Confrontational teaching vs e-learning program

Background Mental Health services in the Capital Region of Denmark have decided that the Risk Assessment Instrument, the Brøset Violence Checklist (BVC) should be applied to all adult psychiatric wards across the region. The course that is designed to train the staff in using the BVC is only intended for new employees in psychiatry and no other systematic teaching is given in the use of BVC in the region. To meet this challenge a Danish e-learning program have been developed to train or re-train experienced staff members. This study was conducted to determine 1) can a e-learning program help raise staffs understanding of how to use the BVC? and 2) can the e-learning program improve the quality of the way the BVC is used? 
MethodsAll participants were after they had attended the regular 3 hours course (confrontational teaching) or after they had taken the e-learning program, giving a multiple-choice test (MCQ-test) and an evaluation form. The result of the MCQ-test and the evaluation-form from the course and e-learning program was compared to see if there were differences between the results of the MCQ-test and satisfaction with the course and e-learning program. 
Results257 people have completed the MCQ test. Of these, 147 people participated in confrontational education and 110 people have completed the e-learning program. The results show that for six questions out of 13 there was a significantly higher proportion of wrong answers in the group of test takers who had completed the e-learning program.In total, 140 (54%) respondents answered the evaluation-form. For confrontation teaching, 55% of participants responded and for the e-learning program it was 58%. For the confrontational education, a higher proportion of participants generally report their satisfaction with the academic benefits, the academic level and the knowledge they have acquired through the module compared with the participant who has evaluated the e-learning program.
ConclusionsThere were a higher proportion of wrong answers in the MCQ test for participants in the e-learning program compared to participants in the confrontational education.The participants in the e-learning program had a generally lower satisfaction than participants in the confrontational education course. Implications for practice, research, education & training, organisation / management, policy and guidance: How might your work inform similar initiatives in broader health service and/or geographical contexts ?It is important to use the right e-learning activity at the right time. It is about finding the right blend. What is best suited for confrontational education and what is best suited for a e-learning program.