Live demonstration versus procedural video: a comparison of two methods for teaching an orthodontic laboratory procedure

Traditional Lecture Versus Procedural Video Randomized Trial: Comparative Analysis of Instructional Methods for Teaching Baclofen Pump Management

OBJECTIVE

This study compared the effectiveness of traditional lectures and microvideos in teaching baclofen pump programming and refilling to physicians who have completed less than 10 refills for the previous 2 yrs.

DESIGN

A mixed-method approach was used with 60 participating physicians specializing in physical medicine and rehabilitation or pain management. Preintervention and postintervention assessments were conducted using a rubric, and the participants' perceptions and preferences were gathered through focus group sessions.

RESULTS

Two thirds of the participants specialized in physical medicine and rehabilitation. No significant differences in the preintervention, postintervention, or knowledge retention scores were found between the traditional lecture and microvideo groups. Both methods demonstrated comparable effectiveness in improving the baclofen pump refilling and programming skills. Qualitatively, participants perceived both approaches as equally helpful, but those in the microvideo group raised concerns because of instructors' unavailability and online platform navigation. Nevertheless, they preferred the convenience, accessibility, and time efficiency of the microvideos.

CONCLUSIONS

The study concluded that microvideos are an effective alternative to traditional lectures for acquiring knowledge on baclofen pump programming and refilling. Further research should consider learners' characteristics and investigate the benefits of blended learning in medical education.

Undergraduates' comparative assessment, utilizing a structured rubric, of hands-on versus video-supported presentation in class II cavity preparation

BACKGROUND

Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an important step in many health professions to become a successful professional. During under graduation, class II cavity preparation exercise is of utmost important in dentistry.

OBJECTIVE

To compare class II cavities prepared by students after hands-on live demonstration and pre-recorded video demonstration using well-organised evaluation rubrics.

METHOD

Preclinical dental students (n= 50) were divided into two groups. The students in group I (n= 25) attended a hands-on live demonstration performed by one faculty while students in group II (n= 25) watched a 15-minute pre-recorded procedural video on the projector. Both groups were appealed to prepare class II cavity for amalgam involving disto-occlusal surface of mandibular second molar articulated on jaw model (TRU LON study model, Jayna industries, Ghaziabad U.P., India). Following completion of the preparations, all teeth were collected, and labelled grades of prepared cavities were given according to prespecified rubrics. The data of scores were presented as means and standard deviation. Statistical analysis of data was executed using SPSS software. A paired t-test was used to compare scores between groups.

RESULTS

The study shows that the video-supported demonstration of a cavity preparation was better than the live hands-on demonstration. A higher mean response for the procedural video group was found compared to the live demonstration group (p= 0.000133).

CONCLUSION

Pre-recorded video-supported demonstration along with guidance by a tutor may be a viable alternative to hands-on live demonstration in cavity preparation procedures during undergraduate dental training. Moreover, rubric methods can be implemented in the teaching of various preclinical exercises for conservative dentistry and endodontics.

Face-to-face versus 360° VR video: a comparative study of two teaching methods in nursing education

BACKGROUND

The practical sessions during skills laboratory simulation or clinical simulation are cores of nursing education. For this, different modalities have been devised to facilitate psychomotor skills learning. One of the commonly used educational material or instructional method to supplement skills learning across various disciplines is video-based teaching method. The opportunities of traditional two-dimensional video might be limitless and maximized with 360º virtual reality (VR) video, which offers immersive experience. This study incorporates 360º VR video into skills laboratory training as an alternative approach to face-to-face procedure demonstration.

METHODS

An open-label, parallel (1:1), randomized controlled trial study was conducted among third-year undergraduate nursing students at Hiroshima University, Japan. The nursing students were block-randomized into 360º VR video and face-to-face demonstration group. After a 3-hour theoretical class of patient management on ventilator and closed-suction principles of mechanically ventilated patients in an Intensive Care Unit focused class, the 360º VR group watched the 360º VR video of closed tracheal suction (including oral) using the head-mounted display of Meta Quest 2 individually, while the face-to-face group attended the instructor's demonstration. A week after the skills laboratory, the students' psychomotor skills, knowledge, satisfaction, confidence were evaluated; the 360º VR video group's perception was explored; Wilcoxon rank-sum test was used to compare the two groups.

RESULTS

A total of 57 students were analyzed; 27 students in the 360º VR video group and 30 students in face-to-face group. There were no statistically significant differences between both groups in skills, knowledge, and confidence. However, the face-to-face group had higher satisfaction level than the 360º VR group; this difference was statistically significant. In the 360º VR video group, 62% agreed that VR makes learning more interesting; more than half of students (62.5%) experienced VR sickness symptoms, and "feeling of drunk" is the highest. The students appreciated the ready to use, immersiveness, and realism; however, symptoms and discomfort, burdensomeness, and production limitations were improvements recommended.

CONCLUSION

Although face-to-face demonstration is the established method of teaching psychomotor skills to nursing students, the use of 360º VR video could achieve similar learning effect as an alternative approach.

Dental students' perceptions and educational impact of preclinical interactive videos compared and in combination with live demonstrations

OBJECTIVE

To study the utility of simulation videos with embedded quiz items compared and in combination with live hands-on demonstrations of dental procedures.

METHODS

Thirty-three videos with embedded items were developed to help students understand the procedures they had to practice in the simulation laboratory. Videos were uploaded to the university LMS platform for students to watch and complete the embedded items as many times as they liked. All 76 students from 2021 and 73 from 2022 Integrated Dentistry III courses were invited to participate in the study. Practical (OSCE) and theoretical (MCQ) exam grades of the 2021 academic year, when interactive videos replaced live demonstrations, were collected and compared to those of the previous years (2017-2020) when only live demonstrations were performed, as were those from the 2022 academic year, when videos were complemented with hands-on live demonstrations. At the end of each year, a perception questionnaire was voluntarily completed by the students.

RESULTS

Assessment grades were significantly higher in the 2021 academic year when interactive videos were incorporated versus the 2017-2020 period when only live demonstrations were performed. However, the combination of interactive videos with live demonstrations performed during 2022 showed the highest exam grades. Seventy-nine percent of students answered the questionnaire, highly valued the utility of the interactive videos and liked the embedded items. Overall, they stated that they learned from the videos.

CONCLUSIONS

Interactive videos of preclinical procedures with embedded items combined with live demonstrations can significantly enhance students' learning and are valued by students.

Evaluation of video teaching on resident competency for all-ceramic crown tooth preparation

PURPOSE

This study aimed to analyze the impact of live video instruction using digital evaluation of residents' performance in full ceramic crown preparation.

METHODS

Digital evaluation using CEREC computer-aided design/computer-assisted manufacturing (CAD/CAM) 5.1.3 software was conducted of preparation on a typodont for all-ceramic crowns of mandibular first molars (MFMs) with a radial shoulder finish line, carried out by 30 residents. Each participant prepared two MFMs: group A prepared the right side without live video instruction, and group B prepared the left side after instruction. All prepared teeth were scanned by Dentsply Sirona chairside CAD/CAM system with Omnicom to assess the inter-occlusal space, undercut, the finish line of the preparation, and surface texture. The data were analyzed using Pearson Chi-square, Wilcoxon signed-rank test, and paired t-test. P-values less than 0.05 were considered to be statistically significant in all tests.

RESULTS

Based on the Pearson Chi-square test, there were significant differences between the two groups in terms of inter-occlusal space on the buccal and lingual surface of the prepared tooth, in the presence of rough surfaces before and after the preparation, and difference in the type of finish line. The Wilcoxon signed-rank test revealed a significant difference in convergence angle buccolingually and the remaining height of the prepared teeth before and after the video instruction.

CONCLUSIONS

The use of educational live video instruction can be helpful to residents in learning the principles of tooth preparation.

Skill Retention of Light-Curing Technique Using Only Verbal Instructions versus Using an Instructional Video: A 2-Year Follow-Up Study of Dental Students

PURPOSE

To evaluate the retention of light-curing skills among dental students after two years of clinical experience and determine if there are any differences in the skills retention between students who received verbal instructions or those who had received an instructional video. The students' satisfaction with past learning, self-confidence, and general knowledge about light-curing were also evaluated.

METHODS

This study is a 2-year evaluation of previous work. Students had previously been divided into two groups: those who received only verbal instructions, and those who received only an instructional video about the correct light curing technique to use clinically. Each student had light-cured simulated restorations (anterior and posterior) for 10 sec using the Managing Accurate Resin Curing-Patient Simulator (MARC-PS) (BlueLight Analytics, Halifax, Nova Scotia, Canada) and a multiple-emission peak light-emitting-diode (Bluephase N, Ivoclar Vivadent, Schaan, Liechtenstein) curing light. Students then received instructions according to their assigned group and light-cured the simulated cavities again. Two years later, students from both groups light-cured the same simulated cavities. Then, they completed a modified version of the National League of Nursing (NLN) satisfaction and self-confidence questionnaire and answered light-curing knowledge questions. Statistical analysis: The mean radiant exposure values delivered before receiving specific instructions on light curing, immediately after, and two years after instruction for both teaching methods (Friedman test followed by Wilcoxon signed-rank post hoc test), and the difference between both teaching methods was assessed (two-sample Wilcoxon rank-sum test). The satisfaction and self-confidence scores were compared between teaching method groups (Wilcoxon rank-sum test) (p<0.05).

RESULTS

The mean and median irradiance values ranged between 194-1777 and 1223-1302 mW/cm² before instructions, 320-1689 and 1254-1394 mW/cm² immediately after instructions, and 95-1945 and 1260-1331 mW/cm² two years later regardless of the simulated restoration or the teaching method. The mean and median radiant exposure values ranged between 2-23 and 12.5-13.6.4 J/cm² before instructions, 3-28 and 12.8-14.3 mW/cm² immediately after instructions, and 0.7-20 and 12.8-13.6 mW/cm² two years later regardless of the simulated tooth being light cured and the teaching method. Students retained their light-curing skills after two years of clinical experience, with no significant differences between both groups. The instructional video group delivered significantly higher radiant exposure values (p=0.021) when light-curing the anterior tooth than the posterior. Students were satisfied with their past learning and confident in their light-curing skills (p=0.020). There were statistical differences in how well the two groups remembered what they had been taught about light-curing. Only 5.7% of students answered all knowledge questions correctly.

CONCLUSION

Students retained their light-curing skills after two years of clinical experience, with no significant difference between verbal instructions or instructional video teaching methods. However, their knowledge about light curing remained very poor. Nevertheless, the students were satisfied with how they had been taught and had confidence in both teaching methods.

Effectiveness and perception of demonstration-observation- assistance-performance (DOAP) versus video-assisted learning (VAL) in training advanced cardiac life support (ACLS) among medical interns - A comparative study

BACKGROUND

Demonstration-Observation-Assistance-Performance (DOAP) and Video-Assisted Learning (VAL) are small-group teaching/learning methods (TLM) in medical education. Comparison studies between the two are scanty. There is a gap in knowledge, skills, and attitude among medical interns toward Advanced Cardiac Life Support (ACLS). The author studied the effectiveness of DOAP and VAL in training ACLS using mannequins and automated external defibrillator (AED)-simulators among interns in 2021.

MATERIALS AND METHODS

This descriptive study was done in the Emergency Department of a tertiary teaching hospital in South India. Out of 80 medical interns, 39 and 41 were allocated to ACLS training by DOAP (Group 1) and VAL (Group 2), respectively, by convenient sampling with random allocation, with the use of mannequins and AED-Simulators (10 interventions in each small group; three-five participants in each session). Pre-validated pre-test and posttest multiple-choice questionnaires (MCQs) and attitude questionnaires, OSCE by two blinded assessors, and perception by Likert-based questionnaire were analyzed with appropriate statistical analysis.

RESULTS

The mean pretest and posttest MCQs and Attitude and OSCE scores of DOAP and VAL showed no statistically significant difference between them (MCQ pre-test 44.51 (11.43); 42.54 (6.56); p = 0.350 and MCQ posttest, 78.97 (8.59); 77.22 (11.29); p = 0.438; OSCE 40.51 (2.43) and 40.63 (1.92); p = 0.804; Attitude: 11 (3), 11 (2); p = 0.567; 14 (2), 14 (3); p = 0.095). MCQ post-tests showed improved scores (p < 0.001) in both the methods and the standardized mean difference based on the MCQ scores for the DOAP group was 3.02, and for the VAL group 3, showed the effectiveness of both methods. Perception scores showed learners' interest and positive feedback to both methods and ACLS.

CONCLUSION

Both DOAP and VAL were equally effective TLMs in imparting knowledge, skills, and attitude to medical interns with positive feedback. In DOAP, the learner performs under supervision and clarifies doubts. As repeatable and cost-effective, VAL is useful in resource-limited settings. Both can be used as complementary methods in training ACLS. The attitude of learners towards ACLS improved with training.

Insight on the influence of technology-enhanced learning in orthodontics' education: A systematic review

OBJECTIVES

Technology-enhanced learning (TEL) provides a pliable and current way to present orthodontic curriculum material to students. This review aimed to assess the effectiveness of TEL compared with traditional learning methods in the field of orthodontics.

MATERIALS AND METHODS

The search comprised randomised controlled trials (RCTs) related to orthodontics' interactive learning from the following databases: PubMed, Scopus, CENTRAL, Psyclnfo, ERIC, Web of Science, Dissertations and Theses Global. Two authors performed the screening, data extraction and assessed risk of bias using the Cochrane tool (Rob 2) blindly and in duplicate. Kirkpatrick's 4-level evaluation model was used to evaluate educational outcomes.

RESULTS

A total of 3131 records were identified of which 11 RCT were included. On level 1 (Reaction), students had a positive attitude towards TEL. On level 2 (Learning), included studies did not report any significant knowledge improvement when TEL was compared with traditional learning strategies. One study assessed level 3 (Behaviour), where students felt that flipped classroom learning created feelings of greater confidence. On level 4 (Results), most studies suggested that TEL tools are as equally effective in imparting information as traditional tools and recommended that both methods should be considered in teaching students.

CONCLUSION

Technology-enhanced learning techniques might have the potential to enhance educational outcomes in orthodontic education and students seem to enjoy the implementation of technology in the learning process. These educational tools should be used as an adjunct to the traditional didactic classroom, and not as a replacement, due to the challenges encountered with their application.

Dental Student’s Satisfaction with the Video-assisted Educational Approach in Teaching Oral and Maxillofacial Surgery Principles

BACKGROUND: Educating dental students in practical skills are a difficult task that has become increasingly demanding since the outbreak of COVID-19. Today, the use of digital media plays an essential role in teaching practical skills. AIM: This study investigated the effect of educational videos on oral and maxillofacial surgery basics on dental student’s satisfaction. METHODS: Six subjects were chosen from the principles of oral and maxillofacial surgery, and according to the necessary standards, educational videos were made based on the needs assessment of students. Fellow attending evaluated and approved each video. Students were shown videos in six 2-h sessions. Students were given a researcher-created questionnaire with proven validity and reliability. Students filled out questionnaires to evaluate the impact of educational videos as well as the structure of educational videos. RESULTS: Two hundred and three students participated in this study in their 4th−6th years. In this study, 203 students in their 4th to the 6th year participated. Most students were satisfied with the structure of educational videos (73.9%); in general, 84.7% of students expressed their satisfaction with this method. Half of the students preferred video training over face-to-face training in oral and maxillofacial surgery (50.4%). Many students suggested that these videos be included in the curriculum (80.7%). CONCLUSION: Students’ overall satisfaction with the structure and impact of educational videos indicates that educational videos made and evaluated by dental professors can help teach practical topics as a part of the curriculum.

The utility of a gross dissection anatomical model for simulation-based learning in pathology

INTRODUCTION

The examination of morphological alterations in tissues is fundamental in Pathology. Traditional training in gross dissection has several limitations, including the risk of transmissible diseases, formaldehyde exposure and limited specimen availability. We describe a teaching method using anatomical simulators.

METHODS

Liquid silicone-based artisan neoplastic anatomical models were used in conjunction with clinical scenarios. Eighty-five medical students participated in a gross dissection experience and were asked to complete a feedback questionnaire. Additionally, a workshop was organized for students to compare three different teaching methods. The first one used still images (Group1-G1), the second a video explanation (Group2-G2), and the third directly observed a pathologist while grossing (Group3-G3).

RESULTS

The knowledge acquisition questionnaire showed an average value of 4.4 out of 5 (1-5) (range 3.4-4.7, σ0.89). The categories 'knowledge of resection margins' and 'macroscopic diagnosis' received the highest values (4.8, σ0.11 and 4.7, σ0.32, respectively), followed by 'understanding of handling and gross examination of the surgical specimen' (4.5, σ0.49), 'prognosis' (4.3, σ0.67) and 'understanding of a tumor resection' (3.9, σ0.96) (p<0.05). Regarding teaching methods, G3 spent less time than G2 and G1 with mean times of 15'39″ (σ2'12″), 16'50″ (σ3'45″), and 17'52″ (σ2'12″), respectively (p<0.05). Gross dissection marks (0-5) showed statistically significant differences (p<0.05). G2 obtained better results (3.7;σ0.54) than G3 (3.4;σ0.94) or G1 (3.1;σ0.8).

CONCLUSIONS

This preliminary study demonstrates that it is possible to implement a gross dissection simulation module at medical school and thus enable the acquisition of skills in a secure environment.

Effects of different delivery modes on teaching biomedical science practical skills in higher education during the 2021 pandemic measures

The COVID-19 pandemic related measures had augmented the rise of online education. While online teaching had mitigated the negative impacts from educational institutional closures, it was unable to displace hands-on biomedical laboratory practical lessons effectively. Without practical sessions, there was concern over the imparting of laboratory skills even with video demonstrations. To investigate the effectiveness of different delivery modes in imparting laboratory skills, theoretical and practical student assessments were analyzed alongside an anonymous survey on their motivation and prior experience. The undergraduate students were exposed to (1) instructor-live demonstration; (2) video demonstration or (3) no demonstration prior to the practical test which was a plasmid extraction. Significantly higher mini-prep yields and purity were found for both instructor-live and video demonstrations compared to no demonstration. Comparison with pre-pandemic theoretical assessment performance showed no significant differences despite longer contact hours during pre-pandemic times. Prior lab experience and motivation for selecting the course did not significantly affect student mini-prep yields. In conclusion, our findings suggest that video demonstrations were as effective as instructor-live demonstrations during the pandemic without noticeably compromising the teaching and learning of biomedical laboratory skills.

Comparing Domain-Specific Self-Efficacy in Pediatric Physical Therapy Education Across Classroom-Based, Online, and Hybrid Curriculum Designs

PURPOSE

To describe the pediatric curriculum across 3 years when different instructional designs were used, quantify change in self-efficacy (SE) after completing the curriculum, and define relationships between pediatric experience, SE, and interest in future pediatric practice.

METHODS

Students (N = 137) were included over 3 consecutive years. Instructional design varied across cohorts: classroom-based (n = 48), online (n = 44), and hybrid (n = 45). Pediatric content hours were analyzed. Measures were the Pediatric Communication and Handling Self-Efficacy Scale, pediatric experience, and interest in future pediatric practice.

RESULTS

Pediatric content hours met published recommendations. Significant growth in SE occurred for all cohorts, with no significant differences in SE scores based on instructional design. Experience and interest in pediatrics were significantly related to communication SE.

CONCLUSIONS

The pediatric physical therapy curriculum delivered via classroom-based, online, or hybrid instruction can be effective in promoting pediatric-specific growth in student SE. Remote pediatric experiential learning is a feasible option for physical therapy programs with limited direct contact with children. What this adds to the evidence : When pediatric curricula meet recommended total hours of instruction, regardless of instructional method or amount of direct laboratory time with real children, pediatric-specific student SE increases. This supports the use of alternative approaches for experiential learning activities in programs with limited access and availability for direct in-person child interactions. Programs may expand integrated clinical experiences (ICE) opportunities to include telehealth when in-person ICE is limited due to distance or availability in nearby clinical settings. Online learning activities (asynchronous or synchronous) may be viable options for laboratory activities when live child volunteers are limited or unavailable. Use of multiple methods of instruction (classroom-based, online, or hybrid) can be beneficial in covering pediatric physical therapy content and improving SE. This evidence can help programs expand their options for exposing student physical therapists to pediatric practice.

Students' perception on flipped classroom in contrast to live demonstration for teaching orthodontic wire-bending skills: A focus group study

OBJECTIVE

This study aimed to explore students' perceptions of flipped classroom (FC) compared to live demonstration (LD) in transferring skills of fabricating orthodontic wire components for orthodontic removable appliances.

METHODS

Forty third-year undergraduate dental students were randomly assigned to two groups: FC (n = 20) and LD (n = 20). Students in group FC attended FC, while students in group LD attended LD. Both groups underwent a series of standardized teaching sessions to acquire skills in fabricating six types of orthodontic wire components. Eight students (four high achievers and four low achievers) from each group were randomly selected to attend separate focus group discussion (FGD) sessions. Students' perceptions on the strengths, weaknesses, and suggestions for improvement on each teaching method were explored. Audio and video recordings of FGD were transcribed and thematically analyzed using NVivo version 12 software.

RESULTS

Promoting personalized learning, improvement in teaching efficacy, inaccuracy of three-dimensional demonstration from online video, and lack of standardization among instructors and video demonstration were among the themes identified. Similarly, lack of standardization among instructors was one of the themes identified for LD, in addition to other themes such as enabling immediate clarification and vantage point affected by seating arrangement and class size.

CONCLUSIONS

In conclusion, FC outperformed LD in fostering personalized learning and improving the efficacy of physical class time. LD was more advantageous than FC in allowing immediate question and answer. However, seating arrangement and class size affected LD in contrast to FC.

Students' perception on flipped classroom with formative assessment: A focus group study

OBJECTIVE

To explore students' perception on the implementation of flipped classroom (FC) combined with formative assessment during the undergraduate teaching of orthodontic wire-bending skills.

METHODS

Third-year undergraduate dental students were taught wire-bending skills via FC teaching method using a series of pre-recorded online video demonstrations. As part of the formative assessment, the students were given the results and assessment rubrics of their prior wire-bending assessment before every subsequent session. Purposive sampling method for focus group discussion was used to recruit eight students comprising four high achievers and four low achievers. Strengths, weaknesses and suggestions for improvement of the FC with formative assessment were explored. Data were transcribed and thematically analysed.

RESULTS

Students perceived that FC allowed for a more convenient and flexible learning experience with personalised learning and improved in-class teaching efficiency. The pre-recorded online videos were useful to aid in teaching wire-bending skills but lacked three-dimensional representation of the wire-bending process. Students suggested better standardisation of instructions and access to the marking rubric before and after assessment.

CONCLUSIONS

FC teaching with continuous formative assessment and constructive feedback as a form of personalised learning was viewed favourably by students. The implementation of periodic individual feedback can further enhance their learning experience.

Enhancement of Skill Competencies in Operative Dentistry Using Procedure-Specific Educational Videos (E-Learning Tools) Post-COVID-19 Era-A Randomized Controlled Trial

E-learning has completely transformed how people teach and learn, particularly in the last three pandemic years. This study evaluated the effectiveness of additional procedure-specific video demonstrations through E-learning in improving the knowledge and practical preclinical skills acquisition of undergraduate dental students in comparison with live demonstration only. A randomized controlled trial was conducted for the second-year dental students in the College of Dentistry, Jouf University, to evaluate the impact of E-learning-assisted videos on preclinical skill competency levels in operative dentistry. After a brief introduction to this study, the second-year male and female students voluntarily participated in the survey through an official college email. Fifty participants were enrolled in the study after obtaining informed consent. The participants were randomly divided into two groups, twenty-five each. The control group (Group A) was taught using traditional methods, and the intervention group (Group B) used E-learning-assisted educational videos and traditional techniques. An objective structured practical examination (OSPE) was used to assess both groups. The faculty members prepared a structured, standardized form to evaluate students. After OSPE, statistical analysis was done to compare the grades of OSPE between Group A and Group B. Logistic regression analysis was done to express the effect of components of the OSPE on gender, cumulative gross point average (CGPA), Group A and Group B. The results showed a significant difference in the experimental groups after the intervention (p < 0.000). The simulator position parameter demonstrated that the participants had a significant competence level after the intervention by procedure-specific videos (p < 0.000) and an exponential value of 6.494. The participants taught by E-learning-assisted procedure-specific videos and traditional teaching strategies demonstrated an enhanced learning and skill competency level than participants who used only traditional teaching strategies.

An Evaluation of the Usefulness of YouTube® Videos on Crown Preparation

Background

You Tube is one of the most commonly used online sources for sharing information and knowledge. Academic topics or clinical data shared on this platform is not peer reviewed or evaluated by subject specialists for accuracy. No study was found in the literature examining the validity of crown preparation videos available at this platform.

Objective

To evaluate the authenticity of the content and quality of the crown preparation videos uploaded on the YouTube.

Methods

The systematic search for YouTube videos was carried out over a period of one year from January 2020 until February 2021. The keywords or phrases and tags used were crown preparation, PFM crown preparation, all ceramic crown preparation, and dental crown preparation. The videos were shortlisted on the basis of inclusion and exclusion criteria to select educationally useful videos in terms of content and quality.

Results

Three subject specialists evaluated the videos on crown preparation three times to shortlist only 12 (11%) educationally useful videos out of 109 relevant videos. These 12 videos met the preset inclusion criteria.

Conclusion

Although YouTube is the most popular social media platform used as the source of information by the students, the majority of uploaded content lacks authenticity. This study found that crown preparation videos uploaded by the faculty members or subject specialists can be considered as the reliable source.

A comparison of video-based and slide-based teaching before hands-on rubber dam application: A quantitative and qualitative study

PURPOSE/OBJECTIVES

Instructional videos may demonstrate the execution of complex clinical procedures and the cooperation between members of the dental team better than traditional slide-based teaching materials. The aim of the present study was to compare the effect of a procedural video on student ratings to a traditional still-image-based presentation in a course on rubber dam application.

METHODS

In a randomized, double-blind, parallel arm design, participants (46 dental students) completed a seven-item, five-step Likert-scale questionnaire at baseline (t1), after a video-based or slide-based demonstration of rubber dam application (t2) and after hands-on training (t3). The students' judgement on the benefits of rubber dam (items 1-3), their motivation to use rubber dam (item 4), their self-efficacy (items 5-6) and their expected use of the teaching material (item 7) were assessed. Changes in the students' individual answers were analyzed for each item and comparison between intervention groups made. Moreover, the impact of the teaching format on in-class discussions was analyzed qualitatively using a thematic approach RESULTS: Both interventions arose comparable significant improvement in the students' Likert-scale ratings from t1 to t2, and again from t2 to t3. No significant differences between intervention groups were found in the students' ratings or in the qualitative analysis.

CONCLUSIONS

Procedural videos have proven to be a valuable learning aid in a variety of teaching formats, but in the context of a live lecture, they may not constitute an improvement over traditional text- and still-image-based presentations.

Comparing flipped classroom and conventional live demonstration for teaching orthodontic wire-bending skill

Flipped classroom may overcome weaknesses of live demonstration in teaching orthodontic wire-bending. This study aims to compare the effectiveness between flipped classroom and live demonstration in transferring skills for fabricating Adams clasp. Forty third-year undergraduate dental students were assigned to two groups. The students in group LD (n = 20) attended a live demonstration while students in group FC (n = 20) attended a flipped classroom. Both groups were taught on skills to fabricate Adams clasp in a standardised way. Each student from both groups were asked to submit an Adams clasp for a blinded quality assessment by two trained and calibrated assessors using a 18-item rubric, followed by validated students’ satisfaction questionnaires to evaluate their perceived satisfaction on the teaching method received. A crossover study was then conducted three weeks later where LD attended a flipped classroom while FC attended a live demonstration. Students’ satisfaction questionnaires were again collected from each student for blinded analysis. Mean scores for the quality of Adams clasp were 9.775 and 9.125 for LD and FC, respectively. No significant difference was detected between the two groups. Statistically significant association was found for one statement on the questionnaire, “I found the classroom arrangements conducive for the wire-bending activity” (p = 0.010). No significant differences were found between the two groups for other statements (p > 0.05). In conclusion, within the limitations of the study, flipped classroom is equally effective as conventional live demonstration in transferring orthodontic wire-bending skills for fabrication of Adams clasp. However, students perceived the classroom arrangements during the flipped classroom significantly more conducive for teaching orthodontic wire-bending.

The effect of live demonstration and flipped classroom with continuous formative assessment on dental students' orthodontic wire-bending performance

BACKGROUND

Wire-bending skills is commonly taught through live demonstrations (LD) though flipped classroom (FC) method has gained popularity. Continuous formative assessment promotes personalised learning via closely monitored progress, with the identification of students' strengths and weaknesses. This study aims to evaluate the effects of LD and FC teaching methods, supplemented with continuous formative assessment, on dental students' learning of wire-bending skills for six types of removable orthodontic appliance components. A deeper understanding of the relative effectiveness between LD and FC teaching methods can help identify the most appropriate method to achieve student learning objectives, which is especially important given the current Covid-19 pandemic.

METHODS

Forty third-year undergraduate dental students were randomly assigned into FC (n = 20) or LD (n = 20) cohort. Each student attended six teaching sessions, each to teach students' competency in fabricating one type of wire component, for a total competency in fabricating six wire components over the course of six teaching sessions. Either LD or FC teaching methods were used. After each session, wire assignments had to be submitted. Wire assignments were then evaluated using a blinded wire-bending assessment protocol. As part of their formative assessment, the assessment results were distributed to students, lecturers, and technicians before the next session. After the first session (T0) and at the end of all six sessions (T1), students completed a self-reported questionnaire.

RESULTS

The mean wire-bending scores for FC were significantly higher than LD for two of the six assignments, namely the Adams clasp (p < 0.01) and Z-spring (p = 0.03). Scores for both LD and FC increased significantly over time, which may be attributed to formative assessment. There was no statistically significant correlation between wire-bending scores and video usage. Students were satisfied with both teaching methods, according to T0 and T1 questionnaires.

CONCLUSIONS

Both LD and FC are equally effective in transferring practical orthodontic wire-bending skills and well-received by students. Continuous formative assessment may have enhanced students' learning of orthodontic wire-bending skills. Further studies with control group are recommended to investigate the effect of formative assessment on teaching practical dental skills.

Hands-on live demonstration vs. video-supported demonstration of an aesthetic composite restoration in undergraduate dental teaching

PURPOSE/OBJECTIVES

Live hands-on demonstration of dental procedures is a central format in undergraduate dental teaching. It captures the immediacy of the clinical situation and allows for direct communication between instructor and students, but it also requires an experienced instructor who is able to handle both the performed treatment and its visualization alongside the actual teaching. The aim of the present work is to compare the hands-on demonstration of a class IV composite restoration to a teaching format where the instructor guided the students through a prerecorded procedural video of the same treatment.

METHODS

The effect of both interventions on the students' self-perceived learning outcomes was analyzed by questionnaires (response rate 100%) in a randomized controlled double-blind (participants, outcome assessor) parallel group design (September 10 to October 3, 2019). In-class discussions were explored qualitatively by thematic analysis.

RESULTS

Both teaching formats increased the students' self-reported motivation, self-efficacy, and patient-centeredness in a similar way, with no significant differences between interventions. During in-class discussions, both the instructor and the students were more active in the video group. In contrast to the hands-on group, discussions in the video group also involved patient-related topics, such as aesthetics and general health. The video-supported teaching format considerably reduced the amount of time spent on optimizing the visualization of the performed treatment.

CONCLUSION

Video-supported instructor-guided demonstrations may represent a promising teaching format as an alternative to live hands-on demonstrations of dental procedures in undergraduate dental education.

Effectiveness of Using an Instructional Video in Teaching Light-Curing Technique

PURPOSE

To investigate dental students' ability to deliver satisfactory amounts of irradiance and radiant exposure to simulated cavities by teaching the light-curing technique using instructional video compared to verbal instructions.

METHODS

Students attended the didactic light-curing lecture explaining the light-curing technique. Participants were divided into two groups (n=60). Each participant light-cured a class III and a class I simulated cavities with sensors built-in a Managing Accurate Resin Curing-Patient Simulator (MARC-PS) system, using a multiple-emission-peak light-emitting-diode unit. Each student either 1) watched an instructional video (V) showing the light-curing technique, or 2) received individual verbal instruction (I). The light-curing performance, in terms of the mean irradiance and radiant exposure, was recorded. Each student performed light-curing again on the simulated cavities. Students' feedback for the corresponding teaching method was collected. Comparisons between before and after each instructional method were analyzed using the Wilcoxon signed-rank test. Comparisons between both instructional methods were analyzed using a Mann-Whitney U-test (α=0.05).

RESULTS

The students' light-curing performance improved after both methods, as observed on the MARC-PS laptop monitor. The mean irradiance values were anterior-V=1280.6 (183.2), anterior-I=1318.0 (143.5), posterior-V=1337.5 (181.1), posterior-I=1317.6 (248.2) mW/cm². The mean radiant exposure values were for anterior-V=13.5 (2.7), anterior-I=13.3 (1.6), posterior-V=13.7 (1.9), posterior-I=13.7 (2.5) J/cm². No significant difference was found between both instruction methods. Students reported that each method was effective.

CONCLUSION

Using V was comparable to I and an effective tool for teaching the light-curing technique per the students' ability to deliver sufficient amounts of irradiance and radiant exposure to simulated cavities.

Video-based, student tutor- versus faculty staff-led ultrasound course for medical students - a prospective randomized study

BACKGROUND

Ultrasound education is propagated already during medical school due to its diagnostic importance. Courses are usually supervised by experienced faculty staff (FS) with patient bedside examinations or students among each other but often overbooked due to limited FS availability. To overcome this barrier, use of teaching videos may be advantageous. Likewise, peer teaching concepts solely with trained student tutors have shown to be feasible and effective. The aim was to evaluate 1) objective learning outcomes of a combined video-based, student-tutor (ViST) as compared to a FS-led course without media support, 2) acceptance and subjective learning success of the videos.

METHODS

Two ultrasound teaching videos for basic and advanced abdominal ultrasound (AU) and transthoracic echocardiography (TTE) were produced and six students trained as tutors. Fourth-year medical students (N = 96) were randomized to either the ViST- or FS course (6 students per tutor). Learning objectives were defined equally for both courses. Acquired practical basic and advanced ultrasound skills were tested in an objective structured clinical examination (OSCE) using modified validated scoring sheets with a maximum total score of 40 points. Acceptance and subjective learning success of both videos were evaluated by questionnaires based on Kirkpatrick's evaluation model with scale-rated closed and open questions.

RESULTS

79 of 96 medical students completed the OSCE and 77 could be finally analyzed. There was no significant difference in the mean total point score of 31.3 in the ViST (N = 42) and 32.7 in the FS course (N = 35, P = 0.31) or in any of the examined basic or advanced ultrasound skill subtasks. Of the 42 ViST participants, 29 completed the AU and 27 the TTE video questionnaire. Acceptance and subjective learning success of both videos was rated positively in 14-52% and 48-88% of the rated responses to each category, respectively. Attendance of either the student or faculty tutor was deemed necessary in addition to the videos.

CONCLUSIONS

A ViST versus FS teaching concept was able to effectively teach undergraduate students in AU and TTE, albeit acceptance of the teaching videos alone was limited. However, the ViST concept has the potential to increase course availability and FS resource allocation.

Efficacy of Lecture cum demonstration versus video-based teaching regarding active management of third stage of labor in terms of knowledge and skills of GNM students: An interventional study

INTRODUCTION

Educational interventions have been associated with improved performance and significant changes, especially in perinatal outcomes. Teaching is one of the main components in educational planning which is a key factor in conducting educational plans through various teaching strategies such as simulation, demonstration and video teaching.

AIM

The study aimed to assess lecture cum demonstration (LCD) versus video-based teaching (VBT) regarding active management of the third stage of labor (AMTSL) in terms of knowledge and skills of General Nursing Midwifery (GNM) students.

METHODS

This was a quasi-experimental study conducted on 100 GNM third-year students selected by purposive sampling and randomly assigned to LCD (n = 50) and VBT (n = 50) groups. Sample characteristics performa, Structured Knowledge Questionnaire, and observational checklist were used to collect data from GNM students through self-report and observational technique.

RESULTS

The study results showed that the mean posttest knowledge scores of LCD (17.32 ± 2.14) and VBT group (16.90 ± 2.41) were nearly equal and mean rank posttest skills score of LCD group (54.40) was slightly higher than VBT group (49.51), but computed " t " value of mean posttest knowledge and computed " Z " value of skill score of both LCD and VBT group (0.47, 0.54) were found to be statistically non-significant at 0.05 level of significance.

CONCLUSION

It can be concluded that both LCD and VBT were found to be effective in improving knowledge and skills of GNM students regarding AMTSL.

Utility of an educational video on epinephrine prefilled syringe usage for anaphylaxis: a randomized control trial

Background

Anaphylaxis is a serious allergic reaction that needs early administration of intramuscular epinephrine for treatment. Currently, structured education on epinephrine prefilled syringe usage for anaphylaxis does not exist.

Objective

This study aimed to examine the effectiveness of the epinephrine prefilled syringe usage video, compared with routine teaching method.

Methods

This was a randomized controlled trial. A total of 129 medical students were assigned either to the routine teaching group or the video teaching group. The main outcome is the total number of medical students who passed (>70%) the test. The pre-, posttest, and objective structured clinical examination (OSCE) were used to evaluate the students.

Results

At the 2-week follow-up, the individual scores increased significantly after both interventions (p < 0.001). The percentages of medical students who passed the exam in the pre-, posttests, and OSCE were not significantly different between the groups. In the routine teaching group and video teaching group, the percentages of students who passed increased from 32.2% to 96.6% and 28.1% to 95.3%, respectively (p = 0.99). Using univariate logistic regression analysis, previous knowledge of anaphylaxis was a factor to pass the test (odds ratio, 5.07; 95% confidence interval, 1.93–13.31; p < 0.01).

Conclusion

The study demonstrated that the scores after the video education intervention were not inferior to the routine teaching group. This technique might be applied for patients in clinical practice. However, the further researches in general population are needed to confirm the efficacy of this method.

The Effect of Live-Video Demonstration on Dental Students' Orthodontic Bending Performance

The aims of this study were to evaluate the effects of a live-video teaching tool on the performance of dental students in bending an orthodontic vestibular arch and to assess the students' perceptions of the technology. All 135 fourth-year dental students in the 2018 academic year at Hacettepe Dental School, Ankara, Turkey, were invited to participate in the study; after exclusions, the remaining 116 were randomly divided into two demonstration cohorts. These students had no prior experience bending an orthodontic wire. Cohort 1 (control, N=58) was shown a conventional live demonstration of the orthodontic bending of a vestibular arch, and Cohort 2 (experimental, N=58) was shown a live-video demonstration of the same procedure. Both cohorts saw the demonstration before beginning the exercise and were evaluated afterwards on their performance of the procedure. In addition, the students' perceptions of the demonstration techniques were collected with a questionnaire. The results did not show any significant differences in the students' bending scores between the control and experimental cohorts (p=0.767). The median values on the questionnaire indicated almost no statistically significant difference in responses between the cohorts. The only significant difference was that Cohort 1 had a higher percentage who answered "yes" they would like to rewatch the demonstration than did Cohort 2 (p=0.024). In this study, the live-video technique was found to be as effective as a conventional live demonstration for orthodontic practical education, suggesting that either technique could be used as an appropriate method for training in orthodontic wire bending.

Comparison of Live-Video and Video Demonstration Methods in Clinical Orthodontics Education

The aim of this study was to compare the effectiveness of live-video and video demonstration methods in training dental students in orthodontic emergency applications. A total of 105 fifth-year dental students at a dental school in Turkey participated in the study in 2018. A pretest was given to the students to evaluate their level of knowledge about band cementing and re-bonding of brackets. Subsequently, two clinical applications were demonstrated with either live-video or video demonstration. During the live-video demonstration, the lecturer gave information about the steps of the procedure while performing the clinical application on the patient using a camera attached to the loupes. The students were able to see the process on the screens. During the video demonstration, previously recorded videos of those clinical applications were shown, and information was given to students in a classroom. On the next day, posttests were given to the students. The posttest also asked students to give their opinions about both methods. The results showed that the mean posttest scores on the video demonstration were significantly higher than on the live-video demonstration. However, no significant difference between the demonstration methods was found with regard to increase of scores from pre- to posttest. Most students preferred use of the two demonstrations together for education in the clinical orthodontics lecture. This study found that the two demonstration methods had comparable effects on increasing students' level of knowledge. However, from the students' perspective, the two should be used together to achieve the highest effect.

Student Perceptions of Instructional Ultrasound Videos as Preparation for a Practical Assessment

Background

Learning ultrasound early in the medical school curriculum helps students to understand anatomy and pathology and to perform defined ultrasound standard views. Instructional videos are a potentially valuable tool for improving the process of learning ultrasound skills. It was the aim of the present study to investigate how students perceived instructional videos as a learning aid, compared to other learning opportunities, in preparation for an Objective Structured Clinical Examination (OSCE).

Materials and Methods

Eleven concise ultrasound videos were created and implemented in the 4 ^th year at the Medical University of Vienna. The videos illustrate the predefined examination process, image optimization, and nine standardized ultrasound views. The videos were available to be used in preparation for the practical ultrasound examination, which was part of the objective structured clinical examination. The students’ perceptions of the instructional videos and other learning methods were surveyed using an online questionnaire.

Results

In total, 445 of 640 students (69.5% of the cohort) used the instructional videos. Of those students, 134 (30%) answered the questionnaire. Of this group, 88.9% rated the instructional videos as very helpful (49.6% as extremely helpful). An ANOVA revealed a significant difference between various learning materials in terms of helpfulness. Post hoc analysis showed that instructional videos were perceived as the second most helpful learning material after “self-execution and feedback.”

Conclusion

The study revealed that students use instructional videos frequently and appreciate them as an extra tool for effective studying.

Examining the Efficacy of Online Self-Paced Interactive Video-Recordings in Nursing Skill Competency Learning: Seeking Preliminary Evidence Through an Action Research

A key challenge in nursing education is how to teach the students clinical competencies effectively and to provide opportunities for practicing the fundamental nursing skills safely. The purpose of this study was to examine the competency scores of practicing a clinical skill and the satisfaction level of nursing students on three instructional methods using an action research: the online self-paced interactive video learning, demonstration-only method, and a video demonstration in class. Participants were both male and female nursing students enrolled in the Foundations of Nursing Course (N = 26, 6 males and 20 females; mean age = 19.42 ± 0.50) and were evaluated at precycle, postcycle 1, and postcycle 2. Each cycle of inquiry was planned to address the problems quickly and efficiently through four steps: planning, acting, observing, and reflecting. A triangulation technique was employed for data collection using a competency skill evaluation checklist, a satisfaction questionnaire, and a focus group feedback questionnaire. A video was developed in the researcher's college pertaining to the practical skills. Each research cycle was successively built up on one another using the reflections and feedback from the students based on the previous cycle. The competency skills at various cycles did not demonstrate significant differences between three instructional methods, whereas satisfaction score was the highest with the online self-paced interactive video demonstration. Online video learning use as a supplement in nursing instruction is well supported and offers a promising alternative in teaching clinical skill compared with other teaching strategies. However, more rigorous studies are required to get further empirical evidence in replacing the demonstration method, for teaching nursing practical skill and in improving students' learning ability and competence.

Different ways to present clinical cases in a classroom: video projection versus live representation of a simulated clinical scene with actors

BACKGROUND

Use of the video digital format in the classroom is a common way to present clinical cases to stimulate discussion and increase learning. A simulated live performance with actors, also in the classroom, could be an alternative way to present cases that may be more attractive to arouse students' interest and attention. The aim of the present study was to compare the learning process between a group of students who saw a clinical case as a simulated live scene in the classroom and others seeing the same clinical case projected by video.

METHOD

One hundred and thirty-one students (69 from physiotherapy and 62 from medicine) attended an interactive seminar on delirium in older people. Each group was subdivided into two groups: one saw the clinical case as a theatrical performance in the classroom (scene group; n = 68), while the other saw the same case projected on video (video group; n = 63). Before and after attending the seminar, students answered a questionnaire [four questions on theoretical knowledge of delirium (score 0-7) and two on subjective learning perception (linear scale: 0-10) (score 0-20)]. At the end, a further question was included on the usefulness of the scene or a video in the learning process (linear scale: 0-10).

RESULTS

Students in both groups (live scene and video) significantly improved in all questionnaire scores after the seminar (p = 0.001) with a large Effect Size (ES > 0.80). Students of the scene group obtained higher scores on theoretical delirium knowledge [6.41 ± 0.73 vs 5.93 ± 1.31 (p = 0.05)], subjective learning perception questions (what they thought they knew about delirium) (16.28 ± 3.51 versus 15.92 ± 2.47 (p = 0.072)], and the overall questionnaire (22.45 ± 4.15 versus 21.48 ± 2.94 (p = 0.027)] than the video group. Students of the scene group opined that live scene was very useful for learning with a mean score of 9.04 ± 1.16 (range 0-10), and opinion in the student's video group scored 8.21 ± 1.22 (p = 0.001).

CONCLUSIONS

All students improved significantly their knowledge but those who saw the theatrical performance obtained slightly better results, which suggest that this form of clinical case presentation in the classroom may be an alternative at least as effective as traditional video projections.

A qualitative analysis of students' perceptions of videos to support learning in a psychomotor skills course

INTRODUCTION

This qualitative study analysed students' experiences and perceptions about different types of videos in a psychomotor skills course, relating to clinical knowledge and skills and how they benefited learners in and out of the classroom.

METHODS

Subjects were recruited from 4th and 5th year dental undergraduate programme. The recruitment was terminated after 24 students participated since data saturation was reached. A semi-structured interview was conducted with each participating student, digitally recorded and transcribed verbatim. A thematic analysis was performed using an inductive approach to identify key themes.

RESULTS

Four key domains were identified from thematic analysis: functionality and access; learning and understanding; clinical skills preparation and performance and supplementary learning resources. Students perceived videos to be an important and vital learning tool relating to its on-demand access, control of functionality and use for particular needs that is not possible from textbooks or lectures. Video learning materials allows students to clarify knowledge, improve cognitive thinking and enhance revision of theoretical concepts and clinical skills. Two types of video were regarded as particularly useful as students reported being actively and cognitively engaged in the learning content and broadened their clinical experience. In addition, students reported mental preparation of clinical psychomotor skills using their own mental visualisation which enabled them to prepare for the clinical care of their patients.

CONCLUSION

This qualitative research supports the benefits of learning from videos in relation to convenience of access and functionality of the videos. In addition, it shows novel aspects to learning from videos that are more cognitively engaging and in mental preparation of clinical skills prior to patient care.

Effectiveness of Procedural Video Versus Live Demonstrations in Teaching Laboratory Techniques to Dental Students

Even though the traditional live demonstration method is commonly used in teaching laboratory techniques to dental students, it has many drawbacks. The aim of this study was to assess the acquisition of knowledge, practical skills, and perceptions of dental students who had a live demonstration versus procedural video on arranging artificial teeth. All 79 third-year dental students at a dental school in Sri Lanka, who had no previous experience in arrangement of teeth, were randomly divided into two groups in 2016. Students in group 1 had a live demonstration, while students in group 2 had a video demonstration. A pretest and posttest were conducted to assess the students' knowledge about arrangement of teeth. After one week, students in both groups were requested to arrange teeth, and a practical skills score was given. Following this, a questionnaire was used to assess the students' perceptions regarding their method of learning. Three students in group 1 did not attend the live demonstration, so the results were based on 76 participants: group 1 n=36, group 2 n=40. The results showed no significant difference between the two group's mean pretest scores (p=0.460). However, group 2 showed a statistically significant increase in mean posttest score over its pretest score (p=0.002). This difference was not seen in group 1. There was no significant difference in the mean skills test score for the two groups (p=0.588). These results suggest the procedural video was as good as the live demonstration in teaching the specific task selected for this study. However, when the perceptions of the two groups were compared, the students considered the video as a better teaching tool except when clarification was needed.

Influence of Teaching Strategies and its Order of Exposure on Pre-Clinical Teeth Arrangement - A Pilot Study

INTRODUCTION

Teeth arrangement is a vital skill for the undergraduate dental student. The attainment of skills depends largely on the methodology of teaching. In a dental curriculum, the students are exposed to a wide variety of inputs and teaching methodologies from different sources. The educational unit in dental school must identify the sequence of teaching methods that enhance the learning and practising ability of students.

AIM

The aim of this study was to evaluate the effectiveness of three different teaching methodologies for teeth arrangement and compare the differences between the orders of exposure to each teaching methodology on the development of teeth arrangement skills.

MATERIALS AND METHODS

The first year B.D.S students were study participants and were divided into three groups A, B, C. They were exposed to three teaching patterns namely live demonstration with video assisted teaching, group discussion with hand-outs and lectures with power point presentation. After each teaching methodology, their skill was assessed. The groups were exposed to three methodologies in different order for three arrangements. The scores obtained were analysed using Kruskal Wallis rank sum test and Dunn test for statistical significance.

RESULTS

Significantly higher scores in the teeth arrangement procedure were obtained by the Group A students who were exposed initially to live demonstration with video-assisted teaching. Difference in the scores was noted among and within the groups. The difference between Group A and Group C was statistically significant after both first and third teeth arrangement (p=0.0031, p=0.0057).

CONCLUSION

The study suggests each pre-clinical practice should begin with a live demonstration to enhance immediate learning absorption followed by lectures with power point presentation and group discussion for retention of knowledge and memory retrieval.