A review of computer assisted learning in medical undergraduates

Potential Barriers to the Implementation of Computer-Based Simulation in Pharmacy Education: A Systematic Review

Computer-based simulation (CBS) is an interactive pedagogical training method that has seen increased interest, especially in recent years. There is some evidence that CBS in pharmacy education is not as widely adopted compared to other healthcare disciplines. Pharmacy education literature to date has not specifically discussed the potential barriers which may cause this uptake challenge. In this systematic narrative review, we attempted to explore and discuss potential barriers that may impact the integration of CBS in pharmacy practice education and provide our suggestions to overcome them. We searched five major databases and used the AACODS checklist for grey literature assessment. We identified 42 studies and four grey literature reports, published between 1 January 2000 and 31 August 2022, which met the inclusion criteria. Then, the specific approach of Braun and Clarke for thematic analysis was followed. The majority of the included articles were from Europe, North America, and Australasia. Although none of the included articles had a specific focus on barriers to implementation, thematic analysis was used to extract and discuss several potential barriers, such as resistance to change, cost, time, usability of software, meeting accreditation standards, motivating and engaging students, faculty experience, and curriculum constraints. Ad- dressing academic, process, and cultural barriers can be considered the first step in providing guidance for future implementation research for CBS in pharmacy education. The analysis suggests that to effectively overcome any possible barriers to implementing CBS, different stakeholders must engage in careful planning, collaboration, and investment in resources and training. The review indicates that additional research is required to offer evidence-based approach and strategies to prevent overwhelming or disengaging users from either learning or teaching process. It also guides further research into exploring potential barriers in different institutional cultures and regions.

Insight on the influence of technology-enhanced learning in orthodontics' education: A systematic review

OBJECTIVES

Technology-enhanced learning (TEL) provides a pliable and current way to present orthodontic curriculum material to students. This review aimed to assess the effectiveness of TEL compared with traditional learning methods in the field of orthodontics.

MATERIALS AND METHODS

The search comprised randomised controlled trials (RCTs) related to orthodontics' interactive learning from the following databases: PubMed, Scopus, CENTRAL, Psyclnfo, ERIC, Web of Science, Dissertations and Theses Global. Two authors performed the screening, data extraction and assessed risk of bias using the Cochrane tool (Rob 2) blindly and in duplicate. Kirkpatrick's 4-level evaluation model was used to evaluate educational outcomes.

RESULTS

A total of 3131 records were identified of which 11 RCT were included. On level 1 (Reaction), students had a positive attitude towards TEL. On level 2 (Learning), included studies did not report any significant knowledge improvement when TEL was compared with traditional learning strategies. One study assessed level 3 (Behaviour), where students felt that flipped classroom learning created feelings of greater confidence. On level 4 (Results), most studies suggested that TEL tools are as equally effective in imparting information as traditional tools and recommended that both methods should be considered in teaching students.

CONCLUSION

Technology-enhanced learning techniques might have the potential to enhance educational outcomes in orthodontic education and students seem to enjoy the implementation of technology in the learning process. These educational tools should be used as an adjunct to the traditional didactic classroom, and not as a replacement, due to the challenges encountered with their application.

Comparing computer-assisted learning activities for learning clinical neuroscience: a randomized control trial

BACKGROUND

Computer-assisted learning has been suggested to improve enjoyment and learning efficacy in medical education and more specifically, in neuroscience. These range from text-based websites to interactive electronic modules (eModules). It remains uncertain how these can best be implemented. To assess the effects of interactivity on learning perceptions and efficacy, we compared the utility of an eModule using virtual clinical cases and graphics against a Wikipedia-like page of matching content to teach clinical neuroscience: fundamentals of stroke and cerebrovascular anatomy.

METHODS

A randomized control trial of using an interactive eModule versus a Wikipedia-like page without interactivity was performed. Participants remotely accessed their allocated learning activity once, for approximately 30 min. The primary outcome was the difference in perceptions on enjoyability, engagement and usefulness. The secondary outcome was the difference in learning efficacy between the two learning activities. These were assessed using a Likert-scale survey and two knowledge quizzes: one immediately after the learning activity and one repeated eight weeks later. Assessments were analysed using Mann-Whitney U and T-tests respectively.

RESULTS

Thirty-two medical students participated: allocated evenly between the two groups through randomisation. The eModule was perceived as significantly more engaging (p = 0.0005), useful (p = 0.01) and enjoyable (p = 0.001) by students, with the main contributing factors being interactivity and clinical cases. After both learning activities, there was a significant decrease between the first and second quiz scores for both the eModule group (-16%, p = 0.001) and Wikipedia group (-17%, p = 0.003). There was no significant difference in quiz scores between the eModule and Wikipedia groups immediately afterwards (86% vs 85%, p = 0.8) or after eight weeks (71% vs 68%, p = 0.7).

CONCLUSION

Our study shows that increased student satisfaction associated with interactive computer-assisted learning in the form of an eModule does not translate into increased learning efficacy as compared to using a Wikipedia-like webpage. This suggests the matched content of the passive webpage provides a similar learning efficacy. Still, eModules can help motivate self-directed learners and overcome the perceived difficulty associated with neuroscience. As computer assisted learning continues to rapidly expand among medical schools, we suggest educators critically evaluate the usage and cost-benefit of eModules.

β-arrestin2 recruitment at the β2 adrenergic receptor: A luciferase complementation assay adapted for undergraduate training in pharmacology

In the context of pharmacology teaching, hands-on activities constitute an essential complement to theoretical lectures. Frequently, these activities consist in exposing fresh animal tissues or even living animals to selected drugs and qualitatively or quantitatively evaluating functional responses. However, technological advancements in pharmacological research and the growing concerns for animal experimentation support the need for innovative and flexible in vitro assays adapted for teaching purposes. We herein report the implementation of a luciferase complementation assay (LCA) enabling to dynamically monitor β-arrestin2 recruitment at the β2 adrenergic receptor in the framework of pharmacological training at the faculty of Pharmacy and Biomedical Sciences. The assay allowed students to quantitatively characterize the competitive antagonism of propranolol, and to calculate pEC50 , pKB , and pA2 values after a guided data analysis session. Moreover, the newly implemented workshop delivered highly reproducible results and were generally appreciated by students. As such, we report that the luciferase complementation-based assay proved to be a straightforward, robust, and cost-effective alternative to experiments performed on animal tissues, constituting a useful and flexible tool to enhance and update current hands-on training in the context of pharmacological teaching.

Simulation as a Tool to Illustrate Clinical Pharmacology Concepts to Healthcare Program Learners

Purpose of Review

Recent Findings

Summary

Students' perception of animal or virtual laboratory in physiology practical classes in PBL medical hybrid curriculum

Over the years, much criticism against animal use for physiology teaching has been made. Hence, replacement by suitable alternatives has increased in several pedagogical approaches. This study examined students' perceptions of animal versus virtual (video/computer) laboratory classes in physiological sciences associated with the effectiveness of the problem-based learning (PBL) hybrid curriculum. Three cohorts of medical students from the University of Ribeirão Preto, who participated in animal or virtual physiology classes or both, were asked to fill out a 5-point Likert questionnaire about knowledge acquisition/motivation, importance to PBL learning goals, skills acquired, need for animal use, academic formation, learning impairment, and alternative methods. We also assessed their grades in the final exam. A total of 350 students were included, in which 108 participated only in virtual classes, 120 only in practical animal laboratory classes, and 122 in both approaches. The majority agreed that the two methods improved their knowledge acquisition/motivation and helped to reinforce tutorial goals and to acquire skills. However, the cohort who experienced both approaches favored animal laboratory. Students believe animal use is needed and did not impair their learning. Conversely, their opinion about academic formation without animal laboratory classes was divided, as was whether this approach inspired them to seek alternative methods. Despite the different perceptions, there was no difference among the groups' final grades (7.3 ± 1 vs. 7.2 ± 1 vs. 7.2 ± 2 for virtual or practical animal laboratory classes or both, respectively). Therefore, virtual activities are not as effective as animal use in the opinions of the students, but they are successful strategies in physiology learning that can be used in practical classes in a hybrid PBL curriculum.

Computational strategy for visualizing structures and teaching biochemistry

Computational techniques have great potential to improve the teaching-learning. In this work, we used a computational strategy to visualize three-dimensional (3D) structures of proteins and DNA and help the student to comprehend biochemistry concepts such as protein structure and function, substrate, and inhibitors as well as DNA structural features. The practical classes included tutorials to be done in the computer using structures from Protein Data Bank and a free 3D structure visualization software, Swiss PDB Viewer. The activity was done with 76 students from biology and pharmacy undergraduate courses. Questionnaires were administered to evaluate the knowledge regarding specific biochemistry contents before and after the activity and the opinion of the students. An overall increased percentage of correct answers post-classes (75.91%) were observed in comparison to pre-classes (35.53%). All the students indicated that it could contribute to the learning of DNA and protein structure contents; approximately 90% stated that it enables structures visualization or makes the learning and understanding easier. Therefore, the strategy has shown to be effective, allowing the contextualization of biochemistry themes and may complement theoretical classes. © 2018 International Union of Biochemistry and Molecular Biology, 47(1):76-84, 2018.

Development of a user-friendly training software for pharmacokinetic concepts and models

Although there are many commercially available training software programs for pharmacokinetics, they lack flexibility and convenience. In this study, we develop simulation software to facilitate pharmacokinetics education. General formulas for time courses of drug concentrations after single and multiple dosing were used to build source code that allows users to simulate situations tailored to their learning objectives. A mathematical relationship for a 1-compartment model was implemented in the form of differential equations. The concept of population pharmacokinetics was also taken into consideration for further applications. The source code was written using R. For the convenience of users, two types of software were developed: a web-based simulator and a standalone-type application. The application was built in the JAVA language. We used the JAVA/R Interface library and the ‘eval()’ method from JAVA for the R/JAVA interface. The final product has an input window that includes fields for parameter values, dosing regimen, and population pharmacokinetics options. When a simulation is performed, the resulting drug concentration time course is shown in the output window. The simulation results are obtained within 1 minute even if the population pharmacokinetics option is selected and many parameters are considered, and the user can therefore quickly learn a variety of situations. Such software is an excellent candidate for development as an open tool intended for wide use in Korea. Pharmacokinetics experts will be able to use this tool to teach various audiences, including undergraduates.

Computer-Assisted Learning Applications in Health Educational Informatics: A Review

Computer-assisted learning (CAL) as a health informatics application is a useful tool for medical students in the era of expansive knowledge bases and the increasing need for and the consumption of automated and interactive systems. As the scope and breadth of medical knowledge expand, the need for additional learning outside of lecture hours is becoming increasingly important. CAL can be an impactful adjunct to conventional methods that currently exist in the halls of learning. There is an increasing body of literature that suggests that CAL should be a commonplace and the recommended method of learning for medical students. Factors such as technical issues that hinder the performance of CAL are also evaluated. We conclude by encouraging the use of CAL by medical students as a highly beneficial method of learning that complements and enhances lectures and provides intuitive, interactive modulation of a self-paced curriculum based on the individual's academic abilities.

Is There Any Benefit of Integrating Computer-assisted Learning with Conventional Teaching Format in Pharmacology to Demonstrate the Effects of Different Drugs on Mean Arterial Blood Pressure in an Anesthetized Dog?: A Comparative Study

Purpose:

Computer-assisted learning (CAL) tools are often used in medical education as it can complement conventional teaching formats and as an alternative to animal experiments in undergraduate medical students. To identify if there is any benefit of integrating CAL tools with conventional teaching format in pharmacology for a specific topic.

Materials and Methods:

Two groups of fourth semester students, Group I (n = 55) and Group II (n = 60), were taught a specific topic in pharmacology using only conventional teaching format (Group I), and both conventional teaching format as well as CAL format (EP Dog version 1.1.0) (Group II). The students were assessed with two different sets of multiple-choice questions, relevant to the topic taught, immediately at the end of the teaching sessions and after 30 days. Acceptability of the two teaching sessions by the students was also assessed using Likert scale.

Results:

There was no significant difference in the scores of the students of the two groups immediately after teaching (P = 0.1260), there is definitely better residual knowledge reflected by the significantly (P = 0.001) better test scores of the Group II students after 30 days in comparison to Group I students. However, there was no significant difference with regard to the acceptability of the CAL teaching format alone and along with the conventional teaching format between the two groups (P = 0.6033).

Conclusion:

Integrating CAL with conventional teaching format improves students’ understanding and performance for a specific topic.