A Computer-Assisted, Real-Time Feedback System for Medical Students as a Tool for Web-Based Learning

Article information

Kosin Med J. 2016;31(2):134-145
Publication date (electronic) : 2016 January 20
doi : https://doi.org/10.7180/kmj.2016.31.2.134
Department of Laboratory Medicine, College of Medicine, Kosin University, Busan, Korea
Corresponding Author: Hyunyong Hwang, Department of Laboratory Medicine, College of Medicine, Kosin University, 262 Gamchen-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-6279 FAX: +82-51-990-3010 E-mail: terminom@hanmail.net
Received 2015 May 21; 2015 August 04; Accepted 2015 September 03.

Abstract

Abstract

Objectives

Medical students sometimes do not receive proper feedback from their instructors. This study evaluated a newly developed automated and personalized real-time feedback system intended to address this issue.

Methods

Third- and fourth-year medical students participated in quizzes focusing on 17 learning objectives and a five-scale survey that queried their prior knowledge related to blood transfusions. Immediately after completing the quizzes, the students received automated and personalized, real-time feedback and were instructed to take part in self-directed learning. This activity was followed by a final quiz. After completion of the final quiz, the students responded to the five-scale survey that probed the usefulness of and satisfaction with the automated, personalized, real-time feedback system.

Results

Eighty students took part in this study. The third-year group had a higher score for prior knowledge and also on the first quiz (P= 0.008, P= 0.046, respectively). There was no significant difference in final quiz scores between the third- and fourth-year groups (P= 0.633). The scores for usefulness of and satisfaction with the automated, real-time feedback system were 4.45 and 4.34, and 4.55 and 4.40 in the third- and fourth-year students, respectively.

Conclusions

The automated, personalized, real-time feedback system provided timely and effective feedback for medical students and was helpful for their self-directed learning.

Fig. 1.

The quiz, feedback, and final exam provided to the students in this study. The quiz, feedback, and final exam were hosted on the website, which was developed by the author on the Moodle platform. When students clicked on the quiz question number (A), the quiz question appeared on the screen (B). After completing the quizzes, the students could view feedback that varied depending on quiz score (C), view the activated feedback, and perform self-directed learning guided by the feedback (D). After completion of the self-directed learning, students were permitted to take the final exam.

Fig. 2.

Subjective opinions from students about the merits and drawbacks of the automated, real-time feedback system. Some highly ranked opinions are listed, and more opinions are included in the “Other” category.

Mean, standard deviation (SD), and t-test results of third- and fourth-year medical students on a survey of prior knowledge, usefulness, and satisfaction conducted using Moodle

Scores between third-year and fourth-year medical students

The degrees of satisfaction with and usefulness of a computer-assisted, automated, real-time feedback system amongst medical students

References

1. Branch WT, Jr. , Paranjape A. Feedback and reflection: teaching methods for clinical settings. Acad Med 2002;77:1185–8.
2. Hewson MG, Little ML. Giving feedback in medical education: verification of recommended techniques. J Gen Intern Med 1998;13:111–6.
3. van de Ridder JM, Stokking KM, McGaghie WC, ten Cate OT. What is feedback in clinical education? Med Educ 2008;42:189–97.
4. Ende J. Feedback in clinical medical education. JAMA 1983;250:777–81.
5. Garra G, Wackett A, Thode H. Feasibility and reliability of a multisource feedback tool for emergency medicine residents. J Grad Med Educ 2011;3:356–60.
6. Gil DH, Heins M, Jones PB. Perceptions of medical school faculty members and students on clinical clerkship feedback. J Med Educ 1984;59:856–64.
7. Burr SA, Brodier E, Wilkinson S. Delivery and use of individualised feedback in large class medical teaching. BMC Med Educ 2013;13:63.
8. Halkoaho A, Matveinen M, Leinonen V, Luoto K, Keränen T. Education of research ethics for clinical investigators with Moodle tool. BMC Med Ethics 2013;14:53.
9. Gormley GJ, Collins K, Boohan M, Bickle IC, Stevenson M. Is there a place for e-learning in clinical skills? A survey of undergraduate medical students' experiences and attitudes. Med Teach 2009;31:e6–12.
10. Kim KJ, Han J, Park Ie B, Kee C. Medical education in Korea: the e-learning consortium. Med Teach 2009;31:e397–401.
11. Lee SP, Su HK, Lee SD. Effects of computer-based immediate feedback on foreign language listening comprehension and test-associated anxiety. Percept Mot Skills 2012;114:995–1006.
12. Fox S, Reid WA, Evans P. Web-based feedback of medical student assessment results. Med Educ 2003;37:1036–7.
13. Barnett S, Jones SC, Caton T, Iverson D, Bennett S, Robinson L. Implementing a virtual community of practice for family physician training: a mixed-methods case study. J Med Internet Res 2014;16:e83.
14. Saidinejad M, Zorc J. Mobile and web-based education: delivering emergency department discharge and aftercare instructions. Pediatr Emerg Care 2014;30:211–6.
15. Kuhbeck F, Engelhardt S, Sarikas A. Online TED.com – a novel web-based audience response system for higher education. A pilot study to evaluate user acceptance. GMS Z Med Ausbild 2014;31:Doc5.
16. Sampaio-Maia B, Maia JS, Leitᾶo S, Amaral M, Vieira-Marques P. Wiki as a tool for Microbiology teaching, learning and assessment. Eur J Dent Educ 2014;18:91–7.
17. Seluakumaran K, Jusof FF, Ismail R, Husain R. Integrating an open-source course management system (Moodle) into the teaching of a first-year medical physiology course: a case study. Adv Physiol Educ 2011;35:369–77.
18. Sparacia G, Cannizzaro F, D'Alessandro DM, D'Alessandro MP, Caruso G, Lagalla R. Initial experiences in radiology e-learning. Radiogra phics 2007;27:573–81.
19. Wilkinson ST, Couldry R, Phillips H, Buck B. Preceptor development: providing effective feedback. Hosp Pharm Jan 2013;48:26–32.
20. Sisson SD, Rastegar DA, Hughes MT, Bertram AK, Yeh HC. Learner feedback and educational outcomes with an internet-based ambulatory curriculum: a qualitative and quantitative analysis. BMC Med Educ 2012;12:55.

Article information Continued

Fig. 1.

The quiz, feedback, and final exam provided to the students in this study. The quiz, feedback, and final exam were hosted on the website, which was developed by the author on the Moodle platform. When students clicked on the quiz question number (A), the quiz question appeared on the screen (B). After completing the quizzes, the students could view feedback that varied depending on quiz score (C), view the activated feedback, and perform self-directed learning guided by the feedback (D). After completion of the self-directed learning, students were permitted to take the final exam.

Fig. 2.

Subjective opinions from students about the merits and drawbacks of the automated, real-time feedback system. Some highly ranked opinions are listed, and more opinions are included in the “Other” category.

Table 1.

Mean, standard deviation (SD), and t-test results of third- and fourth-year medical students on a survey of prior knowledge, usefulness, and satisfaction conducted using Moodle

Test items Grade N Mean SD P
Survey of prior knowledge 3 4 40 40 3.35 3.82 0.85 0.67 0.008
  3 40 4.55 0.46  
Usefulness survey 4 40 4.40 0.58 0.190
Survey of satisfaction 3 4 40 40 4.45 4.34 0.64 0.67 0.480

N, number; SD, standard deviation; P, p-value in t-test

Table 2.

Scores between third-year and fourth-year medical students

Category Mean (SD) T-test
Third year (n=40) Fourth year (n=40)
Quiz 85.57 (10.26) 89.66 (7.51) P = 0.046
Final quiz 96.02 (4.56) 95.53 (4.74) P = 0.633

Table 3.

The degrees of satisfaction with and usefulness of a computer-assisted, automated, real-time feedback system amongst medical students

Category Questions Min Max M SD
Degree of Satisfaction I was pleased with the Blood Transfusion class. 1 5 4.29 0.81
  Quizzes used in the Blood Transfusion class were helpful for learning about blood transfusions. 2 5 4.55 0.61
  The feedback used in the Blood Transfusion class 3 5 4.46 0.64
  was helpful for studying blood transfusions. It was easy to follow the feedback presented. 2 5 4.31 0.88
  The content of the quizzes and the feedback were related to what is necessary for studying blood transfusions. 2 5 4.41 0.79
  As a whole, I am satisfied with this Blood Transfusion class that was supported by a computer-assisted feedback system. 1 5 4.34 0.91
Usefulness The quizzes provided on the homepage were helpful for learning about blood transfusions. 3 5 4.58 0.61
  The content of the quizzes was related to what was taught during the Blood Transfusion class. 3 5 4.70 0.54
  The content of the feedback adequately pointed out what I need to know. 3 5 4.36 0.66
  The content of the feedback was helpful to me when I took the final exam. 2 5 4.40 0.74
  The spontaneous feedback after the quiz was helpful. 2 5 4.58 0.69
  It was easy to read and comprehend the feedback. 1 5 4.34 0.86
  The computer-assisted feedback system was helpful for studying about blood transfusions. 1 5 4.39 0.83

Min, minimum; Max, maximum; M, mean; SD, standard deviation.