Successful teaching of pediatric fluid management using computer methods

Objectives: To identify and measure differences in knowledge of pediatric fluid management procedures between students taught by computer tutorial and others taught by lecture or seminar. Design: Cohort analytic study. Setting: Two community-based medical school pediatric teaching services. Participants: Eighty-nine third-year medical students with no prior pediatric fluid management experience. Interventions: Forty-eight students at one community campus completed a microcomputer-based tutorial program that replaced all teaching sessions in pediatric fluid management. Forty-one students from a similar community campus were taught identical content by a pediatric critical care specialist using a seminar, reading material, and handouts. Main Outcome Measures: Scores on 2 free-answer problems on treatment of a dehydrated child, which were graded by a single evaluator blinded to the teaching method used, and scores on a 20-item multiple-choice examination. Results: The computer instruction group achieved significantly higher test scores than the seminar group for both the multiple-choice examination (81.1% vs 62.2%; P<.001) and the free-answer test (85.4% vs 61.0%; P<.001). Conclusions: The computer tutorial in fluid therapy has been an effective means of meeting the defined objectives of the pediatric clerkship. Compared with traditional methods, students taught using the computer achieved significantly higher scores on tests of both factual knowledge and practical problem solving.