Livescribe (Oakland, CA, USA) introduced

Temporally Contiguous Pencast Instruction Promotes Meaningful Learning for Dental and Dental Hygiene Students in Physiology Darren M. Roesch, Ph.D. Abstract: Smartpens allow for the creation of computerized pencasts that combine voice narration with handwritten notes and illustrations. The purpose of this study was to test the effects of voluntary participation in extracurricular instruction with a pencast on student learning. Dental and dental hygiene students were given instruction in a complex physiological topic using lecture and static slides. An Internet link to a pencast that covered the complex topic in a more temporally contiguous fashion was also provided for voluntary review. The students were given a multiple-choice exam that consisted of retention and transfer test questions. Sixty-nine percent of the students who did not watch the pencast and 89 percent of the students who watched the pencast answered the retention test question correctly (p=0.08). Fifty-four percent of the students who did not watch the pencast and 90 percent of the students who watched the pencast answered the transfer test question correctly (p=0.005). This finding indicates that students who watched the pencast performed better on a transfer test, a measurement of meaningful learning, than students who received only the narrated instruction with static images. This supports the hypothesis that temporally contiguous instruction promotes more meaningful learning than lecture accompanied only by static slide images. Dr. Roesch is Assistant Professor, Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis, Texas A&M University Baylor College of Dentistry. Direct correspondence and requests for reprints to Dr. Darren M. Roesch, Texas A&M University Baylor College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246; 214-828-8324; Roesch@tamhsc.edu. Keywords: pencasts, blended learning, educational technology, transfer tests, dental education, dental hygiene education, respiratory physiology Submitted for publication 2/12/13; accepted 4/16/13 Livescribe (Oakland, CA, USA) introduced the first smartpen in 2007 that is able to digitally record voice narration as well as record handwriting both digitally and on paper using a specialized electronic ink pen and dot paper. 1 The introduction of the smartpen and associated software has allowed for the creation of computerized pencasts that combine voice narration with handwritten notes and illustrations. 1 The purpose of this study was to test the effects of voluntary participation in extracurricular instruction with a multimedia pencast on dental and dental hygiene student learning. Educational psychologist Richard E. Mayer identified three major processing demands that are placed on the learner s cognitive system during learning: extraneous processing (cognitive processing that does not support the objective of the lesson), essential processing (cognitive processing required to mentally represent the presented material), and generative processing (cognitive processing that causes the learner to make sense of the presented material). 2 Over the years, Mayer has tested twelve principles of multimedia instruction that improve the effect of combining printed and spoken word with pictures during instruction on learning outcomes (Table 1). Specifically, Mayer s work identifies five principles that reduce extraneous processing, three principles for managing essential processing, and four principles that foster generative processing. 2 Of all of the principles Mayer has tested, the principle of temporal contiguity has the greatest average effect size. 2 Temporal contiguity involves the presentation of narration at the same time as illustration rather than before or after, and temporal contiguity is thought to reduce the amount of extraneous processing that the learner must undergo. 2 A common current lecture technique is to combine static slide presentations with instructor narration. In contrast, the pencast technique allows for a more temporally contiguous presentation of spoken and written words and illustrations. My study hypothesized that students who participated in voluntary multimedia instruction using a pencast would have improved learning outcomes, in part due to the temporally contiguous nature of the pencast. There are two classic methods for measuring learning outcomes: retention tests and transfer tests. 3 Retention tests ask the learner to recall or recognize what was learned, and transfer tests ask the learner to use what was learned in a new situation. In his work over the years, Mayer has argued that there are three possible learning outcomes: no learning (as indicated by poor performance on retention and transfer tests), January 2014 Journal of Dental Education 51

Table 1. Mayer s twelve principles of multimedia learning I. Principles of Reducing Extraneous Processing Coherence Principle Signaling Principle Redundancy Principle Spatial Contiguity Principle Temporal Contiguity Principle II. Principles for Managing Essential Processing Segmenting Principle Pretraining Principle Modality Principle III. Principles for Fostering Generative Processing Multimedia Principle Personalization Principle Voice Principle Image Principle People learn better when extraneous words, pictures, and sounds are excluded rather than included. People learn better when cues that highlight the organization of the essential material are added. People learn better from graphics and narration than from graphics, narration, and on-screen text. People learn better when corresponding words and pictures are presented near rather than far from each other on the page or screen. People learn better when corresponding words and pictures are presented simultaneously rather than successively. People learn better when a multimedia lesson is presented in user-paced segments rather than as a continuous unit. People learn better from a multimedia lesson when they know the names and characteristics of the main concepts. People learn better from graphics and narration than from animation and on-screen text. People learn better from words and pictures than from words alone. People learn better from multimedia lessons when words are in conversational style rather than formal style. People learn better when the narration in multimedia lessons is spoken in a friendly human voice rather than a machine voice. People do not necessarily learn better from a multimedia lesson when the speaker s image is added to the screen. Source: Adapted from Mayer RE. Multimedia learning. 2nd ed. New York: Cambridge University Press, 2009. rote learning (as indicated by good retention but poor transfer performance), and meaningful learning (as indicated by good performance on both retention and transfer tests). 3 The aim of my study was to test the hypothesis that voluntary participation in pencast instruction would promote meaningful learning as indicated by good performance on both retention and transfer tests. In addition to testing the effect of voluntary participation in multimedia pencast instruction on student learning, this study also utilized a survey instrument to assess student attitudes towards the pencast method of instruction. Methods Texas A&M University Baylor College of Dentistry offers a bachelor s degree in dental hygiene and a doctorate in dental surgery. As part of the curriculum, dental hygiene students learn respiratory physiology in Biomedical Sciences II (DDHS 3340), and dental students learn respiratory physiology in Physiology (DDDS 6870). In each course, respiratory physiology is taught in nine lecture hours. In the spring semester of 2012, both courses were taught by the author of this article. As part of the respiratory physiology lectures, the students were introduced to the concept of body plethysmography using a static figure from the monograph from which the lectures were largely derived. In the lecture, the students were told that body plethysmography utilizes Boyle s law, and they were shown the equations for calculating the residual lung capacity using pressure measurements obtained with a body plethysmography apparatus. In addition, students were given an Internet link to a pencast (http://youtube/rbemildj03g) that covered the complex topic in a more temporally contiguous fashion, and the students were told that there would be two questions (one retention and one transfer) on the topic of body plethysmography on their exam. The pencast was narrated and illustrated using an Echo Smartpen made by Livescribe. During the narration and illustration, the instructor applied as 52 Journal of Dental Education Volume 78, Number 1

many of Mayer s principles of multimedia instruction as possible. 2 The pencast worked through the application of Boyle s law to calculating residual lung capacity in a step-by-step, temporally contiguous fashion. At the end of the unit on respiratory physiology, the students were given a multiple-choice exam that consisted of one retention and one transfer test question on body plethysmography. The retention test question asked the students to recall that Boyle s law is utilized in the process of determining residual lung capacity using body plethysmography, and the transfer test question asked the students to use Boyle s law to predict the effect of changing volume in syringe by pulling the plunger on the pressure within the syringe. At the completion of the section exam, the students were given a voluntary and anonymous survey that had a place for them to record the answers to the two test questions of interest, indicate how many times they had watched the pencast, and share their attitudes toward the pencast. Because the survey was handed out as a supplement to the exam and was completed at the time of the exam, it is unlikely there were significant differences between the student responses on the exam and the responses on the survey. This research protocol was granted exempt status by the Texas A&M University Baylor College of Dentistry Institutional Review Board. In spring 2012, there were 105 students in DDDS 6870 and twenty-seven students in DDHS 3340. The pencast was viewed 134 times by the students of DDDS 6870 and thirty-nine times by the students of DDHS 3340. Sixty-nine students in DDDS 6870 and sixteen students in DDHS 3340 participated in this study. For the analysis of performance on the retention and transfer test questions, performance data from the two classes were combined. A two-sided Fisher s exact test was conducted using Prism 5 for Mac OS X (GraphPad Software, La Jolla, CA, USA) in order to determine if there was a relationship between viewing the pencast and responding correctly to either the retention or transfer test question. Statistical significance was concluded when alpha was less than 0.05. Results Eighty-four percent of the dental students who participated in the survey watched the pencast; 10 percent of the dental students watched the pencast more than twice (Table 2). Eighty-eight percent of the dental hygiene students who participated in the survey watched the pencast; 13 percent of the dental hygiene students watched the pencast more than twice. Sixty-nine percent of both dental and dental hygiene students who did not watch the pencast answered the retention test question correctly, and 89 percent of the students who watched the pencast answered the retention test question correctly (Table 3). A Fisher s exact test indicated that there was no significant effect of watching the pencast on student performance on the retention test item (p=0.08). Fifty-four percent of both dental and dental hygiene students who did not watch the pencast answered the transfer test question correctly, and 90 percent of the students who watched the pencast answered the transfer test question correctly (Table 4). A Fisher s exact test indicated that there was a significant effect of watching the pencast on student performance on the transfer test item (p=0.005). The results of the survey of attitudes toward the pencast are summarized in Table 5. In general, the students were not previously familiar with the concept of pencasts, and they were neutral in their feelings about the usefulness of seeing mathematical concepts worked out. However, the students reported feeling that the pencast was clear and easy to understand, helped them learn, and helped them see the link between the mathematical concept of Boyle s law and the biological process of changing lung volumes. The dental hygiene students were somewhat less likely than the dental students to report that the pencast helped them learn. The students also generally agreed that pencast instruction would be useful in other classes. Table 2. Pencast viewing frequency among dental and dental hygiene students Zero Times 1-2 Times 3-4 Times More Than 4 Times Dental students 11 51 7 0 Dental hygiene students 2 12 2 0 January 2014 Journal of Dental Education 53

Table 3. Effect of watching pencast on student performance on retention test item Discussion Incorrect Correct Did not watch 4 9 Watched 8 64 Fisher s exact test result, p=0.08 Table 4. Effect of watching pencast on student performance on transfer test item Incorrect Correct Did not watch 6 7 Watched 6 54 Fisher s exact test result, p=0.005 The results of this study demonstrate that students who elected to review a temporally contiguous multimedia pencast performed well on both a retention question and a transfer test question. This finding suggests that pencast instruction promoted meaningful learning for these students. Moreover, those students who watched the pencast performed better on the transfer test, a measure of meaningful learning, than students who received only the narrated instruction with static images. This finding supports the findings of Mayer 2 that temporally contiguous multimedia instruction promotes more meaningful learning than voice narration accompanied only by static slide images. Since students in this study voluntarily elected to view the pencasts, a limitation of the study is that the better performing students may have elected to view the pencast and this may have biased the results. The survey results were not linked in any way to overall student performance on the exam or in the course, so it is not possible to determine if this selection bias did indeed exist. Therefore, the results of this study do not provide conclusive evidence that this temporally contiguous multimedia pencast improved student learning, although the results do support the findings of Mayer that conclusively demonstrate that temporally contiguous instruction improves meaningful learning. 2 Student attitudes toward the pencast in this study were relatively positive. Most reported that the pencast was clear and helped them learn how to apply Boyle s law to the process of measuring lung volumes using body plethysmography. Although the trend was not significantly different, the dental hygiene students were less likely than the dental students to rank the pencast as helpful to their learning experience. Most dental hygiene students at Texas A&M University Baylor College of Dentistry have only two years of college experience before entering the program, whereas most dental students have completed a four-year college degree before entering dental school. It is possible that it may have been more difficult for the less-experienced dental hygiene learners to grasp the fairly complex and mathematical Table 5. Dental and dental hygiene students attitudes toward pencast instruction in study, by number of respondents 1 5 Strongly 2 3 4 Strongly Average Disagree Disagree Neutral Agree Agree (SD) I was familiar with the concept of pencasts Dental 31 18 1 9 10 2.3 (1.5) before taking this respiratory physiology course. Dental hygiene 10 3 1 2 0 1.7 (1.1) It is easier for me to understand mathematical Dental 7 14 16 23 10 3.1 (1.2) concepts if I see them worked out step-by-step. Dental hygiene 1 5 8 2 0 2.7 (0.8) The pencast was clear and easy to understand. Dental 2 0 0 23 44 4.6 (0.8) Dental hygiene 0 0 3 4 9 4.4 (0.8) The pencast helped me learn. Dental 1 3 14 35 16 3.9 (0.9) Dental hygiene 1 1 7 4 3 3.4 (1.1) The pencast helped me understand the link Dental 1 3 25 26 14 3.7 (0.9) between mathematical concepts and biological Dental hygiene 1 2 5 6 2 3.4 (1.1) processes. I would like to see pencasts used in other classes. Dental 1 5 20 33 10 3.7 (0.9) Dental hygiene 1 3 4 7 1 3.3 (1.1) 54 Journal of Dental Education Volume 78, Number 1

application of Boyle s law. Therefore, these results emphasize that instructors should keep in mind the prior experiences and abilities of the targeted learners when creating pencasts. Pencast instruction may be useful in courses that utilize a blended learning model that combines face-to-face instruction with computerized activities. Math problems and other complex concepts might be especially well suited for presentation through the pencast method. Idealized versions of the lesson can be recorded and placed on the Internet; then, the lesson can be viewed at students leisure and as many times as desirable. While the pencast provides a temporally contiguous method of instruction that can be reviewed at the discretion of the learner, it has similarities and differences with other types of computerized learning activities that are typically used in the blended classroom. For example, some computerized activities used in the blended learning environment allow the student to self-pace instruction by progressing through modules at his or her own pace. Since pencast instruction can be broken up into short lessons that students can review at their own pace, it can be used for self-paced instruction similar to other types of computerized programs used in the blended classroom. Other computerized activities used in blended learning allow students to receive immediate feedback on performance by answering quiz questions that are immediately graded and explained by the computer program. The pencast differs from these computerized methods of blended learning because the pencast does not provide a method for getting feedback on performance. Still, multimedia pencast instruction could be a beneficial tool for those using blended instruction techniques. In addition to promoting more meaningful learning, the process of having students view a pencast outside of lecture time frees in-class time for more face-to-face discussion with instructors and colleagues and time for work on solving complex problems that utilize critical thinking. The technology is also easy to use, so it would be possible to have students create their own pencasts, a process that would likely contribute to student learning. The smartpens themselves cost about two hundred dollars, and the technology requires the use of a special dot paper that is somewhat more costly than regular paper. Therefore, cost may be a limiting factor in scenarios where multiple pens are required, such as in situations where instructors would like students to create their own pencasts. It is a well-known argument that traditional lectures are ineffective methods of instruction because they fail to engage the learner. However, it is clear that sometimes step-by-step instruction is useful. In many types of instruction, temporally contiguous methods are preferred over lecture accompanied by static images. This study s results suggest that multimedia pencasts provide an effective temporally contiguous instruction tool that can be utilized outside of class time to promote meaningful learning and free in-class time for face-to-face discussion and critical thinking exercises. REFERENCES 1. Livescribe celebrates five years of digital writing. May 23, 2012. At: www.livescribe.com/blog/press/?p=6708. Accessed: February 12, 2013. 2. Mayer RE. Multimedia learning. 2nd ed. New York: Cambridge University Press, 2009. 3. Mayer RE. Applying the science of learning. Boston: Pearson, 2011. January 2014 Journal of Dental Education 55