Health Science Students’ Health Science Students’ Perceptions of Online Perceptions of Online

Problem-Based LearningProblem-Based Learning

Ruta Valaitis, School of Nursing, McMaster University

Wendy Sword, School of Nursing, McMaster University

Bob Jones, Visualization Design Institute, Sheridan College

Andrea Hodges, Social and Public Health Services, and McMaster University

McMaster Nursing Academic Seminars

Nov 2002

Research Partnership

Visualization Design Institute

AgendaAgenda

Brief glance at the literatureBrief demo of some of the tools developed

and used for the projectReport on the research findings to dateDiscussion

Online PBL Literature ReviewOnline PBL Literature Review

Type of Student Frequency

Undergraduate 9 Graduate 5 Prof Development 4 Continuing Education 1

Total 17

Discipline Frequency

Medicine 6 Education 5 Nursing 2 Nurse-midwifery 1 Sociology 1 Business 1 Computer science 1 Social Economy 1

Total 17

Research Method Frequency

Case study 11 Cohort 2 Action research 1 Qualitative evaluation 1 Qualitative pilot 1 RCT 1

Total 17

FindingsFindings

Methods poorly describedAnalysis rarely describedInterpretation and application of

PBL rarely consistent with McMaster approach

Ronteltap & Eurelings (2001)Ronteltap & Eurelings (2001)

University of Maastricht undergraduate medical students (n=9) and law students (n=7)

used CMC for discussions over a 6-8 week block in between face-to-face PBL sessions

Authors concluded that: writing in an asynchronous communication

system may lead students to a deeper level of information processing

participants need time to get used to communicating online

Witucki, Hodson & Malm (1996)

2 groups of nursing students (n= 98) in a course aimed to improve critical thinking using online communication to solve clinical problems

Student satisfaction survey conducted at the end of the experience – 80% felt that the conference was effective in

thinking critically about client situations – Majority enjoyed the collaborative aspect of the

online assignment and felt that they could express themselves more easily online than in a face-to-face discussion

Bjorck, 2001Bjorck, 2001

2 distance education courses in social economy in Sweden

What do students do in dPBL?Findings showed Messages are more frequent and detailed as

students gain more experience Decreased need to scaffolding by the

facilitator as students get used to dPBL Commenting on other’s comments builds

community, fosters reciprocity and engagement

Orrill, 2001Orrill, 2001 Two graduate classes in Education in US Content analysisFindings showed that Threaded discussions support divergent and

convergent thinking Threads were overwhelming for many Synchronous communication was needed Lack of visual / auditory feedback makes it

difficult to discern whether points made are clear

Applied Research Project

• How to extend PBL online while maintaining unique qualities

• Using existing ICTs

• Broaden access to information resources

• Provide new learning objects

• Evaluate online PBL by experienced• Students

• Tutors

Research QuestionsResearch Questions

To explore senior health sciences students’ perceptions and experiences of:– learning in online PBL– group process in online PBL – the use of online consultations with

Fetal Alcohol Spectrum Disorder (FASD*) experts

Communication via:

Synchronous Chat

Asynchronous Conferences

Access to online resources

CMC System LearnlinkCMC System Learnlink

Scenario

Fetal Alcohol Spectrum Disorder

Brigitte Boire

Pregnancy

Newborn infant

Young child

Presenting the Case

Text

Videos

Transcripts

Clinical Data

Brigitte Boire is 23 years old. She has recently moved to Hamilton from Timmins, Ontario, to ….

Resources

Videos

Links/ Forms

Computer Animations

Fetal Development

People Resources

Professionals

Anna Guardian – Expert Community Member

Student GroupsStudent Groups

• Level IV Midwifery • Self-selected to participate in place of paper

• Level III Nursing• Self-selected -1 dropped out

• Graduate Neonatal Nurse Practitioners • Self-selected to participate in place of paper

Methods

Focus groups and interviewsOnline reflections (Brookfield,

1995)Tutor interviews Quantitative analysis of online

notes

ReflectionsReflections

At what moment in the online class this week did you feel most engaged with what was happening?

At what moment in the online class this week did you feel most distanced from what was happening?

What action that anyone (tutor or student) took in the online class this week did you find most affirming and helpful?

ReflectionsReflections

What action that anyone (tutor or student) took in the online class this week did you find the most puzzling and confusing?

What about the online class this week surprised you the most?

Is there anything else that you think we should know about your experience in the online class this week?

Focus Group QuestionsFocus Group Questions

Getting started and computer set upPBL and group process onlineCase and resourcesDesign issues

AnalysisAnalysis

Level one coding for one focus group conducted by four researchers – Where coding differed, consensus was

reached – 176 codes identified

All remaining reflections and focus groups coded by at least two researchers – Agreement reached by consensus – 11 trees and 487 codes

Quantitative Results

• Group size: 5 to 10 students

• Time online: 4 to 6 weeks

• Postings: 107 to 444 notes

• New Conferences: 6 to 12 folders

• Chats: Up to 4 sessions

FindingsFindings

LearningGroup processUse of online experts

Many enjoyed online learning experience

I like having the opportunity to try something different. I figure I’ve written enough and I don’t love writing papers so it was a nice ... it had its frustrating moments but I really welcomed the opportunity of having a new experience The novelty of it. I thought it was a cool way of doing something different.Overall I really enjoyed it.

Lack of in-depth discussion

I appreciate all the work that everyone is doing, but the in-depth discussion/analysis seems to be lagging

I thought we had done some excellent work. But where I felt that we were missing out was on the overall synthesis of the material that we would ordinarily get out of our verbal conversation. I think for me solidifying it through that synthesis was missing.

. . everybody was like barfing out their information on the screen. I mean everybody, myself included, we were just like, oh found this, found this, and there was no integration. Like there was nobody commenting on other people’s [notes].

Lack of stimulation onlineLack of stimulation online

• I have been finding this project tedious and time consuming. Most of this relates to having everything on screen, having to pull back bits of info from various messages and having to read a lot of stuff that isn't always relevant. • I felt like I was a robot. I put down my stuff and that was it. Like I didn’t feel stimulated in the same way. • It felt like initially we made some objectives and then it just felt like we were pulling teeth on this sort of forever never ending thing. And I think that that could have been dealt with better if there had been more layers to the scenario.

Discussion threads hard to follow

• . . . by the time you got to [the 19th note in the thread], it didn’t really didn’t make sense with the first. [It] wasn’t really a thread, know what I mean?

• . . . talking with my classmates many of us have felt that it is hard to follow the threads and actually absorb any of the info posted, because it feels like you are jumping all over the place...

Quantity and quality of notes as well as frequency of login

• This is so time-consuming!! Reading and responding to everyone takes 10 X the amount of time online than face-to-face.

Online learning workload heavy

Time pressuresTime pressures

More time than face-to-face No end of the week Time not saved

I’d rather do my work and get it done and be able to do other things, and this

had just seemed like something that’s going to go on and on and on, and I had to keep checking.

I never anticipated it to be so time-consuming. I

thought it was going to save me time because I commute

here from Toronto. And honestly at the end I

thought, …oh I’d rather make the drive.

Depth / extensiveness of Depth / extensiveness of information valuedinformation valued

I have to say that something I really actually liked about LearnLink was the depth of the information that got posted. If you’ve ever sat in one of our PBL classes on Friday we get like next to nothing accomplished. I mean, in terms of the actual academics, because we spend so much time talking about our personal clinical experiences and births and that kind of stuff. And …the academic stuff is actually there. [I felt most engaged] going through the tonnes of information that has been posted. [It] has been very informative and engaging this week

Enhanced ability to reflect and synthesize

• . . . Compared to what we do when we come to class, … you cram a lot in for that sort of one session and then we all sort of go bananas. In order to process that… I guess I’m a slower processor, I reflect, I go back and think, and then that makes me go down another path. That’s what I really liked about the PBL. . . It afforded itself the extra time to reflect.

Enhanced ability to reflect and synthesize

• …you really had to synthesize it because you were putting it down on paper and words.

• …We don’t write out typically points on the stuff that we’ve read [in preparation for class] or critically think about it, and analyse the resources. You really had to do that when you were writing it out online, which was much more time-consuming.

• I really liked that I could go in and do it any time because that was convenient having kids at home. I could go in when they’re asleep. . .

• I valued the ability to research and post material at variable times. The process kept me "on task" but still afforded independence.

Flexibility of Time and Place

Easy Access Valued

• The evolution of learnlink… to be able to study cases in this manner … is amazing. I think that this format has a lot of potential for both teaching courses and to enhance print or lecture based courses. I also enjoy the convenience of being able to access the information and contribute when I have time.

Learned about computers, Learned about computers, web resources and the web resources and the

InternetInternetI decided it was an online case and we were using computer technology, so I’ve used a lot more Internet resource than normally I do in my PBL, and took advantage of the time to really do a lot of exploring around the literature that’s on the Internet . . .

It’s increased my confidence in computers, and now I know how to do e-mail by myself.

Findings ContinuedFindings Continued

Group Process

Decision-making frustrating

•In the chat group when we were trying to set up the learning objectives. Talk about coronaries …If you guys could see my face.

•I mean it took forever just to get our objectives for that first layer. That would be so difficult if we were trying to do that for four layers.

• For me the chats at first they were overwhelming, but it was the only time when the group would make group decisions, and you wouldn’t take a week after to decide where are we going now.

Chats were valued to support decision-making

Potential to misinterpret Potential to misinterpret notesnotes

• . . . it has been a challenge to phrase and write things, so as not to accidentally offend anyone.

• I guess people are less inhibited because it’s online and there’s no face that you’re saying it to and I found the language very offensive at times, very abrupt and harsh to the point of being offensive. And so I think that you have to make the language more sensitive, because you’re writing it and there’s no intonation or whatever.

Students felt pressure to show knowledge

• I felt pressured, especially when there’s a lot of students that are really giving a lot, I thought oh, I’m not keeping up.

• And that was the thing that kept going on with me was always, oh I have to get on there, I have to get on there. And you’re thinking, there’s not going to be anything left and what am I going to put on, and then you’re looking for more information and thinking, well maybe hopefully nobody has come up with this yet.

Repetitive information Repetitive information postedposted

I find it frustrating when people post info. that has already been touched upon or presented....it's almost like people think they just need to get something down so that they can be graded....but it just makes it redundant and boring.

Peer validation importantPeer validation important

• It also helps when you go back and see that someone has responded to what you have said, then you feel more like, ok this is a group thing, it’s kind of like being around a table and having a discussion. It’s not just, you know, putting information out there that nobody responded to.

• I really have enjoyed it when people copy parts of other messages and then speak to that in the new info that they have to offer. It makes it feel more conversation like and less fragmented.

• … Everyone was more equal, because in our group setting there [are] always more quiet members. But there were no quiet members, because everyone had to put their postings on. So, it was very equal in some respects.

• I liked the fact that, I’m usually a quieter person but it’s easier for me to sit and think about things and then post them rather than if I’m face-to-face kind of like the group keeps on going …

Quiet members participated more Quiet members participated more

Chats helped some feel connected

• It was my routine. You log on and then I’d check who’s online.

• … I enjoyed it just because I knew that the people that I knew and interacted with were on the other end.

Chats overwhelming & frustrating

– Everyone talking– Fast paced– Affected by typing skills– Slow connection problematic

•The chat for me was frustrating because I would type something in and three people have already said it. Or I’d erase it and then I’d start over, and then somebody else would say something and then somebody would say, where is Mary? Well I’ve been trying to put something on here for the last 5 minutes. Oh, Dave just said that. Ok.

Findings ContinuedFindings Continued

Perceptions and Use of Experts

Using Online FASD ExpertsUsing Online FASD Experts

Online Dialogue between Online Dialogue between Anna Guardian and a student:Anna Guardian and a student:

Student:Any strategies that you have developed as their caregiver that

you have found really helpful?

Anna Guardian:I have tried many differnt stratigies , one for her eatingproblems,

one for her behavior , one for sleeping . For her eating problems we have tried giving her finger foods with different tectures , i would try to give her a little bit of something new , but she wasnot ready to eat , she would spit it uot after chewing it , i tried giving her things she wanted to eat , like a sandwhich but that did not work . I tried telling her that she can have the same as granma but that did not work . I tried peer pressure with her cousin who is 1 year younger , sometimes that worked and the next time it didnot . she does eat better at school than at home because of all the kids.

Advantages of Online Experts

• Provided authentic learning experience

Well just that it was a real person. It wasn’t a thing that was cleanly made and polished and whatever. It’s a real person reacting to your question and reacting to

their experience and relating their experience to you.

Advantages of Online Experts

• Provided authentic learning experience

• Felt confidence to write to experts

It just gave me confidence that no matter what I wrote or whatever question I

wanted to ask that it mattered and that I would get a response and so it was a

valuable part of the experience.

Advantages of Online Experts

• Provided authentic learning experience

• Felt confidence to write to experts• Experts invited dialogue

The [expert] also posted another message. I don’t know if you guys saw, [he said] “and keep the questions

coming,” . . . which was really good. Because you think you don’t want to kind of take up [the expert’s] time

really, but that was encouraging.

Advantages of Online Experts

• Provided authentic learning experience

• Felt confidence to write to experts• Experts invited dialogue• Experts provided detailed

responses

That [expert] posted like a huge response. Like, very,

very detailed.

Advantages of Online Experts

• Provided authentic learning experience

• Felt confidence to write to experts• Experts invited dialogue• Experts provided detailed

responses• Experts were easy to access onlineLike, we have people contacts but we rarely

use them. Just because we can post an e-mail to them it was much easier to access

those resources.

Limitations of Online Experts

• Information not always relevant

So in that way it was useful but I found that I skimmed through a lot that I really wasn’t

interested in or the question wasn’t quite what I was looking for, so I just sort of

skimmed through that.

Limitations of Online Experts

• Information not always relevant• Responses sometimes

disappointing

I was disappointed in a response from [one of the experts]. [The expert] really didn't answer

my question and it took a week for [the expert] to respond.

Limitations of Online Experts

• Information not always relevant• Responses sometimes

disappointing• Some forgot about experts online

or how to access themHabits are hard to break. . . . there had been so many other things that happened in that first week or so that remembering about those other resources just fell off

of the neurons.

Perceptions likely influenced by:

• Short time spent online (4 – 6 weeks)

• Not true distance learners

• All had previous face-to-face experience with study group members

• Students may have told researchers what they thought we wanted to hear

ConclusionsConclusionsTakes time to adapt to online PBL Not all students found it effective

for their learning styleTime-consuming and heavy

workloadPeer validation important to keep

flow of discussion and increase connectedness

Conclusions ContinuedConclusions Continued

Mix of synchronous and asynchronous methods helped group decision-making

Increased flexibility valuedEase of access to online experts valuedPotential for deep learning with

increased time for reflection and synthesis

For More Information:

For our database of literature pertaining to online collaborative learning, go to:http://www.ltrc.mcmaster.ca/pblonline/