JDE
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Dent Educ. 71(2): 269-278 2007
© 2007 American Dental Education Association
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pahinis, K.
Right arrow Articles by Cannavina, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pahinis, K.
Right arrow Articles by Cannavina, G.

Educational Methodologies

Evaluating a Blended-Learning Course Taught to Different Groups of Learners in a Dental School

Kimon Pahinis, D.D.S., M.Sc.; Christopher W. Stokes, M.Ed., Ph.D.; Trevor F. Walsh, B.D.S., F.D.S.R.C.S., M.Sc., D.D.Sc.; Giuseppe Cannavina, Ph.D.

Key words: dental education, computers, web-based, blended learning, online, evidence-based

Submitted for publication 07/18/06; accepted 10/27/06


   Abstract
Top
 Abstract
The ict course
 Methods
 Results
 Discussion
 Conclusions
 References
 
The purpose of this study was to present and evaluate a blended-learning course developed for undergraduate (B.D.S.), postgraduate, and diploma (hygiene and therapy) students at the University of Sheffield School of Clinical Dentistry. Blended learning is the integration of classroom face-to-face learning with online learning. The overall methodology used for this study was action research. The data were collected using three processes: questionnaires to collect contextual data from the students taking the course; a student-led, nominal group technique to collect group data from the participants; and a non-participant observer technique to record the context in which certain group and individual behaviors occurred. The online component of the course was accepted as a valuable resource by 65 percent of those responding. While online information-sharing occurred (31 percent of the students posted in forums), there was no evidence of online collaboration, with only 8 percent replying to forum postings. Accessibility of the online environment was one of the main concerns of the students at the nominal group sessions. Differences regarding overall engagement with the course between the student groups (years) were observed during the sessions. The majority of the students were satisfied with the Information and Communication Technologies (ICT) course. No statistically significant differences between males and females were found, but there were differences between different student cohorts (year groups).

One of the most important and valuable developments in recent years is the evolution of technology, especially in the form of information and communication technologies. Many aspects of our everyday life have changed as a result of technology: our means of communication, information retrieval, even the way we spend our free time (e.g., computer games). Dentistry could not be left unaffected. Nowadays, several aspects of dentistry are subserved or performed with the use of computers, and computers are increasingly prevalent in dental education, including continuing professional development. It has been reported that this technological shift could help dental education to overcome the challenge of meeting the growing need and expectations for higher-quality education with reduced funds.1–3

Computers in dentistry have been used as a learning tool since the early 1970s,4 and the first CAL (Computer-Aided Learning) tool was developed at the University of Kentucky.5 However, the real development did not actually start until the early 1990s, when several CAL packages were developed.6–8 These were mainly distributed through floppy disks and CD-ROMs, as the Internet was not as widely available and easily accessible as it is today. Whilst those packages were mainly meant for continuing professional education, after the mid-1990s there were some attempts to create CAL packages for undergraduate education.9–11

From the beginning of this decade, as Internet accessibility and connectivity speeds have increased (and are likely to continue to do so),12 electronic education (e-education) is moving away from the hard mediums (floppy disks, CD-ROMs, etc.) and is now primarily offered in online environments,13–16 as they offer numerous advantages for the learner, including increasing the student’s independence and "anytime, anywhere" access to educational opportunities, as well as allowing teachers to more easily update e-education materials than they could with the previous hard mediums. The move towards e-education evolves through e-publishing (the use of static material) to e-learning (the use of interaction) as described by Allen.17

E-education has progressed in recent years to a new approach in the form of blended learning. Blended learning is the thoughtful integration of classroom face-to-face learning experiences with online learning experiences.2 The main advantage of blended learning is that it integrates the strengths of synchronous (face-to-face) and asynchronous (web-based) learning activities.

Two key approaches for the development of online materials are described in the literature: direct instruction and student-centered approach.18 The direct instruction model is based on behaviorist learning theory,19,20 described as a direct provision of information. The student-centered approach is based on constructivist learning theory,21,22 which supports the notion that knowledge is constructed by learners through interaction. Another approach that lies between the two key approaches is minimalism, first described by Carroll.23 The key ideas behind this theory are that instructional material should be kept to a minimum to avoid obstruction of learning and the design should be focused on activities that support learner-directed activities.

In recent years, more and more dental schools have moved to supporting face-to-face teaching using online platforms,24–26 but only a few studies have evaluated this transformation of the curriculum,27 especially in relation to a specific course.14 Furthermore, as the blended-learning approach is relatively new to education, only a few studies are available in the literature.28–30 To address this gap in the literature, our research study evaluated a blended-learning course titled "Information and Communication Technologies" (ICT), developed for the undergraduate dental students (B.D.S.), postgraduate students (PG), and Diploma of Hygiene and Therapy students (DHT) at the School of Clinical Dentistry of the University of Sheffield. Student behaviors, attitudes, and opinions towards the blended-learning ICT course were evaluated.


   The ICT Course
Top
 Abstract
 The ict course
Methods
 Results
 Discussion
 Conclusions
 References
 
In the academic year 2003–04, the Information and Communication Technology course (ICT) was redesigned to be the first electronic course at the dental school in Sheffield. The course, which has been a part of the curriculum since 1999, was redeveloped using a blended-learning approach that accommodates face-to-face learning environments with the support of an asynchronous online environment.

The environment used to host the course was the iCT Portal. The iCT Portal was developed in 2003 on an independent web server, connected to the University of Sheffield’s main data network. The front-end screen shot is shown in Figure 1Go.


Figure 1
View larger version (73K):
[in this window]
[in a new window]

  		Figure 1. iCT Portal partial front-end screen-shot original version

 
The iCT Portal was used as a VLE (Virtual Learning Environment). Information and instructions regarding each session were posted on the iCT Portal by the course tutor before each session. Furthermore, the iCT Portal allowed intra-student communication and student-tutor communication through forums. The course was taught to five different groups of students each academic year. Groups and teaching hours were as follows: first-year B.D.S., twelve academic hours; third-year B.D.S., twelve academic hours; fourth-year B.D.S., eight academic hours; DHT (Diploma in Dental Hygiene and Therapy) students, twenty academic hours; and postgraduate dental students, twenty academic hours.

The core objectives of the ICT course were for the students to learn information-sourcing techniques, data manipulation, and evidence appraisal while building on their practical IT skills.

As shown in Table 1Go, there were similarities between the structures of the different course years (modules). The first and last sessions of the course were in a traditional lecture setting, while the middle sessions were online-supported practical sessions. For the practical sessions, all the information required to complete the sessions was given through the iCT Portal, and the presence of the tutor was mainly to provide synchronous support to the students. Attendance at the course sessions was compulsory for all groups. Course assessment was based on the session assignments.


View this table:
[in this window]
[in a new window]

  		Table 1. Course outline and structure
 
The sessions were based on the three approaches described above (Table 1Go). For the sessions based on the direct instruction approach, a step-by-step instruction guide was given to the students. For the sessions based on the minimalism approach, only minimum instructions were given to the students to assist them in completing the task. For example, at the finding literature session, students were asked to retrieve the full reference of several articles using the hints provided by searching the suggested citation indices or another Internet search engine. Finally, for the session using the student-centered approach, students were required to work in groups based on their experience gained in previous sessions. For example, students had to create presentations in groups using the skills gained in prior sessions of the course.


   Methods
Top
 Abstract
 The ict course
 Methods
Results
 Discussion
 Conclusions
 References
 
The sample of this study consisted of students from the first, third, and fourth B.D.S. years, DHT students, and postgraduate dental students. These students participated in the ICT course during the year 2004 at the dental school of the University of Sheffield.

For the purpose of this study, the overall methodology used was action research.31,32 The action research model is a spiral process: the cycle comprises diagnosis (data gathering, analysis, and representation), action planning, action taking, and action evaluation.33 The data were collected using three processes: questionnaires to collect contextual data from students taking the course; a student-led, nominal group technique to collect group data from participants of the course; and non-participant observer technique to record the context in which certain group and individual behaviors occurred.

Questionnaires34 consisted of both closed and open-ended questions. The questions focused on eliciting attitudes towards the course content, the educational setting, and the e-learning innovations applied, as well as past, current, and possible future behaviors. Anonymous questionnaires were distributed at the start of the last session of each class (year group) and were collected at the end of it. The students were informed that participation was voluntary.

The Nominal Group (NG) Technique35 was used to identify strengths and weaknesses, using a group setting, to allow solutions to be thought out and analyzed and plans for their implementation to be considered. This technique can be split into four main stages: idea, "round Robin," clarification, and voting.36 One NG session was organized for each student year, and five to ten students were invited for each session. The NG sessions took place on all occasions within two weeks of the completion of the course. The researcher introduced the NG technique to the students and responded to any queries. The same instruction sheets were given to all student groups, and the venue for all sessions was the same. Only the students were present during the nominal group sessions, and group participants were self-selected.

Non-participant observation37 is an ethnographic technique that provides information about the group dynamics. The researcher was present at all sessions. Students were not informed of the intention of the observation in order to avoid change in behaviors.

The quantitative analysis of the closed questions data was done with SPSS v13.38 Chi square ({chi}2) test was used to compare means between categorical data and ANOVA.39 The level of statistical significance was set at p< 0.05. Thematic analysis was performed for the nominal group, non-participant observation, and open questions data from the questionnaires.


   Results
Top
 Abstract
 The ict course
 Methods
 Results
Discussion
 Conclusions
 References
 
An overall response rate of 95 percent of the distributed questionnaires was obtained (158 out of 165). For each individual class, the response rate was as follows: first-year B.D.S., 100 percent (n=63); third-year B.D.S., 95 percent (n=36); fourth-year B.D.S., 79 percent (n=19); postgraduate students, 100 percent (n=10); and DHT students, 100 percent (n=30). Thirty-eight percent of the respondents were male (n=60) and 62 percent female (n=98). There was a statistically significant difference in gender distribution among participants from each year (p<0.01), mainly due to the DHT course as it consisted mainly of female students (96 percent). There was no statistically significant difference in gender distribution if the DHT course was excluded from the analysis (p>0.85). For the nominal group session, participation varied from five to eight students.

For each individual class the participation was as follows: first-year B.D.S., six students (three female/three male); third-year B.D.S., five students (three female/two male); fourth-year B.D.S., six students (three female/three male); postgraduate dentists, seven students (four female/three male); and DHT, eight students (eight females).

Thirty-six sessions of non-participant observations were observed. Six sessions were for the first-year B.D.S. course, six for the third-year B.D.S. course, four for the fourth-year B.D.S. course, ten for the postgraduate course, and ten for the DHT course.

The following sections summarize the findings from the questionnaires, nominal group, and non-participant observations.

Summary of Data from the Questionnaires
According to 64 percent of the respondents, the aims and objectives of the course were clear. A significant difference was found between the years, as postgraduate and DHT students gave a more positive response than did the B.D.S. students (p<0.01; Table 2Go). There was no difference between male and female students.


View this table:
[in this window]
[in a new window]

  		Table 2. Response to question "were the aims and objectives of the course clear?"
 
Almost 63 percent of the respondents agreed that the teaching sessions were well constructed and understandable. On the question of whether the practical sessions were understandable, 63 percent of the respondents gave a positive response. No statistically significant difference was found between years or genders for these questions.

When asked about skills gained from the course, around 60 percent of the respondents believed that their skills had improved. A statistical difference between the classes (years) was found, with p<0.01. Again the difference was between B.D.S. students and the other groups (Table 3Go).


View this table:
[in this window]
[in a new window]

  		Table 3. Response to question "this course has added to my skills"
 
The iCT Portal was a valuable resource, according to 65 percent of the respondents. There was no statistical difference between years and genders. Most respondents expressed a neutral (37 percent) to positive (32 percent) opinion on the question regarding the use of the iCT Portal in the future after the course has finished. When comparing between the different years, a statistical difference (p<0.01) was found (Table 4Go). The respondents mainly (57 percent) used the iCT Portal to gain access to course content outside sessions. There was not a statistically significant difference between the years. Table 5Go summarizes the various student-iCT Portal interactions and designates where a statistically significant difference occurred. The relationship between online communication and the future use of the portal is demonstrated in Figure 2Go.


View this table:
[in this window]
[in a new window]

  		Table 4. Response to question "I will continue to use the iCT Portal regularly now that the course has finished"
 

View this table:
[in this window]
[in a new window]

  		Table 5. Main iCT Portal interactions throughout the years
 

Figure 2
View larger version (10K):
[in this window]
[in a new window]

  		Figure 2. Relationship between future use and communication

 
Finally, the sessions on "finding literature online," which was based on the minimalist approach, and "MS Excel/statistics," based on the direct instruction approach, were rated to be the most difficult but the most useful by all student groups.

Summary of Data from the Nominal Group Sessions
On the iCT Portal, the students commented positively on the usefulness of the environment, but they would have preferred it to be integrated with other online resources at the university. Problems accessing the portal due to passwords were also reported by some groups. According to the first-year B.D.S. and the DHT students, the variety of available forums was effective for student communication. The DHT students reported problems with the interface and the design of the iCT Portal, while the other student groups found it easy to use.

In relation to the course content, students indicated that the following sessions were valuable: finding literature online and referencing based on the minimalism approach; MS Excel/statistics using the direct instruction approach; and presentation sessions based on the student-centered approach. B.D.S. students suggested including more dental-oriented subjects in the session material. Another issue reported from the third- and fourth-year B.D.S. students was that, due to similarities between the B.D.S. levels, no new IT skills were obtained. Postgraduate students would have preferred the material to be available online before the sessions.

For the sessions’ structure and timing, differences were found between the groups. Postgraduate students proposed extending the practice time; third-year B.D.S. students believed that the course was time-consuming and they would prefer to distribute that time in more clinical-related courses; and fourth-year B.D.S. students wanted more tutors available in the practical sessions.

Finally, another aspect reported was the diversity of computer skills among the students. A more detailed view of the similarities and differences between the years as revealed from the nominal group session analysis is presented in Table 6Go.


View this table:
[in this window]
[in a new window]

  		Table 6. Key points from nominal groups
 
Summary of Data from the Non-Participant Observations
Differences regarding overall engagement with the course between the student groups (years) were observed. Postgraduate and DHT students showed an increased interest during the course sessions; interactions between students and tutors were quite frequent; and most students attended the sessions. The first-year B.D.S. students showed some interest but less than the postgraduate and DHT groups. The interest level was limited for the two remaining student groups: fourth-year B.D.S. and especially third-year B.D.S. Frequently, the third-year B.D.S. students were occupied with noncourse activities like browsing the Internet and checking emails during the practical sessions. Moreover, in some sessions, limited attendance was recorded.

Regarding the group behaviors and group dynamics, similarities were recorded among the students’ cohorts (year groups). When the direct instruction approach was used for development of the session, students worked alone, with interactions occurring only between adjacent sitting students and with the tutor. Those interactions were minimal and, in most cases, were related to clarification of the instructions. At the minimalism-based sessions, some interaction among the students was recorded, but to a limited extent. Besides the queries regarding instructions, some students engaged in group discussions and collaborated to assist each other in completing the tasks. During sessions that employed a student-centered approach, students worked collaboratively, and group formation increased. However, this collaboration was mainly face-to-face: the iCT Portal forums were used only for student communication by the first-year B.D.S. and DHT students and that was outside sessions only.


   Discussion
Top
 Abstract
 The ict course
 Methods
 Results
 Discussion
Conclusions
 References
 
Some U.S. dental schools have implemented courses with content and activities similar to the Information and Communication Technologies course described in this report.40 However, the majority of dental schools in the European Union have not yet included an ICT course in the curriculum, and the use of online environments is limited.41

Many studies have been carried out in the past to evaluate computer-assisted education in dentistry.6–11,13,42,43 But a careful review of the literature did not reveal any study that evaluated a blended-learning course using more than a single group of learners in a dental school.

We have to accept that a possible limitation of this study was the subject of the course. Even though ICT skills are seen as useful, they are often not yet seen as essential by dental students. Hence, the interest level in the course, especially from the B.D.S. students, may have been limited. Nevertheless, there was an advantage in that the subject of the course was related to computers, which may have minimized the novelty effect44 of a new learning environment.

The results from our study indicate that the majority of students were satisfied with the course. No differences were found between genders in any of the responses. It is clear though that there were several differences between the different student groups (Table 2Go and Table 3Go). An interesting finding was the impressive positive difference recorded between postgraduate students and the other student groups. This difference could possibly be attributed to the fact that postgraduate students see themselves more as researchers and therefore ICT skills are more essential to them. The other student groups seemed to be, as it has been reported and in some nominal group sessions, more focused on the clinical aspects of dentistry. It is also worth noting that overall third-year B.D.S. students gave the lowest level of positive responses. This finding can not be solely attributed to the "clinical focus" reason, since fourth-year B.D.S. students—who are expected to be more clinically oriented—had better results. It may be that it is a coincidental finding attributed to this specific group of students and thus requires further investigation.

The comparison of the two learning experiences—face-to-face and online-supported (blended)—showed no differences, and the students felt comfortable with both. Indeed, both teaching sessions and practical sessions were understandable for 63 percent of the students. The teaching sessions were based on the traditional face-to-face model, while practical sessions employed an online-supported model.

Postgraduate and DHT students responded that they gained significantly more skills from the course than did B.D.S. students. Postgraduate students attending this course were mainly overseas students from several countries; similarly, DHT students came from a variety of backgrounds and age groups. As a result, the initial ICT skills for those two groups were probably lower than for the B.D.S. students. Nominal group sessions also pointed out the diversity of ICT knowledge and the lack of ICT skills within those two student groups. Moreover, based on the questionnaires, skills gained from the course seemed to decrease in more junior B.D.S. cohorts (Table 1Go), which actually contradicts the comments made at the nominal group session by the third- and fourth-year B.D.S. students regarding similarities of the years. This may be explained by the possibility that the younger B.D.S. students possessed a wider variety of initial ICT skills than their older colleagues. A state of readiness survey could provide a more definite answer.

Drawing on these results, it may be said that a web-based course has the potential to provide a highly personalized learning content. This course design could provide the means to cope with the diversity of knowledge and skills among students and also could possibly increase the students’ online expertise regardless of their prior experience.

All students groups said the iCT Portal was a valuable resource. If the online environment could be integrated with other university resources, then the problems regarding its accessibility and passwords, reported at the nominal group sessions, could be minimized. It may also be pointed out that the easier it is to access a system, the higher its acceptance, especially when most people have to remember numerous passwords and URLs.

Several reports in the literature indicate that the online learning experience is enhanced when the web delivery of information is combined with interaction.42,43 This is what actually distinguishes e-publishing from e-learning according to Allen.17 Moore45 describes three types of learner interaction: learner-content, learner-instructor, and learner-learner. The design of the iCT Portal was based on the social constructivism learning theory22 and promoted learner-instructor and learner-learner types of interaction through the use of forums. However, the majority of students did not use the iCT Portal as a communication tool; they used it mainly to retrieve information. There was some information-sharing through posting outside sessions in the forums, but practically no discussion and collaboration within the student groups (Table 5Go). Synchronous face-to-face access to the tutor and their colleagues during the practical sessions is probably one reason for not using this feature in the sessions. The reasons for the unsatisfactory use of this feature outside the sessions are not clear. Some possible explanations could be the students’ previous inexperience with online forums and their preference for other types of communication or that the session material itself did not actually promote online communication. This remains to be investigated in the future.

However, it is encouraging that when students used the iCT Portal forums to communicate with their colleagues and tutors, they then seemed to perceive the value of the system as more important. Figure 2Go correlates the data from Table 4Go and Table 5Go. One could argue that those more comfortable with the use of the software were the ones expected to post more. But it is not always true that the most comfortable users are those who post in forums. A wide variety of reasons are put forward for active participation.46 It was also important that new undergraduate intakes explored those capabilities of the environment to a greater extent than did students in the more senior B.D.S. years.

Finally, no difference in relation to the usefulness and difficulty of the different approaches applied was found in the students’ responses to the questionnaires and in the nominal group sessions, but as the aim of this study was not to evaluate those three approaches, those data have limited value. It is clear, however, from the non-participant observations that as we move from behaviorism to minimalism and constructivism, learner-to-learner interaction and group formation increase significantly.


   Conclusions
Top
 Abstract
 The ict course
 Methods
 Results
 Discussion
 Conclusions
References
 
Within the limitations of this study, the following conclusions can be drawn. The majority of the students were satisfied with the ICT course in its current form. There were statistically significant differences between the student groups (years) on several questions, but no significant differences between males and females were found.

The online component of the course was accepted as a valuable resource by the majority of learners. This type of blended-learning environment decreases the necessity for online collaboration. Online information-sharing outside the sessions occurred, but no evidence of online collaboration was recorded.

Both face-to-face and online structured sessions were similarly understandable and valued. The future use of the virtual learning environment increased when learners perceived it as a communication tool.

The different pedagogical approaches did play a role in collaborative learning, but according to the students, not on session difficulty and usefulness. More than a single group evaluation may be required for this type of research to avoid coincidental findings.


   Footnotes
 
Dr. Pahinis is a Dentist and a Ph.D. student, Department of Adult Dental Care; Dr. Stokes is a University Teacher, Department of Adult Dental Care; Dr. Walsh is a Professor of Restorative Dentistry and Dean; and Dr. Cannavina is Director of the WILeN Project, Department of Adult Dental Care—all at the School of Clinical Dentistry, University of Sheffield. Direct correspondence and requests for reprints to Dr. Kimon Pahinis, Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, United Kingdom; 00441142679741 phone; 00441142665326 fax; k.pahinis{at}sheffield.ac.uk.


   REFERENCES
Top
 Abstract
 The ict course
 Methods
 Results
 Discussion
 Conclusions
 References
 

  1. Cornell R. The onrush of technology in education: the professor’s new dilemma. Educ Technol 1999; 39(3): 60–3.
  2. Garrison DR, Kanuka H. Blended learning: uncovering its transformative potential in higher education. Internet Higher Educ 2004; 7:95–105.
  3. Maye T. Teaching, technology and talk. Psychologist 1998; 11:375–7.
  4. Fitzgerald WF. The instructional use of computers in dental education. Comput Biol Med 1973; 3:307–18.[Medline]
  5. Mast RA, Watson JJ. Dental learning resources center. J Dent Educ 1976; 40:797–9.[Abstract]
  6. Stephens C, Grigg P. A computer-based orthodontic learning package: report of a trial. Dent Update 1994; 21:64–8.[Medline]
  7. Vullo RP, Eisner J. DentLE—the dental learning environment: a prototype demonstration. Proc Annu Symp Comput Appl Med Care 1992:800–1.
  8. Irvine NR, Moore RN. Computer-assisted instruction in mixed dentition analysis. J Dent Educ 1986; 50:312–5.[Abstract]
  9. Demirjian A, David B. Learning medical and dental sciences through interactive multi-media. Medinfo 1995; 8(Pt 2):1705.
  10. Grigg P, Stephens CD. Computer-assisted learning in dentistry: a view from the UK. J Dent 1998; 26:387–95.[Medline]
  11. Lechner SK, Thomas GA, Bradshaw M. Interactive computer teaching/learning in the dental curriculum: partial denture design. Aust Prosthod J 1995; 9:21–6.
  12. OECD. OECD broadband statistics. At: www.oecd.org/document/16/0,2340,en_2649_34225_35526608_1_1_1_1,00.html. Accessed: June 2006.
  13. Komolpis R, Johnson RA. Web-based orthodontic instruction and assessment. J Dent Educ 2002; 66:650–8.[Abstract]
  14. Grimes EB. Student perceptions of an online dental terminology course. J Dent Educ 2002; 66:100–7.[Abstract]
  15. Lechner SK, Kandlbinder P, Gonsalkorale S, Bradshaw M, Harris K, Rasool F, et al. Negotiating the maze: problem based, collaborative distance learning in dentistry. Annu Rev Australas Coll Dent Surg 2000; 15:315.
  16. Peroz I, Seidel O, Boning K, Bosel C, Schutte U. Dentocase: open-source education management system in dentistry. Int J Comput Dent 2004; 7:169–77.[Medline]
  17. Allen R. The web: interactive and multimedia education. Comput Networks ISDN Systems 1998; 30:1717–27.
  18. Starr DR. Virtual education: current practices and future directions. Internet Higher Educ 1998; 1:157–65.
  19. Watson JB. Behaviorism. New York: Norton, 1924.
  20. Skinner BF. The technology of teaching. New York: Meredith Corporation, 1968.
  21. Dewey J. Democracy and education. New York: The Free Press, 1916.
  22. Vygotsky LS. Mind and society: the development of higher psychological processes. Cambridge: Harvard University Press, 1978.
  23. Carroll JM. The Nurnberg funnel: designing minimalist instruction for practical computer skill. Cambridge, MA: MIT Press, 1991.
  24. Andrews KG, Demps EL. Distance education in the U.S. and Canadian undergraduate dental curriculum. J Dent Educ 2003; 67:427–38.[Abstract]
  25. Kassebaum DK, Hendricson WD, Taft T, Haden NK. The dental curriculum at North American dental institutions in 2002–03: a survey of current structure, recent innovations, and planned changes. J Dent Educ 2004; 68:914–31.[Abstract/Free Full Text]
  26. Hendricson WD, Panagakos F, Eisenberg E, McDonald J, Guest G, Jones P, et al. Electronic curriculum implementation at North American dental schools. J Dent Educ 2004; 68:1041–57.[Abstract/Free Full Text]
  27. Hendricson W, Eisenberg E, Guest G, Jones P, Johnson L, Panagakos F, et al. What do dental students think about mandatory laptop programs? J Dent Educ 2006; 70:480–99.[Abstract/Free Full Text]
  28. Kennedy DM. Standards for online teaching: lessons from the education, health and IT sectors. Nurse Educ Today 2005; 25:23–30.[Medline]
  29. Alonso F, Lopez G, Manrique D, Vines JM. An instructional model for web-based e-learning education with a blended learning process approach. Br J Educ Technol 2005; 36:217–35.
  30. Shaffer K, Small JE. Blended learning in medical education: use of an integrated approach with web-based small group modules and didactic instruction for teaching radiologic anatomy. Acad Radiol 2004; 11:1059–70.[Medline]
  31. Armstead P. Designing, embedding and evaluating C&IT through action research. Active Learning 1999; 11:22–6.
  32. Lousberg M, Soler J. Action research and the evaluation of IT projects. Active Learning 1998; 8:1–8.
  33. Coghlan D, Brannick T. Doing action research in your own organisation. London: Sage Publications, Ltd., 2001.
  34. Moser CA, Kalton G. Survey methods in social investigation. Hants, UK: Dartmouth Publishing Company Limited, 1993.
  35. Delbecq AL, VandeVen AH. A group process model for problem identification and program planning. J Appl Behav Science VII 1971; 7(4):466–91.
  36. Reis HT, Judd CM. Handbook of research methods in social and personality psychology. Cambridge, UK: Cambridge University Press, 2000:181–2.
  37. Louis C, Lawrence M, Morrison K. Research methods in education. 5th ed. New York: Routledge Farmer, 2000.
  38. SPSS for Windows v13. At: www.spss.com/spss/. Accessed: June 2006.
  39. Mazhindu D, Moore K, Scott I. An introduction to statistics for health care practice. London: Sage Publications Inc., 2005.
  40. Schleyer T. Assessing outcomes of an academic computing initiative. J Dent Educ 1998; 62:432–40.[Abstract]
  41. Mattheos N, Nattestad A, Schittek M, Attstrom R. Computer literacy and attitudes among students in 16 European dental schools: current aspects, regional differences and future trends. Eur J Dent Educ 2002; 6:30–5.[Medline]
  42. Berridge E, Roudsari A, Taylor S, Carey S. Computer-aided learning for the education of patients and family practice professionals in the personal care of diabetes. Comput Methods Programs Biomed 2000; 62:191–204.[Medline]
  43. Lechner SK, Thomas GA, Bradshaw M. An interactive multimedia solution to learning removable partial denture design. J Prosthod 1998; 7:177–82.
  44. Tulving E, Kroll N. Novelty assessment in the brain and long-term-memory encoding. Psychon Bull Rev 1995; 2: 387–90.
  45. Moore MG. Three types of interaction. Am J Distance Educ 1996; 3:1–7.
  46. Preece J, Nonnecke B, Andrews D. The top five reasons for lurking: improving community experiences for everyone. Comput Hum Behav 2004; 20:201–23.



This article has been cited by other articles:


Home page
 J Dent EducHome page
K. Pahinis, C. W. Stokes, T. F. Walsh, E. Tsitrou, and G. Cannavina
A Blended Learning Course Taught to Different Groups of Learners in a Dental School: Follow-Up Evaluation
J Dent Educ., September 1, 2008; 72(9): 1048 - 1057.
[Abstract] [Full Text] [PDF]

Home page
 J Dent EducHome page
F. D. Salajan and G. J. Mount
University of Toronto's Dental School Shows "New Teeth": Moving Towards Online Instruction
J Dent Educ., May 1, 2008; 72(5): 532 - 542.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pahinis, K.
Right arrow Articles by Cannavina, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pahinis, K.
Right arrow Articles by Cannavina, G.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS