Pedagogical impact of different levels of e-learning teaching during anesthesia residency: a randomized clinical trial

INTRODUCTION: E-learning is in expansion although its pedagogical performance has not been validated in the anesthesia residency. E-learning can be divided into passive e-learning; guided e-learning, interactive e-learning, and adaptive e-learning. The objective was to compare the impact of passive e-learning versus interactive e-learning on anesthesia residents' acquisition of theoretical knowledge and clinical reasoning. MATERIAL AND METHODS: Anesthesia residents were randomized into a Passive E-learning group (Pass-EL group) and an Interactive E-learning group (Int-EL group). The Pass-EL group had documents sent by email and the Int-EL group had access to a pedagogical internet platform. A test composed of one clinical case, evaluating the clinical knowledge, and, 15 script concordance tests (SCT), evaluating the clinical reasoning, was conducted before and after e-learning. The outcome of the comparison was the means of the paired within-subject differences (delta) of clinical knowledge scores (pre-and post-test) between the two groups. RESULTS: Fifty-four residents were randomized in this prospective multicentric study in Normandy, France. Twenty-eight in the Int-EL group and 26 in the Pass-EL group. The mean of the paired within-subject differences of theoretical clinical knowledge scores after versus before e-learning was significantly higher in the Int-EL group compared to the Pass-EL group (Int-EL group 8.5 [-1.0; 19.5] vs. Pass-EL group 5.4[-6.0; 21.5], mean delta score difference: 3.1 [0.1; 6.1], P = 0.045). There was no difference for SCT. Seven residents (25%) reached out to the mentor within the Int-EL group. CONCLUSION: Interactive e-learning showed efficacy for theoretical clinical knowledge but did not improve clinical reasoning. TRIAL REGISTRATION: www.clinicaltrialsgov NCT07121400, registered 2025–08-13.