Medical Teacher, Vol. 12, No. 3/4, 1990 349

SHORT COMMUNICATION

Assessment of an interactive microcomputer= videodisc programme for teaching medical students to evalute the peripheral blood smear

T. J. GARRETT,’ DAVID G. SAVAGEZ & GERRY HENDRICKSON3, Department of Medicine, Harlem Hospital Center and ZCenter for Medical

Informatics, 3College of Physicians and Surgeons, Columbia University, New York

SUMMARY A n interactive microcomputer-videodisc programme for providing instruc- tion in interpreting the peripheral blood smear was evaluated by 23 medical students. The mean scores of the students on a test of interpretation of photomicrographs of blood smears increased significantly after use of the teaching programme. The students’ responses to a questionnaire indicated that they viewed computer based instruction as a useful learning tool. The results of the study suggest that computer assisted instruction may be one method for addressing some of the current problems in medical education.

The combination o f a microcomputer and videodisc player permits the development of interactive teaching programs which incorporate high quality visual images. Factors inhibiting the adoption of interactive video in medical education were outlined by Kramer & Polan (1988). They pointed out the importance of demonstrating teaching effectiveness of this technology. An additional issue is the acceptability of this teaching method to student users. The study described in this report was designed to address these concerns.

Materials and methods

An interactive microcomputer-videodisc program was developed to provide third year medical students with an introduction to the use of the peripheral blood smear in evaluating patients with anaemia. The generic videodisc ‘Atlas of Hematology’ pro- duced by the Health Sciences Center for Educational Resources at the University of Washington was selected as the source for video images. A commercially available

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350 T. J. Garrett et al.

authoring system was used to create the computer program which ran on a microcom- puter with a hard disc drive. The program was designed to be used independently by students with no computer background.

Students interpreted a set of colour photomicrographs of peripheral blood smears and then individually worked through the computer-videodisc program at their own rate without faculty supervision. Immediately following completion of the computer- assisted instruction, they re-interpreted the same photomicrographs. They also com- pleted a questionnaire which sought their opinion of this educational method. The questionnaire took the form of a series of statements to which the students responded on a Likert type scale with 1 indicating that they agreed with the statement, 5 was neutral and 9 that they disagreed.

Student’s t-test for paired samples was used to analyze the scores on the pre- and post-test. A p value of less than 0.05 was considered to be significant.

Results

The microcomputer-videodisc program was evaluated by 23 third year students. The mean pre-test score was 66.1% (standard deviation 7.7%) while the post-test score was 85.3% (standard deviation 5.5%), a statistically significant difference (p<O.OOl). The mean time for 21 medical students to complete the programme was 59.2 minutes (standard deviation 12.9 minutes). The questionnaire was completed by all 23 students and results are summarized in Table I.

TABLE I. Responses to Questionnaire by 23 Medical Students. Numbers Shown are Mean Responses (Scale of 1 to 9 with 1 =Agree with Statement; 9=Disagree with Statement) with the Standard Deviation in

Brackets

The program was easy to use The instructions were clear The program was fun to use The program was too simple There was too much text to read The pictures of the blood smears were of good quality Using the computer program was more effective than attending a lecture with slides of the smears Computer programs should replace some lectures Computer programs should supplement some lectures

1.1 (0.3) 1.1 (0.3)

6.5 (2.3) 7.5 (1.6)

2.0 (1.1)

2.2 (2.1)

2.7 (1.7) 4.0 (3.0) 1.1 (0.3)

Discussion

While videodisc technology offers a means for providing a visual component to computer-assisted instruction, it does so at an increased cost for equipment and program development. This increases the importance of assessing the effectiveness of microcomputer-videodisc teaching programs, assessing their role in the medical school curriculum and determining the acceptability of this technology to potential users.

While a number of microcomputer-videodisc programs have been described in the medical education literature (Wheeler, 1983; Abdullah et al., 1984; Blackman et al., 1985; Jensh, 1987; Verbeek, 1987), there are relatively few reports on efforts to validate their effectiveness (Blackman et al., 1985; Mitchell et al., 1985). The results

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Interactive videodisc in teaching haematology 35 1

of the study reported in the present communication also demonstrate that a microcom- puter-videodisc program can be an effective method of teaching subject matter with a major visual component.

A new teaching method must be acceptable to students if it is to be effectively incorporated into their learning patterns. Published reports on student reaction to microcomputer-videodisc programs, although limited in number, have been favorable (Mitchell et al., 1985; Jensh, 1987). The questionnaire results from the current study (Table I) indicate that medical students had a positive view of this educational technology. They had no difficulty using the programme, enjoyed it and considered it effective in comparison to traditional slide-lecture presentations of haematology material.

Interactive microcomputer-videodisc programs may provide one method for dealing with some of the current problems in medical education. However, before a major commitment of faculty time and financial resources is made to this technology, its effectiveness must be established and its appropriate role in curriculum determined. A limited number of studies (Blackman et al., 1985; Mitchell et al., 1985), including the current report, have demonstrated efficacy in different settings. However, this is a small body of information upon which to base major decisions on educational approaches. Further studies in a variety of subject areas, both basic and clinical, are in order to establish the case for interactive microcomputer-videodisc programs in medical education.

Acknowledgements

This project was supported in part by grant LM04419 from the National Library of Medicine.

REFERENCES

ABDULLAH, A.M., WATKINS, L.O. & HENKE, J.S. (1984) The use of natural language entry and laser videodisc technology in CAI, Journal of Medical Education, 59, pp. 739-745.

BLACKMAN, J.A., ALBANESE, M.A., HUNTLEY, J.S. et al. (1985) Use of computer-videodisc system to train medical students in developmental disabilities, Medical Teacher, 7, pp. 89-97.

JENSH, R.P. (1987) Use of interactive-video programmes in education in basic medical science, Journal of Medical Education, 62, pp. 942-944.

KRAMER, T.A.M. & POLAN, H.J. (1988) Uses and advantages of interactive video in medical training, Journal of Medical Education, 63, pp. 643-644.

MITCHELL, J., MCNEELY, M.D.D. & CHANG, E.J.H. (1985) A computer-controlled video disc system for teaching white cell morphology and differential counting to medical technology students, Journal of Medical Technology, 2, pp. 655-658.

VERBEEK, H.A. (1987) Self-instruction through patient simulation by computer, Medical Education, 21, pp.

WHEELER, L.A. (1983) Medical student instruction in hematology via computer-video material, Journal of 10-14.

Medical Education, 58, pp. 667-668.

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