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Case-based e-learning to improve the attitude of medical students towards occupational health, a randomised controlled trial
  1. P B A Smits1,
  2. L de Graaf1,
  3. K Radon2,
  4. A G de Boer1,
  5. N R Bos1,
  6. F J H van Dijk1,
  7. J H A M Verbeek1,3
  1. 1Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  2. 2Unit for Occupational and Environmental Epidemiology & Net Teaching, Institute and Outpatient Clinic for Occupational-, Social- and Environmental Medicine, Hospital of the Ludwig-Maximilian-University, Munich, Germany
  3. 3Knowledge Transfer Team, Finnish Institute of Occupational Health, Kuopio, Finland
  1. Correspondence to Dr Paul Smits, Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands; p.b.smits{at}


Objectives Undergraduate medical teaching in occupational health (OH) is a challenge in universities around the world. Case-based e-learning with an attractive clinical context could improve the attitude of medical students towards OH. The study question is whether case-based e-learning for medical students is more effective in improving knowledge, satisfaction and a positive attitude towards OH than non-case-based textbook learning.

Methods Participants, 141 second year medical students, were randomised to either case-based e-learning or text-based learning. Outcome measures were knowledge, satisfaction and attitude towards OH, measured at baseline, directly after the intervention, after 1 week and at 3-month follow-up.

Results Of the 141 participants, 130 (92%) completed the questionnaires at short-term follow-up and 41 (29%) at 3-month follow-up. At short-term follow-up, intervention and control groups did not show a significant difference in knowledge nor satisfaction but attitude towards OH was significantly more negative in the intervention group (F=4.041, p=0.047). At 3-month follow-up, there were no significant differences between intervention and control groups for knowledge, satisfaction and attitude.

Conclusions We found a significant decrease in favourable attitude during the internship in the experimental group compared with the control group. There were no significant differences in knowledge or satisfaction between case-based e-learning and text-based learning. The attitude towards OH should be further investigated as an outcome of educational programmes.

  • Attitude towards occupational health
  • undergraduate medical education
  • case-based e-learning
  • occupational health practice
  • fitness for work
  • training and education
  • back disorders
  • health and safety
  • epidemiology

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  • Funding This study was supported by EU Lifelong Learning, NeTWoRM project.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.