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COMPARISON OF TWO FORMATS FOR TEACHING DIAGNOSTIC REASONING SKILLS TO EXPERIENCED PHYSICAL THERAPISTS: LEARNING OUTCOMES. Michel TH, Jette DU, Watkins MP, Watts NT, Purtilo R; MGH Institute of Health Professions, Boston, MA. tmichel1@mghihp.edu. PURPOSE: This study was done to compare learning outcomes for a single course offered both online and on site. The course engages small groups of clinicians in analyzing confusing cases to decide on a physical therapy diagnosis or referral. A final case analysis was used for this comparison, a form of authentic performance assessment (Suen & Parkes 2002), which allows students to demonstrate their skills in higher level thinking processes. Students may make the choice of taking a course in either of these two modes of learning for the same number of credits, and for the same degree requirement. The null hypothesis was therefore selected: there will be no difference between the two groups in their ability to perform diagnostic reasoning based upon their group score. Inherent differences in learning experiences, however, may make a difference in learning outcomes. METHODS: Three independent blinded expert evaluators used the scoring system developed for this study, based on the course objectives. The final 5 cases were assigned to small groups of students, and were used repeatedly over the 5 times the course was taught. A group consensus narration provided evidence of critical thinking, using a hypothetico-deductive reasoning model. The 3 evaluators each reviewed 25 papers without knowing the class, group, or personal identity of any of the student authors. Fifteen of the 25 papers were from the online, and 10 were from the on site groups; 101 students were enrolled. ANALYSIS: Analysis was performed with SPSS 10.0. Interrater reliability and internal consistency of raters was determined with ICC (Model 1,3). A mean score of the 3 raters was entered into a univariate analysis of case vs. score vs. group. A mixed model repeated measures independent samples t-test compared rater scores separately against group assignment. RESULTS: Online were consistently higher than on site scores, but this difference was not significantly different by either analysis. Only one of the cases used showed a marked difference, indicating either highly proficient online compared to weaker on site groups working on this case, or a particularly difficult case, more successfully analyzed by the online groups. This difference was not statistically significant. CONCLUSIONS: In spite of differences in learning experiences, the on site and the online learning outcomes for these two cohorts of clinicians showed no significant differences. The additional time for preparation and reflection provided to online learners may have contributed to their consistently higher scores. FUNDING SOURCE: Faculty Seed Grant.
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