Department of Pediatrics, Section of Pediatric Sleep Medicine, University of Chicago, 5841 S. Maryland Avenue, University of Chicago, Chicago, IL 60605, USA.
J Clin Sleep Med. 2012 Aug 15;8(4):439-43. doi: 10.5664/jcsm.2042.
Sleep disorders are highly prevalent across all age groups but often remain undiagnosed and untreated, resulting in significant health consequences. To overcome an inadequacy of available curricula and learner and instructor time constraints, this study sought to determine if an online sleep medicine curriculum would achieve equivalent learner outcomes when compared with traditional, classroom-based, face-to-face instruction at equivalent costs.
Medical students rotating on a required clinical clerkship received instruction in 4 core clinical sleep-medicine competency domains in 1 of 2 delivery formats: a single 2.5-hour face-to-face workshop or 4 asynchronous e-learning modules. Immediate learning outcomes were assessed in a subsequent clerkship using a multiple-choice examination and standardized patient station, with long-term outcomes assessed through analysis of students' patient write-ups for inclusion of sleep complaints and diagnoses before and after the intervention. Instructional costs by delivery format were tracked. Descriptive and inferential statistical analyses compared learning outcomes and costs by instructional delivery method (face-to-face versus e-learning).
Face-to-face learners, compared with online learners, were more satisfied with instruction. Learning outcomes (i.e., multiple-choice examination, standardized patient encounter, patient write-up), as measured by short-term and long-term assessments, were roughly equivalent. Design, delivery, and learner-assessment costs by format were equivalent at the end of 1 year, due to higher ongoing teaching costs associated with face-to-face learning offsetting online development and delivery costs.
Because short-term and long-term learner performance outcomes were roughly equivalent, based on delivery method, the cost effectiveness of online learning is an economically and educationally viable instruction platform for clinical clerkships.
睡眠障碍在所有年龄段都很普遍，但往往未被诊断和治疗，导致严重的健康后果。为了克服可用课程以及学习者和教师时间限制的不足，本研究旨在确定在线睡眠医学课程是否可以在与传统的基于课堂的面对面教学等效成本下实现等效的学习者成果。
在必修临床实习中轮转的医学生接受了 4 个核心临床睡眠医学能力领域的教学，教学形式为以下 2 种方式之一：单次 2.5 小时的面对面研讨会或 4 个异步电子学习模块。在随后的实习中，使用多项选择题考试和标准化患者站评估即时学习成果，通过分析学生的患者记录，评估长期结果，包括干预前后患者对睡眠投诉和诊断的纳入。通过教学形式跟踪教学成本。通过教学交付方法（面对面与电子学习）的描述性和推断性统计分析比较学习成果和成本。
与在线学习者相比，面对面学习者对教学更满意。短期和长期评估测量的学习成果（即多项选择题考试、标准化患者就诊、患者记录）大致相当。由于与面对面学习相关的更高持续教学成本抵消了在线开发和交付成本，因此在 1 年结束时，按格式计算的设计、交付和学习者评估成本是相等的。
由于短期和长期的学习者表现结果大致相当，因此基于交付方法，在线学习的成本效益是临床实习的一种经济和教育可行的教学平台。
