Research design and setting
This action research was conducted to explore the impacts of a course blended with flipped classrooms on both the attitude of master students towards their wiki-supported group work and the quality of their group work. It was took place at the education development center affiliated with our university of medical sciences in six consecutive semesters, from September 2016 to December 2019. Conducting the study was approved by the university ethics review board (N: 1396.1129).
Participants
Participants were master students at the School of Medicine. All students had to pass a course entitled: “Writing and presenting articles in English”, in the first two semesters of their study at medical school. During four semesters, 205 master students enrolled in this course. They were studying in eight different disciplines: physiology, biochemistry, bacteriology, virology, anatomy, immunology, hematology and medical education. All students, who had not previously passed a similar course, were included in the study. Later, the data about the students who had not completed the research questionnaire was set aside and only the data on 171 remaining students was analyzed.
Intervention
All students were involved in a blended course, with both online and in-class parts. While learning from online and in-class activities, students were asked to do a group work. They were free to choose one of the two available options for doing their group assignment. Those options were doing the group work through an educational wiki or doing it in a traditional way. Regardless of their selected option, all students were informed that 40 percent of their overall score would be allocated to their group work. Students in both groups had to follow all in-class and out-of- class activities. The only difference between the two groups was in the form of their group work, so the results of the study will be classified into two groups: wiki or non-wiki groups. .
Out of class activities of the course
This part was delivered through an open-source and freely available Moodle (Modular Object-Oriented Dynamic Learning Environment)(10). The version of employed Moodle was 3.0.4. (11). An orientation session was hold to ensure that all students can manage all predetermined activities on the platform.
Using the iSpring Suite 8 software, twelve electronic- content (e-content), in the form of the sound synchronized with PowerPoint slides, were produced and uploaded into the platform. Those contents were standard in format and the students could control them on their own players (on a personal computer or a smartphone). The e-contents covered all the learning objectives of the course and students could use them many times, in their desired time and place.
The expected online activities were: studying e-contents of the course and discussion on a forum. Students in the wiki group had to do their group work on line, as well.
In-class activities of the course
In this part, students attended flipped classrooms (FCs). Students were divided into groups of four. They were asked to summarize the content of each session in their group and bring a one-page summary to the class. They were also requested to be prepared for a 15-minute in-class presentation. They were explained that each session they should take on different roles (presenter, note taker or writer) in the group.
Details for students activities in each FC, divided by in or out of class activities, according to their implementation order are summarized in Table 1.
Table 1
Details for students activities during a semester, divided by in or out of class activities, according to their implementation order
| Order | Type of activity | Description | Duration |
Online(out-of class) activities | 1 | Self-regulated learning | Downloading and listening to the e- contents, whenever and wherever students liked (flexible asynchronous e-learning) | Variable according to students' interest and need |
2 | Group discussion in a forum | Raising questions in the forum and discussion with each other(peer-assisted learning) |
in-class activities(at flipped classrooms) | 3 | Quiz at the beginning of the class | Discovering any possible misunderstandings of the content(formative assessment) | 10 minutes |
4 | Summary sharing by students | Sharing a brief one-page summary of the e-content of that session with other groups(collaborative learning) | 10 minutes |
5 | Student presentations | A 15-minute presentation by one group (Peer education) | 15-minutes |
6 | QA & Group discussion | Questions and answers from students and facilitation by the teacher | 35 minutes |
7 | Micro lecture by the teacher | Summarizing and closing the session | 10 minutes |
8 | Quiz at the end of the class | Summative evaluation | 10 minutes |
Wiki activity
The version of the wiki, which was used in this research, was 2015111600 (11)(Dent et al., 2017)(Dent et al., 2017)(Dent et al., 2017) (Delandshere & Arens, 2003)and its programming language was PHP ( Hypertext Preprocessor)(12). It had been already installed with the Moodle package and had a simple markup formatting. Students in the non-wiki group, who did their group work in the traditional way, did not have access to the wiki on the LMS (Learning Management System).
The wiki had various features including, writing and editing text, importing and editing images, importing audio and video files, drawing tools, drawing and editing tables, hyperlinking, inserting and editing statistical formulas, structuring and organization of the text.
Through a pilot study, wiki's features were improved based on the feedback from eight peer students and five peer researchers. Reflections by the research team were helpful as well. After the modifications, the features of search, spell check, insertion of emotions and email notification were added to the wiki too.
The learners’ group work was focused on a collaborative writing about do’s and don’ts in writing the articles in English. Applying the above mentioned features of the wiki, students were able to start writing, editing and structuring from everywhere in the text. They could also structure their group writing with the subject division hierarchical method. Each semester, the wiki was available for only students of that term. So, students could contribute to the web pages of their own group.
The course teacher (SGH) was able to supervise LMS activities of all learners 24 hours a day. By controlling history and logs of the learners, she was able to assess both the quantity and the quality of each student’s activity on the LMS and wiki. So it was possible to differentiate the various activities of the students in the system. Different activities of students included a simple log in, moving between pages or typing and editing in the wiki. When students made any changes in their writing, those changes would be highlighted in the text. Those highlights were evaluated by the teacher. When the quantity or quality of a student’s activity was not desirable, the teacher sent an email to her/him via the LMS. Drawing figures of “content access”, “number of active participants” and “hits distribution”, the teacher realized passive or very active students. Those figures also helped the teacher figure out which contents were not accessed by every student.
Evaluation of the intervention and data analysis
First, students self-assessed their satisfaction with different educational activities of the course. They also specified the amount of their learning from each component of the course. An 11-item satisfaction questionnaire was designed and validated for the present study. To assess the content and face validity of the satisfaction questionnaire, ten experts in the field of medical education evaluated the necessity, relevance, appropriateness and clarity of the items (13, 14) and 6 master students examined any ambiguity in understanding of the items(13, 14). Internal consistency of the items was assessed by calculating Cronbach’s Alpha and Intra-class Correlation Coefficient (ICC) was calculated to judge the stability of the results (14). For doing so, 30 master students completed the questionnaires twice with a two-week interval.
Students’ satisfaction with each item of the questionnaire was specified, employing a five-point Likert scale (Very high, above average, Average, below average, Very low). Students specified their attitude toward performing their group, responding to 5 questions with the same Likert scale.
Students’ learning was assessed in two ways: First, as a formative assessment, both the quantity and the quality of each student's participation in doing their group work were continually evaluated during the semester. At the end of the semester, the quantity and quality of each student’s participation was rated in a range from zero to five, using a five-item checklist. Second, students’ average score in their summative exam was used to assess their learning. The summative exam included extended matching items, multiple choice questions and fill-in- the blanks items.
Students’ competency in transferring their learning into creating an outline for a hypothetical article and writing topic sentences for each part of that article was used to assess the impact of the course. That competency was examined in students’ summative exam.
In order to regard some unanticipated consequences of the wiki-authoring activity, all learners were asked to critique the process of their co-construction activity as well. Students' feedback together with their aliases was emailed to the course teacher by the class representative immediately after the end of the semester.
Statistical analysis
Students’ satisfaction with each component of the education; their overall self-declared satisfaction with the whole course; their average score in the summative exam of the course; quantity and the quality of each student's participation in doing their group work and also their attitude toward performing their group were described in wiki and non-wiki groups, reporting proper descriptive statistics.
Employing independent samples t test or Mann –Whitney U test, the results of the course were compared in two groups. As the distribution of some variables was not normal, they were first transformed to their natural logs. Then, the correlation between the mean score of students’ satisfaction with flipped class rooms and the mean score of the quality of each student's participation in doing their group work as well as their the mean score of their attitude towards their group work were investigated, using Spearman's rank correlation coefficient. The causal associations between those variables were evaluated by univariate linear regression analysis. The data was analyzed Using SPSS for windows version 21.0. Significant meaningful differences were reported based on the Asymp.Sig. (2-tailed). Values of P less than 0.05 were considered statistically significant.