Computer-based Teaching Module Research Articles

Successful learning of surgical liver anatomy in a computer-based teaching module.

To analyze factors influencing the learning of surgical liver anatomy in a computer-based teaching module (TM). Medical students in their third to fifth year of training (N[Formula: see text]410) participated in three randomized trials, each with a different primary hypothesis, comparing two- (2D) and three-dimensional (3D) presentation modes in a TM for surgical liver anatomy. Computed tomography images were presented according to the study and allocation group. Students had to answer eleven questions on surgical liver anatomy and four evaluative questions. Scores and time taken to answer the questions were automatically recorded. Since the three studies used the same 15 questions in the TM, a pooled analysis was performed to compare learning factors across studies. 3D groups had higher scores (7.5±1.7 vs. 5.6±2.0; p < 0.001) and needed less time (503.5±187.4 vs. 603.1±246.7s; p<0.001) than 2D groups. Intensive training improved scores in 2D (p<0.001). Men gave more correct answers than women, independent of presentation mode (7.2±2.0 vs. 6.5±2.1; p [Formula: see text] 0.003). An overall association was found between having fun and higher scores in 11 anatomical questions (p<0.001). In subgroup analysis, 3D groups had more fun than 2D groups (84.7 vs. 65.1%; p<0.001). If given the option, more students in the 2D groups (58.9%) would have preferred a 3D presentation than students in the 3D group (35.9%) would have preferred 2D (p <0.001). 3D was superior to 2D for learning of surgical liver anatomy. With training 2D showed similar results. Fun and gender were relevant factors for learning success.

Computer-based teaching module design: principles derived from learning theories

The computer-based teaching module (CBTM), which has recently gained prominence in medical education, is a teaching format in which a multimedia program serves as a single source for knowledge acquisition rather than playing an adjunctive role as it does in computer-assisted learning (CAL). Despite empirical validation in the past decade, there is limited research into the optimisation of CBTM design. This review aims to summarise research in classic and modern multimedia-specific learning theories applied to computer learning, and to collapse the findings into a set of design principles to guide the development of CBTMs. Scopus was searched for: (i) studies of classic cognitivism, constructivism and behaviourism theories (search terms: 'cognitive theory' OR 'constructivism theory' OR 'behaviourism theory' AND 'e-learning' OR 'web-based learning') and their sub-theories applied to computer learning, and (ii) recent studies of modern learning theories applied to computer learning (search terms: 'learning theory' AND 'e-learning' OR 'web-based learning') for articles published between 1990 and 2012. The first search identified 29 studies, dominated in topic by the cognitive load, elaboration and scaffolding theories. The second search identified 139 studies, with diverse topics in connectivism, discovery and technical scaffolding. Based on their relative representation in the literature, the applications of these theories were collapsed into a list of CBTM design principles. Ten principles were identified and categorised into three levels of design: the global level (managing objectives, framing, minimising technical load); the rhetoric level (optimising modality, making modality explicit, scaffolding, elaboration, spaced repeating), and the detail level (managing text, managing devices). This review examined the literature in the application of learning theories to CAL to develop a set of principles that guide CBTM design. Further research will enable educators to take advantage of this unique teaching format as it gains increasing importance in medical education.

Regular three-dimensional presentations improve in the identification of surgical liver anatomy – a randomized study

BackgroundThree-dimensional (3D) presentations enhance the understanding of complex anatomical structures. However, it has been shown that two dimensional (2D) “key views” of anatomical structures may suffice in order to improve spatial understanding. The impact of real 3D images (3Dr) visible only with 3D glasses has not been examined yet. Contrary to 3Dr, regular 3D images apply techniques such as shadows and different grades of transparency to create the impression of 3D.This randomized study aimed to define the impact of both the addition of key views to CT images (2D+) and the use of 3Dr on the identification of liver anatomy in comparison with regular 3D presentations (3D).MethodsA computer-based teaching module (TM) was used. Medical students were randomized to three groups (2D+ or 3Dr or 3D) and asked to answer 11 anatomical questions and 4 evaluative questions. Both 3D groups had animated models of the human liver available to them which could be moved in all directions.Results156 medical students (57.7% female) participated in this randomized trial. Students exposed to 3Dr and 3D performed significantly better than those exposed to 2D+ (p < 0.01, ANOVA). There were no significant differences between 3D and 3Dr and no significant gender differences (p > 0.1, t-test). Students randomized to 3D and 3Dr not only had significantly better results, but they also were significantly faster in answering the 11 anatomical questions when compared to students randomized to 2D+ (p < 0.03, ANOVA). Whether or not “key views” were used had no significant impact on the number of correct answers (p > 0.3, t-test).ConclusionThis randomized trial confirms that regular 3D visualization improve the identification of liver anatomy.

Impact of a computer-based teaching module on characterization of diminutive colon polyps by using narrow-band imaging by non-experts in academic and community practice: a video-based study

Experts can accurately characterize the histology of diminutive polyps with narrow-band imaging (NBI). There are limited data on the performance of non-experts. To assess the impact of a computer-based teaching module on the accuracy of predicting polyp histology with NBI by non-experts (in academics and community practice) by using video clips. Prospective, observational study. Academic and community practice. A total of 15 gastroenterologists participated-5 experts in NBI, 5 non-experts in academic practice, and 5 non-experts in community practice. Participants reviewed a 20-minute, computer-based teaching module outlining the different NBI features for hyperplastic and adenomatous polyps. Performance characteristics in characterizing the histology of diminutive polyps with NBI by using short video clips before (pretest) and after (posttest) reviewing the teaching module. Non-experts in academic practice showed a significant improvement in the sensitivity (54% vs 79%; P< .001), accuracy (64% vs 81%; P< .001), and proportion of high-confidence diagnoses (49% vs 69%; P< .001) in the posttest. Non-experts in community practice had significantly higher sensitivity (58% vs 75%; P= .004), specificity (76% vs 90%; P= .04), accuracy (64% vs 81%; P< .001), and proportion of high-confidence diagnoses (49% vs 72%; P< .001) in the posttest. Performance of experts in NBI was significantly better than non-experts in both academic and community practice. Selection bias in selecting good quality videos. Performance not assessed during live colonoscopy. Academic and community gastroenterologists without prior experience in NBI can achieve significant improvements in characterizing diminutive polyp histology after a brief computer-based training. The durability of these results and applicability in everyday practice are uncertain.

355 Learning Curves Using Cumulative Sum Analysis (CUSUM) for the Histologic Characterization of Diminutive Colorectal Polyps Using a Computer-Based Teaching Module and Narrow Band Imaging (NBI) Videos: Implications for Resect and Discard Strategy

A paradigm shift of a “diagnose, resect and discard” strategy for diminutive (≤ 5 mm) colorectal polyps has been proposed. ASGE has established thresholds for this strategy in the recently published PIVI document. Appropriate training tools to achieve these benchmarks need to be developed and assessed before this strategy can be considered in clinical practice.

Tu1653 Community Gastroenterologists Can Easily Learn Characterization of Diminutive Colorectal Polyps With Narrow Band Imaging (NBI)

Community Gastroenterologists Can Easily Learn Characterization of Diminutive Colorectal Polyps With Narrow Band Imaging (NBI) Amit Rastogi*, Neil Gupta, Deepthi S. Rao, Sachin Wani, Prateek Sharma, Ajay Bansal, Scott R. Ketover, John I. Allen Gastroenterology, University of Kansas School of Medicine, Kansas City, KS; Gastroenterology, Veterans Affairs Medical Center, Kansas City, MO; Gastroenterology, Washington University in St. Louis, St. Louis, MO; Gastroenterology, University of Colorado, Denver, CO; Gastroenterology, Minnesota Gastroenterology, Bloomington, MN Background: Real time endoscopic assessment of histology of diminutive polyps ( 5mm) has the potential for enormous cost saving. For the ultimate goal of community gastroenterologists (GI) implementing this in practice, training tools have to be developed and the technology used should be feasible, and easy to learn. Aim: To evaluate the impact of a computer based teaching module on the performance of community GI in the characterization of diminutive polyps using NBI video clips. Methods: A 20 minute audiovisual Power Point presentation was created detailing the previously validated endoscopic features differentiating adenomas from hyperplastic polyps using NBI. To simulate clinical practice, 80 high quality NBI video clips of diminutive colorectal polyp were selected and distributed into two sets (pre test and post test) of 40 videos each (26 adenomas and 14 hyperplastic) by a computer generated random sequence stratified by polyp histology. 15 gastroenterologists in a large community practice group participated in the study. Each participant was provided with the video clips in a Pre test and Post test DVD along with the teaching module. They first reviewed the pre test video clips and entered their responses for polyp histology and the confidence in diagnosis: high 90% or low 90%. Following this, they reviewed the teaching module and then assessed the post test videos. Performance characteristics were calculated for both pre and post test by comparing predicted histology with actual histology. Fisher’s exact test was used for analysis and kappa statistic was calculated for interobserver agreement. Results: 15 gastroenterologists in community practice with varying levels of experience (1-28 years) and performing 300 1200 colonoscopies annually completed the study. Sensitivity, specificity and accuracy in characterization of polyp histology improved significantly in post test compared to pre test (Table 1). Furthermore, performance when diagnosis was made with high confidence was superior compared to low confidence in both sets (Table 2). In post test, participants had an accuracy of 92% for high confidence diagnoses and the proportion of these increased with training from 46% (pre test) to 64% (post test); p 0.001. Interobserver agreement for diagnosis improved from fair (kappa 0.23) in pre test to moderate (kappa 0.56) in the post test. Conclusions: Community GI with varying levels of experience can learn polyp histology characterization by NBI with the help of a short computer based teaching module. Their accuracy for high confidence predictions in post test ( 90%) was comparable to that reported for experts in NBI. These results suggest that real time endoscopic assessment of diminutive polyps using NBI could be incorporated into community clinical practice with similar expected results compared to expert centers.

Three-dimensional visualisation improves understanding of surgical liver anatomy

Three-dimensional (3-D) representation is thought to improve understanding of complex spatial interactions and is being used more frequently in diagnostic and therapeutic procedures. It has been suggested that males benefit more than females from 3-D presentations. There have been few randomised trials to confirm these issues. We carried out a randomised trial, based on the identification of complex surgical liver anatomy, to evaluate whether 3-D presentation has a beneficial impact and if gender differences were evident. A computer-based teaching module (TM) was developed to test whether two-dimensional (2-D) computed tomography (CT) images or 3-D presentations result in better understanding of liver anatomy. Following a PowerPoint lecture, students were randomly selected to participate in computer-based testing which used either 2-D images presented as consecutive transversal slices, or one of two 3-D variations. In one of these the vessel tree of portal and hepatic veins was shown in one colour (3-D) and in the other the two vessel systems were coloured differently (3-Dc). Participants were asked to answer 11 medical questions concerning surgical anatomy and four questions on their subjective assessment of the TM. Of the 160 Year 4 and 5 medical students (56.8% female) who participated in this prospective randomised trial, students exposed to 3-D presentation performed significantly better than those exposed to 2-D images (p < 0.001). Comparison of the number of correct answers revealed no significant differences between the 3-D and 3-Dc modalities p > 0.1). Male students gave significantly more correct answers in the 3-D and 3-Dc modalities than female students (p < 0.03). The gender difference observed in both 3-D modalities was not evident in the 2-D group (p = 0.21). This study showed that 3-D imaging significantly improved the identification of complex surgical liver anatomy. Male students benefited significantly more than female students from 3-D presentations. Use of colour in 3-D presentation did not improve student performance.

Enhanced student experience: an analysis of subjective evaluation and objective learning success after the transformation of a pharmaceutical physiology course

In the present article, the reorientation of a fourth-semester physiology course for pharmacy students is described. The motivation for the introduction of changes was to prepare the students to not only assimilate facts but to learn and understand how to integrate and apply them. The article considers how this reorganization was received by the students in both subjective and objective terms. Specifically, we investigate whether our changes resulted in both an enhanced learning experience and improved learning success. The following changes were introduced to the course: first, we integrated either experimental, computer-based teaching modules or case studies in five of the eight course units to give the students the opportunity to gain more hands-on experience; second, we organized regular meetings to enhance communication among the course tutors; and finally, we increased the pass mark for the entrance exam to the course from 50% to 60%. Student opinion was evaluated by means of a questionnaire that was distributed at the end of each course semester throughout the three-semester evaluation period (summer 2008, winter 2008/2009, and summer 2009). The students gave convincing positive feedback concerning the efficacy of the changes in both quantitative and qualitative terms. Moreover, their learning success improved significantly in objective terms as evidenced by enhanced final and State exam performance.

Learning Styles of Orthodontic Residents

Significant challenges face many orthodontic residency programs, particularly a shortage of full-time experienced faculty members. Due to this shortage, it is critical that program directors design comprehensive curricula that incorporate the most effective and efficient teaching methods. It is theorized that teaching effectiveness and efficiency are optimized when the course design and content closely match students' learning preferences. This survey study was designed to distinguish the learning preferences of orthodontic residents utilizing Felder and Soloman's Index of Learning Styles, which assesses student learning preferences in four dimensions using dichotomous scales, thereby providing insight into how teaching strategies can best be structured. As a secondary focus, additional questions on the survey were asked to gain information about residents' access to the Internet and comfort level with online learning so as to address acceptance of web-based courses in response to the shortage of full-time faculty members. Orthodontic residents, contacted via email, were requested to complete an online survey; 261 responses were collected. The results indicate that orthodontic residents are highly visual learners and show a preference for sensing and sequential learning strategies. In terms of information technology, the residents are comfortable with and have adequate access to current technological assets; therefore, they may be well suited for inclusion of computer-based teaching modules and other multimedia devices in their residency curriculum.

Testing the Satisfaction and Feasibility of a Computer-Based Teaching Module in the Neonatal Intensive Care Unit

To examine the satisfaction with and feasibility of a computer-based teaching module to teach healthcare professionals how to use and apply the Premature Infant Pain Profile (PIPP) to clinical scenarios. Sixty-eight healthcare professionals who were employed in the neonatal intensive care unit (NICU) on a full-time or part-time basis and had received an educational session regarding the PIPP. A pilot study using an exploratory descriptive design was used to answer: (1) How satisfied are healthcare professionals with the computer-based teaching module? and (2) What is the feasibility of a computer-based teaching module in the clinical setting? Satisfaction was measured using an investigator-developed 5-point Likert scale. Feasibility was measured in terms of time to complete the module, satisfaction with instructions and ability to navigate through the module, acceptability of the module as a teaching method, and format with the computer-based module. Ninety percent of those sampled were very satisfied with the computer-based teaching method. Use of video and audio clips and photographs enhanced the learning process. Healthcare professionals identified the computer-based teaching method as an effective way of learning about the PIPP and thought that it was feasible to use within the clinical setting. Computer-based teaching is a feasible method for educating NICU healthcare professionals about the PIPP. Additional research is required to examine the effectiveness of this teaching method on relevant patient outcomes such as pain management.

Evaluation of Instructional Design of Computer‐Based Teaching Modules for a Manufacturing Processes Laboratory

AbstractStudies concerning student preferences and student learning as a function of the instructional design and delivery of a computer‐based teaching (CBT) module are presented. The studies were conducted in conjunction with the development of twenty‐one CBT modules for an Introduction to Manufacturing Processes laboratory that emphasized metal removal. Study results indicate there is no statistically relevant difference in learning between students using material presented with traditional multimedia (35 mm slides and cassette tapes) and the identical material presented with digital multimedia. Engineering students' preferences for interface design and audio‐visual information presentation are also presented. The most important result is that learning outcomes of a reader‐driven CBT module were found to be statistically lower than those associated with author‐driven CBT module, especially for average and below‐average students. These results suggest that if students must absolutely understand material, e.g., laboratory safety, the CBT should be author‐driven. Based on these results, we speculate that average and below average engineering students are more linear learners. A hybrid scheme, where information presentation transitions from an author‐driven to a reader‐driven environment may help weaker students develop better non‐linear, open‐ended problem solving skills.

General numerical scheme for heat exchanger thermal analysis and design

This article describes two personal computer–based teaching modules designed to instruct engineering students in the more fundamental thermal aspects of the analysis and design of heat exchangers. One module applies to shell-and-tube exchangers; the other applies to cross-flow types. Enhanced numerical algorithms solve discretized forms of the governing differential energy-conservation equations. Graphical user interfaces display temperature distributions along with traditional design and performance measures. © 1997 John Wiley & Sons, Inc. Comput Appl Eng Educ 5: 231–242, 1997

Strategies for developing effective computer-assisted instruction: a computer-based teaching module on color Doppler US.

Computer-assisted instruction is an effective method for teaching visually oriented subjects such as ultrasonography. Although many different forms of instructional strategy can be effective, the process of designing a teaching program should follow the same general procedures, regardless of the format. The first step is to consider the subject material and the target audience; this helps to determine the style of the computer-user interaction (eg, whether the program should be more interactive or dissertative in nature). Teaching objectives should be carefully defined and resources for development identified. Before actually writing the program, the authors should carefully define a lesson plan and develop a set of specifications for implementation. Finally, the program should be tested thoroughly before it is put to use, and the effectiveness of the instruction should be evaluated.