DESIGNING CLICKER QUESTIONS THAT ENCOURAGE ACTIVE LEARNING IN A TECHNOLOGY ENHANCED PRACTICAL LAB SETTING

INTRODUCTION
Clickers or Classroom/Audience response systems (CRS) are handheld electronic devices used to elicit anonymous student responses to questions using electronic on-screen presentations wherein the results of students' responses are also immediately displayed thus giving immediate feedback. However, it is the pedagogy rather than the CRS technology that is important. CRS is a valid and effective tool for evaluation of learning, and has good predictive value, usability and benefits in a curriculum focused on interaction.

RATIONALE
With ever increasing enrolment in professional courses like medicine in the Asia pacific, the constraint of adequate student-teacher ratio poses a challenge to ensure that all students within a large cohort achieve the learning outcomes and competencies in practical skills. To overcome this, this study proposes the use of CRS within a practical lab based setting. CRS use in Practical/skills based based curriculum (except in Physics) has not been studied extensively. Their efficacy, however, depends strongly on the quality of the questions used. CRS question should have an explicit pedagogic purpose consisting of a content goal, a process goal, and a metacognitive goal. Questions can be designed with the objective of directing students' attention, stimulating specific cognitive processes, communicating feedback both to instructor and students, facilitating the articulation and confrontation of ideas and measuring learning outcomes in achieving competence in practical skills.This study is based on the framework of Bloom’s taxonomy to target questions to various cognitive levels.

OBJECTIVE
To elicit feasible ways in designing CRS questions in practical/ skills based learning that can assess and stimulate higher cognitive levels of application, analysis, synthesis and evaluation as well as in the psychomotor domain.

METHODOLOGY
Principles of a good CRS questions were presented as preset questions in a semi structured interview with a snowball sample of experienced Clinical anatomy practical tutors. Views on the best ways to convert traditional text/picture/photo/video/case based Clinical Anatomy questions into CRS questions that aid active learning were elicited.Using a grounded theory approach, the transcript of interviews were analyzed through content analyses in terms of their nature, range and frequency (quantitative) with illustrations drawn from examples (qualitative) of good CRS questions.

RESULTS AND DISCUSSION
In answering the research question of what the principles and feasible ways to design effective CRS questions to improve learning outcomes of a active learning environment in health sciences could be, this study, came up with the common agreed principles, feasibility, and examples of content of higher order CRS. It also created the much needed awareness amongst experienced Clinical Anatomy teachers regarding the ways to enhance effectiveness of CRS as a tool for engaging students in active learning in a Practical lab setting. CONCLUSION: CRS questions that aids active learning in Practical lab needs thorough and in-depth design that is different from traditional CRS questions in a lecture setting. This study highlights the need to design CRS questions that target higher order psychomotor and cognitive processes and recommends developing a question bank for its widespread use in medical education.