:async: Investigating Students’ Learning Achievement after Blended Learning in ECG Reading

Authors: Liongrung Liu, Hung-Wen Chiu Chiu, Kung-Pei Tang
Institutions: Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan, Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University
Country: Taiwan

Topic: Applications of Open Education Practices/Open Pedagogy/Open Education Research
Sector: Higher Education
UNESCO Area of Focus: Sustainable OER
Session Format: Poster

Abstract

The electrocardiogram (ECG) is an indispensable diagnostic procedure in clinical practice. It is challenging to provide sufficient training to all medical students. The ECG learning is typically achieved through lectures. However, ECG interpretation relies on practice and clinical exposure. We adopted the Peer-assisted Learning (PAL) and Game-based Learning (GBL) and gave a one-day workshop to train our ER clerks for ECG interpretation.This study aimed at investigating students’ learning performance during this workshop. Two days before the workshop, each participant was asked to prepare a topic, such as acute coronary syndrome, so that they could benefit from the PAL in the workshop. After PAL, participants played a card game so that they could train on ECG interpretation. A pre- and post-test study was conducted to investigate students’ leaning performance. The results of the paired sample T-test indicated that there was a significant increase in students’ test scores of ECG reading in the end of the GBL (M=6.47, SD =1.59), compared with the beginning of the course (M=5.33, SD=1.67), t(29) =4.131, p < .001. Although the paired T-test indicated significant improvement in participants’ learning performance, after the card game, the post-test score for one learning task in the object 10 declined after GBL.

Keywords

medical education, electrocardiogram (ECG) interpretation, Game-based Learning(GBL), Peer-assisted Learning(PAL), Blended Learning

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Fig.1 The results of the paired sample T-test after GBL (M=6.47, SD =1.59)
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Fig.2 The results of the paired sample T-test after PAL (M=5.33, SD=1.67)
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Fig.3 The paired T-test results of PAL and GBL indicated that there was a significant increase in students’ test scores.


Fig.1 Peer learning about ECG interpretation.

Fig.2 Game-based Learning by play card game.

Background
The electrocardiogram (ECG) is an indispensable diagnostic procedure in clinical practice. The period of clinical internship in the Emergency or Cardiology Department varies between 2 to 4 weeks. This short timeframe makes it challenging to provide sufficient training to all medical students. [3] The ECG learning is usually achieved through lectures. However, ECG interpretation relies on practice and clinical exposure. [4]We adopted the Peer-assisted Learning (PAL) and Game-based Learning (GBL) and conducted a one-day workshop to train our ER clerks for ECG interpretation. This study aimed at investigating students’ learning performance, during this workshop.
Methods
A total of 30 Year-six medical students participated this workshop. Two days before the workshop, each participant was asked to prepare a topic, such as acute coronary syndrome, so that they could benefit from the PAL in the workshop (Fig.1). After PAL, participants played a card game to train on ECG interpretation (Fig.2). A pre- and post-test study was conducted to investigate students’ leaning performance. Ten multiple choice questions were developed to measure students’ ECG learning achievements. Students took the test after the two learning assignments were completed. The tests aimed at inquiring students’ understanding of ECG reading after each assignment. An accuracy calculation for each learning task and a paired sample t-test were conducted to compare students’ pre- and post-test performance.
Results
The results of the paired sample T-test indicated that there was a significant increase in students’ test scores of ECG reading in the end of the GBL (M=6.47, SD =1.59) (Fig.1), compared with the beginning of the course (M=5.33, SD=1.67) (Fig.2), t(29) =4.131, p < .001. However, we noted that in object 10, students’ performance slightly declined, after the GBL. (PAL: GBL=0.67:0.63) (Fig.3)
Discussion and Conclusions
Although the paired T-test indicated significant improvement in participants’ performance, after the card game. We still have some notable findings. In Object 1, we noted that students’ accuracy rate is low in PAL and GBL. We thought that the reason may be the ECG rhythm, which be might too hard for them, or that ECG is not typical for students.
The post-test score for one learning task—in terms of early repolarization—(object 10) declined after GBL because the mimic ECG rhythm for ST-segment elevation myocardial infarction (STEMI) can easily confuse medical students. We deliberately excluded mentioning this in the GBL and PAL course. We designed object 10 to identify whether students could notice the minor difference in the ECG wave. Over half of participants confused the image for early repolarization with acute anterior STEMI. The difference between the signs will be addressed in the next workshop.
Take-home Messages (Conclusion)
Thus, blended learning in combination with a card game is extremely beneficial for training medical students to read ECG accurately, [5] but a study for a students’ long term ECG learning retention.