Dr. Cook is professor of medicine and medical education, Department of Medicine, College of Medicine, Mayo Clinic, and director, Office of Education Research, Mayo Medical School, Rochester, Minnesota. Dr. Thompson is associate professor of medicine, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota. Dr. Thomas is associate professor of medicine, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota.
Acad Med. 2014 Jan;89(1):169-75. doi: 10.1097/ACM.0000000000000084.
Questions enhance learning in Web-based courses, but preliminary evidence suggests that too many questions may interfere with learning. The authors sought to determine how varying the number of self-assessment questions affects knowledge outcomes in a Web-based course.
The authors conducted a randomized crossover trial in one internal medicine and one family medicine residency program between January 2009 and July 2010. Eight Web-based modules on ambulatory medicine topics were developed, with varying numbers of self-assessment questions (0, 1, 5, 10, or 15). Participants completed modules in four different formats each year, with sequence randomly assigned. Participants completed a pretest for half their modules. Outcomes included knowledge, completion time, and module ratings.
One hundred eighty residents provided data. The mean (standard error) percent correct knowledge score was 53.2 (0.8) for pretests and 73.7 (0.5) for posttests. In repeated-measures analysis pooling all data, mean posttest knowledge scores were highest for the 10- and 15-question formats (75.7 [1.1] and 74.4 [1.0], respectively) and lower for 0-, 1-, and 5-question formats (73.1 [1.3], 72.9 [1.0], and 72.8 [1.5], respectively); P = .04 for differences across all modules. Modules with more questions generally took longer to complete and were rated higher, although differences were small. Residents most often identified 10 questions as ideal. Posttest knowledge scores were higher for modules that included a pretest (75.4 [0.9] versus 72.2 [0.9]; P = .0002).
Increasing the number of self-assessment questions improves learning until a plateau beyond which additional questions do not add value.
问题能够促进网络课程的学习，但初步证据表明过多的问题可能会干扰学习。作者试图确定在网络课程中改变自我评估问题的数量如何影响知识成果。
作者于 2009 年 1 月至 2010 年 7 月在一个内科和一个家庭医学住院医师培训项目中进行了一项随机交叉试验。开发了 8 个关于门诊医学主题的基于网络的模块，自我评估问题的数量不同（0、1、5、10 或 15）。参与者每年以四种不同的格式完成模块，顺序随机分配。参与者在一半模块中完成预测试。结果包括知识、完成时间和模块评分。
180 名居民提供了数据。预测试的平均（标准误差）正确知识分数为 53.2（0.8），后测试的平均（标准误差）正确知识分数为 73.7（0.5）。在汇总所有数据的重复测量分析中，10 题和 15 题格式的平均后测知识分数最高（分别为 75.7 [1.1]和 74.4 [1.0]），0 题、1 题和 5 题格式的平均后测知识分数较低（分别为 73.1 [1.3]、72.9 [1.0]和 72.8 [1.5]）；所有模块之间的差异具有统计学意义（P =.04）。问题较多的模块通常需要更长的时间完成，评分也更高，尽管差异很小。居民最常将 10 个问题确定为理想的数量。包含预测试的模块的后测知识分数更高（75.4 [0.9] 与 72.2 [0.9]；P =.0002）。
增加自我评估问题的数量可以提高学习效果，直到达到一个额外的问题不再增加价值的平台。
