HUfiAN ANAYQMY SNSTRUCTIOR‘ ENVQL¥§N$ A PEER ASSiSYEE’ LEARMNG DESK}?! 5AM?) COMFL‘TER TWOREAL‘i s MEWS"! KEN. a. . LIBRAR Y Michigan Sm: University This is to certify that the thesis entitled HUMAN ANATOMY INSTRUCTION INVOLVING A PEER ASSISTED LEARNING DESIGN AND COMPUTER TUTORIAL INTERACTION presented by ROBERT JOSEPH HILBERT has been accepted towards fulfillment of the requirements for _P1L..D_.__ degree in _Anatomy_ flaw . Major profe Date I 77 HUMAN ANATOMY INSTRUCTION INVOLVING A PEER ASSISTED LEARNING DESIGN AND COMPUTER TUTORIAL INTERACTION BY Robert Joseph Hilbert A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Anatomy 1977 ABSTRACT HUMAN ANATOMY INSTRUCTION INVOLVING A PEER ASSISTED LEARNING DESIGN AND COMPUTER TUTORIAL INTERACTION BY Robert Joseph Hilbert Both peer teaching and learning sessions and computer managed drill and practice sessions appear to be effective in— structional strategies: not as a replacement for the classroom teacher but rather as supplementary and complimentary to the traditional format. In order to evaluate the effectiveness of instruction augmented with computer interaction and peer assisted learn- ing. one hundred and eight community college students enrolled in Human Anatomy, Physiology and Medical Terminology at Delta College, University Center, Midhigan, were randomly assorted into a six-group Solomon research design. The first and sec- ond groups were pre-tested for their prerequisite knowledge of osteology. The testing instrument consisted of 20 ques— tions requiring a written response to test items representa- tive of behaviors expected for this instructional unit. This particular testing format was employed so that spelling could also be evaluated. Groups Two and Four received traditional instruction, based on lecture-recitation and laboratory Robert Joseph Hilbert demonstration. Groups One and Three attended the group anat— omy lecture but the usual laboratory experience was replaced with the experimental protocol of Peer Assisted Learning and Computer-Assisted Drill and Practice. Experimental Group Five received only the Peer Assisted Learning (PAL) sessions as lecture supplements. Experimental Group Six received only the Computer Augmented Instructional (CAI) supplements. All groups received the same post—test having the same for— mat as the pre-test, but containing different test items. Students comprising the experimental group were re- quired to schedule at least an hour of computer assisted drill and practice each week. The Peer Assisted Learning sessions for this group required the student to study and learn anatomy concepts and 'teach' them to classmates indivi— dually and in small groups. Students alternately had the op— portunity to teach and be taught. Random assortment of experimental groups was approved by analysis of pre-test scores for separate groups. Analy- sis of student biographical data further confirmed group equivalency. By paralleling the common pre-test, post—test, control design with experimental and control groups lacking the pre- test, both the main effects of testing and the interaction of testing and the experimental protocol were determinable. In this way, not only is generalizability increased, but in addition, the effects of the experimental protocol were re— plicated in four different ways with these results: Robert Joseph Hilbert 1. All post- -test scores were significantly greater than pre-test scores. 2. Post-test scores for experimental groups were significantly greater than post-test scores for control groups. 3. Post-test scores for pre—tested group were not significantly greater than group not pre-tested. 4. Post-test scores for experimental groups not pre-tested were significantly greater than pre- test scores of equivalent groups. Significantly greater achievement was demonstrated in groups receiving the PAL and CAI augmented instruction. There was no evidence of a pre—testing influence. Ancillary inquiries showed spelling errors to be less and study time reduced for students receiving the PAL and CAI protocol. Both control and treatment groups showed reduced retention after six months. In addition, post-test achievement was found to be. greater for groups receiving the combined PAL and CAI in— structional supplements, as compared with independent ad- ministration. Student attitudes for the experimental proto— col were conservative but favorable. Most students were re- ceptive to an instructional strategy that allowed them ac- tive participation. Dedicated to Dr. Pamela K. Hilbert, DDS my wife 'PAMI' ii ACKNOWLEDGMENTS The support of doctoral research in the area of anatomy instruction is in itself unique for a Medical School Anatomy Department. Michigan State University is indeed fortunate to have on its medical faculty, Dr. Allen W. Jacobs whose en- couragement and enthusiasm for improving instructional metho— dology has been exemplary for me in this pursuit. The counsel and advice of my Doctoral Guidance Committee was substantive and cordially offered. For their support, I wish to express my sincere appreciation to: Dr. Robert Echt College of Human Medicine Department of Anatomy Dr. Allan J. Abedor College of Education Department of Educational Development Dr. Walter Hapkiewicz College of Education Department of Educational Psychology Dr. Allen W. Jacobs, Chairman College of Human Medicine Department of Anatomy A special thanks to Viola Schwartz for translation, transcription and composition. Also, thank you, Marie Sharp, Kathleen Seder and Janet Wood. iii Chapter ONE. WOO FOUR. TABLE OF CONTENTS INTRODUCTION AND HISTORICAL PERSPECTIVES The Problem . . . . . . . . . . . . Related Learning Theory . . . . . . Personalized System of Instruction PAL and CAI as Proposals for Change LITERATURE REVIEW: COMPUTER-ASSISTED INSTRUCTION . . . . . . . . . . . . Tutorial . . . . . . . . . . . . . Problem-Solving . . . . . . . . . . Simulation . . . . . . . . . . . . Drill and Practice . . . . . . . . Arithmetic . . . . . . . . . . . . Summary . . . . . . . . . . . . . . LITERATURE REVIEW: PEER ASSISTED LEARNING . . . . . . . . . . . . . Summary . . . . . . . . . . . . . . EXPERIMENTAL DESIGN . . . . . . . . . Rationale . . . . . . . . . . . . . Research Design . . . . . . . . . . Composition of Research Groups . . Response Table One . . . . . . . . Control and Experimental Instruc- tional Formats . . . . . . . . . Ancillary Studies . . . . . . . . . Study Time . . . . . . . . . . . Spelling Accuracy . . . . . . . Retention . . . . . . . . . . . Attitudinal Evaluation . . . . . Research Hypotheses . . . . . . . . iv Page 18 21 27 28 30 31 33 36 SO 53 53 56 65 66 68 76 76 76 76 77 77 Chapter Page FIVE. RESEARCH FINDINGS . . . . . . . . . . . . 80 Statistical Analysis to Test for Random Distribution of Test Subjects . . . . . . . . . . . . . 82 Statistical Analysis to Test for Effectiveness of Traditional Teaching . . . . . . . . . . . . . 83 Statistical Analysis to Test for Prompting Influence of Pre- testing . . . . . . . . . . . . . 84 Statistical Analysis to Test for Effectiveness of the Treatment Protocol PAL & CAI . . . . . . . . . 86 Evaluation of Peer Assisted Learning and Computer Assisted Instruction as Independent Instructional Supplements . . . . . . . . . . . . 88 Evaluation of Study Time as a Func— tion of Instructional Protocol . . . 90 Evaluation of Spelling Accuracy as a Function of Experimental Protocol . 91 Evaluation of Six Month Retention as a Function of Instructional Protocol . . . . . . . . . . . . . . 94 Evaluation of Student Attitudes To— ward the Experimental Protocol of Peer Assisted Learning and Com- puter Assisted Instruction . . . . . 96 Student Opinion Toward Peer Assisted Learning . . . . . . . . . . . . . . 100 Student Opinion Toward Computer Assisted Instruction . . . . . . . . 102 SIX. CONCLUSIONS AND RECOMMENDATIONS . . . . . 107 APPENDIX A . . . . . . . . . . . . . . . . . . . 120 . . . . . . . . . . . . . . . . . . . 122 . . . . . . . . . . . . . . . . . . . 125 . . . . . . . . . . . . . . . . . . . 131 . . . . . . . . . . . . . . . . . . . 136 147 . . . . . . . . . . . . . . . . . . . 1J0 . . . . . . . . . . . . . . . . . . . 158 . . . . . . . . . . . . . . . . . . . 159 . . . . . . . . . . . . . . . . . . . 161 QtfifiIQ'UFJU(3U1 Chapter Data Data Data Data Data Data Data Data Data Data Data Data Data Data Data Data Data Data Data APPENDIX K . Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table APPENDIX L . BIBLIOGRAPHY One . Two . Three Four Five Six . Seven Eight Nine Ten . Eleven Twelve Thirteen Fourteen Fifteen . Sixteen . Seventeen Eighteen Nineteen vi Page 164 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 185 190 CHAPTER ONE INTRODUCTION AND HISTORICAL PERSPECTIVES The Problem Large, mixed ability, classes are typically seen in the colleges of today, especially at the undergraduate level. The typical community college has an admission policy of complete "open-door" to all individuals having a high school, or equivalent, education. Such a policy results in a broad range of abilities among students and a definite challenge to the educational process. As a result, many students are forced into a non-participation role in the classroom and of~ ten experience the college or university as an alienating en- vironment. This problem becomes acute as higher education becomes even more available to larger numbers. The ineffec- tiveness and impersonal character of the large lecture classes conditions students as passive observers in the edu- cational process. The lecture system, for instance, assumes that all students have the same capability and can learn at the same rate of speed. Grading often depends on whether the student understood the material at the rate it was given. The lecture system has other drawbacks. In some ways it is too unstructured. Some lecturers follow a text or outline, but many discuss whatever comes to mind at a particular time of day. In other ways the lecture system is too structured. 1 2 Students are required to be in a certain place at a specific time to hear the lecture. Exams for courses are usually scheduled within a short period of time and few exceptions are made for any outside problems or commitments (financial, social, personal) a student may have. There is always change going on in teaching, whether we arrive at anything new is another question, but there is change. Most teachers, in fact, are constantly "trying hard- er" to spice up their lectures, to prepare better tests, to make discussions more worthwhile, and to spend more time talk- ing with students as individuals. These innumberable trial and error efforts are essential to good teaching, but they are difficult to describe and to evaluate. Many of the educational problems of the 1960's persist. Many instructional strategies of the 1970's could well be criticized for apparent aimlessness, and of being deadening, formalistic, mechanical, passive, and rote. Modern learning systems, which make use of tape, slide film loop, closed-circuit television, programmed, and mas- tery models, in many ways fail to meet the educational chal- lenges of (a) providing individualized instruction, (b) in- creasing motivation, (c) scheduling enrichment opportunities, and (d) encouraging self-realization. So, until educational research confirms the merits of an alternate approach, we practitioners continue with the "tried and true" lecture, practical and tutorial methodology. Related Learning Theory Experiments in developmental and educational psychology have shown that more efficient methods of teaching can be de- vised. When B. F. Skinner published his treatise on behavior analysis, outcries reverberated through all segments of so- ciety. Psychologists, psychoanalysts, poets, preachers, and politicians charged that in Beyond Freedom and Dignity Skinner (1971) had equated people with pigeons and rejected those qualities that set humans apart from animals. But the humanists weren't the only ones out to crucify Skinner. Some doubting Thomases among the behaviorists denied their master's philosophy while continuing to practice his techniques. One reason they and a host of pragmatic practitioners continue to operate in the Skinnerian mold is the immediate positive. reinforcement it provides. In other words, the scientific model of behavior modification works. It produces the de- sired effects rapidly and efficiently. So, regardless of philosophical implications, behavior technology is being used increasingly on a variety of levels in a variety of areas. Teachers have been meting out combinations of reward and punishment to students for hundreds of years and they will continue to do so, with or without formal knowledge of the principles of reinforcement and their relation to learn- ing. The Skinner and Gagne concepts of reinforcement have been a central theme in the historical development of sev- eral theories of learning and their applications to educa- tion, but psychology did not discover this phenomenon nor v.1 . 'V n bl ~- ‘- L) 1 4 invent the term. Its effects can be seen wherever people learn and change their ways of doing things. Understanding the theory of reinforcement is worthwhile in its own right as well as for guiding the teacher as he adapts and reshapes its principles to fit the special conditions of his course. The importance of reinforcement for college teaching should not be prejudged by textbook conceptions of salivating dogs, bar—pressing rats, and eye-blinking humans. These are laboratory arrangements used to determine precise conditions and to test hypothesis derived from theory. Reinforcement is the behavioral counterpart of "feedback" in a cybernetic sys— tem and in essence it means that a given response is strength— ened (or weakened) by the consequences of having made that re- sponse. Teachers implement the effects of reinforcement near- ly every time they meet with students or evaluate their tests, papers, and reports. The contingencies of reinforcement (the dependent consequences of particular responses) can be posi- tive or negative: as blunt as a kick on the shins or as sub— tle as a vocal inflection, or a word 29; used. The short and intensive history of programmed instruc- tion illustrates an over—simple, over-managed and over- controlled use of reinforcement. Demonstrating that one knows the right answer to someone else's questions is less rewarding to college students than pursuing a personal line of inquiry. As a consequence, the technology of programmed learning has not been widely used in higher education and the teaching machine rather quickly ran its course as a rela— tively trivial page-turning device. The alogorithmic 5 chaining of questions and answers gave "feedback" to students that they didn't really need and constrained the otherwise powerful effects of the reinforcement principle. But the con- cept of programming as a mgggl for organizing a course to— ward explicit objectives, has become a significant force on the college campus. These developments have mushroomed during the past three years under various labels, although the common feature is best represented by the heading: self-paced supervised study. Several specific applications of the programming (or reinforcement) model would include: mastery learning, modu— lar units, precision teaching, contingency contracting, con- tingency management, and the Keller Plan. The influence of Keller's research and instructional de- sign has been extensive. Its success was particularly in- spirational for my continued research with peer and computer augmented instruction. Because of this influence, the Keller Plan should be further detailed. Many features of the Keller Plan are incorporated into the research design of this thesis. In a 1967 address Professor Fred Keller (1967), a dis- tinguished investigator of basic processes of learning, des- cribed to fellow educators a method of college teaching which breaks radically with past practices. In the eight years since Keller’s address, the method--sometimes known as "self-paced supervised study" but often called simply the Keller P1an--has been applied in numerous college courses around the country. 6 The work of a course taught by the Keller Plan is di— vided into units. In a simple case, 15 units may be deline— ated which reflect the 15 chapters of the course text. A stu- dent starting the first unit is given a printed study guide that introduces the unit, describes its objectives, recom— mends procedures for studying to achieve these objectives, and includes sample questions. The student works individual- ly on the unit, and must demonstrate his mastery of the ma— terial before moving on to the next unit in the sequence. Mastery is ordinarily demonstrated by perfect or near perfect performance on a short-essay examination (Keller's preference for his introductory psychology course). The stu— dent may take an examination on a given unit whenever he feels ready, and failure to pass the test on the first try, the sec- ond, the third, or even later, is not held against him. How- ever, he is given the study guide for the next unit only af— ter he demonstrates mastery of the unit. Thus, students move at their own pace through a course from start to finish. A student may meet all course requirements in less than a se- mester, or he may not complete the course within the semester. Throughout much of the course, the classroom simply functions as a study hall, where the student may read course material. Lectures and demonstrations are given less fre— quently than in a conventional course (perhaps six lectures in the course of a semester). In Keller's courses lectures and demonstrations were vehicles for motivation: they were not compulsory and no examination was based on them. 7 Keller (1968) summarizes those features of the plan that seem to distinguish it most clearly from conventional teach- ing procedures. "(1) "(2) "(3) "(4) "(5) The go—at-your-own-pace feature, which per— mits a student to move through the course at a speed commensurate with his ability and other demands on his time. The unit-perfection requirement for advance, which lets the student go ahead to new ma- terial only after demonstrating mastery of that which preceded. The use of lectures and demonstrations as vehicles of motivation, rather than sources of critical information. The related stress upon the written work in teacher-student communication: and finally, The use of proctors, which permits repeated testing, immediate scoring, almost unavoid— able tutoring, and a marked enhancement of the educational process." It has been estimated that over 500 faculty members in' a variety of disciplines have taught (or are about to teach) Keller-based courses. Net all the courses include all five of the features described by Keller: modifications have been introduced to fit a variety of local demands. A review by Kulik (1973) of early reports on application of Keller-based plans made the following points: 1. Students taking Keller courses report spending a good deal of time on their studies. Several investigators report relatively high dropout rates from Keller-based courses, and the most frequent comment from students who withdraw is that these courses are "too much work.” Students finishing Keller—based courses usually are given high grades. Since grades are as- signed in a manner having little parallel in traditional courses, grade distributions do not necessarily indicate that students learn more. but there are no reports of poorer learning under the Keller Plan. 't- 8 3. In a number of comparisons, there are no sig— nificant differences on final examination per- formances of students in Keller and conven— tional classrooms and in a few investigations, students studying under the Keller Plan do somewhat better on final examinations. Inter- pretation of these results must take into ac- count dropout rates. 4. Most studies show that students completing Keller courses are highly satisfied with the learning method. In the University of Florida project, for instance, all students reported that they preferred the unit-performance for- mat to typical course formats. Evidence show- ing strong student dissatisfaction with the Plan has not yet been presented. Interpretation of these results also must take into account dropout rates and grading practices. 5. There is some consensus among those who have used the Keller Plan that undergraduate stu- dents serving as proctors benefit especially from the method. 6. Several authors have noted the possible cost— savings to institutions using the Keller Plan. The use of undergraduate assistants is one basis for the economy. After over a decade of racing to produce more scientists than the Russians, educators are taking a long, second look at science for the citizen, introducing healthy doses of lit- erature and historical perspective into even the most rigor- ous disciplines and allowing the student to discover science for himself, as the "new humanity." Currently we see a change in educational philosophy from mass education for the masses to relevant, individualized instruction. At the same time, a "Fourth Revolution" is taking place throughout the educational world, with sophisticated elec- tronics beginning to assist the teacher in providing infor- mation, guidance and the inevitable testing to students. 9 Armed with new discoveries in educational psychology and the experience gained in 10 years' experimentation under abundant government funding, academic innovators are eager to apply this Fourth Revolution to science education. But they are already being challenged by declining financial sup— port, decreasing science enrollment and competition from pri— vate industry. It is not surprising that great interest in learning should arise at the present time. The current movement to— ward educational reform has been closely related to a number of highly significant educational trends: decentralizing of teadhing, differentiated staffing, the individualization of instruction, the self—help and the human potential movements, the need for more teaching resources, the growing criticism of competitiveness in the schools and the demand for more co— operative learning situations, the use of the consumer of the service as a service giver, the demand for accountabili- ty in the schools and the recognition of the schools' waste and inefficiency, and the great new emphasis on participatory processes, the recognition that the teacher is not the sole repository of knowledge and the concomitant demystification of the learning process, the increased interest in tutorial methods, and the popularity of such informal learning as ed- ucational television. There is increasing recognition today that learning need not be a win-lose game in which some pupils presumably learn a good deal in a competitive grading system and others do not. 10 As in most enterprises of man, there is the element of derision. Such is the case with modern learning theory: how- ever, this discord often provokes continued research rather then establishing a destructive schism. The "Discoverist" and "Behaviorist" have carefully constructed cogent arguments for their separate points of view. The Discoverist's theory of education, for instance, is based in part on the work of the Swiss psychologist Jean Piaget. For the past 40 years Piaget has been investigating intellectual development. Experiments with children have led him to conclude that intelligence develops through various stages, stemming from active interaction with the environment. In the first or sensori~motor stage a child learns basic con- cepts of the physical world by being exposed to a variety of tangible and visible objects. This and other intermediate stages are necessary, says Piaget, before a child or student can build up to more difficult, abstract modes of thinking. In a traditional chemistry course, for instance, stu- dents memorize formulas and perform classic experiments that confirm foregone conclusions. According to Piaget this can be damaging to lively minds. Instead, his theory says, stu- dents should learn the basic principles of chemistry by being allowed to develop their own experimental projects. Dis- covery through doing, says Piaget, not only teaches but can awaken original thinking (Wadsworth, 1971). At the same time this discoverist approach was being de— veloped and expanded, a behaviorist or stimulus-response ap— proach to education was gaining acceptance among educators. 11 The Harvard psychologist B. F. Skinner has been an influ- ential theorist for this school of thought. Experimenting with animals instead of humans, Skinner (1968) developed a method of teaching that is much more structured and control- led than that of Piaget. Upon operant conditioning or rewarding desired re- sponses, Skinner has been able to teach pigeons to play Ping— Pong. Because both pigeons and humans are organisms, Skinner pontulated that operant conditioning and a mechanical treat- ment of stimuli and responses could be used in the classroom. The desired response being a correct answer and rewarding re- inforcement being approval from the teacher or, in the case of a teaching machine, permission to go on to the next prob— lem. In a chemistry course hundreds of formulas and reac- tions can be learned in this way. By designing precise con? tingencies, Skinner suggests that very subtle discriminations can be taught. Discoveristswould say such learning is mere- ly mechanical mastery of skills and leaves no room for ori- ginal or insightful thought. Behaviorists would answer that insight is nothing more than the proper use of previously con- ditioned responses. The discoverist and behaviorist approaches are not dia- metrically opposed and they are not mutually exclusive. But putting either of them into operation requires trained teach- ers, special texts and specially designed equipment and en- vironments. The discoverist teacher needs texts that are based on Piaget's stages of development, a variety of stimu- lating objects and equipment and an open type of classroom. 12 The behaviorist teacher, on the other hand, needs a whole different set of texts (programmed instruction sets and even teaching machines) and a highly structured environment. One teacher or group of teachers might decide on a par— ticular teaching methodology only to find that the materials are not available. Even when the materials are available, a student might move from one teacher and theory in the morning to a completely different approach in the afternoon. A spe- cific theory or approach is necessary if a teacher is to do more than impart information on a hit-or—miss basis, but the superimposition of theories, subtheories and neotheories on <1lder theories leads to a muddled education system. It is tilis muddle that is at the root of much of the criticism leaveled at our present education system. Pearsonalized System of Instruction For years teachers have been giving gold stars for good garades or good behavior. But Skinner and behavior technology TRIVE taught more than positive reinforcement to teachers. Innogrammed instruction and teaching machines are the result Cfi71nore sophisticated uses of behavior modification. One System in particular--based on Skinnerian conditioning and learTIing theory--is gaining increasing acceptance in univer- Sitiéés and colleges. It is known as the personalized sys- ta“ CDf'instruction (PSI), and was designed by Fred S. Keller (19653) £§E_§Eyd CAI as Proposals for Change ,And who will carry out the innovations of the "Fourth R9W31ution"? In a 1967 paper, the biologist-educator. 13 Sir Eric Ashby, classified four revolutions in education: 1) Shift of education from parent to teacher. 2) Adoption of the written word. 3) Invention of printing. 4) Introduction of computerized instruction. According to a report entitled "The Fourth Revolution" by the Carnegie Commission on Higher Education (1972), electronic ed- ucation will lessen routine for faculties and offer a richer variety of courses and increase the opportunity for indepen- dent study by students. But the success of this technology in education will require more talent than money. New tech- Iualogy and curriculum changes can be beneficial, but it is al- sc> a matter of GIGO (Garbage in, Garbage out). You put gar- kmage into the computer, and you will get nothing other than ga rbage out . The fact that well-conceived CAI (Computer—Assisted In- stzruction) can and does lead to increases in instructional cuitput has been well publicized. What has received less pub- lLicity, however, is the fact that these learning gains are at— tnxtbutable less to the hardware aspects of CAI than they are tothe pedagogical wisdom built into the CAI software, the aCtLhal programs that control the responses of the computer to the :student. The most effective CAI programs always gave stu— dentfls individually tailored remediation, pin—pointing the stu- dent'-'s errors for him, and often suggesting an improvement. Suckl programs also insured that a student would get as much prafirtice as he needed to be able to satisfy the requirements 0f tflae lesson. In effect, the CAI student could carry on a 14 continuous instructional dialogue with a highly accurate and proficiency-oriented tutor. That such applications of CAI have been successful comes as no surprise when one contrasts this pedagogical quality of this kind of CAI experience with the experience offered in the typical classroom setting. Cost and availability factors greatly limit CAI imple— mentation for most colleges. What is needed is an education- al strategy that encompasses the merits (e.g. Drill and Prac- tice opportunities) of CAI and could be easily, quickly and economically put to use in the classroom. I perceive the PAL system as one possible solution. Peer Assisted Learning. The essential notion underlying the PAL system is that trle critical supervisory functions that are attended to by a nuacmine in CAI can, in principle, be attended to by a trainee ir1 a sort of buddy system. One in which each member plays al- tearnating "teacher" and "student" roles. Net only might the tasainee functioning as a student derive all the benefits of tlue CAI trainee, but so might the trainee functioning as a teacher derive special benefits resulting from his special role; in relation to his pal. Such a system of peer assisting peer, resolves the well known) instructional problems of inadequate opportunity for Supelfvised practice that students can actually receive in con"’Eiilntionally structured teacher-mediated learning environ- mentEB- The PAL system has involvement as its greatest Strerlgth. Even in the best intentioned teacher—mediated ClasBrooms, a sustained level of involvement for any ‘- y.“ ‘5, u.‘ 54. ‘ 15 particular student is an impossibility, especially seen in the large university classes. an-involvement, to whatever extent it exists, inevitably induces the student to 'turn off' or 'tune out.’ Within the PAL system, students working in pairs and within small groups exercise full responsibility for their own instructual progress, each providing pacing and coaching fer the other. The "student" proceeds through the required material at his own pace while receiving immediate feedback as to the correctness of his performance and his progress from his "teacher." When a class is run this way, students can progress as Inupidly as they are able and spend extra time on those points Hm>st difficult for them. They are not required to wait for ttie rest of the class before they can proceed, nor are they' jpearmitted to leave a topic they are not sure of merely be— caruse the majority of their classmates have already moved on. This system, then, insures individualized instruction: it: is the student's own performance, and only his performance, ifluat regulates his progress. Also, because each student must grasqp each part of the course before he is allowed to move on, therta is no uncertainty about what an individual is supposed to learn. Finally, there is no uncertainty in the mind of the stu— dent- as to the correctness of his performance: he is told im- mediEitely whether his response is right or wrong, and if he makQfiS a mistake, he is immediately provided with remediation— al iInformation. ‘..- .u . .. '0 16 PAL, then, uses the buddy system to implement a course of instruction based on a preselected sequencing of content which insures individualized yet uniform teaching. The course instructor would assume the role of implemen- tor, facilitator, organizer and trouble-shooter. His lecture material could become less content directed and more concep- tual in design. Freed from the preponderance of subject mat— ter usually "lectured out," the instructor is permitted to in- tegrate, synthesize and make relevant the topic under discus- sion. His lecture would become more idiosyncratic and more efficaciously paced. The lecture would be more pursuant of affective than cognative objectives. Students working to— gfiather are certainly not very novel to instructors of labora— tc>ry sciences where lab partners are required to make maximum usae of available equipment, but, the control, organization, arnd.management required of the PAL system is unique and, I nuigmt add, essential. Implicit in the "Learning Cell" strategy developed at NkKSill University by Goldschmid (1971) and others, is the necxassity of student preparation in advance of the dyad en- cxnniter. While idealistic in design, pragmatically students are beten less than eager or in some cases even unable to prepare themselves prior to class. The PAL system encourages mutual student learning via a multISL—mediated learning strategy, followed by mutual review. pracilice and evaluation as each assumes the role of "teacher" and "1earner." 17 There is no attempt here to define the PAL system to its finite, but rather to propose an educational strategy. The detail of its implementation will be later hung to this skel- etal philosophy. In essence, I chose to examine the follow- ing considerations: 1. Will instruction, augmented with peer interaction and computer tutorlage, provide a more successful educa- tional experience in the mixed ability classroom found in the large community college? Is the subject of Human Anatomy particularly suited for an instructional design which encourages peer and com— puter interaction? WOuld provisions for student tutorlage outside the class- room stimulate and encourage the lecturer to be less ped- antic and detail oriented and more involved with applica— tion and relevance of material? would peer learning promote the development of scientific communication skills? To what extent can the potent influence of peer pressurev be used in an instructional design? Can the successful application of peer tutorial programs in public schools be implemented at the college under- graduate level? Can the learners need for drill and practice be success- fully administered by the computer? lNill students demonstrate greater learning, longer reten— 'tion, and more satisfaction with a Peer Assisted Learning :System.over conventional teaching strategies? kater the novelty of computer operation has ebbed, will ETFudents continue to utilize the computer as an instruc- tlonal aid? Iqlese considerations are later structured into testable resealrch hypotheses that become the central objective for this investigation . CHAPTER TWO LITERATURE REVIEW: COMPUTER~ASSISTED INSTRUCTION Education, besieged by demands for higher quality and greater quantities of instruction at lower cost, is turning to computer technology for assistance. Success will not be achieved overnight, but computers seem likely to prove as indispensable for education as they have for most other ap- ;plications. One of these intriguing applications is the po- ‘tential of computer-assisted instruction for answering to- ned that CAI is essentially indifferent to the color, SDCial status, or sex of the student, and unlikely to show 'r o. 2O favoritism on these grounds. If CAI does help to hold the interests of the quicker students (with more interesting and advanced material) and the slower ones (with timely assistance, remediation, etc.), and if teachers are able to provide more personal attention to individual students seeking help or more opportunities, then the benefits to society could be enormous. Additional apprehension probably results from the loss of confidence that computers brought upon themselves in the mid 1960's. Far more was promised, even for CAI, than was actually delivered. In the late 1960's, private companies assembled and marketed "CAI Systems" for educational purposes. In most cases, the equipment and software that was pressed into service had been designed for business or scientific applications, and they proved to be too slow, unreliable, and expensive for instructional use. While there are numerous descriptive accounts of com- puter applications in education, there have been few studies to determine the effectiveness of computer-assisted instruc— tion. Attempts to measure the effectiveness of CAI versus other instructional strategies suffer from the same problem as traditional educational research, namely the use of stu- dent achievement of content as the sole criterion of effec- tiveness. Many subjectively based studies are published, but finding conclusive answers in reported research is more difficult. In many ways, CAI research could still be con- Sidemed.in the developing stage. Computer interaction 21 generally follows along four basic modes: tutorial, prob- lem solving, simulation, and drill and practice. TUTORIAL The tutorial mode of computer-assisted instruction is intended to approximate the interaction which would occur be— tween a skilled, patient tutor and an individual pupil. A tutorial system is used to initially present a concept and to develop a student's skill in using the concept. The basic model is the presentation of instructional frames which elicit frequent responses from the student. Each response is then evaluated and appropriate new instructional material is presented on the basis of the pupil's responses. Much of the CAI tutorial material is similar to printed programmed in— structional material. A number of research studies have shown that CAI tu- torial programs are at least as effective as traditional in- structional modes in teaching several subject areas. An early study reported by Atkinson (1968a) concerned the first year of operation of the Stanford CAI Project as conducted at the Brentwood School in East Palo Alto, Cali- fornia. Visual display terminals were used in the teaching of initial reading skills to first graders. A control group received traditional classroom instruction in reading, but were exposed to CAI for mathematics instruction. In terms 0f achievement the group receiving CAI reading instruction Performed significantly better on the California Achievement Test and on a test developed by the Project. 22 In addition to better overall achievement for the CAI group, it was found that boys and girls progressed through the CAI materials at a comparable rate. This is contrary to the long accepted assumption that girls acquire initial read— ing skills at a faster rate then boys. A comparison of cum- ulative rates of progress for fastest, medium, and slowest students showed consistency over time, also suggesting the capability of CAI to accommodate individual differences. Similar results were reported by Fletcher and Atkinson (1972a) in a later evaluation of the Stanford CAI reading pro- gram. Teletypewriter terminals with audio headsets were used for daily eight-to-ten minute sessions of computer-assisted instruction in initial reading. For comparative purposes, the study used 50 matched pairs of first graders, selected on the basis of performance on the Metropolitan Readiness Test and drawn from classrooms having teachers of comparable ability. One student in each pair was taught via the CAI program. while the other student received no CAI instruction in read- ing. Achievement results of the CAI group were compared with those for the group taught in traditional fashion. After one year of instruction, the CAI students made significantly greater gains in average reading grade placement as measured by post-test performance. Again, CAI was found to positvely affect the reading PrOgress of boys compared to girls. Cross—sex comparisons if! this study seem to cooroborate the earlier finding re— PCNrted.by Atkinson (1968b) that boys in CAI reading perform 23 about as well as girls, suggesting a greater rate of prog- ress for boys due to CAI. Mbrgan and Richardson (1972), in describing the Montgomery County Public Schools (Maryland) Project REFLECT, reported significantly higher gain scores on standardized tests for students using tutorial CAI. The pupils were in a remediation program for Algebra II. All students were taught by the same teachers but those who had access to CAI programs made the higher scores. The total instruction time for both groups was equal. In comparing CAI tutorial and the conventional lecture mode of instruction in teaching the basic elements of tests and measurements to prospective teachers, Lorber (1970) found the mean post—test score of the CAI group to be significantly higher. The study, conducted at Ohio University, involved students enrolled in a test and measurement course. The ex- perimental group received course instruction via CAI while the control group attended regular lectures. The Measurement Competency Test was administered to both groups at the con- clusivion of the course. In addition to achieving a higher mean score on the test, it was found that the experimental group had spent less time in instruction than had the con— trol group. The CAI group also indicated a desire to have further contact with CAI both as users and as authors. Cropley and Gross (1973) found no differences in achieve- ment of students who learned the FORTRAN computer programming -hinguage through tutorial CAI, traditional, and programmed in S tructional methods . 24 Even when tutorial CAI does not result in more effec— tive learning, efficiency is often achieved in terms of in- struction time. Proctor (1968), in comparing CAI with a lecture— discussion strategy for the presentation of general curricu- lum concepts at Florida State, found that the only difference between the groups was in the amount of instructional time required, which was less for the CAI group. There was no difference between the groups on achievement or retention. In a study designed to assess the effect of CAI on at- titudes toward CAI and mathematics, Kockler (1973) found simi- lar results. At the end of the study, the 64 college-level students displayed no differences in attitude but the CAI group spent less time in instruction. The compression of time seems also to hold true for adults as demonstrated by Krupp (1972). The Honeywell plant in Walthem, Mass. needed to teach employees general concepts of higher level computer languages and develop their skills in programming in APL. Since the objectives were criterior referenced, no difference was expected between the achievement levels of the CAI and lecture groups: the CAI group, however, spent an average of seven hours learning, with a range of 5-10 hours, while the lecture group spent 24—30 hours covering the same material. Fletcher and Suppes (1972b) in a study of Computer Cur— riculum Corporation reading program for grades four through 813:, found that the CAI program presented about twice as many neWV words as were presented in the comparable classroom text 25 program. The increased amount of material presented was found to prevail even though students used the teletypewriter termi— nals for brief sessions of ten minutes. Alpert and Bitzer (1970) report on experiments aimed at evaluating the effectiveness of a medical science course run on the PLATO system at the University of Illinois. Although the statistics are not given, the researchers claim that those students taught with the PLATO system scored as well in grade performance on a nationally administered test as did a con- trol group. The significant fact was that the experimental group required only one-third to one-half as many student- contact hours of instruction as compared to conventional clas- ses. Further, measurements made over a 26-week period showed the PLATO group to have greater retention than the control group. Alpert and Bitzer come to the following conclusions based on these results: 1. The interactive nature of the system maintains student interest and involvement. 2. The student has considerable choice of alterna- tive teaching strategies and can proceed at his own pace. 3. The program is response—sensitive, which means that lessons can be modified according to the student's performance. Kromhout, Edwards, and Schwarz (1969) report on two StUdies conducted at Florida State University: 1. CAI review lessons were given to student volun— teers. Slightly more than one-third of the class 26 in freshman physics volunteered for this review. Their exam grades on four hourly exams averaged 10 percent higher than those who did not use the review. The authors mention that a selectivity factor might have been present and that students who volunteered for the review might have been more interested or motivated than the average student. This criticism, in my opinion, is im- portant enough to make the validity of the en— tire study questionable. An entire introductory physics course was taught in two ways. One used lectures, PSSC movies, and graduate assistants for consultations: the other substituted a self-paced CAI program for the lectures and personnel at the CAI center for consultations. There were so many volunteers for the experiment that selectivity was not a- problem. (A random sample was taken from the larger number of volunteers.) Results, which are displayed graphically, seem to show that the students in the self—paced CAI group perform better than the students who receive group lec- tures. However, no statistics are given and some important criticisms can be made of the study. The researchers credit the increased in- volvement of the students with CAI in producing the increase in grade points. It is also pos- sible that the self—paced nature of the course 27 was responsible for the increase or that proc— tors in the CA1 center provided better counsel— ing than the graduate assistants. PROBLEM-SOLVING In the problem-solving mode the student develops his own computer program for solution of a problem or a class of programs. In analyzing it for computer solution, the student, it is claimed, gains a deeper understanding of the problem and the algorithm for its solution. Tedlous and repetitious cal- culations are taken over by the computer, freeing the student to focus on structure and relationships and to research for patterns. The most common subject area for use of the computer for problem solving has been mathematics, and the research that has been done in this mode has been in the field of mathe- matics, from grade seven through college. In the Computer—Assisted Mathematics Project at the University High School, University of Minnesota, the BASIC programming language was taught to students in grades seven, nine, and eleven. All students except low achievers learned the language with no difficulty. In this program, however, thnson (1966) found no significant differences in achieve— ment between the students who had continued their regular mathe— .matics curriculum and those who had, in addition, written pro— gréuhs in BASIC. The results were similar for grades seven, nine , and eleven. 28 The Opposite effect was found in a study by Bitter (1970). Five Colorado colleges and universities participated with in- terested instructors teaching a computer—extended introductory college calculus class. Students in the computer—extended classes learned BASIC on their own (with a programmed text) and solved homework assignments by writing and running compu- ter programs. Each instructor also taught a control class which covered the same content but without the computer. The students who were provided with computer«extended instruction achieved significantly higher than did those in the traditional classes. Interestingly, all of these studies report a high degree of interest and motivation on the part of students participat- ing in use of the computer, and little difficulty in learning to program in BASIC, even for seventh graders. Simulation In this mode of computer use, students interact with a c3C>mputer—based model of reality. The model may represent an eGenomic system, a social system, or a set of physical rela- .t*i~onships. In using the simulation students learn the struc- 1:l-Jlre of the system, the relationships and assumptions Operat- jrtfilg, and they have an opportunity to test and refine decision saitlrategies. Often, a science experiment can be simulated on ‘tilile computer when it is too costly, difficult, dangerous, or t:‘:irme consuming to perform in the school laboratory. Computer-based simulations have been developed in virtu- El:Lly all of the sciences, including social science. It is in 4 ; '7‘,“ ‘— ...v» \ ,J (L) (n In ‘D-- ~u.‘ On- my. on v ‘d 29 those areas that research has been reported on the effective- ness of simulations in instruction. Culp and Castleberry (1971) report on two studies at the University of Texas in undergraduate organic chemistry classes. In one, an experimental group was given access to computer simulations in addition to the regular lectures and laboratory exercises. The semester test average for those students who used the computer was significantly higher than those Who did not use it. In the second study, one group used supplementary computer simulations, one had supplementary tu— toring from teaching assistants, and a third group had only the usual lectures and laboratory. The results were equivocal - the computer group scored significantly higher than either of the other two groups on only a few of the chemistry subtests. Another experiment with chemistry laboratory simulation was reported by Hollen, et a1 (1971). Students interacted with a computer simulation to perform qualitative analysis of unknown substances, for example, a substance in the Silver group. A student could, for instance, direct the computer to add 5 drops of a reagent, heat the substance, filter it, per- form a flame test, and so on. The computer reported the re- sult of each action. Some students were shown colored slides of the results, e.g. a test tube with a clear solution and a white precipitate in the bottom. Finally, the student could make a conclusion about the substance, e.g. "lead is present," and was told if he was right or wrong. The results of this study demonstrate that a simulated exercise of this type will produce terminal behaviors equivalent to (or slightly better 30 than) traditional exercise, and at a significant saving in student time. In view of the problems in scheduling equip- ment and laboratories in overcrowded courses, these findings could offer some viable alternatives. Lunetta and Blick (1973) conducted an experiment with computer-based simulations of inductive experiments in force and motion with high school physics students. A control group performed the experiments in a traditional laboratory, using PSSC materials. One experimental group used only com— puter—generated data sheets plus film loops, and a second ex- perimental group used only film loops plus computer simula— tions. Analysis of the data showed that learning was signi— ficantly greater for students using the computer simulations than for either of the other two groups. Furthermore, stu- dents in the control group spend 8.3 times as long in instruc- tional unit activities. However, retention was greater for the control group than the simulation group. A favorable at— titude toward CAI was reported by both experimental groups. Drill and Practice The drill and practice mode of CAI involves the use of the computer to drill students in facts or to assist the stu- dent in practicing skills. With drill and practice, facts or skills are previously learned through some other mode or means. The students then use CAI drill and practice programs to memo- rize those facts or to practice those skills. This has been a very popular mode of CAI and one in which considerable research has been done, particularly in ‘.-‘I -.o¢ -., V p l ‘1- f . 31 elementary arithmetic and language arts. Arithmetic Extensive research on the effectiveness of CAI drill and practice in arithmetic was reported by Suppes and Morningstar (1972a). The students in experimental groups received from 5 to 8 minutes a day of CAI drill and practice in addition to normal classroom instruction in arithmetic. The students in the control group received only normal classroom instruction in arithmetic. The arithmetic portion of the Stanford Achieve— ment Test was used both as a pre-test and as a post-test. About 800 California students in grades 3-6 were in- cluded in the experimental (CAI) groups in 1966-67. During that year the students in the experimental groups gained more than the students in the control (traditional) groups at all grade levels. The differences between gains of the experi- mental and control groups were statistically significant for all grades except the fifth. The largest difference in'gains was in grade four. In general, the low ability students gained relatively more from CAI than did the middle and high ability students. Martin (1973) reported on a study of the effectiveness of CAI drill and practice conducted by TIES, using the Suppes arithmetic programs. Their sample included 1,448 third and fourth grade students in the Minneapolis area. The sample was divided into two groups, a control group that received traditional arithmetic instruction and an experimental group that received in addition to traditional instruction, from five to seven minutes of CAI drill and practice either every «pa 4..— A. .a’ A‘v a *5. v... 5d .,..‘ d‘. u ..i 9,.“ h,. fiv- ‘ a 4 ‘ ~C \V I). (I) 32 day or every other day. The results were analyzed by type of instruction, sex, grade level, and ability level. The stu— dents who received CAI drill and practice gained more than the students who received traditional instruction only. CAI drill and practice was most effective for boys, fourth graders, and low ability students. Arnold (1970) and Scrivens (1970) reported the results of CAI drill and practice in Waterford, Michigan. During 1968—69 CAI drill and practice was used in grades three through six. In 1969-70 it was used in grades two through six. In both years gains on standardized arithmetic achievement tests were com- pared between the CAI students and students receiving tradi- tional instruction. During 1968—69, the CAI students in grades three and four gained more than the non—CAI students, the fifth grade non-CAI students gained more than the CAI students, and the gains were the same for the sixth graders. During 1969—70, however, the gains at all levels, two through six, were greater for the CAI students. Gipson (1971) measured gains in arithmetic ability of seventh grade remedial students with both a standardized test (WRAT) and a test specially designed to measure the objectives of CAI drill and practice. In that study, the gains as meas- sured by the special test were significant although the gains as measured by the standardized test were not. Suppes and Merningstar (1969b) evaluated computer- assisted instruction programs in Russian.. A computer-based Russian program was tested at Stanford on a class of 30 fresh- ment in the fall of 1967 and on 19 sophomores in the fall of 33 1968. The 1967 study used two of the four sections as control groups. The CAI group spent about 50 minutes a day, 5 days a week, receiving computer instruction. Seventy—three percent of the students who started the computer course finished, com- pared to thirty-two percent in the control group. The results show that the computer-based course held the interest of the students significantly better than did the regular course. The study also showed that the computer-based students had lower error rates in all three quarters, but the difference was statistically significant only for the fall term. I would agree with the researcher's opinion that the high mortality rate in the control class biased the experiment against the CAI group. Summary The use of computers as educational tools is still ex- tremely limited when one considers their potential for im— proving the instructional process. Many problems remain to be solved, namely the obvious problems of hardware and costs as well as the deeper problems of understanding the learning process more fully and applying that knowledge in both cur- riculum development and evaluation. Rather than being a unique medium of instruction, the computer should more correctly be considered as the core of a system which combines several different media for instruction- al delivery. Computer-based instruction often makes use of printed display which obviously is not unlike the printed display in texts. The response component of CAI instruction, 34 generally via type, is quite appropriate for information learning. Most of the techniques employed to date have a weak or non-existent pedagogical base. Undoubtedly, we can look for— ward to revisions in this area as more soundly based theoreti- cal approaches are developed. In fact, it is the power of the computer that may well lead to the development and confirma- tion of new theories of learning, through its ability to re- cord and subsequently analyze the reactions of great numbers of students of computer—assisted programs and systems. When this study was begun,it was anticipated that there would be a wealth of research on the effectiveness of CAI. That is not the case. Although there have been some excellent studies of the effectiveness of CAI, most CAI programs have never been evaluated for effectiveness-~at least the results have not been publicly reported. However, based on the research that has been reported, the following conclusions can be drawn: 1. In general, CAI has proven to be an effective in- structional tool as measured by the resulting stu- dent achievement. It appears to be more effective in the tutorial and drill and practice modes than in the problem solving and simulation modes. 2. When students are permitted to proceed at their own rate, they will generally learn more rapidly through CAI than through traditional instructional methods. 35 Retention of material learned does not appear to be as high for some CAI as for traditional in- struction. As a supplement to normal classroom instruction CAI is as effective as other means of individu— alized supplemental instruction. CAI, especially in the tutorial and drill and practice modes, is relatively more effective for low ability students than for middle and high ability students. Except for times when equipment malfunctions, both students and teachers are highly enthusi- astic toward CAI as a means of instruction. CHAPTER THREE LITERATURE REVIEW: PEER ASSISTED LEARNING It has long been known that students learn from their peers. Teachers have made use of monitors, lab partners, and tutors for as long as formal education has existed. But a more significant observation that has captured the imagina- tion of educators recently is that students learn MORE from teaching other students. In recent peer tutoring research, the focus has shifted from the learner to his tutor. Sever- al studies have shown greater gains in achievement for the tutor than for the learner. The tutors gain through repeti— tion, review, reformulation, and raising the learning task from the knowledge to the application level. The technique of learners teaching each other can be traced back to the first century, the great Roman teacher, Quintilian, pointed out in his Institutio Oratoria how much the younger children can learn from the older children in the same class. In Didactica Magna, probably completed in 1632 but published first in 1849, the Meravian teacher, John Comenius, wrote: 36 37 "He who teaches others, teaches himself is very true, not only because of consistent repeti- tion impresses a fact indelibly on the mind, but because the process of teaching in itself gives a deeper insight into the subject taught . . . The gifted Joachim Fortius used to say that . . . if a student wished to make progress, he should arrange to give lessons daily in the subjects which he was studying, even if he had to hire his pupils." A few years later the English schoolmaster, John Brinsley, in his book The Grammar Schoole, which appeared in 1612, des- cribed his use of "two or foure Seniors in each fourme . . . for overseeing directing, examining, and fitting the rest of the children in every way." Cloward (1967). This method of helping the teacher was also used with very young children before the eighteenth century. Jean Baptiste de la Salle, who founded the Christian Brothers to educate young children, outlines in his Conduite des Ecoles the monitorial system he used at Theims in the 1680's. The Reverend JOhn Barnard said in his autobiography that it hap- pened to him when he was a five-year—old schoolboy in Massachusetts in 1686. But it was not until the late eight- eenth century, when the Industrial Revolution spawned intense public interest in education, that mutual instruction became widely publicized. In 1791, the Anglican cleric Andrew Bell took charge of a bOYS' orphanage in Madras, India. Bell found himself un- able to influence the adult teachers available to teach his children properly. Having observed the Hindu system of mu- tual instruction, he turned to his boys for help and dis- covered that they could be excellent teachers to one another. 38 Bell recorded his experience in An Experiment in Educa— tion, published in 1797, and considered himself the inventor of monitorial instruction. But the man who most vehemently and successfully claimed the new" idea for his own and who did the most to spread it as a revolution in education was Jeseph Lancaster, an English Quaker. In 1798 Lancaster opened a school for poor children in London. He intended to hire adult assistanusto help him teach but could not raise the money. As a result he was forced to see whether the children themselves could help one another. Like Bell, Lancaster was so overwhelmed with the constructive consequences of this invention that in 1803 he wrote a book, Improvements in Education, describing his ex- periences and devoted the rest of his life to telling the world about the new educational method. Lancaster lectured passionately on the monitorial sys- tem in Britain, the United States, and South America. His personal endeavors were beset by difficulties, since his proj- ects invariably exceeded his resources, but the ideas he spread and the schools he caused to be established were im- pressively popular for some thirtyyears. In the pursuit of economy, Lancaster grossly overmecha- nized his system. The educational idealists of the day oh- jected and argued that good adult teachers were better than children any time. These protests were somewhat irrelevant at first since there were hardly any teachers—-good or bad. By the mid- nineteenth century, however, the growing supply of teachers 39 and the combined pressures of organized labor, the con- sciences of the rich, and the ideals of the pure in mind led to the birth of public education and the end of the moni— torial system. Economy is not the essential virtue of mutual instruc— tion and many were not deluded by its tempting economic ap— peal. William Bentley Fowle (1875) was one of these. Fowle grew up in Boston. His first experiment with the monitorial system dates back to the early 1820's when he found himself with a school for uneducated poor children on his hands and no teacher. Fowle, who was then a printer and bookseller, took the teacher's place temporarily rather than deprive the children of school. But since no other teacher could be found, Fowle ended up serving for several years as schoolmaster to well over a hundred boys and girls of all ages. Fowle's work was so impressive that in 1827 a group of Bostonians sought him to organize a girls' private school a- long the same lines. This school of about a hundred pupils he taught on his own from 1827 until 1840. For anyone who has lived with children the educational benefits of mutual instruction are apparent. Fowle found that it was the rare child who could not teach something to his classmates. Do we have in mutual instruction an obvious and promising way to personalize and individualize instruction? It is therefore clearly apparent that benefits to both tutor and tutee were recognized and exploited by even the earliest educators. From the monitorial schools of the early nineteenth century came the first normal schools and the first 4O organized teacher training institutions. The experience of the 1960's seems to indicate that the key to learning is in— dividualization and the use of the student as a teacher is one way to increase this individualization. The concept of learning through teaching appears to be one of these basic ideas which works and it is finding a place in a variety of settings. During the last several years, a few dozen schools in the United States have experimented with students teaching each other. The purpose seems to be to help the tutor, the tutee, or both. Compared to the tutee, the tutor may or may not be older, brighter, or more maladjusted: of a different socio-economic class: or attend the same school. The tutor may drag the tutee over teacher—prescribed remedial materials or he may teach a lesson he himself has planned for his pupil: he may serve as drillmaster, friend, consultant, guide, big brother, or teacher. Participants in tutoring programs may be volunteers or they may be selected by authorities: individ- ual, classes, or special clubs set up for the purpose may be involved. Tutoring programs have so far been conceived, planned, and supervised by teachers, but there is no reason why students could not shoulder much of this responsibility. Most of the pilot tutoring programs have been directed to elementary schools and some involve community volunteer groups. In the early 1960's Peggy and Ronald Lippitt (1965) at the Institute for Social Research of the University of Michigan, began work using older elementary and junior high 41 school students to work with younger Detroit elementary grade children in cross—age learning experiences. Their program involves older tutors working directly with the younger chil- dren for 20-50 minutes, three or four days a week in reading, writing, spelling, math, physical education, shop, and other activities. Sometimes the tutors would work with small groups as well as with the single individual. The success and con— tinued operation of this program is dependently related to several behavior modifying outcomes. The behavior and atti- tude of the older tutors were recognized by the younger stu- dents as models for their own behavior. In essence the tutors became very potent and influential socialization agents. Since the older tutors worked closely with the adult teacher in a trust and responsible relationship, their collaborative involvement produces a significant socialization impact for the tutor. The Lippitt's found that the "teaching studentsfl assist- ing in a teaching function, were able to test and develop their own knowledge and discover the significance of that knowledge. In the journal Education News (1968) a New Yerk city pro— gram of student tutoring is reported. Each of thirty stu— dents enrolled in the teacher preparation program at Hunter College tutors one fifth or sixth grader in Public School 158. Each of these children then tutors a third grader on the les— son just taught by the college students. The college students spend six hours a week during one semester in the project: they hold their own seminar for four hours and they tutor and 42 supervise tutors for two hours. The fifth-grade tutor and the third—grade tutee may be selected as having similar learn- ing problems, and the college tutor plans a lesson that will benefit both children. Many benefits are claimed: the regu- lar classroom teacher has assistance in dealing with learn- ing problems of individual pupils: the older pupil gains new respect for himself and the teacher: the college students, in- vited to experiment with a microcosmic learning situation, are challenged to create learning activities and pedagogical principles. Cloward (1967) describes another New Yerk city program involving peer mediated instruction. Program direc- tor, Dr. Albert Deering reports that a program called Home- work Helper was develOped by Mbbilization for Youth, the Low- er East Side anti—poverty agency, and has been Operating in two school districts. It was expanded and offered to twenty- nine school districts and within six months 5,000 elementary school tutees and 2,000 high school tutors were busily at work within about 100 centers set up in neighborhood schools. The cost of the program was estimated to be about $1.2 million. According to the New Yerk Times, "The tutors work with the pupils on a one-to one basis two days each week. They help them with their homework and then give them instruction in reading. High school and elementary teachers are assigned to the centers to supervise the tutors. The tutors are paid up to $2 an hour for their work . . . A study of the program released last year by Columbia University School of Social work found that the tutors from slum areas not only helped their pupils but also made great improve- ments in reading themselves . . . (thus the tutees in the program showed a 6.2 month gain in their reading levels after 5 months. A control group that had had no tutoring showed the usual slum school rate. a 3.5 month gain in the same period. 43 The tutors improved even more than their pupils. In a 7—month period their mean gain in reading level over their control group was a year and seven months." Davis (1968) conducted an experimental study for eight months in which he used junior high school students to tutor other junior high students. It was hypothesized that in cer— tain language skills, pupil-tutoring could produce positive changes that might be reflected in standardized test results and English grades among tutees as well as their tutors. In evaluating the progress of the tutors, Davis found a signifi- cant difference between the experimental and control groups in favor of the experimental group. No significant differ- ences were found between the groups for the tutees. Rogers (1969) reported, in an unpublished doctoral dis- sertation, an experiment conducted for eight weeks in the city school system of Tuscaloosa, Alabama. Sixth-grade children were used as tutors for third-grade children whose reading performance was below the median score for their grade. It was found that thirdpgrade underachievers made significantly greater gains than their controls in reading achievement. The researcher also reported that even though reading gains were not significantly larger for sixth—grade tutors in the experi- mental group, the trend of the gains indicated that tutoring may be an effective remedial reading program for tutors as well. Erickson (1971) conducted an experimental study concern— ing the efficiency of a tutorial program upon both tutors and tutees. The dependent variables were reading scores, grades, interests and attitudes, social acceptance and attendance. 44 The tutoring program was carried out for five months using seventh-grade boys as tutors and third-grade boys as tutees. The tutoring schedule consisted of two sessions a week for 30 minutes each. Results indicated improved reading scores for both tutors and tutees but no significant quantitative differ- ences between the groups for the remaining dependent variables. Gardner (1973) investigated the effects of intergrade tutoring upon the reading achievement, self-concept attitudes toward school and behavior of third and fourth-grade low a- chieving tutors. A secondary purpose of the study was to ex- amine the effects of tutoring on the reading achievement and behavior of first and second-grade tutees. At the conclusion of the 10-week program, only negligible results were found in comparing experimental tutee groups' reading achievement with control tutee groups. However, all experimental tutor groups showed gains in reading achievement greater than those of tu— tor control groups. Neither experimental tutor or tutee groups showed gains in behavior greater than their respective control groups. Finally, all experimental tutor groups showed gains in self-concept and attendance compared to tutor control groups. Peter S. Rosenbaum (1973), Associate Professor of Lin— guistics and Education at Teachers College, Columbian Univer- sity, in his book entitled Peer Mediated Instruction describes several of his experimental programs employing a peer teaching strategy. New York Public School 129 Spelling Project (1970) New Yerk Telephone Company Project (1971) Jackson, Mississippi, Schools Project (1972) 45 The described instructional systems design, called Peer- Mediated Instruction directs students to do their work in pairs, interacting with one another according to a structural pattern of dialogue that insures for both members of the pair a successful learning experience. The concept of peer teaching grows out of the author's earlier research on applying techniques of so—called "drill and practice" computer-assisted instruction (CAI) to language skills learning. He recognizes computers as good teachers. but Rosenbaum emphasizes that the success of many such CAI programs does not necessarily result from the hardware itself but dialogue between student and machine. Noting that CAI technology was prohibitively expensive anyway, he developed an instructional method based upon peer interaction that stim- ulates the key features of exemplary drill and practice CAI at a fraction of the cost. Dr. Rosenbaum, in his book Peer Mediated Instruction, p. 149, describes his strategy. "Almost from the first, however, classroom teachers with whom I was working advised me that pupils would also learn while performing as Teach— ers. And, too, the homespun wisdom that 'there is no better way to learn something than to teach it' frequently cropped up in discussions. Of course the classroom teachers were right. Not only do Students learn, Teachers learn also. The choice of terms for the roles of the dyad, 'Teach— er' and 'Student,' turn out toteequite unfortunate because of the connotations that attach to the words 'teacher' and 'student:' they generally con- jure the idea of someone who knows transmitting and imprinting what he knows upon someone who doesn't. But in a PMI system, these terms simply identify different, although interwoven, acts: all of these acts, whether Teacher initiated or Student initiated, address the course content as it exists in the materials of instruction. 46 "In any case, a probable cause for the appar— ent potency of PMI is the simple fact that the two roles, Teacher and Student, force a multi—mode en- gagement with the subject matter in such intensity as has not heretofore been achievable under conven- tional classroom communication structures." Unlike many peer tutoring methods that rely on advanced students for tutors, Rosenbaum's PMI strategy considers the tutor's skill level irrelevant. Tutors were provided with correct answers to every lesson exercise, so all they have to do is compare the answers to their classmates' responses. "PMI is favorably received and works well with students of many ages (from first grade through adulthood) and socioeconomic identification. It is especially effective for students of average or be- low average ability." McGill University published a report of the Goldschmid (1970) ”Learning Cell Study." The experimental design con- sisted of two options for peer interaction. Option A consisted of an arrangement Whereby both part- ners read the same assignment. The objective being to create in the classroom and between two students an intensive dia— logue which served to check on and deepen the understanding of the reading as well as to exchange additional ideas and information pertaining to the chosen topic. In option B the student partners in a learning cell read different assignments. In the classroom, for the first half of the period, student "A" of the dyad describes and explains the major points to student "B", then "A" asks his questions to check out "B's" understanding and corrects or elaborates if necessary. During the second half the roles are reversed: "B" communicates the substance of his reading and "A" responds 47 to the questions. The Learning and Development Center of McGill University Vol. 2, No. 5 is quoted: ,"Goldschmid (1970) compared several learning options in a psychology course. Students were able to choose one method among the following four: sem- inar, discussion, independent study (essay), and learning cell. Despite the fact that there were no differences among the four groups of students at the beginning of the course with respect to personality as measured by the California Psychological Inven- tory, background characteristics - including the num- ber of psychology courses taken, overall grade point average, major, etc. - (as measured by an extensive questionnaire), and knowledge of the subject of the course (as measured by a psychology content achieve- ment pretest), students in the learning cell per- formed significantly better on an unannounced essay examination administered towards the end of the course. (It is still possible, of course, that stu- dents in the four groups initially differed on some trait not measured by the pretests). A 'morale barometer' was used to derive a subjective rating of the overall satisfaction with each class hour. This measure also demonstrated that the average rating of the learning cell was significantly high- er than those of the other three methods. Finally, a comprehensive course evaluation the students com- pleted after the course indicated the superiority of the learning cell method over the other three learning options." Alden and Feldman (1973) describe research where peer teaching provided significant gains for low-achieving children. Low-achieving fifth-grade children either taught a third— grader or studied alone for a series of daily sessions. At the end of the two—week period, the low—achievers' perform- ance was significantly better in the tutoring condition than in the studying alone condition--a reversal in direction of the initial difference between conditions. There was no dif- ferential effect on tutees of being taught versus studying a- lone. Results suggest that serving as a tutor may be a par- ticularly useful method for enhancing the academic performance 48 of low—achieving children. The Alden report concludes: "In conclusion, enactment of the role of teacher by low—achievers seems to be a useful tech- nique for increasing their learning. This results in more academically-successful students. The positive effects of teaching on the tutor may be most dramatic, however, in cases where the student has experienced a history of failure in a school situation using the more traditional pedagogical methods." An instructional strategy which not only involves peer— assisted instruction but also peer testing and evaluation is described by Thiagarajan (1973) in Educational Technology. "Not all systems currently in use derive all these benefits from peer tutoring or testing. Many are interested primarily in learner gains. In this situation the above-average students-—the ones to gain least from tutoring-~get to tutor. It is also limited to remedial (and not initial) instruction, which unfortunately involves learn— ers from the lower end of the distribution. Evalu— ation is missing in many systems of peer tutoring. However, in Personalized Systems of Instruction (Keller, 1968), periodic and repeatable unit tests and the requirement of mastery of each unit before going onto the next one are built in efficiently. Unfortunately, in this system, tutoring is only incidental, taking place during the discussion of the test performance of the learner. "I have recently field tested a system which combines peer teaching and testing. In this sys— tem each student is required to learn, teach, and test each unit of instruction before going onto the next one. All students--not merely the first to finish—-get a chance to teach and test. Mbtiva- tional responsibility is also shifted to the peer setting. Tutor, learner, and tester need each other to advance to the next step. This encourages the tutor to locate, motivate, and support a learner in addition to teaching him. Testing is done by another student member of the class, resulting in more objec- tivity and less leniency. "Thus far the system has been tested with high school students in Madras, India, and college stu- dents in Indiana. Its use has been limited to those parts of the course for which instructional and test materials have been developed. It is used for ini— tial rather than remedial instruction. There seems 49 to be no obstacles to prevent the adaption of the system to other settings and younger age groups." In the Journal "Psychology in Schools," Jeane Crowder (1974) of the University of Kansas reports on a study con— ducted in an urban poverty area of Birmingham, Alabama. The objective of the study was to attempt a replication of pre- vious findings where substantial gains were reported for both tutor and tutee in a peer—mediated instructional design. Twelve eighth-grade tutors, who had participated in a seven-month tutoring program for deficient readers, were matched in terms of achievement and ability with 12 eighth- graders in the same school who had not participated in the previous tutoring program. The only requirements for tutor- ing were the desire to do so and a free daily class period. The experimental group was pretested and post-tested one year later, when the tutoring program ended, using the California Achievement Test. Tutors gained a median of 9 months in reading achievement during the seven-month tutoring program. However, the control group made a median gain of 11 months during the same period. A comparison of the gains made by the two groups indicate that the difference was not statisti- cally significant and thus the tutoring experience did not appear to affect the reading level of the tutors. Dr. Crowder summarizes her findings: "While the gains of tutors reported previously may have been artifacts, there are other possible explanations. Different tutoring techniques may produce varying tutor gains. The techniques used in the present study were relatively structured and emphasized careful charting of progress. Other studies have used less structured approaches with 50 an emphasis on the development of positive, flexi- ble relationships between tutor and tutee. Similar- ly, different types of tutors may profit from tutor- ing to a greater or lesser degree. The tutors in this program actually were achieving already at or above the level expected when ability level is con- sidered. Perhaps it is children with severe defi- cits who, as tutors, can make marked gains themselves. Until further research provides some definite answers, caution should be exercised when the virtues of tu- toring experiences for tutors are described." Summary In classroom lectures and discussions we teachers try to reach and involve all our students because we feel that learn- ing is an active experience, not a passive one. We no longer think of the student as a sponge, but rather as a participant in a two-way process of communication. Every teacher develops his own methods to help achieve this communication of ideas. One technique centers around drawing out questions from the students. An ideal situation of this type would be one in which a flow of questions came from all members of the class. But in the formal classroom situation the teacher is, in a sense, a barrier to the free flow of ideas simply because he is not one of the students. Although the personality of the teacher may range from the disinterested type on the one ex- treme to the "one of the boys" type on the other, his status is different. He represents the adult world and authority and to that extent inhibits the response of students. When a student attempts to instruct his classmates, how- ever, a new and dynamic factor seems to be injected into the learning experience, an element affecting both the student and his audience. There is something of the competitive 51 spirit between student and class, a game to be participated in, a contest to be won. an enemy to be defeated. This relation- ship encourages a free flow of questions in which nearly all class members seem to become involved. Recent experimental evidence indicates that a positive effect on learning does indeed occur for the student who enacts the role of teacher: in fact, the tutor may benefit more in many cases than the tutee. Abundant anecdotal evidence suggests that the tutor may profit in several ways from his involvement in teaching: the tutor's motivation, sense of responsibility, and attitude to- ward school may show a positive shift. Encouraged by the pros- pect of positive effects when using older children to teach younger children, many schools have recently initiated some form of tutoring program. Yet, little in the way of system- atic theory and research is available in this area. The research studies conducted to date concerning student- to-student tutoring have not been entirely without methodolo- gical inadequacies. The main limitations of those reviewed include: 1. The reliability and/or validity of some of the instruments employed to gather data is ques— tionable. 2. Experimental and control groups have not always been equated before the initiation of the ex- periment. In some instances (Rogers, 1969), subjects were matched on selected variables without being randomly assigned to experimental and control groups. While this may serve as a good compromise procedure, since it does tend to equalize the groups in reference to the vari- ables matched, it does not equate the groups on what might be other relevant variables. In is more 52 A few of the studies (Cloward, 1967a, 1967b: Davis, 1968) were conducted with what may have been a biased sample, since available students were used as subjects without any type of ran- dom selection. This, of course, limits the generalizations that can be made in regard to the findings of the study. The Hawthorne Effect was not always controlled. Knowledge that an experiment was being conducted may have caused some subjects to change in re- lation to the criterion measure(s). This is true of nearly all the research studies reviewed. summary, it can be said that additional research that tightly controlled is needed before position papers advocating student-to-student tutoring as a means to individu- alize instruction can be realistically evaluated. This con- clusion is based on the ambiguous findinmsand obvious limita- tions of some of the research conducted to date. CHAPTER FOUR EXPERIMENTAL DESIGN Rationale For sometime educators have agreed that instruction, if it is to be successful, must be directed toward a mass of stu- dents gathered in some lecture hall. It is generally known that each student brings to the learning experience a diverse background demanding that instruction, if it is to be meaning- ful, be tailored to his individual requirements. Background greatly affects the ability and capability of each student to such an extent that it is assumed that, if the quality of learning is dependent upon a large number of variables, then it would be improbable that any two persons would be ready for the same instruction from the same media at the same time. It seems, then, that we must fit the subject matter presenta- tions to the individual requirements of the learner so that What is unique or special about every learner, that may affect his achievement, will be taken into consideration. Education reform for the 1970's cries out for instruction- al strategies that recognize individual differences and learn- ing rates: for a methodology that both challenges and motivates. Students deserve an educational format that allows for active participation and involvement: where enrichment and self— realization are also desired educational objectives. Peer 53 54 meditated and computer augmented instruction may answer many of these challenges. Mest of the Peer Assisted Learning research has been con- ducted in the elementary grade levels or through community ser- vice agencies. There is no documentation for a peer teaching strategy in the area of college level undergraduate Human Anatomy. That is not to say that the theoretical construct of peer teaching could not be applied to this subject area. In fact, I believe it can be and quite successfully. Mbst of the reported research supporting computer aug- mented teaching has been in the math and physical science areas. The computer is programmed to tirelessly generate mathe- matical or physics problems to be solved. The students are drilled at the computer terminal rather than the chalk board. The computational skills of students are perfected through repetitive drill and practice. The structural detail of Anat- omy and Terminology spelling compares similarly to the detail and precision required in mathematics. The logical extension would suggest similar learning gains for Anatomy using com- puterized drill and practice as demonstrated for many mathe- matical and physical science models. The drill and practice mode of CAI would appear to offer the greatest adjunct to Anatomy instruction. The Simulation and Tutorial modes too closely resemble the "ill-fated" teach- ing machine. Certainly the choice of strategic mode and the fine detail of program design and delivery lacks for a secure theoretical base. 55 According to Suppes (1969b) "the principal obstacles to computer-assisted instruction are not technological but peda- gogic." Most of the computer techniques employed to date are based on pure and simple "pedagogical intuition." CAI awaits for more soundly based theoretical approaches. Interestingly, most likely it will be the power of the computer that may well lead to the development and confirmation of new educational theories suitable for CAI. The computer's ability to record and subsequently analyze the reactions of great numbers of CAI program and system users may affect substantative evaluation and pedagogical development. Computers are now so much a part of our lives, and even more so for the future,that quite soon a basic knolwedge of computers will not only be useful, but perhaps be essential in order to be considered "literate." The drill and practice mode of computer tutorage is in- deed the least complex of all the CAI modes. However, its simplicity should not malign its effectiveness as a supple- ment to classroom instruction. NUmerous studies in the liter- ature have repeatedly confirmed "Drill and Practice" as an ef- fective and fruitful adjunct to the instructional process. Computer managed "Drill and Practice" should be correctly viewed as supplemental instruction and reinforcing in nature. Nevertheless, this mode is entirely under computer control with considerable interaction between computer and learner and as such, is certainly full-fledged CAI. The choice of this particular CAI mode for supplemental instruction in the area of Human Anatomy, is most appropriate. 56 The strong terminologic emphasis necessary for an understand- ing of anatomic detail, commonly requires that the student learn by repetition, association and self—disciplined drill. A common learning strategy for the Anatomy student involves repetitive reading, repetitive writing, and repetitive verba- lization, with self-testing and self—evaluation. The self- discipline and motivation required for such learning is often limited and engenders fatigue and promotes short-term recall. A computer—managed drill and practice strategy intro- duces the element of competition, "man versus the machine." The computerized program will tirelessly drill and test the user, and by reporting the student score, the challenge is thereby made to do one's best and beat the machine. I pro- pose, that by tempting the learner with this "mechanized car- rot," learning becomes more efficient, less routine and more fun. The thrust of this research is to ascertain the effec- tiveness of a teaching strategy that has peer interaction and computer teaching as an instructional experience complimentary to the lecture format. Research Desigg When selecting an experimental design, the researcher must be cognizant of several factors which may well jeopard- ize the validity of any findings. These concerns for validi- ty must include internal validity--did the experimental treat- ment really have an effect??-—and external validity or gen- eralizability--to what populations, settings, treatment vari— ables, and measurement variables can this effect be general- ized?? Both types of criterion are obviously important, even 57 though they are frequently at odds in that features increas- ing one may jeopardize the other. Clearly, an experimental design must insist on internal validity else the entire ex- ercise becomes futile. In educational research, particularly, the generalizability to other applied settings becomes the sought goal. In regards to internal validity there are essentially eight extraneous variables which might easily produce effects confounded with the effect of the experimental treatment and obviously the neutralization of these variables is required: 1. History: Specific events occurring between the first and second measurement in addition to the experimental protocol. 2. Maturation: The biological and/or psycho- logical processes occurring over a passage of time which might affect individual re- sponse (hunger, fatigue, aging). 3. Testing: The prompting or potentiating ef— fect of taking a test upon the scores of a second test. Mbst influential in the tradi- tional Pretest to Post-test design. 4. Instrumentation: Variation in the calibration or design of the measuring instrument in exam- ination may produce changes in the obtained data. 5. Statistical Regression: Operating with groups selected on some basis of their extreme scores (lower percentiles, disadvantaged, gifted). 6. Statistical Biases: The non-random or differ— ential selection of respondents for comparison groups. 7. Experimental Mortality: The loss of respond- ents for the comparison groups. 8. Multiple Effect: Interaction of several vari- ables (Selection-Maturation) which become con- founded with the experimental treatment and bias the outcome. 58 The single variable that most often influences the repre- sentatives or external validity of the experimental design is the repetition effect of testing. 9. Interaction Effect of Testing: Pretesting might increase or decrease the respondent's sensitivity or responsiveness to the experi- mental variable and thus make the results obtained for a pretested population unrepre- sentative of the effects of the experimental variable for the unpretested universe for which the experimental respondents were se- lected. The classical Solomon Four-Group design was selected for this research, not only because it has a higher prestige a— mong educational researchers, but also because this design would control factors influencing external validity. Six randomly equated groups were drawn from college stu- dents currently enrolled in Human Anatomy, Physiology and Medical Terminology at Delta College. The mean group size was 25. 28 students 26 students 31 students 23 students 21 students 19 students Group One Group Two Group Three Group Four Group Five Group Six Total 148 students The Solomon Four-Group design in my research to evalu- ate the PAL and CAI experimental protocol might be illustrated thusly: 59 Randomly Egpated Testing over Time Group One Pretest Instruction Using PAL/CAI Post-test Experimental Protocol Group Two Pretest Traditional Lecture/Lab Post-test Instruction Group Three Not Pre- Instruction Using PAL/CAI Post-test tested Experimental Protocol Group Four NOt Pre- Traditional Lecture/Lab Post-test tested Instruction Group Five Not Pre- Instruction Using PAL Post-test tested Protocol Only Group Six Not Pre— Instruction Using CAI Post-test tested Protocol Only This experimental design controls for all of the nine listed challenges to validity, both internal and external. History is controlled insofar as general events that might have produced a significant difference between Pretest and Post-test scores of the experimental groups would also pro- duce a similar Pretest and Post-test difference for the con- trol group. Maturity_and Testing are controlled in that they should be manifested equally in experimental and control groups. Instrumentation was controlled by having the respondents com— plete a printed test. Regression is controlled as far as mean differences are concerned since both the experimental and control groups were randomly assigned from the same pool: therefore, the control group would regress as much as the ex- perimental group. Selection Bias is ruled out as an explana- tion of differences to the extent that randomization has as- sured group equality from the onset of the research. 60 In summary, the control of these variable main effects in the experimental design assure internal validity. The threats to external validity for the Solomon Six- Group experimental design involve interaction effects of the experimental protocol and some other variable, namely the in- fluence of pretesting. There are valid designs avoiding the pretest and often it is to unpretested groups that one wants to generalize. Therefore, such designs are often preferred on grounds of external validity or generalizability. In the area of teaching, the doubts frequently expressed as to the applicability in actual practice of the results obtained by highly artificial experimentation are certainly judgments a- bout external validity. The influence of pretesting on the effects of an experimental treatment: first described by Solomon in 1949, is a function of the extent to which such re— peated measurements are characteristic of the universe to which one wants to generalize. In educational research, one is interested in generalizing to a setting in which testing is a regular phenomenon. Further, by using regular classroom examinations for testing, one may safely assure that no un- desirable interaction of testing and the experimental treat- ment will be present. Certainly one significant feature of the Solomon design is its explicit consideration for external validity factors. Thus, by paralleling the common pretest, post-test, control design with experimental and control groups lacking the pre— test, both the main effects of testing and the interaction of testing and the experimental protocol are determinable. In 61 this way, not only is generalizability increased, but in ad- dition, the effects of the experimental protocol is repli- cated in four different ways with these expected results. Post-test scores of the experimental group will be significantly greater than pretest scores for the experimental group. Post—test scores of the experimental group will be significantly greater than post—test scores of the control group. Post-test scores of the experimental group not pre- tested will be significantly greater than post—test scores of the control group not pretested. Post-test scores of the experimental group not pre- tested will be significantly greater than pretest scores of the experimental group pretest. Because of omnipresent experimental variation and insta- bility, it clearly becomes imperative that these comparisons must be in agreement if any broad generalizable influence is to be made. A total of 148 students were divided into six groups to conform to the Solomon array. The first and second groups were pretested as to their prerequisite knowledge of osteo- logy. The testing instrument consisted of 20 questions re- quiring a written response containing items representative of the behaviors expected for this instructional unit. This par- ticular testing format was employed so that spelling could also be evaluated. Groups Two and Four received the usual in- struction, based on lecture-recitation and laboratory demon— stration. Groups One and Three also received the traditional lecture, but in addition these two groups participated in the Peer Assisted Learning and Computer-Assisted Instruction ac- tivities. Experimental Groups Five and Six received the my v0\ A 9‘2 £32 v6, ,4 .Tl ‘: 5‘ .2! V. 62 supplementary instructional protocols as independent strate— gies. Group Five only received PAL supplements and Group Six only received CAI supplements. All groups received the same post-test having the same format as the pretest, but consist— ing of a different assortment of test items (see Appendix A and B). The Kuder-Richardson and Hoyt reliability coefficient was routinely computed for both pretest and post-test re— sponses. All reliability coefficients were greater than 0.60 which would indicate that the individual items on the tests were producing similar patterns of response in different in— dividuals. Therefore, the high coefficient value confirms that the test items were homogeneous and consequently reli- able. The research design essentially involves an evaluation of instructional experiences supplemental to the classroom lecture. By pretesting not only is prerequisite knowledge de- termined, but also the statistical analysis of pretest scores enables an evaluation of homogenity between control and treat- ment groups. The instructional sequence for both the control and treatment groups is illustrated diagrammatically. INSTRUCTIONAL UNIT LECTURE /\ CONTROL GROUPS GROUP TWO GROUP FOUR PRETESTED PRETESTED N = 26 N = 23 TRADITIONAL LABORATORY EXPERIENCE 1r lr INSTRUCTIONAL UNIT POST—TEST 64 INSTRUCTIONAL UNIT LECTURE // \\ EXPERIMENTAL GROUPS GROUP ONE GROUP THREE GROUP FIVE GROUP srx PRETESTED PRETESTED NOT PRETESTED NOT PRETESTED N = 28 N = 31 N = 21 N = 19 i 0 PAL and CAI PAL CAI \\ // 65 Composition of Research Groups The open door admission policy of the community college registers students into classes simply on a first come basis. The student has the option to enroll into any desired section of a course, provided space is available. The usual tracking by ability or prerequisite is not employed. As a result, each course section contains a random assort— ment of abilities, background, and prerequisite preparation. For this study, the random assignment of Delta College regis- tration procedures was relied on to establish equivalent class sections and, therefore, randomly equated experimental groups. Each student was asked to complete a "Biographical Data" questionnaire. The questionnaire was designed to enable as- sessment of individual student backgrounds and especially to enable a statistical comparison of student composition for each test group. The format of this questionnaire is pre- sented in Appendix F. The student responses for each exper— imental group is summarized in RESPONSE TABLE ONE. In addition, the experimental design requires Group One and Two to be pretested before receiving the experimental treatment. A statistical comparison of these pretest scores showed no significant differences which further supports the equivalency of each group. This statistical comparison is summarized in DATA TABLE ONE. The typical composite student for this research would be a 24-year old female, having only a high school education with an overall GPA of 2.6 or B—. The composite has completed high school science and biology and majors in an allied health curriculum. 66 ©©.N V®.N ©h.N HB.N fimw me2 ma. ha. 0N. vw. o.¢lm.m mm. mm. mm. mm. v.MIO.m 0H. ma. dd. 0H. m.NIm.N ON. mm. Hm. 0H. V.NIO.N OH. mo. 00. mo. m.HIO.H Ammmpceowmm CA >ocmoomumv ammo noomom mOHm e.em H.mm o.mm m.em was cams mm. om. ha. mm. mm Hm>o No. no. Ho. Ho. vmlmm m0. m0. No. Ho. Hmlmm mo. 00. «0. Ho. mmlwm 00. mo. m0. m0. mmlmm ma. ea. Hm. ON. 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Noumea mowaaoo mo. so. so. mo. momaaoo .mu» m so. oH. mo. so. momaaoo .mus N am. am. am. am. momaaoo .us H mm. we. om. om. saco .m.m Amomucwoumm ca socmoomumc "ozoomomoam qaonsaooom gem Han and com Hao monouo mcfl>flmowm QDOHO mcw>emomm QdOHO ocfl>fimomm QDOHO Honucoo 68 Control and Experimental Instructional Formats The Anatomy, Physiology and Medical Terminology course at Delta College is a twelve-credit (two-semester) course specifically designed for Allied Health majors. The instruc- tional schedule includes 2 hours of lecture-demonstration— 1aboratory, three times weekly for 15 weeks each semester. The lecture is supplemented with audio-visual and printed ma— terial. Precise behavioral objectives are distributed for each instructional unit and testing measures mastery of these objectives. During the laboratory-demonstration periods stu- dents are shown pro-sections of laboratory animals, models and on occasion they may conduct typical physiologic experi- ments. The traditional format would involve terminology pre- sented in lecture, and reviewed in workbook exercises. In general, opportunities for drill and practice in the class- room were either limited or non-existent. As typical of most lecture based classes, the drill and practice often comes the night before the examination and is not a formal part of classroom strategy. However, this soc- ratic strategy is often successful in producing significant gain scores in spite of its inheritant weaknesses and dis- regard for individual differences. Student Groups One and Three received the experimental protocol that supplemented the usual instructional strategy. Students of Group One were first pretested over general os- teology, using the same twenty-item pretest instrument ad— ministered to the control Group Two. Students of Group Three were not pretested, but they received the identical 69 experimental instruction as Group One, namely, lecture- recitation, augmented with computer and peer assisted learn- ing opportunities. Three weeks later, after 18 classroom hours of instruction, including computer and peer assistance, both experimental Groups One and Three were post-tested for achievement using the twenty-item post—test administered to the control group. The control protocol administered to Groups Two and Four might be illustrated thusly: Instructional Unit Pretest (Group Two) 9 Hours of Lecture 9 Hours of Traditional Laboratory Unit Post-test The experimental protocol administered to Groups One and Three might be illustrated thusly: Instructional Unit Pretest (Group One) 9 Hours of Lecture 6 Hours of Peer Interaction Sessions 3 Hours of Computer-Assisted Drill and Practice Instructional Unit Post-Test Both the control Groups Two and Four and the experimental Groups One and Three attend the same lecture given by the author. The three-hour lecture each week was structured from the instructional behavioral objectives. For the osteology unit a total of 9 lecture hours was presented to all groups. The lecture outline for the osteology unit is found in Ap- pendix C. The student behavioral objectives for this 70 osteology unit is found in Appendix D. The lecture is richly illustrated with color transparencies and 2 x 2 color slides. Models and displays were used to illustrate relevant concepts. such as "bone types," "bone sections,‘ and "skull anatomy." Even with a class size of over 100, student questions were encouraged and incorporated into the lecture presentation. All students were expected to attend three hours of lab- oratory sessions each week. The activities for these labora- tory sessions were designed to supplement and reinforce con- cepts presented in lecture. Also, because of their small size (20-25), such sessions provide opportunities for indivi— dual assistance and instruction. For the osteology unit, students had the opportunity to assemble and examine human skeletal material. Provided lab- oratory guides directed the students to important osteology features and in particular, those required in the behavioral objectives. In many ways the format for these laboratory sessions followed the traditional protocol whereby most of the activities and learning strategy involved the individual working in a group setting. On occasion "lab partners" or small groups of students were formed, but for the most part, no organized, well-structured, format was designed that en- couraged or required peer interaction. Such volunteer peer associations has long been the tradition of similar labora- tory sessions. These experiences can be successful but their failure to provide active student participation, encourage student passivity and discourage the less motivated student. Traditional laboratory sessions have been justly criticized 71 for their failure to provide meaningful educational exper- ences. Their lack of structure and direction often leads to an inefficient waste of time for all concerned. Control Groups Two and Four attended laboratory sessions similar in design to those found in most undergraduate sci- ence laboratories. Pro—sections, models, displays, film—loops. histologic and other usual instructional media and materials were available. Each student was directed to important fea— tures of the material by referring to their laboratory guide. There was no testing during these periods. The course in- structor would circulate throughout the laboratory to provide assistance and instruction. Experimental Groups One and Three attended laboratory sessions where peer interaction was required or encouraged by design. Students were assigned or volunteered to small study groups of four or five. Each group was responsible for a por- tion of the instructional assignment. Their group task was to master assigned learning objectives. Each of two groups had different but related learning tasks. For example, two groups of 4-5 students were responsible for anatomic features of the arm and shoulder whereas the remaining two groups of 4-5 students were responsible for anatomic features of the leg and pelvic girdle. Using the same laboratory guides as the control group, the experimental groups would review the required features in a group dynamic setting. Often indivi- dual assignments were made within the small experimental groups such that each student was forced into an active, par- ticipating role. Group pressure and peer expectations 72 became strong motivating factors which encouraged individual contribution. Once each group had fulfilled the learning objectives for that session, two groups with dissimilar but related ob— jectives were brought together for a joint interaction ses— sion. In these combined sessions, students were compelled to assume the role of teacher and instruct members of the group. The individual would present the material he had learned (e.g. the anatomy of the scapula) and be in a position to answer questions regarding "his" bone or assignment. In its simplest form we would have students versed in skeletal anatomy of the arm sharing, instructing and interacting with the other group assigned the skeletal anatomy of the leg. The "teacher" role requirement of such interaction necessitates active partici- pation by all. Failure to provide your assignment leads to peer admonishment and the potent force of peer rejection. Such a format for the laboratory sessions provided a lively and highly productive experience. Other topics that were paired and managed by similar peer group interactions included: osteology of the arm-—osteology of the leg-- osteology of the shoulder girdle-~osteology of the pelvic girdle-—osteology of the hand--osteology of the foot-—paired bones of the skull—-unpaired bones of the skull. The course instructor assumed the role of resource per- son and coordinator for the laboratory sessions. Experimental Groups One and Three were also provided with computer assistance for drill and practice of osteology material. An instructional program was written in the 73 computer language BASIC and made available to students through a time sharing arrangement with the Dartmouth College computer in Hanover, New Hampshire. The program consisted of a pool of 200 drill items derived from the osteology behavior- al objectives. Although the format of presentation varied somewhat from "fill in the blank" statements to single word identifications, the student was required to respond with cor- rect spelling via teletype terminals located at Delta College, University Center, Michigan. By using a random number generator to determine the branch- ing sequence and a matrix design, it was possible to randomize the order of drill items for each practice session. In this way, the same student could return as often as desired with- out repetition. In general, because of time commitments or fatigue, students would only drill and practice with the com- puter for 60-90 minutes and respond to 50—75 items. The com- puter was programmed to keep score and report to the student the cumulative number of correct and incorrect responses as well as the percentage of correct responses. This report of score was made to the student after each item: in this way. the students often perceived the computer interaction as a contest. When the student concluded and signed off the termi- nal, their total score would be stored into a file for later access. Such stored data became, in part, the Data base for this study. The stored information consisted of student's name, items attempted, percentage correct, data and time. The following is a sample of the stored student data for January 23, 1975, which was accessed from computer memory one week later (see report sheet). The complete program for the 74 DARTMOUTH TIME-SHARING LINE 2/¢441 0N AT 11:34 LIST CCNEWS*** 11/20/7u USER NUMBER-—E06685, RXNNXRIE NEW OR OLD—~OLD SCORE READY LIST SCORE LORI KWATER SEAR LINCOLN LORI KWATER DOROTHY KING GLORIA SABIAS MARION WARE MARIANNE MALOTT CINDY ANDERSON GLORIA SABIAS KEVEN CONLEY BILL HURLES JAN WOOD SANDY GOSKO DEBBIE DOYLE READY UN S AVE READY 30 JAN 75 29 58 4% 29 15 54 45 75 64 4¢ 56 57 54 82 11:55 ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS ATTEMPTS 50 JAN 75, PERCENT PERCENT PERCENT PERCENT PERCENT PERCENT PERCENT PERCENT PERCENT PERCENT PERCENT PERCENT " PERCENT 10¢ PERCENT 155 USERS 1/23/75 1/23/75 1/23/75 1/23/75 1/23/75 1/23/75 1/23/75 1/23/75 1/25/75 1/23/75 1/23/75 1/25/75 1/23/75 1/23/75 16: l¢z l7: 1¢z 13: ll: 11: 11: 13: ll: 18: 1Q): 12: 12: 42: 48: 15: 55: Q51: 12: 54: 51: 47: 15: 22: 15: 24: 75 osteology unit is presented in Appendix E. An additional feature of this program enables the student to self-test by commanding a random assortment of test items to be printed at the terminal. Also, once the student decided to end the drill and practice session, she could do so by typing "NO" to the question "DO YOU WANT ANOTHER ITEM?” At this point, the stu- dent would have the option to reexamine any of the previously attempted items in order to test a different response or dif— ferent spelling. The students had 15—hour availability to the terminals, Monday through Saturday. Students of experimental Groups One and Three were re- quired to schedule one hour of computer interaction each week. This arrangement would insure for each student a total of three hours of computerized drill and practice for the three- week instructional unit. The computer was programmed to store utilization data and student identification so that the re- quired interaction could be supervised. The computer was programmed only to accept correct spell— ing but where two or more possible answers were acceptable, the computer would accept either one. This strategy was de- signed to encourage accurate spelling and precision in selec- tion of response choice. The instructor could easily monitor class progress and utilization of computer assistance by having the computer print out the stored names and related data of terminal users. Following an orientation session the students were free to schedule time on the computer when they wished. Even 76 though students were encouraged to drill and practice indivi- dually, peer or colleague interaction was never denied. The prevailing honor system would assure that correct names and data were entered for research evaluation. It was made clear to the students that their interaction with the computer was not a testing experience and that their score would not be re- corded for course evaluation purposes. The instructor was only interested in utilization and achievement correlations. Ancillary Studies Several subordinate investigations were part of the major study. Study Time Students for all research groups were required to log the time spent for examination preparation. This study time would be submitted with the post- test and was meant to be the student's best esti- mate of the time necessary to prepare for the a— chievement test. Students were assured that this information was meerly for research purposes and not a part of the evaluation process. SpellingfiAccuragy The post—tests required a short written re— sponse. Electronic scanning and grading was not employed so that spelling accuracy could be evalu— ated and correlated with instructional strategy. Retention All students were repost—tested after a six- month period in order to correlate retention with 77 instructional strategy. This intention was not announced to the research participants to pre- clude advanced preparation. Attitudinal Evaluation All research participants were required to complete an attitudinal questionnaire consisting of both open-ended and specific inquiries. See Appendix I and J for questionnaire format. Research Hypotheses Because of randomly equated assortment of research groups, there will be no significant difference in pretest scores for control Group TWo and experimental Group One. The post-test scores of control Group Two, receiving the traditional instructional program, will be significantly greater than pretest scores for this group. There will be no prompting influence for pretesting in the experimental groups such that post-test scores of pre~ tested Group One will not be significantly greater than post-test scores of the experimental Group Three that was not pretested. There will be no prompting influence for pretesting in the control groups such that post—test scores of the pre- tested control Group Two will not be significantly great— er than post—test scores of control Group Four that was not pretested. The instructional protocol of PAL + CAI for Groups One and Three will produce significantly higher post-test 78 scores as evidenced by the following comparison: a. When experimental Group One pretest scores are compared with experimental Group One post—test scores. When experimental Group One pretest scores are compared with experimental Group Three post-test scores. When control Group Two post—test scores are compared with experimental Group One post- test scores. When post—test scores of experimental Group Three (not pretested) is compared with post— test scores of control Group Four (not pre- tested). When post-test scores of both experimental Groups One and Three are compared with the post—test scores of both control Groups Two and Four. The experimental protocol of PAL + CAI will be signifi— cantly more effective in the combined format such that post-test scores for experimental Groups One and Three receiving the combined treatment will be greater than post-test scores for Groups Five and Six, receiving in- dependent treatments of PAL and CAI. The average examination preparation or study time will be significantly less for experimental Groups One and Three than for control Groups Two and Four. The mean number of post-test spelling errors will be sig— nificantly less for Groups One and Three receiving the experimental PAL + CAI treatment, than for control Groups Two and Four. 10. 79 Six-month retention as measured by repost-testing will be significantly greater for Groups One and Three re- ceiving the experimental protocol than for control Groups Two and Four. Students receiving the experimental protocol of PAL + CAI will report a favorable attitude for this instruc- tional strategy. CHAPTER FIVE RESEARCH FINDINGS The Solomon array as an eXperimental design allows for testing treatment effects or internal validity by four dif- ferent statistical comparisons. l. Post—test achievement compared with Pretest scores. 2. Post-test achievement for the nonpretested group compared with the Pretest scores of the Pretested group. 3. Post-test achievement for experimental group compared with Post-test achievement of control group. 4. Post-test achievement comparisons between control and experimental groups not pre— tested. The Solomon Four Group experimental design used in this research could be illustrated thusly: Randomly Research Design Equated Testing over Time Group One Pretest Instruction Using Post-test Experimental Protocol Group Two Pretest Traditional Post-test * Instruction Group Three No Pretest Instruction Using Post-test Experimental Protocol Group Four No Pretest Traditional Post-test Instruction 80 81 There is no single statistical procedure which makes use of all six sets of observations simultaneously. The asymmet— tries of the total six-cell design rule out the usual analy- sis of variance of gain scores. A structure of the Post-test scores into the following array would permit several statis- tical analyses. Instruction Augmented with Usual Instructional Format PAL and CAI Lecture-Demonstration Pretested Group One Group Two Not Pretested Group Three Group Four From the column data, one estimates the main effects of the experimental protocol or the internal validity of the re- search. From the row means, one estimates the influence of pretesting or external validity. From the cell data one can estimate the interaction of testing with the experimental protocol. An analysis of variance program was written in computer language BASIC and made operational on the Dartmouth Time Sharing System. See Appendix E for the full program. 82 STATISTICAL ANALYSIS TO TEST FOR RANDOM DISTRIBUTION OF TEST SUBJECTS If students were indeed placed into the research experi- mental cells randomly as the result of existing registration procedures, one would expect no significant difference in pretest performance for Groups One and Two. Research Hypothesis No. 1 Because of randomly equated assortment of research groups, there will be no significant difference in pretest scores for control Group Two and experimental Group One. Research Finding_: 61.6 60.1 31 Pretest Mean 26 Pretest Mean Experimental Group One n Control Group Two n |+|+ 00) mm F Value = 0.06: Critical F = 4.02 Variance of Means NOT significant. P == ).05 See Data Table One, Appendix K This finding plus inspection of compositional data (Re- sponse Table One) confirms that research groups were equated. and, therefore, treatment effect inferences between groups should have validity. 83 STATISTICAL ANALYSIS TO TEST FOR EFFECTIVENESS OF TRADITIONAL TEACHING The usual or traditional instruction also produced sig- nificant achievement gains. It would certainly be desirable that the teaching strategy used by most instructors, namely, the lecture-demonstration, produced significant learning. Research Hypothesis No. 2 The post-test scores of control Group Two, receiving the traditional instructional program will be significantly great- er than pretest scores for this group. Research Findings; Control Group Two n Control Group Two n 26 Pretest Mean = 60.1 26 Post-test Mean = 78.4 I+J+ F Value = 10.44: Critical F = 4.03 Variance of Means significant, P = ( .001 See Data Table Two, Appendix K These highly significant results would support the effec- tiveness afforded the traditional lecture-laboratory format of undergraduate anatomy instruction. There is certainly no contention that traditional methods fail to produce achieve- ment. 84 STATISTICAL ANALYSIS TO TEST FOR PROMPTING INFLUENCE OF PRETESTING The major threat to the external validity of this re- search design involves the possible interaction of pretest- ing with the experimental protocol. It was certainly hoped that pretesting, especially for the short (three-week) ex- perimental period, would have no measurable effect on post- test scores, thus enabling generalizable inferences to be made for the experimental treatment. Research Hypothesis No. 3 There will be no prompting influence for pretesting in the experimental groups such that post-test scores of pre- tested Group One will not be significantly greater than post- test scores of the experimental Group Three that was not pre- tested. Research Finding_: 87.9 Experimental Group One n = 25 Post-test Mean = 83.6 Experimental Group Three n 31 Post-test Mean I+l+ bub F Value = 2.05: Critical F = 4.02 Variance of Means NOT significant: P = > .05 See Data Table Seven, Appendix K 85 STATISTICAL ANALYSIS TO TEST FOR PROMPTING INFLUENCE OF PRETESTING Research Hypothesis No. 4 There will be no prompting influence for pretesting in the control groups such that post-test scores of the pre- tested control Group Two will not be significantly greater than post—test scores of control Group Four that was not pre— tested. Research Finding_: 26 Post-test Mean 78.4 Control Group Two n = 23 Post-test Mean = 73.4 Control Group Four n F Value = 1.33: Critical F = 4.04 Variance of Means NOT significant: P = ) .05 See Data Table Three, Appendix K The failure to find significant differences in post-test scores for the pretested groups and those not pretested, in either the control or experimental groups, would allow the assumption that pretesting had no effect on resulting post- test scores. 86 STATISTICAL ANALYSIS TO TEST FOR EFFECTIVENESS OF THE TREATMENT PROTOCOL PAL & CAI A critical statistical comparison would be between post- test scores of students receiving the traditional educational format compared to post-test scores of those receiving the ex- perimental protocol. Research Hypothesis No. 5 The instructional protocol of PAL + CAI for Groups One and Three will produce significantly higher post—test scores as evidenced by the following comparisons: a) When experimental Group One pretest scores are compared with experimental Group One post-test scores. b) When experimental Group One pretest scores are compared with experimental Group Three post- test scores. c) When control Group Two post-test scores are com- pared with experimental Group One post—test scores. d) When post—test scores of experimental Group Three (not pretested) are compared with post-test scores of control Group Four (not pretested). e) When post-test scores of both experimental Groups One and Three are compared with the post-test scores of both control Groups Two and Four. Research Finding_: a) Experimental Group One n = 31 Pretest Mean = 61.6 $ 6.2 Experimental Group One n = 25 Post-test Mean = 87.6 - 4.9 F Value = 41.85: Critical F = 4.19 Variance of Means significant, P = < .001 See Data Table Four, Appendix K b) Experimental Group One n = 31 Pretest Mean = 61.6 E 6.2 Experimental Group n = 31 Post-test Mean = 83.6 - 3.8 Three F Value = 23.26: Critical F = 4.02 Variance of Means significant, P = (’.001 See Data Table Nine, Appendix K rH 87 c) Control Group Two n = 26 Post-test Mean = 78.4 E 6.0 Experimental Group One n = 25 Post—test Mean = 87.6 — 4.9 F Value = 5.74: Critical F = 4.03 Variance of Means significant, P = < .025 See Data Table Five, Appendix K d) Control Group Four n = 23 Post-test Mean = 73.4 E 6.4 Experimental Group n = 31 Post-test Mean = 83.9 - 3.8 Three F Value = 9.037 Critical F = 4.03 Variance of Means significant, P = (,.005 See Data Table Six, Appendix K e) Control Groups Two and n = 49 Post-test Mean = 76.1 i 4.6 Four + Experimental Groups n = 56 Post-test Mean = 85.3 — 3.2 One and Three F Value = 12.82: Critical F = 3.95 Variance of Means significant, P = ( .001 See Data Table Ten, Appendix K Analysis of the variance in gain scores between these groups shows significant improvement in achievement for those receiving the experimental protocol. Clearly, the augmenta- tion of instruction with peer teaching sessions and supplemen- tary computer drill and practice produces significant achieve— ment. In each comparison described one finds the level of a- chievement to be significantly greater for those students ex- periencing the experimental protocol. A summary statistical comparison is presented in Data Table Ten, Appendix K, where the two post-test scores of those classes receiving the usual lecture-demonstration instruction were compared with the two post‘test scores of those classes receiving the experimental protocol. Analysis of variance shows a significant difference be- tween these post-test scores. The combined control groups 88 had a mean post—test score of 76%. The combined experimen- tal groups had a mean post-test score of 85%. The larger mean score for those receiving the experimental protocol was significant at the .001 level. This evidence would confirm the beneficial effects of the experimental design, where sig- nificantly greater achievement was obtained. EVALUATION OF PEER ASSISTED LEARNING AND COMPUTER ASSISTED INSTRUCTION AS INDEPENDENT INSTRUCTIONAL SUPPLEMENTS The experimental protocol thus far evaluated has con- sisted of both peer interaction teaching and learning in com- bination with computer-managed drill and practice as an ad- junct to the classroom lecture. This PAL/CAI experimental protocol was compared with traditional instructional format of lecture-laboratory. Analysis of post-test scores shows significantly greater achievement for the group receiving the experimental PAL/CAI protocol. In order to evaluate the singular effectiveness of peer interaction and computerized drill, two additional treatment groups were formed. One group, numbering 21, attended only the peer interaction sessions for a total of six hours. A- nother group, numbering 19, was excused from the peer sessions and were required to drill and practice at the computer termi- nal for an accumulated total of 3 hours before the instruc- tional unit post-test. The instructional unit post—test, identical to the one administered in the combined study, was administered to each of the additional treatment groups. Post-test statistics and variance analysis of mean differences are presented. 89 Research Hypothesis No. 6 The experimental protocol of PAL + CAI will be signifi- cantly more effective in the combined format, such that post- test scores for experimental Groups One and Three receiving the combined treatment will be greater than post—test scores for Groups Five and Six, receiving independent treatments of PAL and CAI. Summary statistics are provided by Statistics Table Two, which follows, and detailed in Data Tables 13, 14, 15, 16 and 17 in Appendix K. STATISTICS TABLE TWO Comparison of Post-test Scores for Groups Receiving the Usual Instruction (Control) and Groups Receiving the Experimental CAI/PAL Protocol in the Combined and Individual Format Student Post-Test Standard Number Mean Score Deviation Traditional 23 73.3 i 6.15 15.04 Instruction Lecture with 31 83.9 i 3.66 10.40 CAI and PAL Lecture with CAI 19 71.6 i 3.78 8.42 Lecture with PAL 21 73.9 i 2.54 5.95 VARIANCE ANALYSIS OF POST—TEST SCORES Statistical Comparisons Total # Variance Significance 1. CAI + PAL X CAI 50 94.34 Sig P =<.001 Mean = 83.9 Mean = 71.6 2. CAI + PAL x PAL 52 79.23 Sig P =(.001 Mean = 83.9 Mean = 73.9 3. Control x CAI 42 156.3 NS Mean = 73.3 Mean = 71.6 4. Control x PAL 44 135.3 .NS Mean = 73.3 Mean = 73.9 5. CAI PAL 40 52.17 NS mean = 71.6}{Mean = 73.9 6. CAI + PAL Control 54 159.8 Sig p =<(.001 Mean = 83.9XMean = 73.3 90 No significant difference in achievement was found for either of the additional experimental groups (Comparison No. 3 and No. 4) where the PAL and CAI were independently pro— vided. In the combined form of PAL and CAI, significantly greater achievement was found compared to the usual tradi- tional lecture-laboratory format (Comparison No. 6). The post-test performance for the PAL group and the CAI group was statistically similar (Comparison No. 5). The PAL and CAI groups separately failed to provide comparable achievement as when administered in the combined form (Comparison No. l and No. 2). This study would support significant achievement for PAL and CAI only in combined form. Independently, achievement is no greater than that of the control group receiving the usual instruction. EVALUATION OF STUDY TIME AS A FUNCTION OF INSTRUCTIONAL PROTOCOL In order to compare the time required for examination preparation, participants in this research were requested to record their study time. Both the control group, receiving the usual instruction of lecture—laboratory, and the treat— ment group receiving the experimental protocol of lecture augmented with Peer Assisted Learning Sessions and Computer Managed Drill and Practice, recorded their study time out- side of the assigned class period. The students realized that their records were in no way related to their test scores. Their voluntary participation and accuracy was requested. .6 HF). & .H l 11 CE 91 Each student submitted their estimate of study time along with their post—test examinations. Research Hypothesis No. 7 The average examination preparation or study time will be significantly less for experimental Groups One and Three than for control Groups Two and Four. Research Findings: Control Groups Mean Study Time = 4.33 Hours Experimental Groups Mean Study Time = 2. 98 Hours F Value = 17.77 Critical F = 3.94 Variance of Means significant, P = < .001 See Data Table Eleven, Appendix K Variance analysis of these mean scores in Data Table Eleven, Appendix K, shows the observed differences to be high- ly significant, with the experimental group requiring signifi- cantly less time to prepare for the instructional unit exami- nation. This proven feature of CAI, namely more efficient learn— ing rates, is consistent with other studies where increased learning rates are observed without necessarily greater con— comitant achievement. EVALUATION OF SPELLING ACCURACY AS A FUNCTION OF EXPERIMENTAL PROTOCOL The pre and post-tests for this research consisted of questions requiring the student to write their response. Al— though the capability for multiple choice questions with com— puterized scanning and grading was available, such a system makes spelling evaluation difficult. A written student re- sponse enables both anatomic accuracy and spelling to be 92 evaluated. The student responses to the pre and post—tests of this research were evaluated for both anatomic and spell— ing accuracy. Data of spelling errors for both the control and treat- ment groups were obtained. The control group of 48 received the usual instruction consisting of lecture with laboratory. The treatment group of 56 received the experimental protocol of lecture augmented with Peer Assisted Learning Sessions and required Computer Managed Drill and Practice. The peer sessions enabled the student to develop correct pronunciation of anatomic terms which would ultimately pro- mote better spelling. The computer—managed drill and prac- tice opportunity challenged the student to respond with cor- rect spelling. The program was purposely selected for cor- rect spelling in order to develop these skills. The Drill and Practice Program could be modified to allow acceptable misspelling: however, such an alteration would invalidate one important feature of computer interac- tion, namely the requirement of precise spelling, grammar, and syntax. Commonly used synonyms, plurals and hyphena- tions were allowed, but such variance was minimized by having the question call for terminology found in the course ma- terial. 93 Research Hypothesis No. 8 The mean number of post-test spelling errors will be sig— nificantly less for Groups One and Three receiving the experi- mental PAL + CAI treatment, than for control Groups Two and Four. Research Findings: Control Groups Mean Post-test Spelling Errors = 9.35 Experimental Groups Mean Post-test Spelling Errors = F Value = 19.57 Critical F = 3.94 Variance of Means significant, P = < .001 See Data Table Twelve, Appendix K Clearly, computer usage with its concomitant demands for correct spelling results in substantial improvement. In a subject area where spelling accuracy is a desirable objec- tive, computerized drill and practice provides a most effi- cient and effective study aid. Certainly a human tutor would, not have the patience and infatigability inherent in a com- puter-managed system. Anatomy, Physiology and Medical Term- inology are indeed subject areas where spelling accuracy is very desirable, and spelling skills are often part of the ex- pected and evaluated behaviors in undergraduate courses. An endorsement of computer efficiency is assured, especially when knowledge, achievement and spelling both Show signifi- cant gains as a result of computer interaction. The generalizability of this observation to other sub- ject areas where spelling accuracy is also a desirable in- structural goal, would seem quite apparent. 94 EVALUATION OF SIX MONTH RETENTION AS A FUNCTION OF INSTRUCTIONAL PROTOCOL The successful memorization and recall of anatomic de- tail requires that the student practice and review the new material repeatedly. Numberous retention studies have Shown that recall is enhanced when the student can perceive the meaningfulness and applicability of the material being stud- ied. In order to improve the level of learning anatomic de- tail, the instructor is compelled to demonstrate associa- tions, explain terminology origins, and in general raise the learning task up from meer rote. Research shows there to be marked forgetting of rote learned material where meaningful- ness and relevance are obscure. If the level of learning is sufficiently intense, where the student can clearly identify the applicability of the subject matter, then greater reten- tion and recall should result. Other things being equal, the intensity of learning is often related to the amount of practice and repetitive drill. Students receiving the traditional or usual instruction program and students of the experimental group which re- ceived instruction augmented with peer interaction sessions and computer-managed drill and practice, were pretested. post-tested, and repost-tested six months later. From the mean scores, the percent of retention was computed as: Percent = Re-test Pretest Post-test Pretest Retention Score Score Score Score 95 Research Hypothesis No. 9 Six month retention as measured by repost-testing will be significantly greater for Groups One and Three receiving the experimental PAL and CAI treatment, than for control Groups Two and Four. Research Findings: Mean Pre- Mean Post- Six Menths Percent test Score Test Score Later Retention Control Group + + + Traditional 60.1 - 9.46 76.1 - 4.32 67 — 5.13 43% * Instruction Experimental + Group PAL 61.6 - 5.93 85.4 and CAI *No Significant Difference 2.94 71 1' 4.86 39% * No significant difference in retention was found be- tween the two groups. The small retention percentages is consistent with similar studies. Tyler (1933) reported a 22.5% retention of anatomic detail in a zoology course fol— lowing fifteen months. ("Permanence of Learning," Tyler, R. W., Journal 9; Higher Education 4:203-204, 1933). McDougall (1958) reports a 72.6% retention for knowledge of facts in an Educational Psychology course after only a four- month interval. ("Differential Retention of Course Outcomes in Educational Psychology," McDougall, W. S., Journal 9: Educational Psychology, 49:53-60, 1958). It appears that the degree of retention may depend on the intensity of initial learning as well as activities pur- sued during the retentional interval. For instance, the students in this retention study, continued as full—time 96 students during the retention interval. During this six- month interval subsequent related material may have had a reinforcing influence on eventual retention. EVALUATION OF STUDENT ATTITUDES TOWARD THE EXPERIMENTAL PROTOCOL OF PEER ASSISTED LEARNING AND COMPUTER ASSISTED INSTRUCTION Following post-testing, students receiving the experi— mental protocol either in combined (PAL and CAI) form or independently (PAL or CAI) were asked to complete a two-part questionnaire. Part One of the questionnaire consisted of fifteen items for PAL evaluation and twenty—one items for CAI evaluation (see Appendixes H, I, and J). The five—point weighted response of students was evaluated. The question- naire was designed so that the possible range of student re- sponse was from 1 — most favorable attitude, to 5 - least favorable attitude. The mean response within this range was computed for each questionnaire item as well as for the en- tire questionnaire (see Data Tables Eighteen and Nineteen, Appendix K). Research Hypothesis No. 10 Students receiving the experimental protocol of PAL + CAI will report a favorable attitude for this instructional strategy. In order to obtain additional-individual response, Part Two of the administered questionnaire consisted of Open— ended inquiries as to which aspects of the experimental pro- tocol students liked best and least (see Appendix H). A representative sampling of student comment follows. 97 Questionnaire Item One: "What did you like BEST about the peer teaching and learning sessions?" "it's new; refreshing departure from the usual classroom activities" "being student—managed, the pressure of teacher presence wasn't there" "it was fun, doing something for a change: rather than just listening" "seeing the mistakes of others made it easier for me to accept my own weaknesses" "gave us a chance to practice teaching" "anything's better than just sitting and taking notes" "we get to know each other and learn from each other" Questionnaire Item Two: "What did you like LEAST about the peer teaching and learning sessions?" "one or two people just dominated everyone else" "it was difficult making yourself understood when explaining the lesson" "too much pressure and tension from others in the group" "you can't teach it if you don't know anything" "I don't like talking in front of groups" "it was too embarrassing" Questionnaire Item Three: "What would you recommend to im- prove the peer teaching and learning sessions?" "allow more preparation time, perhaps 1-2 days" "match students together so that the dominant types aren't in the same group" "provide other options for those unable or un- willing to participate in group activities" "experiment with somebody else" "expand this form of teaching, especially for those, like myself, interested in becoming teachers" "have students choose the group they want to be in" 98 Questionnaire Item Four: "What did you like BEST about the computer drill and practice sessions?" "being able to schedule whenever you have time" "not being afraid of making mistakes: except when it affected my computer score" "the computer was fun and helpful but at times I felt that it was as dumb as me, because it wouldn't take my answer" "I liked the immediate grading of answers, so that you knew quickly if your answer was right" "I liked being able to go to the computer room as many times as I wanted" "it was new and different" "I liked having the typed pages to take home for study" Questionnaire Item Five: "What did you like LEAST about the computer drill and practice sessions " "sometimes it would disconnect you and then I'd have to start over" "the computer wouldn't tell you why your answer was wrong. Some I thought were right, but it said NO II "it was really a waste time if you hadn't studied first. It doesn't teach" "I found that if you only have a slight error it was counted wrong. I typed 'nerves' and the answer was 'nerve.‘ Because it said I was wrong. I had to look it up to see what the right answer was" "I wished that we would have had more time to practice before the test" Questionnaire Item Six: "What are some recommendations you have to improve the computer drill and practice sessions?" "let the computer give the correct answers if a student misses one" "Delta needs more terminals so that more students could use them during the school hours" "have the computer at least tell you if your spell— ing was right" 99 "have the same group from class go to the computer room together and drill as a team" "program the computer to teach as well as drill and practice" "suggest to other teachers that they use computers in their courses" In general, the student response was encouraging and from some, very enthusiastic. It appears that their weak- ness in the area of communication poses some difficulty with peer interaction. The extremely potent force of peer pres— sure for cooperative participation resulted in psychologi- cal difficulties for some, who chose to withdraw or transfer. Fortunately, the number of individuals with this problem was very small. There was concern that enthusiasm for computer assist- ance was largely related to its novelty. However,subsequent applications of computerized drill and practice received the same receptive evaluation which would support an expansion of the program. Although students frequently requested that correct answers appear following the student's incorrect re- sponse, it was felt that not having the answer printed would serve to encourage the student to review texts, notes or other reference material, and in so doing, the student would develop the skills required to research the correct answer. To have the question and answer printed would make the stu- dent too dependent on computerized "spoon feeding" and tend to suppress motivation and individual resourcefullness. The Program did permit the student to reexamine any question Previously missed which would allow for a new spelling or a 100 different reply to be evaluated. Since the total interaction between student and computer is printed on paper that may be removed by the student, each print—out becomes a very useful study aid. STUDENT OPINION TOWARD PEER ASSISTED LEARNING The five-choice option provided by the fifteen—item ques— tionnaire was designed so that a choice of one to each item represented a very favorable attitude for PAL. Conversely, the selection of the fifth response represented the least favorable attitude for Peer Assisted Learning (see Data Table Eighteen, Appendix K). The overall questionnaire mean response was 2.62 for the range one to five. This relationship might be illustrated thusly. 1.... ...... 2. ........ 0.3 .......... 4 ........ .05 Most Favorable Uncertain Least Favorable Attitude Attitude Research Findings: Mean Questionnaire Item Response 1. The PAL sessions challenged me to do my 2.13 best work. 2. I found the PAL sessions embarrassing and 1.66 uncomfortable. 3. I would prefer the usual classroom teaching 3.03 and learning format. - 4. Having to teach fellow classmates enabled 2.91 me to learn more effectively. 5. Peer teaching was an inefficient use of 1.99 class time. 5- Classmate assistance with study and learn- 3.35 ing would have resulted without the formal program. lOl Mean Questionnaire Item Respgnse 7. I felt capable of teaching my material to 2.30 fellow classmates. 8. The assigned time for the Peer sessions was 3.00 adequate. 9. I would recommend the use of Peer Teaching 2.56 for other courses. 10. Individual personality differences made 2.98 c00peration awkward. 11. I found it difficult to explain scientific 3.04 concepts to fellow classmates. 12. It was especially difficult to make myself 2.91 understood. 13. I would enroll in additional anatomy classes 2.90 where PAL was being used. 14. I particularly enjoy the involvement and 2.03 participation afforded by the PAL sessions. 15. I would prefer to have all of the teaching 2.57 done by the instructor. OVERALL QUESTIONNAIRE MEAN: 2.62 An item-by-item analysis identifies areas of student enthusiasm and areas of student concern. Students appeared receptive to the departure from the traditional format (Items 5 and 14), but appear reserved about any permanent change in strategy (Items 3, 9, l3 and 15). The students viewed teaching and learning effectiveness for the PAL ses— sions with mixed reactions (Items 1 and 4). While most felt that peer interaction compelled their best effort (Item 1): many were uncertain as to its effectiveness (Item 4). The response to Item 4 calls for a comparison by the student and the consensus of a noncommitted response (Mean Response a 2.91) may well reflect their inability to make such a 102 comparison. Most students were receptive to the participatory aspects of PAL (Item 14) and did not find that their active involvement and exposure produced apprehension (Item 2). Half of the respondents felt that peer assistance and associ- ations would have resulted as part of usual student classroom activities and interaction (Item 6). Group concerns for time allowances (Item 8), personality discord (Item 10) and com- munication difficulties (Items 11 and 12) appeared to have been manageable even though individual differences were evi- dent. In summary, student reaction appeared conservatively favorable (Overall Mean Response = 2.62) toward the peer medi- ated teaching and learning experience. Their cautious opti- mism would encourage the continual exploration of this teach- ing strategy. STUDENT OPINION TOWARD COMPUTER ASSISTED INSTRUCTION A questionnaire to solicit student attitudes toward the computer interaction sessions was administered to all stu— dents participating in and completing the required three- hour computer—managed drill and practice sessions. The total number of questionnaires distributed and evaluated was sixty- five. . The questionnaire was designed in such a manner that favorable responses for CAI were found as first and second choices. The attitude most favorable for CAI would be in the first position, for each item and conversely the least 103 favorable attitude was the last and fifth possible item re- sponse. Attitudinal Questionnaire Item 1.... ...... 2 ........... 3 .......... 4 ..... 0.0.05 Mbst Favorable Uncertain Least Favorable Attitude Attitude Such a design enables quantification of student response and statistical analysis. A mean response value near 1.0 would reflect a consensus of favorable agreement with the at- tidues presented by questionnaire item (see Date Table Nine- teen, Appendix K). Research Finding : Mean Questionnaire Item Response 1. The method by which I was told whether 3.15 I had given a right or wrong answer be- came monotonous. 2. I felt challenged to do my best work. 2.55 3. I felt as if someone were engaged in con- 2.23 versation with me. 4. I was more involved in operating the termi— 1.31 nal than in understanding the course ma- terial. 5. The learning was too mechanical. 2.69 6. I felt as if I had a private tutor. 2.16 7. The equipment made it difficult to con- 2.49 centrate on the course material. 8. Computer assisted instruction, as used in 2.60 this course, is an inefficient use of the student's time. 9. I felt frustrated by the situation. 2.39 10. I found the computer assisted instruction 3.31 approach in this course to be inflexible. 104 Mean Questionnaire Item Respgnse 11. I was satisfied with what I learned while 2.21 working with the computer. 12. I would prefer computer assisted instruc— 3.35 tion to traditional instruction. 13. Computer assisted instruction is just a- 3.13 nother step toward depersonalized instruc- tion. 14. I was not concerned when I missed a ques- 3.23 tion because nobody was watching me. 15. I found myself trying to get through the 2.59 material rather than trying to learn. 16. I felt I could work at my own pace. 2.00 17. Questions were asked which I felt were not 2.21 related to the material presented. 18. Material which is otherwise boring can be 2.80 interesting when presented by CAI. 19. The CAI material was presented too slowly. 2.97 20. Computer malfunctions made learning diffi— 3.12 cult. 21. Computer assisted instruction makes it 2.26 possible for me to learn quickly. OVERALL QUESTIONNAIRE MEAN: 2.60 Several items examined student attitudes toward the often heard CAI criticism that computer-managed teaching, and drill/practice in particular, is too mechanized, too imper— sonal, and without any of the qualities desirably found with "living" tutors. Student responses to Items 3, 6 and 13, would not support this criticism. Mbst students viewed the computer as a "private tutor," engaged in a private conver- sation with the user. This rapport is encouraged by pro- gramming the CAI lesson to use the student's name and vary 105 the reply message so that the computer becomes as unpredicta- ble as a "living” tutor in its response. While many students do view CAI as another step toward depersonalization of in- struction (Item 13), it would appear that such a trend might not be viewed as totally undesirable. Such a "depersonalized" or nontraditional approach allows for self-pacing (Item 16). The competitive or game aspect does challenge the student for their best effort (Item 2), with substantial learning (Item 11). Students were reticent of making errors (Item 14) even though the computer interaction is privately conducted with- out grading or disclosure of student performance. Again the gaming aspect of the user versus the "machine" challenges the student to perform well. The technology interface may present some difficulty. The "Drill—Response-Drill" methodology may become monotonous (Item 1). However, the novelty of "Buttons to Push" and "Computer Mystique" does not appear to interfere with inter- action (Items 4 and 7). The machine does malfunction on oc- casion resulting in frustration for all concerned. Students viewed such equipment failures as not being a serious detri— ment to the instructional process (Item 20), and not an in- efficient use of time (Item 8). Mest students were not frus- trated by CAI (Item 9) and perceived the interaction as a learning experience (Item 15). While the material may have been presented slowly (Item 19), its relevance to the instruc- tional unit was confirmed (Item 17), and most students felt that the CAI presentation of instruction may be more desira- ble for certain material (Item 18). Interestingly, there 106 was agreement that the CAI sessions enabled the material to be mastered more quickly (Item 21). This finding is in agree- ment with other studies where faster learning rates prevail even though no significant difference may exist for achieve— ment. While not an unqualified endorsement for CAI, the ques- tionnaire analysis does suggest a favorable student attitude for the computer drill and practice interaction sessions. (The overall questionnaire mean response was 2.60.) Major strengths are identified as individualization and the pri- vate opportunity to be tirelessly tutored without fear of making errors. Major weaknesses relate to the students not wanting to remove the "human" teaching from the instruc- tional delivery. The inevitable equipment problems are a source of frustration and certainly distract from the in- tended outcomes. Students are conservative in their approv- al of CAI, and in particular with the extension of its use into other subject areas. It would appear that as long as CAI remains an instructional option which may augment but not replace classroom teaching, students favorably approve. CHAPTER SIX CONCLUSIONS AND RECOMMENDATIONS Both peer teaching and learning sessions and computer— managed drill and practice sessions appear to be effective instructional strategies: not as a replacement for the class- room teacher but rather supplementary and complimentary to the traditional format. Evidence from the literature, from student achievement records, anecdotal responses from par- ticipating students, and especially evidence derived from this controlled and statistically evaluated study would sup- port the finding that CAI and PAL were most effective for this application. Students are eager and most receptive to an instructional strategy that allows them active participa- tion. The passivity of traditional methods tends to stifle independent effort and provide little in the way of individu- alized instruction. However, the K~12 years of being a pas- sive recipient of pedagogical wisdom has conditioned stu- dents to this role. Any abrupt change could create psycho- logical trauma for some. The exposure, the responsibility and the close association required in a peer structured learn- ing experience may create unmanageable difficulties for the individual. Because of these inherent weaknesses, the gen— eralizability of peer learning may well depend more on the expertise, talent and perceptiveness of the instructor 107 108 rather than documentation that peer teaching is effective. The common notion of teaching as simply giving informa- tion to a class, disregards other very important facets of the task. Such a notion presents a very limited View of the variety of teaching methods and techniques available and of the kinds of behavior changes possible. By and large instruc- tional practices are based on principles from learning theory psychology and when a clear application to teaching is lack— ing, the teacher must simply resort to the methodology that produces desired results. While it is true that an indivi- dual, particularly one that is motivated and bright, can learn without a teacher, his efforts can be quite inefficient. Individuals who need to learn health information and skills, even though they are motivated, often do not have sufficient orientation to health matters to attain the goal alone. It. therefore, becomes encumbered upon the teacher to provide as- sistance, in whatever form, which will offer to each student the opportunity for success. In order to maintain motivation and be truly self- directing, an individual must receive satisfaction for learn- ing. The teacher maximizes this by establishing realistic objectives and goals for the student. In addition, by in- volving the student as an active participant in the educa- tional process, the wise teacher utilizes the creative and expressive talents of the student to bring about a feeling (Jf fulfillment and self-worth for himself. To change the ed- L‘lCa.t.:i.ona1 setting from one highly competitive to one highly COOperative, is to establish a sense of community and common 109 purpose that encourages learning and personal growth. An instructional strategy that provides several Options for learning can challenge the individual with a varied de— parture from the passive traditional methods. The pedagogi- cal format becomes truly individualized as each student is offered an instructional option that truly leads to a sense of adequacy. The ideal might be perceived as the college pro— viding a "supermarket" of instructional strategies. Clearly, peer learning and computerized assistance is a movement to this end, where the individualization of instruction is the desired goal: where the acquisition of knowledge has its hu- mane uses such as enabling stimulating interactive discourse, establishing rapport, and the tools for sharing common in- terests. Allowing students to learn by teaching raises learn- ing from the Knowledge level to the higher level of Applica- tign, which offers the student a broad opportunity for self- fulfillment. The experimental protocol consisting of both peer and computer interaction appears to provide such a substantial level of learning intensity, that minimum additional study time is required. In a very real sense these supplementary sessions (PAL and CAI) constitute both group and individual study sessions, where concepts and detail are tested, verba- lized, and drilled. Such an accomplishment is indeed the desired objective of any supplementary exercise that follows the lecture. However, the classical laboratory period of demonstration, experimentation and data gathering often fails to attain the objective of instructional enrichment, but 110 rather becomes merely an appendage of the usual instructural process. Providing answers for an anatomical diagram, label— ing of illustrations and Similar mechanical exercises, al- though classical in style, are not always challenging to the student. The tasks are often carried out in a rote and me- chanical manner where the intensity of learning is indeed quite shallow. Learning, retention, and application are known to be correlated with the intensity of the educational experience and its mode of delivery. The active involvement of the stu- dent, required in PAL and the individualized drill and prac- tice offered by CAI provides an instructional delivery sys— tem that challenges best performance, offers involvement and establishes an intense educational experience. Because of the rapid increase in school enrollment, the fantastic expansion of knowledge, and the demand by the bill- paying public for economical yet sound educational practices. educational institutions are confronted with a multi-faceted dilemma that requires utilization of new and better teaching techniques. This problem has been a growing one for several decades and the educational specialists have emerged with many interim solutions-—everything from the mass lecture to broadcast television--in an attempt to cope with the problem. Although each medium has its obvious strengths and weak— nesses, most are coming under increasing attack by educators who feel that the learning process is not nourished to the extent that it should be. Thus, we too often have a medium that only enables an institution to group hundreds of 111 students and hopefully lower the educational cost. Unfortu— nately, even though the cost in dollars has been decreased. the wasted student time and the less-than-acceptable learn- ing is a cost that our society cannot afford. Early attempts at adapting instruction to the needs of the learner resulted in an interim solution known as indivi— dual instruction. This instruction merely allowed students to work individually through a programmed text or audio/ visual presentation in a lock-step fashion that resulted only in pacing students and not considering individual differences other than speed. On the other hand, individualized instruc- tion suggests that something unique about the learner has been taken into account in a dynamic way to build an instruc- tional sequence. The simple, yet important act of purveying information is also in dire need of improvement. Lecture halls are sad- ly lacking: instructional television seems not to be the answer: and the long-time stand-by, the textbook is, in it— self, not an acceptable medium to present material to an un- motivated student. For some time educators have agreed that instruction, if it is to be successful, must not be directed toward a mass of students gathered in some lecture hall. It is important that new methods and techniques be de- veloped that will improve the quality of instruction and, at the same time, make it available to all students, whether ad- vanced, disadvantaged, or removed physically from centers of learning. we must have available, now, instructional 112 techniques that will provide relief from standard teaching methods and yet have the capacity to include the fast-rising number of students clamoring for education. The newest technology to appear, and one that promises to open this door to efficient, low cost, and sound educa— tion, is computer assisted instruction. Computer assisted instruction (CAI) is just now entering its second decade of development, and so far has shown itself to be a most promis- ing medium for improving the educational process. Because adequate data for evaluation requires time and because the development of techniques and hardware must preceed utiliza- tion, the concept is still young and not totally proven. The future, however, seems to be bright. When one looks at the cost of CAI, he must take into ac— count three areas of potentiality which may affect the proba— bility of acceptance. First is the comparison of CAI to the cost of other modes of instruction. CAI costs per student hour are not as expensive as other modes of instruction such as remedial instruction, vocational instruction, or home- bound instruction. Neither is it high when one thinks of al- lowing the people termed as uneducable to remain so. Secondly, there is the fact that while the costs of technology required to produce and maintain CAI are steadily decreasing, the costs of conventional education are soaring. The increasing number of personnel and the increasing cost of this staff suggests that schools should very seriously consider modern educational technology as an alternate ap- proach for meeting some of their goals. 113 The third potentiality is the fact that a computer in- stalled as an instructional tool may well be adapted for ad- ministrative duties, e.g., after hours use as a scheduler, grade reporter, bookkeeper, etc. On this basis alone the cost of a CAI system could be justified. It is also this use which helps make the cost of CAI, as an instructional tool, inexpensive. Using the computer most closely simulates the ideal in- structional situation, i.e., a one—to-one relationship be- tween instructor and student, for CAI has the flexibility and capacity for individualizing instruction which is necessary for the adaptive education that a wide variety of learners requires. There are three fundamental characteristics of computer applications in instruction which suggest that significant steps in improving instruction can be achieved through the utilization of computers. The first characteristic of com— puter assisted instruction is the active responding by the student. This characteristic is quite important for the slower learner. A properly prepared child may learn by read- ing through a textbook or other printed material. The un- motivated child simply needs the active response to and the feedback from the computer program. A second characteristic is the ability of a program in the computer to evaluate the student's responses and provide information regarding these responses. This allows feedback tailored to the ability level of each student, regarding his responses: whether he be the most advanced or the poorest 114 student. It also indicates that the poorest student still received feedback regarding his work at the minimum of once per minute, while in a regular classroom, this same student. governed by his reticence, may respond and receive feedback only two to three times per week. This individual attention and individual responsibility tend to motivate even the most reluctant pupil. A third feature of the computer's ability as an instruc- tor is its individualization of instruction not only at the level of achievement but in reference to the specific in- terests and abilities of the student. The computer can keep a record of the student's performance and progress through a course and alter that course based upon the immediate past history of the individual student in studying that subject matter. This dynamic characteristic of CAI makes it possible to begin considering not the passage of time nor the covering of a specific text nor doing a given number of problems as criteria for progressing through the curriculum, but the op- portunity to base student assessment upon the mastery of pre— determined criterion levels. Thus, each pupil takes a "branching" route through his course with his exact path de- pending upon his own successes in each stage. No pupil is allowed to persist in practice that is too easy for him or to suffer repeated failure in lessons that are too difficult. An important side advantage of using the computer is its ability to keep the teacher constantly informed of the progress being made by each student. At the same time, be— sides informing the teacher of the progress of each pupil, 115 the system also has the capacity to deliver periodic reports on the progress of the class as a whole, thus enabling the teacher to make necessary changes in her plans, methods, etc. Invariably, when one begins to speak of a new or an im- proved technology to aid the educational process, an outcry arises relative to what this innovation will do to the status of the present teacher. Some believe that a newer technology, such as CAI, is a "flash-in-the—pan" and will die out if left alone. Others become upset because of fear that they will be replaced by a computer, and their defense mechanism puts forth arguments to school boards that are often quite con— vincing. In actual experience to date, it has been seen quite clearly that the computer and CAI do not replace the present teacher, but merely rearranges teacher priorities. With CAI handling drill and recitation, the teacher can do what a teacher does best: develop new concepts. CAI will take a— way the drudgery of rote teaching: a consistently endless time and energy draining technique. It is during this time that the teacher is freed to act as diagnostician: to help individuals with problems. Also, the computer, used as an administrative tool, will virtually eliminate the teacher's acting as a human data processing machine, i.e., inventory— ing, grading papers, counting heads, scheduling, etc. This technology allows teachers to concentrate their attention on the personally human concerns of their students. Teachers can spend time on the higher order activities of motivating pupils, diagnosing learning handicaps of individuals, and 116 prescribing appropriate and effective remedial instruction. Released from their normal repetitive tasks, they can now facilitate such activities as group meetings in which students discuss their hopes, fears, dreams, and anxieties. Teachers can help students in their struggle to resolve value issues and conflicts and overcome feelings of alienation, powerless- ness and self-doubt. Teachers can help students set meaning- ful goals, order their priorities and make important personal and social decisions. Onaof the strongest educational features of the computer, is its ability to provide tireless drill and immediate evalua- tion. Its demand for precision in Spelling as well as fact- ual accuracy, makes computer augmented instruction in anatomy most appropriate. Computerized drill and practice must be viewed as an in- structional aid, supplemental to the educational process. This particular computer mode is not designed to be the major instructional delivery system. Its published record for a- chievement is significant. Only when used as an adjunct to classroom teaching rather than constitute the major instructional delivery system is post-test achievement found to be significant. While post— test achievement for the group participating in computerized drill and practice is not significantly greater than achieve- ment for the control group, the important factors of study time, instructional time, and supply and equipment require- ments must also be considered. 117 The laboratory periods that are traditionally supple- mental to the formal lecture, are designed to provide enrich- ment and instructional reinforcement, where opportunities for individual, personalized tutorlage is a prime objective. Tu- torlage in this setting is invariably instructor mediated and as such, introduces the significant weakness of this de- livery system. The instructor is physically unable to per- sonally tutor, drill, and interact with each class member as individuals. While computer assistance and peer teaching in— dependently may not provide additional achievement on post- test scores, the merger of an instructional system, where in— dividual "active” participation is required and automated drill and practice is encouraged, offers the most significant achievement in the shortest time frame. Examination scores and similar measures of achievement fail to evaluate second— ary outcomes and learning qualities that are often more af— fective than cognitive. The attitudinal data provided by students which appears in this document reveals an acceptance for the experimental design not entirely related to better performance on instruc- tional post-tests. It seems obvious that one would expect that student at— titude toward the method of instruction will play an impor— tant role in both the acquisition of and the transfer of learning. A student with a more favorable attitude will prob- ably be inclined to learn more and to apply what he has learned to other situations. 118 Because PAL/CAI is what one would consider a new and dif- ferent learning environment, it is important to determine what the attitude of participating students is toward the medium. Several studies to date indicate an overwhelming prefer- ence for CAI instruction over traditional courses primarily because of the convenience of this method and the constant interaction in the learning process. Attitudinal data is al- so valuable in gauging improvements to the course content, the instruction, and the media. The attitudinal responses reported in this thesis, while favorable, were obtained in such an independent and indivi- dual manner (i.e. CAI groups and PAL groups were not pre- sented with the same evaluation instrument) that attitudinal inferences and comparisons between groups would not be valid. However, as discrete reports of student opinion, one may val- idly interpret a favorable student attitude for each of the independent strategies. It must be remembered, however, that although prelimi- nary information is favorable, adequate data will not be a- vailable until students have been exposed to CAI over a num- ber of years in varying subject matter. Recommendation for future study would include the following considerations: a) To what extent were the achievement gains docu- mented related to the experimental population being 90% women? b) Could computer lessons effectively prepare the student for an in-class, Peer Assisted Learning role? 119 c) To what extent was the success of this study and its subsequent generalization related to the enthusiasm and charismic influence of the experimentor? d) Could student involvement beneficially extend beyond peer teaching to peer evaluation and testing? e) Would a teaching design that allowed and en- couraged the students to develop and actually program computer lessons, provide a worth- while learning environment? The educational challenge of the seventies which cries out for instructional individualization, must be met with re— sponse, research and renewal: not apathy and the continuance of past practices. Of course, the amount of teaching theoretically possible in a school is limited by the number of students and by the teacher's ingenuity in providing mass education. Teaching is easy when the learner is dealing directly with materials or events, in which the teacher assumes the role of coordina- tor, manager or resource person. On the other hand, teach- ing is very difficult when the learner must deal mostly with the teacher and only through the teacher for instructional opportunities. There is much evidence that the teacher could be effectively and efficiently assisted by employing peer group and computerized learning. APPENDI CES APPENDIX A 10. 11. 12. 13. 14. 15. 120 APPENDIX A OSTEOLOGY PRE-TEST Identify the long bone of the thigh. Identify the larger of the lower leg bones. Identify the group of 7 bones that form the ankle. Identify the group of 5 bones found in the palm of the foot. Identify the long bone of the upper arm. Bone cells are termed. A break in cartilage or bone is termed. Identify the group of 8 bones that forms the wrist. Identify the group of 5 bones found in the palm of the hand. Identify the scientific name for the collarbone. The bones of the neck are known as . . . . . vertebrae. The vertebrae that attaches to the skull is designated. The largest of the three hip bones is termed. Identify the term for the lower jaw. Identify the term for the upper jaw. 121 APPENDIX A (continued) 16. Bones of the upper and lower extremity comprise the . . . . . Skeleton. 17. Bones of the skull, vertebrae, ribs, sternum, and hyoid comprise the Skeleton. 18. The shaft of a typical long bone is termed. 19. The Skull bone which forms the forehead is termed. 20. The skull bone which contains the ear passage is termed. APPENDIX B 10. ll. 12. 130 APPENDIX B OSTEOLOGY POST—TEST Identify the larger of the lower leg bones. The microscopic arrangement of bone cells and canals is known as the . system. Identify the group of 7 bones that form the ankle. Identify the group of bones found in each toe (two for the great toe.) Identify the term for the blood forming function of bones. Identify the scientific name for the shoulder blade. Ribs that attach directly to the sternum are termed. The five vertebrae of the lower back are termed. Name the largest of the sesamoid bones. Identify the bone at the base of the skull which contains the large foramen magnum. The cheek bone of the skull is termed. The skull bone which contains the ear passage is termed. The so called soft spots of the skull where ossification is incomplete are termed. —m.o—-~'_ —-.-.— —- 123 APPENDIX B (continued) 1A. 15. l6. 17. 18. 19. 20. The ossification process that forms the bones of the body except skull and face bones is termed. A multiple break in bone or cartilage is termed. (Two words) Spongy or lacy appearing bone is termed . . . . . bone. Since the second cervical vertebrae pivots 0n the first cervical vertebrae, this 02 vertebrae could be termed. The Shaft of long bones is termed. The connective tissue Sheath which covers the bone is termed. The osteopatholcgy that results in demineralization of the mature bony matrix is termed. Identify the bone that has the listed feature. Supraorbital notch Sella Turcica Carotid and Jugular Foramina Acromion Process Medial Epicondyle Foramen Magnum Xiphoid Process Olecranon Process Acetabulum Superior and Middle Turbinates Obturator Foramen 124 APPENDIX B (continued) 32. Trochanter 33. Mental Foramina 34. Medial Malleolus 35. Lateral Malleolus APPENDIX C 125 APPENDIX C SKELETAL SYSTEM INSTRUCTIONAL OUTLINE Function Support Protection Movement Hemopoiesis Calcium Storage Ul-DKNNl-J Types 1. Cancellous (spongy) 2. Compact (dense) Shapes 1. Long (humerus) 2. Short (carpals) 3. Flat (ribs) 4. Irregular (vertebrae) 5. Sesamoid (patella) Classification 1. Axial: Skull, vertebrae, ribs, sternum 2. Appendicular: upper and lower extremities Gross Anatomy of a Long Bone Diaphysis Epiphysis Articular cartilage (hyaline) Periosteum Medullary cavity Traveculae Epiphyseal plate Compact bone Cancellous bone KomNIONKJ'l-L‘UJNH 126 APPENDIX C (continued) F. Bone Markings l. Depressions and openings a. fossa b. sinus c. foramen d. meatus 2. Projections and protuberances a. Condyle b. Head 0. Trochanter d. Crest e. Spinous process f. Tuberosity g. Tubercle G. Osteogenesis 1. Intramembranous (face and skull bones) 2. Endochondral osteogenesis H. Compact Bone Histology l. Haversian system a. Lamellae b. Lacuma c. Canaliculi d. Haversian canal e. Osteocyte f. Volkmann's canals I. Types of Fractures Fatique Pathologic Longitudinal Spiral Compression Greenstick Simple Compound Comminuted Transverse OKOCDNONU'l-PUJNH H 127 APPENDIX C (continued) Fracture Repair 1. Hematoma production 2. Granulation development 3. Callus growth 4. Ossification via periosteum Osteopathology l. Rickets 2. Ostecmalacia 3. Osteoporosis CD\]O\Ul-I> a. Postmenopausal b. Disuse c. Ca++ deficiency d. Idiopathic Osteomyelitis Osteogenic sarcoma Scoliosis Kyphosis Lordosis Axial—Skull and Vertebrae l. 2. 3. Frontal a. Frontal Sinuses b. Supraorbital notch (sometime foramen) Zygomatic Temporal a. Mastoid process b. External auditory meatus (canal) c. Zygomatic process . Internal auditory meatus . Mandibular fossa . Styloid process Stylomastoid foramen . Carotid canal or foramen . Jugular foramen and fossa Occipital a. Foramen magnum b. Condyles Sphenoid a. Sella turcica, or Turk's saddle b. Optic foramen 0. Superior orbital fissure d. Foramen rotundum e. Foramen ovale intrmzHamxl 128 APPENDIX C (continued) 9. 10. 11. 12. l3. l4. Ethmoid a. Perpendicular plate b. Horizontal (cribiform) c. Superior and middle turbinates (conchae) Mandible a. Body b. Ramus C. Condyle (or head) d. Alveolar process e. Mandibular foramen f. Mental foramen Maxilla a. Alveolar process b. Palatine process 0. lnfraorbital foramen d. Lacrimal groove Palatine — Horizontal plate Parietal Nasal Vomer Special features of Skull a. Sutures (l) Sagittal (2) Coronal (3) Lambdoidal (4) Squamosal b. Fontanels c. Sinuses - Air (or bony) Bones of the thorax a. Sternum (1) Body (2) Manubrium (3) Xiphoid process True ribs (7 pairs) False ribs (3 Pairs) Floating ribs (2 pairs) Costal cartilage Costal facets HJCDQ-«OU’ M. Appendicular 1. Bone Anatomy — general considerations a. There are four types of bones (1) Long bones (humerus, femur) (2) Short bones (wrist and ankle) (3) Flat bones (ribs, skull top, hip) (4) Irregular bones (vertebra, jaw) 129 APPENDIX C (continued) b. Bones have markings (1) (2) Depressions and openings (a) Fossa (depression) (b) Sinus (cavity) (0) Foramen (hole) (d) Meatus (tube-like) Protuberances or processes (a) Condyle (joint surface) (b) Head (joint surface) (0) Trochanter (large prominance) (d) Tuberosity (smaller prominance) (e) Tubercle (smallest prominance) 0. Bones have anatomical regions (1) (2) Diaphysis (shaftlike portion) Epiphysis (bulbous joint end) 2. Appendicular skeleton a. Bones of the shoulder girdle and upper extremity (l) (4) (5) Scapula (a) Glenoid fossa (b) Scapula spine (0) Acromion process (d) Coracoid process Clavicle — sternoclavicular joint Humerus (a) Head (b) Greater tuberosity (c) Lesser tuberosity (d) Deltoid tubercle (e) Olecranon fossa (f) Medial epicondyle (g) Trochlea and capitulum (h) Bicipital groove (i) Coronoid fossa Ulna (a) Olecranon process (b) Coronoid process (0) Styloid process (d) Head Radius (a) Head (b) Neck (0) Styloid process (d) Radial tuberosity (bicipital) Carpals (8) Metacarpals (5) Phalanges manus (14) APPENDIX C (continued) b. Bones of the pelvic girdle and lower extremity (l) (2) (3) (1+) Hip bone (a) Ilium Iliac crest Acetabulum Sciatic notch (b) Pubis Pubic symphysis Pubic angle (0) Ischium Ischial spine Obturator foramen Ischial tuberosity Femur (a) Head (b) Neck (0) Greater trochanter (d) Lesser trochanter Lateral condyle Medial condyle Adductor tubercle Lateral epicondyle Patella Popliteal surface AAAAAA U. H‘ Sm *"b (D vvvvvv Tibia (a) Lateral condyle (b) Medial condyle (c) Medial malleolus (d) Fibula facet (e) Tibial tuberosity Fibula (a) Head facet (b) Lateral malleolus (c) Talus socket Tarsals (7) (a) Talus (b) Calcaneum Metatarsals (5) Phalanges pedis (l4) APPENDIX D 131 APPENDIX D OBJECTIVES AND STUDY GUIDE OSTEOLOGY A student's level of mastery for these stated goals will be determined by his ability to correctly answer a series of test questions which sample these behaviors. Each of the following statements can be prefaced with the phrase, "The student should be able to". 1. DJ 4. After defining the skeletal system, list and describe its five primary functions. Describe the classification of bones by shape and give samples of each of these bone types: a. long b. short 0. flat d. irregular e. sesamoid Given a longitudinally sectioned bone or a diagram of a longitudinally sectioned bone identify each of the parts listed below. epiphysis diaphysis epiphyseal plate or line periosteum medullary (marrow) cavity articular surface endosteum compact bone Spongy (cancellous) bone Phqutbmsl()o‘m Draw and identify on a diagram or model these components of a Haversian system seen in a section of compact bone: a. Haversian canal b. Haversian canal contents 0. concentric lamellae 132 APPENDIX D (continued) U'l d. canaliculi e. lacunae f. Volkmann's canals g. osteocytes List and describe the three connective tissue components of bone tissue. Distinguish between endochondral (cartilaginous) and intramembranous ossification in the embryo and relate these processes to the longitudinal and diameter growth of bone following birth. Define each of the following and then compare and contrast them in terms of their function and location: a. osteocyte b. osteoblast c. osteoclast When given a diagrammatic representation of an anterior and posterior view of the human skeleton, distinguish between the components of the axial and appendicular divisions of the Skeleton, by marking them in some way (e.g. shading or labeling). When given a diagrammatic representation of an anterior and posterior view of a human skeleton or an adult human skeleton, identify each of the following bones and bony landmarks; also describe the distinguishing character— istics of each bone: a. Clavicle b. Scapula (1) spine (2) acromian process ) coracoid process ) supraglenoid tuberosity ) supraspinous fossa ) infraspinous fossa ) inferior angle ) superior angle ) medial border ) lateral border ) glenoid cavity merus 1) head (2) greater tubercle 3 z, 5 6 7 8 9 0 1 U. C. ( ( ( ( ( ( ( 1 1 H ( 133 APPENDIX D (continued) (3) lesser tubercle (4) deltoid tuberosity (5) trochlea (6) capitulum (7) medial epicondyle (8) lateral epicondyle (9) Olecranon fossa d. Radius (1) radial tuberosity (2) styloid process e. Ulna (l) Olecranon process (2) ulnar tuberosity (3) styloid process (4) coronoid process f. Carpal bones (l) pisiform bone g. Metacarpal bones h. Phalanges (thumb and fingers) 1 Hip bone (1) acetabulum (2) iliac crest ( ) ischial tuberosity ( ) Obturator foramen ( ) iliac fossa ( ) anterior superior iliac Spine ( ) anterior inferior iliac spine ( ) superior pubic ramus (9) ischiopubic ramus (1) head (2) greater trochanter (3) lesser trochanter 4 medicalirecture 5 medial condyle 6 lateral condyle 7 medial supracondylar ridge 8 lateral supracondylar ridge 9 lines aspera k. Patella (l) tibial tuberosity (2) medial malleolus (3) medial condyle (5) lateral condyle 3 surfaces of the tibia (medial, lateral and posterior) 134 APPENDIX D (continued) 10. 12. m. Fibula (1) head (2) lateral malleolus n. Tarsals (l) talus (2) calcaneus 0. Metatarsals p. Phalanges (toes) When given a series of diagrammatic representations of the anterior, superior, inferior, internal floor and lateral aspects of the skull, correctly identify and label the following bones, classify each as a paired or unpaired bone of the cranium (neurocranium) or face (viscerocranium), classify each according to its shape, describe the distinguishing characteristics of each, and when possible, palpate the: a. occipital b. parietal c. frontal d. temporal e. Sphenoid f. ethmoid g. nasal h. lacrimal i. maxilla j. zygomatic k. mandible l. palatine m. vomer n. inferior concha (turbinate) State the location of these specialized bones of the skull: a. auditory ossicles (malleus, incus and stapes) b. sutural (Wormian) bones c. hyoid bone Define the word suture and describe the location of these specific examples: a. coronal suture b. sagittal suture c. lambdoidal suture 135 APPENDIX D (continued) 15. 14. 15. 16. Define the word fontanel and state its function and/or when given a diagrammatic representation of the superior and lateral aspects of the fetal skull, correctly identify and label the: a. anterior fontanel b. posterior fontanel c. sphenoidal (anterolateral) fontanel d. mastoid (posterolateral) fontanel Given a diagram of the anterior and posterior skeleton or a human Skeleton correctly identify these components of the axial Skeleton: a. cervical vertebrae b. thoracic vertebrae c. lumbar vertebrae d. sacrum e. coccyx f. sternum (manubrium, body and xiphoid process) g. ribs Given a diagrammatic representation of the superior and lateral aspects of a "typical vertebra" or a real thoracic vertebra correctly identify the: a. body b. neural arch c. pedicle d. lamina e. transverse process f. vertebral foramen g. spinous process h. superior articulating process 1. inferior articulating process Describe and discuss the relative size and distinguishing characteristics of the following components of the spine (vertebral column): a. cervical vertebrae (l) atlas or C-1 (2) axis or C-2 b. thoracic vertebrae c. lumbar vertebrae d. sacrum e. coccyx APPENDIX E RNRT-E 5 LET U80 10 11 13 13 14 15 50 PRINT PRINT PRINT PRINT 136 APmnmrxa COMPUTER PROGRAM IN BASIC THE SKELETAL SYSTEM LET 080 LET U30 PRINT"THI3 PROGRHN 13 DESIGNED TO PROVIDE DRILL 8ND PRRCTICE IN THE RRER PRINT” PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT INPUT PRINT INPUT PRINT INPUT PRINT PRINT PRINT PRINT PRINT PRINT PRINT PRINT HUNRN HNRTONY& ' INSTRUCTIONRL UNIT TWO 3 THE SKELETHL SYSTEM“ "THIS PROERRN MR? BE USED 93 R PRETESTTPOST-TEBT OR FOR" "TUTORIRL DRILL HND PRRCTICE. QUESTIONS RRE RRNDONLT” ”SELECTED FROM 8 POOL OF 200 ITEMS. 8 REPORT OF CORRECT” ”RESPONSES I3 CRLCULRTED RND PRINTED FOLLOWING ERCH RHCUER." “SUMNER? CRLCULRTION? RRE PROVIDED UHEN CONCLUDED 8ND THE " “OPPORTUNITV FOR RErEKRNINRTION OF RN? ITEN I3 RVRILRBLE." ”REMEMBER: ERCH QUESTION MUST BE HNBUERED UITH CORRECT SPELLING” "UKRY. LET’S BEGIN 2:" “PLERSE TYPE YOUR FIRST Nana“; 91$ "PLEHSE TYPE YOUR LNST NRME '3 3:: "TYPE TOUR INSTRUCTOR’S LRST NRNE”? C13 - ”THRNK YOU, "381$?“ YOU RRE 1002 CORRECT SO ERR . ”NOU , FOR THE TOUGH ONE? 2!" LET J=0 LET U30 RRNDONIZE DIN C(30) LET R=1 LET 3=31 LET N=INT (RHDOCB-N)+ND RNHT-E (:oNTznuen) 33 IF 3(3) (30 THEN 3000 34 LET Q=O+1 35 PRINT X 96 IF XPSO THEN 3033 '3? LET S (:4): 93 IF X<=16 THEN 105 39IF X4333 THEN 106 100 IF .44 =43 THEN 1053 101 IF 44:64 THEN 110 103 IF X<= ‘30 THEN 113 103 104 105 ON X SOTO 3309 36 09300934093'30943 09 46095009 54095'309 63096?09?109?509?909370 106 LET X=X'16 107 ON X SOTO 9109950939091030910?09111091150911909136091L 370,1310, 50913'309 4409303093030 103 LET K=K‘33 109 OH H SOTO 313093160933009334093371933? 3009335093390 110 LET X=h-4'3 111 ON K SOTO 3- 330933 30934109345093430935409359093630936309330093340933309 010940509410094140 113 LET X=X-64 113 ON X SOTO 43009434094330943 3094330944309 44516944619 446594470944? 49 447‘39 433944339443194495 114 119 130 PRINT CHR'3(HSS (BE L) I 131 330FRINT"IDENTIFT THE LONS BONE OF THE THISH" 330 INPUT HS 340 IF HS="FENUR"THEN 1430 350 SOTO 1650 360 FRINT"IDENTIFT THE LHRSER OF THE LOUER LES BONES" ‘ 3? INPUT BS 330 IF BS="TIBIH"THEN 1430 330 SOTO 1650 300 PRINT"IDENTIFY THE SJRLLER OF THE LOUER LES BONES" 310 INPUT SS 330 IF C$="FIBULH"THEN 1430 330 SOTO 1650 . 340PRINT"IDENTIFY THE BONE THHT FORMS THE KNEE CHP " 350 INPUT 0% 360 IF DT="FHTELLH"THEN 1430 - “x 3?0 SOTO 1650 330 FRINT"IDENTIFY THE SROUP OF ? BONES THRT FOR” THE HNVLE" 390 INPUT ES 400 IF E'3=" THRS 3L3" THEN 1430 410 SOTO 1650 4309RINT"IDENTIFY THE SROUP OF 5 BONES FOUND IN THE EHLN OF THE FOOT" 430 INPUT F3 440 IF F$="HETRTHRSHL3"THEH 1430 450 SOTO 1650 460 PRINT"IDENTIFY THE SROUP OF BOPEE FOUND IN EHCH TOE (3 FOR THE SREHT TOE' "'33 931009 315 M' [:10 224 222 2 22 24. 0.0 37'39 ff.- I'IJ 138 . HNHT-B (EDNTINUED) 420 IHPUT 55 420 IF G$="PHRLHHCES"THEH 1420 420 EaTn 1550 SOOPRIHT“IDEHTIFY THE LONG BONE OF THE UPPER HRH“ 510 INPUT H5 520 IF HI="HUMEEUE"THEH 1420 530 GDTD 1550 540 PRINT“IDENTIFY THE BONE 3F EUEEHEM THRT 13 IN LINE wITH TH 55o INPUT 15 550 IF I$="RHDIUS“ THEN 1420 5?0 EnTn 1550 530 PRINT”IDENTIFY THE BONE as THE FEEEHEM wHIEH IS IN LINE 01TH THE THIRD" 520 PRINT"FIHGER any ELEU EOEME THE POINT OF THE ELBDU“ 600 INPUT J$ 610 IF 15:"ULHH" THEN 1430 520 EUTU 1550 THUMB”. "I 9 630 PRINT "IDENTIFY THE GROUP OF EIGHT BONES THHT FORMS THE WRIST“ 640 INPUT K3 650 IF K$="CHRPHLS“ THEN 1430 660 GOTO 1650 . 670 PRINT ”IDENTIFY THE GROUP OF FIHE BONES FOUND IN THE PRLN OF THE HHHD" 680 INPUT L3 690 IF L$=“NETHCHRPHL3" THEN 1430 700 SOTO 1650 710PRINT“IDENTIFY THE GROUP OF 5 BONES FOUND IN EHCH FINGER (2 FOR THE HHND)" ?30 INPUT N3 ‘ 730 IF M$=“PHHLHNGES"THEN 1430 740 GOTO 1650 ?50 PRINT"IDENTIFY THE SCIENTIFIC NRNE FOR THE COLLHRSONE" 760 INPUT N3 ??0 IF N$="CLRVICLE"THEN 1430 730 GOTO 1650 790PRINT"IDENTIFY THE SCIENTIFIC NHHE FOR THE SHOULDER BLHDE" 300 INPUT Of 310 IF O$="3CHPULH"THEN 1430 330 GOTO 1650 330 LET H=1 340 LET B=15 9 3?0PRINT"RIBS THHT DO NOT HTTHCH DIRECTLY TO THE STERNUN REE TEPMED ???" 330 INPUT P3 390 IF P$=”FHLSE" THEN 1430 900 GOTO 1650 ' 910 PRINT "RIBS THHT HTTPCH DIRECTLY TO THE BTERNUM HRS TEPMED ??" 920 INPUT 0% 930 IF Q$="TRUE” THEN 1430 340 GOTO 1650 950 PRINT "RIBS THHT ONL? HTTHCH TO THE HERTEBRHE ORE TERMED ??” 360 INPUT R3 9?0 IF R$="FLOHTING" THEN 1430 930 GOTO 1650 3HHT-3 990 PRINT 139 ' (cauTxuUEnb “THE SEVEN VERTEBQRE OF THE NECK BEE TERHED " 1000 INPUT 30 1010 IF 31="3E.0133L“ THEH 1430 1030 30T0 1350 1030 PRINT"THE TMELVE VERTEBRHE OF THE 3HE3T H301H3 313 HTTHCHMENTS 33E TERMS 1040 INPUT T3 1050 IF T3="TH033313" THEH 1430 1030 3010 1350 1030 PRIHT "THE FIVE 0E313333E 0P THE L00E3 3033 r33 TERMED " 1030 INPUT 03 1030 IF U3="LUH333" THEH 1430 1100 30Tu 1350 - 1110 PRINT “THE L331 LUHBHR 0E313333E HTTHCHES Ta UH1EH 30HE OF THE 3PIHE" 1130 IHPUT 03 1130 IF V$="3HCRUM” THEH 1430 1140 30To 1350 1150 PRINT "THE 0E31E333E THHT 31133H33 T0 THE SKULL 13 0E3 3H31E0" 1130 IHPUT Us 1170 IP 03:"31" THEH 1430 1130 30T0 1350 1130 PPIHT "THE L33T NECK 0EPTE333E 13 03313HHTE0" 1300 IHPUT H3 1310 IF 33:"33" THEH 1430 1330 30T0 1350 1330 PRIHT "THE 03313333E THHT HTTHCHES 10 THE 3303UH 13 BEEIGHHTED" 1340 INPUT v3 1350 IP Y$=”LS" THEH 1430 1330 30Tu 1350 13?0 PRINT "THE LHST VERTEBRHE wITH HTTRCHED 3133 13 0E313HHTE0 " 1330 INPUT :3 1330 IF 33:"T13" THEH 1430 1300 30Tn 1350 1310 PRINT “THE L333E3T UP THE THREE HIP BGNES 13 TERMED" 1330 IHPUT 33 1330 IP H3="ILIUH"THEH 1430 1340 30T0 1350 1350 PPIHT"THE PELvIc BUHE JUST BEHEHTH THE PUBIC HRIR 13 TERMED 1?" 1330 IHPUT 33 1330 IF B3="PU313"THEH1430 " 1330 30T0 1350 1330PEIHT "THE PELVIC GIRDLE 30HE HHIcH FORMS THE Lqun 3030E3 OF THE " 1400 PRINT "031U33T03 FDRHHEN 13 TERMED " 1410 INPUT 33 1430 IF 33:"133H1UH"THEH 1430 1430 30T0 1350 1440 PRINT “THE PUIHTEn TIP UP THE STERHUM IS TP3050 1450 INPUT 03 1430 IP D£="ETPHGID"THEH 1430 14P0 30T0 1350 1430 LET J=J+1 140 . RNRTPB (CONTINUED? 1431 1433 1433 REM LINE3 1430«1330, 3ENER3133 RHNDDN 33LECT10N DF 3T3TENENT3 MHICH 1434 REN HCKHDMLEDGE THE CDRRECTHESS UR 1N30RRE3TNE33 UP THE 3N3wER. 1435 1433 1430 LET 3:1 1500 LET 3:3 1510 LET D= RHD P (B-H)+H 1515PR1NT 1330 U” D 50 TU 153091550015709159011610 1530 PRINT "HE? "1313;",THaT’3 R13HT111" 1540 30 TD 1330 1550 PRINT"R13HT ON *1 313;".11" 1530 30 To 1330 1530 PR1NT"0KRY "1313;".I’LL HCCEPT THRTs'1" 1530 33 TD 1330 1590 PRINT“YES “§Ri$3",THRT’3 RI3HT111“ . 1300 33 T0 1330 1310 PRINT"GREHT1"3R1£3"'23THHT’3 RIGHT!!!" 1330 30 TD 1330 . 1330 IF 3:33 THEN 3030 1331 PRINT “YOU Now H303 1333 IF 0-J=10 THEN 4500 1335 PRINT 1340 30 TD 1330 1345 PRINT 1350 LET 3:1 1351 LET 3:3 1353 PRINT 1353 PRINT 1330 LET E= RND o (B—3>+a 1330 UN E 30 T0 1330.1300.1330,1340,1330 1330 PRINT"30RR3 "1313;",TH3T'3 0R0N5111 1330 30 TO 1330 1300 PRINT 3133" YOU’VE GOT TO BE KIDDING!!!“ 1310 30 To 1330 1330 PRINT “YOU REE anN3 ";313 1330 30 To 1330 1340 PRINT"N0T HHRDLY1"391$ 1350 30 TO 1330 1330 PRINT "T50 330,";a131" ’YDU 995 anN3 :1 " 1330 30 TD 1330 1330 PRINT "CHECK YOUR 3PELLIN3 0R GRANNHR 11:" 1335 PRINT - 1333 30 TD 1330 . 1330 PRINT "00 YOU MHNT HNUTHER 0UE3110N 33 13PE 3E3 DR N0 --"; 1300 INPUT T3 1301 PR1NT 1305 PRINT ' J 3“CDRRECT RHD "3Q-J 3”INCDRRECT RESPONSES" 141 . HNHT-E (CONTINUED) 1310 IF T$=”YES" THEN 9? 1320 IF T$="NO" THEN 1330 1325 GOTO 1790 1330 PRINT 8103”: YOUR TOTHL SCORE UHS";INT (J!OOI00)3“PERCENT CORRECT" 1340 IF J/Q>.90 THEN 1390 1350 IF JIO>.30 THEN 1910 1360 IF J/QP.F0 THEN 1930 1970 IF J/O>.50 THEN 1950 1990 IF J/Q>-1 THEN 19?0 1390 PRINT " EXCELLENT 1!! YOUR GRHDE IS ... H 1900 SOTO 3000 1910 PRINT ” SPY: PRETTY GOOD 1! YOUR GRHDE IS ... B “ 1920 GOTO 3000 1930 PRINT " NOT TOO END 1 YOUR GRRDE IS ... C" 1940 GOTO 3000 1950 PRINT f_SORRY1 BETTER LUCK NEXT TIME 1 YOUR GRRDE IS ... D " 1960 GOTO 3000 1970 PRINT "YOU COULD HHVE DONE BETTER THHN THHT !! STUDY HND TRY RGRIN “ 1930 GO TO 3000 2030 PRINT "IDENTIFY THE BONE RT THE BASE OF THE SKULL UHICH CONTRINS“ 2040 PRINT "THE LHRGE FORHNEN NHENUN“ 2050 INPUT H0 2060 IF H$="OCCIPITRL“ THEN 1490 2070 GOTO 1650 2030 PRINT "IDENTIFY THE TERN FOR THE LOUER JHU” 2090 INPUT Bi 2100 IF B$="NHNDIBLE" THEN 1430 2110 GOTO 1650 2120 PRINT "IDENTIFY THE TERN FOR THE UPPER JHU“ 2130 INPUT CS . 2140 IF C$="NHXILLR” THEN 1430 2150 GOTO 1650 2160 PRINT "TH- CHEEK BONE OF THE SKULL~IS TERNED" 21?0 INPUT D0 2130 IF 0% ="ZY50NH" THEN 1430 2190 GOTO 1650 2200 PRINT “THE SKULL BONE UHICH CONTHINS THE ERR PRSSHGE IS TERNED ' 2210 INPUT ES 2220 IF E$="TENPORRL" THEN 1430 2230 GOTO 1650 2240 PRINT "MOST OF THE SKULL CRP IS FORMED BY UHICH BONE PHIR???" 2°50 INPUT F3 2260 IF FS="PHRIETHL” THEN 1430 22?0 GOTO 1650 2271 PRINT "THE SKULL BONE UHICH FORMS THE FOREHEHD I: TERNED ?" INPUT 63 IU 10 TU 10 To 1‘ 1'0 l‘u 1'3 Tu N f 01 UI J4 I» To IF 5% =“FRONTHL” THEN 1430 GOTO 1650 PRINT"THE BONE IN THE FLOOR OF THE SKULL THHT RESENBLES 3 SET INPUT H3 142 '5 o NERVES OF" A" f "ICLHS RNRT-2 (CONTINUED) 22?? IF H3 ="SPHENOID"THEN 1430 22?3 SOTO 1650 ' 22?9 PRINT ”THE PITUITRRY SLHND IS LOCATED IN THE SELLR TURCIH DEPRESSION“ 2230 PRINT "OF UHICH SKULL BONE ? " 2231 INPUT 1% 2332 IF IS="SPHENOID" THEN 1430 2233 SOTO 1650 2234 PRINT“THE CRIBIFORN PLRTE THROuGH UHICH PRSSES OLFHCTORV 2235 PRINT"SNELL IS 3 FERTURE OF wHICH SKULL BONE ? " 2236 INPUT JS 2237 IF J3=“ETHMOID" THEN 1430 2233 SOTO 1650 ' 2239 PRINT“IDENTIFY THE SKULL SUTURE BETUEEN THE TUO PRRIETRL 2290 PRINT "PHSSES HCROSS THE TOP OF THE SKULL" 229IINPUT KS 2292 IF K3="SRSITTHL" THEN 1430 2293 SOTO 1650 .. 2294 PRINT "IDENTIFY THE POSTERIOR SKULL SUTURE BETMEEN THE PHRIETRLS RND" 2295 PRINT"OCCIPITHL BONE" 2296 INPUT LS 229? IF L3="LHNEDOIDHL“ THEN 1430 2293 SOTO 1650 ' 2299 PRINT “THE SO CRLLED SOFT SPOTS OF THE SKULL UHERE OSSIFICHTION 2300 PRINT ”INCOMPLETE RRE TERNED ? " - 2301 INPUT N3 2302 IF N$="FONTRNELS“ THEN 1430 2303 SOTO 1650 2500 STOP 3000 PRINT 3010 PRINT 3015 FILE 91:“BONES” 3013 PRINT 31:8131" “3313,03“ RTTENPTS”:INT(Jf30100>3“PERCENT”:DHT$3“ 3019 PRINT 3020 PRINT "UOULD YOU LIKE TO TRY RNY OF THE QUESTIONS HSRIN 3021 PRINT ”TYPE VES OR NO” 3022 INPUT 6% 3023 IF S3="VES" THEN 3023 3024 IF SS=“NO" THEN 5000 3025 SO TO 3021 3023 PRINT "UHRT IS THE QUESTION NUMBER ??“3 3029 INPUT S 3030 LET X=S 3031 LET U=33 3032 SO TO 95 ‘ 3040 PRINT "THIS PROSRHN IS NOU TERMINHTED 1!!“ 3041 PRINT 3042 PRINT 3043 PRINT 3044 PRINT 3050 SO TO 5000 RNHT-2 (canrxuuan) 3100 PRINT“THE OSSIFICRTION PROCESS THRT FORMS THE BONES OF THE FRCE RND" 3110 PRINT”SHULL IS TERMED ?? “ ' 3120 INPUT R3 3130 IF RB="INTRRMENBRRNOUS" THEN 1430 3140 SO TO 165 3150 PRINT “THE OSSIFICRTION PROCESS THRT FORMS RLL BONES OF THE BODY“ 3160 PRINT "EXCEPT SKULL RND FRCE BONES IS TERMED T?“ 31?0 INPUT B43 3130 IF 343:"ENDOCHONDRRL“ THEN 1430 3190 SO TO 1650 . 3200 PRINT "THE CELL RESPONSIBLE FOR THE SECRETION OF THE PROTEIN MRTRIX" 3210 PRINT "IN MHICH BONY SRLTS RRE PRECIPITRTED IN THE OSSIFICRTION PROCESS" 3220 INPUT C43 3230 IF C43="OSTEOBLRST " THEN 1430 3240 SO TO 1650 3250 PRINT "NRME THE CELLS RESPONSIBLE FOR BONE REHBSORBTION" ' 3260 INPUT D43 32?0 IF D43="OSTEOCLRSTS" THEN 1430 3230 SO TO 1650 3290 PRINT "CELLS wHICH PRODUCE CHRTILRSE RRE TERMED ?? “ 3300 INPUT E43 . 3310 IF E43=“CHONDROCYTES” THEN 1430 3320 SO TO 1650 3330 PRINT“?ITRMIN D DEFICIENCY IN THE ELDERLY RESULTS IN H PHTHOLOSY TERNED" 3335 INPUT F43 3350 IF F43="OSTEOMRLRCIR“ THEN 1430 3360 SO TO 1650 33?0 PRINT"R BRERK IN BONE OR CRRTILRSE IS TERMED ??" 3330 INPUT S43 ‘ 3390 IF S43=“FRRCTURE“ THEN 1430 3400 SO TO 1650 3410 PRINT “R FRRCTURE wHERE THE SKIN IS BROKEN IS TERMED ??“ 3420 INPUT H43 3430 IF H43="SOMPOUND" THEN 1430 3440 SO TO 1650 3450 PRINT"BONES OF THE UPPER RND LOSER EKTREMIT? CONPRISE THE ---F- SKELETON” 3460 INPUT I43 34?0 IF I43=“RPPENDICULRR“ THEN 1430 3430 SO TO 1650 3490 PRINT ”BONES OF THE SKULL:VERTEBRRE:RIBS:STERNUM:RND HYOID CONFRISE" 3500 PRINT"THE ----- SKELETON“ 3510 INPUT J43 ' 3520 IF J43="HKIRL” THEN 1430 3530 SO TO 1650 3540 PRINT“DENSE:STRONS BONE wHERE THE LRMELLRE OF MIFERRL DEPOSIT HRE" 3550 PRINT“CLOSELY SPHCED IS CLRSSIFIED RS ----- BONE." 3560 INPUT K43 35?0 IF K43="COMPRCT” THEN 1430 3530 SO TO 1650 3390 143 ' PRINT"3PONST OR LHCY HPPERHRINS BONE IS TERNED ----- BONE." HNHT- 3500 3510 3520 3530 3540 3550 3550 3570 3550 3590 3?00 3?10 3?20 3300 3510 3320 3530 3340 3550 550 33?0 3330 3390 3900 4000 4010 4020 4030 4040 4050 4050 40?0 4020 4090 4100 4110 4120 4130 4140 4150 4150 41?0 4150 4190 4200 4210 4220 4230 4240 4250 144 2 (CONTINUED) INPUT L43 IF L43="CHNCELLOUS" SO TO 1650 THEN 1430' PRINT"SINCE THE S