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Anonymous Audience Response Technology in Image-Based Quiz (IBQ) Neuropathology Lecture for Undergraduate Pre-clinical Medical Students: a Comparison with Traditional Lectures


Pathology teaching, an intensively image loaded discipline, poses a significant challenge in its delivery. A lot of effort has been placed into sourcing teaching methods that could effectively enhance students’ understanding and knowledge retention in this discipline. We describe for the first time in the literature the use of an image-based quiz (IBQ) to deliver a neuropathology lecture. The participating medical students were randomised into either the study group (IBQ) or the control group (traditional lecture, TL). The students were asked to complete the pre- and post-multiple choice question (MCQ) test before and after attending either of the allocated interventions. In the IBQ group, the students were presented with image-based quizzes, and answers to the quizzes were projected in real-time on screen. The students in the TL group were given the usual, traditional lecture. A total of 75 third-year medical students participated in this study. The participants were recruited from third-year medical students representing two different academic years. There was no significant difference in the pre- and post-MCQ scores between the IBQ and TL groups. However, a significant improvement in the mean scores for the pre- and post-MCQ results in both the study (p = 0.001; 95% CI 0.572–1.954) and control (p < 0.001; 95% CI 0.561–1.763) groups was observed. We found that the IBQ was a simple, personalised, and cost-effective digitalised tool which our study suggests it to be as effective as the traditional lecture in the delivery of pathology knowledge in undergraduate medical students.

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Availability of Data and Materials

The anonymized datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.



Image-based quiz


Traditional lecture


Audience response technology


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The authors would like to thank all the medical students that had participated in this study.

Author information




SCL and VN conceived and conceptualised the study design. DHFA analysed the data. All authors interpreted the data and prepared, revised, and approved the manuscript.

Corresponding author

Correspondence to Siaw Cheok Liew.

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This study was approved by the Institutional Research Board (IRB) of Perdana University (PUIRBHR0155).

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Non applicable.

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The authors declare no competing interests.

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Liew, S.C., Naik, V. & Azim, D.H.F. Anonymous Audience Response Technology in Image-Based Quiz (IBQ) Neuropathology Lecture for Undergraduate Pre-clinical Medical Students: a Comparison with Traditional Lectures. Med.Sci.Educ. (2021).

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  • Pathology teaching
  • Image-based quiz
  • Quiz
  • Medical students
  • Medical education