Computer-Assisted Learning Helps Teach Epistaxis Management

The CAL module content was based entirely on the same article, but had interactive components such as quizzes and exercises. Its content was designed to be identical to that of the article provided to the students. The video included text as well as audio/video to describe the relevant procedures, Mr. Glicksman said. He noted that development of the module was a team effort.

Students were also provided with a plastic model of a nose to pack by one of two methods: either a formal nasal pack, or a tampon pack. Students were evaluated on proper nasal packing technique, using both standardized subjective and objective outcome measures, by three board-certified otolaryngologists.

We feel that CAL is an excellent way of orienting students through these interactive activities and quizzes, and we feel that this could potentially allow students a better educational experience.

-Jordan Glicksman, BSc

Objective measurements were taken using a global rating system, which included how long it took to perform the procedure, respect for tissue, instrument handling, flow of operation, knowledge of procedure, overall performance, and quality of the final product. For tampon placement, the students were graded as either correct or incorrect for use of a headlamp, forceps, placement of the tampon, and moistening of the gauze afterward. Blinded assessments of the students and their nasal packing skills were performed prior to instruction from their assigned method, as well as after they completed their study. They were also videotaped while they did the nasal packing.

CAL Leads to Greater Improvements than Text Alone

Not surprisingly, both groups of students performed poorly before studying nasal packing techniques. After the text-based learning there were definite improvements, but when you compare it to the CAL group, the CAL group did much better, Mr. Glicksman said. The difference between the two groups was, overall, statistically significant.

Students who studied the formal packing technique via CAL packed the model nose faster with the gauze and were able to insert larger amounts of gauze than the students who studied via the text-based approach.

As for the time to pack the model nose, the computer-based group took an average of 125.3 seconds, compared with the text-based group’s average of 155.6 seconds, after completing the study units. The computer-based group packed an average of 178.3 cm of gauze, compared with 134.6 cm by the text-based group, a difference that was statistically significant. With tampon insertion for epistaxis, the computer-based group took an average of 75.4 seconds, compared with 62.3 seconds by the text-based group, but here the difference was not statistically significant.