Optional anatomy and physiology e-learning resources: student access, learning approaches, and academic outcomes

Perspectives on self-directed learning in bioscience in nurse education - An integrative review

OBJECTIVES

There is a lack of synthesized knowledge on nursing students self-directed learning in bioscience and how to best support students' learning in this subject. The purpose of this integrative review is to synthesize current literature on perspectives on self-directed learning among nursing students studying bioscience to guide further research aiming to support students' learning more effectively.

METHODS

An integrative review in line with Whittemore & Knafl's modified framework containing five stages: problem identification, literature search, data evaluation, data analysis and presentation. A structured literature search was undertaken in the Web of Science, ERIC, Medline and CINAHL databases from November 2022 to January 2023. The inclusion criteria were nursing students enrolled in a bachelor programme, research addressing activities intended for learning bioscience, in addition to formal taught lectures and perspectives on self-directed learning in natural science subjects within nurse education such as views, actions, activities, habits and attitudes. Exclusion criteria were students in other education programs, research in formal learning contexts, and self-directed learning in other subjects than natural science subjects. Rigour of each included source was assessed using Whittemore & Knafl's suggested 2-point scale (high or low). A constant comparison method was used to synthesize results.

RESULTS

Of the initial 1143 sources, 12 articles were included after abstract and full-text screening: one pilot study for randomized controlled trial, one qualitative study, two mixed methods studies and eight quantitative studies. The sample size was from 23 to 563 participants.

DISCUSSION

This review identifies self-directed learning in bioscience understood as a continuum of teacher-directedness and self-directedness rather than as distinguished orientations. There seem to be no consistent definition of self-directed learning in bioscience, yet descriptions commonly imply metacognitive learning approaches. Nursing students value digital learning resources, yet technology might be secondary to the skill of self-directed learning.

Self-regulated learning of anatomy during the COVID-19 lockdown period in a low-income setting

In March 2020, universities in Zimbabwe temporarily closed and switched to remote learning to contain the spread of SARS Cov2 infections. The sudden change to distance learning gave autonomy to students to direct their own learning. To understand how the students at the University of Zimbabwe and Midlands State University adapted to emergency remote learning, focus group discussions and a self-administered questionnaire survey based on the self-regulated learning inventory were conducted to capture cognitive, motivational, and emotional aspects of anatomy learning during the COVID-19 pandemic. Thematic analysis was used to identify patterns among these students' lived experiences. Two coders analyzed the data independently and discussed the codes to reach a consensus. The results showed that students at the two medical schools cognitively and meta-cognitively planned, executed and evaluated self-regulated strategies in different ways that suited their environments during the COVID-19 lockdown. Several factors, such as demographic location, home setting/situation, socioeconomic background and expertise in using online platforms, affected the students' self-directed learning. Students generally adapted well to the constraints brought about by the lockdown on their anatomy learning in order to learn effectively. This study was able to highlight important self-regulated learning strategies that were implemented during COVID-19 by anatomy learners, especially those in low-income settings, and these strategies equip teachers and learners alike in preparation for similar future situations that may result in forced remote learning of anatomy.

Pedagogical impact of integration of musculoskeletal anatomy blended learning on physiotherapy education

Background

In physiotherapy education, blended learning is recognized to be more effective compared to traditional teaching. The aim of this study was to assess the consequences of a musculoskeletal anatomy blended learning program on skills developed by students.

Methods

We conducted an observational retrospective monocentric study in a French physiotherapy school named "X." Ninety-two first-year students in the 2017-18 baseline group (students with traditional face-to-face learning), and ninety-eight first-year students and ninety-five second-year students in the 2018-19 and 2019-20 blended learning experimental groups was included. A success rate of the anatomy final written exam, defined by the percentage of students scoring 50% or above, was analyzed between 2017 and 2020. We also evaluated the pedagogical value of musculoskeletal e-learning and its usefulness for preparing the student for their anatomy final written exam at «X».

Results

We observed an improvement in the success rate of the anatomy final written exam between the 2017-18 baseline group, 2018-19 and 2019-2020 experimental groups during first (Kruskal-Wallis = 74.06, df = 2, p < 0.001) and second semester (Kruskal-Wallis = 173.6, df = 2, p < 0.001). We obtained a data survey and questionnaire response rate of 74% (n = 89/120) for the 2018-19 and 62% (n = 72/116) for the 2019-20 experimental groups. Concerning questionnaire response, they were no significant statistical difference between 2018-19 and 2019-20 experimental groups.

Conclusion

Blended learning could improve student success rate of the anatomy final written exam and learning of professional physiotherapy skills.

Teaching Histology Using Self-Directed Learning Modules (SDLMs) in a Blended Approach

INTRODUCTION

New technologies like virtual microscopy have revolutionized histology education. However, first-year students often require additional assistance with virtual slides. Online self-directed learning modules (SDLMs) were developed to provide such support to learners by offering them short instructional videos that are uploaded to YouTube and the instructional website. The purpose of this study was to determine the effectiveness of SDLMs and to sample students' opinions about SDLMs.

METHOD

Over a 3-year time span, SDLMs were used to augment histology lessons, and their effectiveness (on learning outcomes) was measured by using traditional steeple-chase and/or virtual slide assessments. Average percentage scores for both methods of assessment were compared using paired or independent t-tests. Student opinions about SDLMs were collected using an anonymous survey. The survey results were analyzed by average scores and thematic analysis of the narrative responses.

RESULTS

Using SDLMs in a blended approach showed significant improvement in students' academic performance - irrespective of the method of assessment. There was a strong positive correlation with the performance when students were assessed using the virtual slide method. However, a standalone approach using SDLMs did not positively impact learning outcomes. Survey results indicated that most students perceived the videos as helpful for understanding the subject better and as quick review opportunities.

CONCLUSION

The results support the use of SDLMs in a blended instructional approach and as an adjunct resource to conventional microscopy. This use of SDLMs was positively received by learners and significantly improved the learning outcome.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01669-9.

A blended learning exercise physiology theory module that supports student autonomy and improves academic performance

A limited number of studies have explored the impact of blended exercise physiology theory curricula on student learning and experience. This study aimed to investigate the impact of an exercise physiology blended learning theory module on student performance, engagement, and perceptions. The module, which comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), was implemented in a third-year subject taken by students in nonspecialist undergraduate science, technology, engineering, and mathematics (STEM) degrees. Students chose which elements to engage with to support their learning. Exam performance was assessed by comparing exam marks from fully face-to-face delivery to the blended delivery with an independent t test. Student perceptions were determined via an end-of-module questionnaire comprised of Likert-scale questions and open-ended questions. Descriptive statistical analysis was conducted on the Likert-scale responses, and qualitative content analysis was conducted on the open-ended responses. Student engagement with online resources was determined through analysis of access statistics from the learning management system. Student exam marks in the blended learning student group were significantly higher (P < 0.0001) than in the face-to-face group, even though the questions were of a higher Bloom's level in the blended learning group. Students preferred blended delivery over fully face-to-face delivery. Most students accessed the student guide, lecturer-recorded videos, and quizzes, with supplementary videos, workshops, and discussion forums accessed by fewer students. In conclusion, a blended exercise physiology theory module improved student exam performance and was positively perceived by students, and engagement with the elements of the module was varied.NEW & NOTEWORTHY Few studies have explored the impact of blended delivery of exercise physiology theory curricula on student learning and experience. This study investigated the impact of a novel blended model on student learning and experience. The module comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), where students were able to choose which elements to engage with to support their learning.

The impact of using an "anatomy escape room" on nursing students: A comparative study

BACKGROUND

Anatomy is an important part of health science education. In teaching anatomy, new teaching strategies have been studied in comparison with traditional-based approaches. In this manner, strategies such as the escape room-based approach have been used as an innovative learning approach in nursing education, but little is known about its application in an Anatomy module.

OBJECTIVE

To evaluate the effectiveness of the escape room for anatomy-related knowledge retention in nursing and the perceived value of the game.

DESIGN

In the first semesters of the academic years 2017-2018 and 2018-2019, a comparative cross-sectional study was conducted.

SETTINGS

This study took place at the University of Almeria with students enrolled in the Anatomy module.

PARTICIPANTS

A total of 248 first-year nursing students took part in the study.

METHODS

The study included two groups: an experimental group (EG) that participated in an escape room in the final session of their Anatomy module, and a control group (CG) that received a traditional-based teaching approach in their final lesson.

RESULTS

Students enrolled in the Anatomy module were randomly assigned to either the experimental (EG, n = 128) or control groups (CG, n = 120). The escape room was conducted in groups of four and lasted no more than 15 min. In terms of satisfaction with the escape room, EG scored above the mean. The item "I enjoyed playing" received the highest score (4.88 ± 0.35). Taking the final scores of each group into account, the EG had a final average score of 8.94 ± 0.96, while the CG had a final average score of 7.70 ± 1.25 (p = 0.001).

CONCLUSIONS

According to the findings, the "Anatomy Escape Room" is a game-based approach that motivates students and constitutes a down-to-earth resource for anatomy learning in healthcare students.

Electronic teaching resources for university cell biology supports improved student learning outcomes

An optional electronic resource (e-resource) that requiring subscription was offered to 2nd year students studying university cell biology. An online survey attitudes identified cost, the relative (lack) ease of use, and a "general preference", as primary reasons for not utilizing the e-resource. The ability to access graphics, videos, and animations, as well as practice questions, was all seen as positive features. Of the 44 e-resource students, a performance increase of 10% (73%, and 63%, p-value = 0.004) was seen compared to those that did not (90). Within the e-resource cohort, academic performance in the previous year, when other online resources were not optional, less of a differentiation was apparent, suggesting difference were not attributable to individual academic aptitudes. Overall, an increase in academic performance was seen in students that used the optional e-resource. These findings will be presented to assist new students in deciding how to approach their learning in cell biology.

Measuring the value of a digital supplemental resource

Supplemental resources in science education are made available to students based on the belief that they will improve course-based student learning. This belief is ubiquitous, with supplemental resources being a traditional component of physiology education. In addition, the recent large-scale transition to remote learning caused by the Covid-19 pandemic suggests an increased relevance and necessity of digital versions of supplemental resources. However, the use of a supplemental resource is entirely dependent on whether students view it as beneficial. If students in a specific course do not perceive a supplemental resource as useful, there is little reason to believe the resources will be used and are worthy of investment. Consequently, measurement of student perception regarding the effectiveness of any digital learning tool is essential for educators and institutions in order to prioritize resources and make meaningful recommendations to students. In this study, a survey was used to determine student perceptions of a digital, supplemental resource. Quantitative methods, including exploratory factor analysis, were performed on data collected from the survey to examine the dimensionality and functionality of this survey. The findings from this study were used to devise an improved, standardized (i.e., reliable and valid) survey that can be used and adapted by physi3ology researchers and educators to determine student perception of a digital supplemental resource. The survey, with known construct validity and internal reliability, can provide useful information for administrators, instructors, and designers of digital supplemental resources.

Working in Creative Partnership with Students to Co-Produce Neuroanatomy e-Learning Resources in a New Era of Blended Learning

Anatomists are well placed to tackle the transition from face-to-face to blended learning approaches as a result of the rapidly forced changes brought about by Covid-19. The subject is extremely visual and has, therefore, previously been a target for the development of technology-enhanced learning initiatives over the last ten years. Today's students have come to expect the integration of technology in the classroom and remotely. They adjust quickly to the innovative use of new applications and software and have begun to integrate it within their own workflow for note taking and study aids. Given the intense drive toward blended deliveries of anatomy as a result of the Covid-19 pandemic, it is easy to picture how the benefits of working in partnership with students (in order to achieve many of these aims) would be possible, particularly in difficult subjects like neuroanatomy. In doing so, it provides anatomists with new opportunities to engage students in a way that aligns well with best practice frameworks for engaging students through partnership. The current United Kingdom guidelines set out by Advance HE (a professional membership organization for promoting excellence in higher education) strongly encourages the higher education community to seek out appropriate academic contexts where a balance of power can be struck between staff and student to create a community of practice. If such an approach can be fully embraced by anatomists, a strong argument can be made for seizing the opportunity to optimize the benefits of student partnership work in this discipline.

Quantitative study showing how and why students access lecture recordings, and of the association between accessing and academic outcomes, in a biochemistry course

Many factors predict academic performance at university but accessing lecture recordings has not been established as one. Our aims were to quantify how and why biochemistry students accessed lecture recordings and to determine any association between accessing lecture recordings and academic outcomes. Lecture recording access data was collected and related to academic outcomes. On average, students accessed 46% of lecture recordings and each recording was accessed 2.3 times, but not to completion. After lecture delivery, students were slow to access lecture recordings, and the number of accesses was still increasing prior to the examinations. For the entire cohort, there were weak positive associations between accessing lecture recordings and academic outcomes for the semester, and between the access to lecture recordings in weeks 1-5 and 6-11 with the mid-semester and final examination, respectively. For programs, the weak association for the semester was only apparent for the pharmacy and biomedical science students, and not for the medical laboratory or nutrition students. The most common reason for accessing lecture recording was to "Revise lecture concepts for assessment purposes." For students, who did not attend lectures, lecture recordings were accessed predominantly as "I prefer the flexibility of online recordings." Flexibility was also the theme of the positive additional feedback on accessing lecture recordings. In conclusion, consideration needs to be given on how to persuade students to access lecture recordings in a timelier way. As accessing lecture recordings is weakly associated with positive academic outcomes for some program cohorts, this supports their continued availability.

To what extent do preclinical veterinary students in the UK utilize online resources to study physiology

Online resources are becoming increasingly important in undergraduate education and have been associated with a number of advantages and positive outcomes on students' learning experience. However, online resource use by veterinary students for physiology learning remains poorly understood. Thus the present questionnaire-based study aims to investigate the extent to which first- and second-year veterinary students use online resources, including online video clips and social media, in their physiology learning and if this is influenced by factors of age, gender, entry status, or year of study. One-hundred and twenty-two students across seven UK universities completed the survey. Traditional resources (the lecturer and recommended textbooks) were the most preferred sources for physiology learning. Nonetheless, 97.5% of students used Internet search engines to explore physiology topics. Furthermore, students' tendency to contact their instructor regarding a physiology question was low. Rather, 92.6% said they would first search for an answer online. Particularly popular was the use of online video clips with 91.1% finding them valuable for physiology learning and 34.21% finding them more useful for understanding physiology than university taught material or lecture slides. YouTube was the most common online video clip platform used by students. Most students stated that they would enjoy interacting with course materials on an instructor-led social media page, but only 33.9% currently use social media to discuss physiology-related issues with classmates. Additionally, most students expressed concerns regarding the reliability of online resources but attempts to fact-check these resources were relatively low. Therefore, online resources represent an essential part of veterinary students' physiology learning and this suggests that educators can significantly improve student engagement and understanding of physiology by integrating these resources.

To capture the research landscape of lecture capture in university education

The use of lecture capture has been burgeoning in the higher education sector. Scholarly interest on the topic is also on an upward trajectory. Hence, the goal of this paper is to clarify the literature on the use of lecture capture in higher education through a systematic review, which involved 71 articles that came from Scopus and Education Resources Information Center (ERIC). The systematic review revealed that most research focused on university education in the US, the UK and Australia. The most studied Science, Technology, Engineering and Mathematics (STEM) subject area in the sample is Biological Sciences. In contrast, the most studied non-STEM subject area is Business/Economics/Management. In terms of methods, descriptive and exploratory research dominates the research landscape while causative evidence is relatively limited. The literature includes two overarching research streams: While one focuses on the benefits of lecture capture, the other focuses on its drawbacks. Apparently, the assumption among most students is that lecture capture is helpful for learning, and among staff is that it takes a toll on attendance. Future research needs to reconcile students' perception of lecture capture, instructors' perception of lecture capture, and the reality of lecture capture. On the practical front, students should be explicitly told about the benefits and the drawbacks of lecture capture. This would ensure that they make the most of the technology. Educators are urged to reflect on why students should be attending the face-to-face sessions, and thereafter also watch the recorded lectures.

Spotlight on the Shift to Remote Anatomical Teaching During Covid-19 Pandemic: Perspectives and Experiences from the University of Malta

Covid-19 has spread globally, affecting all nations. Preventive measures were implemented by governments including the closure of universities. The aim of this study was to evaluate the student's perspectives and experiences on the shift to remote preclinical medical education while inquiring whether there has been any psychological impact on the students. A customized questionnaire utilizing Likert-scale-based questions and the Generalized Anxiety Disorder-7 assessment tool was distributed online to enrolled preclinical medical students at the Faculty of Medicine and Surgery at the University of Malta. Quantitative and qualitative analyses of the data gathered was carried out. Multivariate logistic regression analyses was performed to establish independent variables associated with anxiety symptoms. A total of 172 responded out of a cohort of 299 preclinical students (58%). The majority perceived a positive learning experience following the shift to remote lectures, however, it was not the case for small group teaching including dissection sessions. Nonetheless students reported concerns about their education, examinations, progression to next academic year and wellbeing. Less than half the students exhibited symptoms of anxiety. Students exhibiting "moderate" worry (OR:7.6; CI 95%:1.98-29.31; P < 0.01) and "severe" worry (OR: 2.0; CI 95%: 5.0-80.5; P < 0.01) on their mental, emotional, and wellbeing due to Covid-19 were associated with anxiety symptoms after adjusting for cofounders. Apart from the short-term effects, the Covid-19 pandemic may have a long-term impact on both the medical education and the students' future careers. It is important that the implemented changes in medical education are recorded and studied since such data will be essential on how to proceed post-Covid-19 pandemic.

No apparent association between lecture attendance or accessing lecture recordings and academic outcomes in a medical laboratory science course

BACKGROUND

The effect of availability of lecture recordings on academic outcomes is not clear and it is not known whether these recordings change the association between lecture attendance and academic outcomes. Few surveys of lecture attendance or lecture recordings use by students are linked to academic outcomes. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to determine any association between accessing lecture recordings and academic outcomes and (iii) to use a survey to determine why students attend lectures and/or access lecture recordings in a course in medical laboratory science.

METHODS

Consenting students signed in when attending lectures and/or completed an online survey. Pearson's correlation coefficients were calculated to determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes.

RESULTS

Consent rates were high for both the sign-in (90%) and survey (64%). The main findings were that in 2017 and 2018: (i) the average lecture attendance was 39 and 27%, respectively, (ii) there was no association between lecture attendance and academic outcomes, (iii) there was no association between accessing lecture recordings and academic outcomes. Survey respondents were almost equally divided between those attending lectures weekly, sometimes or not. Reasons for attending lectures included greater perceived learning and interaction with staff and other students, while reasons for not attending related to inconvenience or other commitments. Lecture recordings were accessed to clarify, revise or catch up on content, or as an alternative to attending lectures. One-third of students provided additional feedback on accessing lecture recordings, and the most common themes were 'flexibility' and 'useful'. Lecture slides (PowerPoints), independently of lecture recordings, were used extensively by the students.

CONCLUSIONS

From this study, it does not seem that either lecture attendance or accessing lecture recordings are major determinants of academic outcomes for most students. As students vary in their lecture attendance and use of online resources including lecture recordings and lecture slides, academic staff should continue to provide a range of resources for students.

No apparent association between lecture attendance or accessing lecture recordings and academic outcomes in a medical laboratory science course

BACKGROUND

The effect of availability of lecture recordings on academic outcomes is not clear and it is not known whether these recordings change the association between lecture attendance and academic outcomes. Few surveys of lecture attendance or lecture recordings use by students are linked to academic outcomes. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to determine any association between accessing lecture recordings and academic outcomes and (iii) to use a survey to determine why students attend lectures and/or access lecture recordings in a course in medical laboratory science.

METHODS

Consenting students signed in when attending lectures and/or completed an online survey. Pearson's correlation coefficients were calculated to determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes.

RESULTS

Consent rates were high for both the sign-in (90%) and survey (64%). The main findings were that in 2017 and 2018: (i) the average lecture attendance was 39 and 27%, respectively, (ii) there was no association between lecture attendance and academic outcomes, (iii) there was no association between accessing lecture recordings and academic outcomes. Survey respondents were almost equally divided between those attending lectures weekly, sometimes or not. Reasons for attending lectures included greater perceived learning and interaction with staff and other students, while reasons for not attending related to inconvenience or other commitments. Lecture recordings were accessed to clarify, revise or catch up on content, or as an alternative to attending lectures. One-third of students provided additional feedback on accessing lecture recordings, and the most common themes were 'flexibility' and 'useful'. Lecture slides (PowerPoints), independently of lecture recordings, were used extensively by the students.

CONCLUSIONS

From this study, it does not seem that either lecture attendance or accessing lecture recordings are major determinants of academic outcomes for most students. As students vary in their lecture attendance and use of online resources including lecture recordings and lecture slides, academic staff should continue to provide a range of resources for students.

Modernising Anatomy Teaching: Which Resources Do Students Rely On?

The way in which we learn anatomy has changed exponentially over the decades and students now have access to lecture notes, textbooks, computer-assisted programmes, and a wide variety of internet based information. This study explored which resources were the most (and least) useful for a group of first year, undergraduate, medical students, with minimal prior content exposure (aged 18 and 19 years old, n = 76), over an 18 month period. Anatomy websites were found to be the most useful (30%), followed by tutorials (20%) and lectures (19%). A total of 13% found the university computer-assisted learning (CAL) platform least useful. We subsequently enhanced our 'urogenital' CAL anatomy module, with inclusion of new and updated images, videos and tutorials, as well as, digital and printed 3D-models. A post-intervention survey (n = 81) showed an increase from 12% to 27% for CAL as being most useful, and a decrease from 13% to 3% as being least useful. Our results provided a snapshot of students' preferences in studying anatomy, and highlighted the importance of digital platforms and the need for evaluating our own learning resources. We must be mindful that there is an increasing tendency for students to rely on the Internet for information, which may expose them to unfiltered and unreliable content. We conclude that educators must be aware of the spectrum of learning resources used by students, to ensure that our own Institutional eLearning platforms are optimised to meet the diverse needs of learners.

Relationship Between Pharmacy Students' Use of Self-Regulated Learning Strategies and Course Outcomes

Objective. To determine the relationship between student-reported, self-regulated learning (SRL) with use of supplementary material, and overall performance in an advanced therapeutics course in a Doctor of Pharmacy program. Methods. A modified version of the Self-Regulated Strategy Inventory (SRSI-SI) was used to measure three distinct SRL factors: managing study behaviors, managing environment, and maladaptive regulatory behaviors. An instructor created a supplemental 36-question practice quiz and flashcard activity. The in-class assessment and the three SRL factors were analyzed using the practice quiz, and the association between overall course grade and score in each factor domain was determined by regression. Results. Two-hundred seven students (98%) completed the SRSI. One hundred fifty-eight (79%) students reported using the optional practice quiz and doing so was associated with significantly higher in-class quiz scores (8.2 vs 7.6 out of 10) and higher overall course grade (88.0% vs 85.3%). Students reporting use of the optional practice quiz were significantly less likely to report poor study behaviors, inability to manage study environment, and maladaptive study habits. Lower overall course grades were significantly associated with maladaptive study habits. Conclusion. A positive association was determined between use of instructor-created supplemental activities and in-class quiz scores, self-regulated study behaviors, and overall course performance. Maladaptive study habits were associated with a modest negative correlation with overall course grade. The results suggest that when instructors create optional supplementary activities and assessments, many of the students who would benefit the most from the use of these activities fail to utilize the opportunity for extra practice.

Student acceptance of e-learning methods in the laboratory class in Optometry

Today's students have increased expectations for flexible learning options and evidence-based practice resources to be available to support curricular activities. We investigated: (i) the suitability of a static website for teaching ocular anatomy and physiology and an interactive version of the website with quiz and self-assessment activities and (ii) the usefulness of a blended online and in-lab environment to teach in Optometry. We administered a survey to compare responses of optometry students who had access to the interactive website, with those from students from a previous year who used the static version. We examined learning preferences of students in a focus group. Students were positive about the value of the website for their learning and the clarity of the website content. Nevertheless, objective comparison of pass rates for students using the static and interactive websites did not show significant changes. The majority of students commenting on the static website felt they did not get sufficient feedback via the website (67%) compared with only 22% from students who used self-assessments in the interactive website. Interestingly, users of the static website commented that it was perceived as just another resource while users of the interactive website commented on the usefulness of the material to review knowledge before laboratories. In the focus group, students reported they preferred a blended learning over the website alone even by students using the interactive website as they felt the need to revise content with the educator before the test. We conclude that there is acceptance of online learning methods due to the technologically 'savvy' environment of students in the first year of the Optometry programme but there is still dependence on the educator as the main administrator of their learning.