The incremental value of Internet-based instruction as an adjunct to classroom instruction: A prospective randomized study

Purpose. Computer-based methods of instruction offer the possibility of hel ping medical students to learn clinical skills and professionalism. Without rigorous documentation of its pedagogic advantages, the utility of Interne t-based teaching is not solidly grounded. The authors carried out a prospec tive, randomized study of educational outcomes, comparing a traditional cla ssroom course in clinical ethics with the same course supplemented by Inter net-based discussion. Methods. Introduction to Clinical Ethics is a sophomore medical school cour se that teaches a specific method for analyzing clinical ethical problems. One sophomore class was randomly assigned to either classroom teaching alon e (traditional group; n = 65) or classroom teaching supplemented with Inter net-based discussions of cases illustrating ethical issues (Internet compon ent group; n = 62). A final case analysis comprehensively evaluated student s' understanding of the analytic method taught in the course. Grades for bo th groups on the final case analyses, which were rated by two external revi ewers, were compared. Results. The students' understanding of ethical analysis, as measured by gr ades of external reviewers on the final paper, was significantly higher for those in the course with the Internet component than it was for those in t he traditional course (3.0 +/- 0.6 and 2.6 +/- 0.7, respectively; P < .005) . Conclusion. The study documents the incremental value of Internet-based tea ching of clinical ethics to sophomore medical students.