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This study aims to contribute to empirical and interdisciplinary knowledge on how visual learning analytics tools can support students' cognitive engagement in complex in-class scenarios. Taking a holistic approach, instructional design, learning analytics, and students' perceptions were examined together. The teaching of systematic viewing and image interpretation in radiology education was used to exemplify a complex in-class scenario, and a specific learning dashboard was designed as a support tool. The design was based on both educational and visualization theories and aligned with a pedagogical scenario integrating individual and class-wide activities. The quantity and quality of the cognitive engagement of a group of 26 students were explored. A mixed method approach was used, including computer log file analyses of individual work, analysis of video recordings of in-class small group discussions, and a focus group discussion with the students involved. The in-class scenario with the learning dashboard resulted in a good balance between individual tasks and group discussions and a high degree of active cognitive engagement. Constructive and interactive forms of cognitive engagement were, however, less evident. In addition, the products of these constructive (description of findings) and interactive (type of dialogue) cognitive engagements were of mediocre quality and therefore not optimal for knowledge transfer. The study also showed that the way the students and teacher understood their respective tasks and used the available interaction techniques of the learning dashboard highly influenced the students' cognitive engagement. Finally, several ideas emerged that could help to overcome the deficits found in the training of participants and to improve the tasks set and the learning dashboard itself.

In the complex practice of today's blended learning, educators need to be able to evaluate both online and face-to-face communication in order to get the full picture of what is going on in blended learning scenarios. The aim of this study was to investigate the reliability and feasibility of a practical instrument for analysing face-to-face communication that is in alignment with tools for analysing online communication. We examined whether an existing coding scheme for online communication could be modified to evaluate face-to-face communication. We investigated the reliability, validity and usability of a modified version of the Transcript Analysis Tool (TAT) in analysing communication among students during small-group sessions comprising presentations by students and discussion. The modified TAT proved to be effective in obtaining a detailed description of students' participation in the communication and of the focus of the communication. Evaluation was more efficient when direct video analysis was used than when a transcript of the same video was analysed. Direct analysis took about 2 h for 20 min of video recording and had an inter-rater reliability of [kappa] = 0.56. The modified TAT appears to be an effective and efficient instrument to analyse face-to-face communication in small group sessions. Its combined use with an evaluation instrument for online learning may create a powerful evaluation instrument for blended learning. Further studies are needed to establish the value of such an instrument. (Contains 6 tables and 3 figures.)

We designed an e-learning model to promote critical thinking about basic science topics in online communities of students during work placements in higher education. To determine the effectiveness and efficiency of the model we explored the online discussions in two case studies. We evaluated the quantity of the interactions by looking at quantitative data of the discussion "threads" and we evaluated the quality of the discussion by content analysis of the individual messages. Both the procedural facilitation of the discussion and the instrument for content analysis were based on Garrison's "Practical Inquiry model of Cognitive Presence". Furthermore, we explored the experiences of the students and moderators by interviewing them and we organised their perceptions using the framework of an activity system. On the basis of the quantitative and qualitative data we conclude that the e-learning model was successful in establishing a dialogue among a group of students and an expert during work placements at different locations. The "Practical Inquiry model" was useful in facilitating a sustained on-topic discourse involving critical thinking. Although the amount of critical thinking was moderate, the results suggest ways to increase integration and resolution activities in the online discussions. (Contains 2 tables and 7 figures.)

Abstract Background Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT) task, often resulting in a paper. Because such a paper may contain errors, students could profit from discussion with peers, leading to paper revision. Active peer discussion by a Computer Supported Collaborative Learning (CSCL) environment show positive medical students perceptions on subjective knowledge improvement. High students’ activity during discussions in a CSCL environment demonstrated higher task-focussed discussion reflecting higher levels of knowledge construction. However, it remains unclear whether high discussion activity influences students’ decisions revise their CAT paper. The aim of this research is to examine whether students who revise their critical appraisal papers after discussion in a CSCL environment show more task-focussed activity and discuss more intensively on critical appraisal topics than students who do not revise their papers. Methods Forty-seven medical students, stratified in subgroups, participated in a structured asynchronous online discussion of individual written CAT papers on self-selected clinical problems. The discussion was structured by three critical appraisal topics. After the discussion, the students could revise their paper. For analysis purposes, all students’ postings were blinded and analysed by the investigator, unaware of students characteristics and whether or not the paper was revised. Postings were counted and analysed by an independent rater, Postings were assigned into outside activity, non-task-focussed activity or task-focussed activity. Additionally, postings were assigned to one of the three critical appraisal topics. Analysis results were compared by revised and unrevised papers. Results Twenty-four papers (51.6%) were revised after the online discussion. The discussions of the revised papers showed significantly higher numbers of postings, more task-focussed activities, and more postings about the two critical appraisal topics: “appraisal of the selected article(s)”, and “relevant conclusion regarding the clinical problem”. Conclusion A CSCL environment can support medical students in the execution and critical appraisal of authentic tasks in the clinical workplace. Revision of CAT papers appears to be related to discussions activity, more specifically reflecting high task-focussed activity of critical appraisal topics.

In medical education, the use of flipped classrooms is on the increase. The complex, interdependent active- and social learning activities often built into the 'in-class' phase of this new approach may, however, cause cognitive overload, impeding learning. Computer-supported collaborative learning could play a role in reducing such cognitive load. The current study investigated how four constituent factors of 'in-class' scenarios for 'flipped' classrooms affect the intrinsic, germane and extraneous cognitive load for students. After participating in a computer-supported 'in-class' scenario for a radiology training course that combined face-to-face individual activities, small-group work and class-wide activities, undergraduate medical students (n = 135) completed a questionnaire rating the cognitive load perceived. Computer support comprised a program for radiology assessment and a learning dashboard that captured and visualized the assessment results. Total intrinsic load, germane load, and extraneous load (EL) were calculated from the results obtained. The 'high' intrinsic load, 'high' germane load, and 'low' EL indicate that the computer-supported 'in-class' scenario was cognitively challenging but that sufficient mental effort could be spent on task performance and learning. We attribute the successful management of the cognitive load imposed by this complex in-class scenario to the specially designed learning dashboard. [ABSTRACT FROM AUTHOR]

Background: Virtual patients (VPs) are increasingly used to train clinical reasoning. So far, no validated evaluation instruments for VP design are available. Aims: We examined the validity of an instrument for assessing the perception of VP design by learners. Methods: Three sources of validity evidence were examined: (i) Content was examined based on theory of clinical reasoning and an international VP expert team. (ii) The response process was explored in think-aloud pilot studies with medical students and in content analyses of free text questions accompanying each item of the instrument. (iii) Internal structure was assessed by exploratory factor analysis (EFA) and inter-rater reliability by generalizability analysis. Results: Content analysis was reasonably supported by the theoretical foundation and the VP expert team. The think-aloud studies and analysis of free text comments supported the validity of the instrument. In the EFA, using 2547 student evaluations of a total of 78 VPs, a three-factor model showed a reasonable fit with the data. At least 200 student responses are needed to obtain a reliable evaluation of a VP on all three factors. Conclusion: The instrument has the potential to provide valid information about VP design, provided that many responses per VP are available. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the effects of working face to face in small groups on the processes that occur when students elaborate on computer-based simulated cases., Methods: We performed a randomized controlled experiment that was designed to measure the effect of "social context" (triads versus individuals) on students' perceptions of the elaboration process and on the time spent on the different parts of the computer case. We sought students' perceptions using a questionnaire that was administered to all participating students (N = 47) and we examined the actions of the students working in triads (N = 12) and individually (N = 11) by analyzing the log files of the computer case., Results: The results demonstrated no significant effect of social context on the degree of elaboration of the computer case., Conclusions: Working with computer-based simulated cases in small groups as opposed to individually in itself is not enough to increase the scope and depth of the elaboration of computer cases.