Using interactive multimedia e-Books for learning blood cell morphology in pediatric hematology
Hsiao et al. BMC Medical Education (2016) 16:290
DOI 10.1186/s12909-016-0816-9
TECHNICAL ADVANCE
Open Access
Using interactive multimedia e-Books for
learning blood cell morphology in pediatric
hematology
Chih-Cheng Hsiao1,4*, Mao-Meng Tiao2,4 and Chih-Cheng Chen3
Abstract
Background: This prospective study compares the use of interactive multimedia eBooks (IME) with traditional
PowerPoint (TPP) for teaching cell morphology of blood and bone marrow.
Methods: Fifty-one interns from three Taiwan medical schools training by a single teacher in the pediatric
hematology department of Kaohsiung Chang Gung Memorial Hospital, Taiwan, participated in this study. 25 interns
were allocated for training with a traditional PowerPoint atlas and 26 interns for training with an interactive
multimedia eBook atlas. Learning outcomes were examined by pre-test and post-test using the CellQuiz of CellAtlas
App. Attitudes and perceptions were collected by survey questions regarding interest, motivation and effectiveness.
Results: There was no difference in the pre-test scores between TPP and IME groups (mean score 27.0 versus 27.9,
p = 0.807). However, the interns in the interactive multimedia eBook group achieved significantly better scores in
the post-test than the ones in the PowerPoint group (mean score 103.2 versus 70.6; p < 0.001). Overall results of
interest, motivation and effectiveness were strongly positive in the multimedia eBook group.
Conclusions: Our data supports that interactive multimedia eBooks are more effective than PowerPoint to facilitate
learning of cell morphology of blood and bone marrow.
Introduction
E-learning offers many advantages over conventional
teaching methods. A recent review of e-learning medical education reported that learners are more likely to
be engaged when the technology is easy to use [1–4].
There is the potential to utilize multimedia applications
with interactivity. It allows users to learn at their own
pace as well as at their own convenience. The basis for
this interactive e-learning research is to increase student
learning interest and efficiency and allow students to more
fully comprehend the basics necessary for clinical practice.
We hope that interactive e-learning provides a higher
motivation for learners by presenting content in an
interactive, game-based and competitive environment.
* Correspondence:
1
Division of Hematology/Oncology, Department of Pediatrics, Kaohsiung
Chang Gung Memorial Hospital and Chang Gung University College of
Medicine, 123 Tai-Pei Road, Niao Sung, Kaohsiung Postal code: 833, Taiwan
4
Chang Gung Memorial Hospital Research Centre for Medical Education,
Taipei, Taiwan
Full list of author information is available at the end of the article
E-learning is associated with greater learning efficiency,
problem solving abilities and satisfaction [5, 6].
In recent years, there has been increasing emphasis of
active learning and self-directed learning in medical
education curriculum [7, 8]. Schneider et al. created
computer-based cases for important diagnoses in urology using the authoring system CASUS® [9]. They
found that members of the CASUS® group using the
online cases for preparation scored significantly higher
with an average of 20% better test results than students
using textbooks for preparation. They confirmed that elearning resulted in an interesting and engaging learning
model with improved learning outcomes. In the study of
Boeker M et al., comparing the effectiveness on the learning outcome of a Game-based e-learning instruction with
a conventional script-based instruction in the teaching
of microscopy urinalysis for medical students [10]. In
this study, the students in the Game-based e-learning
group achieved significantly better results in the cognitive
knowledge test than the students in the script group. Attitudes also towards the recent learning experience were
© The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
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Hsiao et al. BMC Medical Education (2016) 16:290
significantly more positive with Game-based e-learning
group. Currently, E-learning has a major impact on the effectiveness of learning and provides students to active
learning and self-directed learning. However, development
of good e-learning materials including multimedia, simulation or game-based resource requires a multidisciplinary
team and can be resource intensive [10–13]. To achieve a
highly interactive and active learning experience for the
student, not only considerable programming is required
by the instructional teams, but also ensuring that the time
and money invested is justified by institutions on many
impacts. The concepts were perceived by previous reports
[5, 6]. Therefore, the development and promotion toward
interactive e-learning has shown limitation in the medical
education.
Using traditional teaching methods to teach interns
hematology, one issue with students was that the materials
used did not effectively train students to differentiate
blood cells, when they started to study in the pediatric
hematology department, because the knowledge delivered
was limited. Also, many students find the PPT materials a
little dry, and we hoped to create more engaging materials
for students. The creation of an interactive eBooks has the
potential to transform learning away from basic acquisition of facts (i.e. printed materials, didactic lectures, PPT)
to actively acquiring and applying knowledge and skills as
it can include multimedia and interactive learning.
In this study, SimMAGIC eBooK editing software
(http://www.simmagic.com.tw/Products/eBook/intro.aspx.
com.tw/Products/eBook/functions.aspx) was employed to
create an interactive multimedia eBook of blood cell
morphology. This eBook software uses a simple and clear
editing layout and includes customized editing tools
and various content editing functions enabling editors
to make creative content for eBooks and publications
quickly. In addition, it emphasizes interactive quiz creation and easy design by integrating and importing
various multimedia, such as PPT, PDF or video to make
a simulative and operational eBook. Students interact
with the operational eBook very well. In addition,
eBook includes many different operation simulations,
allowing students to not only enjoy reading but also
interact with the book and take simulated tests.
Customize right/wrong answer pop-up message windows, simulative interactive functions such a (...truncated)
