Cartoon versus traditional self-study handouts for medical students: CARTOON randomized controlled trial

Abstract

Objective: The objective of this study is to compare the effectiveness of a "cartoon-style" handout with a "traditional-style" handout in a self-study assignment for preclinical medical students. Methods: Third-year medical students (n ¼ 93) at the Faculty of Medicine Ramathibodi Hospital, Mahidol University, took a pre-learning assessment of their knowledge of intercostal chest drainage. They were then randomly allocated to receive either a "cartoon-style" or a "traditional-style" handout on the same topic. After studying these over a 2-week period, students completed a post-learning assessment and estimated their levels of reading completion. Results: Of the 79 participants completing the post-learning test, those in the cartoon-style group achieved a score 13.8% higher than the traditional-style group (p ¼ 0.018). A higher proportion of students in the cartoon-style group reported reading 75% of the handout content (70.7% versus 42.1%). In post-hoc analyses, students whose cumulative grade point averages (GPA) from previous academic assessments were in the middle and lower range achieved higher scores with the cartoon-style handout than with the traditional one. In the lower-GPA group, the use of a cartoon-style handout was independently associated with a higher score. Conclusions: Students given a cartoon-style handout reported reading more of the material and achieved higher postlearning test scores than students given a traditional handout.

Emotional experiences of reading health educational manga encouraging behavioral changes: a non-randomized controlled trial

“…In accordance with the current results, it is believed that manga-based approaches may enable the combination of cognitive understanding based on narrative story-telling to provide practical knowledge in a general lifestyle context as well as the effects of visual image stimuli on sensory understanding and reduced psychological burden. Nevertheless, the overall small effect size observed in the results of the current study is consistent with those of previous randomized controlled trials (Junhasavasdikul et al, 2017 ; Kovacs et al, 2011 ).…”

“…A previous systematic review revealed that the application of manga positively influenced health care settings (Branscum & Sharma, 2009 ). Several randomized controlled trials reported a small effect on initiatives of health behavior change for promoting general health (Junhasavasdikul et al, 2017 ) and for preventing back pain (Kovacs et al, 2011 ). However, other studies challenged the application of health promotion manga or comics for a range of patient education or health education initiatives, such as programs for promoting physical activity and healthy diet (Baranowski et al, 2002 ; Branscum, Sharma, Wang, Wilson, & Rojas-Guyler, 2013a , 2013b ; Leung et al, 2017 ; Leung, Tripicchio, Agaronov, & Hou, 2014 ; Manes, Liu, Burke, & Dworkin, 2014 ); the prevention infectious diseases (Bieri, Yuan et al, 2013 ; Yuan, Manderson, Tempongko, Wei, & Aiguo, 2000 ), HIV/AIDS (Dworkin et al, 2013 ; Gillmore et al, 1997 ), and cancer (Lyzun & McMullen, 2009 ; Risi et al, 2004 ); immunization (Diamond et al, 2016 ; Muzumdar & Nania, 2015 ; Muzumdar & Pantaleo, 2017 ); smoking cessation (Bush et al, 2005 ); reduction of disease-related stigma (el-Setouhy & Rio, 2003 ), education on pesticide exposure and health (Liebman, Juárez, Leyva, & Corona, 2007 ); prevention of accidents among children (Cardenas & Simons-Morton, 1993 ); and patient education (Maxwell, Simmons, Franklin, Arnold, & Pall, 2014 ; Shigehatake et al, 2014 ).…”

The emotion storyboard: A method to examine social judgments of emotion

“…Graphic novel methods have been used to teach concepts in medicine [28], business [30], history [31], literacy [32], and secondary school [33]. Studies in these domains have demonstrated that graphic novels and illustrated content resulted in greater recall [30], enhanced test performance and reading behavior [34], greater reading motivation [2], and comparable decision-making while requiring less reading time [35] than text-only formats. Overall, graphic novel formats have resulted in greater memory of content, greater ease of processing, and greater motivation to engage with content, than text alone.…”

Graphic Narrative Versus Journal Article for Teaching Medical Students About P Values: A Randomized Trial

“…Previous studies have shown that comics improve student [2], patient [3], and resident [4] understanding of medical information and often outperform traditional instructional methods. Junhasavasdikul et al [2] found better third-year student results on a thoracostomy quiz in students randomized to a comic compared with a text-based handout. Brand et al [3] showed that patients having angiography given a comic explaining the procedure had better understanding and satisfaction and less anxiety than patients receiving only standard informed consent.We performed a randomized trial to compare knowledge level by exposure to a comic or a traditional journal article describing P values among firstyear medical students.…”

“…Fig. 1) [5] modeled on the Calvin and Hobbes [6] comic strip with elements from Peanuts [7], The Flintstones [8], The Jetsons [9], Batman [10], and other classic comics tropes [11,12] or (2) an article from a statistics journal [13]. Participants completed an online in-class eight-question (four true-or-false, three multiple choice, one sentence completion) prereading quiz (e-only Appendix 1) and on the same day received their reading assignment.…”