Wiecha John M, Chetty V K, Pollard Timothy, Shaw Petter F
Department of Family Medicine, Boston University, Boston Medical Center, 1 BMC Place, Boston, MA 02118, USA.
Fam Med. 2006 Oct;38(9):647-52.
Relatively little is known about the effectiveness of Web-based learning (WBL) in medical education and how it compares to conventional methods. This study examined the influence of an interactive, online curriculum in a third-year medical school family medicine clerkship on students' ability to create a management plan for a patient newly diagnosed with type 2 diabetes. We also evaluated how the online curriculum compared to a conventionally taught curriculum.
The online course included three integrated activities: (1) self-study modules, (2) a patient case study, and (3) a moderated discussion board for posting and discussing patient care plans. The WBL curriculum was compared to small-group case-based sessions with a faculty facilitator. Students completed a test case before and after the clerkship.
Among standard-of-care diabetic management interventions not ordered on the pretest, 38% were subsequently correctly ordered by WBL students on the posttest, versus 33% by students in the comparison group. For four out of five subgroups assessed on the case write-ups, the gain from before to after the clerkship favored the WBL group.
Improvement among students learning online exceeded that of students learning face to face. This suggests superiority of the online method, a finding consistent with other recently published, well-controlled studies.
关于基于网络的学习（WBL）在医学教育中的效果以及它与传统方法相比情况如何，人们了解得相对较少。本研究考察了医学院三年级家庭医学实习中一个交互式在线课程对学生为新诊断出2型糖尿病患者制定管理计划能力的影响。我们还评估了该在线课程与传统授课课程相比的情况。
在线课程包括三项综合活动：（1）自学模块，（2）一个患者案例研究，以及（3）一个用于发布和讨论患者护理计划的有主持人的讨论板。将WBL课程与有教员指导的小组案例讨论课进行比较。学生在实习前后完成一个测试案例。
在前测中未开出的糖尿病标准护理干预措施中，WBL组学生在后测中有38%随后正确开出，而对照组学生为33%。在对案例报告进行评估的五个亚组中的四个，实习前后的进步情况有利于WBL组。
在线学习的学生的进步超过了面对面学习的学生。这表明在线方法具有优越性，这一发现与其他最近发表的、控制良好的研究一致。
