JMIR Publications

ABSTRACT

Background:

Digital learning environments have become very common in the training of medical professionals. Students use such platforms for exam preparation. Multiple choice questions (MCQs) are a common format in medical exams and are used by students to prepare for their medical exams.

Objective:

We analyzed data from users of an online platform that provides learning materials for medical students in preparation for their final exam. We analyzed whether the number of learning cards viewed (H1) and the number of MCQs taken (H2) were positively related to learning outcomes. We also examined whether viewing learning cards or answering MCQs was more effective. Finally, we tested whether taking individual notes predicted learning outcomes (H3a), and whether taking notes had an effect after controlling for the effects of learning cards and MCQs (H3b).

Methods:

Our analyses from the online platform Amboss are based on user activity data which supplied the number of learning cards studied and test questions answered. We also included the number of notes from each of those 23,633 users who had studied at least 200 learning cards and had answered at least 1,000 test exam questions in the 180 days before their state exam. The activity data for this analysis was collected retrospectively, using Amboss archival usage data for the timeframe between April 2014 to April 2017. Learning outcomes were measured using the final state exam scores that were calculated through the answers voluntarily entered by the participants.

Results:

We found correlations between the number of cards studied (r=.22, P<.001) and the number of test questions that had been answered (r=.23, P <.001) and the percentage of correct answers in the learners’ medical exam. The number of test questions answered still yielded a significant effect even after controlling for the number of learning cards studied in a hierarchical regression analysis (β=.14, P <.001, ΔR2=.017, P <.001). We found a negative interaction between the numbers of learning cards and MCQs, indicating that users with high scores for learning cards and MCQs had the highest exam scores. Those 8,040 participants who had taken at least one note had a higher percentage of correct answers (80.94%; SD=7.44) than those who had not taken any notes (78.73%; SD=7.80; T(23631)=20.95, P <.001). In a stepwise regression, the number of notes the participants had taken predicted the percentage of correct answers over and above the effect of the number of learning cards studied and of the number of test questions entered in step one (β=.06, P <.001 ΔR2=.004, P <.001).

Conclusions:

These results show that online learning platforms are particularly helpful whenever learners engage in active elaboration in learning material, for example, by means of answering MCQs or taking notes.