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Teaching with Technology
ana Kukolja TaradiDepartment of Physiology and Immunology, University of Zagreb Medical School, 10 000 Zagreb, Croatia
Address for reprint requests and other correspondence: S. Kukolja Taradi, Dept. of Physiology and Immunology, Univ. of Zagreb Medical School, 10 000 Zagreb, 
alata 3, Croatia (E-mail: skukolja{at}mef.hr)
Abstract
Discussion and writing are very powerful ways to support learning. This article describes the use of a free, asynchronous online forum to expand student-teacher discussions beyond the time/place constraints of the physical physiology classroom. The main participants were medical students enrolled in physiology class at the University of Zagreb Medical School and their teachers. The assessment data were collected by the electronic administration of the software, by anonymous paper questionnaires, and by the results of the final examination in physiology. During one academic year, 25% (n = 55) of 220 students enrolled in a traditional physiology course participated in online discussions. Physiology teachers and other faculty also joined the forum. All forum members (n = 99) posted 395 messages. Nine documents were published by six students who participated in two online collaborative projects. The difference in the mean grade of the final examination in physiology between student members and nonmembers was statistically significant (P = 0.0328, t = 2.1526). Students who participated in Web discussions were self-selected. Likely, they are the most motivated students, who would perform better on the final examination with or without this resource. Nevertheless, using an online forum could be very successful in teaching critical thinking in physiology because the Internet removes traditional time/place barriers. However, new barriers related to technology and behavioral changes are created. For most teachers and students, the main obstacles to information technology implementation are lack of motivation and lack of professional incentives. To overcome these barriers, institutional support is needed for both students and teachers.
Key words: Web-based learning; online teaching
HUMANS HAVE LEARNED EFFECTIVELY by collaborating with each other for thousands of years. Neither the Internet nor any other technology is going to change that, but it can be a vehicle to enhance it through asynchronous collaboration tools like discussion forums (4). The American Association for Higher Education states that one purpose of educational institutions is to make better connections among people who want to learn, people who want to teach, and the world of information and ideas. Ideas, questions, and individual discoveries are not restricted to the "three-hours-per-week" contact time of the standard classroom. However, students’ discussion opportunities and contact with their teachers are restricted to scheduled class meeting times and teachers’ office hours. Recent interactive implementations of the World Wide Web offer opportunities for sharing ideas, posing questions, and presenting individual discoveries at a time of convenience, and better, at the time of thought. Interactivity here develops outside official teaching hours and learning programs. It challenges students and makes them more independent. We want to help our students achieve meaningful learning. We want them to be able to find logical interrelationships among data, to respect different points of view, and to see from different points of view. We want them to be flexible and rethink their opinions when reason leads them to do so. We want them to develop critical thinking—an intellectual process of actively conceptualizing, applying, analyzing, synthesizing and evaluating information gathered from observation, experience, reflection, or communication. We want our students to talk about physiology and not just have them listen to us talking about physiology (8). Online discussions can be used as an excellent pedagogical tool for teaching and practicing critical thinking beyond time and place constraints of the physical classroom, thus providing a stimulating supplement to standard teaching practices.
MATERIALS AND METHODS
Software.
For setting up an online, asynchronous learner discussion forum named the "I
F-CLUB," we used Nicenet’s Internet Classroom Assistant (ICA; http://www.nicenet.org), a free, Web-based learning environment for classrooms, distance learning programs, and collaborative academic projects. ICA features include conferencing, scheduling, document sharing, personal messaging, and link sharing. All features are fully integrated. Five conference topics were made by the moderator: one for each of the courses offered by the Department of Physiology and Immunology (Physiology, Immunology, and Neuroscience) one about subjects of general interest ("Small Talk"), and one for posting news. Students were taking the courses in Physiology and Neuroscience at the same time, and the course in Immunology was scheduled separately. The idea was that, in the three course topics, instructors pose questions that provoke thinking, answer questions posed by students, and motivate students to answer to each other. The aim of the Small Talk was to create a friendly environment for learning, to give students and teachers the opportunity to get to know each other better, for fun, and for a sense of belonging to a community.
The program organizes messages into "threads," a collection of messages stemming from a single original posting. Threaded discussions are easier to follow, because it is clear which responses relate to which postings. Thought-provoking questions require that students go beyond facts and use knowledge in exercise of judgment. Conferencing is important for learning critical thinking. Document and link sharing enable academic Web-based collaborative inquiry learning (1). The system was designed not as a replacement for the classroom but rather as a supplement allowing greater communication and sharing of information among students and between teachers and their students.
Online forum participants.
Second-year medical students enrolled in Physiology (University of Zagreb Medical School) comprised the target population, but also other students, educators, faculty, staff, and physicians were welcome to register and log in with a password. We recruited students by advertising the IF-CLUB learner discussion forum during our face-to-face Physiology classes at the beginning of the academic year 2000–2001 and by advertising it on our Web site "Interactive Physiology" (http://www.mef.hr/if/).
The University of Zagreb Medical School provides computer facilities for classroom use and general student access. Computer labs and public Internet workstations with unrestricted Internet access are open to all students, staff, and faculty.
Teacher’s role. The teacher’s role in Web-based teaching is very different from the teacher’s role in formal education, with terms such as facilitator or supporter being used (6). Facilitator refers to the person who is online and is interacting with students in various ways. It is a combination of content expert, learning process design expert, and process implementation manager. Two main roles of the educators/facilitators of the discussion forum were outlined: the pedagogic or content role and the combined social moderator and technical role. These roles were assumed by two educators.
Our traditional face-to-face Physiology classes mostly have an instructor-oriented approach where the students concentrate on a superficial understanding of the subject which results in "reproduction" of knowledge. The online guided discovery approach offers an alternative mode of teaching that emphasizes development of a different range of skills, such as analytical and critical thinking, research skills, communication skills, and the ability to work productively on a team. The essence of this style is a particular teacher-student relationship in which the teacher’s sequences of information and questions cause a corresponding set of responses by the learner. The combination of information and questions by the teacher elicits a correct response that is discovered by the learner. The cumulative effect of this converging process leads the student to discover the sought-after concept or principle resulting in "production" of new knowledge. The authors posted thought-provoking questions that require students to build on what they already know, go beyond facts, and use knowledge in exercise of judgment. Here is an example of a question posed by the second author in a Physiology topic that provoked 15 student-teacher interactions until a precise explanation was found. During the isoelectric S-T segment in the ECG there is no current flow in the heart despite opposite charges of atria and ventricles. Explain why. A "thought-provoking question" leads the students to find solutions. They can discuss their own solutions, research information, and receive the tutor’s feedback.
Assessment. The assessment data were collected by the ICA electronic administration, by the paper questionnaire, and by the final examination in Physiology.
The electronic administration data (automatically generated by the software) enables the tracking of students’ activities (number of log-ins; number of posts).
At the end of the academic year 2000–2001, all students enrolled in the Physiology class (n = 220) were requested to complete an anonymous questionnaire on paper. Questions were divided into two groups: 13 multiple-choice questions were for students who had joined and participated in the discussion forum (see Table 2), and 6 multiple-choice questions were for nonparticipants (see Table 3). The questionnaires were evaluated electronically.
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Statistical analysis.
Descriptive statistics were used for presenting the results obtained by the electronic administration data of the software and by the anonymous questionnaire on paper. Comparison between two groups and the evaluation of the difference between them was performed by Student’s t-test and a 
2 test. P values < 0.05 were considered statistically significant.
RESULTS
The study results divide into three groups. One group of results was derived from the descriptive analysis of the ICA electronic administration data, the second group of results arose from the analysis of the questionnaires, and the third group was obtained from the grades of the final Physiology examination.
Descriptive analysis of the electronic administration data. Of 220 students enrolled in traditional Physiology course, 25% (n = 55) joined the online discussions. The Department of Physiology has 17 educators; 12 of them opened a forum account, but only two teachers were actively participating and facilitating the discussions. Table 1 depicts all the data of the electronic administration showing the distribution of the 395 messages posted by five types of 99 forum members in five discussion topics. Two types of members, students and active teachers, posted the most messages in the three discussion topics (Small Talk, Physiology, and Immunology). The conference topic Neuroscience never came to life. The number of messages posted per student ranged from zero ("lurkers") to 27, with an average of 3.2 messages per learner. Students interacted more often with the educators/facilitators than with each other (of 117 messages posted in Physiology, only four messages were direct student-student interactions; all other interactions were facilitated by the two instructors).
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F-CLUB learner discussion forum (October 20, 2000 to June 20, 2001) 1,563 times. It was a daily job of welcoming newcomers, responding to new messages, giving positive feedback, and stimulating critical thinking. She spent a total of about 120 minutes online per week. The other teacher who had the role of content facilitator spent a total of about 90 minutes online per week. Both teachers spent an additional one to two hours per week on offline facilitator activities like making up meaningful questions to support critical thinking, reading student papers, monitoring progress, and resolving problems. In addition, at the beginning of the academic year, the facilitators undertook activities to encourage participation through face-to-face explanation of the online process during real-time Physiology classes and by advertising it on our Interactive Physiology Web site. To encourage online exploration and content generation, students worked together on collaborative composition of essays. Nine documents were posted by six students who participated in two collaborative projects ("Cystic Fibrosis" and "Malignant Hyperthermia"). The online projects were a supplement to regular classroom Physiology seminars dealing with principles of membrane transport, resting, and membrane potentials. Students were asked to find credible information on the Internet. The first author guided students in finding and evaluating the information, facilitated the writing of essays, and motivated student-student collaboration. Special emphasis was given to online teamwork, peer review of electronic papers, and the problem of copyrights and intellectual property in electronic environments.
Analysis of the questionnaire results.
The population of the study consisted of 220 students enrolled in the Physiology course during the academic year 2000–2001. Of 195 students who filled out the paper questionnaires, 22% (n = 42) were IF-CLUB members (13 electronically registered student members didn’t respond). Tables 2 and 3 depict the 19 questions along with the response data.
Most student IF-CLUB members visited the discussion forum on a regular weekly basis (Table 2, question 1). The program allows participants to log into the forum either anonymously, by their full names, or both. The majority participated in discussions by their real names (Table 2, question 2).
Students participated in the discussion forum because of multiple motivations, although curiosity was most often the single reason (Table 2, question 6).
Almost 60% of students rated the discussions in Physiology as useful or very useful, and for more than 60% of students the online discussions were more thought-provoking then standard classroom discussions (Table 2, question 11). Maybe this was the reason that some 30% of students showed no great interest in discussing physiology (Table 2, question 7). In contrast to Physiology, only about 10% of students showed no interest in Small Talk (Table 2, question 8).
Of 195 students who filled out the paper questionnaire, 78% (n = 153) never joined the IF-CLUB learner discussion forum, mainly because of lack of motivation and/or lack of time (Table 3, question 1).
Students of both groups were asked to rate their computer literacy (Table 2, question 4; Table 3, question 2). More student nonmembers considered themselves as beginners than students who were forum members. There was a very statistically significant difference (2 = 9.688, P = 0.0019) between the two groups. Similarly, statistically significantly more online forum members considered themselves as advanced computer users than did nonmembers (2 = 13.861, P = 0.0002).
Almost all students in both groups were of the opinion that computers enhance learning and teaching (Table 2, question 13; Table 3, question 6) and that online communication in the virtual environment can foster better real-life relationships and communication (Table 2, question 10; Table 3, question 4). There was no statistically significant difference between the two groups (2 = 0.78, P = 0.376). On the other hand, there was a highly statistically significant difference (2 = 33.55, P < 0.0001) between the two groups when asked about crediting student participation to online discussion. Eighty-five percent of student members thought that they should get credit for their constructive contribution to online discussions (Table 2, question 12). In contrast, only 34% of the 153 nonmembers shared the same opinion (Table 3, question 5).
Final examination. Students’ grades on the final Physiology examination were analyzed. The mean grade achieved by the members was 3.59 ± 0.14, whereas the nonmembers’ mean grade was 3.23 ± 0.08. There was a statistically significant difference (P = 0.0328, t = 2.1526) between student members and nonmembers regarding the mean grade of the examination.
DISCUSSION
Communication and collaboration tools facilitate discussion, debate, and learning among student peers and faculty (14). Teachers may have a variety of reasons for introducing Web-based discussion forums into their face-to-face Physiology class. These could be pragmatic: a distributed class, need for common "workspace," availability of adequate technological resources, mixed timetable demands across the student group; or pedagogical: offering perceived benefits for student learning through "virtual" written discussion. Online asynchronous discussion has a number of advantages. It increases time for discussion, gives time for reflection for thoughtful and articulate responses, allows for giving and accepting feedback, and allows students to seek clarification or help as soon as the need arises. They also support face-to-face discussion by giving "voice" to silent students, thereby providing a more egalitarian learning environment. It also increases involvement with the course content outside the regular classes. Because of their written nature, online discussions leave transcripts available for review and feedback, enabling instructors to see how the material is being intellectually interpreted and integrated by each student, as well as allowing students to benefit from feedback from their fellow students and the instructor. All these are the reasons that advocates of the use of online discussion groups in education are enthusiastic about the benefits this opportunity for interaction affords the learner (7).
Our modest experience is in agreement with all the mentioned benefits. But teachers must be aware that all these benefits won’t happen just by creating and putting a physiology forum on the Web. We noted that facilitating a physiology online discussion and tutoring online collaborative projects is time consuming, as it requires the teacher to react to students’ comments, point out relationships between postings of various students, develop emergent themes and assignments, and synthesize points raised (2). Consequently, faculty play a key role in fostering critical thinking among students using Web-based communication tools. Therefore, the evolution from traditional teacher to online facilitator needs institutional support, motivation, and training (13). The main obstacles to information and communication technologies implementation are time and equipment. We can take as an example the lesson of the topic Neuroscience, which never came to life because the teachers involved in the Neuroscience class were not willing to participate in the online forum. Thus the moderators’ input is crucial for the success of the activity. Therefore, there is a need to employ further research on conference moderation. In general, although educator enthusiasm is a necessary ingredient to the successful implementation of Web technologies, it should not be the only factor for adopting them.
Similarly, students also need motivation and support by getting credit for their participation and constructive contribution to the discussion. Students need concrete incentives to respond positively to the use of technology and new pedagogies (17). For our students, this means that they do what they earn points for; getting credit is a strong motivating factor. For asynchronous discussion to be productive, instructors must give credit for student contributions and provide detailed guidelines for participation. Unfortunately, our efforts to integrate the IF-CLUB learner discussion forum into the official class curriculum failed, and formal credit points for online participants were not allowed. Because of that, the majority (75%) of our students experienced a lack of motivation and showed no willingness to participate in online learning. At the same time, 25% (n = 55) of students readily used the online discussion forum as a learning tool without getting any formal credit. Because of their intrinsic motivation for learning, these students achieved better examination grades. This is in concert with the the Myers-Briggs psychological type indicator concerning the source of motivation. The so-called introverts are self-motivated, whereas extroverts are motivated by the response they get from others. Two-thirds of the population is classified as extroverts by the Myers-Briggs type indicator. Feedback and praise are important to extrovert psychological types, thus to two-thirds of population. Failure to recognize this need may lead to an inappropriate distinction between "willing" and "unwilling" learners (9).
We are confident that student/teacher participation in our IF-CLUB learner discussion forum would have beeen greater and more successful if there had been formal support by our Department of Physiology and Immunology and if more educators had participated in the online discussions. We are aware that new ideas and ways of doing things do not necessarily take hold all at once but often spread gradually through social groups. It is not possible to convince everyone of a new idea at once. Some individuals are relatively quicker to adopt new ideas than others (11).
Despite the potential isolation of Internet and e-mail-based communications, computer-based technology may, ironically, facilitate an important shift from teacher-orchestrated to student-centered learning (15). To accomplish learning goals in an online learning community, both social and intellectual interactions are needed (3). Social interaction is a prerequisite for collaboration and collaborative learning (5). Therefore, when one is starting a physiology forum it is a good idea to provide a topic like Small Talk. It gives students and teachers the opportunity to get to know one another better, to relax, have fun, and a have a sense of belonging to a community (12). All of these are essential to good pedagogy.
On the basis of the data presented in this paper, as well as in works of others, we conclude that using an online asynchronous learner discussion forum could be successful in teaching critical thinking in physiology, but it creates new barriers related to technology and behavioral change. Traditional courses do not necessarily prepare students and teachers for the level of interdependence required in an online course. For most teachers, the main obstacles to information and communication technology implementation are lack of time and/or lack of motivation as well as lack of institutional support. Universities should, in addition to technical skills, also take care of pedagogical knowledge. Despite the obstacles, we need to learn ways to overcome these barriers. Therefore, students and teachers need to learn strategies for effective collaboration (16). Group processes and how collaboration can be facilitated need to be taught. The task may become easier as communication technologies and software applications improve and both teachers and students become more experienced in using computers and gain more fluency with information technology.
Faculty vary considerably in both their abilities and their attitudes toward the new technologies, and institutionally based attempts to engage the faculty must take these variations into account to be successful. Technical, organizational, and philosophical barriers can be overcome. A good way for an instructor to enter the online world of teaching is through the use of technology (like online forums) to enhance an already existing on-campus class (10). Look out for some hard work, a little frustration, and a great deal of satisfaction in becoming a more effective teacher. We need to continue to grow because we live in a technologically advanced and information rich world.
Received for publication June 5, 2003. Accepted for publication December 12, 2003.
REFERENCES
This article has been cited by other articles:
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  S. K. Taradi, M. Taradi, K. Radic, and N. Pokrajac Blending problem-based learning with Web technology positively impacts student learning outcomes in acid-base physiology Advan Physiol Educ, March 1, 2005; 29(1): 35 - 39. [Abstract] [Full Text] [PDF]
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