Teaching doctors how to diagnose paroxysmal events: a comparison of two educational methods Michelle Farrar, 1 Anne M Connolly, 2 John Lawson, 1,2 Annette Burgess, 2 Amy Lonergan 1 & Ann M E Bye 1,2 OBJECTIVES Two educational methods, facilitated case discussion and a computerised tutorial, were compared for teaching about childhood epilepsy. We used a comprehensive and clinically relevant assess- ment method to evaluate the hypothesis that a computerised tutorial more effectively increases knowledge acquisition than a facilitated case discussion. METHODS Paediatric trainees (n = 66) were arbitrarily allocated to facilitated case discussion or computerised tutorial. The analysis of paroxysmal events was taught by the same teacher, using a stan- dardised protocol and principles of active learning. Outcome measures included knowledge acquisition, clinical confidence and usefulness pre- and post- teaching, and at 3 months follow-up. RESULTS Computerised tutorial participants scored significantly higher on knowledge acquisition post- teaching. There was gain in clinical confidence in both modalities post-teaching which did not differ between the groups. Confidence and knowledge were not related post-teaching. Both groups found the teaching relevant to clinical practice. However, facil- itated case discussion participants rated the session as more enjoyable, and more useful in reinforcing and acquiring knowledge, and felt more motivated for further learning. At 3 months follow-up, participants in both modalities showed significant increases in knowledge acquisition, with no difference between modalities. CONCLUSIONS The computerised tutorial more effectively imparted knowledge immediately post- teaching. However, facilitated case discussion is the preferred modality in terms of participant enjoyment and perceived usefulness. KEYWORDS teaching / *methods; paediatrics / *education; *educa- tion, medical; clinical competence / *standards; *acute disease; emergency medicine / *education. Medical Education 2008: 42: 909–914 doi:10.1111/j.1365-2923.2008.03146.x INTRODUCTION The training of undergraduate medical students and paediatric hospital residents is a critical issue that has received substantial attention in the medical educa- tion literature. 1–3 Greater demands on university resources and the practice of restricting the hospi- talisation of paediatric patients both limit the expo- sure of trainees to common problems. There is a need to explore how other educational modalities compare with traditional face-to-face medical teaching, in efficacy and in the learning experience achieved, in order to address these challenges. Computerised technology is increasingly used in medical education 4 and theoretically provides possible solutions. Scientific studies with rigorous research design are few. 3,5 Previous research comparing modalities has shown that learning experiences differ. It has been argued that computerised tutorials promote active learning, whereas face-to-face lectures are often deemed to promote passive learning. 6 Unfortunately, this study did not assess knowledge acquisition. Others have shown that each approach increases immediate knowledge effectively. 7–9 Knowledge acquisition in this literature 7–9 is typically assessed through the use of multiple-choice questions (MCQs). However, the use of this form of assessment as a means of clinical teaching 1 Department of Paediatric Neurology, Sydney Children’s Hospital, Sydney, New South Wales, Australia 2 School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia Correspondence: Dr Michelle Farrar, Department of Paediatric Neurology, Sydney Children’s Hospital, Level 4 Emergency Wing, High Street, Randwick, New South Wales 2031, Australia. Tel: 00 61 2 9382 1547; Fax: 00 61 2 9382 1580; E-mail: michelle.farrar@sesiahs.health.nsw.gov.au ª Blackwell Publishing Ltd 2008. MEDICAL EDUCATION 2008; 42: 909–914 909