Aims (1) To evaluate the use of an online multimedia learning package incorporating an evidence-based guideline on acute breathing difficulties (ABD) as an adjunct to standard clinical teaching. (2) To assess its impact on knowledge gain and self-assessed confidence prior to starting a paediatric clinical attachment.

Methods A randomised cohort of 108 fifth-year medical students in six teaching blocks undertaking their paediatric clinical attachments were evaluated during February 2008–July 2009. Teaching blocks were randomly assigned to receive either the learning package and standard clinical teaching (n=55) or the standard clinical teaching alone (n=53). A formative 24-item knowledge assessment in multiple-choice question format incorporating video case scenarios and a seven-item questionnaire for self-appraisal of confidence in the assessment of paediatric ABD cases was administered before and after instruction. A 36-item questionnaire evaluating postinstruction student satisfaction in multimedia instruction clearness, learning methodology, presentation material quality, motivation and learning material adequacy for subsequent case management was also administered.

Results All students (100%) had <1 month of previous exposure to paediatrics prior to commencement of their clinical attachment and possessed either good or excellent computer awareness. The intervention group performed significantly better on the knowledge assessment (p<0.05) than the control group despite both groups receiving standard clinical teaching incorporated in their clinical attachment. An improvement in self-assessed confidence was noted in six of seven statements in the questionnaire (p<0.0001–p<0.02) in the intervention group compared to no significant difference in the control group.

The learning package was also noted to be highly satisfactory to students in all sections.

Conclusion The ABD learning package delineated a positive impact on cognitive gain and self-assessed confidence improvement in paediatric medical students. These results support the conclusion that a thoroughly designed tool can be invaluable in preparing students with minimal experience in paediatrics for clinical contact in addition to introducing the concept of clinical practice guidelines at undergraduate level. Further study is needed to see if similar advantages could be gained in other clinical specialities.