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Adapting the contents of computer-based instruction based on knowledge tests maintains effectiveness of nutrition education^1,2,3,4

¹ From the Department of Nutrition, School of Medicine and School of Public Health, University of North Carolina at Chapel Hill (MK, KCL, and SHZ), and the Department of Internal Medicine, North Texas University Health Sciences Center at Fort Worth (WJM).

Background: Nutrition education of many medical students continues to be inadequate. Computer-based instruction in nutrition is a resource that introduces a new level of flexibility for instructors and students while maintaining a high level of educational quality. Previous evaluations have demonstrated the efficacy of our programs on nutrient physiology and the role of nutrition in the disease process, but some students complained about the time spent on content that they had covered in other courses.

Objective: We wanted to explore the effectiveness of an abbreviated program version that bypassed topics that the students had mastered already.

Design: Multiple-choice questions were used to determine knowledge of 117 second-year medical students in each of the main knowledge areas covered by our Nutrition and Cancer instructional module. The students were then randomly assigned to complete either the full version or a shortened version adapted to their demonstrated knowledge. Four days later the same as well as new questions were used to compare knowledge gain between the 2 groups.

Results: The shorter time spent with the tailored version than with the full version (2.5 h versus <1.5 h) decreased learning efficacy to only a small extent. More tailored-version users than full-version users were interested in further computer-based instruction (59% versus 41%, P < 0.05), suggesting better acceptance.

Conclusions: Our experience underscores the power of computer-based instruction to bring nutrition education to medical students. The newly developed adaptive features of the nutrition programs may also be helpful for practicing physicians to efficiently bridge knowledge gaps.

Key Words: Computer-based instruction • nutrition education • cancer education • efficacy evaluation • tailored instruction

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