Text messaging versus email for emergency medicine residents' knowledge retention: a pilot comparison in the United States.
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ABSTRACT:
SUBMITTER: Hoonpongsimanont W
PROVIDER: S-EPMC5121189 | biostudies-literature | 2016
REPOSITORIES: biostudies-literature
Publications
Text messaging versus email for emergency medicine residents' knowledge retention: a pilot comparison in the United States.
Hoonpongsimanont Wirachin W Kulkarni Miriam M Tomas-Domingo Pedro P Anderson Craig C McCormack Denise D Tu Khoa K Chakravarthy Bharath B Lotfipour Shahram S
Journal of educational evaluation for health professions 20161026
We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. ...[more]
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Project description:Background: 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.Objective: Assess if text messaging improves resident knowledge during an inpatient pediatric pulmonary rotation.Methods: 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 t tests compared knowledge and value scores. The difference between pretest and posttest scores (delta) for both arms was calculated, then compared using an unpaired t test. Spearman's rho evaluated maturation bias. Analysis of variance evaluated year of training as a confounding factor.Results: 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 (P = 0.04). However, the delta mean did not show a statistically significant difference (P = 0.6). Text messaging was viewed as "effective" by 80% of participants in the intervention arm.Conclusion: A scripted text messaging intervention is perceived as effective by learners but did not result in measurable increased resident knowledge.
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Project description:PurposePrior descriptions of the psychometric properties of validated knowledge assessment tools designed to determine Emergency medicine (EM) residents understanding of physiologic and clinical concepts related to mechanical ventilation are lacking. In this setting, we have performed this study to describe the psychometric and performance properties of a novel knowledge assessment tool that measures EM residents' knowledge of topics in mechanical ventilation.MethodsResults from a multicenter, prospective, survey study involving 219 EM residents from 8 academic hospitals in northeastern United States were analyzed to quantify reliability, item difficulty, and item discrimination of each of the 9 questions included in the knowledge assessment tool for 3 weeks, beginning in January 2013.ResultsThe response rate for residents completing the knowledge assessment tool was 68.6% (214 out of 312 EM residents). Reliability was assessed by both Cronbach's alpha coefficient (0.6293) and the Spearman-Brown coefficient (0.6437). Item difficulty ranged from 0.39 to 0.96, with a mean item difficulty of 0.75 for all 9 questions. Uncorrected item discrimination values ranged from 0.111 to 0.556. Corrected item-total correlations were determined by removing the question being assessed from analysis, resulting in a range of item discrimination from 0.139 to 0.498.ConclusionReliability, item difficulty and item discrimination were within satisfactory ranges in this study, demonstrating acceptable psychometric properties of this knowledge assessment tool. This assessment indicates that this knowledge assessment tool is sufficiently rigorous for use in future research studies or for assessment of EM residents for evaluative purposes.
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Project description:Physical exam skills of medical trainees are declining, but most residencies do not offer systematic clinical skills teaching or assessment.To assess knowledge of clinical signs and physical exam performance among incoming internal medicine residents.For this study, 45 incoming residents completed a multiple choice question test to assess knowledge of clinical signs. A random selection of 20 underwent a faculty-observed objective structured clinical examination (OSCE) using patients with abnormal physical findings. Mean percentage scores were computed for the multiple choice question test, overall OSCE, and the 5 individual OSCE systems.The mean scores were 58.4% (14.6 of 25; SD 11. 5) for the multiple choice question test and 54.7% (31.7 of 58; SD 11.0) for the overall OSCE. Mean OSCE scores by system were cardiovascular 30.0%, pulmonary 69.2%, abdominal 61.6%, neurologic 67.0%, and musculoskeletal 41.7%. Analysis of variance showed a difference in OSCE system scores (P < .001) with cardiovascular and musculoskeletal scores significantly lower than other systems.Overall, physical exam knowledge and performance of new residents were unsatisfactory. There appears to be a pressing need for additional clinical skills training during medical school and residency training and we are planning a new clinical skills curriculum to address this deficiency.
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