Adaptive tutoring system in Cardiology

Zahra Al Rawahi, College of Medicine & Health Sciences, Sultan Qaboos University, Sultanate of Oman.

ABSTRACT:

Context. This study has investigated the use of an adaptive tutoring system to overcome problems with clinical teaching. Whilst a number of systems have been developed based on cognitive styles, and a significant body of research has been carried about learning with multiple representations, little was known about the effectiveness of systems based on multiple intelligences (MI). To address this, a prototype was built based on Gardner's theory of multiple intelligences and experiments were performed to study the effectiveness of the system on medical students' clinical reasoning abilities. Further experiments were performed to study the effect of providing a clinical context that adapt to students' cognitive style in understanding medical knowledge. In particular, this research investigated the clinical problem solving abilities of medical students.

Objectives. (1) To study the effectiveness of the adaptive tutoring system based on medical students cognitive styles on their clinical reasoning abilities, and (2) to study the effect of providing a clinical context that adapt to students' cognitive style in understanding medical knowledge.

Method. This involves two main issues: (1) the designing of an interactive tutoring system and (2) using it as a research tool to evaluate the main research objectives.

A Virtual Hospital Round (VHR) was developed for the domain of cardiovascular diseases. The VHR prototype consists of an Interactive Hypermedia Library (IHL) and a cyber-round. IHL enables students to explore a topic according to their learning style preferences. The cyber-round provides students with a simple simulated patient on which to practice clinical diagnostic reasoning abilities.

The approach used involved seven phases: Multiple Intelligences Developmental Assessment Scale (MIDAS) questionnaire, the USMLE Pre-test, Cyber-Round (initial case), Adaptive hypermedia library, Cyber-Round (final case), USMLE Post-test, and finally the usability questionnaire.

The subjects were given the MIDAS questionnaire to fill out, and then administered Step One of the United States Medical Licensing Examination (USMLE) as a pre-test. Thereafter, each subject was given a demonstration about using the Virtual Hospital Round Prototype. The subjects were then asked to work individually with a clinical case in the Cyber-Round. After working with a case, the subjects had to read one to two pages of medical material from the hypermedia library. Furthermore, for each group, the material given was according to their cognitive styles, opposite of their cognitive styles, according to the traditional way of teaching the topic, or by using modality choices. Soon afterwards, the subjects were given another clinical case to solve. Finally, the subjects were given the USMLE post-test.

Results & Conclusions. The results showed that students who were given material to learn according to their cognitive style did significantly better in a test of medical knowledge. Providing medical students with medical knowledge that adapted to their cognitive style had no significant effect on their performance in solving a clinical problem. However, the study showed that providing students with relevant medical context before solving a clinical case helped them to integrate that knowledge in solving the case. The study found that there were no significant interactions between different intelligence profiles and clinical reasoning skills. An evaluation of the system indicated that it was highly received by students and medical practitioners.

Zahra Al Rawahi

College of Medicine & Health Sciences

Computer & Information Technology Office

P.O. Box 35, P.C. 123

Sultanate of OMAN

Phone: (968)515102

Fax: (968)513419

Email: mailto:rawahiz@squ.edu.om

Website: http://www.squ.edu.om