Statistical analysis
Continuous variables are described using the mean and standard deviation (SD). Categorical variables are presented as frequencies and percentages. The mean comparison of continuous variables between groups was computed using analysis of variance (ANOVA). For comparison of repeated measurements within group, the Wilcoxon Sign Rank Test was adopted due to the sample size. A generalized estimating equation (GEE) was employed to examine the effect on learning performance between the different groups and times of measurement. For all results, p < 0.05 was considered statistically significant. Analyses were performed using SPSS 23.