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Cheap & Effective Way to Improve Learning:or
Multimedia (MM) Principles Applied to PPT
Cheap & Effective Way to Improve Learning:or
Multimedia (MM) Principles Applied to PPT
Nabil Issa MD, Mary Schuller MSEd, Ed Wang PhD.,
Michael Shapiro MD, Susan Santacaterina MHPE,
Debra A. DaRosa PhD.1
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An Important Title
• This is important• This is also important• This is very important• This is very very important• This is extremely important• I swear this is the most important• I will die if you do not remember this one• You will die if you do not remember this one
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DEATH BY POWER POINT
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Multimedia = Words + PicturesMultimedia = Words + Pictures
The cognitive theory of multimedia learning
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*
*Mayer, ‘02
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Principle Definition EffectSize
Studies
Spatial Contiguity
Place words next to corresponding graphics
1.30 8/8
Multi-Media Use Words & Pictures 1.90 3/3Modality Present words as narration
instead of printed text1.30 8/8
Signaling Highlight essential material 0.52 6/6Coherence Exclude unneeded words &
sounds0.97 13/14
Five Evidence-Based & Theoretically Grounded MM Principles
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Does instruction using MM principles result in:
enhanced retention
enhanced transfer of learning
of third year medical students?
Study Protocol• Pre-test /post-test control group design• Lecture topic = Shock.• Traditional lecture- already in place• Modified lecture- selected MM principles • 10 questions= 5 (retention) + 5 (transfer)• Content validity of questions – expert review• Reliability of scores – percent agreement
among raters
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180 M3 students
Q2-3 (Modified) n=91
Q1: pilot n = 50
Q4 (Traditional) n=39
130 students included
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Example of change:Signaling Principle
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[IV] Obstructive Shock
Tension Pneumothorax: results in hyperinflation of the hemithoraxresulting in kinking of IVS and decreased prelaod
Pulmonary Embolism: results in obstruction of the R ventricular outflow and decrease in L ventricular stroke volume resulting in cardiac failure
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[IV] Obstructive Shock
Tension Pneumothorax
Pulmonary Embolism
Cardiac Tamponade
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Swan-Ganz (PAC) insertion is like ‘Surfing through Blood Stream’
Coherence Principle
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Changes in wave tracings
Multimedia Principle
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Oxygen Delivery vs. Consumption
You can increase your delivery but you can not control your consumption as it is a function of tissue physiology
You have to meet your tissue’s requirements or else you will accelerate lactic acid production and tissue ischemia
Critical DO2 is that point were DO2 meets VO2 and tissues are utilizing aerobic metabolism
Up till that point there is an inverse relation between DO2 and VO2 a state we call flow dependent
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Relationship between DO2 and VO2
Critical DO2
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Pre n=39M(SD)
Post*n=39M(SD)
Pren=91M(SD)
Post*n=89M(SD)
Retention 2.3 (.61) 3.3 (.64) 2.1 (.91) 3.9 (.70)
Transfer 2.3 (.88) 2.9 (.99) 2.3 (1.1) 3.2 (1.1)
Total Score 4.6 (1.3) 6.2 (1.2) 4.3 (1.7) 7.0 (1.3)
*P<.0001
TRADITIONAL MODIFIED
Inter-rater Percent Agreement
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Generalized Linear Models
Retention score Transfer score Total score
b p value b p value b p value
Group (Modification) 0.45 0.0022 0.29 0.1504 0.75 0.0064
Pre/Post Improvement 1.08 <.0001* 0.59 0.0124 1.67 <.0001*
Group*Time 0.66 0.0016 0.30 0.278 1.02 0.0081
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Results- Total Score
Results- Retention Score
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Results- Transfer Score
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Limitations of the Study
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SHOCK
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Future Directions
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The use of selected MM principles enhances:
retention of information transfer of learning
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