Demonstrating equivalence and non‐inferiority of medical education concepts

Klasen, Martin; Sopka, Saša

doi:10.1111/medu.14420

Cited by 10 publications

(10 citation statements)

References 33 publications

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“…16 While various factors, such as staff, material, and time spending and faculty train-ing, may affect developing SBL modules, student learning outcomes should be the most important factor to be considered. 17 This study investigated the effectiveness of the proposed remote SBL module for developing skills in periodontal instrumentation compared with the onsite SBL modules. Our findings indicated that the proposed remote SBL module achieved comparable student learning outcomes, although this module offered a less practice opportunity under faculty instruction.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous SBL modules have been implemented to teach different skills in dentistry, but no evidence‐based frameworks guiding SBL curriculum development have been suggested in dental education 16 . While various factors, such as staff, material, and time spending and faculty training, may affect developing SBL modules, student learning outcomes should be the most important factor to be considered 17 . This study investigated the effectiveness of the proposed remote SBL module for developing skills in periodontal instrumentation compared with the onsite SBL modules.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of remote simulation‐based learning for periodontal instrumentation: A non‐inferiority study

Mishler

Yang

et al. 2021

Journal of Dental Education

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Objectives While numerous virtual/remote simulation‐based learning (SBL) modules were implemented due to the COVID‐19 pandemic, limited data on their effectiveness are available. This study aimed to investigate the effectiveness of a remote SBL module for periodontal instrumentation compared to traditional onsite SBL modules. Methods Calibrated faculty members have instructed in all modules. Synchronous remote SBL activities using a secure videoconferencing application, which replaced onsite practices, were conducted in a small group setting in the remote SBL module for the class of 2023. After the class took the onsite second‐year practical examination, a set of multiple and logistic regression analyses (N = 389) were conducted to test if the second‐year practical examination scores and the passing rates were significantly different between the remote SBL (class of 2023) and onsite SBL I and II (class of 2019 and 2022) groups. Results Both mean practical examination score and passing rate from the remote SBL group (class of 2023) were significantly higher than those from the onsite SBL II group (class of 2022) when their first‐year practical examination scores were not considered (p < 0.05). Once the first‐year practical examination scores were considered, the remote SBL group was not significantly different from the onsite SBL I and II groups with respect to the mean second‐year practical examination score and the passing rate. Conclusion The proposed remote SBL module achieved the comparable student learning outcomes compared to the onsite SBL modules while it utilized less staff, time, and material expenditure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effectiveness of remote simulation‐based learning for periodontal instrumentation: A non‐inferiority study

Mishler

Yang

et al. 2021

Journal of Dental Education

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“…We used an equivalency analysis. 19 We assessed equivalence by determining whether the between-group difference and the associated 95% confidence interval (CI) fell entirely within a pre-stablished equivalence margin (Δ). 20,21,22,23 The data from the results of the pre and post-tests were analyzed with Microsoft Excel 365 (Version 1905; Microsoft Office, Redmond, Washington), https://www.socscistatistics.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Learning Outcomes of High-fidelity versus Table-Top Simulation in Undergraduate Emergency Medicine Education: Prospective, Randomized, Crossover-Controlled Study

Offenbacher

Petti

et al. 2021

WestJEM

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Introduction: Over the last several decades simulation, in both graduate and undergraduate emergency medicine education, has continued to develop as a leading and highly effective teaching modality. Limited research exists to evaluate the efficacy of low-fidelity (table-top) simulation, as compared to high-fidelity standards, as it relates to medical knowledge learning outcomes. We sought to assess the efficacy of a low-fidelity simulation modality in undergraduate emergency medicine education, based on quantitative medical knowledge learning outcomes. Methods: A prospective, randomized, crossover-control study comparing objective medical knowledge learning outcomes between simulation modalities. Analysis was designed to evaluate for the statistical equivalence of learning outcomes between the two cohorts. This was done by comparing a calculated 95% confidence interval (CI) around the mean difference in post-test scores, between experimental and control modalities, to a pre-established equivalence margin. Results: Primary outcomes evaluating student performance on post-test examinations demonstrated a total cohort CI (95% CI, -0.22 and 0.68). Additional course-subject subgroup analysis demonstrated non-inferior CIs with: Shortness of Breath (95% CI, -0.35 and 1.27); Chest Pain (95% CI, -0.53 and .94); Abdominal Pain (95% CI, -0.88 and 1.17); Cardiovascular Shock (95% CI, -0.04 and 1.29). Secondary outcome analysis was done to evaluate medical knowledge acquisition by comparing the difference in pre and post-test examination between the cohorts. CI of the full cohort ranged from (95% CI, -0.14 and 0.96). Conclusion: The student’s performance on quantitative medical-knowledge assessment was equivalent between the high-fidelity control and low-fidelity experimental simulation groups. Analysis of knowledge acquisition between the two groups also demonstrated statistical equivalence.

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“…The trial aims to assess whether tele-instructor based BLS training was non-inferior to a conventional training approach ( 28 ). However, due to an increased infection risk in the 2020 COVID-19 pandemic, a control group using the conventional training approach with group sizes of 12 trainees was not possible.…”

Section: Methodsmentioning

confidence: 99%

Innovative Tele-Instruction Approach Impacts Basic Life Support Performance: A Non-inferiority Trial

et al. 2022

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BackgroundSustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substantial challenges. The limited availability of highly qualified instructors and tight economic conditions complicates the delivery of these life-saving trainings. Consequently, innovative and resource-efficient approaches are needed to minimize or eliminate contagion while maintaining high training standards and managing learner anxiety related to infection risk.MethodsIn a non-inferiority trial 346 first-year medical, dentistry, and physiotherapy students underwent BLS training at AIXTRA—Competence Center for Training and Patient Safety at the University Hospital RWTH Aachen. Our objectives were (1) to examine whether peer feedback BLS training supported by tele-instructors matches the learning performance of standard instructor-guided BLS training for laypersons; and (2) to minimize infection risk during BLS training. Therefore, in a parallel group design, we compared arm (1) Standard Instructor Feedback (SIF) BLS training (Historical control group of 2019) with arm (2) a Tele-Instructor Supported Peer-Feedback (TPF) BLS training (Intervention group of 2020). Both study arms were based on Peyton's 4-step approach. Before and after each training session, objective data for BLS performance (compression depth and rate) were recorded using a resuscitation manikin. We also assessed overall BLS performance via standardized instructor evaluation and student self-reports of confidence via questionnaire. Non-inferiority margins for the outcome parameters and sample size calculation were based on previous studies with SIF. Two-sided 95% confidence intervals were employed to determine significance of non-inferiority.ResultsThe results confirmed non-inferiority of TPF to SIF for all tested outcome parameters. A follow-up after 2 weeks found no confirmed COVID-19 infections among the participants.ConclusionTele-instructor supported peer feedback is a powerful alternative to in-person instructor feedback on BLS skills during a pandemic, where infection risk needs to be minimized while maximizing the quality of BLS skill learning.Trial registrationhttps://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00025199, Trial ID: DRKS00025199.

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Demonstrating equivalence and non‐inferiority of medical education concepts

Cited by 10 publications

References 33 publications

Effectiveness of remote simulation‐based learning for periodontal instrumentation: A non‐inferiority study

Effectiveness of remote simulation‐based learning for periodontal instrumentation: A non‐inferiority study

Learning Outcomes of High-fidelity versus Table-Top Simulation in Undergraduate Emergency Medicine Education: Prospective, Randomized, Crossover-Controlled Study

Innovative Tele-Instruction Approach Impacts Basic Life Support Performance: A Non-inferiority Trial

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