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'Press the space bar to learn about nematodes.' (computer-assisted lessons for your laboratory)

The microcomputer, a fast-growing asset to clinical laboratory management, has also begun to prove its worht as an educational tool. It can teach complex subjects using sophisticated graphics, and it can test comprehension and retention. It also allows students to work individually, at their own pace and schedule. Just as important as these factors, it enlivens learning with an element of fun.

For students in the medical technology program of our 396-bed hospital, computer-assisted instruction, or CAI, has replaced a lengthy lecture series with a series of diskettes. The lessons have proved at least as effective as the hard-to-schedule lectures, and we're now extending the microcomputer into continuing education for the laboratory staff.

You don't need to be an experienced programmer to create computerized lessons for lab staff or students. If you can develop a coherent lecture, you can develop a computer teaching package, thanks to day's simplified software. In fact, I found the greatest challenge was planning lesson content and format. My experience may encourage other computer ovices to explore the personal computer's potential for continuing education and other instructional uses.

A few years ago, our medical technology program purchased Apple PILOT software, a simple computer teaching language that is also available for other microcomputer models. We had two Apple computers in the laboratory, easily available for teaching. The software at the time cost only $150--the price of two large laboratory texts--and I knew that CAI was gaining acceptance as an instructional method. Soon, I found myself with a programming manual, but no idea what to do first.

A search of the literature yielded a number of articles with glowing accolades for CAI in medical education, but no practical advice on how to develop it. Early efforts at computerized learning, it seemed, were either evaluative testing programs only, or instructional only with no testing. I wanted an interactive program that both taught and evaluated.

To produce one, I used some concepts learned in workshops on course development. These techniques, like mapping and story-boarding, were originally used to create slide-tape presentations, but they adapted excellently to programmed learning. The process of developing a major teaching program evolved in the following series of 10 basic steps.

* Define goals. You need a good reason for bothering to work up computer lessons. First, decide how you intend to use the lessons. Who will be the target audience, what background will they have, and what should students accomplish in the course of study? These questions may sound obvious, but write down the answers. Later, they will help you keep focused when factual material bogs you down.

When we purchased PILOT, I was looking for a new approach to teaching parasitology. Six medical technology students from various colleges rotate through our laboratory for their year of clinical training. Their backgrounds in parasitology are varied, ranging from cursory knowledge to a full semester course. Since we aim for a uniform level of competency, I needed a flexible approach. Lab methods and identification would continue to be taught in the laboratory, but I planned to convert a series of seven lecture hours into a microcomputer program. This move would also cut the teaching time required of our staff technologists.

I set several goals for the project: to develop a self-paced program replacing the existing lecture unit; to make it accessible to students with varying knowledge of the subject; to make the program available for continuing education; and to include self-evaluation in the format.

* Develop objectives. In this phase, you decide what material to cover. It's a very important step, because it determines what you're aiming for in the final product.

The established objectives for our parasitology lecture series provided a good springboard, once we reviewed and updated them. In addition to these individual lesson objectives, I developed overall objectives for the whole program: For each parasite, the student should be able to state both the infective and diagnostic stages, general life cycle, geographic distribution, and a means of prevention.

* Map the course. Now that you have decided that students must learn a certain mass of material, you must discover the best approach to presenting it. Mapping, an idea gleaned from a Centers for Disease Control course planning workshop, helps find that approach. It's vital in developing any course, but especially so in programmed learning. Each lesson should build on previous ones for continuity and reinforcement.

Mapping may be easier if you work backward from the desired outcome. What must the student know in order to reach the program goals? I laid out our lecture series topics on paper to figure out the most logical order of presentation. In drawing this map (Figure I,) I realized that the lessons on basic definitions and classifications should come first and second. The remaining ones, on various parasite groups, could follow the introductory material interchangeably.

* Establish a format. Once you have a map, devise a good format for your lessons. I knew from experience that computer lessons can be effective and enjoyable, but I also recalled that students often have nothing concrete to take away for reference and review. It's easy to forget material, and troublesome to look up key topics in a programmed text.

Only one of our Apples has a permanent printer, and PILOT software is not designed to produce hard copies. To fill this gap, I designed an accompanying notebook. PILOT has powerful graphic capabilities, but i can't reproduce cysts or trophs very clearly, so I supplemented the notebook ith photographs.

The original objectives became part of each lesson's standard format. I adapted Centers for Disease Control parasite life cycle charts to CRT screen images, like that shown in Figure II for Ascaris lumbricoides. The computer presents the chart and a brief introduction for each organism, and then displays blocks of information interspersed with questions and memory ticklers.

The student notebook follows this pattern, showing the life cycle chart in detail and leaving blanks for notes on each topic. Figure III displays the notebook page for Plasmodium. The blanks are organized to highlight important information in the computer text. Students work at their own pace, pressing the keyboard space bar to continue to the next frame.

Your choice of format will vary with the type of lesson and the computer's capabilities. Students might not need hard copies of a case study or review. It's your decision.

* Assemble the lesson. This is the first point where you need the facts that are to be taught. Consult experts and reliable sources for the most accurate source material available. Once lesson material is gathered, decide when to interrupt it with questions, and determine how the computer will respond to students' answers. A case study approach may call for a program with more branching, or decision points, than a straight tutorial lesson.

For practice in lesson development, I created a small, simple program on laboratory accidents, presented as a diagram in Figure IV. My first map was considerably less neat. Since then, I have taken a computer course to learn some diagram-shorthand. This flow chart shows the sequence of text, questions, and answers in the lesson.

When planning a lesson, remember that attention spans are relatively short. I aimed for 15 to 25 minutes at the computer per session. You will have to experiment to see how much material you can cover in a given period of time.

* Create a storyboard. The storyboard, a planning technique of filmmakers and animators, is used routinely in developing audiovisual presentations. It's simply a way of writing the lesson text as the student will view it, one frame at a time. I applied the method in selecting the material to include on each computer screen image, and on the corresponding notebook page.

To visualize what the student would see, I folded a blank sheet of paper in half and labeled one half "notebook" and the other "CRT." I organized the parasites easily by making one storyboard frame for each organism. Eventually, I used several screens per organism, but the storyboard helped keep the flow of information concise.

* Program the software. After deciding what information to present, and organizing the text frame by frame, you can turn the job over to a computer expert--but believe it or not, the actual programming isn't hard. The PI-LOT system comes with an easy-to-understand Editor's Manual. With no experience in computer programming, I was able to produce working programs. An expert programmer could probably translate lessons into BASIC as well, although PILOT is easier to use and geared specifically to teaching functions.

Begin by experimenting with a very simple lesson, like ours on lab safety, to hone your course planning and programming skills. Don't be afraid to personalize the lessons. We all like to be addressed individually, so make sure the computer will "talk" to students by name. Figure V shows how the computer poses an opening question on nematodes, and how it responds to two possible answers. The student is also told: "Press the space bar to learn about nematodes, Sarah."

* Run a field test. After you complete a lesson, test it on novice subjects. Of course, you will have tested the program to check that it runs, but you must confirm that the sequence of text, questions, and answers makes sense to the student as well as you.

No matter how careful and clever you were, a field test will point out flaws. To test the parasitology lessons, I chose our histology supervisor as an intelligent but uninitiated subject. She sat patiently through all the lessons, and gave me valuable insights into a student's thought processes.

* Validate the program. After a novice tests the program for clarity and good sense, have a reliable authority review the lessons for factual errors. Working on my own with textbooks, I acted as my own editor by double-checking everything against its source.

* Evaluate. Now you are already to unleash your masterpiece on students. But does it teach? Each of my lessons has a computer post-test, which gives

students instant feedback on newly acquired knowledge. They also seem to retain the material. Our classes are too small for statistical analysis, but final exam grades have remained high for the two classes that have completed the CAI parasitology course.

Finally, interview students on their attitudes toward computer learning. I included a short questionnaire with the final exam. The program didn't receive unanimous rave reviews, but the students' comments gave me valuable ideas on how to improve it. Several suggested that the lessons be made more lively and interesting, so I am now investigating the use of programmed musical tunes, inside jokes, and other light-hearted devices to keep students awake in front of the terminal.

CAI has turned out to be a valid instructional method in our school of medical technology. The program fulfilled most of its goals. It replaced the lecture series, was self-paced, and had the added advantage of year-round availability, allowing students to schedule the study of parasitology theory during their rotation through the microbiology department. The lessons also covered the lecture material in about half the time originally required.

I suggest attempting a smaller project for your first foray into CAI. This one left me with a case of computer burnout for months. Since then, members of the laboratory staff have expressed an interest in computer lessons, and we are making efforts to integrate their ideas into our continuing education menu.

The parasitology series is available for CE, and I have also created a series of hemostasis case studies. So far, it has been challenging to persuade technologists to sit down and use the disk. Computerized CE just isn't as enticing as an out-of-town workshop. Once they try it, though, they tend to respond with enthusiasm. Lessons on computer disks have an added advantage for management, because technologists don't have to leave the laboratory en masse to attend a scheduled session.

Our lab is still experimenting with the microcomputer's potential as a teacher. In the course of researching the project, I ran across this quote: "Learning is enhanced by problem solving, dependent on feedback, and augmented by novelty, variety, and change."

That statement went up on a sign tacked over my desk. Computer-assisted instruction offers ample opportunity for feedback, problem solving, and challenge--and it's still a novelty, even in this age of Pac-Man. For us, it was worth the effort to add a new dimension to laboratory education.
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Author:Horton, Judy A.
Publication:Medical Laboratory Observer
Date:Oct 1, 1984
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