Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis

Objectives 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.Design This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic...

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Main Authors: Mary Shelton, Mark E Engel, Charle André Viljoen, Rob Scott Millar, Vanessa Burch
Format: Article
Language:English
Published: BMJ Publishing Group 2019-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/11/e028800.full
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author Mary Shelton
Mark E Engel
Charle André Viljoen
Rob Scott Millar
Vanessa Burch
author_facet Mary Shelton
Mark E Engel
Charle André Viljoen
Rob Scott Millar
Vanessa Burch
author_sort Mary Shelton
collection DOAJ
description Objectives 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.Design This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources 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.Eligibility criteria 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.Data extraction and synthesis 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.Results 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.Conclusion 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.PROSPERO registration number CRD42017067054.
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spelling doaj-art-8ef53a7d0687433ead87a28b36b70f912025-08-20T02:06:43ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2018-028800Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysisMary Shelton0Mark E Engel1Charle André Viljoen2Rob Scott Millar3Vanessa Burch43 Health Sciences Library, University of Cape Town, Cape Town, South AfricaDepartment of Medicine, Cape Heart Institute, University of Cape Town Faculty of Health Sciences, Observatory, South AfricaCape Heart Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa1 Cardiology, University of Cape Town, Cape Town, South Africa2 Medicine, Unversity of Cape Town, Cape Town, South AfricaObjectives 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.Design This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources 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.Eligibility criteria 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.Data extraction and synthesis 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.Results 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.Conclusion 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.PROSPERO registration number CRD42017067054.https://bmjopen.bmj.com/content/9/11/e028800.full
spellingShingle Mary Shelton
Mark E Engel
Charle André Viljoen
Rob Scott Millar
Vanessa Burch
Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis
BMJ Open
title Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis
title_full Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis
title_fullStr Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis
title_full_unstemmed Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis
title_short Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis
title_sort is computer assisted instruction more effective than other educational methods in achieving ecg competence amongst medical students and residents a systematic review and meta analysis
url https://bmjopen.bmj.com/content/9/11/e028800.full
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