Saha R, Pal B, Harinarayan R, Aranan A, Swe K M M, Kumarasamy P, Kaur G, Wijegunathileke P A L S
Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, NE1 7RU, United Kingdom.
Newcastle University Medicine Malaysia (NUMed), 1, Jalan Sarjana 1, Kota Ilmu, Educity@Iskandar, 79200 Iskandar Puteri, Johor, Malaysia.
Med J Malaysia. 2025 Jul;80(4):473-480.
Electrocardiography (ECG) interpretation is a vital yet challenging competency for preclinical medical students due to limited clinical exposure. While high-fidelity simulation teaching (HFST) offers immersive, experiential learning, video-assisted teaching (VAT) provides scalable, consistent instruction. Despite growing interest in both methods, comparative evidence remains limited. This study aimed to evaluate the effectiveness of HFST versus VAT in enhancing ECG knowledge and retention among preclinical students using a Multiple-Choice Question (MCQ) assessment for knowledge cognition.
It was a randomised controlled trial study where 136 first year undergraduate medical students were randomised into control (VAT) and intervention (HFST) groups. The intervention group received a 20-minute simulation session using SimMan, demonstrating ECG lead placement, interpretation, and basic management, followed by a 20-minute interactive discussion whereas the control group underwent a VAT session mirroring the HFST content with a 20-minute pre-recorded video followed by a 20-minute faculty-led discussion. MCQs were used to assess the acquisition and retention of knowledge, both as a pre-test (week 1) and a post-test (week 12). The outcomes were measured using the mean and standard deviation of the total scores of MCQ. Intragroup analyses were conducted using a dependent sample t-test, whereas intergroup analyses were performed using an independent samples t-test. ANCOVA was used to assess the difference in post-test MCQ scores among the groups after adjusting the Pre-test scores. The Pvalue was set at 0.05. "Institutional research trial registration number": RMC_NUIR_2024_21 RESULTS: Both groups demonstrated significant enhancement in knowledge gain and retention from the pretest to the post-test. The VAT group showed a greater mean score improvement compared to the HFST group. While the VAT group outperformed the HFST group in the post-test, this difference was not statistically significant. Adjusting for pre-test scores using ANCOVA further confirmed the nonsignificance of post-test score differences between the two groups. Two-way mixed ANOVA revealed no significant interaction between group and time point, indicating comparable patterns of knowledge gain across both teaching methods.
Both HFST and VAT significantly increased knowledge and retention among preclinical medical students. The VAT group showed a slightly higher knowledge gain than the HFST group, although the difference was statistically insignificant. The study demonstrated that both VAT and HFST were effective in midterm knowledge acquisition and may offer a viable alternative for inclusion in undergraduate preclinical curricula.
由于临床接触有限，心电图（ECG）解读对于临床前医学生来说是一项至关重要但具有挑战性的技能。虽然高保真模拟教学（HFST）提供沉浸式的体验式学习，但视频辅助教学（VAT）则提供可扩展的、一致的指导。尽管对这两种方法的兴趣都在增加，但比较证据仍然有限。本研究旨在通过多项选择题（MCQ）评估知识认知，评估HFST与VAT在提高临床前学生心电图知识及知识保留方面的有效性。
这是一项随机对照试验研究，136名本科一年级医学生被随机分为对照组（VAT）和干预组（HFST）。干预组使用SimMan进行了20分钟的模拟课程，展示了心电图导联的放置、解读和基本管理，随后进行了20分钟的互动讨论；而对照组则进行了一次VAT课程，内容与HFST相同，先是一段20分钟的预录制视频，然后是由教师主导的20分钟讨论。MCQ被用于评估知识的获取和保留情况，在第1周进行了前测，在第12周进行了后测。结果通过MCQ总分的均值和标准差来衡量。组内分析使用相关样本t检验，而组间分析使用独立样本t检验。协方差分析用于在调整前测分数后评估各组后测MCQ分数的差异。P值设定为0.05。“机构研究试验注册号”：RMC_NUIR_2024_21结果：从预测试到后测试，两组在知识获取和保留方面均有显著提高。VAT组的平均分数提高幅度比HFST组更大。虽然VAT组在后测试中的表现优于HFST组，但这种差异没有统计学意义。使用协方差分析调整前测分数后，进一步证实了两组后测分数差异不显著。双向混合方差分析显示组和时间点之间没有显著交互作用，表明两种教学方法的知识获取模式相当。
HFST和VAT均显著提高了临床前医学生的知识和知识保留率。VAT组的知识增益略高于HFST组，尽管差异无统计学意义。该研究表明，VAT和HFST在中期知识获取方面都是有效的，并且可能为纳入本科临床前课程提供可行的替代方案。
