Integrating e-learning to improve learning outcomes: a proven way for teachers to engage students and improve learning outcomes is through the appropriate use of e-learning and Web 2.0 tools in teaching.
Davies, Anne
THE BEST LEARNING HAPPENS WHEN STUDENTS ARE ENGAGED and everyone
participates. The challenges facing educators go beyond course content.
Instruction must be culturally responsive to support the achievement of
a diverse population. Instructors need to facilitate understanding using
a framework that meets every student's level of learning within the
affective, cognitive, and psychomotor domains so that each reaches a
higher form of creativity and innovation. A proven way for teachers to
engage students and improve learning outcomes is through the appropriate
use of e-learning and Web 2.0 tools in teaching. The literature supports
the case for incorporating technology into teaching to improve learning
in the medical field.
The future of medical education needs to include e-learning
resources to interest technologically advanced students and encourage
learner-centered responsibility and accountability. To inspire learning,
the curriculum must meet the needs of today's students. Colleges
that pride themselves on being leaders in delivering the best, most
educated, students in the medical field must continue to set themselves
apart from other institutions by offering state-of-the-art education
supported by emerging digital technologies.
It is not challenging to find information using the Internet. A
great deal has been published about the future of medical education, the
current and future state of international medical education, and the
importance of keeping learning central when integrating emerging
technologies.
The literature regarding the incorporation of Web 2.0 technologies
in medical imaging education is extensive. This vast amount of
information can be gathered and grouped into a cohesive review that
supports the case for using e-resources to achieve better learning
outcomes in the medical sciences.
Learning the theories involved in medical imaging is complex. For
example, students of magnetic resonance imaging (MRI) are required to
learn the physics principles behind the creation of optimal diagnostic
images. Historically, the teaching methods used included assigned
readings supported by lectured PowerPoint presentations (Hoegerl and
John 2010). Unfortunately, this model of learning does not meet the
needs of every student. There are distinct differences in how students
and teachers engage in the educational process (Guri-Rosenblit 2001).
Teachers expect students to come prepared for the lecture by reading the
assignment in advance. Students attend the lecture without any
preparation and expect to learn the material only during the class
period. The same can be true for online teaching, with the added
concerns of distance education: accountability, instructional quality,
technical issues, motivation, and isolation (Westbrook 2012).
Current higher education trends are leading to the adoption of a
different academic culture. To increase student understanding, the
curriculum must be learner-centered, engaging, and interactive
(Guri-Rosenblit 2001). Implementing educational programming that
increases the interactivity of and engagement with the learning process
by using problem-based activities promotes an increase in understanding
(Davis and Davis 2010). Integrating technology in learning is intended
to help students form meaningful connections with the content and
improve their knowledge and retention of the material (Davis and Davis
2010). New technologies are stimulating change in the development and
delivery of both conventional and distance teaching. These new
technologies in e-learning include blogs, discussion boards, chat rooms,
e-mails, Twitter, Wikis, game-based learning, virtual learning
environments, and a variety of other Internet-based Web 2.0 utilities
(Hoegerl and John 2010). Research shows that universities are using
these applications in a push toward globalization: enrolling more
international students, building inter-institutional partnerships, and
offering distance education (Guri-Rosenblit 2001). Distance teaching
universities excel at the development of high-quality educational
materials created by instructional design experts to reach more students
and motivate richer learning experiences (Guri-Rosenblit 2001).
Evidence of this can be found in a study conducted in the United
Kingdom. A review conducted at the Anglia Ruskin University evaluated
the effectiveness of three online collaborative initiatives designed to
enhance the educational experiences of postgraduate distance learning
MRI pathway students (Westbrook 2012). The online learning tasks
included in these initiatives were aligned with the Salmon model for
creating effective e-learning experiences (Salmon, Nie, and Edirisingha
2010). The model promotes online socialization through creation of a
virtual learning environment to provide students with connection to the
content and each other, information exchange to access learning
materials, knowledge construction to facilitate communication, and
development to support future and extended learning experiences
(Westbrook 2012). Included were well-delivered directions for
introducing oneself and meeting fellow classmates in an online forum,
e-learning activities such as a discussion board and live chat room to
exchange and share information, and collaborative tasks to create
questions and answers to assess knowledge of new topics. Research showed
that participation in all the activities was above 89 percent. Because
of successful early socialization resulting from the introduction
activity, students were motivated to collaborate in understanding the
learning outcomes (Westbrook 2012). A final questionnaire showed that
students found value in the e-learning activities and that those
activities contributed to their distance learning experience (Westbrook
2012).
This trend is also international. In the near future, medical
universities in Asia will include problem-based, student-centered
learning in their educational models (Rajabi, Majdzadeh, and Ziaee
2011). For example, Iran is expected to increase the use of innovative
educational techniques in teaching new advancements in diagnostic and
therapeutic technologies (Rajabi, Majdzadeh, and Ziaee 2011). A recent
qualitative study discussed significant trends affecting Iranian medical
education. One trend in particular, the advancement in information
technologies (IT), has led to greater access to long distance and
virtual learning education and continued medical training (Rajabi,
Majdzadeh, and Ziaee 2011). Integrating these technologies has also
significantly increased medical research and medical teaching (Rajabi,
Majdzadeh, and Ziaee 2011). In those countries that did not integrate
technology, the disparate aspects of medical education resulted in
fragmented learning (Rajabi, Majdzadeh, and Ziaee 2011).
It is clear that e-learning and the integration of technology in
teaching are affecting medical instruction. Medical education is
shifting from what the learner needs to know to what the learner should
be expected to do as a result of education (Davis and Davis 2010). For
example, in emergency and disaster training, the development of online
collections of emergency medical literature aids doctors in learning
specific procedures and techniques (Harden 2006). In medical education,
this trend also includes the use of simulators, which were first
introduced in the 1970s with "Harvey" the cardiology patient.
This early mannequin patient was an effective tool for teaching bedside
cardiovascular assessment to both undergraduate and postgraduate
students. Rapid advancements in technology have increased the use of
mannequin simulators in clinical training as realistic models can now be
programmed to provide a more sophisticated level of interaction.
There are a number of other interesting applications involving the
integration of technology in medical education. One study evaluated the
benefits of having graduate students use personal digital assistants
(PDAs) to record clinical notes, look up references, check online
resources, and communicate with medical faculty (Luanrattana et al.
2012). The research showed that medical students may prefer to use these
devices to help organize their four years of medical studies
(Luanrattana et al. 2012). Figure 1 depicts the potential integration of
PDAs into medical education as described in the study. The risks and
benefits of using PDAs were detailed in three specific areas:
functionality, technical aspects, and practical aspects. Each area was
further broken down into subthemes to help visualize the potential for
this technology. The study identified some concerns related to training,
data security, information privacy, ethical issues, network
connectivity, system maintenance, and technological support and
concluded that it is important to address these concerns by providing
sufficient education, training, security, maintenance, and support to
medical educators, students, and administrators (Luanrattana et al.
2012).
Education practice must meet the needs of 21st-century students.
The purpose of teaching is to support learning; the only authentic
measure of teaching is student learning (Hay et al. 2008). The challenge
for instructors is to enhance and ensure learning by delivering
innovative content (Tunks 2012). Advancements in technology and Web 2.0
tools offer a variety of ways to support education and transform
teaching (Dew 2012). A study was conducted to measure the quality of
e-learning designed to teach the principles of MRI to third-year medical
students. The process involved measuring student understanding of MRI
before and after the course using concept mapping, a Web 2.0 tool.
Assessments of student understanding were evaluated to distinguish
between meaningful learning and rote learning outcomes. Students were
also scored on the breadth of their conceptual knowledge as compared to
the content of the e-teaching material (Hay et al. 2008). In addition,
the study addressed some of the concerns regarding the use of Web 2.0
tools in learning, including the complexity of developing an empirical
measurement of student knowledge and the concern that learning is not a
result of teaching but rather of student behavior (Hay et al. 2008). It
was determined that neither of these two concerns precluded the study
from assessing the effectiveness of the teaching.
The prerequisites for the study defined the baseline against which
the learning quality was measured:
* Students must have relevant prior knowledge of MRI concepts.
* The material to be learned must be relevant to prior knowledge.
* Students must actively learn new material.
Students were taught how to create concept maps using a Web 2.0
resource and asked to create a map to describe MRI principles. After an
hour, this information was collected from the students on CD-ROMs.
Students were next taught basic principles of MRI over the course of six
to eight hours. Afterward, students were asked to compose a new concept
map. Evaluators compared the prior concept maps with the new concept
maps, analyzing the structural changes and the quality of non-learning,
rote learning, and meaningful learning for each of the participants. In
addition to evaluating individual student learning of relevant concepts,
the quality of the e-instruction was also evaluated.
[FIGURE 1 OMITTED]
Figure 2 depicts the learning measures of students before and after
the teaching of new MRI principles. Comparing the two columns
illustrates the extent to which students applied new concepts to
existing knowledge. Non-learners reflected the same conceptual structure
after a day of instruction. Their connections were simple, lacking a
link between prior knowledge and newly acquired knowledge. Rote learners
demonstrated some connections between new concepts and prior knowledge
in their concept maps. Meaningful learners demonstrated increased
understanding of MRI topics. Their conceptual structures linked prior
knowledge with newly acquired knowledge. The study concluded that
student knowledge structures were improved through the integration of
technology in learning: more than half of the student population
achieved the level of knowledge of either a rote or meaningful learner.
Empirical evidence indicated that the quality of student learning was a
product of student activities and behaviors and not necessarily a direct
consequence of the content being taught (Hay et al. 2008).
A study designed to assess the use of hands-on experiments and
computer modeling in teaching the basics of MRI physics showed that
students better understood magnetic resonance principles after using
computer visualizations of atomic movement (McBride, Murphy, and Zollman
2010). This study evaluated research-based learning materials in both
formats. It found that students who used computer animations
outperformed students who completed only hands-on experiments. The
educational training assessed in the study advanced through three
manipulative learning experiences in which students experimented with
bar magnets to learn about magnetism, studied pendulum motion to learn
about frequency and resonance, and then connected these to the concept
of magnetic resonance imaging. Subsequent to the hands-on training,
students interacted with computer models that allowed them to visualize
atoms at varying frequencies simulating atomic motion in a magnetic
field (figure 3).
[FIGURE 2 OMITTED]
[FIGURE 3 OMITTED]
The research determined that integrating technology helped students
correlate both learning experiences to build a better understanding of
magnetism. However, this was not the case with understanding the
concepts of frequency and resonance. It was apparent that additional
teaching, careful wording, and more incremental building blocks were
required to help students learn these advanced concepts (McBride,
Murphy, and Zollman 2010).
Given the growing popularity of e-learning and the increase in
research supporting e-learning in teaching, it is important to consider
why educators are hesitant to use technology in medical education. The
most obvious reason is that something this new takes time. A survey of
305 faculty members compared early adopters of technology in teaching
with mainstream faculty (figure 4). The values highlighted in black are
done so to emphasize the differences between the early adopters and the
mainstream faculty. It was found that early adopters used a wider
variety of technologies and significantly more technologies in their
curriculum (Zayim, Yildirim, and Saka 2006).
This study also found that early adopters perceived the use of
technology in teaching to be more relevant and useful than mainstream
faculty did (figure 5). These faculty members had statistically stronger
beliefs that technology enabled them to teach to a variety of learning
styles more effectively and with increased productivity (Zayim,
Yildirim, and Saka 2006).
The integration of Web 2.0 tools in education is unavoidable (Cakir
2012). The Internet is not going away. Students access Internet
technologies on a daily basis using their computers and smart phones.
For educators, positive attitudes about the use of digital tools are not
enough to integrate 21st-century technologies into the classroom (Cakir
2012). Educators themselves must embrace, research, evaluate, and master
their use so that application in the curriculum is relevant and
instruction effective (Grosseck 2009). They need to develop an
understanding of how these applications are used in education and how
they can contribute to each student's personal achievement both
inside and outside the classroom (Grosseck 2009).
Given the advancements in technology, the globalization of
education, and the technological sophistication of today's
students, medical schools must find a balance in the integration of
innovative and effective instructional strategies with traditional
teaching methods (Flynn and Vredevoogd 2010). As previously noted, the
only authentic measure of teaching is student learning (Hay et al.
2008). The use of e-learning resources has been shown to enhance and
ensure learning through personalization, active engagement,
collaboration, frequent communication, and authentic application (Tunks
2012). It is important for educators to embrace the use of Internet
technologies to prepare students for their future employment in the
global economy.
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AUTHOR BIOGRAPHY
ANNE DAVIES is the clinical coordinator and instructor for the
Magnetic Resonance Imaging Program at MCPHS University in Boston,
Massachusetts. She completed a bachelor's of science degree in
electrical engineering at Southeastern Massachusetts University. In
2008, she obtained certification in magnetic resonance imaging from
MCPHS University. She furthered her studies with a master's in
education with a concentration in teaching with technology from Post
University in 2013. She is an active member in the community in
presenting and researching potential ways to incorporate technology into
education.
Figure 4 Early Adopters vs. Mainstream Faculty
Table 1. Adopter Groups' Technology Use
Early Adopter Mainstream
% Faculty %
Blackboard 62.5 67.4
Overhead 75.5 69.$
Slide Projector 75.0 76.7
Computer + Projection 100.0 94.6
Video 25.0 19.4
Sound 8.3 3.1
Special Laboratory 29.2 20.9
Course web sites 33.3 10.9
Web resources as a part of content 37.5 14.7
Commercial educational software 16.7 0.0
Word processors for course materials 45.8 31.0
Presentation software 50.0 29.5
Source: Zayim, Yildirim, and Saka 2006.
Figure 5 Differences between Early Adopters and Mainstream Faculty
Significant Differences between Adopter Groups on the Perceived Value
of IT
Items t df P Means
Technology enables me to -3.055 153 0.003 1.24 vs. 1.64
address the different
learning styles of students.
Using technology enables me -2.357 153 0.020 1.28 vs. 1.61
to use lecture time
efficiently
Using technology increases my -2.357 153 0.020 1.28 vs. 1.61
productivity as an
instructor
Source: Adapted from Zayim, Yildirim, and Saka 2006.
