Academic Radiology
Volume 14, Issue 7 , Pages 877-889, July 2007

Linear Versus Web-Style Layout of Computer Tutorials for Medical Student Learning of Radiograph Interpretation

  • Martin V. Pusic, MD, MA

      Affiliations

    • Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
    • M.V.P. is currently at the Division of Pediatric Emergency Medicine, Columbia University, Department of Pediatrics, PH1-137, 622 West 168th Street, New York, NY 10032.
    • Corresponding Author InformationAddress correspondence to M.V.P.
    • ,
  • Vicki R. LeBlanc, PhD

      Affiliations

    • Centre for Research in Education, University of Toronto, Toronto, Canada
    • ,
  • Steven Z. Miller, MD

      Affiliations

    • Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY.

Received 28 March 2007; received in revised form 16 April 2007; accepted 18 April 2007.

Rationale and Objective

We sought to determine which is more effective in increasing skill in radiograph interpretation: a linear (PowerPoint-style) computer tutorial that locks the student into a fixed path through the material or a branched (Web-style) version that allows random access.

Materials and Methods

We prepared a computer tutorial for learning how to interpret cervical spine radiographs. The tutorial has 66 screens including radiographs or graphics on almost every page and five unknown radiographs for the student to interpret. One version (linear) presents the material in a linear sequence with the unknown radiographs heading up “chapters” detailing an important aspect of the task. In the second (branched) version, the same 66 screens were accessed through hyperlinks in a frame beside the unknown radiographs. One hundred thirty-nine medical students at two sites participated in a randomized single-blinded controlled experiment. They interpreted cervical spine images as a pretest and then completed one of the two tutorial versions. Afterward, they did the same examination as a post-test.

Results

The tutorial was successful, in both layouts, in improving the subjects’ ability to interpret cervical spine radiograph images (effect size 2.1; 95% confidence interval 1.7−2.5). However, the layout did not make a difference to their gain in ability. Students in the linear group completed the tutorial in 17% less time (P < .001) but were slightly less likely to rate the tutorial as “valuable.”

Conclusion

For these novice learners, computer tutorial layout does not affect knowledge gain. Students may be more satisfied with the linear layout, but in time-pressured situations, the Web-style layout may be preferable because it is more efficient.

Key Words: Computer Assisted Instruction, Educational Research, Hypermedia, Instructional Design, Learner Controlled Instruction, Radiology, Randomized Controlled Trail, Undergraduate Medical Education

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 This study was funded by a Canadian Institute of Health Research and Association of Canadian Medical Colleges Research in Medical Education grant.

PII: S1076-6332(07)00205-X

doi:10.1016/j.acra.2007.04.013

Academic Radiology
Volume 14, Issue 7 , Pages 877-889, July 2007

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