Computer-supported collaborative learning at the clinical workplace: students and #8217; perceptions and the effect of knowledge construction on learning outcome

Abstract

Objective: Individual online learning in medical education has shown positive learning outcome. However, from a social-constructivist perspective, students are participants of a collaborative learning process. Online collaborative learning in a clinical environment can be organised by computer-supported collaborative learning (CSCL). Although it is known that student‟s perceptions influences their knowledge construction in CSCL arrangements, it remains unclear whether students� knowledge construction in a CSCL environment can positively influence students‟ learning outcome, expressed by grades given by an expert. Therefore, the purposes of present study are (1) to explore medical students‟ subjective perceptions on a task in an asynchronous discussion forum of a CSCL environment. (2) To explore the effect of medical students knowledge construction on knowledge improvement. (3) To explore whether medical students‟ learning outcome was positively improved by active knowledge construction. Methods: Forty-four medical students were randomly assigned to either an experimental (n=21) or control group (n=23). Each individual student had to solve a self-selected clinical problem, written down in a pre-formatted critical appraisal paper. Students of the experimental group participated in a structured asynchronous on-line discussion on their papers. Students in the control group did not discuss their papers with peers. All students submitted their final paper for grading. Students in the experimental group were asked whether the paper was revised after discussion according to peer feedback. A questionnaire and a semi-structured interview was used to address students‟ perceptions on preparation, design, participation and knowledge improvement. Students‟ discussion postings were analysed on content. Postings were classified in revised or unrevised paper discussions, and compared. All papers were blinded by the researcher and independently rated by two experienced staff-members. Papers were classified in control group papers, and in pre and post (revised) papers from the experimental group. Grades were compared between pre and post papers, and between papers from the control group and post papers. Students‟ post papers were paired with the corresponding pre papers and compared by grade. Results: Questionnaire items showed positive students‟ perceptions on participation, design, and knowledge improvement. Interview items reported both positive and negative perceptions by students. Content-analysis of postings showed a significantly higher level of knowledge construction in the revised paper discussions. However, no grade differences were found between the pre and post papers, as well as between the control group papers and the post papers from the experimental group. Six post papers were revised by students after discussion and paired with corresponding pre papers, showing no significant differences between pairs. Conclusion: Medical students show positive subjective perceptions on a structured asynchronous on-line discussion of their papers. Medical students revising their written task after discussion, show significantly higher active knowledge construction during an asynchronous CSCL discussion. Active knowledge construction of medical students during an asynchronous CSCL discussion is not necessarily paralleled by a significantly higher expert grading.