Interactive Computer-assisted Instruction Research Articles

Interactive computer-assisted instruction in acid-base physiology for mobile computer platforms

In this project, the traditional lecture hall presentation of acid-base physiology in the first-year medical school curriculum was replaced by interactive, computer-assisted instruction designed primarily for the iPad and other mobile computer platforms. Three learning modules were developed, each with ∼20 screens of information, on the subjects of the CO2-bicarbonate buffer system, other body buffer systems, and acid-base disorders. Five clinical case modules were also developed. For the learning modules, the interactive, active learning activities were primarily step-by-step learner control of explanations of complex physiological concepts, usually presented graphically. For the clinical cases, the active learning activities were primarily question-and-answer exercises that related clinical findings to the relevant basic science concepts. The student response was remarkably positive, with the interactive, active learning aspect of the instruction cited as the most important feature. Also, students cited the self-paced instruction, extensive use of interactive graphics, and side-by-side presentation of text and graphics as positive features. Most students reported that it took less time to study the subject matter with this online instruction compared with subject matter presented in the lecture hall. However, the approach to learning was highly examination driven, with most students delaying the study of the subject matter until a few days before the scheduled examination. Wider implementation of active learning computer-assisted instruction will require that instructors present subject matter interactively, that students fully embrace the responsibilities of independent learning, and that institutional administrations measure instructional effort by criteria other than scheduled hours of instruction.

The effectiveness of interactive computer assisted instruction compared to videotaped instruction for teaching nurses to assess neurological function of stroke patients: A randomized controlled trial

Background Teaching inexperienced nurses to assess neurologic function of acute ischemic stroke patients poses challenges to educators in Taiwan. Objectives The purpose of this study was to examine the effectiveness of two programs that teach nurses the use of the Chinese version of the National Institute of Health Stroke Scale (C-NIHSS), and to evaluate the level of learner satisfaction with these teaching programs. Design An experimental research design with two groups, one pre-test and two post-tests was utilized. Setting Six neurology and neurosurgery wards at two hospitals in southern Taiwan. Participants Participating nurses were stratified based on their clinical level of experience and prior training on the National Institute of Health Stroke Scale (NIHSS). They were randomly assigned to either the experimental C-NIHSS interactive computer assisted instruction (ICAI) group ( n = 44) or the Instructor-led videotape learning program (IVLP) group ( n = 40) to learn the C-NIHSS. Methods The measurement tools included the score verification unit (SVU) (score range from 0 to 45, content validity index, CVI = 0.96, percentage agreement = 84%) and the learner satisfaction scale (CVI = 0.92, Cronbach's alpha = 0.97). Results Both groups’ scores on the assessment of correctness significantly increased ( F = 35.50, p = 0.00) after intervention. However, there was an insignificant difference between the changes in the two groups ( F = 0.02, p = 0.89). After using one-way ANCOVA analysis, and adjusting for the length of experience in neurological nursing, the results showed that in the second post-test, the ICAI group's score was significantly higher than that of the IVLP group ( F = 4.81, p = 0.03). There was a positive correlation between assessment correctness on the second post-test and length of experience in neurological nursing ( r = 0.35, p < 0.05). It was concluded that nurses with less experience in neurological nursing, who receive ICAI will perform a better assessment of stroke patients than those who received IVLP. Conclusion The C-NIHSS ICAI teaching program contributed to better assessment correctness after adjusting for the length of experience in neurological nursing, and to some extent increased satisfaction for the participating nurses. Therefore it is worth promoting the use of ICAI for in-service education of nurses, especially for nurses with less experience in neurological nursing, in order to enhance long-term effects of learning.

Comparison of three interventions to increase mammography screening in low income African American women

Background: Low-income African American women are more likely to die of breast cancer than their Caucasian counterparts, and at least part of the difference in mortality results from differential screening adherence. The purpose of this study was to identify more efficacious methods of promoting routine mammography screening in underserved populations. Methods: A prospective randomized intervention study of 344 low income African American women compared the impact of three interventions on mammography adherence and stage of readiness: (1) pamphlet only; (2) culturally appropriate video; and (3) interactive computer-assisted instruction program. Results: The interactive computer intervention program produced the greatest level of adherence to mammography (40.0%) compared to the video group (24.6%) and the pamphlet group (32.1%). When subjects in the pamphlet and video groups were combined to form a non-interactive group, this group had a significantly lower adherence than the group who received the interactive computer intervention (27.0% versus 40.0%). There was also significantly more forward movement in mammography stage of readiness among participants in the computer group (52.0%) compared to those in the pamphlet group (46.4%) or the video group (31.3%). When combining the non-interactive technology (pamphlet and video) there was also more forward movement in mammography stage of readiness for those in the interactive intervention group (52.0% moved 1 or 2 stages) compared to those in the non-interactive group (36.2%). Conclusions: These data indicate that tailored approaches are more effective than targeted messages either in print or video format. Another finding of this study is that interactive interventions are more effective than non-interactive interventions in increasing adherence and moving African American women forward in their mammogram stage of readiness.

Development of an interactive computer-assisted instruction (ICAI) program for patient prenatal genetic screening and carrier testing for use in clinical settings

Educating patients on prenatal genetic screening and carrier testing in a timely and effective manner is faced with barriers including, providers’ limited knowledge, and little time available to spend discussing screening and testing during a visit. This paper describes the use of cognitive response interviews (CRI) and usability testing (UT) in the development of an interactive computer assisted instruction (ICAI) program for use by prenatal patients in clinical settings. Lessons learned during the program development process included simplification of content and adaptation of navigational features in response to observations and interviews of a sample of patients representing the intended population. The resulting program functions as a targeted patient education program that maintains the level of medical information needed, as specified by professional practices guidelines, in a patient friendly format. In addition, this ICAI program functions as a research tool that can collect data on program effectiveness. Researchers developing other patient education programs will benefit from the lessons learned during development of this ICAI program by considering rephrasing of content to fit patient understanding, and adding navigational features to help further facilitate effective program use.

Tutor versus Computer: A Prospective Comparison of Interactive Tutorial and Computer-Assisted Instruction in Radiology Education

Rationale and Objectives This study compared the educational effectiveness of an interactive tutorial with that of interactive computer-assisted instruction (CAI) and determined the effects of personal preference, learning style, and level of training. Materials and Methods Fifty-four medical students and four radiology residents were prospectively, randomly assigned to receive instruction from different sections of an interactive tutorial and an interactive CAI module. Participants took tests of factual knowledge at the beginning and end of the instruction and a test of visual diagnosis at the end. They completed questionnaires to evaluate their preferred learning styles objectively and to elicit their subjective attitudes toward the two formats. Mean test scores of the tutorial and CAI groups were compared by means of analysis of covariance and two-tailed repeated-measures F test. Results Both the tutorial and CAI groups demonstrated significant improvement in posttest scores ( P < .01 and P < .01, respectively) with the tutorial group's mean posttest score marginally but significantly higher (32.84 vs 28.13, P < .001). There were no significant interaction effects with participants' year of training ( P = .845), objectively evaluated preferred learning style ( P = .312), subjectively elicited attitude toward learning with CAI ( P = .703), or visual diagnosis score (tutorial, 7.61; CD-ROM, 7.75; P = .79). Conclusion Interactive tutorial and optimal CAI are both effective instructional formats. The tutorial was marginally but significantly more effective at teaching factual knowledge, an effect unrelated to students' year of training, learning style, or stated enjoyment of CAI. The superiority of the tutorial is expected to increase when it is compared with commercially expedient CAI modules.

Computer-Assisted Instruction in Reducing Errors in Scoring of the WISC—III

The current study assessed the effectiveness of interactive computer-assisted instruction software in reducing subsequent errors in scoring the WISC–III. Errors in scoring from 84 protocols of graduate students presented with this software simulation as part of their initial training were compared with errors in scoring from 77 protocols of graduate students without such training. These were different sets of students matched for amount of training and differing in having the training component. Protocols from the former group contained significantly fewer errors of correct assignment of points, failure to question when specified to do so, and over-all total number of errors. Mechanical errors, conversion errors, and errors establishing correct starting and stopping points (basal and ceiling points) were not significant. The results support the effectiveness of computer-assisted instruction when used in conjunction with classroom training.

The AcCell series 2000 as a support system for training and evaluation in educational and clinical settings.

Providing effective training, retraining and evaluation programs, including proficiency testing programs, for cytoprofessionals is a challenge shared by many academic and clinical educators internationally. In cytopathology the quality of training has immediately transferable and critically important impacts on satisfactory performance in the clinical setting. Well-designed interactive computer-assisted instruction and testing programs have been shown to enhance initial learning and to reinforce factual and conceptual knowledge. Computer systems designed not only to promote diagnostic accuracy but to integrate and streamline work flow in clinical service settings are candidates for educational adaptation. The AcCell 2000 system, designed as a diagnostic screening support system, offers technology that is adaptable to educational needs during basic and in-service training as well as testing of screening proficiency in both locator and identification skills. We describe the considerations, approaches and applications of the AcCell 2000 system in education programs for both training and evaluation of gynecologic diagnostic screening proficiency.

Meeting the educational needs of clinical equipment users.

Training equipment users to operate medical equipment effectively and safely is one of the most important and difficult tasks of clinical engineers. As medical equipment proliferates and becomes more complex, the task of education also becomes more difficult. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that all equipment users be trained annually in proper operating procedures for the equipment they use and that the training be documented. Therefore, each hospital must develop educational programs to meet those needs. This paper illustrates the use of an interactive computer-assisted instruction (CAI) program, entitled EquipTeach, to provide an effective, standardized and cost-effective method of training equipment users at the John Dempsey Hospital of The University of Connecticut Health Center in Farmington, Connecticut.

Effective education of adults with asthma who are allergic to dust mites

The effects of supplementary computer instruction in house dust mite—avoidance measures on adherence to implementing measures, on home dust mite—allergen levels, and on symptomatology were investigated in 52 adult patients with mite-associated asthma. Twenty-six patients received conventional instruction (counseling and written instruction) and the other 26 patients received conventional plus 22 minutes of interactive computer-assisted instruction. Instructions were aimed at mite-avoidance measures. Pre- and postinstruction dust samples were collected, and adherence was monitored. All patients kept symptom diaries twice a day. Patients' progress was followed for 12 weeks, and all patients completed the study. Adherence, number of observed and self-reported mite-avoidance measures implemented after visit, was higher for the computer group ( p = 0.023). The computer-instructed group achieved significantly lower levels of mite allergen in bedroom carpets ( p = 0.004) with mean levels of mite allergen declining from 6.5 ± 7.6 to 2.2 ± 4.3 μg/gm of dust (two-site monoclonal antibody assays), whereas levels for the conventional-instructed group did not change. Moreover, by study weeks 9 and 10, the computer-instructed group was significantly less symptomatic ( p = 0.033). Mean symptom scores for this group decreased from 12.4 to 7.7, compared with 16.4 to 14.3. Conventional instruction supplemented with computer instruction is suggested in mite education.

AUA Decision Making

American Urological Association (AUA) Decision Making program is an interactive computer-assisted instruction package designed for the practicing clinical urologist. Available programs are reviewed as is the technical requirements and components of the program. Plans for the future are discussed.

Effectiveness of computer-based education in elementary schools

A meta-analysis of 32 comparative studies showed that computer-based education has generally had positive effects on the achievement of elementary school pupils. These effects have been different, however, for programs of off-line computer-managed instruction (CMI) and for interactive computer-assisted instruction (CAI). The average effect in 28 studies of CAI programs was an increase in pupil achievement scores of 0.47 standard deviations, or from the 50th to the 68th percentile. The average effect in four studies of CMI programs, however, was an increase in scores of only 0.07 standard deviations. Study features were not significantly related to study outcomes.