Creating a Web-Enhanced Interactive Preclinic Technique ... · PDF fileCreating a Web-Enhanced Interactive Preclinic Technique Manual: Case Report and Student ... ciples of cavity

December 2004 ■ Journal of Dental Education 1245

Creating a Web-Enhanced Interactive PreclinicTechnique Manual: Case Report and StudentResponseKenneth G. Boberick, D.M.D.Abstract: This article describes the development, use, and student response to an online manual developed with off-the-shelf

software and made available using a web-based course management system (Blackboard) that was used to transform a freshman

restorative preclinical technique course from a lecture-only course into an interactive web-enhanced course. The goals of the

project were to develop and implement a web-enhanced interactive learning experience in a preclinical restorative technique

course and shift preclinical education from a teacher-centered experience to a student-driven experience. The project was

evaluated using an anonymous post-course survey (95 percent response rate) of 123 freshman students that assessed enabling

(technical support and access to the technology), process (the actual experience and usability), and outcome criteria (acquisition

and successful use of the knowledge gained and skills learned) of the online manual. Students responded favorably to sections

called “slide galleries” where ideal and non-ideal examples of projects could be viewed. Causes, solutions, and preventive

measures were provided for the errors shown. Sections called “slide series” provided cookbook directions allowing for self-paced

and student-directed learning. Virtually all of the students, 99 percent, found the quality of the streaming videos adequate to

excellent. Regarding Internet connections and video viewing, 65 percent of students successfully viewed the videos from a

remote site; cable connections were the most reliable, dial-up connections were inadequate, and DSL connections were variable.

Seventy-three percent of the students felt the videos were an effective substitute for in-class demonstrations. Students preferred

video with sound over video with subtitles and preferred short video clips embedded in the text over compilation videos. The

results showed it is possible to develop and implement web-enhanced and interactive dental education in a preclinical restorative

technique course that successfully delivered information beyond the textual format.

Dr. Boberick is Associate Professor, Department of Restorative Dentistry, Temple University School of Dentistry. Direct

correspondence to him at Department of Restorative Dentistry, Temple University School of Dentistry, 3223 North Broad Street,

Philadelphia, PA 19140; 215-707-7708 phone; 215-707-2840 fax; [email protected].

Key words: computer-assisted instruction, video streaming, computers, web-enhanced, interactive, educational software,

education

Submitted for publication 8/5/04; accepted 10/19/04

The objective of preclinical restorative den-

tistry courses has always been multidisci-

plinary. Students are expected to learn and

apply foundation knowledge concerning the prin-

ciples of cavity preparation and properties of dental

materials; develop and refine perceptual motor skills

(manual dexterity) to a level that allows for smooth

transition into the clinical setting; and develop self-

evaluation skills that allow critical value judgments

concerning the acceptability of work produced. Re-

vision of the overcrowded dental curriculum and the

current trend toward elimination of redundant den-

tal laboratory procedures have produced a need to

develop educational tools and teaching methods that

maximize the learning experience of students in pre-

clinical restorative dentistry technique courses.

Foundation didactic knowledge is traditionally

taught using a lecture and textbook format, while the

corresponding laboratory section teaches dental

motor and discrimination skills using a “show then

do” or demonstration format. Because most teach-

ing institutions have customized laboratory courses

with corresponding manuals, the ability to deliver

high-quality still and video images within the manual

has the potential to improve the effectiveness of the

laboratory manual as a teaching tool by improving

the quality and quantity of information delivered.

Hoban and Van Ormer1 found that the use of

moving images helped students improve retention

of concepts, facilitated thinking and problem solv-

ing, and in some cases functioned as well as an in-

structor in communicating facts or demonstrating

procedures. Goodyear and Steeples2 noted that video

can provide vivid descriptions to articulate tacit in-

formation and knowledge difficult to describe

through text. Dale3 believed the moving image could

balance the “over-verbalization” he saw as endemic

in education. Moss4 felt that video could help tilt the

balance away from teacher-centered instruction to-

ward learner-centered study.

1246 Journal of Dental Education ■ Volume 68, Number 12

Teaching preclinical restorative dentistry is a

resource-intensive endeavor. The large number of

techniques requiring demonstration and the high stu-

dent to faculty ratio make one-on-one instruction

difficult. In addition, because students learn at dif-

ferent rates and have different learning styles, instruc-

tor time and talent quickly become taxed. Time and

resource limitations affect the availability and qual-

ity of instructor demonstrations. It is important for

dental educators to recognize that students have dif-

ferent learning styles and should consider ways of

accommodating different learning preference modali-

ties.5 Therefore, the goals of this project were to pro-

vide high-quality digital multimedia resources (still

images and video) in the form of an interactive web-

based manual that would lessen the teaching burden

on faculty and allow students to develop in a self-

paced, student-directed learning environment.

The widespread use of video in education has

always been limited by production costs and deliv-

ery difficulties. However, the availability of high-

quality digital cameras and desktop video editing

software combined with the growth and development

of broadband Internet video streaming technologies

allows for the creation and use of high-quality web-

based video in dental education.

This article describes the development of a

web-enhanced online manual that was developed

with off-the-shelf software and delivered using a

web-based course management system (Blackboard).

It transformed a freshman restorative preclinical tech-

nique course from a lecture-only course into an in-

teractive web-enhanced course. The interactivity pro-

vided students with opportunities for self-paced

learning by providing “anytime, anywhere” access

and control over the study materials and learning

environment. Students had access to the material in-

side the school via the local intranet and from re-

mote locations using a broadband Internet connec-

tion. A library of video materials provided the student

with choice and control by providing on-demand

viewing with the ability to start, stop, pause, skip,

and review the material.

I accomplished all work on the project during

a three-year period of development, implementation,

and annual revision. During the first year, a compre-

hensive laboratory manual for the freshman opera-

tive and prosthodontic courses was developed that

included revisions of outdated sections of previous

manuals and addition of newer customized sections.

The manual, developed as an MS Word document

and converted to PDF format, was made available

as a web-interactive resource with selected sections

provided as hard copy for reference during the labo-

ratory session. During year two, the visual content

of the manual was improved by incorporation of high-

quality color images within the document text. In

year three, streaming video was developed and in-

corporated into the manual as hyperlinks, which pro-

vided the students with on-demand viewing. It was

determined, based on previous evaluation of the stu-

dents, that the entering freshman possessed the ba-

sic computer skills necessary to access the

online teaching material without the need

for additional training.

MethodsThe initial writing and revision of the

manual in year one did not require intense

computing power and was easily accom-

plished using Microsoft Word on a PC-

compatible machine (Pentium II 500 MHz,

256 MB Ram, Windows 2000) connected

to a flatbed scanner. The incorporation of

digital images in year two produced large

file sizes that were barely manageable by

the existing system. The resource-intensive

nature of the software required for video

editing in year three forced a substantial up-

grade to the system. An important lesson

learned from this project is that faculty in-Figure 1. Picture-formatting option


Figure 2. Slide gallery showing classic MO amalgam preparation in tooth #30

Figure 3. A detailed slide series documents fabrication of a gold crown


terested in creating web-based learning should work

closely with a computer consultant to review the

components required to create a customized system.

Excess technology will substantially increase ex-

penses while outdated technology will be ineffec-

tive.

A system designed for video editing requires a

powerful processor (Pentium IV or AMD Athlon XP

1800 or higher) capable of handling a heavy pro-

cessing load. A minimum of 512 ram (random ac-

cess memory) is required to minimize freezing of

the system during video editing and rendering. Video

acquisition requires the use of a FireWire for import-

ing digitized video or the ability to digitize analog

video (VHS, HI-8 tapes) using a video capture card.

A large capacity hard drive (100 GB or greater) with

a large slave drive for archival purposes and a CD

rewriter (CDRW) for transfer and backup of large

files is essential. All work for this project was ac-

complished using a PC-compatible machine with the

following specifications: AMD Athlon XP 2000Mhz,

Windows XP Professional operating system, 512 MB

2100DDR ram, ATI All-in-Wonder 8500DV video

capture card with 64 MB video Ram, 100 GB mas-

ter drive, 160 GB slave drive for video archives, DVD

Rom at 16X, and CDRW at 48X.

The manual was created in Microsoft Word by

digitizing and incorporating pertinent sections of ex-

isting manuals using optical character recognition

(OCR) software and flatbed scanning. New sections

of the manual were written directly into the Word

document. Pictures were obtained by flatbed scan-

ning and digital photography. High-quality still color

images were incorporated into the document and

formatted using “tight” layout (Figure 1). Tight lay-

out wraps text around the object allowing for free

movement of the image in the document during ed-

iting and annual revision. The color images were used

to create sections called “slide galleries” that con-

tained examples of practical exams (Figure 2). Sec-

tions called “slide series” provided the students with

detailed instructions for performing the laboratory

projects (Figure 3).

The use of the Document Map option (Figure

4) during text editing was important because it al-

lowed for the creation of headings in the Word docu-

ment. During conversion to PDF format using Adobe

Acrobat Writer 6.0, these headings became naviga-

tion bookmarks. The creation of these bookmarks

was essential because it allowed for easy navigation

through the large PDF document and helped students

keep track of their location in it (Figure 5). Annual

updates to the manual can be performed directly in

Word, and the original bookmarks are retained dur-

ing conversion to PDF format. Security can be set in

the PDF file limiting printing and preventing unau-

thorized changes.

The incorporation of digital images produced

an extremely large file size (530 MB). Conversion

to PDF format using Adobe Acrobat Writer 6.0 was

required to produce a file with manageable size (11.5

MB) that can be uploaded to a server and viewed by

students from a remote site. Students with high-speed

Internet connections were able to view the manual

as a single document. To accommodate students with

dial-up connections, the manual was uploaded in sec-

tions, or chapters, each not greater than 600 KB,

which allowed for download and viewing over a

slower connection.

The incorporation of images into the manual

improved the quality and quantity of the visual in-

formation that could be delivered and was well re-

ceived by the students. However, it was a static for-

mat with limitations. Students commented negatively

in annual course evaluations about the lack of in-

class demonstrations by instructors. The next phase

in the development of the manual was the incorpo-

ration of streaming video that could be accessed on

demand from a central video library or through

hyperlinks embedded in the text of the document.

I digitized VHS and Hi-8 format tapes using

the Radeon All-in-Wonder 8500DV capture card.

Videos were captured in the MPEG-1 format. Video

editing using Pinnacle Studio 8 produced video seg-

ments suitable for streaming over the net as well as

still images and video suitable for insertion into

PowerPoint presentations. The program also allowed

sound editing and the addition of subtitles that could

be placed as overlay items or title pages in the video

(Figure 6).

The Pinnacle program is capable of rendering

the final edited video in a number of different for-

mats depending on what media player will be used

and the speed of the Internet connection available.

Dial-up connections are not suitable for streaming

video. In this project, image quality was a high pri-

ority, and high-speed broadband connection was

available in the computer library using the local

intranet. Therefore, video for broadband PAL (1500

Kbps total) was chosen as the mode of delivery for

streaming over the net (Figure 7). Since the rendered

video file, MPEG or WMV format cannot be edited,

it is important to save the edited video as a “Pin-

nacle Project” allowing for future editing.


Video was obtained from both VHS and Hi-8

format tapes. Both formats produced videos with

acceptable clarity and detail. However, VHS and Hi-

8 tapes are analogue format requiring a video cap-

ture card to digitize and transfer the video to the com-

puter. Digital format cameras can connect via a

FireWire (IEEE1394), thereby allowing for direct

connection between the camera and the computer and

eliminating the need for a capture card. Higher-qual-

ity material is possible because the video remains

digital throughout the capturing process. Mini-Digi-

tal video cameras would be the best digital video

source, but any quality video camera with a macro-

zoom lens would be acceptable.

Once edited, a video must be rendered and en-

coded in the proper format for delivery. Encoding

has two purposes: compression for web delivery and

saving in a suitable video file format. How you en-

code your video depends on two main questions: 1)

what media player will be used, and 2) what Internet

connection speed will be available. Because of the

high detail required in the videos, video for broad-

band PAL (1500 Kbps total) was chosen as the ren-

dered format (Figure 8). This format is viewable on

a PC-compatible computer using a broadband con-

nection (DSL or cable). The ability to view video on

both a PC-compatible (Windows operating system)

and Macintosh computer would require the use of

QuickTime video format. Video titles, copyright,

authorship, and short descriptions can be added to

the video before final rendering.

The manual was converted to a PDF file and

posted on Blackboard, the web-based resource tool

utilized by Temple University for e-course manage-

ment (Figure 9). Registered students accessed the site

to view the syllabus, print posted lecture notes, view

videos from a central video library, and link to rec-

ommended web-based resources using navigation

buttons. The use of Blackboard (a web-based course

management system) was important because it al-

lowed interactivity and integration. Interactivity was

achieved by linking computer technology with video

technology, allowing the student control over the pace

and direction of the learning. Integration was

achieved by using the web to interlink the video with

slides, supporting texts, and resource links, creating

a virtual learning environment. The use of hyperlinks

within the manual, created using the “insert

hyperlink” tool found on the tool bar (Figure 10),

further increased the interactivity and integration.

Once linked to the uploaded videos, the manual

was converted to PDF format using the Adobe con-

vert button found in the Word toolbar (Figure 11).

The created hyperlinks were retained during the for-

mat conversion and provide the students with the

ability to link/interact with the uploaded video and

recommended external URL sites.

Student response to the project was obtained

using an anonymous post-course survey administered

on the last day of class. The survey was adminis-

tered to 123 freshman dental students, with 117 stu-

dents completing the survey. Multiple choice and

Likert-type questions were used to assess the stu-

dents’ perceptions regarding type of remote Internet

connection used and remote viewing success, accept-

ability of video format and video quality, and per-

sonal viewing habits and preferences. Open-ended

questions gave students an opportunity to provide

feedback regarding their perceptions of the effective-

ness of various components of the online laboratory

manual and streaming video. A section regarding the

use of laptop computers and wireless Internet use

was included in the survey to measure student inter-

est regarding the use of wireless Internet in the

preclinic lab, a logical next step in development of

the manual.

Faculty opinion regarding the effect of the

manual was obtained through informal conversations

during the course and a short survey completed

shortly after the course ended. Likert-type questions

elicited faculty perceptions of the following issues:

course organization and flow, stress levels in the stu-

dents and faculty, changes in the quality of student’s

work, and possible changes in student learning style

and faculty teaching styles. Faculty were encouraged

to provide written comments expanding on each of

the questions. Six of nine faculty responded, and all

six were instructors in the course throughout the

three-year development period.

ResultsUnderstanding the full impact of technology-

based learning events such as streaming video and

web-based resources is difficult because of the nu-

merous variables involved. As described previously,

the student survey elicited perceptions about en-

abling, process, and outcome criteria. Enabling cri-

teria are those that relate to technical support and

flexibility of access to the technology. Process crite-

ria included those criteria that relate to the actual ex-

perience and process such as friendliness and usabil-

ity of the interface, usefulness of the material, issues


Figure 5. Headings in the original Word document become navigation bookmarks duringconversion to PDF format using Adobe Acrobat Writer 6.0

of self-pace and attention span, and ease of

interactivity with the learning material. Out-

come criteria included the effects or impact

of the materials on the student’s ability to

acquire and successfully use the knowledge

and skills learned promoting self-paced

learning.6

Regarding the enabling criteria, 65

percent of the students reported that they

were able to view the videos at home. Forty-

five percent of students had cable connec-

tion, 41 percent had DSL, and 14 percent

had a dial-up connection. Students with

cable connections had the fewest problems

with remote viewing. Students with dial-up

connections could not view the videos at

home, and 50 percent of the students with

DSL had problems. Problems with DSL

seemed to be related to file size and time of

day. Shorter videos with smaller file size

were easier to view. Late evening viewing

was more successful than daytime viewing,

indicating traffic volume was a problem.

Sixty-seven percent of the students unable

to view the videos at home reported theyFigure 4. Document Map option


Figure 6. Pinnacle Studio version 8 was used for video editing

Figure 7. Rendering the final video as an MPEG or WMV file


could successfully view the videos using the com-

puter lab in the school. Thirty-seven percent of the

students reported reviewing 75-100 percent of the

available videos, 28 percent reviewed 50-75 percent,

21 percent reviewed 25-50 percent, and 16 percent

reviewed 0-25 percent. Most of the videos were in-

tegrated into PowerPoint presentations and shown

during scheduled lecture sessions. Several students

reported reviewing the videos online was not neces-

sary because they had already viewed them during

lectures.

Regarding process criteria (students’ opinions

of the learning experience), 48 percent of the stu-

dents agreed or strongly agreed that the quality of

the videos was excellent, 51 percent reported the

video quality was adequate, and 1 percent reported

that the quality was poor. Seventy-three percent of

the students agreed or strongly agreed that the vid-

eos were an acceptable substitute for in-class dem-

onstrations, 17 percent were neutral, and 10 percent

disagreed or strongly disagreed. Most students who

felt the videos were not an acceptable substitute wrote

comments indicating that the videos were “useful,

helpful and should remain in the course,” but felt

that live in-class demonstrations were also needed.

Thirty-seven percent preferred videos with sound,

18 percent preferred videos with subtitles, and 45

percent reported the two were equally effective.

Videos were available as short clips (one to five

minutes in length) and as compilation videos com-

bining several clips edited to form a sequence (length

forty-five to seventy-five minutes) of the entire pro-

cedure. Forty-three percent of students preferred the

short clips, 8 percent preferred the compilation video,

and 49 percent thought both were equally effective.

Difficulty in navigating through the large compila-

tion videos was cited most often by students as a

reason they preferred the shorter clips. Links to the

video clips were embedded into the text of the manual

as hyperlinks allowing for interactivity while read-

ing. This feature was noted as excellent by the stu-

dents because it allowed for easy interaction with

minimal navigation.

The online manual was made available as a

complete document (11 MB) and also as individual

sections or chapters with a file size limit of 600 KB.

Because of slower download speeds, students with

dial-up connections preferred downloading the indi-

vidual sections of the manual. Students with faster

connections initially downloaded the entire manual

but later downloaded the individual sections as

needed, reporting improved computer performance

and easier navigation using the smaller sections rather

than the entire manual.

Regarding outcome criteria, response to the

open-ended questions provided the most specific

feedback regarding student perceptions of the effec-

tiveness of the online manual. The videos in particu-

lar were cited as extremely helpful in preparing stu-

dents for upcoming laboratory sessions. Many

students requested that the videos remain available

to them so they could review procedures before per-

forming them for the first time in the clinic. Students

were quite specific in their written comments, with

many reporting they felt less stress because they were

more organized and prepared for lab, resulting in

fewer laboratory mistakes requiring project remakes.

Faculty feedback was generally positive re-

garding the impact of the manual on course flow and

organization and student organization and prepared-

ness. Response was mixed regarding the effects on

stress levels, quality of the student’s work, student

learning behavior, and faculty teaching style. One

faculty member commented: “The manual is an ex-

cellent resource that can only be successful if it is

used by the students. Those students that used the

manual seemed better prepared, and ways should be

explored to encourage usage.” Another commented

the manual and video were especially helpful “for

new faculty orientation and calibration.” A third in-

dicated the videos will function well as a supplemen-

tary resource compensating for faculty who are not

entirely comfortable performing in-class demonstra-

tions.

DiscussionStudies have demonstrated the effectiveness of

Internet and CD-based multimedia programs to de-

liver education material. Aly et al.7 compared an in-

structional multimedia program with a standard lec-

ture for teaching an undergraduate orthodontic

curriculum. The instructional interactive multimedia

program was found to be at least as effective as the

standard lecture for undergraduate training in orth-

odontics. Bissell et al.8 showed that computer-assisted

learning and traditional teaching methods are equally

effective in teaching periodontal pocket charting to

undergraduate dental students. Clark9 in a study ex-

amining web-based continuing dental education in

California concluded the best type of online continu-


ing education course would be one designed to pro-

vide an interactivity opportunity to take full advan-

tage of the unique features and opportunities pro-

vided by the Internet.

The process of becoming an expert is a learn-

ing continuum progressing from novice, to begin-

ner, competency, proficiency, and eventually mas-

ter.10 It could be argued that the educational

development of dental students in a preclinical re-

storative technique course progresses along a simi-

lar learning curve from novice to beginner to com-

petent. Beginning students can be defined as novices.

They attend to what they are told is important and

are almost entirely dependent upon faculty. Novice

learners become frustrated when faculty do not cre-

ate standardized circumstances and routines that al-

low them to follow the rules that will lead to satis-

factory results.10 The online manual was intended to

guide students along this early learning continuum

in the preclinic.

Sections in the manual labeled “slide series”

provided students with detailed instructions for per-

forming the laboratory projects. The “cookbook”

instructions provided students with enough detailed

information to promote a self-paced learning envi-

ronment that encouraged student-directed indepen-

dent study. The detailed instructions were designed

to answer the most frequently asked student ques-

tions and addressed causes and solutions for the com-

mon errors and problems encountered in the lab. In-

corporation of the slide series into the manual

provided the structure and detail required by begin-

ning students.

The ability to have a paperless preclinic restor-

ative manual was very appealing; however, previ-

ous work showed that students preferred a hard copy

in the lab to allow for quick reference and note-

taking. Selected sections of the digital manual were

provided as hard copy to the students, eliminating

the need for expensive individual printing by the stu-

dent. The hard copy was printed directly from a CD

by a commercial printer providing excellent image

quality.

Another reason for incorporation of color im-

ages into the manual was to improve the effective-

ness of visual learning beyond that which is avail-

able from line drawings and black and white images.

Knowledge of the desired outcome would appear to

be a major contributor to the acquisition of dental

motor skills.11 Instructional approaches that result in

the acquisition of knowledge about the desired out-

come and the performance necessary to obtain it are

important to facilitate the learning of student dental

motor skill.11 Sections of the manual called slide gal-

leries containing examples of practical exams were

not printed but rather made available for viewing

online. These slide galleries helped students develop

discrimination skills by providing examples of com-

mon errors that occur during cavity preparation and

restoration. Strategies were provided for correction

and future prevention of these errors

The use of streaming video provided the stu-

dents with on-demand quality demonstrations in a

format that allowed the course director to control both

the quality and content of the demonstration. The

ability to provide quality on-demand streaming video

was an important goal of the project. All video pro-

duction was accomplished by the author with the help

of a fourth-year dental student. In order to minimize

the volume of tape requiring editing, video produc-

tion followed a predetermined script. I edited all the

videos myself because it is my experience that pro-

duction and editing are most efficient if performed

by the same person.

Shooting video for streaming is a trade-off be-

tween quality and speed of connection. Streaming is

a method of making video, audio, and other multi-

media available relatively quickly via the Internet.

The advantage of streaming is that the video is not

downloaded in its entirety to the user’s computer

before it can be played. With streaming, the file re-

mains on the server. The initial part is copied to a

buffer on the computer and then, after a short delay,

starts to play and continues as the rest of the file is

being pulled down.6 Because the video is never down-

loaded to the user’s computer, availability of hard-

drive space is not an issue, and copyright concerns

related to unauthorized copying and distribution are

minimized. The server regulates the stream accord-

ing to network congestion and thereby optimizes the

presentation on the student’s computer.6 A better for-

mat to stream video for remote viewing might be a

multiple bit rate profile for target audiences with dual-

channel ISDN, LAN, cable modem, or xDSL con-

nections. Bandwidth is between 100 and 500 Kbps.12

Accessibility would be improved, but the effect on

quality may be unacceptable. For this project, excel-

lent video quality was a higher priority than remote

access because students were guaranteed access to

the video using the local intranet. Therefore, video

for broadband PAL (1500 Kbps total) was chosen as

the rendered format.


Figure 8. Choices for rendering a WMV file

Figure 9. Blackboard web page


Figure 10. Insert hyperlink tool in Word

Figure 11. Adobe PDF conversion button found in Word


Educational video is not a type of incidental

learning; the learning still needs to be organized as

part of a deliberate learning experience.13 The vid-

eos were organized in a video library with short nar-

ratives describing the content. The videos were avail-

able for on-demand, stand-alone viewing and were

also accessible through hotlinks in the body of the

text, making the videos an adjunct or supplement to

the text. Students reported in the post-course survey

that the ability to read about a procedure and imme-

diately view a demonstration was extremely valu-

able.

Student responses in post-course surveys con-

ducted at the end of each year were always quite

positive. The survey in year three was particularly

positive regarding the streaming video. Future di-

rection of the project includes the development of a

self-contained, CD/DVD-ROM-based delivery for-

mat or utilization of wireless Internet in the preclinic

lab. Students commented in the survey that the avail-

ability of the material on a CD or DVD would elimi-

nate most of the access problems. However, CD-

based delivery rather than web-based might decrease

integration potential by eliminating the ability to add

or modify links to other web-based resources.

Regarding wireless connectivity, 55 percent of

the students reported owning a laptop, and 72 per-

cent indicated they would consider bringing their

laptop to lab to access the manual if wireless Internet

was available. Wireless Internet connectivity and

successful video streaming have been pilot-tested and

are possible in the preclinic laboratory; this would

be a logical next step in the ongoing development of

this project.

Regarding the evaluation process, it was never

my intent to answer the question: Is computer-

assisted instruction better than traditional instruction?

This would have been a difficult endeavor, requiring

a randomized experiment with at least one interven-

tion group and one control group. Most randomized

studies do not account for the effects of changes in

the media and educational methods separately and

are therefore confounded.14 In addition, it would be

unethical to withhold a potentially beneficial educa-

tional methodology from a group of students.

The evaluation strategies were employed

throughout the three-year project and were designed

to obtain student feedback that could be used to guide

the development and implementation phases of the

project. In the future, the evaluation process will be

expanded to determine whether the educational de-

sign achieves its goals and explore the reasons for

success and failure. This would most likely require

the help of evaluation specialists with training in in-

structional design. A study of student usage patterns

using the course evaluation tools available in Black-

board would also be helpful. Student feedback to this

point helped direct the development of this web-

based manual and will certainly influence the future

direction.

It should be noted that I do not have formal

training in computer technology. As the course di-

rector for the freshman restorative dentistry preclinic

technique course, I developed this project over a

three-year period as my research, teaching, and uni-

versity service schedules permitted. Overall, I con-

sider the project a success because it helped change

the preclinical experience of the students from a

teacher-centered style of instruction to a student-

driven experience.

SummaryThe development of effective educational soft-

ware is expensive and time-consuming and requires

resources that may not be available. Ideally, educa-

tional software development should be a team pro-

cess involving faculty and various types of educa-

tional, computer, and multimedia specialists.15

However, these team resources are not available at

many dental schools, so faculty need to be creative

and resourceful if they wish to incorporate web-based

learning into their courses. This article described a

method, using off-the-shelf software and existing or

easily created text and video teaching materials, to

create an interactive web-enhanced technique manual

for a preclinic restorative dentistry course that in-

corporates interactivity for the student and integra-

tion with web-based resources. The use of an online

web-enhanced laboratory manual with interactivity

and integration features demonstrates that the Internet

can be used successfully to deliver information be-

yond the textual format.

AcknowledgmentsI would like to thank Mike Stabinski, Faculty

Support Technical Specialist, Instructional Support

Center, Temple University, for his technical support

and advice regarding video streaming and Dr. John

Lignelli, Jr. (Temple ’03) for his valuable help in

video production.


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