A comparison of computer aided learning and traditional didactic lectures for teaching clinical decision making skills to optometry undergraduates

Abstract

This study was designed to compare computer aided learning (CAL), in the form of a Virtual Patient (VP), and traditional didactic lectures as methods of teaching clinical decision making (CDM) skills to second year Optometry undergraduates. Comparisons were based on performance in multiple-choice examinations testing CDM skills (actual mastery), student feedback relating to confidence in CDM skills (perceived mastery or self-efficacy) and student satisfaction. The influence of sex, learning style and academic ability was also investigated. This is the first time that these aspects of teaching pedagogy have been studied together. Current literature informed development of didactic lectures and an online VP. Both teaching methods were designed to ensure that the same clinical content was included. This content was aimed at training students to perform problem-orientated eye examinations. A cohort of 102 students was taught using the traditional didactic lectures in academic year 2010-11 and 93 students using the online VP in academic year 2011-12. An established Index of Learning Styles instrument was used to classify students according to their preference in four learning style dimensions. Both teaching methods were designed to cater for both poles of each learning style dimension. Most students had no strong learning preferences but those that did had a tendency towards the active-sensing-visual-sequential profile. Actual and perceived mastery were scored for five key learning objectives; question selection, critical symptom recognition, test selection, critical sign recognition and referral urgency selection. The influence of academic ability and teaching method differed for each learning objective; didactic lectures favouring some, the VP others. Learning style and sex had no influence, indicating that both teaching methods catered equally for males and females with all learning styles. Comparisons between perceived and actual mastery revealed poor self-assessment accuracy. Student satisfaction, rated on a five point Likert scale, was equally high for both teaching methods. Sex was the only influential variable, with males favouring one aspect of VP training. Overall, the findings suggest that CAL should be used to supplement traditional teaching rather than replace it in order to ensure that all students benefit equally. Future research may wish to focus on self-assessment accuracy as a means of improving academic performance.