***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aim The aim of this study was to determine whether an educational intervention delivered by a computer aided learning package improved the sensitivity and specificity of dentists ' restorative treatment decisions Method The study was a r and omised controlled study using a Solomon three-group design . Ninety-five dentists were r and omly allocated to the three study groups . One group of dentists read the radiographs pre and post an educational intervention , a second group read the radiographs once , after the intervention , and a third group read the radiographs twice , but received no intervention . On each occasion the dentists read 24 surfaces on each of 15 radiographs and made 360 decisions on how certain they were about restoring the tooth surface . Comparisons of mean sensitivity , specificity and areas under ROC curves were made within and between the study groups . Kappa values were used to assess changes in the level of agreement between dentists . Results There were no significant changes in sensitivity , specificity or area under ROC curves caused by the intervention . There was no evidence that the level of agreement between the dentists improved after the intervention . Conclusion A computer aided learning package had no effect on dentists ' treatment decision-making behaviour BACKGROUND The EFAST ( extended focused assessment with sonography for trauma ) is part of the recommended curriculum for Emergency Medicine and Surgery residents .  Computer-based lectures may represent a time-efficient alternative to traditional lectures . OBJECTIVES Our hypothesis was that computer lectures in basic ultrasound and the EFAST are not inferior to classroom lectures in test score improvement for residents with or without prior training . METHODS First-year Emergency Medicine and Surgery residents were enrolled and completed a pre-test . Subjects were then r and omized into a classroom group , which attended traditional lectures , and a computer group , which listened to narrated lectures on computers . After the didactic training , all subjects completed a post-test . RESULTS Forty-four subjects completed the study : 64 % were General Surgery residents , 66 % were male . Overall , mean test score improvements were higher in the classroom than in the computer group ( 28.0 % vs. 18.4 % ) . In 25 residents without prior training , mean improvements in the computer and classroom groups were 25 % and 27 % , respectively . The 95 % confidence limit around the difference was 9 % , falling within the a priori non-inferiority range of 10 % , and consistent with non-inferiority of computer-based lectures . In 19 residents with prior training , mean test score improvements for the computer and classroom groups were 13 % and 29 % , respectively . The 95 % confidence limit of 24 % exceeded the non-inferiority range , consistent with inferiority of computer-based lectures . CONCLUSIONS Computer-based lectures are not inferior to classroom lectures and may represent a worthwhile substitution in subjects without prior ultrasound education . Our data suggest that didactic ultrasound training through classroom lectures is more effective than computer-based lectures in individuals with prior training CONTEXT A well-suited e-learning program might be a feasible strategy to maintain competence following a resuscitation course . AIM This study had 2 aims : ( 1 ) to examine the effect of an e-learning program as a booster of competence acquired from an Advanced Life Support ( ALS ) course . ( 2 ) To identify factors related to the use of the e-learning program . MATERIAL S AND METHODS The study contained two parts pertaining to the two aims . The first part was a prospect i ve single blinded r and omised controlled study on junior doctors . The intervention was the monthly use of an e-learning program during one year and effect was measured as ALS-competence , a composite of a knowledge and skills test . The second part was a telephone interview of the  intervention  group . An interview guide was constructed based on existing knowledge of e-learning . In order to identify factors explaining the use of e-learning a univariate correlation was used to select significant variables to be included in a multiple regression analysis . RESULTS Of the 134 invited to participate , 103 accepted the invitation . There were 79/103 ( 77 % ) participants , 40/51 in the intervention group and 39/52 in the control group . There was no difference between the groups with regards to ALS competence . Only ' social interaction ' was an individually significant factor influencing the use of the e-learning program . CONCLUSIONS This study did not demonstrate an effect of an e-learning program as a booster of competence acquired from an ALS course . The primary factor influencing the use of e-learning was the lack of social interaction BACKGROUND AND OBJECTIVES Family medicine clinicians and residents have increasing educational and work dem and s that have made it difficult to provide and access training on specific procedures such as IUD insertion . The purpose of this study was to determine whether the use of video-module instruction could provide residents with the necessary knowledge and skills to perform an IUD insertion correctly when compared with the traditional form of instruction , which is a lecture-demonstration session provided by an academic gynecologist . METHODS Thirty-nine family medicine residents participated in the study during the induction period at the beginning of their residency program in July 2012 at the University of Calgary . A r and omized , two group pretest/posttest experimental research design was used to compare the procedural knowledge and skills performance ( posttest only ) of residents trained using an alternative instructional intervention ( video-module teaching ) with the traditional lecture-demonstration approach to teaching IUD insertion . RESULTS Both teaching methods were effective in providing procedural knowledge instruction , and the paired- sample s t tests results were almost identical : t (37)=1.35 . On the other h and , performance scores were significantly higher in the video-module group : t (37)=2.37 , 95 % CI ( 0.61 , 8.00 ) , with a mean difference in performance of 4.31 . There were no significant differences in residents ' satisfaction scores , and there was no correlation between the different scores and sex or age or between performance and level of satisfaction . CONCLUSIONS This video-module instruction is an effective method to provide comprehensive IUD insertion training , and the psychomotor skills gain ( performance component ) was significantly higher than the traditional method of instruction Objective Medication errors are common , with junior doctors accounting for the majority in acute healthcare . Paediatrics is uniquely challenging , but the evidence base to guide prescribing education is limited . The authors set out to develop a short , educationally sound , low cost e-learning re source for paediatric prescribing to improve junior doctors ' prescribing skills and to evaluate its effectiveness . Design A non-blinded r and omised controlled trial . Setting North Western Deanery Foundation School , UK . Participants 162 volunteer foundation ( junior ) doctors r and omised into control ( 86 ) and intervention ( 76 ) groups . Interventions On study entry , participants were assessed on prescribing skill , prescribing habits and confidence . The intervention group completed the e-learning course design ed for the study , which took 1–2 h. At 1 and 3 months after the intervention , both groups were assessed on similar prescribing assessment s , habits and confidence . Main outcome measures Total score ( expressed as a percentage ) on prescribing assessment s , confidence and satisfaction scores . Results There were no preintervention differences in prescribing assessment s ( 67 % vs 67 % , p=0.56 ) . Postintervention , the e-learning group scored significantly higher than the control group ( 63 % vs 79 % , p<0.0001 ) . At 3 months , the e-learning group still scored significantly higher ( 69 % vs 79 % , p<0.0001 ) , with improved confidence scores ( p<0.0001 ) . Conclusions This short e-learning re source significantly improved the paediatric prescribing skills of junior doctors . Outcomes were maintained at 3 months , suggesting the utility of low cost , low fidelity , educationally sound e-learning interventions . However , the direct impact on patient outcomes following this intervention has yet to be determined BACKGROUND : Simulation experience alone without debriefing is insufficient for learning . St and ardized multimedia instruction has been shown to be useful in teaching surgical skills but has not been evaluated for use as an adjunct in crisis management training . Our primary purpose in this study was to determine whether st and ardized computer-based multimedia instruction is effective for learning , and whether the learning is retained 5 wk later . Our secondary purpose was to compare multimedia instruction to personalized video-assisted oral debriefing with an expert . METHODS : Thirty anesthesia residents were recruited to manage three different simulated resuscitation scenarios using a high-fidelity patient simulator .  After the first scenario , subjects were r and omized to either a computer-based multimedia tutorial or a personal debriefing of their performance with an expert and videotape review . After their respective teaching , subjects managed a similar posttest resuscitation scenario and a third retention test scenario 5 wk later . Performances were independently rated by two blinded expert assessors using a previously vali date d assessment system . RESULTS : Posttest ( 12.22 ± 2.19 , P = 0.009 ) and retention ( 12.80 ± 1.77 , P < 0.001 ) performances of nontechnical skills were significantly improved in the st and ardized multimedia instruction group compared with pretest ( 10.27 ± 2.10 ) . There were no significant differences in improvement between the two methods of instruction . CONCLUSION : Computer-based multimedia instruction is an effective method of teaching nontechnical skills in simulated crisis scenarios and may be as effective as personalized oral debriefing . Multimedia may be a valuable adjunct to centers when debriefing expertise is not available Background At postgraduate level evidence based medicine ( EBM ) is currently taught through tutor based lectures . Computer based sessions fit around doctors ' workloads , and st and ardise the quality of educational provision . There have been no r and omized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine . Methods This was a r and omised controlled trial involving six postgraduate education centres in the West Midl and s , U.K. Fifty five newly qualified foundation year one doctors ( U.S internship equivalent ) were r and omised to either computer based sessions or an equivalent lecture in EBM and systematic review s. The change from pre to post-intervention score was measured using a vali date d question naire assessing knowledge ( primary outcome ) and attitudes ( secondary outcome ) . Results Both groups were similar at baseline . Participants ' improvement in knowledge in the computer based group was equivalent to the lecture based group ( gain in score : 2.1 [ S.D = 2.0 ] versus 1.9 [ S.D = 2.4 ] ; ANCOVA p = 0.078 ) . Attitudinal gains were similar in both groups . Conclusion On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic review Background : Conventional educational systems seem to be improper throughout the cardiopulmonary resuscitation ( CPR ) teaching process . The most common causes of failed resuscitation are unfamiliarity with cardiopulmonary resuscitation algorithms , poor performance of leader of the CPR team and lack of skilled personnel , coordination among members during resuscitation , and responsibility of staff . Objectives : Electronic learning , as a new educational method is controversial issue in medical education for improving physicians ’ practical knowledge and it is inevitable that further research on its effectiveness should be done . Material s and Methods : The present study is a prospect i ve , pre- and post-educational , cross-sectional research , in which 84 interns were r and omly divided into two groups .  pre- and post- educational interventions that took place in the Department of Emergency Medicine , interns were evaluated by 21 multiple choice questions related to American Heart Association guidelines on cardiopulmonary resuscitation drugs . Questions were assessed in terms of routes for CPR drugs administration , CPR drug dosage forms , clinical judgment and appropriate CPR drug administration , and the alternative drugs in emergency situations . Data were analyzed by generalized estimating equations regression models and P < 0.05 was considered statistically significant . Results : Evaluating the effectiveness of both educational methods revealed that the mean answering score for 21 questions before education was 7.5 ± 2.6 and no significant difference was observed in groups ( P = 0.55 ) . However , after education , the average scores significantly increased to 11.0 ± 3.9 ( P < 0.001 ) . Electronic learning method was not associated with considerable increase in the knowledge of interns in this group compared with the lecture-based group ( P = 0.49 ) . Conclusions : No significant differences were observed between electronic learning and lecture-based education in improving interns ’ knowledge of CPR drugs Background The world is short of 7.2 million health – care workers and this figure is growing . The shortage of teachers is even greater , which limits traditional education modes . eLearning may help overcome this training need . Offline eLearning is useful in remote and re source –limited setting s with poor internet access . To inform investments in offline eLearning , we need to establish its effectiveness in terms of gaining knowledge and skills , students ’ satisfaction and attitudes towards eLearning . Methods We conducted a systematic review of offline eLearning for students enrolled in undergraduate , health – related university degrees . We included r and omised controlled trials that compared offline eLearning to traditional learning or an alternative eLearning method . We search ed the major bibliographic data bases in August 2013 to identify articles that focused primarily on students ’ knowledge , skills , satisfaction and attitudes toward eLearning , and health economic information and adverse effects as secondary outcomes . We also search ed reference lists of relevant studies . Two review ers independently extracted data from the included studies . We synthesized the findings using a thematic summary approach . Findings Forty – nine studies , including 4955 students enrolled in undergraduate medical , dentistry , nursing , psychology , or physical therapy studies , met the inclusion criteria . Eleven of the 33 studies testing knowledge gains found significantly higher gains in the eLearning intervention groups compared to traditional learning , whereas 21 did not detect significant differences or found mixed results . One study did not test for differences . Eight studies detected significantly higher skill gains in the eLearning intervention groups , whilst the other 5 
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CONCLUSIONS The effect of OCDE compared with other methods of education on medical doctors ' knowledge and cognitive skill gain is uncertain .
OCDE may improve doctors ' knowledge compared with no intervention but its effect on doctors ' cognitive skills is uncertain .
OCDE may have little or no effect in improving patients ' outcome