A Controlled Trial of an Interactive, Web‐based Virtual Reality Program for Teaching Physical Diagnosis Skills to Medical Students

Multimedia instruction offers many potential advantages over traditional methods of instruction. Multimedia programs can interact with the learner, use graphic images, sound, and video, and keep track of progress. Students complete programs at their own pace while accessing material both at school and at home. Multimedia instruction can provide an interactive alternative to lectures and textbooks by quizzing the student over concepts as they are presented and requiring that the student think about the material before proceeding. While several studies have found that multimedia instruction can be more efficient by reducing instructor and classroom time, few have been able to show an increase in learning when compared with traditional methods of instruction. Santer and colleagues compared a multimedia textbook with a lecture presentation on the same material and found an increase in the post-test scores of the multimedia group, but no difference when they compared the multimedia group with a group using a printed textbook. Studies comparing multimedia and traditional approaches to learning in the areas of psychology and computer science instruction suggest an improvement in students’ performances using the multimedia versions. Thus, there is a need for well-designed studies to determine whether multimedia instruction more effectively facilitates students’ learning—including medical students’ learning—than do traditional methods. Multimedia instruction is particularly well suited to help students learn physical diagnosis. Sound, pictures, and movies augment the learning of examination skills and diagnosis findings by allowing students to hear heart and lung sounds, watch videos of physical examination procedures, and see more pictures of pathologic findings than can be included in a textbook or lecture. These visual and audio aids should increase students’ recognition of these findings when encountered in patients. We wished to test whether a Web-based multimedia program using interactive learning and virtual reality would be more efficient and effective than traditional print-based self-study by medical students. To accomplish this, we designed a course on physical examination of the eye and ear. Using this material, we conducted a controlled study of first-year medical students to determine whether having students use a multimedia version of the course resulted in a change in the time spent with the material and an increase in knowledge gained when compared with having students study a printed version of the same material.