An Analysis Comparing Online and In-Person Education on In Vitro Fertilization Medication Injection

An Analysis Comparing Online and In-Person Education on In Vitro Fertilization Medication Injection | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 20 August 2025 V1 Latest version Share on An Analysis Comparing Online and In-Person Education on In Vitro Fertilization Medication Injection Authors : Nicholas Stansbury , Mary Conley 0009-0001-8142-8310 [email protected] , Nhat Minh Ho , Claire Schenken , Nathan Porteshawver , Pam Schumann , and Belinda Yauger Authors Info & Affiliations https://doi.org/10.22541/au.175566803.33696292/v1 205 views 124 downloads Contents Abstract Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective: To study the differences in patients’ perceived knowledge, perceived confidence, and comprehension of in vitro fertilization (IVF) injection training when using in-person nurse training compared to an online platform. Design: Comparative effectiveness research Setting: In vitro fertilization clinic in Texas Population: Patients undergoing educational training of in vitro fertilization injection training. Main Outcome Measures: Patient comprehension, knowledge, and confidence in the IVF medication injection process were deduced from pre- and post-test surveys. Changes in scores were compared between the conventional education group and the online education group. Data was analyzed using paired student t-tests. Results: 82 pre-tests and 58 post-tests were completed. All post-test comprehension scores were higher (Pre=4.8 vs Post=5.7; p<0.001). All participants with prior IVF medication experience were excluded from the comparative analysis (n=13). Post-test comprehension scores between conventional and online teaching groups were similar (5.1 vs 5.2; p=0.5) as were perceived knowledge and confidence (4.3 vs 4.2; p=0.3). Overall confidence of IVF injection and medication process was significantly higher in the online learning group (3.3 vs 3.7; p<0.05). Conclusions: Comprehension scores were similar between patients receiving injection training with the online education as those who completed in-person training. Patients felt more confident with overall IVF injection and medication preparation with online education versus conventional teaching alone. This is the first study to evaluate the differences between in-person and online training of IVF injection and medication modules. Funding: No funding was received for this work. Introduction In recent years, the demand for fertility treatments has risen significantly, with more individuals seeking assisted reproductive technologies (ART) to achieve pregnancy. 1 In 2022, 2.5% of all births in the United States were the result of ART. 2 This trend underscores the necessity of optimizing patient education to enhance understanding and confidence in infertility treatments. Traditional in-person counseling has been the cornerstone of patient education; however, the integration of online learning platforms is emerging as a promising adjunct to conventional methods. Incorporating online platforms alongside standard medical and nursing consultations can significantly enhance patient knowledge regarding procedures such as intrauterine insemination (IUI) and in vitro fertilization (IVF). 3 For instance, the implementation of an interactive e-learning platform not only increased patient comprehension but also reduced the duration of in-person visits, thereby streamlining clinical workflows. This dual benefit suggests that digital tools can effectively complement traditional educational approaches. Moreover, online tools have been instrumental in improving the informed consent process for complex procedures like preimplantation genetic testing (PGT). A study assessing the utility of digital tools for pre-test PGT education found that such resources facilitated better patient understanding and enhanced the overall consent experience. 4 Given the anxiety often associated with infertility treatments, interventions that enhance patient comprehension are crucial for improving psychological well-being. 5 The emotional burden of fertility treatments is well-documented, with patients frequently experiencing heightened stress and anxiety. Injection-related anxiety was found to be the second greatest barrier to IVF initiation. 6 Implementing online learning platforms has been associated with reductions in patient anxiety levels, as these tools provide accessible information that empowers patients to navigate their treatment journey with greater confidence. 7 By delivering educational content in a patient-friendly format, these platforms can demystify complex medical procedures and alleviate apprehension. Building upon these findings, this study aims to evaluate the differential impact of conventional in-person training versus an online platform on patients’ perceived knowledge, confidence, and comprehension of IVF injection protocols and medication functionalities. Understanding these differences is pivotal for developing educational strategies that not only enhance patient outcomes but also optimize clinical efficiency. Methods Informed consent was obtained from all individuals prior to participation. From the period of September 2023 to March 2024, patients received a questionnaire before and after their IVF medication injection training. The initial pre-test was completed at the patients’ baseline ultrasound visit before receiving injection teaching. From September to December 2023, trainings were conducted in-person only with nurses, which represented the conventional intervention. Patients in the conventional group received a 25-minute education session with IVF nurses, teaching them proper injection techniques via simulation as they guided the patient through their specific medication regimen. From January to March 2024, patients received education from the online teaching platform MedReady (MR), a site developed by SMP Pharmacy and EngagedMD. Patients were able to watch videos at their discretion and had the ability to rewatch videos should future questions arise. Both the in-person and online teaching were tailored towards the patients’ specific medication regimen. Nurses were available to answer any additional questions that arose from all participants. All post-tests were completed during the egg retrieval appointment. The questionnaire contained 16 questions regarding their personal IVF history, previous IVF education, comprehension of the IVF injection process and IVF medication functionality, and perceived knowledge and confidence of the entire IVF injection and medication process. Utilizing the completed questionnaires, total comprehension and perceived knowledge and confidence were calculated using the Likert scale. R-studio paired student t-tests were then used to analyze the data. Results A total of 82 participants completed the pre-test survey, including 43 from the in-person group and 39 from the online teaching group. We excluded anyone from the comparative analysis who had prior experience with IVF medications. The post-test survey was completed by 58 participants, 30 from the in-person group and 28 from the online teaching group. Regardless of the teaching method employed, analysis revealed a statistically significant increase in post-test comprehension (mean score 80% pre-test vs 95% post-test, p<0.001). No statistically significant difference was identified between the in-person group and the online teaching group in post-test comprehension scores (85% vs 87%, respectively, p=0.37. Perceived knowledge and confidence did not significantly differ between the conventional teaching group and the online teaching groups. Overall confidence of the entire IVF injection and medication process was significantly greater in the online teaching group than in the conventional teaching group (62% vs 55%, respectively, p<0.05). Main findings This study is the first to evaluate the role of online platforms in providing education to patients about the complicated processes of medication administration involved in IVF. Previous studies have added online learning platforms to conventional methods and observed improvements in patient comprehension, better patient experiences, and less initial patient anxiety. 1-4 This study compared conventional medication teaching methods to an online teaching platform and found no difference in the effectiveness of injection training between the online teaching platform and in-person training. Notably, patients utilizing the online platform felt more confident of the overall processes taught than those using the conventional methods. Strengths These findings carry important clinical and operational implications. Online platforms offer a standardized format for delivering consistent educational content across patients, while still offering the benefit of access to nurses to answer personalized questions. This could decrease time and cost burdens to clinics and streamline operations. Additionally, online platforms can be accessed remotely, eliminating potential transportation barriers or inconveniences and allowing patients to rewatch videos, potentially reinforcing comprehension. Limitations This study has several limitations. The relatively small sample size may limit the generalizability and statistical power of the findings. Moreover, the single institution design may constrain applicability of findings to different settings or patient populations. Future studies should apply these teaching modalities to different patient populations. Studies should also be conducted to quantify the cost savings to clinics as these preliminary results suggest that online teaching platforms may be as effective as in-person teaching and could potentially provide additional benefits. Conclusions The addition of online teaching modalities proved just as effective as in-person training for IVF injection education, with patients reporting greater overall confidence in the medication process. This shift to online learning could streamline clinic operations, reduce staff burden, and drive significant cost savings—all without compromising comprehension. These findings challenge the necessity of traditional medication training, highlighting the potential for digital education to enhance patient experience and clinic efficiency. Future research should quantify the time and financial benefits of widespread online implementation, as the future of IVF education may lie in digital innovation. Funding No funding was received for this work not-yet-known not-yet-known not-yet-known unknown Disclosures of Interests The authors have no disclosures Authorship Contribution: Nicholas Stansbury was involved with conceptualization data curation formal analysis investigation methodology, project administration, writing the original draft, and reviewing and editing the manuscript. Mary Conley was involved with writing the original draft and writing, reviewing and editing the manuscript. Nhat Ho was involved in data curation and formal analysis. Claire Schenken was involved in writing, reviewing, and editing the manuscript. Nathan Porteshawver and Pam Schumann were involved with resources and software. Belinda Yauger was involved in supervision, writing, reviewing, and editing of the manuscript. Ethics Approval The University of Texas Health Science Center Institutional Review Board deemed that the research (20220785NRR) did not require IRB approval on November 3 rd , 2022 References 1. International Federation of Fertility Societies. IFFS Surveillance 2022: Global Trends in Reproductive Policy and Practice. 9th ed. Glob Reprod Health. 2022;7(3):e58. doi:10.1097/GRH.0000000000000058 2. Society for Assisted Reproductive Technology. National summary report: 2022 clinic outcomes. Published 2024. Accessed April 9, 2025. https://www.sart.org 3. Barbour AK, Bernard AL, Madeira JL, Lindheim SR, Goodman LR. The impact of an interactive e-learning platform on patient comprehension regarding infertility treatment: a randomized clinical trial. Fertil Steril. 2020;114(3):e25–e26. doi:10.1016/j.fertnstert.2020.08.098 4. Sehnert S, Yarnall S, Abdul Aziz SU, Lin PC, Saketos M, Nusblat D. Optimizing provider and patient experience: an analysis of an online tool for preimplantation genetic testing (PGT) pre-test education. Fertil Steril. 2020;114(3):e27. doi:10.1016/j.fertnstert.2020.08.102 5. Bernard AL, Barbour AK, Madeira JL, Lindheim SR, Goodman LR. Emotional well-being during fertility treatment: a randomized controlled trial to evaluate the use of an online learning platform as a resource. Fertil Steril. 2020;114(3):e449. doi:10.1016/j.fertnstert.2020.08.1296 6. Domar A, Gordon K, Garcia-Velasco J, La Marca A, Barriere P, Beligotti F. Understanding the perceptions of and emotional barriers to infertility treatment: a survey in four European countries. Hum Reprod. 2012;27(4):1073–1079. doi:10.1093/humrep/des016 7. Adeleye A, Cruz K, Cedars MI, et al. Learning from Online Video Education (LOVE) improves confidence in fertility treatments: a randomized controlled trial. NPJ Digit Med. 2022;5:128. doi:10.1038/s41746-022-00673-y Information & Authors Information Version history V1 Version 1 20 August 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords endocrinology fertility and assisted reproduction infertility: assisted conception infertility: basic science reproductive science: fertilisation Authors Affiliations Nicholas Stansbury The University of Texas Health Science Center at San Antonio View all articles by this author Mary Conley 0009-0001-8142-8310 [email protected] Texas Christian University Anne Burnett Marion School of Medicine View all articles by this author Nhat Minh Ho University of Colorado Anschutz Medical Campus School of Medicine View all articles by this author Claire Schenken The University of Texas Health Science Center at San Antonio View all articles by this author Nathan Porteshawver EngagedMD View all articles by this author Pam Schumann SMP Pharmacy View all articles by this author Belinda Yauger The University of Texas Health Science Center at San Antonio View all articles by this author Metrics & Citations Metrics Article Usage 205 views 124 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Nicholas Stansbury, Mary Conley, Nhat Minh Ho, et al. An Analysis Comparing Online and In-Person Education on In Vitro Fertilization Medication Injection. Authorea . 20 August 2025. DOI: https://doi.org/10.22541/au.175566803.33696292/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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