Cook David A, Thompson Warren G, Thomas Kris G, Thomas Matthew R, Pankratz V Shane
Division of General Internal Medicine, Mayo Clinic College of Medicine, Baldwin 4-A, 200 First Street SW, Rochester, MN 55905, USA.
Acad Med. 2006 Mar;81(3):231-8. doi: 10.1097/00001888-200603000-00005.
To determine the effect of self-assessment questions on learners' knowledge and format preference in a Web-based course, and investigate associations between learning styles and outcomes.
The authors conducted a randomized, controlled, crossover trial in the continuity clinics of the Mayo-Rochester internal medicine residency program during the 2003-04 academic year. Case-based self-assessment questions were added to Web-based modules covering topics in ambulatory internal medicine. Participants completed two modules with questions and two modules without questions, with sequence randomly assigned. Outcomes included knowledge assessed after each module, format preference, and learning style assessed using the Index of Learning Styles.
A total of 121 of 146 residents (83%) consented. Residents had higher test scores when using the question format (mean +/- standard error, 78.9% +/- 1.0) than when using the standard format (76.2% +/- 1.0, p = .006). Residents preferring the question format scored higher (79.7% +/- 1.1) than those preferring standard (69.5% +/- 2.3, p < .001). Learning styles did not affect scores except that visual-verbal "intermediate" learners (80.6% +/- 1.4) and visual learners (77.5% +/- 1.3) did better than verbal learners (70.9% +/- 3.0, p = .003 and p = .033, respectively). Sixty-five of 78 residents (83.3%, 95% CI 73.2-90.8%) preferred the question format. Learning styles were not associated with preference (p > .384). Although the question format took longer than the standard format (60.4 +/- 3.6 versus 44.3 +/- 3.3 minutes, p < .001), 55 of 77 residents (71.4%, 60.0-81.2%) reported that it was more efficient.
Instructional methods that actively engage learners improve learning outcomes. These findings hold implications for both Web-based learning and "traditional" educational activities. Future research, in both Web-based learning and other teaching modalities, should focus on further defining the effectiveness of selected instructional methods in specific learning contexts.
确定自我评估问题对基于网络课程的学习者知识及格式偏好的影响，并研究学习风格与学习成果之间的关联。
作者于2003 - 2004学年在梅奥 - 罗切斯特内科住院医师培训项目的连续性诊所中进行了一项随机、对照、交叉试验。基于病例的自我评估问题被添加到涵盖门诊内科主题的网络模块中。参与者完成两个带问题的模块和两个不带问题的模块，顺序随机分配。结果包括每个模块后评估的知识、格式偏好以及使用学习风格指数评估的学习风格。
146名住院医师中有121名（83%）同意参与。住院医师使用问题格式时的测试成绩（均值±标准误，78.9%±1.0）高于使用标准格式时（76.2%±1.0，p = 0.006）。偏好问题格式的住院医师得分更高（79.7%±1.1），高于偏好标准格式的住院医师（69.5%±2.3，p < 0.001）。学习风格除了对视觉 - 语言“中间型”学习者（80.6%±1.4）和视觉型学习者（77.5%±1.3）的成绩优于语言型学习者（70.9%±3.0，分别为p = 0.003和p = 0.033）外，对成绩没有影响。78名住院医师中有65名（83.3%，95%可信区间73.2 - 90.8%）偏好问题格式。学习风格与偏好无关（p > 0.384）。虽然问题格式比标准格式花费的时间更长（60.4±3.6对44.3±3.3分钟，p < 0.001），但77名住院医师中有55名（71.4%，60.0 - 81.2%）报告说它更有效。
积极让学习者参与的教学方法能提高学习成果。这些发现对基于网络的学习和“传统”教育活动都有启示。未来在基于网络的学习和其他教学模式方面的研究，应专注于进一步确定特定教学方法在特定学习情境中的有效性。
