The Effect of Providing Protected Time for Utilization of Video-Based Learning in the Pediatric Clerkship: A Randomized Trial

OBJECTIVE: Online learning activities are used in medical school clinical clerkships, but studies report variable learner utilization. This study investigated the effect on lesson completion and knowledge gains when providing protected time and when making a video-based curriculum mandatory during the pediatric clerkship. METHODS: From March 2019 to March 2020, a multicenter, prospective, randomized trial was conducted at 7 medical schools. Students were randomized by clerkship block to receive or not receive protected time and to mandatory versus optional assignment of a 6-video curriculum. Lesson completion, difference between pre- and post-clerkship knowledge tests, and student experience were assessed. RESULTS: One-hundred and sixty students completed the study. Students given protected time completed more lessons (mean = 4.89 [standard deviation = 2.15] vs 2.7 [2.87]; P < .001) and were more likely to complete all 6 lessons as compared to students without protected time (79.2% vs 39.8%; P < .001), with no difference in lesson completion observed between students in mandatory completion versus optional arms (P = .250). There was no difference in knowledge gains across arms (P = .957), but students who completed all 6 lessons had higher knowledge gains as compared to those who viewed fewer or none (P = .002). Students appreciated protected time, although most did not complete lessons during protected time. Critics of protected time encouraged prioritization of patient-related clinical time and desired better integration into the clerkship. CONCLUSIONS: Protected time may improve utilization of supplemental learning activities but should be integrated to avoid competition with patient care. Optimal provision of protected time warrants further study.