Advances in Health Sciences Education

, Volume 10, Issue 3, pp 215–230 | Cite as

Evaluation of an Interactive Case-based Online Network (ICON) in a Problem Based Learning Environment

  • Arif N. Nathoo
  • Patricia Goldhoff
  • James J. QuattrochiEmail author


Purpose: This study sought to assess the introduction of a web-based innovation in medical education that complements traditional problem-based learning curricula. Utilizing the case method as its fundamental educational approach, the Interactive Case-based Online Network (ICON) allows students to interact with each other, faculty and a virtual patient in difficult neurological cases. Given the paucity of available metrics to benchmark online systems, we complement user perceptions with data on system utilization. Methods: We describe a case study of distinct, small group tutorials over 2 years as part of the Human Nervous System and Behavior (HNSB) course at the Harvard Medical School. Participating students and faculty were interviewed following completion of the course and their utilization of the system was recorded and examined. Results: Students each spent 3.2±1.3 h (mean±SD) through 8.6±2.8 accessions per week using ICON outside of required tutorial time. Faculty each spent 4.8±3.4 h through 16.6±8.9 accessions per week on ICON. Students identified real-time engagement, stronger relationships with faculty, increased accountability to the tutorial group and self-selected pace as the most beneficial characteristics of the ICON-based tutorial in comparison to traditional problem based learning (PBL) tutorials. Faculty identified enhanced collaboration with students and more realistic student experiences as the most beneficial characteristics. Both students and faculty reported that limitations of ICON included increased time investment for faculty and increased reliance on good faculty mentorship. Conclusion: This is the first study of the ICON learning system in undergraduate medical education, a platform designed to facilitate collaboration outside of the classroom. Data on user perceptions and system utilization suggest that both faculty and students chose to adopt this online learning system as a means for collaboration. The study also outlines future avenues for research in assessing novel online technologies.


Problem Base Learning System Utilization Virtual Patient Undergraduate Medical Education Group Tutorial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Blumenthal, D. 2002Doctors in a wired world: Can professionalism survive connectivity?Milbank Quarterly80525546CrossRefPubMedGoogle Scholar
  2. Dewey, J. (1994). Thinking in education. In L.B. Barnes, C.R. Christensen & A.J. Hansen (eds.) 3rd ed. Boston, MA: Harvard Business School Press.Google Scholar
  3. Educational Computing (2003). MyCourses Tutorial: A User Guide for Tutors; Using Educational Technology to Enhance Case-Based Learning.< MyCourses/TutorialUserGuide.pdf>. Accessed 10/1/03. Cambridge, MA: Harvard Medical School.Google Scholar
  4. Fleiszer, D.M., Posel, N.H., Steacy, S.P 2004New directions in medical e-curricula and the use of digital repositoriesAcademic Medicine79229235CrossRefPubMedGoogle Scholar
  5. Franke, R.H., Kaul, J.D 1978The Hawthorne experiments: First statistical interpretationAmerican Sociology Review43623643Google Scholar
  6. Frisse, M.E. 1990The case for hypermediaAcademic Medicine651719PubMedGoogle Scholar
  7. Glick, T.H., Armstrong, E.G 1996Crafting cases for problem-based learning: Experience in a neuroscience courseMedical Education302430PubMedGoogle Scholar
  8. Glick, T.H., Moore, G.T 2001Time to learn: The outlook for renewal of patient-centered education in the digital ageMedical Education35505509CrossRefPubMedGoogle Scholar
  9. Hallgren, R.C., Parkhurst, P.E., Monson, C.L., Crewe, N.M 2002An interactive, web-based tool for learning anatomic landmarksAcademic Medicine77263265PubMedGoogle Scholar
  10. Heidger, P.M., Dee, F., Consoer, D., Leaven, T., Duncan, J., Kreiter, C 2002Integrated approach to teaching and testing in histology with real and virtual imagingAnatomical Record269107112CrossRefPubMedGoogle Scholar
  11. Hersh, W.R., Junium, K., Mailhot, M., Tidmarsh, P 2001Implementation and evaluation of a medical informatics distance education programJournal of the American Informatics Association8570584Google Scholar
  12. National Education Agency (2002). Quality on the Line: Benchmarks for Success in Internet-based Distance Education.<>. Accessed 10/1/03. Washington, DC: National Education Association.Google Scholar
  13. Parker, M.J., Seifter, J.L 2001An interactive, ,web-based learning environment for pathophysiologyAcademic Medicine76550CrossRefPubMedGoogle Scholar
  14. Quattrochi, J., Pasquale, S., Cerva, B., Lester, J.E 2002Learning neuroscience: An interactive case-based online network (ICON)Journal of Science, Education and Technology111538Google Scholar
  15. Shaffer, K. 2004Teaching anatomy in the digitized worldNew England Journal of Medicine35112791281CrossRefPubMedGoogle Scholar
  16. Swaak, J., Jong, T 2001Learner vs. system control in using online support for simulationbased discovery learningLearning Environment Research421741CrossRefGoogle Scholar
  17. Vozenilek, J., Huff, J.S., Reznek, M., Gordon, J.A 2004See one, do one, teach one: Advanced technology in medical educationAcademic Emergency Medicine1111491154CrossRefPubMedGoogle Scholar
  18. Wenger, E. 1996Communities of practice: The social fabric of a learning organizationHealthcare Forum Journal392026Google Scholar
  19. Wenger, E. (2001). Supporting Communities of Practice: A Survey of Community-Oriented Technologies, Version 1.3. <>. Accessed 3/11/02.Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Arif N. Nathoo
    • 1
    • 3
  • Patricia Goldhoff
    • 2
    • 3
  • James J. Quattrochi
    • 1
    • 3
    Email author
  1. 1.Francis Weld Peabody Society, Harvard Medical SchoolTosteson Medical Education CenterBostonUSA
  2. 2.Department of Molecular and Cellular Biology, Harvard CollegeTosteson Medical Education CenterBostonUSA
  3. 3.Laboratory for Cellular and Molecular Neuroscience,Program in Neuroscience, Harvard Medical School, Harvard Medical SchoolTosteson Medical Education CenterBostonUSA

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