Clinical Linguistics & Phonetics, 2013; Early Online: 1–14 ß 2013 Informa UK Ltd. ISSN: 0269-9206 print / 1464-5076 online DOI: 10.3109/02699206.2013.807879
MANWA L. NG1, SUSAN BRIDGES2, SAM PO LAW1, & TARA WHITEHILL1 1
Division of Speech and Hearing Sciences, Faculty of Education and 2Department of Dental Education and E-Learning, Faculty of Dentistry, University of Hong Kong, Hong Kong (Received 20 May 2013; accepted 20 May 2013)
Abstract Problem-based learning (PBL) has been shown to be effective for promoting student competencies in selfdirected and collaborative learning, critical thinking, self-reflection and tackling novel situations. However, the need for face-to-face interactions at the same place and time severely limits the potential of traditional PBL. The requirements of space and for meeting at a specific location at the same time create timetabling difficulties. Such limitations need to be tackled before all potentials of PBL learning can be realized. The present study aimed at designing and implementing an online PBL environment for undergraduate speech/ language pathology students, and assessing the associated pedagogical effectiveness. A group of eight PBL students were randomly selected to participate in the study. They underwent 4 weeks of online PBL using Adobe Connect. Upon completion of the experiment, they were assessed via a self-reported questionnaire and quantitative comparison with traditional PBL students based on the same written assignment. The questionnaire revealed that all participating students enjoyed online PBL, without any perceived negative effects on learning. Online PBL unanimously saved the students travel time to and from school. Statistical analysis indicated no significant difference in assignment grades between the online and traditional PBL groups, indicating that online PBL learning appears to be similarly effective as traditional face-to-face PBL learning.
Keywords: Online problem based learning, programme design, programme evaluation
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Designing, implementing and evaluating an online problem-based learning (PBL) environment – A pilot study
Introduction Traditional didactic teaching that usually takes place in a classroom can be characterized by the following features: (1) it involves a unidirectional transfer of knowledge (from the instructor to the students) with limited exchanges between the instructor and students, and (2) the knowledge is usually factual and is presented separately from real-life scenarios (Woods, 1994). With this approach, students often lack the opportunities for acquiring interpersonal communication skills, problem solving skills and practical skills to prepare them to tackle real-life scenarios after graduation.
Correspondence: Manwa L. Ng, 5/F Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong. Tel: +852 28590582. Fax: +852 25590060. E-mail:
[email protected]
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Seeing these shortcomings with traditional didactic teaching, problem-based learning (PBL) emerged as a new approach to learning. PBL was first adopted at McMaster University in the late 1960s (Neufeld & Barrows, 1974), and later introduced in institutions in the North America and Europe in the following decades as both a curriculum design and a pedagogical method for educating clinical practitioners (Albanese & Mitchell, 1993). PBL is a mode of learning that is student-centered and specifically targets understanding and solving clinical or real-life cases that are often not straightforward (Barrows, 2000; Hmelo-Silver, 2004). It aims at facilitating students to be independent learners (Mok, Whitehill, & Dodd, 2008). With its emphasis on self-directed learning, critical thinking and collaborative learning, PBL creates a learning environment in which students define the problems, create hypotheses, gather and analyze data, and generate, evaluate or justify solutions (Barrow, 1988). Given these characteristics, PBL is distinctly suitable for educating clinical practitioners both in terms of clinical reasoning and simulated process (Shuler, 2012). In any PBL curriculum, small group discussion is an essential component. Small group work naturally promotes awareness and understanding of individual differences, oral communication skills and team work (Mok et al., 2008). According to Hmelo-Silver and Eberbach (2012), PBL should help students develop: (1) flexible, non-factual knowledge for real-life scenarios, (2) problem-solving skills, (3) self-directed learning skills, (4) collaboration skills and (5) intrinsic motivation to learn on their own.
PBL at University of Hong Kong (HKU) The Division of Speech and Hearing Sciences of the University of Hong Kong (HKU) has adopted a full PBL curriculum since 1997. Instead of attending large-class lectures, students are organized into small groups to work on a series of problem cases focusing on various communication disorders under the guidance of facilitators. Group discussions involve students’ identifying issues and concepts in each problem for further investigation, formulating learning issues that are subsequently addressed after having done relevant readings, and finally generating hypotheses about the nature of the underlying deficits. Facilitators guide students through the learning process by encouraging them to think more deeply, and by modeling the kinds of questions they need to ask themselves. The PBL program has been implemented with great success and positive outcomes of PBL have been apparent, as indicated by the annual outcome assessment exercises by the external clinical supervisors/examiners and learning experience surveys by students, as well as faculty research (Mok et al., 2008).
The problem – time and venue constraints While enjoying PBL as a successful learning experience and curriculum design, we are faced with difficulties/restrictions associated with its implementation. The key PBL feature of small groups typically engaging in face-to-face interactions imposes strict demands on space, especially when group discussions are carried out simultaneously. This in turn results in difficulties on timetabling. Additionally, for speech/language pathology programs with a strong community-based learning experiences, the need for all groups in the same year to physically meet at specific places occasionally creates the inconvenience of some members, especially on days when they have clinical placement in the community. As clinical practicum is a crucial and inseparable part of experiential learning, students of Speech and Hearing Sciences at HKU are all required to participate in clinical placements for an extended period of time in various off-campus hospitals and clinics since their second year. During this external clinical period, they are scattered in various hospitals and clinics outside campus, which makes it difficult for them to have PBL tutorials on campus.
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A possible solution – e-learning E-learning has become a common form of teaching adopted in many degree courses and continuing education programs in recent years (Moore, 2007; Thompson & Savenye, 2007). E-learning, and specifically for this project, synchronous learning, that makes use of IT facilities, e.g. virtual classrooms, whiteboards, net meetings, and therefore has the advantage of maintaining spontaneous interaction between teachers and students, and among students without constraints in space. An E-learning environment has been shown to yield improved students’ learning outcomes, thanks to the increased accessibility of teaching and discussion materials, and convenience and flexibility of learning (Means, Toyama, Murphy, Bakia, & Jones, 2009). This is often associated with flexibility of ‘‘universities without walls’’ for both students and universities. Students can enjoy the flexibility in accessing content and instructions at any time from any place. E-learning can increase the availability of learning experiences for students, and instructors are able to assemble and disseminate instructional content more cost-efficiently and to handle more students with comparable outcome quality (Means et al., 2009). Results of a meta-analysis of previous e-learning studies carried out by the U. S. Department of Education indicated that students who took all or part of their class online perform better, on average, than those taking the same course through traditional face-to-face instruction (Means et al., 2009). This is especially true when learners in the online condition spend more time on various courserelated tasks. More importantly, the better learning outcomes associated with e-learning appear to work for different types of learners and for different contents. Based on these findings, we hypothesized that PBL carried out in an e-learning environment should yield equally encouraging results. Despite the favorable evidence for e-learning, the current PBL curriculum of the Division of Speech and Hearing Sciences at HKU had thus far failed to take advantage of such technological advances. This limits the ability of our program to deliver its pedagogical benefits to geographically dispersed students. Indeed, there have only been a few attempts to incorporate e-learning into PBL curricula worldwide. However, the number of programs currently making partial use of IT technologies in PBL, such as simulation or information representation is on the rise (Bridges, Botelho, Green, & Chau, 2012; Bridges, Botelho, & Tsang, 2010; Docherty, Hoy, Topp, & Trinder, 2005; Giani & Martone, 1998; Jeong & Hmelo, 2010; Taradi, Taradi, Radic, & Pokrajac, 2005; Uden & Beaumont, 2005; Walker et al., 2011). In the past, the major concern of course designers was that various e-learning technologies could not facilitate the level of interaction necessary for PBL, particularly asynchronous distance-education models (Mattheos, Schittek, Attstrom, & Lyon, 2001). However, recent advances in IT hardware and software technologies can now provide course designers with the synchronous interactive tools they need to effectively accommodate PBL and other collaborative learning methods (Glykas & Chytas, 2004). Powerful online communication tools now support learning environments that afford increasingly reliable and stable one-to-one, one-to-many, and many-to-many text, audio and audio–visual interactions in real time. By including multimedia search engines and databases, hypertext and various synchronous collaborative activities, this framework constitutes a powerful suite of tools for using online PBL to leverage modern technologies in the curriculum. Although the e-learning environment can be applied to all learning practices including traditional one-to-many classroom didactic teaching, it appears to be particularly useful to PBL learning due to the following reasons:
The relatively small PBL class size does not impose a high demand on network speed; thus high quality synchronous online communication is feasible. Online PBL reduces the possible anxiety associated with face-to-face discussion in traditional PBL.
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In addition to facilitating synchronous communication, e-learning can provide learning environments in which clinical students can communicate asynchronously (archiving) and can access online learning materials anytime anywhere; this in turn promotes a community of learning and life-long learning (Gardner, Bridges, & Walmsley, 2012). For PBL, the potential lies in synchronous, distributed online tutorials to replace face-to-face learning models.
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Purpose of the study The present pilot study aimed at designing and implementing an online learning environment for the PBL curriculum of the Division of Speech and Hearing Sciences at HKU. It was expected results from the present small-scale pilot study could shed light on the evaluation of effectiveness of this new mode of learning, specifically: (1) the utility of online delivery, and (2) it’s impact on the outcomes and experiences of long-distance learning. Based on the above discussion, it was hypothesized that an online PBL environment should be as effective as traditional PBL environment.
The pilot study Method
Participants Two groups of third year undergraduate students of the Division of Speech and Hearing Sciences at the University of Hong Kong were selected to participate in the pilot study: (1) online PBL group and (2) traditional PBL group. Traditionally, all third year students are divided into five PBL groups, each of which consists of eight students. Each PBL group is assigned a group number and a PBL facilitator. The PBL facilitators are trained and experienced in facilitating PBL tutorials. During each block of PBL, all students meet 2 days a week, for 3 h each day during (usually on Monday and Thursday). On the Monday session, a new problem case is provided to the students. After studying the problem case for a while, the students collectively construct a list of learning issues related to the problem case. On Thursday’s session, they meet and carry out the relevant discussion. The discussion is continued and completed during the first half of Monday session under the guidance of PBL facilitators. A new problem case is commenced in the second half of the Monday session. In the present pilot study, clustered sampling was used. A group number was randomly generated and all the eight students to which they belonged were assigned to the online PBL group (as the treatment group), while the remaining four PBL groups remained using traditional PBL and served as controls. All students provided informed consent prior to the study.
Instrumentation Adobe Connect (2012) was used as the online PBL platform for the present project. The system has been proven to be reliable and promising in delivering and facilitating multi-node, real time audio and/or visual communication, with other auxiliary functionalities such as document sharing and online chat (e.g. Schullo, Hilbelink, Venable, & Barron, 2007). The system was also capable of archiving meeting sessions in.flv format for later asynchronous retrieval. The web-based interface allowed the students to carry out PBL discussion from their homes via broadband Internet connection, regardless of the operating systems they were using. It should be noted that broadband Internet connection at home is very common in Hong Kong. According to Hong Kong Government statistics (Telecommunications, 2012), Hong Kong’s fixed broadband penetration
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Figure 1. A screenshot from the Adobe Connect system during an active online PBL session. Panel A lists all the members currently logged in the system. Panel B shows the videos of all the participants. Panel C is the panel for file sharing. Panel D lists the learning issues to be discussed. Panel E is the supplementary chat room for online dialog between members.
rate is among the highest in the world. As many as, 87% of the households in Hong Kong are currently using fixed broadband services. This may be an important factor of advocating online learning. In the present study, a total of nine individuals (eight students and one facilitator), each located in different locations in Hong Kong, took part in simultaneous PBL discussion sessions using the Adobe Connect platform. An example screenshot of Adobe Connect is shown in Figure 1. In the figure, Panel A is the Attendee List window and it shows the names of individuals who have connected to the discussion group. Panel B is the Camera and Video window showing the live videos of each one of them. Panel C is the File Share window. It details the file transfer among connected members. Panel D is the Note window. It is a notepad shared by all connected members for directed discussion. It allows all members to update the notes synchronously. However, during the PBL session, usually only the recorder types the notes and all other members are able to see the changes. Panel E is the Chat window. It allows individual member to type information such as related website links and references.
Procedure The experiment began at the onset of the first block of the third year PBL curriculum in September 2011. There are a total of eight problem cases for the first block of the third year PBL curriculum, and they last for 8 weeks. The project lasted from problem cases #1 to #5, but the actual experiment only focused on problem cases #2 to #5. Problem case #1 was provided to the students as practice in order to familiarize them with the new mode of PBL, and to make sure the experimental setup was problem-free. Detailed instructions and demonstrations regarding how to install and how to use the system were provided prior to the start of problem case #1. Although video triggers have been found to have advantages in PBL learning (Chan, Lu, Ip, & Yip, 2012; Chan et al., 2010), a paper trigger was adopted as the method for presenting clinical cases to the students in the present study in order to maintain consistency across groups (Davis & Harden, 1999). In other words, all problem cases and related information were printed on paper
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and distributed to the students prior to the experiment. Problem cases #2–#5 were related to the areas of organic and psychogenic voice disorders, stuttering and cochlear implants.
Assessment and analyses The outcomes of synchronous online PBL tutorials were assessed via two instruments:
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(1) a self-reported questionnaire reflecting students’ experience toward online PBL, and (2) a quantitative analysis of online PBL students’ academic performance. While the first instrument provided qualitative, self-reported feedback of online PBL experience from the participating students, the second instrument provided quantitative data regarding students’ academic performance. Students in the PBL curriculum at HKU are assessed via a range of assessments, including closed-book examination, written assignments, tests, as well as evaluation of their performance in PBL tutorials. To assess students’ academic performance, the scores of written assignment one (out of 100 points) were used. This particular written assignment was selected as its content was covered during the experimental period, and it served as a valid tool to faithfully reflect the knowledge gained by the students during this period of time. Written assignment scores of the students in the online PBL group were compared with those in the traditional PBL group. Due to the small sample size, only descriptive statistical analysis was carried out. Results Self-reported questionnaire The self-reported questionnaire designed for this study is shown in the Appendix. It was administered to the participating students by an independent investigator on a one-to-one basis. Because of the way the questionnaire was administered, the response rate was 100%. Descriptive statistics are presented in Figure 2(a) and (b). Responses from the questionnaire indicated that all students were satisfied or very satisfied with both Adobe Connect system and the online PBL tutorials (Figure 2a and b). All students agreed or strongly agreed that Adobe Connect worked well, was easy to set up, and highly compatible with the network condition at home (Figure 2a). They all believed that Adobe Connect met their requirements for online learning. Regarding online PBL tutorials, all students were satisfied with the online PBL classes (Figure 2b). Of eight students, six believed online PBL improved their learning because it saved their study time, five considered online PBL increased their interest in PBL tutorials, and four felt that they have learned more via online PBL. Seven out of eight students agreed that the system met their expectation toward online PBL. However, it should be noted that only two students admitted that online PBL provided a more relaxed learning atmosphere for them to learn and three believed the archiving feature of the system contributed to their learning (Figure 2b). Regardless, all students unanimously preferred synchronous online PBL to traditional PBL. Quantitative analysis To evaluate the learning outcome of online PBL, grades of the written assignment obtained from the eight online PBL students were statistically compared with the rest of the class, who were enrolled in traditional PBL. The results showed that the online PBL group exhibited an average
An online PBL environment (a)
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Figures 2. Questionnaire responses obtained from the eight participating students from the online PBL group. Figure 2(a) refers to questions related to students’ perception of the Adobe Connect system. Figure 2(b) contains questions related to students’ perception of online PBL tutorials.
percentage mark and standard deviation values of 69.88% (SD ¼ 7.680); whereas the traditional PBL group achieved 71.00% (SD ¼ 7.562). The 95% confidence interval was 69.875 5.593.
Discussion The technology Adobe Connect was selected as the online PBL platform because: (1) it was already located on campus and equipped with a high-speed Internet connection, (2) the system supported high-speed multi-node, synchronous audio and/or visual communication with reliable quality of service and (3) it possessed archiving functionality which allowed the asynchronous access of files by students. Despite the different operating systems (Linux, Windows 7 and Mac OSX) being used, the students found the cross-platform video communication problem-free, thanks to the userfriendly, web-based interface. Regardless of operating system, students just opened any web browser to connect to Adobe Connect. At the beginning (during the first problem case), some students experienced an echo problem with the sound, but it was immediately resolved as soon as the students started using headset microphones, instead of built-in microphones. All PBL sessions went smoothly, with no significant delay in audio or serious jerkiness in video transmission. All students found the quality of transmission well within tolerable limits. As shown in Figure 2(a), all students believed that the Adobe Connect platform was smooth, easy to install and worked well with their home Internet connection. In fact, the students unanimously agreed that the system met the requirements for an online tutorial arrangement.
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The facilitator Facilitation of PBL discussion under the online environment was essentially the same as the traditional PBL environment. According to the facilitator who was experienced with traditional PBL, the flow of discussion seemed to run more smoothly, and the amount of intervention required by the tutor was reduced, compared to traditional PBL. This might be related to the fact that the students did not need to speak face-to-face. Without conventional classroom atmosphere, they became more willing to speak and to contribute to the discussion under the online PBL environment (see Figure 2a). According to the facilitator, his role was not at all different from under traditional PBL. The students Results from the self-reported questionnaire revealed that all students enjoyed using online PBL for their learning. According to their feedback, most students believed online PBL was more time efficient without compromising pedagogical quality. In particular, the online environment helped them save travel time to and from school (1.5 h on average each way). In addition, although most of them were at home during the PBL discussion, the students did not think they learned or contributed less with online PBL. Perhaps without the anxiety and reluctance of speaking up physically in front of the others, the students felt greater freedom to talk and express their ideas in front of their peers via computers. The freedom associated with online PBL (without the need to be at school during the designated time) actually allowed them more time to prepare for PBL tutorials. This is consistent with the retrospective study reported by the U.S. Department of Education (Means et al., 2009). Although not specifically mentioned in the questionnaire results, the use of Adobe Connect allowed the students to retrieve archived materials. Students were able to review their performance from previous sessions, and improve their performance in the coming sessions. Unfortunately, no usage information of the archived materials retrieval by the students is available in the pilot study. Such information can provide more quantitative data regarding how useful this functionality is to the students. The outcomes Comparison of assignment scores between the two groups of students revealed that, academically, online and traditional PBL students did not perform differently from each other. This indicates that the pedagogical effectiveness of online PBL in the third year of the curriculum is similar to that of traditional PBL. This echoes what the students reported in their questionnaire: they did not perceive that they learnt less under the online PBL environment (see Figure 2b). In addition, all students agreed that online PBL helped them saved their study time and they unanimously would choose online PBL as the format of their next PBL tutorial. To sum, with the exception of making use of archived materials, the students generally had favorable comments about online PBL tutorials. Based on the above discussion and results depicted in Figure 3, it may be tentatively concluded that the pedagogical effectiveness associated with online PBL is not different from traditional PBL for students in their later years with the curriculum who are well inducted into the PBL process. With synchronous online PBL, students enjoyed PBL more while saving a significant amount of travel time. As such, online PBL seems to be the way to go in the future when the stringent requirements of time and place of PBL cannot be fulfilled, or when weather or other conditions do not allow regular schooling such as severe rainfall warning or typhoon.
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Figure 3. Mean marks of written assignment obtained from students of the traditional PBL groups and the online PBL group.
Problems with the system The use of Adobe Connect in designing and implementing the online PBL was considered a success. However, there was one limitation observed associated with the system. The problem reported by the PBL facilitator was the system’s lack of multilingual support. As the official medium of instruction for the curriculum is English, all PBL tutorials as well as traditional lectures are carried out in English. Yet, during the experiment, there were times when Chinese was needed, such as when describing some culturally-related issues or topics that were related specifically to Chinese language. The lack of multilingual support posed a difficulty to the notetaker who wanted to write down something in Chinese. In the present study, this limitation was overcome by using either IPA or other phonetic transcriptions to mimic the sounds of the Chinese characters. This was apparently an inconvenience to the students and the facilitator. In the future when online PBL is put in practice, the platform needs to have multilingual support in place before one can enjoy all of the advantages brought forth by the online PBL environment. Limitations of the study The first apparent limitation of the pilot study is its small sample size. Due to time and resource limitations, only one PBL group was selected to participate in the pilot study. This unavoidably has reduced the representativeness of the present findings. In addition, the present study examined the synchronous online PBL experience of third year undergraduate students who had prior experience with traditional PBL and known each other well. This might have biased the results of the study. Future studies perhaps can adopt a larger scale study adopting a within-subjects design where the students are exposed to traditional PBL first and followed by online PBL. This can help the students familiarize each other prior to using online PBL, and reduce the individual variations of participating students. Conclusion The present study described the design and implementation of a synchronous online PBL environment for the third year undergraduate students of the Division of Speech and Hearing
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Sciences of HKU. Adobe Connect was used as the online PBL platform. Results of the selfreported questionnaire obtained from the participating students indicated that online PBL was popular and appeared to be as effective as traditional PBL learning. The major benefit gained from adopting online PBL was saving travel time to and from the university campus where traditional PBL tutorials were held. Quantitatively, online PBL students performed similarly to traditional PBL students on an academic assignment, indicating that synchronous online PBL tutorials may be as effective as traditional PBL in their final year of PBL curriculum.
Acknowledgements This study was conducted with support by the Teaching Development Grants (TDG) for the 4-Year Undergraduate Curriculum Reform 2010 (Grant number: 10100387) of the University of Hong Kong.
Declaration of interest The authors report no conflict of interest. The authors alone are responsible for the content and writing of this article.
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Appendix
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