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J Am Med Inform Assoc. 1999;6:38-52. DOI .
© 1999 American Medical Informatics Association


Research Paper

An Ethnographic, Controlled Study of the Use of a Computer-based Histology Atlas during a Laboratory Course

Harold P. Lehmann, MD, PhD, Joan A. Freedman, MS, John Massad, PhD and Renee Z. Dintzis, PhD

The Johns Hopkins University, Baltimore, Maryland.

Corresdpondence and reprints: Harold P. Lehmann, MD, PhD, 407 Blalock, Johns Hopkins, 600 North Wolfe Street, Baltimore, MD 21287-4461. e-mail: <lehmann{at}welch.jhu.edu >.

Received for publication: 01/20/98; accepted for publication: 09/18/98.

Objective: To evaluate the use and effect of a computer-based histology atlas during required laboratory sessions in a medical school histology course.

Design: Ethnographic observation of students' interactions in a factorial, controlled setting.

Measurements: Ethnographer's observations; student and instructor self-report survey after each laboratory session with items rated from 1 (least) to 7 (best); microscope practicum scores at the end of the course.

Results: Between groups assigned the atlas and those not, the ethnographer found qualitative differences in the semantic categories used by students in communicating with each other and with the faculty. Differences were also found in the quality of the interactions and in the learning styles used with and without the computer present in the laboratory. The most interactive learning style was achieved when a pair of students shared a computer and a microscope. Practicum grades did not change with respect to historical controls. Students assigned the atlas, compared with those not assigned, reported higher overall satisfaction (a difference in score of 0.1, P = 0.003) and perceived their fellow students to be more helpful (a difference of 0.11, P = 0.035). They rated the usefulness of the microscope lower (a difference of 0.23, P < 0.001).

Conclusion: A computer-based histology atlas induces qualitative changes in the histology laboratory environment. Most students and faculty reacted positively. The authors did not measure the impact on learning, but they found that there are aspects of using the atlas that instructors must manipulate to make learning optimal. Ethnographic techniques can be helpful in delineating the context and defining what the interventions might be.




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T. Greenhalgh
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BMJ, January 6, 2001; 322(7277): 40 - 44.
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