Case study on the use of mobile technology in accessing virtual learning environment in postgraduate medical education

Introduction

Postgraduate medical education has been making increasing use of virtual learning environments (VLE), with several popular platforms such as Moodle and Blackboard representing the largest components of the educational environment, and bespoke solutions forming the remainder platforms.^1–3 These have been used to deliver content in a blended or hybrid manner, and occasionally as the primary mode of delivering content. The use of these VLEs carries significant advantages, primarily around the increased access to linked educational resources.⁴ The increased access has been theorised to enable a more flexible approach to study, which may lend itself to the postgraduate medical education setting, particularly where learning may be carried out alongside clinical commitments. Mobile technology, which offers enhanced flexibility, has encountered difficulties in being incorporated into these systems.

Literature review

It has been argued that technological advances have enabled new methods of delivering content, evolving towards a more comprehensive medium of delivery for the content. The increased flexibility has translated into a widening of access to a variety of courses ranging up to the level of recognised formal postgraduate qualifications from multiple institutions, as well as the massive online-only courses. Online delivery of education in the postgraduate medical context has been demonstrated to both enhance and develop the knowledge base, as well as positively impact on practice, with this application of knowledge acting as a validating tool for online medical education as capable of achieving higher learning outcomes.

The increased availability of smart mobile technology, both in the form of ‘smartphones’ as well as tablets across various operating systems, has the potential to enable the access to VLEs to be more mobile, potentially increasing the opportunity to access learning materials in a more flexible manner. This has particular value in the context of postgraduate medical education, where studying alongside clinical commitments would be necessary. Difficulties can be broadly divided into either technological inadequacies, or via the mobile device acting as a distraction away from study materials, rather than facilitating learning.

Aim of study

This study investigated ithe impact of different technological platforms used to access VLEs, and  piloted the data capture and analysis, thus forming the basis for a larger future study.

Method

Theoretical framework

This study is based on the unified theory of acceptance and use of technology theoretical framework developed to predict intention and actual use of technology.⁵ This has been linked to four predictive factors, divided into extrinsic factors and intrinsic factors. For the purposes of this study, the single modifiable factor was increasing experience of the VLE. The results were evaluated using phenomenological approach.

Course design

The programme was delivered via the Moodle VLE. The programme was designed over five sections, with each section comprising a mixture of designated reading materials and discussion boards, with equal amount of readings and discussion boards. The sections were released to learners in series.

The subject of this study was part of a cohort of 20, with discussion board usually split into four groups of five, although all members of the cohort had access to all discussions. The programme was delivered over a 5-month period.

Initial case study

An experienced student, familiar with the use of VLEs in the undergraduate and postgraduate settings, documented prospectively the use of various devices, on a taught research methodology programme, across a 4-month period. The student participated voluntarily, and data collected regarding the use of devices to access the course did not impact other aspects of course grading or progression. The student was selected due to prior experience of VLEs, but without specific experience of Moodle, enabling the evaluation of increasing familiarity of the platform while minimising the effect of distance learning. The subject had unlimited access to the Moodle site on laptop, desktop, smartphone and tablets on both Android and iOS platforms. The subject documented the number of times resources were accessed, occasions the discussion forum was read and contributions to discussion forums were made, as well as the device, during both the initial and final sections of the programme. Additionally, a subjective assessment of the accuracy of the documentation as a validation of the data, and noted reflection on the choice of device used at certain key points.

Results

Over the period of this programme, there was an increasing trend in utilising mobile devices for all aspects, with the trend being more marked for accessing resources and reading contributions from others rather than contributing to discussions. Overall, there was a slight trend in increased participation over the duration of the programme. Figure 1 is a graphic representation of device utilisation in both the first and final sections of the programme.

Figure 1.

Use of mobile and desktop devices over the course of the programme. The trend in increased utilisation of mobile devices is evident, with a relative decline in the use of desktops over the course of the programme.

For the purposes of further analysis, participation was further grouped into active (contributions) and passive (reading contributions from other members of the cohort or accessing resources). Statistical analysis via a two-tailed Student’s t-test demonstrated the trend in increasingly utilising mobile devices over the duration of the programme for all components (p<0.05).

Annotation of the data by the student expressed a preference to use desktops for more ‘intensive’ work, particularly when writing larger contributions. The advantage of reading ‘on the go’ by accessing contributions from others on mobile phones was persistent and led to greater use as the programme developed.

Discussion

This pilot study demonstrated that while there is increasing use of mobile ‘smart devices’ to access the online module, there is a persistent and continuing use of standard computer systems in the form of laptops and desktops. It may be that mobile devices complemented, rather than supplanted, traditional computers. The increasing use of mobile devices may enable a more flexible and responsive learning methodology, and may therefore enable a greater access to higher education. Therefore, it is reasonable to recommend the support of mobile devices across various platforms, without losing the support for desktop computers. Furthermore, at the end of the programme desktop devices still accounted for a substantial proportion of the active contributions, and thus may represent a disproportionate component of higher learning outcomes.

This study is limited to the study of one individual, and therefore the interpretation of the results is limited. Further investigations with a larger cohort is planned to be able to provide more robust and generalisable conclusions.