Medical Teacher, Vol. 18, No. 4, 1996

SHORT COMMUNICATION

Student-centred multimedia projects for teaching and learning in pre-clinical medicine

JAMES F. AITON', SUSAN WHITEN' & HANIA ALLEN2 'School of Biological and Medical Sciences and the 2Computing h b o r a t o y , University of St Andrews, St Andrews, Scotland

SUMMARY This paper describes an innovative, student- centred approach to the integrated study of histopathology, anatomy and physiology in which medical students are taught the skills that enable them to create computer-based multimedia tutorials aimed at third-year pre-clinical students. In addition to improving their technological skills, stdents acquire a broad range of personal and educational skills as they aaUress the issues involved in planning and authoring their teaching materials.

Introduction

In 1993, we received funding for a pilot project from the Scottish Higher Education Funding Council (SHEFC) as part of their Flexibility in Teaching and Learning Scheme. We introduced a course which enabled the intercalating medical students to create their own multimedia teaching tutorials (Aiton et al., 1994). This group of students is a small, self-selecting cohort (between 10 and 15 per year) with good academic records who elect to complete an intercalated year leading to an Honours Degree in Medical Science. Based on the success of the pilot scheme, we have embedded the project within the intercalated programme and the course has now been running for 3 years.

Two major factors influenced the introduction of the student-centred projects. First, the development of relatively low-cost, high-performance desktop computers led us to introduce innovative computer-based histology tutorials and we were greatly encouraged by student acceptance of this new approach to teaching and learning (Whiten et al., 1992). Second, changes in the curriculum were seen as being essential in the light of the General Medical Council's (1993) Tomorrow's Doctors report which highlighted the development of self-directed learning skills as an essential component of student training. Extensive use of computer technology was specifically encouraged as a key, transferable skill. Against this background, we designed a project which we hoped would address some of

the issues raised by the GMC. Our principal aims for the students were that, as they were completing their tutorials, they would acquire:

factual knowledge and a deep understanding of a clinically relevant special topic as they reflected upon and modified information from the basic biomedical sciences; a wide range of transferable information technology skills; interpersonal communication skills; team work within the peer group, time and resource management and oral presentation skills.

Implementation

A wide choice of projects was offered and students were encouraged to suggest others. In the event, all students were able to work on their chosen subject area and this helped to contribute to the enthusiasm they showed. Examples of topics included endoscopy (a case-history chosen to illustrate pathology, Figure la) and prenatal diagnosis (the scientific basis and methods used to assess fetal development, Figure 1 b) .

The equipment dedicated to the project included eight Macintosh computers, two flat-bed and two 35 mm slide scanners and video-capture and digitizing equipment. The students used Hypercard to create their teaching modules along with a variety of general purpose and specialist software tools such as ClarisWorks, Adobe Premiere, Adobe Photoshop and Morph to acquire and edit their resource materials and produce simple animations. Staff from within the school and clinicians from local hospitals acted as supervisors, assisting students to research and collect material for the scientific content of their pro- grammes. A computer adviser was seconded part-time

Correspmaimz: Dr Susan Whiten, School of Biological and Medical Sciences, University of St Andrews, St Andrews, Fife, KY16 9TS, Scotland. Email: sw last-andrews.ac.uk.

338 0142-159X/96/040338-03 0 1996 Journals Oxford Ltd

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Student-centred multimedia projects

Figure 1. Screen shots taken from two different student tutorials: (a) this stack describes the technique of endoscopy and is based on a case study involving the diagnosis and treatment of peptic stricture. It includes a number of QuickTime movies showing the exploratory investigation, the biopsy process and subsequent treatment as well as histological and pathological images and a multiple-choice self-assessment section; (b) a card taken from a prenatal diagnosis tutorial showing a still photo and QuickTime movie of an ultrasound scan. A number of different genetic and imaging techniques which are used to assess

the health of the fetus are described in detail.

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3. F. Aiton et al.

from the University Computing Services Department and she devised and taught a course on ‘Creating Multimedia Tutorials with Hypercard’ (this course is now available in an on-line format from the World Wide Web location http://www.st-andrews.ac.uMcYcal/courseHC/home.html). The course equips students with the skills necessary to assemble their primary sources into an integrated teaching package. Within the first six weeks, students learn techno- logical skills in a series of seminars, consolidated by super- vised practical sessions. Projects are constructed during the remaining period (approximately 8 weeks) when students are dividing their time between a ‘special topics’ seminar programme, a laboratory research project and our comput- ing project on an approximately equal basis. The design brief given to the students is that they should produce a multimedia teaching tutorial requiring a maximum of 45 minutes to complete.

Assessment

The student projects are an assessed component of the Honours course and account for 20% of the total marks. This weighting approximates to the level of commitment expected from the students (1 day per week over 14 weeks), and is the same as the weighting given to the laboratory research project.

The student projects are evaluated on a number of criteria by different assessors. Content is reviewed by the supervisor (organization, accuracy, clarity, relevance, emphasis). Technology skills are assessed by the computer adviser (elegance of scripting and interface design). A third-year student and an independent member of staff examine the effectiveness of the tutorial as a teaching package. Students also deliver an assessed audio-visual presentation on the design and production of their project using an LCD data projection tablet. The final mark for the project is based on the input from five evaluators.

Student feedback

Thirty students have now completed the course and the feedback has been consistently positive. With two excep- tions, the project students have started with only the

basic skills taught to all our medical students. Never- theless, the majority initially described themselves as being anxious about using computers but, by the end of the course, all felt very confident. Some 85% enjoyed the project very much, found it well organized and intellec- tually stimulating.

Conclusions

Both staff and students feel that the project is successful with the overall quality of the material produced by the students being high. Our own impressions are supported by the external examiners who have consistently com- mented very favourably on the quality of the student tutorials as well as the innovative nature of the project. Students clearly enjoy the freedom and creativity of this new component of their course. Perhaps for the first time in their preclinical years, they become active participants in the learning process and set the agenda for their own studies.

Acknowledgements

We are grateful to the Scottish Higher Education Funding Council for financial support under their Flexibility in Teaching and Learning Scheme.

Notes on contributors

SUSAN WHITEN is a Lecturer in Anatomy and JIM AITON is a Lecturer in Cell Physiology at the School of Biological and Medical Sciences. HANm ALLEN is the University Computer Assisted Leam- ing Development Officer. All three are based at the University of St Andrews, St Andrews, Fife, Scotland.

References

Arro~, J., WHITEN, S. & ALLEN, H. (1994) Student centred multi- media projects in preclinical medicine, in: A. TOWEL (Ed.) Innovative Laming and Assessment, Sharing Ideas 3 pp. 76-77 (London, King’s Fund).

GENERAL MEDICAL COUNCIL (1993) Tomorow’s Doctors (London, GMC) .

WHITEN, S., PETERSON, N. & AITON, J.F. (1992). Scenes fiom the movies: developing extensible multimedia in histology, The CTISS File, 14, pp. 36-40.

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