A discussion of medical students’ attitudes to the integration of computer technology in medical education

L.M. Almond MBChB, MRCS(Eng)

Department of Medical Education,

Warwick Medical School,

United Kingdom

mxa891@hotmail.com

Abstract

Objective: After a decade of increasing computer use in medical education, we survey current students’ attitudes to computer technology, identify specific concerns, and discuss areas where the role of computers might be expanded.

Methods: A questionnaire survey of 176 pre-clinical medical students was undertaken at Warwick medical school in May 2006. 82 (47%) students completed and returned the questionnaire.

Results: 98% of students felt confident using computer technology for educational purposes but ergonomic issues and concerns over software reliability and technical support were identified. Only 17% students would like the role of computers to extend to formal written assessments and only 33% would prefer to take lecture notes on computer. 24% of students would like the medical curriculum to be altered to facilitate greater use of computer technology.

Conclusions: The positive impact of computer technology, particularly in enhancing self-directed learning, was recognized by the students surveyed. Interestingly almost a quarter of students would like to see the curriculum altered to facilitate wider computer use. However, whilst students value the use of technology in many areas, they were reluctant to see its role increase in lectures and formal summative assessments. It is important that faculties consult students on the elements of the curriculum which would benefit from further integration of computer technology.

Keywords

Computers, medical education, information technology.

Introduction

Over the last decade the use of computer technology has transformed courses and teaching strategies across a huge variety of disciplines. The British General Medical Council has actively promoted the use of technology in the education of future doctors¹ and hence, largely without student consultation, syllabus structures have been altered to allow a greater integration of technology into curricula. During this period, university education has tended to shift away from didactic approaches and towards group collaborative learning strategies such as problem based approaches, to encourage and facilitate self discovery and student reflection, and computer based facilities have been crucial to this shift².

The use of computers to enhance discussion in group tutorials is well documented and computers are now used widely for this purpose. However, everyday use of computers to assist lecture-based education is less widespread, and although the amount of didactic teaching has decreased, it still forms an essential part of all medical courses in the United Kingdom. Similarly, computers are rarely used for formal summative assessments with faculties still preferring traditional techniques in this aspect of the course.

This study aims to reflect on computer technology after a decade which has seen a dramatic increase in its use in medical education. We assess students’ current attitudes to computer use, and also ask whether their might be a greater role for computer technology in certain aspects of the curriculum to enhance traditional teaching techniques, such as lecturing, and in summative assessment.

Methods

176 questionnaires were provided to pre-clinical medical students at Warwick medical school in May 2006, in order to assess students’ volume of computer use and attitudes towards the increasing integration of IT in medical education. Attitudes on a role for computers in student summative assessment and to augment lecture programmes were also surveyed. 82 (47%) students completed the questionnaire. We report these results below.

Results

98% of students surveyed felt confident using computers for educational purposes. The majority (80%) had received some formal computer training during the past 10 years and over half (51%) are able to touch type.

Computer use was very prevalent among our cohort of students. 99% of students stated that they used a computer everyday, and 85% of students stated they use a computer every day for work related tasks.

62 (76%) students surveyed would like more computer based revision aids and 52 (63%) stated that computers should be used for mock assessments but only 14 (17%) would like to take formal assessments on computer. Almost a half of all students 49% stated they would be concerned about eye strain if they were required to use computers more frequently as part of their medical training. 46 (56%) also stated frequent crashing and lack of technical support (38%) would currently pose a problem to the wider integration of computers in medical training.

Table 1 illustrates students’ attitudes to the role of personal computers for note-taking and storage of lecture notes³. 76% of students stated they would prefer to revise from their own hand written notes rather than computer based resources/notes, even though 86% of students recognize that the superior visual aids are available on computer, such as 3-dimensional anatomical images help them to retain information for longer³.

Table 1. Attitudes to computer use by students in lectures.

Just over a half of respondents would feel comfortable taking summative extended matching / multiple choice assessments on computer but only 17% felt comfortable using computers for formal written assessments. Over half (54.8%) of students would prefer to be able to submit essays / dissertations on-line.

98% of students felt they should be expected to have at least a basic grasp of computer skills but only 36% thought they should be taught routinely as part of the medical school course and only 9% thought computing competencies should be formally assessed. Almost a quarter (23.7%) felt that the medical curriculum should be changed to allow greater integration of computer technology.

Table 2. Familiarity of students with use of various software.

Discussion

There has been considerable research exploring the role of computer technology in medical education and how to successfully integrate it into medical courses.^3-6 Many of the advantages of this technology have been reported, but there has been little research done to gain a student’s perspective. This survey was designed to highlight the attitudes of current students to the increased role of computer technology in medical education. We also discuss students’ attitudes to the use of computers in areas where they are comparatively less utilized, such as in lectures and summative student assessments.

Our survey demonstrates how familiar students have become with computer technology in many aspects of their training. 99% of students surveyed use a computer everyday and 98% use a computer for educational purposes at least once a week. Students are clearly confident using a variety of software (Table 2) and appreciate the advantages this technology has brought in terms of improved visual aids and improvements in self directed learning.

The use of computer technology can certainly enhance students’ learning experience. Computers can present written information, databases, images and sounds to keep students’ interest, encourage information retention, and more recently, mimic real clinical scenarios. Students recognize that computer presentation is ideal for topics that are very detailed, visually intensive and difficult to conceptualise, such as complex regional anatomy and biochemical processes.⁷ By facilitating discussion and student collaboration computer technology can encourage students to evaluate and appraise information, thereby employing higher levels of their cognitive domain, which in turn facilitates memory retention as described by Bloom.⁸ The ability to research on-line, and work through simulated cases in groups also projects students through Kolb’s four stage model of experiential learning.⁹ These theoretic models of learning illustrate how computer technology lends itself to enhancing medical education.

Despite the clear advantages highlighted above, and continuing improvements in the technology, the limitations of computers in certain aspects of medical education must be recognised. Nearly one quarter of students (24%) would like the medical curriculum to be altered to allow greater use of computer technology, however, students do not want to see its use increase in all aspects of the curriculum. Students in this survey had reservations about further expansion of the role of technology in traditionally didactic areas of the curriculum and in formal summative assessments. The majority of students felt that computers were useful for mock assessments (63%) and revision aids (76%) but only 17% would like to sit summative assessments on computer. Similarly, 67.5% prefer to take hand-written, rather than computer based lecture notes, and 76% of students stated they would prefer to revise from handwritten notes. In addition, students expressed concerns about eye strain, loss of data, frequent crashing and lack of technical support, as issues universities must consider prior to wider computer integration. The survey demonstrated that whilst students accept and appreciate the value of computers in promoting certain aspects of the curriculum, they are not keen for that role to extend to formal examinations or to rely on computers to take and store lecture notes.

There is an argument that these concerns are specific to this generation of students who may still not be as comfortable with computer technology as future generations. In addition, although we have highlighted technical concerns, future developments in technology may alleviate such problems as ‘crashing’ and loss of data and may diminish the incidence of eye strain.

It is important however, that the current students’ concerns are not ignored by medical faculties in their drive towards increasing the use of computer technology. This survey highlights certain reservations which could become more prevalent should the role of computers continue to increase, and which must be adequately addressed prior to more widespread computer integration. Faculties need to consider which aspects of the curriculum could be enhanced by increased computer use and ensure that the views of the student population towards this are adequately considered.

Conclusions

Widespread integration of computer technology into medical education without understanding students’ attitudes is unlikely to maximize the potential advantages of using such technology. Further successful integration of computer technology will therefore depend on ensuring current students’ views are continually acknowledged and addressed. This study has shown that at present the majority of students are confident with computer use and recognize its advantages in specific settings but, importantly, highlights some key areas where students are reluctant to see further computer integration. The survey results indicate that at present computer use for students in lectures and formal summative assessments would be unlikely to be successful or maximize students’ learning experience, and it is essential that those responsible for implementing technology into students’ education are fully aware of these concerns.

References

1.Issroff K. Computer-supported collaborative learning: an introduction; in Daetwyler, C. (Ed) The use of Computers in (medical) Education. Austrian Association for Didactics in Higher Education, Innsbruck, 2001

2.Dorup, J. Experience and Attitudes Towards Information Technology among First Year Medical Students in Denmark: Longitudinal Questionnaire Survey. Journal of Medical Internet Research: Volume 6, Issue 1. 2004

3.Almond LM, Chawla G, Peile, E. A Discussion of the Merits of Tablet Computers in Medical Education. Awaiting publication in: Interactions magazine.

4.O’Malley CE. Designing Computer Systems to Support Peer Learning in O’Malley C (Ed) Computer Supported Collaborative Learning. Berlin, Springer – Verlag. 1995

5.Eurell JA et al. Tablet Computers in the Vetinary Curriculum. Journal of Veterinary Medical Education, 2005; 32(1): 113-6

6.Daetwyler C. How can computers assist the students in the learning of clinical medicine. In Daetwyler, C. (Ed) The use of Computers in (medical) Education. Austrian Association for Didactics in Higher Education, Innsbruck, 2001

7.Phillips R. Developers’ guide to interactive multimedia. A methodology for educational applications. Perth: Curtin University Press. 1996

8.Bloom BS. A Taxonomy of Educational Perspectives. Allyn & Bacon. 1984

9.Kolb D. Experiential Learning: Experience as the source of learning and development. Prentice Hall, USA. 1984