A comparison of computer aided learning and traditional didactic lectures for teaching clinical decision making skills to optometry undergraduates

  • Bhavna Pancholi

Student thesis: Doctoral ThesisDoctor of Philosophy


This study was designed to compare computer aided learning (CAL), in the form
of a Virtual Patient (VP), and traditional didactic lectures as methods of teaching
clinical decision making (CDM) skills to second year Optometry undergraduates.
Comparisons were based on performance in multiple-choice examinations testing
CDM skills (actual mastery), student feedback relating to confidence in CDM
skills (perceived mastery or self-efficacy) and student satisfaction. The influence
of sex, learning style and academic ability was also investigated. This is the first
time that these aspects of teaching pedagogy have been studied together.
Current literature informed development of didactic lectures and an online VP.
Both teaching methods were designed to ensure that the same clinical content
was included. This content was aimed at training students to perform
problem-orientated eye examinations. A cohort of 102 students was taught using the traditional didactic lectures in academic year 2010-11 and 93 students using the online VP in academic year 2011-12.
An established Index of Learning Styles instrument was used to classify students
according to their preference in four learning style dimensions. Both teaching
methods were designed to cater for both poles of each learning style dimension.
Most students had no strong learning preferences but those that did had a
tendency towards the active-sensing-visual-sequential profile.
Actual and perceived mastery were scored for five key learning objectives;
question selection, critical symptom recognition, test selection, critical sign
recognition and referral urgency selection. The influence of academic ability and
teaching method differed for each learning objective; didactic lectures favouring
some, the VP others. Learning style and sex had no influence, indicating that
both teaching methods catered equally for males and females with all learning
styles. Comparisons between perceived and actual mastery revealed poor self-assessment accuracy.
Student satisfaction, rated on a five point Likert scale, was equally high for both
teaching methods. Sex was the only influential variable, with males favouring one aspect of VP training.
Overall, the findings suggest that CAL should be used to supplement traditional
teaching rather than replace it in order to ensure that all students benefit equally. Future research may wish to focus on self-assessment accuracy as a means of improving academic performance.

Date of Award9 Feb 2017
Original languageEnglish
SupervisorMark Dunne (Supervisor)


  • learning styles
  • academic ability
  • sex
  • self-assessment accuracy
  • academic performance

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