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Article Blog Construction as an Effective Tool in Biochemistry Active Learning

^va ~o Cubas Este Rolim†,‡ Julia Martins de Oliveira†,‡ Luana T. Dalvi† Daniel C. Moreira† Natasha Garcia Caldas†,‡ Felipe Fernandes Lobo†,‡ merson Andre  Polli§ De  Elida G. Campos† Marcelo Hermes-Lima†*

From the †Departamento de Biologia Celular, Universidade de Brasılia, Brasılia, Distrito Federal, Brazil, ‡Hospital Universitario de Brasılia (HUB), Universidade de Brasılia, Brasılia, Brazil, §Departamento de Estatıstica, Universidade de Brasılia, Brasılia, Distrito Federal, Brazil

Abstract To boost active learning in undergraduate students, they were given the task of preparing blogs on topics of clinical biochemistry. This “experiment” lasted for 12 teachingsemesters (from 2008 to 2013), and included a survey on the blogs’ usefulness at the end of each semester. The survey (applied in the 2008-2010 period) used a Likert-like questionnaire with eight questions and a 1-to-6 scale, from “totally disagree” to “fully agree.” Answers of 428 students were analyzed and indicated overall approval of the blog activity: 86% and 35% of the responses scored 4-to-6

and 6, respectively. Considering the survey results, the high grades obtained by students on their blogs (averaging 8.3 in 2008–2010), and the significant increase in average grades of the clinical biochemistry exam after the beginning of the blog system (from 5.5 in 2007 to 6.4 in 2008– 2010), we concluded that blogging activity on biochemistry C 2016 by is a promising tool for boosting active learning. V The International Union of Biochemistry and Molecular Biology, 00:000–000, 2016.

Keywords: Education 2.0; active learning; metabolism; medicine; nutrition

Introduction Weblogs (blogs) are websites that function as online journals and have been serving as a globally widespread communication and discussion tool since the last decade [1, 2]. Even though the most popular blogs are those in which

Volume 00, Number 00, Month/Month 2016, Pages 00–00 *To whom correspondence should be addressed. Tel.: 155-61-31073103. E-mail: [email protected] or [email protected] ECB, JMO, LTD and DCM contributed equally to this work. ECR and JMO were supported by PIBIC-CNPq studentships. DCM is supported by a PhD scholarship from CAPES-Brazil. Received 3 February 2016; Revised 6 August 2016; Accepted 8 September 2016 DOI 10.1002/bmb.21028 Published online 00 Month 2016 in Wiley Online Library (wileyonlinelibrary.com)

Biochemistry and Molecular Biology Education

users add posts about their own lives and experiences, blogs with scientific purposes have become very popular [3]. In 2007, a science blog owner estimated that there were at that time 1,000 to 1,200 science blogs (not considering pseudoscience or computer technology blogs), mostly written by graduate students and postdocs, and to a lesser extent by science teachers and professional journalists [3]—nowadays these numbers are much higher. Blogs with scientific content are not only a place for presentation and discussion of science, but also as a learning tool for both students and lay citizens [4]. The preparation of scientific blogs by graduate and undergraduate students may enhance and stimulate learning, promote student collaboration, and provide an opportunity for the use of different learning strategies [2–5]. An experience with 60 medical doctors in a Masters course, in which the doctors had to post topics on blogs

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Biochemistry and Molecular Biology Education regarding their specialization, showed that 64% of them agreed that this strategy enriched their learning, while 54% agreed that the blogs provided opportunities to learn from classmates [4]. In another experience, first-year dental students were requested to access an existing blog to complete online exercises and to give feedback about the course. At the end of the teaching-semester, students were asked to answer a survey about this blog experience and 100% of those who declared to have used the blog (77% of all students) considered it useful for learning [2]. These examples, along with others [5, 6], indicate how useful blog writing can be for academic learning purposes. At the University of Brasilia, Brazil, the use of blogs was a strategy used in the Basic Biochemistry course (named “BioBio”) to boost the interest of first year nutrition and medical students in learning clinical biochemistry and in actively producing useful contents. This strategy was introduced in the course in 2008, and a total of 174 blogs were produced by undergraduate students until 2013, the last year of the project. The objective of the present study is to describe this experience and to evaluate whether the students support and benefit from the use of this tool. For this purpose, we analyzed in detail the blogs produced in 6 teaching-semesters, from the first teaching-semester of 2008 (March–June) until the second teaching-semester of 2010 (August–November). Information about blogs produced in the 2011–2013 period was also included.

Material and Methods BioBio is a one-semester course offered twice a year at the University of Brasilia. The present activity started in the class of 2008-1, referring to the first teaching-semester (March–June) of 2008. A questionnaire was prepared to evaluate students’ responses on the usefulness and preparation of BioBio blogs. The project was approved by the ethical committee on human research of the Faculty of Medicine (project 039/2011). The questionnaire contained 8 questions prepared by the instructor, with the help of a peer-tutor student, and was answered using a Likert-like scale from 1 to 6 with a NA alternative, where “1” means “totally disagree”, “6” means “totally agree,” and “NA” means “I do not know or would not like to answer” (considered herein an abstention). The eight questions are shown in Table I. At the end of each teaching-semester, all students involved in the elaboration of blogs were asked to complete the 8-item perception questionnaire after the Clinical and Applied Biochemistry (CAB) exam, a True-or-False exam described previously [7, 8]. Those who chose to answer it (independently of giving “good” or “bad” evaluations) received 0.2 points (out of 10) in the CAB exam. The questionnaire was applied to 428 students, from 2008-1 to 2010-2 (the second teaching-semester of 2010).

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TABLE I

Questions and respective numbers presented in the Likert-like questionnaire

Question 1. Making a blog during the Bio-Bio classes was enjoyable and I think it was advantageous to my education. 2. I got involved in the research and writing texts for the blog. 3. Making a blog during the course provoked my interest not only in the discipline but also in its content. 4. Since I started making the Bio-Bio blog I got used to look for extracurricular papers. 5. Making a blog, as it was done during the Bio-Bio class, is a valuable tool for learning. 6. In general, Blogs’ contents were very good. 7. The blog my group made is very good. 8. Older blogs, made by students from previous semesters, were useful as reference for making my own blog. The effect of anonymity was also evaluated in the survey. This test was conducted in the classes of 2010-2 and 2011-1 (data from 2011-1 was only used to assess the anonymity effect). In the tests applied from 2008-1 to 2010-1, students signed their names on the questionnaires; therefore, their identities were known. Thus, to test for a possible bias in the students’ responses, in 2010-2, half of the class received a questionnaire that they did not have to sign. The results of anonymous questionnaires were compared with non-anonymous ones (this was repeated in 2011-1). The anonymous and non-anonymous groups had 40 and 39 students in 2010-2, and 37 and 34 students in 2011-1, respectively. The analysis of the anonymity effect was done using the R statistical software version 2.15.1 (R Core Team, 2012). Variables were analyzed using the Monte–Carlo Chi-square test; statistical significance was considered at p < 0.05. To calculate average values of individual grades for blogs and CAB exams, we excluded those students with zero grades due to lack of participation or plagiarism. The comparative analysis of the exam grades was done using two-tail t tests.

Results Description and History of the BioBio Blogs The BioBio course (composed of structural biochemistry, enzyme kinetics and regulation, metabolic and integrative

Blog Construction as an Effective Tool in Biochemistry Active Learning

List of topics covered by the students’ blogs, as well as their classification, duration, average grades and average number of posts

TABLE II

Topic

Classification

2008–2010 perioda

Grade

Posts

Other perioda

Diabetes

Central

2008-1 to 2010-2 (6)

9.6b

25.6

2011-1 to 2013-2 (6)

Cholesterol

Central

2008-1 to 2010-2 (6)

8.8

29.6

2011-1 to 2013-2 (6)

Free Radicals

Central

2008-1 to 2010-2 (6)

9.2

27.0

2011-1 to 2013-2 (6)

Neurotransmitters

Central

2008-1 to 2010-2 (6)

9.5

26.5

2011-1 to 2013-2 (6)

Exercise Biochemistry

Central

2008-1 to 2010-2 (6)

9.3

33.1

2011-1 to 2013-2 (6)

Corticoids

Central

2008-1 to 2010-2 (6)

9.0

27.0

2011-1 to 2013-2 (6)

Aging Biochemistry

Central

2008-1 to 2010-2 (6)

9.3

21.8

2011-1 to 2013-2 (6)

Central

2008-1 to 2010-2 (6)

9.7

36.3

2011-1 to 2013-2 (6)

Central

2008-1 to 2010-2 (6)

9.0

18.8



Central

2009-1 to 2010-2 (4)

8.4

27.5

2011-1, 2012-1 to 2013-1 (4)

Central

2010-1 to 2010-2 (3)

8.7

24.0

2011-1 to 2013-2 (6)

Phenylketonuria

Minor

2008-1 to 2008-2 (2)

9.4

17.5



Galactosemia

Minor

2008-1 to 2008-2 (2)

8.5

23.0



Fatty Acids and Health

Minor

2008-1 to 2008-2 (2)

9.5

7.5



Vegetarianism

Minor

2008-1 to 2008-2 (2)

9.3

24.5



c

Obesity Extremes of Tolerance

c

Nutrition Biochemistry Hypertension

d

Prions

Minor

Lorenzos Oil

Minor

e

2008-1 (1)

7.2

2.0



2008-2 (1)

8.5

5.0



Minor/Satellite

f

2008-2 to 2009-2 (3)

8.3

15.0



History of Pellagra

Minor/Satellite

f

2008-2 to 2009-1 (2)

9.1

30.5



Media and Public Health

Minor/Satellitef

2008-2, 2010-1, 2010-2 (3)

9.1

22.5

2011-2 to 2012-1 (2)

Satellite

2009-1 to 2010-2 (4)

8.8

21.6

2011-1, 2012-2 to 2013-2 (4)

Alzheimers Disease

Satellite

2009-2 to 2010-2 (3)

9.3

21.6

2011-1 to 2013-2 (6)

Metabolic Syndrome

Satellite

2009-2 (1)

8.1

29.0



Diseases of the Mind

Satellite

2010-1 (1)

6.5

23.0



Alcohol Biochemistry

Satellite

2010-1 to 2010-2 (2)

8.7

22.0

2011-2 to 2013-1 (4)

Cancer Biochemistry

Satellite

2010-2 (1)

9.4

25.0

2011-1 (1)

History of Insulin

Low Carb Diets

g

Topics starting in 2011 or later Fatty liver disease

Central

2013-1 to 2013-2 (2)

Homeopathy

Satellite

2011-1, 2011-2, 2012-2, 2013-1 (4)

Auto immune diseases

Satellite

2012-2 (1)

Sugar and Health

Satellite

2013-2 (1)

a

The number of blogs in the respective period is between parenthesis. One group received “zero” due to plagiarism, thus, only 5 blogs were used to calculate the average grade. c The 2008-2 blogs of these topics were deleted before our study started. Thus, 5 blogs were used to calculate the average number of posts. d Two hypertension blogs were produced in 2010-1. e Even though there were only two posts for this “mini-blog”, it covered most information needed. f They were “mini blogs” in 2008-2. In the following semesters they became “satellite blogs”. g The 2009-2 blog was deleted and thus only 3 blogs could be used to calculate the average number of posts. b

Biochemistry and Molecular Biology Education biochemistry, and clinical biochemistry) has been taught with the aid of different active learning strategies since 1999 in an attempt to stimulate and encourage students to be responsible for their own learning. These strategies— employed in the BioBio discipline until 2013—were discussed in detail previously [7–9]. The use of blogs was implemented in the first teachingsemester of 2008. In this activity, first year medical and nutrition students were responsible for preparing a blog on a topic of CAB, as well as an in-class seminar. The topics included, for example, obesity, diabetes, aging, and cholesterol (see the list of topics in Table II). In the first month of the course, students were divided into groups of 4 or 5 and selected one or more topics to work on from a list prepared by the instructor and the student peer-tutors (12–15 per semester [7, 9]). After this, the groups prepared a one page-long summary of their project for each chosen topic to be approved (by the instructor and peer-tutors) before presenting a seminar and/or preparing a blog. After this selection, the preparation of seminars and blogs were conducted by the students. All students in the class had to be involved in blog preparation. Student’s peer-tutors helped the BioBio students to start the blogging task. Until 2007, before the implementation of the BioBio blog system, students were instructed to prepare posters that were used to assist the presentation of in-class seminars about their specific CAB topic [7, 9]. This activity was part of their evaluation. After the presentations, the posters (in PDF versions), which in most cases were highly complex, served as study material. With the implementation of the CAB blogs in 2008, the posters became more of a visual aid to assist the presentations than a source of content for learning per se. From 2008 to 2013, each group became responsible for preparing a blog to enrich and expand the information presented in class. In this sense, students had an entire teaching semester to present information on CAB topics through blogs, instead of having to present all the content during their seminars. This engaged students in active search of information to be posted on their blogs until the end of the teaching semester. In addition, with the use of blogs, students were able to post videos, scientific articles, hyperlinks to other websites, supposedly improving their own learning and that of their peers who accessed the online information. Students also could post funny cartoons and jokes related to scientific topics (in Section “Example of a successful blog,” we describe an example of a student blog that was outstanding). Moreover, from 2010 to 2013 several groups promoted their blogs among peers and friends during the specific teachingsemester using Twitter (e.g., @neuromed92) or Facebook. The blogs were tutored by second semester students (the peer-tutors students) enrolled in Advanced Biochemistry, and the whole process of blog making was regularly supervised by the instructor. By the end of each teaching semester, the peer-tutors and the instructor evaluated the student groups based on the quality of the blogs and

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seminar presentations. Besides this evaluation, a survey took place to determine students’ favorite blogs, concerning contents and clarity. The winner group gained 0.3 extra points in their final BioBio evaluation (grades 0–10). In 2008, the CAB topics were divided into major and minor according to the amount of information to be presented (Table II). Major topics included, for example, obesity, free radicals, aging, and cholesterol, whereas minor topics included vegetarianism, phenylketonuria and galactosemia. Initially, during the year of 2008, the seminars of the major and minor topics were presented in 40–50 and 20 min, respectively. Besides that, the blogs for major topics contained more posts than those of the minor topics. At the beginning of 2009, minor topics were extinguished, and only major ones were considered in the further activities. The topics were then divided into central and satellite, according to their relevance to the course goals (Table II). Central topics were presented through blogs and 40–50 min in-class seminars, and satellite ones were presented only through a blog. The value of the blogs ranged 7.5%– 10% of the total BioBio grade, according to the teachingsemester. The blog grading was based on quality of contents and clarity of the presentation. The instructor, with the help of peer-tutor students, gave these grades. Approximately 15 BioBio blogs were prepared per teaching-semester, totalizing 91 blogs produced from 2008 to 2010 (6 semesters). The majority of the blogs received a grade equal or superior to 9.0, out of 10 (Table II). Few blogs had grades below 8.0: seven blogs ranged 6.5–7.9 and one blog (produced in 2010-2) received a zero grade due to plagiarism. Partial plagiarism happened in two blogs, in 2008-1 and 2010-1. In these cases, some group members were graded “zero.” In the following six teaching-semesters, from 2011-1 to 2013-2, 83 additional blogs were prepared (Table II), but the students’ perceptions about then were not analyzed in this study. The grades for these blogs were, in average, the same as in the 2008–2010 period (data not shown). The access to BioBio blogs (from 2008 to 2013) was organized by us and it is available at the blog-link. http://blogbiobiounb.blogspot.com.br. We recently noticed (on April 2016) that 166 blogs, out of 174, were still available for online access. Only eight blogs were deleted by the authors. The educational “experiment” of BioBio blogs was used until the 2013-2 teaching-semester.

Example of a Successful Blog One of the best blogs prepared from 2008 to 2010 by BioBio students was a blog on neurotransmitters, produced in the 2010-1 teaching semester. This blog, prepared by five medical students, presented basic concepts regarding the functioning of neuronal synapses with the use of an accessible language to the lay people. With each new post, different information was introduced with short texts,

Blog Construction as an Effective Tool in Biochemistry Active Learning

pictures, videos, and hyperlinks, allowing the reader to acquire knowledge in a pleasant way (Fig. 1 shows selected posts of this blog). During the teaching semester, 27 texts were posted presenting themes of relevance such as biodynamic of psychotropic drugs, functioning of neuronal receptors, and pathophysiology of some diseases with the use of different visual resources that can be seen throughout the blog (http://www.neuromed91.blogspot.com.br/). A post regarding Parkinson’s disease contains not only a text defining its symptoms and pathophysiology, but also a video of an interview with the actor Michael J. Fox. Moreover, the treatment of myasthenia gravis, an autoimmune disease that affects muscle function by impairing appropriated neurotransmitter action, was addressed with the use of a video that demonstrates its symptoms in a dog. The theme “drug abuse” was extensively dealt with throughout the blog. The pathophysiology, biochemistry, and medical aspects regarding the use of cocaine, amphetamines, marijuana, LSD, and cigarettes were emphasized. Even a campaign against cigarette smoking was added in the blog. All the posts were accompanied by the references used, including scientific articles, online magazines, and public organizations. Furthermore, plagiarism, a chronic problem in academia [10], especially among undergrads [11], was absent in this blog. Three of the five authors of this blog were interviewed 2 years after its elaboration. These students emphasized that their blogging activity helped them to expand their interest for biochemistry, being also useful for the activities they had in the university in the following semesters, such as the study of neuroanatomy and neurophysiology. One of them emphasized that the group was concerned in using a more accessible language in the posts, so that the blog could be useful for readers outside the BioBio course, as well as a science education tool.

Student Perception of the Blog-Making Activity We analyzed 428 student-questionnaires from 2008-1 to 2010-2. Only scores 1-to-6 were computed (Figs. 2 and 3); “NA-answers” were excluded (Table III). Question 1 indicated that the blogging experience was relevant for the students professional formation (81% scored 4-to-6). Question 2 indicated that 95% of students had active participation in blog making due to 4-to-6 scores (60.8% scored 6). Moreover, the blogging experience increased students’ interest for biochemistry according to Question 3: 80.2% answered 4-to-6. This is also attested in Question 4 (about boosting scientific paper reading) since 77.6% scored 4-to6. The majority of students believed that the blog preparation was a valuable learning tool: 63.9% marked 5 or 6 in Question 5. Moreover, Question 6 reveals that 73.1% of students thought the blogs’ contents were, in general, very good, scoring 5 or 6. Furthermore, 85.6% of students considered their group’s blog as well done, scoring 5 or 6 in Question 7. Students, however, tend to overrate self-

Cubas Rolim et al.

FIG 1

Example of a successful blog regarding neurotransmitters and prepared by the Bio-Bio students. The panels A-F are print screens of some of the blog’s posts. (A) Weblog’s home page containing: the title “Biochemistry of neurotransmitters”, a figure of a representative neuron with dendrites and synapses, and a brief explanation about the authors and the blog’s content. (B) Depicts a post about Lysergic Acid Diethylamide - LSD and its “father”, Albert Hoffman. (C) The concept of “Drug of Initiation” is explored in this post. It has as supporting data a result from a Brazilian study conducted in 2001 that showed the average age of initiation for alcohol, tobacco and cocaine, among other drugs. (D) This post is a video about the famous actor Michael J. Fox, diagnosed with Parkinson’s disease. It allows comparison between the actor’s appearance in 1991 and then in 2010, when the signs of the disease were evident. This video illustrates the dramas of Parkinson’s disease. (E) Humor and scientific knowledge come together in this post about the mechanism of neuronal excitation by caffeine. Caffeine inhibits the phosphodiesterase enzyme, and causes longer maintenance of excitatory signals promoted by adrenaline. Therefore the image of a small mammal with eyes wide open which correlates with the social stereotype of excitement. (F) Picture of the Weblog’s authors in the first half of 2010. [Color figure can be viewed at wileyonlinelibrary.com]

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Biochemistry and Molecular Biology Education question (p  0.106) (Fig. 4 and S1-Fig.). This was repeated in 2011-1 and the anonymity effect was significant only for Questions 1 and 5, with higher scores for the anonymous group (p 5 0.001 and 0.004, respectively).

Students’ Comments Regarding BioBio Blogs Students made 41 free-comments about the blogs: 46% positive, 32% negative, and 22% “neutral”. A positive comment was: “it really stimulated me to study the subject more. After the cancer-blog experience, I still look for interesting texts about cancer and consider the possibility of working on oncology.” A negative comment was: “the vast amount of information presented throughout the blogs made it difficult to focus on what was essential. A little more objectivity could help.” That was a real problem because 369 posts were published, in average, per semester.

FIG 2

Students’ perception of the blog making activity. Evaluation of questions 1-4 as percentages of responses to scales (1-6) of the Likert-like questionnaire. Left panels: average percentages of responses obtained during the six semesters (2008-1 to 2010-2). Right panels: percentages of responses obtained during each semester.

evaluations because of the emotional bounds to a project made by themselves [12]. Analyzing Questions 1–7 altogether (2,819 scores) indicated an overall approval of the blog system: 68.8% scored 5 or 6. The average score was 4.8 and the modal value was 6. Finally, results from Question 8 demonstrate the usefulness of prior blogs for the preparation of their own: 79.4% responded 4-to-6.

The Anonymity Issue Up to 2010-1, the perception-questionnaires were attached to the CAB exams. That could create a fear that “bad opinions” could cause retaliation, thus possibly making students overrate their perception-scores about the blogs. To test this hypothesis, questionnaires were distributed in 2010-2 (i) attached to the exam or (ii) in an anonymous way, and Questions 1 to 7 were checked. Except for Question 7, where the anonymous group scored higher (p 5 0.036), no differences between groups happened when analyzing each

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FIG 3

Students’ perception of the blog making activity. Evaluation of questions 5-8 as percentages of responses to scales (1-6) of the Likert-like questionnaire. Left panels: average percentages of responses obtained during the six semesters (2008-1 to 2010-2 for questions 5-7 and 2008-2 to 2010-1 for question 8). Right panels: percentages of responses obtained during each semester.

Blog Construction as an Effective Tool in Biochemistry Active Learning

Abstention rate and average score for each question during the period 2008–2010

TABLE III

Question

Abstention (%)

Average Score

n

1

6.5

4.4 6 0.2

400

2

7

5.3 6 0.1

398

3

5.6

4.7 6 0.5

404

4

6.3

4.4 6 0.2

401

5

3

4.7 6 0.2

415

6

3.7

4.9 6 0.1

412

7

9.1

5.2 6 0.1

389

8a

11.8

4.5 6 0.5

253

a

2008-2 to 2010-1.

Grades and Students’ Performances Each blog had its own “overall grade,” and the mean is shown on Table II. However, each student received an individual grade reflecting his/her contribution to the blogging activity. Figure 5A shows the means of the individual blog grades and CAB exams. The mean of individual grades for blogging ranged 7.5-to-9.0 in 2008-2010. When computing all students the value was 8.35 6 1.57 (n 5 393) for 2008– 2010 and 8.57 6 1.54 (n 5 400) for 2011–2013. In the case of the CAB exams, the mean grade was 6.39 6 1.38 in 2008– 2013 (n 5 793). In 2007, before the implementation of the blog system, CAB exams averaged 5.54 6 1.35 (n 5 134), a value significantly smaller than those from 2008–2010 (6.41 6 1.25, n 5 393). Figures 5B and 5C show the frequency of individual grades for blogs and CAB exams in 2008–2010. The most frequent grades for blogging were in the range 8.0–8.9 (31% of students); 76% of students scored 8.0–10. Similar grade frequency for blogs happened in 2011–2013 (not shown). In the case of CAB exams, grades that were equal or above 7.0 increased from 11%, in 2007 (before BioBio blogs), to 33% in 2008–2010 (Fig. 5C).

General Discussion This study describes one of the many educational experiences implemented since 1999 in BioBio classes [7–9] at the University of Brasılia. From 2008-1 to 2013-2—12 teaching-semesters—174 blogs were produced, and we analyzed the students’ perceptions about 91 blogs (52% of the total). The majority of these blogs can still be accessed, offering an enormous amount of information of biomedical relevance. This reinforces the idea stated by other authors that academic blogs are true database of freely accessible

Cubas Rolim et al.

FIG 4

Perception of the blog-making activity by anonymous and non-anonymous responders in two different semesters. Upper panel: Evaluation of questions 1, 3, 5 and 7 as percentages of responses to scales (1-6) of the Likert-like questionnaire in 2010-2. Lower panel: Evaluation of questions 1, 5 and 7 as percentages of responses to scales (1-6) of the Likert-like questionnaire in 2011-1. Data for other questions are available in supplemental material.

information [13]. A total of 26 topics were covered in the BioBio blogs in the period 2008–2010. Four other topics were introduced in 2011–2013 (Table II). In addition to this high amount of topics, the interdisciplinarity between topics (e.g., between diabetes and obesity) allowed connections between blogs, which is a mechanism that reinforces their educational purposes [6]. Besides that, the possibility of learning from student-prepared material should strengthen peer relationship, allowing students to assume an active role in the learning-teaching process [5, 6]. The evaluation of the blogs by the instructor, with the help of peer-tutors, included not only the scientific content per se, but also the manner by which it was presented, as well as the use of videos, hyperlinks, biomedical curiosities and even funny cartoons. Humor, according to some authors, can enhance the learning process [14, 15]. In

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Biochemistry and Molecular Biology Education

FIG 5

Average individual grades for the CAB exam and blogs. Upper panel: blog and CAB exam grades from 2007-1 to 2010-2. Note that the blogging activity started in the 2008-1 teaching-semester. Middle panel: relative distribution of individual grades for the blog-making activity from 2008-1 to 2010-2. Lower panel: relative distribution of CAB exam grades before (2007) and after (2008-2010) the blog activity started. The asterisk indicates that the average CAB exam grades of the whole 2007 year (both 2007-1 and 2007-2 teachingsemesters) is significantly different (P < 0.0001) from those of the whole 2008-2010 period (six semesters combined).

addition, the technical quality of the majority of the blogs, based on their grades, was considered excellent (Table II and Fig. 5). The meaningful number of participants in this study also draws attention: 428 students, throughout 6 teachingsemesters (2008–2010). Moreover, 400 students participated in blogging activity in the following 2011–2013 period. Over 150 student peer-tutors [7, 9] were involved in this

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activity in the total 6-year period. Previous reports of blogs as learning instruments did not deal with such a large amount of students [4, 13, 16]. The main finding of this study was the overall acceptance, in the 2008–2010 period, of the blogs by students. When the whole set of questionnaires was analyzed, the vast majority scored 4-to-6, and a great part scored 5 or 6 (86% and 70%, respectively). The average score for the eight questions was 4.6, indicating overall approval of the blog system. Furthermore, if we separately consider four “main questions” (Questions 1, 3, 4, and 5) regarding students’ perceptions about the experience of blog preparation and whether BioBio blogs boosted their interest for biochemistry and the search of extra-class materials for study, the responses were very positive. For these questions the modal score was 5 (32.4% of answers). Moreover, a preliminary analysis of the blog system in the two teachingsemesters of 2011 (n 5 145 students) revealed essentially the same scores for Questions 1–7 in comparison with the overall responses in the 2008–2010 period (data not shown). The implementation of a new learning tool requires the evaluation of its impact on education and its acceptance among students. To achieve these goals, an adequate tool for evaluation must be used. The development of a quantitative score systems that is adequate for evaluating the teaching-learning process is a challenge not only for basic sciences, but also for activities in hospital environments [17]. The 6-point Likert-like scale used herein has been previously employed by our group [7, 9, 18]. This seemed adequate to define two basic groups of respondents—those who approved the experience and those who did not. In addition, the use of Likert scales, which is a quick answering tool, may have contributed for the low abstention rates observed (3.0%–11.8%; Table III). A main concern that came up during the study was whether the high scores on the questionnaires truly reflected students’ opinions or if they were influenced by the fact that the questionnaires had their names. However, our results showed no major differences between anonymous and non-anonymous groups in two teaching-semesters (2010-2 and 2011-1). Finally, preliminary results from Likertquestionnaires applied to second-year medical students that had prepared BioBio blogs in the previous year indicate that these students still considered the activity to be important for learning purposes after 1 year [19, 20].

Limitations of the Study and the BioBio Blog System There are limitations in objective scales that try to evaluate subjective parameters. The mere acceptation of the use of blogs according to the results obtained herein is not sufficient to conclude that learning improved. Moreover, it is not an easy task to quantitatively evaluate learning improvement when a new educational tool is employed [21]. A

Blog Construction as an Effective Tool in Biochemistry Active Learning

possible solution would be randomly separate the class into two groups: one who would produce blogs and another who would not. The comparison of grades on final exams could be used as an objective parameter to help determine the blogs’ overall impact on learning (and therefore grades). On the other hand, because we considered that the BioBio blog system was relevant for educational purposes, we decided it was unfair to deprive—on purpose—any student from this experience. In our view, the best way to evaluate whether learning is happening is to make exams on the blogs, covering all the content. This would solve the possible problem that many students might focus mostly on their own topic. In fact, these evaluations were performed in our BioBio experience, by means of a True-of-False CAB exam, as described previously [7, 9]. As an example for such a problem, students preparing a blog on obesity tend to read much more about their specific topic and related issues, like diabetes and cholesterol. However these students would fail, for example, to study appropriately free radicals or aging. We recognize that the difficulty level of the CAB exam (composed of 40–50 questions) was high due to the great amount of topics it covered. The fact that the average grade in the CAB exams increased almost one point (from 5.5 to 6.4; Fig. 5A), and that the frequency of grades above or equal 7.0 increased from 11% to 33% (Fig. 5C), after the introduction of the blog-activity indicate that this activity boosted student learning. Until 2012, all BioBio students had to be involved in the blog making activity. However, in the teaching-semesters of 2013 (2013-1 and 2013-2) we allowed some students to be absent in the blog system if they wished. These students did not lose the points from blogging activity, instead of it, the percentage of other activities/exams were redistributed to determine the final grade. We observed that these students (n 5 29) presented lower grades in the CAB exam when compared to those that participated in blogging activity (n 5 134): 6.20 6 1.32 versus 6.89 6 1.52 (p 5 0.024). In addition, frequency of grades above or equal 7.0 were 50% in active bloggers in comparison with 28% for those that were not (L.T. Dalvi and D.C. Moreira, unpublished). On the other hand, the two groups of students had similar performance in the final exam of metabolic biochemistry (6.30 6 1.58 versus 6.86 6 1.91, p 5 0.149; this final exam [7] did not cover CAB topics), indicating that those that did not do blogging activity were not “weaker students.” When summing these observations, together with the raise in the CAB exam grades after 2007 (Fig. 5), it strongly suggest that the blogging activity was of relevance for the actual learning of clinical biochemistry. Another important limitation of the blog system was the lack of quality-control, by the instructor or peer tutors, of the information prior to the online publication. In our case, the only way to verify this was through evaluation and grading at the end of the teaching semester (all blogs were fully evaluated—but not corrected—at the end of the

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semester). In accordance to what was described regarding the evaluation of blogs’ usefulness, possible incorrect or polemic information, once posted, remained available, and this indeed occurred in BioBio blogs. This could be corrected by a good relationship between students and their peertutors, with content-analysis previous to posting. Nevertheless, this would create another problem, which is grading an already corrected text (by the peer-tutors), even though the scientific content is not the only parameter analyzed. We have already tried this strategy in a couple of teachingsemesters, but did not work out due to the immense amount of information posted (it only worked out for few blogs). Considering that there were about 60–70 BioBio students per teaching-semester and that they produced an average of 15 blogs and 369 posts per semester during the 2008–2010 period (an average of 14 blogs were produced per semester in 2011–2013), a possible solution would be to apply the blog system for smaller classes. This would allow previous verification of the content to be posted, for example, previous authorization from the instructor and/or peer-tutors. Our data, however, indicates that this point does not prevent the method from being applied with relatively success in larger classes.

Additional Remarks The blogs were elaborated by first semester “freshmen” students, who started their medical/nutritional education right after high school—therefore, these students are at an earlier stage of their medical education than those in North American colleges. Thus, it is essential the search for a versatile, up-to-date, inexpensive and simple-to-use tool when dealing with students that are not yet familiarized with the scientificacademic university environment. In this sense, blogs can be very well applied for learning purposes not only for undergraduate students, but also for high school and even graduate students. The preparation of a blog, such as these described herein (as an early assignment in college), might enhance the responsibility of undergraduate students for their own learning since the very beginning of their academic experience. This supposedly creates, early in the course, awareness of the importance of questioning and searching the literature, of critically appraising the scientific quality of the materials retrieved and, thus, allowing students to enhance their learning possibilities and their professional development [16]. During the preparation of BioBio blogs, students were advised by peer-tutors to include posts reviewing one or two recent scientific papers (related to their topic), so to achieve higher grades in their work. This happened in many BioBio blogs. It is worth pointing out that the blogs elaborated by BioBio students are different from those of professional researchers that post specific issues about their science agenda, with greater focus in published research (the site http://www.scienceblogs.com hosts many blogs from

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Biochemistry and Molecular Biology Education professional scientists and graduate science students dealing with several science issues), or professional blogs run by journals such as Science. Moreover, BioBio blogs are different from those written by medical and nutritional professionals [22]. In 2014, Prof. Hermes-Lima’s teaching load was moved from BioBio (for medical and nutrition students) to another biochemistry discipline dedicated to undergrads from several courses, mostly biology, pharmacy and agronomy. A new “blog experience” started in 2014-1 using a somehow different set of blogs to fit the courses’ requirements. Blogs on vertebrate hibernation and biochemistry of fruits and cereals were introduced, while some topics were dropped, such as hypertension and Alzheimer’s disease. An example of an excellent blog from this new phase is http://obesidadebioquimica.blogspot. com.br. Thus, 2013-2 was—unfortunately—the last semester of BioBio blogs, leaving a legacy of 174 studentproduced blogs (166 are still active).

Conclusions In summary, this experience demonstrates, with an expressive number of semesters and students, that blogs were successfully used as a learning tool. It is part of our philosophy to develop and search for educational tools that can be potentially used by several different areas of academia, from physics to human sciences and medicine. Blogs are tools that can be easily used for learning purposes, and their use within smaller classes might represent a solution for some of the problems discussed in this article. Student blogs are easily accessible, non-expensive, and simple-touse, enabling students, peer-tutors, and faculty to experience a different teaching-learning activity with important characteristics of constructive learning. It also creates an internet-based “warehouse” containing potentially goodquality scientific information, not only for clinical biochemistry, but also for several fields of scientific knowledge. Moreover, even though we have not included a full analysis of the blog making activity for the 2011–2013 period (the topics covered by these blogs are in Table II), it occurred with the same intensity and the blogs had the same quality as those produced in the previous period.

Acknowledgments We thank all 428 medical and nutritional undergraduate students from Universidade de Brasilia (UnB) who have contributed to this research. Special thanks to Leonardo Soares, who started the project, prepared the 8-item questionnaire and performed the first data collection in 2008, ~ o Carvalho for helping analyzing Dandara Sampaio de Lea the student comments and Gabriel Carvalho for general discussions. They are former UnB medical students, currently in the medical practice. Authors’ Contributions: MHL

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was responsible for the conception and design of the study. MHL, ECR, LTD, DCM, JMO, NGC and FFL collected the data. DAP and DCM performed the statistical analyses. ECR, DAP, LTD and EGC drafted and reviewed the accompanying charts and multimedia data. All authors contributed to writing, reading, and approval of the final manuscript.

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