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Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le dimanche 10 mars 2019
Doi : 10.1016/j.otsr.2019.01.002
Received : 23 April 2018 ;  accepted : 7 January 2019
Experiences with using e-learning tools in orthopedics in an uncontrolled field study application

David Alexander Back a, b, , Jennifer von Malotky c, Kai Sostmann b, Harm Peters b, Robert Hube c, d, Eike Hoff e
a Bundeswehr Hospital Berlin, Department of Traumatology and Orthopedics, Berlin, Germany 
b Dieter Scheffner Center for Medical Education and Educational Research, Charité – Universitätsmedizin Berlin, Berlin, Germany 
c Center for Musculoskeletal Surgery, Department of Orthopedics, Charité – Universitätsmedizin Berlin, Berlin, Germany 
d Orthopedic Surgery Clinic Munich, Munich, Germany 
e Clinic for Orthopedic and Traumatologic Surgery – Center for Joint and Spine Surgery, Helios Clinic Emil v. Behring, Berlin, Germany 

Corresponding author. Bundeswehr Hospital Berlin, Department of Traumatology and Orthopaedics, Septic and Reconstructive Surgery, Scharnhorststrasse 13, Berlin, 10115 Germany.Bundeswehr Hospital Berlin, Department of Traumatology and Orthopaedics, Septic and Reconstructive SurgeryScharnhorststrasse 13Berlin10115 Germany

E-learning is widely used in undergraduate medical education and often in blended learning settings for students learning at home. This study should assess the educative value of e-learning tools in orthopedics and traumatology when used under “field” conditions, in comparison with a controlled laboratory-like setting.

Materials and methods

Medical students were invited for their voluntary online participation in an uncontrolled study (UCS). They were randomly exposed to digital book chapters or podcasts on four different orthopedic diseases, and then filled in pre-/post-tests and evaluations. Test results indicating insufficient study participation were not included in the subsequent analysis. Results in a gain of knowledge and student's satisfaction were compared to existing data of a randomized controlled trial with the same tools in a laboratory environment (RCT).


Among 84 included UCS students and 130 RCT students, podcast learners showed a significantly higher gain of knowledge compared to text learners independent of the learning setting (UCS p <0.011; RCT p <0.001). There were no significant differences in the gain of knowledge for the two different learning tools when comparing each the UCS and RCT settings. Evaluations showed positive ratings for both tools, while podcasts were on the average rated higher than texts were. Significantly more UCS participants (n =46) compared to the RCT (n =34) showed signs of disengagement with the study (p <0.05).


The findings suggest that it is possible to achieve a similar gain of knowledge with e-learning tools in uncontrolled settings and in RCTs. The role of e-learning materials in voluntary and formative learning settings is of value and should be explored in future studies.

Level of evidence

III, case-control study.

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Keywords : Uncontrolled e-learning, Podcast, Digital text, Knowledge, Evaluation

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