Development of an Inexpensive Internet-aided Teaching-Learning Program for Medical Students in the Philippines

Development of an Inexpensive Internet-aided Teaching-Learning Program for Medical Students in the Philippines

Reynaldo O. Joson, MD, MHPEd, MS Surg.

College of Medicine, University of the Philippines Manila, Philippines

rjoson2001@yahoo.com

Presented in 2004 – 4th Asia-Pacific Conference on Problem-based Learning in Medicine in the Health Sciences

Abstract

This paper reports on a one-semestral development of an inexpensive Internet-aided teaching-learning program (IA-TLP) for a group of eight year level IV medical students under a surgery preceptorial in the University of the Philippine College of Medicine.  Free communication and interactive facilities in the Internet were used by the faculty to complement his regular face-to-face teaching sessions of students.  The “Internet Classroom Assistant” website (http://www.nicenet.org); group email (gs_ia_tlp@yahoogroups.com,  http://health.yahoogroups.com/group/gs_ia_tlp), and a webpage (http://gs_ia_tlp.tripod.com) were used in giving assignments, providing reading materials, submitting or reporting of assignments, administering test questions,  and giving feedback. All the students agreed that the IA-TLP complemented the face-to-face teaching-learning sessions by providing pre-session instructional materials; post-session feedback and reinforcements; structured and in-depth assessment of students’ learning; easy venue for submission of reports; flexibility in time management for learning activities; and experience in on-line education.  The average total number of hours consumed by each student in the use of the Internet during the entire course was 24 hours and the average cost of Internet surfing per student was about PhP 200.  All students appreciated the utility of the IA-TLP and would recommend its use by other faculty.

Introduction

Distance education is a growing trend in medical education (1-14).  With the development of Internet technologies, distance education now utilizes more of the electronic rather than the print media.  Internet has made it possible to increase the number and the diversity of on-line resources for both faculty and students.  In the Philippines, even with the technology being widely available, it seems that the Internet is underutilized in medical education as there are very few reports on such topic, both in the undergraduate as well as in the postgraduate levels.

This paper reports on a one-semestral development of an inexpensive Internet-aided teaching-learning program (IA-TLP) for a group of eight year level IV medical students under a surgery preceptorial in the University of the Philippine College of Medicine (UPCM).

The specific objectives of the paper were to: 1) trace the origin and rationale of the author’s IA-TLP; 2) describe its most recent development beginning 2003; 3) present evaluation results; and 4) identify areas for improvement and refinement.

Methods 

The records that pertained to the author’s development of an IA-TLP for medical students of the UPCM were reviewed to answer the four specific objectives of the paper.

An end-of-course evaluation was done primarily to assess whether the IA-TLP was achieving its intended objectives and to get feedback and reactions from the students.  A 10-item evaluation questionnaire was utilized formatted as 5-point Likert scales.  The questionnaire also included space for free-form comments.  Through the evaluation, areas of improvement and refinement were identified and planned. 

Results 

Origin and Rationale of Development of Author’s IA-TLP

In 1999, I started doing Internet-aided teaching-learning sessions with a group of UPCM Year Level IV medical students assigned to me for one semester in a general surgery preceptorial course.  At that time, the Internet facility that I used was just a group email, specifically, the Yahoo! Groups.  The email was used by the students to submit electronic copies of reports to me.  It was also used by me to transmit feedback to the submitted reports.  From 2000 to 2002, I did not pursue the program because of personal constraints.

In 2003, with renewed interest and more experience, I decided to explore further and maximize the utility of Internet to complement the face-to-face teaching sessions of my students.

Description of 2003-2004 Development of IA-TLP

Executive Summary of Development

In essence, I utilized the “Internet Classroom Assistant” website (http://www.nicenet.org); group email (gs_ia_tlp@yahoogroups.com, http://health.yahoogroups.com/group/gs_ia_tlp), and a webpage (http://gs_ia_tlp.tripod.com) for interactions – giving assignments, providing reading materials, submitting or reporting of assignments, administering test questions,  and giving feedback.

Detailed Description of Developmental Activities

Eight UPCM Year Level IV students were assigned to me for one semester for their general surgery preceptorial.

The regular face-to-face interaction between the students and me was on a Tuesday afternoon, 1:30 to 3:30 (2 hours).

On the first meeting, whose objective was orientation to the preceptorial course, the students and I agreed on a teaching-learning contract that included the use of Internet facility to complement the face-to-face teaching-learning sessions.  All the students submitted their respective email addresses to me.

Right after the first meeting, I created a UPCM-YL4-Preceptorial Class in the Internet Classroom Assistant (ICA) website (http://www.nicenet.org).  There was a class key (Q8728ZU35) that I gave to the students to use to join the class.  All the students formally joined the ICA.

After a few posting of instructions and assignments in ICA, I realized the cumbersomeness of the posting system. It seemed to me that the Yahoo! Groups would be easier and had more features.  Thus, I decided to create a Yahoo! Groups (gs_ia_tlp@yahoogroups.com and http://health.yahoogroups.com/group/gs_ia_tlp).  The Yahoo! Groups contained facility for a group email and other features like “polls” which could be used to administer test questions and “files” to store learning resources and information.  I also decided to put up a website to consolidate all the activities of the IA-TLP (http://gs_ia_tlp.tripod.com).

With the Yahoo! Groups and IA-TLP website in place, we dropped the ICA venue.

Through the group email, we, the students and faculty, communicated and interacted with each other after and before the Tuesday face-to-face conference.

Through the “polls”, I administered quizzes and the students answered them.

Through the “files”, I stored learning resources and students’ outputs.

Through the “database”, I placed a table summarizing the teaching-learning activities and assignments.

Feedback of the General Surgery Internet –Aided Teaching-Learning Program

All eight students agreed on the following:

1. Overall, it complemented the Tuesday face-to-face teaching-learning sessions or preceptorials.
2. It provided preparations for the face-to-face sessions with learning and teaching materials.
3. It provided reinforcements with on-line teachings by the faculty and reports submitted by the students.
4. It provided an assessment of students’ learning through the on-line quizzes.
5. It provided an efficient venue for submission of students’ reports.
6. It provided additional venue for feedback and interactions between students and faculty.
7. It gave the students and the faculty flexibility in terms of time management to do the on-line learning and teaching (though there is a set deadline).
8. It gave the students and faculty an experience in on-line education which is the trend nowadays. It was a first-time experience for six out of eight students.
9. The expenses incurred to go on-line were worth the learning and experience gained. The expenses ranged from PhP 100 to 300 with a mean of PhP 200.  The total Internet usage ranged from 3 to 72 hours with a mean of 24 hours.
10. All were satisfied with the IA-TLP. There were no negative comments. Samples of encouraging comments consisted of the following:
    1. It was a great venue for more learning. It provided excellent supplementation to learning. It was practical also- no more printouts.
    2. It was fun and I really learned a lot.
    3. This Internet classroom was a very good idea. I hope that your next preceptorial group would have the same privilege that we had.
    4. Personally, I feel very blessed to be a part of this group. At first I was apprehensive because I felt it was very toxic but now I’m glad we had these kinds of activities. The whole experience gave us an edge over our other classmates with regards the various surgical disorders, operating room, and emergency room. With the aid of the online quizzes, the ideas emphasized in the small group discussion were reiterated; hence facilitated our learning. The kind of approach we had towards patient dealings was very helpful. I very much appreciated the integrative approach that our preceptor utilized for it helped us really experience the various aspects of surgery. The cases that were given and especially in the powerpoint presentation and essays that were forwarded online also served to reinforce our learning and made the whole experience more interactive and worthwhile.

Except for one student, all seven would recommend that the IA-TLP be used by the other faculty of the Department of Surgery. The one student who was uncertain in recommending commented that it worked for the group and for the preceptor. He felt it could not be handled by just anyone.

Areas for Improvement and Refinements

1. Have a set time frame for submissions of reports, papers or polls (from the students).
2. Establish more online banks of learning materials and test questions (from the faculty).

Discussion (Personal Notes)

As mentioned in my introduction, the reason why I tried to develop IA-TLP was that I wanted to explore and maximize the utility of Internet to complement the face-to-face teaching sessions of my students.

Why use the Internet to complement? From past experience, for the past 10 years or so that I have been assigned to teach a group of students in the general surgery preceptorial, I felt that the face-to-face teaching-learning sessions were not enough in terms of follow through and assessment of students’ learning.  With this Internet-aided program, I thought there would be a follow-through after the Tuesday meeting, and there was, and, as the faculty, I thought I would be able to better assess how much the students have learned, and I did achieve this.

In terms of exploration, I discovered Internet Classroom Assistant (ICA) and the Yahoo! Groups as possible free Internet tools that could be used.  There could be other free Internet facilities that could be used.  However, at this point in time, these are the two Internet tools that I have found and that I know of.

ICA has been formally created as an Internet classroom assistant tool.  Thus, the format is really an Internet classroom assistant tool.  Yahoo! Groups has been created for group interactions and sharing of information and interest.  It is not specifically designed as an Internet classroom assistant tool.  However, after this experience, I discovered that the Yahoo! Groups was easier to use in terms of postings for interactions and sharing of information.  In addition, it has a lot of features that could be utilized as or “converted” to Internet classroom assistant tools, such as the database, files, polls, and chat.  Although I have not used “chat” in this program, it could be used for real-time teleconferencing.

From this experience, until I find something better than Yahoo! Groups, I would recommend the use of the Yahoo! Groups rather than the ICA as the Internet tool to complement any face-to-face teaching-learning sessions.

In terms of maximization of utility of Internet, one can use the various features provided by the Yahoo! Groups itself.   The students can and are encouraged to surf the Internet for other reading materials not provided by the faculty.  The faculty can also surf the Internet for teaching and reading materials or references to be used by the students.  If one wants to consolidate all the activities of the on-line teaching-learning program and wants to post teaching-learning materials in easy to retrieve webpages, one can create a website.   There are so many free websites being offered in the Internet, one of which is http://www.tripod.com.

In terms of expenses, Internet surfing is the main cost.  Nowadays, the cost of Internet surfing is only about PhP 25.00 per hour in the Philippines, which is really quite affordable.

For me, the faculty, the cost was definitely greater, incurred mostly in exploring and developing the program.  Again, the expenses were mainly on the time spent on the net.  The Internet tools were free of charge, courtesy of ICA, Yahoo! Groups, and Tripod.  My total cost of Internet surfing amounted to approximately PhP 1,500. (Note: from January 19 to 24, 2004, when I was Boracay, I was doing online teaching with the students and the rate of Internet surfing in Boracay was PhP 70 per hour.)  With the establishment of the program, with the mechanics and learning instructions and resources in place in the Internet, the cost for the faculty would most likely approximate that of the students, if not smaller.

Overall, from the feedback of the students and from my first-hand experience, I say developing the IA-TLP was an enjoyable work of teaching cum learning.  Developing it was a little difficult and challenging initially.  However, at this stage, everything will be smoother and easier.  With the teaching instructions and learning materials in the net, one can use them anytime and anywhere.  The IA-TLP in the net is now a virtual teaching-learning classroom both for me, as the faculty, and any student who will be assigned to me in the future.

To end, with the positive feedback from the students and all the benefits that one can get with the use of Internet to complement face-to-face teaching-learning sessions, I strongly recommend the use of Internet-aided teaching-learning tools, such as the one described here.

References

1. Pulanic R, Ivekovic H, Pulanic D, Vrazic H, Ostojic R, Premuzic M, Lepoglavec Z. First online continuing tele-education in gastroenterology in Croatia.  Lijec Vjesn 2003;125(9-10):271-4.
2. Styra R. The Internet’s impact on the practice of psychiatry. Can J Psychiatry 2004 ;49(1):5-11.
3. Baker HH, Foster RW, Cope MK, Boisvert C, Wallace GH.  Can an Internet-based system assist with administration and distance learning for third- and fourth-year rural clinical rotations? J Am Osteopath Assoc 2001; 101(12):701-5.
4. Clayden GS, Wilson B. Computer-assisted learning in medical education. Med Educ 1988;22(5):456-67.
5. Curran V, Kirby F, Parsons E, Lockyer J.  Short report: satisfaction with on-line CME. Evaluation of the rural MD cme website. Can Fam Physician 2004; 50:271-4.
6. Correa L, de Campos AC, Souza SC, Novelli MD. Teaching oral surgery to undergraduate students: a pilot study using a Web-based practical course. Eur J Dent Educ 2003;7(3):111-5.
7. Wheeler DW, Whittlestone KD, Smith HL, Gupta AK, Menon DK; East Anglian Peri-Operative Medicine Undergraduate Teaching Forum.   A web-based system for teaching, assessment and examination of the undergraduate peri-operative medicine curriculum. Anaesthesia 2003;58(11):1079-86.
8. Sinkov VA, Andres BM, Wheeless CR, Frassica FJ.  Internet-based learning. Clin Orthop 2004;(421):99-106.
9. Letterie GS. Medical education as a science: the quality of evidence for computer-assisted instruction. Am J Obstet Gynecol 2003;188(3):849-53.
10. Rozental TD, Lonner JH, Parekh SG.  The Internet as a communication tool for academic orthopaedic surgery departments in the United States.
    J Bone Joint Surg Am 2001;83-A(7):987-91.
11. Fitzpatrick M.  Learning surgery online in Ireland. JAMA 2000;284(7):821.
12. Lugo-Vicente H. Internet resources and web pages for pediatric surgeons. Semin Pediatr Surg 2000 ;9(1):11-8.
13.  Veldenz HC, Dennis JW.  The Internet and education in surgery. Am Surg 1998; 64(9):877-80.
14. Paoli JR, Barthelemy I, Lauwers F, Boutault F, Fabie M.  The Internet in oral medicine and maxillofacial surgery. Rev Stomatol Chir Maxillofac 1996;97(4):202-8.

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