A Perceptual Adaptive Learning Module Results in Improved Fetal Heart Rate Categorization

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No published studies have evaluated the best method of teaching FHR interpretation. The PALM has been shown to improve learning in skills which require pattern recognition.


All subjects underwent a pretest and received a basic FHR physiology lecture. The subjects were then either exposed to the PALM or to additional lecture time reviewing the details of FHR categorization. All subjects then took a posttest, delayed test 6 weeks later, and survey.


Sixteen subjects completed the PALM module and 19 were assigned to additional lecture. Only the PALM showed significant improvement in accuracy and fluency from the pretest to posttest (accuracy 35% versus 71%, P<.05; fluency 27% versus 65%, P<.05). Both interventions showed significant improvement in accuracy and fluency on the delayed test reflecting learning throughout the rotation. However, the PALM showed a significantly greater improvement as compared to the lecture group in both the posttest (accuracy 71% versus 47%, P<.05; fluency 65% versus 31%, P<.05) and the delayed test (fluency 58% versus 41%, P=.05).


The PALM resulted in more accurate and fluent categorization of FHR tracings compared to traditional lecture methods, and the effect persisted on delayed testing.

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