JMIR Publications

ABSTRACT

Background:

Applying functional anatomy to clinical examination techniques in shoulder examination is challenging for physicians in all learning stages. Anatomy teaching has shifted towards a more function-oriented approach and welcomed e-learning to a greater extent. There is limited evidence on whether the integrated teaching of professionalism, clinical examination technique and functional anatomy via e-learning is effective.

Objective:

This randomized controlled trial aims to investigate the impact of an integrated blended learning course on the ability of first-year medical students to perform a shoulder examination on healthy volunteers.

Methods:

Based on Kolb’s experiential learning theory, we designed a course on shoulder anatomy and clinical examination techniques that integrates preclinical and clinical content across all four stages of Kolb’s learning cycle. The study is a randomized, observer-blinded controlled trial involving first-year medical students who are assigned to one of two groups. Both groups participated in blended learning courses; however, the intervention group’s course combined clinical examination, anatomy, and professional behavior, and included a peer-assisted practice session as well as a flipped classroom seminar. The control group's course combined an online lecture with self-study and self-examination. After completing the course, participants uploaded a video of their shoulder examination. The videos were scored by two blinded raters using a standardized examination checklist with a total score of 40.

Results:

Thirty-eight medical students could be included from the 80 participants needed based on the power calculation. Seventeen intervention and 14 control students completed the three-week study. The intervention group students performed better than the control group students (difference of 5.3 points, p <.001, two-sided Mann-Whitney U test).

Conclusions:

The study shows that anatomy, professional behavior and clinical examination skills can also be taught in an integrated blended learning approach. For first-year medical students, the approach has proven effective compared to online lectures and self-study. Clinical Trial: The study was registered with the identifier ISRCTN13061552.