Thursday, July 2, 2015

Providing Uniform Instruction Using Web-Based, Asynchronous Technology in a Geographically Distributed Clinical Clerkship: Analysis of Student Participation and Satisfaction

Don Peska, DO, FACOS, MEd
Texas College of Osteopathic Medicine

As medical schools in the United States increase their class size, many are forced to extend their teaching affiliations outside of their immediate communities in order to provide adequate clinical experiences for their students. Georgraphic distribution threatens the ability to provide the uniform learning opportunities that students need and accrediting bodies require. The purpose of this work was to determine if the sophistication and availability of Internet technology may provide a solution for this challenge.

Sixty-three third-year medical students from the University of North Texas Health Sciences Center enrolled in an eight-week core clinical clerkship in surgery were required to take part in a Web-based, asynchronous interactive instructional module designed to provide opportunities for higher order thinking through analysis, synthesis and reflective learning. Quantitative and qualitative measures of participation were determined by interrogating the frequency of their interaction and the content of their online discussion. At the compltion of the clerkship stuents completed an attitude survey of their experience to determine both positive and negative attributes of the Web-based learning module.

Students found little difficulty in navigating the Web-based module and were readily able to meet the requirements for completing weekly projects and participating in asynchronous, online discussions. The content of their discussion, as determined by message coding, identified the critical thinking needed to acquire abstract conceptualization of the problems presented. Students found the content fo the module relevant to the clerkship and most valued the participation of an instructor/facilitator to provide feedback on their work. Although they prefer classroom-based instruction stuents indicated that the Web-based module provided an enhancement to their overall cognitive learning experience in the clerkship.

The application of Web-based technology appears to afford an acceptable teaching alternative when face-to-face instruction cannot be provided. Further study of the impact of instructional design on the quality of higher order thinking in this domain is needed as is an appreciation for the dynamics of group learning in a virtual environment.