1. Does Audio Narration of Text Presented Online Improve Information Retention? Anne Mounsey, MD Alfred Reid, MA Department of Family Medicine University of North Carolina at Chapel Hill

2. Does Audio Narration Improve Information Retention? Introduction Computer-based learning is an effective tool to enhance medical education. The Association of American Medical Colleges’ Institute for Improving Medical Education recommend the use of multi media learning principles in the design of presentations for medical students.

3. Does Audio Narration Improve Information Retention? Learning Theories More is better Mayer’s theory of multimedia learning

4. Does Audio Narration Improve Information Retention? Purpose To determine whether addition of narration to a PowerPoint presentation increased learning and knowledge retention.

5. Does Audio Narration Improve Information Retention? Methods: Setting Required Ambulatory Practice Selective 4 th -year medical students (N=130) 1-day orientation »Self-paced computer-based module: Medicare

6. Does Audio Narration Improve Information Retention? Methods: Interventions 1 2 + Audio narration of verbatim slide content

7. Does Audio Narration Improve Information Retention? Methods: Outcomes Number correct: 8-item knowledge quiz »Multiple choice »Pilot tested »Discrimination index > 0.10 Learning efficiency Number of items correct Minutes of study

8. Does Audio Narration Improve Information Retention? Methods: Study Protocol Selective Orientation Day 7 Blocks: September 2011 – March 2012 Student characteristics: Age Gender Degree program Prior exposure Auditory learner (self-identified) Allocation Learning Module Time spent Knowledge Quiz 1 Correct responses Efficiency Capstone Course April 2012 Knowledge Quiz 2 Correct responses Delay: Quiz 1 – Quiz 2 Exempted from review by the UNC IRB

9. Does Audio Narration Improve Information Retention? Methods: Recruitment & Allocation Study Population (n=130) Randomized (n=130) Module with narration(n=65) Skipped module altogether (n=6) Received the intervention (n=59) Module without narration(n=65) Skipped module altogether (n=5) Received the intervention (n=60) Analyzed, Time 1 (n=60)Analyzed, Time 1 (n=59) (N=119) Lost to follow-up (n=17)Lost to follow-up (n=24) Analyzed, Time 2 (n=42)Analyzed, Time 2 (n=36) (N=78)

10. Does Audio Narration Improve Information Retention? Methods Statistics Sample size: 30/group to detect a 1-item difference » α = 0.05 1-β = 0.80 Categorical comparisons: χ 2 Continuous data »Shapiro-Wilk normality test »Mann-Whitney U

11. Does Audio Narration Improve Information Retention? Hypotheses Students allocated to the narrated module will: Spend more time with the module Score higher on the knowledge quiz Have equal efficiency Self-identified Auditory learners allocated to the narrated module will: Score higher than self-identified non-auditory learners

12. Does Audio Narration Improve Information Retention? Results: Student Characteristics NarrationNo narration N=119 n(%)n p Mean age (S.D.) 27.8(2.37)28.4(2.98)0.285 Gender : Female 32(54%)25(42%)0.170 Male27(46%)35(58%) Degree Program : MD only 42(72%)42(70%)0.520 Combined (MPH or PhD)16(28%)18(30%) Self-identified auditory learner : Yes 15(25%)15(25%)0.174 No25(42%)34(57%) Unsure19(32%)11(18%) Prior experience online courses : None 25(43%)16(27%)0.155 1-3 courses19(33%)23(38%) > 3 courses14(24%)21(35%)

13. Does Audio Narration Improve Information Retention? P=0.0001 Results: Retention & Efficiency P=0.13 P<0.0001 Narration duration: 18 min. P=0.18 P=0.84 Time 1 Time 2

14. Does Audio Narration Improve Information Retention? Results: Auditory Learners P=0.63 Self-identified Auditory learner n = 15 n = 25

15. Does Audio Narration Improve Information Retention? Summary Students allocated to the narrated module will: Spend more time with the module Score higher on the knowledge quiz Have equal efficiency Self-identified auditory learners allocated to the narrated module will: Score higher than non auditory learners   

16. Does Audio Narration Improve Information Retention? Conclusion More is better Mayer’s dual learning theory Addition of narration to a PowerPoint presentation did not increase learning or knowledge retention.

17. Does Audio Narration Improve Information Retention? Further Work Take advantage of computers & online resources »natural experimental laboratory »non-intrusive Graphics/Illustrations »Text vs. Narration