Technology-assisted education in graduate medical education: a review of the literature

Studies on computer-aided instruction and web-based learning have left many questions unanswered about the most effective use of technology-assisted education in graduate medical education. OBJECTIVE: We conducted a review of the current medical literature to report the techniques, methods, frequency and effectiveness of technology-assisted education in graduate medical education. METHODS: A structured review of MEDLINE articles dealing with "Computer-Assisted Instruction," "Internet or World Wide Web," "Education" and "Medical" limited to articles published between 2002-2007 in the English language was performed. RESULTS: The two literature searches returned 679 articles; 184 met our inclusion and exclusion criteria. In 87 articles, effectiveness was measured primarily using self-reported results from a survey of subjects. Technology-assisted education was superior to traditional methods in 42 of the 64 direct comparison articles (66%, 95% CI 53-77%). Traditional teaching methods were superior to technology-assisted education in only 3/64 (5%, 95% CI 1-13%). The remaining 19 direct comparison articles showed no difference. A detailed review of the 64 comparative studies (technology-assisted education versus traditional teaching methods) also failed to identify a best method or best uses for technology-assisted education. CONCLUSIONS: Technology-assisted education is used in graduate medical education across a variety of content areas and participant types. Knowledge gain was the predominant outcome measured. The majority of studies that directly compared knowledge gains in technology-assisted education to traditional teaching methods found technology-assisted education equal or superior to traditional teaching methods, though no "best methods" or "best use" was found within those studies. Only three articles were specific to Emergency Medicine, suggesting further research in our specialty is warranted.