Medical Education, 1976, 10, 512-51 3

PRELIMINARY COMMUNICATION

Computer-assisted revision system in immunology G. G. A L L W O O D Department of Immunology and Virology, The London Hospital Medical College

Key

words:

IMMuNoLmY/*eduC; *EDUCATION, *COMPUTERASSISTED INSTRUCTION; CURRICULUM ; EDUCATIONAL MEASUREMENT; ON LINE SYSTEMS ; LONDON MEDICAL,

UNDERGRADUATE;

Immunology is a small but significant part of the medical student’s curriculum. At the London Hospital Medical College, medical students begin their clinical studies with a 6 week long Introductory Course which covers Pathology, Microbiology and Immunology. Ten lectures, with practical sessions, are taken to cover theoretical and clinical immunology. Students take a short multiple choice question (MCQ) examination at the end of this Introductory Course; the students are not examined in these subjects again for a further 18-24 months, in the Final MB Pathology examination. It had been the custom in the past to put on a ‘revision course’ just before the Final MB examination; those lectures on important or difficult topics were simply repeated. It became clear that there were still gaps in the students’ knowledge which the ‘revision lectures’ were not filling. Accordingly, my colleagues and I embarked on a revision system which would enable us to pinpoint and rectify the deficiencies in each student’s knowledge and understanding of immunology. Three 1-hour sessions were set aside for immunology revision. In the first session, students did a multiple-choice question paper based on the syllabus. Correspondence: Dr G . G . Allwood, Department of Immunology and Virology, The London Hospital Medical College, Turner Street, London El 2AD.

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It was explained that this would be used solely to aid revision, and therefore that no marks would be allocated. Each student received a copy of the set of questions (which were of the ‘five-part indeterminate’ type; Lennox, 1967), and space was left below each question for written additions to be made. After the assessment, the course lecturers marked the papers, and provided a short explanation for each question option which the student had answered incorrectly or failed to answer correctly. In the second session, the marked papers were returned to the students, who could then further discuss the questions and answers with each other and with the lecturers. Most of the thirty to sixty students who attended the revision course felt that these two sessions provided them with adequate revision. The few students who were still confused, or who required revision ‘in depth‘ could return for the third session at which they could receive adequate attention on a 1 : 2 or 1 : 3 tutorial basis. Although this revision method was popular with students (and also provided feedback about those areas of the teaching which were inadequately presented!), the repeated writing of the same explanatory text on each student’s paper was felt to be tiresomely repetitive and boring. An attempt was therefore made to use a computer to automate the process of generating the explanatory texts. Firstly, each multiple choice option of each question was furnished with an explanatory text (‘prompt’) which would be appropriate for a student who had answered that option incorrectly. F~~ example, the option: ‘B.C.G. is an attenuated strain

Computer-assisted revision system in immunology

of tubercle bacillus’ would have the ‘prompt’ ‘B.C.G. is an attenuated strain of tubercle bacillus that has been attentuated by repeated subculture. After inoculation into humans, it undergoes limited multiplication, but sufficient to stimulate cellmediated immunity to mycobacteria’. This ‘prompt’ would be appropriate for a student who had failed to mark that option as correct. The ‘prompts’ were entered into a computer disc file once only, before the MCQ paper was set, together with the set of correct answers to each of the multiple-choice questions. A computer program scanned the answers given by a student (see below for the methods by which the students gave their answers to the computer) and printed those parts of the ‘prompt’ file applicable to his particular set of answers, along with additional information common to all answers (explanatory headings, textbook and lecture references). Thus the student received detailed help only where it was needed. There were three modes in which the students’ answers could be entered into the computer. In each case, the computer produced a revision ‘printout’ as described above. (i) All students take the MCQ paper at the same time, and afterwards the tutor enters the results into the computer. The students receive the revision ‘print-out’ within a few hours, or at the latest the next day. (ii) Each student does his MCQ paper, and when he has finished enters his answers into the computer via a remote terminal. As each answer is entered, the computer replies ‘correct’ or ‘incorrect’ as the case may be. In addition, a revision ‘print-out’ is also produced. (iii) The student does his MCQ paper at the

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remote terminal. Each question is displayed on the terminal screen in turn, and the student invited to type his answers. The computer responds as in (ii) above, supplying correct/incorrect feedback, and a ‘print-out’ later. This method has the advantage that a revision test can be done at any time. The computerized revision system has had only a limited trial (one session of twenty-five students, with papers marked by the tutor-method (i)). However, it appeared to have no disadvantages compared with manually compiled revision papers, and seemed to be acceptable to students. Computerassisted revision was superior to the manual system in speed (twenty papers were processed in under 30 minutes, and reply printouts returned in 3 hours, compared with about 6-8 hours manual marking and writing explanatory texts), in legibility of replies, and in the amount of information which could be given in the ‘prompts’. A further development might lie in the development of a flexible revision system, programmed to return repeatedly to those topics where a student appeared to be weak, furnishing immediate feedback, and also hard-copy explanations for permanent reference. Acknowledgments I would like to thank S.J. W. Evans, Supervisor of Computing Services, London Hospital Medical College, and the staff of the Computer Centre, Queen Mary College, University of London, for helpful advice. Reference LENNOX,B. (1967) Marking multiple-choice examinations. British Journal of Medical Education, 1, 203.

Appendix Language: The programs for revision modes (i) (ii) and (iii), and the program to produce the revision ‘print-out’ were written in ALGOL68. There are no language-specific features, and any high level language could be used, provided that disc facilities are available (since the ‘prompt’ file needs to be repeatedly scanned). Hardware: The ICL 1904s processors at Queen

Mary College, University of London, were used. The on-line revision programs were run under MAXIMOP, using ITT visual display units as remote terminals. Disc files containing questions and 2. ‘prompts’ were created and updated under GEORGE Copies of the program may be obtained from the author.

Computer-assisted revision system in immunology.

Medical Education, 1976, 10, 512-51 3 PRELIMINARY COMMUNICATION Computer-assisted revision system in immunology G. G. A L L W O O D Department of Im...
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