Multimedia is enabling innovations to meet critical needs in health professions education. Using mixed methods, we examined the impact of evidence-based multimedia on learning. A randomized control trial found no significant difference between standard versus evidence-based video lectures groups Interview data revealed stress, distraction, and curricular load mediated outcomes.
In recent years, there has been a growing interest in multimedia learning within health professions education due to advances in technology that make it easy to create, edit, and share videos. The literature suggests that students in the health professions are satisfied with multimedia instruction, but learning outcomes vary depending on instructional design. The cognitive theory of multimedia learning (CTML) asserts that people learn better through a concurrent presentation of words and pictures than through words alone, and presents a set of principles for effective design. Although these principles have a solid base of evidence from laboratory studies, there have been few studies of their application in the real world context of health professions education.
This study is aimed at understanding how, why, and under what conditions CTML-based multimedia instruction results in improved transfer learning. This study used mixed methods to develop a rich and meaningful exploration of the causal link between multimedia instructional design and learning within a real world context of an accelerated undergraduate nursing program. An experimental design with stratified-block randomization was used, with learning transfer as the dependent variable, and standard vs. CTML-based multimedia video lectures as the independent variable. The experiment was followed by a series of interviews, Participants were recruited from a single course within an accelerated undergraduate nursing program (N = 30). Learning transfer was measured immediately and after 2 weeks with multiple choice exams, with mean scores analyzed using between group and repeated measures t-tests. Interviews were conducted to understand student experiences with multimedia instruction, and transcripts analyzed to identify emergent themes using methods informed by grounded theory.
Findings showed no significant difference in transfer learning between students watching modified or standard video lectures, in either the between groups (p = .91) or repeated measures t-tests (p = .55). Analysis of interview data resulted in four key findings: students were highly distracted, they felt stressed-out and overwhelmed, they made sense of concepts primarily while studying independently, and illustrations helped students visualize physiological processes but were less helpful for other content.
These findings expand our understanding of how multimedia instruction impacts transfer learning in a real-world context, suggesting that the causal relationship demonstrated in prior laboratory studies may be contingent upon contextual factors including environmental distractions, learner stress, curricular load, and content type. A full understanding of the causal relationship between multimedia instruction and learning requires an exploration of contextual factors including environment, learning preferences, learner stress, study habits, and curricular load.