Artinian Hovig K, Keens Thomas G, Kato Roberta, Chang Todd P
Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California; and.
Helen DeVos Children's Hospital, Michigan State University College of Human Medicine, Grand Rapids, Michigan.
ATS Sch. 2020 Jul 24;1(3):278-287. doi: 10.34197/ats-scholar.2020-0025OC.
Spaced education and the testing effect are both educational methods that increase long-term memory formation; however, these can be difficult to implement during residency training given time constraints. Text messaging is ubiquitous but has not been studied as a spaced education tool. Assess if text messaging improves resident knowledge during an inpatient pediatric pulmonary rotation. A prospective randomized control study with pediatric residents on a pulmonary inpatient rotation was conducted at an urban free-standing children's hospital between 2016 and 2017. The intervention arm received one daily multiple-choice text message scenario and a scripted teaching text for each response. Both arms received standard pulmonary education. Knowledge was assessed using a 23-item pretest and posttest with unique, nonrepeated items with fair reliability, following iterative revisions. Perceived value of texting was assessed using Likert scales. Paired and unpaired tests compared knowledge and value scores. The difference between pretest and posttest scores (delta) for both arms was calculated, then compared using an unpaired test. Spearman's rho evaluated maturation bias. Analysis of variance evaluated year of training as a confounding factor. A total of 65 residents were randomized, with a response rate of 81%. Posttest mean scores were lower than pretest in both arms, attributed to more difficult questions randomized to the posttest. The intervention arm scored higher on the posttest ( = 0.04). However, the delta mean did not show a statistically significant difference ( = 0.6). Text messaging was viewed as "effective" by 80% of participants in the intervention arm. A scripted text messaging intervention is perceived as effective by learners but did not result in measurable increased resident knowledge.
间隔教育和测试效应都是能增强长期记忆形成的教育方法；然而，鉴于时间限制，在住院医师培训期间实施这些方法可能会很困难。短信无处不在，但尚未作为一种间隔教育工具进行研究。评估短信在儿科住院肺部轮转期间是否能提高住院医师的知识水平。2016年至2017年期间，在一家城市独立儿童医院对参加肺部住院轮转的儿科住院医师进行了一项前瞻性随机对照研究。干预组每天收到一条多项选择题短信情景以及针对每个答案的书面教学文本。两组都接受标准的肺部教育。使用一份有23个项目的预测试和后测试来评估知识，这些项目独特、不重复，经过反复修订后具有合理的信度。使用李克特量表评估短信的感知价值。配对和非配对检验比较知识和价值分数。计算两组的预测试和后测试分数之差（差值），然后使用非配对检验进行比较。斯皮尔曼等级相关系数评估成熟偏差。方差分析评估培训年份作为一个混杂因素。共有65名住院医师被随机分组，回复率为81%。两组的后测试平均分数均低于预测试，这归因于后测试随机分配了更难的问题。干预组在后测试中的得分更高（P = 0.04）。然而，平均差值并未显示出统计学上的显著差异（P = 0.6）。干预组80%的参与者认为短信“有效”。一种书面短信干预被学习者认为是有效的，但并未导致住院医师知识有可测量的增加。
