Teaching medical students exposure therapy for phobia/panic – randomized, controlled comparison of face‐to‐face tutorial in small groups vs. solo computer instruction

OBJECTIVE: To compare the teaching value of one session of computer-guided solo instruction in exposure therapy for phobias with that of one face-to-face small-group tutorial. DESIGN: Non-blind, randomized, controlled study. SETTING: King's College Hospital Medical School, London. PARTICIPANTS: Thirty-seven third-year medical students and 11 behaviour therapists. MAIN OUTCOME MEASURES: Seventy-five true/false multiple choice questions relating to (b) below answered at pre- and post-teaching by students and just once by behaviour therapists to obtain 'expert' scores; pre- and post-teaching ratings of interest in behaviour therapy and post-teaching ratings of educational and enjoyment value. EDUCATIONAL INTERVENTIONS: (a) All students had a 20-minute group lecture on basic concepts and historical aspects just before randomization to: (b) 90 min of either solo computer or group face-to-face tutorial teaching. Computer instruction used a short version of 'FearFighter'- a self-help computer system for people suffering from phobias. RESULTS: Solo computer instruction taught exposure therapy principles effectively but improved multiple choice question scores marginally less than did small-group tutorial teaching. Tutorial teaching required 5 times more teacher time but led to knowledge scores that did not differ significantly from those of behaviour therapists. Students clearly rated face-to-face small-group tutorial teaching as more enjoyable. CONCLUSION: The knowledge gain from a solo computer session resembled that from a small-group face-to-face tutorial, and required far less teacher time, but was less enjoyable. Enjoyment might rise if the computer session was group-oriented and aimed at students rather than patients. In general computer teaching might be best used to complement rather than replace conventional teaching.