J.DING1, A.S.J.YAP1, Z.X.THNG2, Y.N.GAN2, T.C.H.TAN3, C.C.YIP4
MOH Holdings Pte Ltd (MOHH)1, Tan Tock Seng Hospital2, Raffles Hospital3, Khoo Teck Puat Hospital4
COVID-19’s social distancing policies have hindered face-to-face ‘peer-learning’ (physical practice/discussion) of clinical examinations. Guided Mental Rehearsal (GMR) may overcome this obstacle by facilitating independent, repetitive practice. Underpinned by the ‘Motor Simulation Theory’, GMR reinforces similar neuro-circuit activations during physical practice and was proven effective in surgical training.
This randomized, controlled study evaluated the efficacy of GMR versus ‘peer-learning’ of Confrontational Visual Field Examination (CVFE). Third-year medical-students without clinical Ophthalmology experience were recruited.
Controls (n=40) watched an e-learning instructional video (8-minute CVFE tutorial) followed by 6-minutes of ‘peer-learning’. GMR-students (n=38) had ‘peer-learning’ replaced by a 6-minute GMR audio-recording (CVFE running commentary).
Pre-test and post-test MCQs were administered to determine baseline knowledge and knowledge acquisition respectively.
28 controls and 24 GMR-students performed CVFE on simulated patients with right homonymous hemianopia. Four Ophthalmologists graded their performances using a checklist-based marking scheme. Non-parametric statistics were used.
Both groups had similar pre-test scores (47.5%vs40.0%, p=0.119); sub-group analysis of mini-CEX candidates was similar (45.0%vs40.0%, p=0.332). Post-test scores were significantly higher than pre-test in both groups (all p<.01), without inter-group difference (72.5%vs75.0%, p=0.968).
GMR-group had significantly higher CEX scores than controls (87.8%vs76.0%, p<.01).
GMR improved psychomotor but not cognitive aspect of learning CVFE. This may be attributable to GMR’s theoretical resemblance with physical practice, with additional expert guidance. By enabling independent learning, GMR may reduce demand on teaching manpower and thus education cost.
Compared to peer-learning, GMR enhances independent e-learning of CVFE by achieving similar cognitive assessment scores and superior psychomotor performances.