Identifying the most effective instructional resources to support the preparatory phase of active learning
Authors: Vale Catarina , Perez Ligia , Fortun Jenny , Niño Diego 
Published: May 2023

PURPOSE: As medical education continues to transition from lecture-based to active learning strategies (e.g., flipped classrooms–FC), maximizing academic performance and learner engagement remain a priority. Different strategies exist to support the preparatory phase, but it remains to be established which is the most effective. We hypothesized that using an interactive multimedia online learning module (OLM) will enhance content retention and academic performance compared to text reading (TXT) or pre-recorded lecture (PRL). METHODS: We first sought to identify students’ perceptions of and preferences for FC preparatory resources and interest in self-directed learning using a survey (Likert scale: 1 = strongly disagree to 5 = strongly agree) of second- and third-year medical students. Then, three FC sessions focused on cardiovascular physiology were developed for the first-year medical physiology course guided by survey results. For each session, a different type of preparatory resource (i.e., TXT, PRL, & OLM) was provided to all learners. Initial learning of material was assessed using a pre- and post-test for each resource. A readiness quiz and performance on related questions on customized NBME course examinations were used to determine short- and long-term content retention, respectively. RESULTS: Analysis of survey data (n=37) demonstrated a significant effect of type of resource (TXT, PRL, YouTube video – YTV, instructor-made video – IMV, and OLM) on self-reported completion of proposed preparatory material (p<0.01). Post hoc pairwise multiple comparisons test indicated that TXT (mean rank = 2.09) was significantly lower than YTV (mean rank = 3.73, p≤0.001) and IMV (mean rank = 3.26, p=0.016). Analysis of first-year physiology course academic performance found a significant difference in readiness quiz scores between preparatory resources (F(2, 246) = 3.034, p =0.05, n=125). Readiness quiz scores for TXT (-0.132(95% CI, .01 to .253)) were 1.14 points lower than for OLM (Bonferroni) on 10 point-scale quiz. A significant difference in initial learning of the material using TXT (p<0.01) and OLM (p<0.01) was shown by the performance in pre- and post-tests, but no difference when using a PRL (p=0.102; paired t-test). Preliminary data analysis of academic performance on related NBME midterm and final exam questions shows an average performance of 91% on questions related to TXT FC, 73% on questions related to PRL FC, and 90.2% on questions related to OLM FC. CONCLUSIONS: Our study suggests that medical students prefer audiovisual resources over text. Our preliminary results suggest that OLM may be a more effective tool to prepare for FC compared to TXT as demonstrated by results in readiness quizzes. Data analysis of NBME midterm and final is limited due to the sample size and characteristics of the data. The results of this study will help to inform instructors when developing asynchronous preparatory resources to support active learning. There are no financial disclosures to report. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.