Cheap & Effective Way to Improve Learning: or Multimedia (MM) Principles Applied to PPT Nabil Issa MD, Mary Schuller MSEd, Ed Wang PhD., Michael Shapiro.

Cheap & Effective Way to Improve Learning:or

Multimedia (MM) Principles Applied to PPT

Cheap & Effective Way to Improve Learning:or

Multimedia (MM) Principles Applied to PPT

Nabil Issa MD, Mary Schuller MSEd, Ed Wang PhD.,

Michael Shapiro MD, Susan Santacaterina MHPE,

Debra A. DaRosa PhD.1

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An Important Title

• This is important• This is also important• This is very important• This is very very important• This is extremely important• I swear this is the most important• I will die if you do not remember this one• You will die if you do not remember this one

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DEATH BY POWER POINT

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Multimedia = Words + PicturesMultimedia = Words + Pictures

The cognitive theory of multimedia learning

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*

*Mayer, ‘02

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Principle Definition EffectSize

Studies

Spatial Contiguity

Place words next to corresponding graphics

1.30 8/8

Multi-Media Use Words & Pictures 1.90 3/3Modality Present words as narration

instead of printed text1.30 8/8

Signaling Highlight essential material 0.52 6/6Coherence Exclude unneeded words &

sounds0.97 13/14

Five Evidence-Based & Theoretically Grounded MM Principles

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Does instruction using MM principles result in:

enhanced retention

enhanced transfer of learning

of third year medical students?

Study Protocol• Pre-test /post-test control group design• Lecture topic = Shock.• Traditional lecture- already in place• Modified lecture- selected MM principles • 10 questions= 5 (retention) + 5 (transfer)• Content validity of questions – expert review• Reliability of scores – percent agreement

among raters

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180 M3 students

Q2-3 (Modified) n=91

Q1: pilot n = 50

Q4 (Traditional) n=39

130 students included

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Example of change:Signaling Principle

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[IV] Obstructive Shock

Tension Pneumothorax: results in hyperinflation of the hemithoraxresulting in kinking of IVS and decreased prelaod

Pulmonary Embolism: results in obstruction of the R ventricular outflow and decrease in L ventricular stroke volume resulting in cardiac failure

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[IV] Obstructive Shock

Tension Pneumothorax

Pulmonary Embolism

Cardiac Tamponade

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Swan-Ganz (PAC) insertion is like ‘Surfing through Blood Stream’

Coherence Principle

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Changes in wave tracings

Multimedia Principle

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Oxygen Delivery vs. Consumption

You can increase your delivery but you can not control your consumption as it is a function of tissue physiology

You have to meet your tissue’s requirements or else you will accelerate lactic acid production and tissue ischemia

Critical DO2 is that point were DO2 meets VO2 and tissues are utilizing aerobic metabolism

Up till that point there is an inverse relation between DO2 and VO2 a state we call flow dependent

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Relationship between DO2 and VO2

Critical DO2

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Pre n=39M(SD)

Post*n=39M(SD)

Pren=91M(SD)

Post*n=89M(SD)

Retention 2.3 (.61) 3.3 (.64) 2.1 (.91) 3.9 (.70)

Transfer 2.3 (.88) 2.9 (.99) 2.3 (1.1) 3.2 (1.1)

Total Score 4.6 (1.3) 6.2 (1.2) 4.3 (1.7) 7.0 (1.3)

*P<.0001

TRADITIONAL MODIFIED

Inter-rater Percent Agreement

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Generalized Linear Models

Retention score Transfer score Total score

  b p value b p value b p value

Group (Modification) 0.45 0.0022 0.29 0.1504 0.75 0.0064

Pre/Post Improvement 1.08 <.0001* 0.59 0.0124 1.67 <.0001*

Group*Time 0.66 0.0016 0.30 0.278 1.02 0.0081

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Results- Total Score

Results- Retention Score

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Results- Transfer Score

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Limitations of the Study

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SHOCK

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Future Directions

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The use of selected MM principles enhances:

retention of information transfer of learning

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