Audience Response System: From Passive Lecturing to Interactive Learning

DURING A PULMONARY PHYSIOLOGY WORKSHOP FOR THE Science Basic to the Practice of Medicine and Dentistry course, Professor Marc Dickstein displays a PowerPoint slide that poses the following scenario and question: A marble is lodged in the right main stem bronchus of a 5-year-old child. What is the pathophysiology: 1. Shunt? 2. Dead Space?
Each student points a small wireless handheld device toward the front of the room and presses a button representing his selected answer. Almost immediately a bar graph slide pops up showing that nearly half of the students chose "Shunt" and half chose "Dead Space." Dr. Dickstein then asks a few students from each answer group to explain their answers and poses the question again. This time the bar graph slide shows that an overwhelming majority have chosen the right answer: "Shunt."
This scene took place in the winter of 2001, the first time Dr. Dickstein tested a new teaching tool called the Audience Response System (ARS). "It was great," says Dr. Dickstein, associate professor of clinical anesthesiology. "I knew immediately how many students knew the correct answer and exactly where the ones who didn't know were going wrong."
The system was compelling for Dr. Dickstein not just because he could measure how many students knew the answer, but also because it helped guide his teaching and the students' learning. "Students knew they weren't alone in not knowing the answer, and this freed them up to talk about their thought process. The class became much more interactive. The system also made me realize immediately that the physiology wasn't taught very effectively in lecture and it got me thinking about how I would change how I taught the subject matter to the next class."
Most professors know that teaching is most effective when it's interactive. Since its introduction in Science Basic to the Practice of Medicine and Dentistry, ARS has transformed large introductory classes from passive lectures to interactive learning environments. The system was purchased in 2002 with a grant from the Gladys Brook Foundation.
ARS is available to the P&S faculty through the Center for Education Research and Evaluation, part of the Office of Scholarly Resources. It consists of Turning Technologies' TurningPoint software, which adds a special toolbar to Microsoft PowerPoint. A small wireless receiver connects to the professor's notebook computer via a USB port. Each student receives a wireless response pad, which resembles a TV remote control device. The receiver captures the data from the response pads and feeds it to the software, which instantly produces a graph showing the percentage of students that gave each response. Creating the interactive slides mostly involves filling out typical PowerPoint slide templates chosen from the TurningPoint toolbar.
Dr. Dickstein and several other professors, including Dr. Frank Lowy, professor of medicine and pathology, and Dr. Alfredo Morabia, professor of clinical epidemiology at the Mailman School of Public Health, have found interesting ways to integrate ARS into the lecturing process.
"I've found that ARS is not effective if it's simply an appendage to a typical highly choreographed lecture," says Dr. Dickstein. "You have to use it to guide the lecture process itself. If you pose a question and most of the class gets it wrong, you have to be ready to change the pace, backtrack, and re-address the topic."
Professors can enhance interaction by allowing students to work together on a response. "Sometimes I'll split the students into groups so they can talk to each other and figure it out before punching in the answer. It really energizes the class," says Dr. Dickstein.
"The best questions are difficult enough so you have to work a little to get the answers, but not so difficult that students get frustrated," says 2005 class president Monjri Shah, who has been in classes where ARS was used.
Professors who use ARS for the first time are often surprised at the results. "I've offered ARS to lecturers who were absolutely confident they were conveying their material with utter clarity. They were shocked when many students give wrong answers to their questions. Then they started to teach."
Dr. Dickstein also found that use of ARS can reduce the stress of first-year students. "Many first-year students don't really know where they stand and how they're doing until their first exams. If they see that they're getting most of the ARS-based questions right, it helps to put them at ease. If they see that they're getting a number of questions wrong, it's an early wakeup call to change what they're doing or pick up a little bit."
Another effective way to use ARS is to help students prepare for exams. "We've used it for review sessions in the second-year microbiology/infectious diseases course," says Dr. Lowy. "We divide the students into teams and ask 25 to 30 questions, one at a time. Then we go over the answers explaining which is correct and why and take questions from the students. We turn it into a game show. It's very entertaining and the students say it really helps them prepare."
As courses throughout the medical center cross disciplinary and even campus boundaries, ARS can help instructors teaching diverse classes for the first time. After teaching advanced epidemiologic concepts for many years, Dr. Morabia was not sure how to proceed with his first Principles of Epidemiology 1 class. "It was a very large, diverse class," he says. "Some students were getting their master's in public health, others were from maternal and child health or the sociology department. I had no idea what they knew and whether I was having any impact."
To the class of 200 students, he displayed a PowerPoint slide with the question, "What is an Odds," and a list of five possible responses. As each student punched a selection into the pad, the breakdown of the answers appeared as a PowerPoint bar graph. "It was great. I could see immediately what proportion of the class knew the answer and where the others had gone wrong. I knew exactly how to proceed."
Dr. Morabia also found ARS helpful in demonstrating the concept of randomization. "I asked the students to punch in whether they were born between January and June or July and December. Exactly half the class fell into each category. Then we had the ARS tally the correct individual answers to other questions by birth group and demonstrated that the two groups' scores were practically identical. This demonstrated randomization in a way that was much more impressive and convincing than simply talking about it."
The ARS technology continues to improve and is now available for use with a PDA. This could eliminate cost of the proprietary remote control devices and make ARS more widely available. "Lecturers are sometimes reluctant to use ARS," says Dr. Dickstein, "but when they do they are often astonished by the increase in class attentiveness and comprehension."


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