Cardiology, University of Cape Town, Cape Town, South Africa
Cardiology, University of Cape Town, Cape Town, South Africa.
BMJ Open. 2019 Nov 18;9(11):e028800. doi: 10.1136/bmjopen-2018-028800.
It remains unclear whether computer-assisted instruction (CAI) is more effective than other teaching methods in acquiring and retaining ECG competence among medical students and residents.
This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Electronic literature searches of PubMed, databases via EBSCOhost, Scopus, Web of Science, Google Scholar and grey literature were conducted on 28 November 2017. We subsequently reviewed the citation indexes for articles identified by the search.
Studies were included if a comparative research design was used to evaluate the efficacy of CAI versus other methods of ECG instruction, as determined by the acquisition and/or retention of ECG competence of medical students and/or residents.
Two reviewers independently extracted data from all eligible studies and assessed the risk of bias. After duplicates were removed, 559 papers were screened. Thirteen studies met the eligibility criteria. Eight studies reported sufficient data to be included in the meta-analysis.
In all studies, CAI was compared with face-to-face ECG instruction. There was a wide range of computer-assisted and face-to-face teaching methods. Overall, the meta-analysis found no significant difference in acquired ECG competence between those who received computer-assisted or face-to-face instruction. However, subanalyses showed that CAI in a blended learning context was better than face-to-face teaching alone, especially if trainees had unlimited access to teaching materials and/or deliberate practice with feedback. There was no conclusive evidence that CAI was better than face-to-face teaching for longer-term retention of ECG competence.
CAI was not better than face-to-face ECG teaching. However, this meta-analysis was constrained by significant heterogeneity amongst studies. Nevertheless, the finding that blended learning is more effective than face-to-face ECG teaching is important in the era of increased implementation of e-learning.
CRD42017067054.
在医学生和住院医师中，计算机辅助教学（CAI）在获得和保留心电图能力方面是否优于其他教学方法，目前仍不清楚。
本系统评价和荟萃分析遵循系统评价和荟萃分析的首选报告项目指南。
于 2017 年 11 月 28 日，对 PubMed、EBSCOhost 数据库、Scopus、Web of Science、Google Scholar 和灰色文献进行了电子文献检索。随后，我们查阅了通过检索确定的文章的引文索引。
如果使用比较研究设计来评估 CAI 与心电图教学的其他方法的效果，以确定医学生和/或住院医师的心电图能力的获得和/或保留情况，则纳入研究。
两名审查员独立从所有合格研究中提取数据并评估偏倚风险。在去除重复项后，筛选出 559 篇论文。13 项研究符合入选标准。有 8 项研究报告了足够的数据纳入荟萃分析。
在所有研究中，CAI 均与面对面心电图教学进行了比较。CAI 和面对面教学方法种类繁多。总体而言，荟萃分析发现接受 CAI 或面对面教学的学生在获得的心电图能力方面没有显著差异。但是，亚分析表明，在混合学习环境中，CAI 优于单独的面对面教学，尤其是如果受训者可以无限制地访问教学材料和/或进行带有反馈的精心练习。没有确凿的证据表明 CAI 比面对面教学更有利于长期保留心电图能力。
CAI 并不优于面对面心电图教学。但是，本荟萃分析受到研究间显著异质性的限制。尽管如此，混合学习比面对面心电图教学更有效的发现，在电子学习日益普及的时代非常重要。
PROSPERO 注册号：CRD42017067054。
