This study aims to identify randomized controlled trials of paediatric patient populations in musculoskeletal healthcare that used multimedia-based patient educational materials (PEMs) and examine how design was reported and impacted patients’ knowledge and rehabilitation outcomes. Design was evaluated using principles from the cognitive theory of multimedia learning (CTML).
PubMed, CINAHL, PsycINFO, and Embase were searched from inception to June 2024 for randomized controlled trials examining paediatric patients with musculoskeletal conditions receiving multimedia PEMs as an intervention and that were compared to any other interventions. The primary outcome was knowledge retention as measured via test scores. Secondary outcomes were any patient-reported measures. Retrievability was noted, and PEMs were sourced through search, purchase, and requests to authors.
A total of 22 randomized controlled trials were eligible for inclusion: 2 (10%) included or partially included their educational materials with the scientific article, 6 (27%) required web-based search, 2 (9%) were obtained via direct requests to the authors, and 12 (55%) contained irretrievable educational interventions that could not be evaluated further. Of the 10 (45%) studies with retrievable materials, one study fully optimized the design of their educational materials, with the rest implementing at least 11 of the 15 design principles but most frequently lacking in the CTML principles of using an on-screen speaker, using a generative learning activity, using cues to highlight the organization of the material, and the avoidance of redundant information between text and graphics. Learning was evaluated in 4 (18%) studies using either an improvised questionnaire (2 studies, 9%) or the knowledge questions of the Medical, Exercise, Pain and Social Support (MEPS) questionnaire (2 studies, 9%).
Musculoskeletal studies should use open science principles and provide their PEMs wherever possible, as over half of the trials identified in this review did not provide retrievable interventions and thus could not be properly appraised. The link between providing multimedia PEMs and patient learning is largely unexamined as most studies did not assess knowledge following their educational intervention. Engagement potential may be better determined when considering the implementation of design principles such as the CTML.
Practitioners in musculoskeletal healthcare who create educational materials for paediatric populations have can take advantage of design optimization principles such as using an on-screen speaker, using a generative learning activity, using cues to highlight the organization of the material, and the avoidance of using redundant information between text and graphics.
Researchers who design and test educational materials as interventions must strive to make these materials accessible so other researchers can replicate and appraise them and the wider public, who often funds the research, has access to them.
Paediatric
Musculoskeletal
