Interactive Spaced Online Education in Pediatric Trauma

Abstract

Pediatric resident trauma education is suboptimal due to lack of a curriculum and limited trauma experience and education resources. The objective of the study was to test knowledge retention and acceptability of interactive spaced education (ISE) in pediatric trauma. Prospective, randomized trial involving 40 physicians in a pediatric emergency department was used. Instrument was comprised of 48 multiple-choice questions (evaluative component) and answer critiques (educational component) on pediatric trauma divided into two modules. The instrument was assessed for test–retest reliability, item difficulty, and construct validity. Intervention consisted of online administration of each module as eight spaced emails (3 questions each) over a course of 4 weeks and was repeated after 2 and 4 months. Participants received an answer critique on committing to an answer. Primary outcome was difference in mean percentage of correct answers at 2 and 4 months versus baseline. Paired t test and effect size (d) were performed. Secondary outcome was exit-survey of ISE acceptability. There was significant improvement at 2 months (8.0, 95% confidence intervel [CI] = [3.6, 12.5], d = 0.75), but improvement at 4 months (1.6, 95% CI = [−4.5, 7.7], d = 0.18) was not significant. Sixty percent would retake and recommend ISE to others. Interactive, spaced education improves knowledge in pediatric trauma and is well accepted. Studies are required to determine the optimal spacing interval for this form of education.

Conceptualising spaced learning in health professions education: A scoping review

“…Information or questions were distributed through online sources daily (n = 10), every 2 days (n = 8), every 3 days (n = 1) , weekly (n = 12), every 2 weeks (n = 1), or monthly (n = 2). In studies explicitly stating that material was not only spaced but also repeated, repetition delays ranged from various days (n = 2), to weeks (n = 24), to months (n = 12). Additionally, there were large variations in the number of repetitions and intervals between repetitions.…”

“…Almost half of the empirical research articles (n = 48, 47%) did not explicitly mention a theoretical framework. In total, nine theoretical frameworks were mentioned in the remaining studies of which the Spacing effect (n = 40) and Testing effect (n = 31) were named most often. Other frameworks were Cognitive Load Theory (n = 4), Desirable Difficulties Theory (n = 2), Retrieval hypothesis (n = 2), Total‐time hypothesis (n = 2), Learning Theory (n = 1), Metacognitive Theory (n = 1) and Kolb's Experiential Learning Theory (n = 1).…”

“…Approximately half of the empirical research articles (n = 51, 48%) applied spaced learning in an online setting, mostly through delivering learning sessions in e‐mails distributed over time using electronic modules, eg, Qstream (n = 38, 37%). Spaced learning was also implemented in simulation settings (n = 24, 23%), generally used to disperse training sessions over time to stimulate clinical skill acquisition.…”

“…Approximately half of the empirical research articles (n = 51, 48%) applied spaced learning in an online setting, mostly through delivering learning sessions in e-mails distributed over time using electronic modules, eg, Qstream [19][20][21]23,[27][28][29][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]47,[51][52][53][54][55]64,74,[78][79][80][81][82][83][84][85] (n = 38, 37%). Spaced learning was also implemented in simulation settings 46,48,53,56,65,67,68,75,76,[86][87][88]…”

Using a gamified mobile app to increase student engagement, retention and academic achievement

“…Based on Ebbinghaus's (2013) theorising of 'the forgetting curve' as a way to explain the finer workings of human cognition and memory, the spacing effect and the testing effect emerged as two pedagogical principles significant when designing mobile apps for learning. With some positive results recoded (Kerfoot, Turchin, Breydo, Gagnon, & Conlin, 2014;Shenoi et al, 2016), when operationalised within an app's design, these principles could allow students to revisit and consolidate what was learnt by being systematically tested on their knowledge.…”