Critical Analysis of an e-Learning and Interactive Teaching Module with Respect to the Interpretation of Emergency Computed Tomography of the Brain

Abstract

Purpose To compare the learning benefit of three different teaching strategies on the interpretation of emergency cerebral computed tomography (CT) pathologies by medical students.

Materials and Methods Three groups of students with different types of teaching (e-learning, interactive teaching, and standard curricular education in neuroradiology) were tested with respect to the detection of seven CT pathologies. The test results of each group were compared for each CT pathology using the chi-square test. A p-value ≤ 0.05 was considered to be significant.

Results Opposed to the results of the comparison group (curricular education), the e-learning group and interactive teaching tutorial group both showed a significantly better performance in detecting hyperdense middle cerebral artery sign (p = 0.001 and p < 0.0001) as well as subarachnoid hemorrhage (p = 0.03 and p = 0.001) on CT. Moreover, an increase in performance for the detection of subdural hematoma and skull fracture could be observed for both the interactive teaching group and the e-learning group, with statistical significance in the latter (p = 0.03 and p < 0.0001, respectively). No statistically significant differences were found for the detection of intracranial and epidural hemorrhage, as well as midline shift, among the groups studied.

Conclusion Our study demonstrates potential learning benefits for both the interactive teaching tutorial and e-learning module group with respect to reading CT scans with slightly different advantages. Thus, the introduction of new learning methods in radiological education might be reasonable at an undergraduate stage but requires learning content-based considerations.

Key points 

• E-learning can offer benefits regarding the reading of cerebral CT scans by students

• Interactive tutorial can offer benefits regarding the reading of cerebral CT scans by students

• E-learning and interactive tutorial feature different strengths for student learning in radiology

• Application of interactive teaching methods in radiology requires learning content-based considerations

Citation Format

• Groth M, Barthe KG, Riemer M et al. Critical Analysis of an e-Learning and Interactive Teaching Module with Respect to the Interpretation of Emergency Computed Tomography of the Brain. Fortschr Röntgenstr 2017; 190: 334 – 340

Zusammenfassung

Ziel Vergleich von drei verschiedenen Lehrmethoden zur Interpretation von Notfall-Pathologien mit der zerebralen Computertomografie (CT) durch Medizinstudenten.

Material und Methoden Drei Studentengruppen wurden bzgl. der Detektion von sieben CT-Pathologien getestet, nachdem sie verschiedene Lehrmethoden absolviert hatten (e-Learning, interaktives Seminar, curriculäre Lehre). Die Testergebnisse der drei Gruppen wurde für jede Pathologie mit einem Chi-Quadrat-Test verglichen. Das Signifikanzniveau wurde ≤ 0,05 gewählt.

Ergebnisse Im Gegensatz zur Vergleichsgruppe (curriculäre Lehre) zeigten die e-Learning- und Interaktivseminar-Gruppe signifikant bessere Ergebnisse bei der Detektion des „hyperdensen Mediazeichens“ (p = 0,001 und p < 0,0001) sowie der Subarachnoidalblutung (p = 0,03 und p = 0,001). Darüber hinaus zeigten sowohl die Interaktivseminar- als auch die e-Learning-Gruppe bessere Ergebnisse für die Detektion eines subduralen Hämatoms und einer Kalottenfraktur, wobei nur die letzte Gruppe hier eine statistische Signifikanz aufwies (p = 0,03 und p < 0,0001). Keine signifikanten Unterschiede zeigten sich für Pathologien wie intrakranielle Blutung, epidurales Hämatom und Mittellinienverlagerung.

Zusammenfassung Unsere Studie zeigt jeweils unterschiedliche potentielle Vorteile der Interaktivseminar- sowie der e-Learning-Gruppe bei der Interpretation von CTs. Daher können interaktive Lehrmethoden das Potenzial besitzen, die studentisch-radiologische Ausbildung zu verbessern, die passende Lehrform muss jedoch dem jeweiligen Lerninhalt angepasst werden.

Kernaussagen 

• E-Learning kann die studentische Beurteilungfähigkeit zerebraler CTs verbessern

• Ein interaktives Seminar kann die studentische Beurteilungfähigkeit zerebraler CTs verbessern

• E-Learning und Interaktivseminare besitzen unterschiedliche Stärken in der studentischen Radiologieausbildung

• Die Anwendung neuer Lehrmethoden in der Radiologie erfordert eine Lerninhalt spezifisch Anpassung

Key words

CT - emergency - e-learning - neuroradiology - student

• References

• 1 Howlett D, Vincent T, Watson G. et al. Blending online techniques with traditional face to face teaching methods to deliver final year undergraduate radiology learning content. Eur J Radiol 2011; 78: 334-341
• 2 Pinto A, Brunese L, Pinto F. et al. E-learning and education in radiology. Eur J Radiol 2011; 78: 368-371
• 3 Wong V, Smith AJ, Hawkins NJ. et al. Adaptive Tutorials Versus Web-Based Resources in Radiology: A Mixed Methods Comparison of Efficacy and Student Engagement. Acad Radiol 2015; 22: 1299-1307
• 4 Moreira IC, Ventura SR, Ramos I. et al. Development and assessment of an e-learning course on breast imaging for radiographers: a stratified randomized controlled trial. J Med Internet Res 2015; 17: e3
• 5 Soh BP, Reed WM, Poulos A. et al. E-tutorial improves students’ ability to detect lesions. Radiol Technol 2013; 85: 17-26
• 6 Salajegheh A, Jahangiri A, Dolan-Evans E. et al. A combination of traditional learning and e-learning can be more effective on radiological interpretation skills in medical students: a pre- and post-intervention study. BMC Med Educ 2016; 16: 46
• 7 Beaulieu Y, Laprise R, Drolet P. et al. Bedside ultrasound training using web-based e-learning and simulation early in the curriculum of residents. Crit Ultrasound J 2015; 7: 1
• 8 Guri-Rosenblit S. Eight paradoxes in the implementation process of e-learning in higher education. Distances et savoirs 2006; 4: 155-179
• 9 Themenblockbuch VI KliniCuM. http://www.uke.de/dateien/einrichtungen/medizinische-fakultät/dokumente/tb6-_blockbuch-_-januar-bis-april-2016_endversion.pdf accessed 20 April 2016.
• 10 Themenblockbuch IV KliniCuM. http://www.uke.de/dateien/einrichtungen/medizinische-fakultät/dokumente/themenblockbuch-4-_-april-bis-juli-2016.pdf accessed 20 April 2016.
• 11 Linn J. Atlas Klinische Neuroradiologie des Gehirns. Berlin / Heidelberg / New York: Springer-Verlag; 2011
• 12 http://hhu.casus.net/pmw2/app/homepage.html accessed 20 April 2016.
• 13 Ernst M, Romero JM, Buhk JH. et al. Sensitivity of visual and quantitative detection of middle cerebral artery occlusion on non-contrast-enhanced computed tomography. Neuroradiology 2014; 56: 1063-1068
• 14 Perry JJ, Stiell IG, Sivilotti ML. et al. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011; 343 DOI: d4277.
• 15 Dubosh NM, Bellolio MF, Rabinstein AA. et al. Sensitivity of Early Brain Computed Tomography to Exclude Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis. Stroke 2016; 47: 750-755
• 16 Gentry LR, Godersky JC, Thompson B. et al. Prospective comparative study of intermediate-field MR and CT in the evaluation of closed head trauma. Am J Roentgenol 1988; 150: 673-682
• 17 Datta R, Datta K, Venkatesh MD. Evaluation of interactive teaching for undergraduate medical students using a classroom interactive response system in India. Med J Armed Forces India 2015; 71: 239-245
• 18 Abdel MeguidE, Collins M. Students’ perceptions of lecturing approaches: traditional versus interactive teaching. Adv Med Educ Pract 2017; 8: 229-241
• 19 Nyhsen CM, Steinberg LJ, O’Connell JE. Undergraduate radiology teaching from the student's perspective. Insights Imaging 2013; 4: 103-109
• 20 Zafar S, Safdar S, Zafar AN. Evaluation of use of e-Learning in undergraduate radiology education: a review. Eur J Radiol 2014; 83: 2277-2287
• 21 Fiehler J, Fiebach JB, Gass A. et al. Diffusion-weighted imaging in acute stroke--a tool of uncertain value?. Cerebrovasc Dis 2002; 14: 187-196
• 22 Wiesmann M, Knauth M, Mayer T. Advanced and continuing education in neuroradiology. Clin Neuroradiol 2015; 25 (Suppl. 02) 127-128