IMEJ main Wake Forest University Homepage Search articles Archived volumes Table of Content of this issue

1. Introduction
2. Technical Overview
2.1 Navigation System
2.2 Still Graphics
2.3 Animations
3. Learning Objectives
4. Topic Reviews
5. Users
6. User Feedback
7. Discussion
8. Conclusions
9. References

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Web-Based Modules Designed to Address Learning Bottlenecks in Introductory Anatomy and Physiology Courses
Myrta Hayes, Douglas College
Allen Billy, British Columbia Institute of Technology and Douglas College

This paper describes the development, use, and evaluation of two Web-based instructional units used to facilitate teaching difficult topics in introductory Anatomy and Physiology courses. These units were developed to specifically address problems identified by students in visualizing ossification (bone formation) and muscle contraction. Nursing and Sports Sciences students at Douglas College have experienced difficulty learning these topics as a wealth of anatomical and physiological detail and vocabulary is introduced in a short period of time. Multimedia units on ossification and muscle contraction, designed to complement instruction in both the classroom and laboratory, have made learning difficult topics a more palatable endeavor for students.

The content, user-interface design, interactive self-testing section, and feedback features of these units are described. Additionally, an evaluation of user response to the units is provided. Key features of the unit include a comprehensive collection of digital photos of anatomical features and processes combined with Flash animations and QuickTime movies to illustrate central concepts.

About the authors...

1. Introduction
Historically, students in the Biology Department at Douglas College were taught introductory Anatomy and Physiology through an audio-tutorial system. Students were required to listen to audiotapes, hear verbal descriptions of various topics, and then they were encouraged to consult either an instructor or a reference textbook if they had questions about the material. Human Anatomy and Physiology courses are presented as service courses in Nursing and Sport Sciences programs. Students survey the major anatomical and physiological features of several organ systems in rapid succession. Students enter these courses with differing levels of academic skills and prior training in Anatomy and Physiology.

Anecdotal complaints from students suggested that the taped verbal descriptions were inadequate to conceptualize dynamic processes or complex structures. Also, when complex topics were presented in classroom lectures, students either retained a simplistic overview of the topic, or were confused when introduced to a topic based on an understanding of sequential processes. In response to repeated complaints about the mode of delivery associated with certain topics, some members of the Biology Department resolved to increase the visual content presented with selected topics.

Based on a survey of the prior instructional experiences of instructional staff working in a laboratory setting, we determined that student learning was often enhanced when topics were explained using diagrams, models and other visual aids. The potential educational value of using well-designed computer-based, interactive multimedia modules was perceived as one way to complement traditional laboratory teaching methods. Since commercial multimedia products did not address the specific concerns raised by our students, nor reflect the exact content of our curriculum, faculty and staff collaborated to develop and produce multimedia units initially for internal use. However, the design team also resolved to produce instructional modules that could be adapted for use in introductory Anatomy and Physiology courses offered at other institutions.

A faculty and staff team in the Biology Department at Douglas College developed a series of web-based instructional units on basic topics in Human Anatomy and Physiology. Modules were developed to specifically address problems identified by Nursing and Sport Sciences students in visualizing key concepts in three areas of basic Anatomy and Physiology.

The modules developed to date review the topics of Ossification, Muscles and Muscle Contraction, and Articulations. The two most recently developed modules, Ossification and Muscle Contraction, will be discussed in this paper. The antecedent module, Articulations, is mentioned solely to illustrate how the development and form of these modules has changed as our team learns more about producing web-based teaching units. The modules presented are currently hosted on the Douglas College server for people with an interest in teaching or learning basic Anatomy and Physiology. The "Ossification - An Introduction to Bone Formation" module is available at (Figure 1). The "Muscles - An Introduction to Muscles and Muscle Contraction" module is available at The "Articulations" module is available at .


demo: external link An external link to the authors' The "Muscles - An Introduction to Muscles and Muscle Contraction" module.

demo: external link An external link to the authors' The "Articulations" module.

figure 1

Figure 1. A screenshot of the "Ossification - An Introduction to Bone Formation" module.

demo: external link An external link to the authors' Ossification - An Introduction to Bone Formation" module.

The Ossification and Muscle Contraction modules present central, dynamic topics found in most introductory Anatomy and Physiology courses. Each module is designed to complement existing Anatomy and Physiology courses and attempts to make student explorations of complex subjects more self-paced, more visual, and clearer.

Each module guides students through a series of concepts and topics presented in a self-paced manner, with a high visual content supported with concise clarifying text. The visual content is presented using still and animated graphics. These modules are presented as a supplemental resource to assist instructors and students in existing introductory Anatomy and Physiology courses. Each module is designed to complement existing courses and does not represent a stand-alone instructional unit. Students would normally be expected to combine information presented in each module with information obtained from the classroom and laboratory. These modules are most likely to be used as complements to existing courses and can be used in lecture and / or laboratory settings to present and review selected topics.

Placing the modules on the Web allows students to access the modules from school or home and review topics as needed. Also, by placing the modules on the Web, instructors from other institutions may freely use the material, instead of developing similar modules independently.

2. Technical Overview
Navigation System
The navigation scheme used is hierarchical and always present on the left side of the screen. Major subjects are shown in a larger font size, with subsections indented and shown in a smaller size font. The navigation scheme facilitates easy selection and viewing of subjects in a logical sequence, or selection of specific topics for review purposes.

The navigation scheme is based on Hypertext Markup Language (HTML) using Cascading Style Sheet (CSS). Using CSS displays font characteristics uniformly throughout all module pages without having to insert elaborate font commands for every link. Students access and view links by using a "Mouse Rollover" feature based on JavaScript. The script allows the mouse pointer to change colour when moving over a link in the navigation bar, indicating that the link is selected and active.

2.2 Still Graphics
Colour still graphics were used to depict anatomical and physiological subject material in a visually informative manner.

Many of the graphics are pictures taken with a Sony Digimatic digital camera. The anatomical models used for the pictures, such as skeletons and the muscle model, were present in the Douglas College Biology lab. Digital pictures were modified, enhanced, and labeled using Adobe Photoshop 5 software.

2.3 Animations
Flash animation software was used to embed subtopics within the first page of a new topic. Use of this technique greatly reduced loading times when new graphics are called up for viewing since Flash movies are more condensed than other animations.

Ninety percent of pages in both modules were constructed with Flash software. The use of Flash software has eliminated the time consuming opening of "windows" (as with conventional web design using JavaScript and HTML) and facilitates interactive viewing of the subject material in a time friendly manner.

As part of the publishing process, Flash automatically performs some optimizing on movies such as reducing duplicate shapes and placing them in the file only once. Movie sequences were further condensed by "tweening" animations to reduce the amount of file space required by animations.

QuickTime movies were used in combination with Flash animations to illustrate dynamic sequences or complex actions. An example of how we combined techniques to produce an animation can be seen in five animations associated with the process of endochondral ossification (

demo: movie AVI (~1 MB): A screen captured movie of one of the five animations in the ossification module.

demo: external link An external link to the authors' ossification module that uses five animations to show the process of endochondral ossification.

3. Learning Objectives
The modules present an inter-related set of topics commonly found in first year Anatomy and Physiology courses. Each topic is presented in a concise manner, usually with an accompanying still graphic or animation to illustrate main points.

Potential sets of learning objectives for each module are listed below. Each learning objective is developed in a series of pages that allow a student to work from a general overview of the topic to a presentation of details associated with that particular topic. A set of learning objectives was not placed within the module to allow different instructors to work with the learning objectives they have developed for their courses. This approach provides flexibility for instructors wishing to selectively use and adapt portions of the modules in their courses.

After working through the Ossification - An Introduction to Bone Formation, Growth and Repair module, students should be able to perform the following:

  1. Describe the basic structure and histology of the skeletal system.
  2. Specify the four major types of bones found in the human skeleton.
  3. Specify the components of the axial and appendicular skeletons, and describe general functions of the two skeletal subdivisions.
  4. Describe a set of structural differences between the male and female pelves.
  5. Name and describe the principle components of the axial skeleton.
  6. Name and describe the principle components of the appendicular skeleton.
  7. Describe the structure and function of the vertebral column.
  8. Describe the structure and function of a typical vertebra, and describe the structure of vertebra from different regions of the vertebral column.
  9. Identify the major features of a long bone.
  10. Compare and describe the composition and function of compact bone, spongy bone, and cartilage.
  11. Define “ossification”, and compare intramembranous ossification with endochondral ossification.
  12. Describe how a long bone grows in length and girth.
  13. Describe the most common types of bone fractures.

After working through the Muscles - An Introduction to Muscles and Muscle Contraction module, students should be able to perform the following:

  1. Describe the structure and function of the three basic types of muscle tissue (skeletal, smooth and cardiac) in the human body.
  2. Describe three kinds of lever systems present in the body and give an example of each type of lever.
  3. Describe the anatomy of a skeletal muscle from the gross to molecular levels of analysis.
  4. Describe the structure and function of the neuromuscular junction.
  5. Describe the structure and function of the sarcomere.
  6. Describe the Sliding Filament Theory of muscle contraction.
  7. Describe common muscle pathologies.

4. Topic Reviews

The technical content of each module can be reviewed by students at the end of each module or as a review exercise prior to a classroom exam. Each module possesses a quiz consisting of thirty multiple choice questions related to central topics in the module ( The interactive quiz provides immediate feedback to students by indicating whether the selected answer was correct or not. Most quiz questions are linked to specific pages so students can return to review topics earlier in the module by clicking a "review" button. Once they have reviewed a module topic, they may click on a button to return to the quiz.




demo: external link An external link to the authors' quiz.

5. Users

These modules were designed for students enrolled in any basic Anatomy and Physiology course. At Douglas College, students in General and Psychiatric Nursing or Sport Sciences programs are the primary users of the modules. Senior students and graduates from programs can also access the modules to review basic topics in Ossification and Muscle Contraction as needed. Our experience at Douglas College indicates that students in other programs and university-transfer first year Biology courses also use and appreciate the modules.





6. User Feedback

Each module is equipped with an optional feedback page that allows a user to evaluate and critically review the module ( This feature allows us to receive a continuous stream of comments and questions from users. While the feedback is voluntary, anecdotal, and accumulating, we have received 20 feedback forms. All of the feedback has been extremely positive in terms of module assessment and use. No negative assessments or comments have been received on any of the modules. Some users have identified themselves as Douglas College students; we have also received feedback from external users who have worked with, and appreciated, the modules.

The module review form consists of four specific questions plus a "comments" section in which a reviewer may enter detailed or lengthy responses. The response to each question is rated on a five-point scale from 1 (strongly agree) to 5 (strongly disagree) with 3 indicating a neutral response. The questions asked are listed below, with the average response score indicated in parentheses after each question. The response scores were derived from a set of eleven complete evaluation forms which provided answers to all of the questions asked. The remaining nine forms were either incomplete or contained comments only.

  1. The site contributed to a better understanding of bone growth (or muscle contraction).
    (average score = 1.1)
  2. I found the site navigation to be effective and easy to understand.
    (average score = 1.2)
  3. There is a good balance between text and images.
    (average score = 1.4)
  4. I found the "review" button on the quiz to be a useful feature.
    (average score = 1.2)

While a small sample of review forms exists, the positive responses to the modules are clear. Users voluntarily reported that they learned from the modules, found the site easy to navigate, and appreciated the composition of the content, the interactive nature of the quiz, and the review feature.

User comments were universally positive in nature. Users identified as students provided anectodal comments that support the idea that the modules do help some students learn complex topics. Representative student comments include:

" I personally found the site extremely helpful in understanding the skeletal system! I think that it has very clear illustrations that help me understand the different subjects studied."
" This site is excellent! I was really into learning about ossification. I plan to come back to this site to help me study for my final."

One comment was received from an instructor at another institution.

" This site is great. Thanks for putting it together. I have used it as a supplement to teaching my high school students about bone growth. The animations were helpful to illustrate the concepts mentioned in our text and brought up in lecture."

User feedback is solicited and received on an ongoing basis as the feedback form is built into each module.




demo: external link An external link to the authors' feedback.

7. Discussion

A series of surveys of over 2000 North American educators on the use of Web-based materials in teaching indicates that the majority of respondents consider Web-based teaching tools to be as important as traditional teaching aids (McGraw-Hill Ryerson, 2002). The report also indicates that student success is enhanced by Web-based learning activities; students perceive Web-based materials to be more effective learning aids than traditional resources, such as the library and tutoring. The survey results also indicate that an ever-increasing number of faculty are integrating Web-based content into course delivery. The trend seems to be for faculty to integrate computer-based modules into existing teaching practices, rather than transforming entire traditional courses to Web-based courses. We would agree that a careful selection of Web-based content modules can complement instruction in specific classroom and lab activities.

The development of specific modules to address learning bottlenecks has proven to be more cost effective than developing entire courses at our institution. Sufficient funds and time are currently not available to transfer a set of Anatomy and Physiology courses to a computer-assisted mode of delivery. However, by carefully using the available resources to address specific, common conceptual problems reported by students, some computer-based modules can be developed to produce a widespread, long-lasting aid to student learning. The use of specific modules to complement other teaching efforts has been used successfully in a variety of educational contexts. For example, instructional modules designed to teach anatomical concepts in a clinical setting combined with Problem-Based Learning activities have proven successful (Kennedy et al., 2001; Keppel et al., 2001). Similarly, prior training with computer modules improved student performance on anatomical dissections in laboratory activities (Gunn and Maxwell, 1996).

The initial learning curve to develop these modules was steep and did require a considerable investment in time and energy. However, we now feel that each module represents a re-usable template that can be edited to quickly develop presentations of new topics. Additional modules are likely to be produced in a shorter period of time, and be less expensive, as the development team gains experience in managing the software used to produce modules.

We recognize that there is a need for a methodology to assess the effectiveness of multimedia units as learning aids. We quite deliberately responded to comments from students to develop these units in an attempt to deal with a recurring complaint about the presentation of difficult topics. Once the modules were used, we received anecdotal feedback from students and external users indicating that the modules were useful in helping people learn more about selected topics. We have made no attempt to quantify learning by the users, but we have assumed that positive feedback from users indicates that some learning process was enhanced when people used the modules.





8. Conclusions

Anatomy and Physiology topics can be complex, and often require students to visualize unfamiliar dynamic processes while assimilating a significant amount of new technical vocabulary. The use of Web-based instructional units provides clear visual images and concise text to assist students in learning new material. Students can work through Web-based modules at their own speed and receive assistance on topics that represent temporary learning roadblocks.





9. References 
Gunn, C. & Maxwell, L. (1996). CAL in Human Anatomy. Journal of Computer Assisted Learning 12, 205-215.

Kennedy, G.E., Kennedy, D.M. & Eizenberg, N.E. (2001). Integrating Computer Facilitated Learning Resources into Problem-Based Learning Curriculum. IMEj 3 (1).

Keppell, M., G. Kennedy, K. Elliot & Harris, P. (2001). Transforming Traditional Curricula: Enhancing Medical Education through Problem-Based Learning, Multimedia and Web-Based Resources. IMEj 3 (1).

Technology and Student Success. 3rd Edition. (2002). McGraw-Hill Ryerson. 171 pp.

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IMEJ multimedia team member assigned to this paper Yue-Ling Wong