Elsevier

Computers & Education

Volume 125, October 2018, Pages 202-211
Computers & Education

The effectiveness of multimedia for teaching drug mechanisms of action to undergraduate health students

https://doi.org/10.1016/j.compedu.2018.06.014Get rights and content

Highlights

  • Four presentations were created to describe drug mechanisms of action.

  • Text only; text and static images; animations and text; and animation were equally effective for learning.

  • Additionally there was no effect of learning style.

  • Students may not require multimedia for effective learning if they possess the necessary mental models.

Abstract

Educators are increasingly turning to multimedia presentations as a means to convey complex information. Pharmacological mechanisms of action are dynamic processes that may be effectively represented as animations. Drug mechanisms of action were described in four different presentation formats: text only; text and static images; animation and text; or animation with narration. A comparison of these presentation modes found no significant difference on performance on a best answer multiple choice quiz. In addition, there was no significant effect of individual learning style. When learning about material related to their discipline of study, students may possess the ability to construct mental models that obviate the need for multimedia. Resources currently invested in the development of multimedia materials may be better diverted elsewhere. Furthermore, the results from this study do not support the routine assessment of individual learning styles in education.

Introduction

As technology has advanced so have the tools available to enhance teaching and learning. With basic computer software an instructor can create multimedia presentations that combine text with images, animation, and narration. In the field of health sciences, educators are increasingly turning to these materials as a way to accurately represent complex information (Yue, Kim, Ogawa, Stark, & Kim, 2013). There are many different ways to approach multimedia design and therefore an evidence-based approach is required. Forming the foundation of research in this area are Cognitive Load Theory and Mayer's Cognitive Theory of Multimedia Learning.

Simply put, cognitive load refers to the various demands placed on working memory during learning. Working memory is an information processing system that converts sensory information into short-term memories (Kirschner, Kester, & Corbalan, 2010). The amount of stimuli that can be processed at any one time is fixed and therefore the system is limited in capacity (Kirschner et al., 2010). Cognitive load can be intrinsic to the task or externally applied. Tasks that are inherently complex have a high essential load (Kirschner et al., 2010). This is in contrast to extraneous load which does not contribute directly to learning, for example the load imposed by a decorative illustration (Kirschner et al., 2010). Finally, germane load is caused by information and activities that foster learning processes (Kirschner et al., 2010). The ideas in cognitive load theory have informed Mayer's Principles of Multimedia design, which aim to minimise extraneous cognitive load whilst enhancing germane load.

Multimedia presentations contain information in both a verbal and pictorial format. The Cognitive Theory of Multimedia Learning assumes that there are parallel channels for processing pictorial and verbal stimuli within working memory (Clark & Paivio, 1991). Thus, the simultaneous presentation of visualisations with text or audio narration makes use of both channels and can increase learning without increasing cognitive load (Mayer & Moreno, 2002).

While there is a strong theoretical basis for the use of multimedia materials in learning, their effectiveness is highly dependent on design, which has given rise to various evidence-based guidelines. Perhaps the most well known are Mayer's Principles of Multimedia Design (Mayer, 2010). However, more recently others have attempted to standardise the use of web-based multimedia instruction in medical classrooms (Yavner et al., 2015). Despite this, several aspects of multimedia design remain controversial, for instance whether animations enhance learning to a greater degree than equivalent static images.

Animation can be defined as a pictorial representation showing the motion of objects (Mayer & Moreno, 2002). Students tend to prefer to learn from animations compared to other forms of representation (Naqvi et al., 2013). In addition, they are theoretically more effective at portraying movement or dynamic processes. For these reasons animations are an attractive option for educators. Despite this, studies investigating the efficacy of animations for learning have had mixed results.

A meta-analysis by Hoffler and Leutner in 2007 demonstrated an overall advantage of instructional animations over static pictures with an effect size of 0.37. Animations had a greater effect on procedural-motor learning tasks (e.g. a knot-tying) compared to the learning of facts, known as declarative learning. In an updated review, Berney and Bétrancourt (2016) replicated these findings with an effect size favouring animation of 0.226. Again they found a clear advantage for procedural motor learning. They also described several moderating factors for the effectiveness of animation such as the inclusion of audio-narration and exclusion of text. Therefore, they concluded that animation might be more effective than static images, but only when designed effectively and possibly only for certain types of learning.

Optimising the design of animations may not be a fruitful pursuit if the information can be conveyed with equal or greater effectiveness using well-designed static images. It has been proposed that animations may overwhelm working memory with information, as learners must process many items simultaneously (Ploetzner & Lowe, 2012; Tversky, Morrison, & Betrancourt, 2002). It has also been suggested that movement may be conceived as being composed of discrete steps and that therefore static images can be equal or superior when learning about dynamic systems (Tversky et al., 2002). Furthermore, mentally animating static images may increase germane load and promote meaningful learning (Hegarty, Kriz, & Cate, 2003). Some recent studies support this theory, with static image presentations performing equally to animation on motor learning tasks (Wong, Castro-Alonso, Ayres, & Paas, 2015; Wong, Leahy, Marcus, & Sweller, 2012).

Recently the debate has moved on from trying to make a general comparison between animation and static images to focusing on specific instructional situations where they may or may not be of benefit. Studies are attempting to investigate moderating factors for animation such as narration, visual cuing, and learner interactivity (Kuhl, Scheiter, & Gerjets, 2012; Munyofu et al., 2007). One of Mayer's design principles, the modality principle, states that students learn better from animation and narration than from animation and on-screen text (Mayer & Moreno, 2002; Moreno & Mayer, 1999). Another proposed moderating factor is the ‘learning style’ of the individual.

The concept of individual learning styles has gained considerable influence in recent decades among educators at all levels of the education system (Kirschner, 2017; Pashler, McDaniel, Rohrer, & Bjork, 2008). It has been suggested that individuals learn information in different ways and that instructional materials should be tailored accordingly (Pashler et al., 2008). A review in 2004 described 71 different schemes for describing learning styles, with the learner typically classified into a style category (Coffield, Moseley, Hall, & Ecclestone, 2004).

Critics of the learning styles concept have pointed to a number of issues. Firstly, placing learners into specific categories may not reflect the graded differences between people on various dimensions of learning preference (Kirschner, 2017). Secondly, learners’ ability to self-report their preferences may not be accurate, with their preference only weakly related to their actual abilities (Massa & Mayer, 2006). Thirdly, the tools currently used to assess “learning style” may not be valid or reliable (Coffield et al., 2004). Finally, the preferred presentation mode is not necessarily the most effective for learning, with little evidence for an interaction between preference and performance on learning tasks (Knoll, Otani, Skeel, & Van Horn, 2017; Massa & Mayer, 2006).

Even multimedia materials designed strictly according to available evidence-based guidelines may not impart the expected benefit. This is abundantly clear in the conflicting research around the use of animations. It remains unclear what the role is for animations in declarative learning tasks and under which circumstances they are effective. This study aimed to contribute to the body of multimedia research by investigating the use of animations in teaching pharmacological mechanisms of action. To our knowledge there have been no studies previously of this type in the discipline of pharmacology.

Drug mechanisms of action are often complex and require conceptualising a series of steps and dynamic movement. It was hypothesised that animation would have the greatest benefit on learning compared to other presentation modes. Additionally, it was hypothesised that narrated animations would out-perform animations with text. The final hypothesis was that the “learning style” of the student would not have an impact on their learning of the drugs.

Section snippets

Setting and ethics

The study was conducted with students from the College of Medicine and Dentistry at James Cook University in Australia. The Human Research Ethics Committee of James Cook University approved the study (approval number H5516). The students were informed that participation in the study was voluntary and would not impact on their results or academic relationship with the investigators. Additionally, an investigator with no academic role at the university was responsible for recruiting the students

Demographics

Approximately 600 students were invited to participate in the study with 58 responses. Two participants were excluded due to prior pharmacology experience and 56 students went on to complete the study (63% female, median age = 20). A further 13 were excluded when they reported prior knowledge of one or more of the drugs in the study. Forty-four were included in the final analysis. Fig. 4 shows a break down of the participants by year and program of study. The majority of the participants (52%)

Discussion

The primary finding of the study was that the quiz scores did not differ significantly across the four presentation modes, nor was there a significant difference between visual and non-visual learners.

The main finding, which suggests that all four presentation modes were equally effective for learning the drug mechanisms of action, was contrary to our predictions. Firstly, the text only presentation mode was equally effective as all the other presentation modes, which contradicts Mayer's

Conclusion

Multimedia materials may not provide the anticipated benefit and this may depend on the motivation and prior knowledge of the learners. For undergraduate medical and pharmacy students with prior biochemistry knowledge, multimedia presentations provided no additional benefit for learning compared to text alone. There was no effect of learning style although the between-group comparisons were likely underpowered. Future research should focus on the benefits of multimedia in low prior knowledge

Conflicts of interest

The authors declared no potential conflict of interest with respect to the research, authorship, and/or publication of this article.

Funding

This work was supported by James Cook University.

Acknowledgements

We would like to thank John Hartman for his programming expertise that facilitated the randomisation technique used in the study.

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