Introduction
Audience response system (ARS) provides an excellent tool for improving interactive learning in radiology residents. However, it is not the technology but the pedagogy that matters the most. It is long past time to upgrade our ARS teaching techniques to match our ARS technology.
Discussion
In this article, several problems with current usage of ARS are discussed and several prescriptions for improving this are presented. Simplifying the ease of use of ARS will get this useful technology into more hands. Using ARS in a bidirectional manner will give us an even better idea of how and what our students are learning. Asking questions on the fly will obviate the usual tedium of multiple-choice questions and allow us to quiz our students in a much more natural manner. It is time to move on to more innovative ARS techniques that are well adapted to radiology and its different styles of learning.
Audience response systems (ARS) have been available since the 1960s . Because prices have dropped and availability has risen, these systems have become increasingly popular as pedagogic tools. ARS technology enables active learning by allowing real-time polling of student opinions and knowledge and by improving attentiveness and engagement in the classroom.
Unfortunately, the promise of ARS has been held back because of the outdated way most people use it. I cannot see a lot of difference between the computer-graded paper Scholastic Aptitude Test (SAT) that I took in the 1960s and the way most lecturers use ARS today. I see the same type of questions that have been used since 1926, when the multiple-choice SAT was introduced as a faster way of testing college applicants. . We are using a computer and a set of clickers, but it is qualitatively the same test .
The result from blindly shoveling in content from an older to a newer medium—without regard for new features or possibilities—has been termed “shovelware” . Many of the first movies were shovelware, because they were created by simply filming a stage play, one of the main entertainment venues of that era. It took >100 years to develop today’s language of cinematography, with techniques such as close-ups, action scenes, location shots, shifting points of view, special effects, and other techniques. We went through this same scenario in the 1990s with the birth of the Web. Most early Web pages were virtual pieces of paper shoved onto the Web. Since then, Web technology has advanced considerably, with the addition of sound and video files, dynamic Hypertext Markup Language, database-backed Websites, Webcams, cascading stylesheets, and other innovations.
In contrast, ARS techniques have remained relatively static over the past 50 years—the technology has evolved, but the way it is used has not. The purpose of this article is to suggest some promising paths forward.
Benefits of an ARS
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Table 1
Comparison of Selected Audience Response Systems
System Uniform Resource Locator Allows Short-Answer Questions Representative Pricing ARSenic http://uwmsk.org/arsenic Yes Free Poll Everywhere http://polleverywhere.com Yes Free for 40 students H-ITT http://h-itt.com Yes on some models $316 rental fee + $3 per clicker per day Fleetwood http://www.replysystems.com/ Yes, but awkward $35 per clicker + $400 per receiver TurningPoint http://www.turningtechnologies.com/ Yes with app ∼ $12 per user per year eInstruction http://www.einstruction.com/ No ∼50 per clicker + $160 per receiver iClicker http://iclicker.com/ No $27 per clicker + $110 per base IML http://www.imlaudienceresponse.com/ Yes $20 per clicker per day Meridia http://www.meridiaars.com/ Yes with some models $13 per clicker per day Qwizdom http://www.qwizdom.com/ Single word $40 per clicker eClicker http://www.bignerdranch.com/apps/ No $10 per smartphone
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Problems with 20th Century ARS Techniques
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Twenty-first Century ARS techniques
Simplify the ARS Process
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Start Using Bidirectional ARS
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Ask Your Questions on the Fly
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Make Use of Innovative ARS Techniques
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Traditional case conference
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“Inverted” case presentation
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Progressive refinement case presentation
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Table 2
Resident Response versus Level of Training
Resident Level Answer First year “Bad” or “mass” Second year Mass with “chondroid matrix” Third year Chondrosarcoma Fourth year Chondrosarcoma 2° to multiple hereditary exostosis syndrome
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Optimal protocol questions
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Optimal imaging workup
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Differential diagnosis
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Peer instruction
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Real-time evaluation of teaching sessions by students
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Guidance from learning theory
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Table 3
Audience Response System (ARS) Techniques for Different Learning Models
ARS Technique Learning Model Traditional case conference Behaviorism “Inverted” case conference Behaviorism Optimal protocol questions Cognitivism Optimal imaging workup Cognitivism Bidirectional ARS Constructivism Progressive refinement case conference Constructivism Differential diagnosis Constructivism Peer instruction Constructivism
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Behaviorism
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Cognitivism
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Constructivism
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Conclusions
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