Interactive Spaced Education Versus Web-Based Modules for Teaching Histopathology Diagnostic Skills to Urology Residents: A Randomized Controlled Trial
BP Kerfoot, Y Fu, EM Genega. Veterans Affairs Boston Healthcare System, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
Background: Although genitourinary (GU) histopathology is core content on the urology board exams, urology residents receive little training in it. Interactive spaced education (ISE) is a novel email-based educational tool based on 'spacing effect', the psychological finding that educational encounters which are spaced and repeated over time result in more efficient learning and improved retention. We performed a randomized trial to compare the efficacy and acceptability of ISE to bolus web-based teaching (WBT) modules as methods to teach GU pathology to US urology residents.
Design: ISE was delivered using emails that contained pathology images and multiple-choice questions. Upon submitting an answer to a question, residents were presented the correct answer and explanations for all answers. Forty validated questions with images were constructed on testis, prostate, kidney and bladder pathology (10/organ). All US urology residents were eligible to participate. Enrollees were randomized to 1 of 2 cohorts. Cohort 1 residents received 3-cycle ISE on prostate-testis (weeks 1-16) and 3 WBT modules on bladder-kidney (weeks 14-16). Cohort 2 residents received 3-cycle ISE on bladder-kidney (weeks 1-16) and 3 WBT modules on prostate-testis (weeks 14-16). The ISE intervention was delivered via daily emails each with 1 question. The ISE material was distributed in 3 cycles or repetitions to take advantage of the spacing effect. Each cycle was 4-weeks long and consisted of 20 questions with unique images. The WBT used the identical content and delivery system, with the questions aggregated into 3 20-question modules. To assess long-term learning, residents were randomized to complete a final 4-week cycle of 40 questions with unique images covering all 4 organs at 1 of 4 time periods during weeks 18-45.
Results: Seven-hundred twenty-four urology residents enrolled. ISE and WBT were completed by 77% and 66% of residents, respectively. ISE generated a median 15% improvement in long-term knowledge (IQR 5to10; Cohen effect size 1.06), while WBT generated a 5% improvement (IQR -5to15; effect size 0.24; p<0.001). Of 596 survey respondents, 77% preferred ISE over WBT, and 99% requested to participate in future ISE programs.
Conclusions: ISE is an effective and well-accepted method to teach GU pathology to urology residents. ISE can be utilized to teach pathology diagnostic skills to pathology residents and attendings across the US.
Wednesday, March 11, 2009 1:00 PM
Poster Session VI # 74, Wednesday Afternoon