Librarians: Kristine Alpi, MLS; Helen-Ann Brown, MLS

MS; Daniel Cleary, MLS; and Carolyn Reid, MA.

Notes on contributors

MADELON L. FINKEL, PhD, is Professor of Clinical Public Health and

Course Director in the Department of Public Health. She is Director of

Cornell Analytics/Consulting Services, a research division in the

Department of Public Health, Weill Medical College of Cornell

University. Her areas of expertise include population-based epidemiology

and health care policy research.

HELEN-ANN BROWN, MLS MS, is a member of the Information Services

of the Weill-Cornell Medical Library.

LINDA M. GERBER, PhD, is Associate Professor of Public Health and

Director of the Clinical Research Methodology Core at the Weill Medical

College of Cornell University. Her areas of expertise include the

epidemiology of hypertension.

PHYLLIS G. SUPINO, EdD, is Clinical Associate Professor of Public Health

and Associate Research Professor of Public Health in Medicine. She is

Director, Data Management, Biostatistics and Educational Programs,

Division of Cardiovascular Pathophysiology at Weill Medical College of

Cornell University.

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Education, 29, pp. 133–138.

Computer-assisted learning for teaching anatomyand physiology in subjects allied to medicine

MICHAEL J. LEWISDepartment of Sports Science, University of Wales Swansea

SUMMARY Computer-assisted learning (CAL) may provide

an effective supplement to conventional methods of teaching,

particularly in subjects such as anatomy and physiology. CAL

provides the student with an important additional resource and

facilitates alternative modes of learning that are well suited to the

requirements of students in subjects allied to medicine. A brief

survey is presented which examines those studies that have

investigated the utility of CAL for teaching anatomy and

physiology within subjects allied to medicine.

Introduction

Subjects allied to medicine traditionally include the health

and biomedical sciences, physiological measurement, vision

sciences, nutrition, occupational therapy, physiotherapy,

osteopathy and radiography. Students in each of these

disciplines study a range of core subjects in the physical,

biological and clinical sciences. Multidisciplinary subjects

such as nursing, pre-hospital care and sports science integrate

elements from several of these individual areas of study. The

most effective higher education programmes provide oppor-

tunities for students to become truly ‘knowledgeable’ in both

the theoretical and practical elements of these courses.

However, with ever increasing student numbers and limited

resources, the problem arises of how best to provide the

learning experiences that will achieve this goal. In this regard,

computer-assisted learning (CAL) may provide an effective

supplement to conventional methods of teaching in subjects

allied to medicine.

A brief survey of CAL in subjects allied to medicine

Medical education

The advantages provided by well-produced CAL materials

are consistent with the General Medical Council (GMC)

recommendation regarding undergraduate medical educa-

tion, i.e. the need to develop learning based on curiosity and

knowledge exploration, rather than the passive acquisition of

knowledge (GMC, 1993). Appropriately, there have been

many reports of the use of CAL for teaching medical and

dental students and as part of professional development

courses.

Anatomy and physiology

Staninger (1994) suggested that hypertext is ideally suited to

the requirements of teaching physiology as it emphasizes the

Correspondence: Dr M.J. Lewis, BSc MSc PhD CPhys MInstP, Department of

Sports Science, Vivian Building, University of Wales Swansea, Singleton Park,

Swansea, SA2 8PP. Email: m.j.lewis@swansea.ac.uk

Short communications

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conceptual interrelationships between the body systems. More

recently, Michael (2001) has presented a comprehensive

discussion of the concept of using computers to achieve

‘meaningful learning’ in physiology, emphasizing the

positive role of problem-based learning in this regard.

Rawson & Quinlan (2002) have provided a useful summary

of general guidelines for educational software development

based on their experience in developing such materials in

physiology.

The objective of the brief survey presented here was to

examine studies that have been performed to evaluate the

utility of CAL in teaching anatomy and physiology within

subjects allied to medicine.

Search criteria. Reports were sought in the literature that

assessed the use of CAL in subjects allied to medicine and

that fulfilled the following criteria: (1) provided a description

of a qualitative or quantitative investigation of the use of CAL

in anatomy or physiology education; (2) compared the

efficacy of CAL with some other form of teaching, whether

as a supplement or a replacement teaching modality; (3)

included a sample population consisting of undergraduate or

postgraduate students. Articles that only described the

development of software or that presented simulation type

software, but that did not otherwise satisfy the admission

criteria, were excluded from the search results.

A systematic search of the literature was performed using a

selection of electronic search databases (PubMed, BIDS and

ERIC). The following combinations of keywords were used:

((computer AND learning) OR (computer AND instruc-

tion)) AND (physiology OR anatomy).

In addition, the following subject headings (SH) were

used to search ERIC: (computer assisted instruction—SH)

OR (computer uses in education—SH) OR (educational

technology—SH) OR (multimedia instruction—SH) OR

(multimedia materials—SH) OR (courseware—SH) OR

(computer software evaluation—SH).

Searches for individual disciplines were performed using

the following combinations of keywords: ((computer AND

learning) OR (computer AND instruction)) AND (‘disci-

pline’) where ‘discipline’ was one of the subjects listed in the

introduction (e.g. ‘physiological measurement’ or ‘sports

science’). Citation tracking was performed from the articles

obtained via the databases, yielding a second source of

references.

Studies that fulfilled the criteria

Only 10 studies satisfied the inclusion criteria for this survey,

these covering a broad range of specific topics within

anatomy and physiology. The highly focused nature of

these topics suggests that the authors viewed CAL as a tool

for presenting ‘concepts’ or for simulating specific scenarios.

The majority of the studies reported an improvement in

student performance after using CAL compared with more

traditional methods of learning. Table 1 summarizes those

Table 1. Studies reporting the evaluation of CAL materials for teaching anatomy and physiology in subjects allied to health.

Author, date Study topic/assessment Study conclusions

Dori & Yochim (1994) ‘Studyware’ on human physiology Student scores were enhanced when using

the studyware

Davis (1997) Use of a Web browser to present online

documents that support lecturer materials

and textbooks for medical physiology

Positive qualitative assessment by students

Richardson (1997) Comparison of standard didactic lectures,

computer-assisted lectures and computer

laboratory assignment on the topics of

Quantitative Circulatory Physiology and

Mechanical Properties of Active Muscle

Students perceived standard lectures as being

the most effective method. Scores on the

computer laboratory assignment were

significantly higher than those on the

didactic or computer-assisted lectures

Plankey (1998) A distance-learning exercise physiology class Student learning via the distance CAL

package performed comparably but scored

non-significantly less than students

receiving lecture-based instruction

Dewhurst & Williams

(1998)

Comparison of computer-based tutorial and

traditional lectures for teaching about the

cardiovascular system

Knowledge gain assessed by pre- and

post-tests was not statistically different

between the CAL and traditional groups

Washington et al.

(1999)

Biomechanics CAL tutorial Improved student performance on tests and

positive student feedback

Michael (2001) Comparison of groups using CAL alone, CAL

in pairs or non-CAL (traditional) learning of

blood pressure regulation

CAL use improved post-test scores

compared with controls Those working in

pairs improved most

Hallgren et al. (2002) An interactive web-based tool for learning

anatomical landmarks

Web-based tool was effective in improving

exam scores

Buzzell et al. (2002) The effectiveness of Web-based, multimedia

tutorials for teaching methods of human

body composition analysis

No significant differences between the

groups in pre- to post-test mean score

changes

Rawson & Quinlan

(2002)

Evaluation of a computer-based approach to

teaching acid/base physiology (no

comparison with other modes of learning)

Scores improved significantly between pre- and

post-tests (students had some previous

experience of the subject but not of using CAL)

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studies that fulfilled the search criteria. A brief outline of the

topic of instruction is presented for each of the CAL studies,

together with a summary of the evaluation and the authors’

conclusions.

Discussion

The survey of CAL for teaching anatomy and physiology

produced relatively few comparative studies that satisfied the

inclusion criteria. The results of these studies were generally

positive, the authors advocating the use of CAL for teaching

anatomical and physiological concepts. However, it is

recognized that quantification of the effectiveness of CAL,

with regard to the transfer of knowledge and/or skills to

the learner, is difficult (Sittig et al., 1995). The ultimate

judgement of the efficacy of a CAL package should be based

on how well it engages the student’s attention, encourages

learning and thus offers an enhanced learning experience.

CAL can provide real benefits through (1) exposure

to alternative representations of conceptual information;

(2) repeated exposure to a broad spectrum of real-life

scenarios; and (3) practice in problem solving. We might

therefore expect that CAL should help to fulfil students’

educational and continuing professional development require-

ments more effectively and more efficiently. The potential of

CAL to fulfil this role in higher education is especially

important in light of the recent trend for increasing student

numbers in the subjects allied to medicine (see Taylor,

2002). The flexibility of CAL (the choice of ‘when, where

and how’ to learn) can be an important factor within an

educational course, particularly for those undertaking part-

time study.

It is reasonable to conclude that if CAL is designed well

and is used appropriately, both students and educators will

benefit from increased satisfaction with the learning process.

The most likely future application of CAL, especially for

teaching anatomy and physiology, will be as a complement

to existing traditional courses. CAL provides the student

with an important additional resource and facilitates alter-

native modes of learning that are particularly well suited

to the requirements of students in subjects allied to

medicine.

Notes on contributor

MICHAEL LEWIS is a Lecturer in Applied Physiology at the Department of

Sports Science, University of Wales Swansea. He is a Chartered Physicist

whose primary research and teaching interests include heart rate

variability analysis, cardiovascular autonomic regulation, physiological

measurement, medical physics, biomedical signal processing and the use

of computer-assisted learning in higher education.

References

BUZZELL, P.R., CHAMBERLAIN, V.M. & PINTAURO, S.J. (2002) The

effectiveness of Web-based, multimedia tutorials for teaching methods

of human body composition analysis, Advances in Physiology Education,

26(1), pp. 21–29.

DAVIS, M.J. (1997) Use of World Wide Web server and browser software

to support a first year medical physiology course, Advances in Physiology

Education, 17(1), pp. S1–S14.

DEWHURST, D.G. & WILLIAMS, A.D. (1998) An investigation of the

potential for a computer-based tutorial program covering the cardio-

vascular system to replace traditional lectures, Computers and Education,

31, pp. 301–317.

DORI, Y.J. & YOCHIM, J.M. (1994) Human physiology: improving

students’ achievements through intelligent studyware, Journal of

Science Education & Technology, 3(4), pp. 263–269.

GMC (GENERAL MEDICAL COUNCIL) EDUCATION COMMITTEE (1993)

Tomorrow’s Doctors: Recommendations on Undergraduate Medical

Education (London, General Medical Council).

HALLGREN, R.C., PARKHURST, P.E., MONSON, C.L. & CREWE, N.M.

(2002) An interactive, web-based tool for learning anatomic landmarks,

Academic Medicine, 77(3), pp. 263–265.

MICHAEL, J. (2001) In pursuit of meaningful learning, Advances in

Physiology Education, 25(3), pp. 145–158.

PLANKEY, R.B. (1998) Piloting exercise physiology in the Web-based

environment, THE Journal, 26(5), pp. 62–64.

RAWSON, R.E. & Quinlan, K.M. (2002) Evaluation of a computer-based

approach to teaching acid/base physiology, Advances in Physiology

Education, 26(2), pp. 85–97.

RICHARDSON, D. (1997) Student perceptions and learning outcomes of

computer-assisted versus traditional instruction in physiology,

Advances in Physiology Education, 18(1), pp. S55–S58.

STANINGER, S. (1994) Hypertext technology: Educational consequences,

Educational Technology, 34, pp. 51–53.

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experiential learning simulation: a case study using criterion-referenced

testing, Computers in Nursing, 13, pp. 17–24.

TAYLOR, J. (2002) Changes in teaching and learning in the period to

2005: the case of postgraduate higher education in the UK, Journal of

Higher Education Policy and Management, 24(1), pp. 53–73.

WASHINGTON, N., PARNIANPOUR, M. & FRASER, J.M. (1999) Evaluation

and assessment of a biomechanics computer-aided instruction,

Computers & Education, 32(3), pp. 207–220.

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