitable for other specialties and postgraduate learning. 
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Purpose: The aim of this study was to measure the effect of an iPad-based asynchronous curriculum on emergency medicine resident performance on the in-training exam (ITE). We hypothesized that the implementation of an asynchronous curriculum (replacing 1hour of weekly didactic time) would result in non-inferior ITE scores compared to the historical scores of residents who had participated in the traditional 5-hour weekly didactic curriculum.
Methods: The study was a retrospective, non-inferiority study. conducted at the University of California, Irvine Emergency Medicine Residency Program. We compared ITE scores from 2012 and 2013, when there were 5 weekly hours of didactic content, with scores from 2014 and 2015, when 1 hour of conference was replaced with asynchronous content. Examination results were compared using a non-inferiority data analysis with a 10% margin of difference.
Results: Using a non-inferiority test with a 95% confidence interval, there was no difference between the 2 groups (before and after implementation of asynchronous learning), as the confidence interval for the change of the ITE was -3.5 to 2.3 points, whereas the 10% non-inferiority margin was 7.8 points.
Conclusion: Replacing 1 hour of didactic conference with asynchronous learning showed no negative impact on resident ITE scores. 
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Objective. To compare performance and preferences of students who were randomly allocated to classroom or online sections of an elective course on immunization. Methods. Students were randomly assigned to either the classroom or online section. All course activities (lectures, quizzes, case discussions, vaccine administration, and final examination) were the same for both sections, except for the delivery of lecture material. Assessment. Students were surveyed on their preferences at the beginning and end of the semester. At the end of the semester, the majority of students in the classroom group preferred classroom or blended delivery while the majority of students in the online group preferred blended or online delivery (p,0.01). Student performance was compared at the end of the semester. There was no significant difference for any of the grades in the course between the 2 sections. Conclusion. There was no difference in student performance between the classroom and online sections, suggesting that online delivery is an effective way to teach students about immunization. 
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Aims: The purpose of this study was to develop and implement a blended course (a combined face-to-face and online instruction) on undergraduate oral radiology and evaluate it by comparing its educational effectiveness (derived from students’ performance and answers to questionnaires) to a conventional course’s. Students’ attitudes concerning the blended methodology were also registered.

Methodology: An original course was developed and implemented, and its electronic version was uploaded to an e-learning educational platform. The course was attended by two groups of final-year students, who were taught by either the conventional face-to-face methodology or the blended learning methodology. Students answered a series of questionnaires, before and after following the course, regarding their perceptions, attitudes and evaluation of the course. Additionally, they completed knowledge assessment tests and their grades (before and after the course) were compared. Educational effectiveness of the course was determined by analysing the results of the questionnaires and the tests.

Results: Students in the blended group performed significantly better than their colleagues of the conventional group in the post-course knowledge test, and female students of the blended group performed better than male students. Students evaluated high the course content, organisation, educational material, and the blended group students additionally appreciated the course design and clarity of instructions. Students’ attitudes towards elements of blended learning (effectiveness, motivation and active engagement) were very positive. Most of the blended group students, who attended the face-to-face meeting (approx. 91%), evaluated it as helpful for summarising the subject and clarifying difficult issues.

Conclusions: Blended learning is effective and well evaluated by dental students and can be implemented in undergraduate curriculum for teaching oral radiology. 
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