A randomized controlled trial of two different types of web-based instructional methods: one with case-based...

Computer-based learning (CBL) is an effective form of medical education. Educators have developed recommendations for instructional design but there is only minimal research that evaluates these recommendations.

To evaluate the effect of case-based questions contained in computer modules on learning efficacy.

The authors conducted a randomized controlled trial in 124 medical students of two CBL PowerPoint modules-based on Medicare. The modules were identical except one contained 11 case-based scenarios followed by multiple choice questions. The primary outcome measurement was a previously validated, 11-item knowledge test taken at the end of the module and at the end of the academic year to test retention.

The students who studied the module with case-based questions answered one more item correctly in the first test (8.9 vs. 10.00 correct answers, p = 0.001). This difference had disappeared by the time of the second test (4.2 vs. 4.7, p = 0.095).

This study shows that computer modules with case-based questions enhance learning in the short-term but at the expense of increased time and so decreased learning efficiency. This learning benefit was not maintained.