Study Examines Blended Learning in Clinical Settings
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Study Examines Blended Learning in Clinical Settings

April 11, 2017

Professional headshot photo of PCOM's chief academic technology officer Dr. Erik Langenau

Dr. Erik Langenau's study, published in the April issue of the Journal of the American Osteopathic Association, examined the effectiveness of a blended-learning format for third-year osteopathic medical students completing their pediatric clinical rotations.

With technological advances continuing to improve the field of healthcare, a pilot study led by Erik Langenau, DO, MS, chief academic technology officer and associate professor, pediatrics, has found that for future physicians, while online tools can be useful for learning, nothing tops face-to-face interaction with a patient.

The study, published in the April issue of the Journal of the American Osteopathic Association, studied the effectiveness of a blended-learning format (online materials combined with face-to-face instruction) for third-year osteopathic medical students completing their pediatric clinical rotations.

Students who participated in the hybrid format—which included online materials such as discussion boards, blogs, video demonstrations and virtual patient encounters—generally performed as well as their counterparts in the traditional cohort, and in fact had higher final scores than their traditional counterparts. But regardless of how helpful the online materials were, the majority of students in the hybrid cohort reported a desire to keep, and even increase, their level of patient interaction.

“Much of the current literature talks about replacing patient interaction with online materials—particularly with videos, games, or virtual patient encounters,” said Dr. Langenau. “But what was surprising was that our students said, ‘No, we want that face-to-face connection.’ As osteopathic physicians, we value that human connection, and it was very heartening to see our students reflect that desire to connect with patients.”

Dr. Langenau said the impetus to study the effectiveness of blended learning stemmed from two areas. First, to improve educational consistency across clinical sites; he noted that if one student rotates through a private practice, and another rotates through a hospital setting, the two will receive very different experiences. Providing a consistent online curriculum helps close that educational gap between rotation sites, he said. The second was to help alleviate the burden on clinical preceptors, many of whom may not have the time to provide thorough didactic instruction.

“I kept thinking back to my time on surgery rotation,” he said. “I spent a month in cardiothoracic surgery, and I was never quite sure what I was supposed to be learning. I would assist with a surgery but be unsure of what I should focus on. We believe that by providing online materials, we can help our students understand learning objectives for the course and better prepare for when they step into the clinical setting.”

To test the effectiveness of the blended learning model, Comprehensive Osteopathic Medical Achievement Test (COMAT) scores were compared between the blended learning cohort (78 students) and the traditional cohort (186 students), and found to be roughly equal across both. In addition, COMAT scores were combined with preceptor evaluations for a final score of “honors,” “high pass,” “pass” or “fail,” and more students the hybrid cohort received a final score of “honors.” However, the researchers noted that more study is needed to determine why that score was higher.

Among those in the blended learning cohort, roughly 70 percent completed a post-survey to determine their level of satisfaction with that format. Half reported that they preferred the hybrid format to the traditional, and more than 80 percent reported being satisfied with the overall experience.

Dr. Langenau says that while this initial study is small, and only looked at one specific rotation, its results are promising. PCOM has since expanded this model to psychology, ob/gyn, cardiology, internal medicine and urban health rotations, and he plans to study the effectiveness of blended learning across all core clinical clerkships.

The College has also hired additional faculty as online clinical preceptors, who are responsible for supervising the online components of their respective courses as students continue to work with their preceptors in the clinical setting. PCOM plans to expand the program for all core rotations with plans to hire two more online clinical preceptors in the coming academic year.

Other authors on this study were Robert Lee, DO, MS, clinical assistant professor, pediatrics, and Marci Fults (DO ’18).

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About Philadelphia College of Osteopathic Medicine

Founded in 1899, Philadelphia College of Osteopathic Medicine (PCOM) has trained thousands of highly competent, caring physicians, health practitioners and behavioral scientists who practice a “whole person” approach to care—treating people, not just symptoms. PCOM operates three campuses (PCOM, PCOM Georgia and PCOM South Georgia) and offers doctoral degrees in clinical psychology, educational psychology, osteopathic medicine, pharmacy, physical therapy and school psychology, and graduate degrees in applied behavior analysis, applied positive psychology, biomedical sciences, forensic medicine, medical laboratory science, mental health counseling, non profit leadership and population health management, organizational development and leadership, physician assistant studies, school psychology, and public health management and administration. PCOM students learn the importance of health promotion, research, education and service to the community. Through its community-based Healthcare Centers, PCOM provides care to medically underserved populations. For more information, visit or call 215-871-6100.

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