Yonago Acta medica 2012;55:69–73

Evaluation of an E-Learning Distance Education System inthe Graduate School of Medical Sciences of Tottori
UniversityDaisuke Houri,* Tatsuo Watanabe,† Kazuhiko Hayashi‡ and Youichi Kurozawa§*Division of Medical Education, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan, †Division of Integrative Physiology, Department ofFunctional, Morphological and Regulatory Science, School of Medicine, Tottori University Faculty ofMedicine, Yonago 683-8503, Japan, ‡Division of Molecular Pathology, Department of Microbiologyand Pathology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japanand §Division of Health Administration and Promotion, Department of Social Medicine, School ofMedicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
Three years have passed since the introduction of a new e-learning system as part of thegraduate study program in the Faculty of Medicine of Tottori University. To improve thissystem, a survey was conducted among graduate students and faculty members to evaluate
it. The subjects of the study were 138 graduate students (in the doctoral programs in Medical Science, 1st- and 2nd-term doctoral programs in Life Science, 1st- and 2nd-term doctoral
programs in the Institute of Regenerative Medicine and Biofunction, and Clinical Psychology)
as well as 108 faculty of the Graduate School of Medical Sciences of Tottori University. Graduate students reported that the e-learning education system is adequate and that they are satisfied to an above average level. The reasons for dissatisfaction with the system were roughly
divided into 3 categories: “contents”, “system” and “student reports”. This e-learning systemis still at an early stage of development, but we are pushing forward to improve this in anticipation of increasing the use of web learning modalities in the future.
Key words: distance education; graduate education; graduate student
In 2009, a new distance education program (thee-learning system) was introduced into the graduate
study program of the Faculty of Medicine at Tottori
University. A report was published about this byHouri et al. (2009). This program involved the delivery of a CD/DVD course to graduate students in theprogram. The education course consisted of sevensub-courses, each going beyond individual fields ofstudy. Each sub-course is divided into 1–6 categories(1 category corresponds to a 1-credit class) and eachcategory has 7–8 content units. A graduate student
studies 7–8 content units from each selected category,chooses 3 of its 7–8 content units and writes a reportabout the problem specified in the 3 units. A content
teacher evaluates these student reports.

We believe that this type of distance education is useful because it enables us to deal with anincrease in graduate students from society. Three
years have now passed since the introduction of thise-learning system. Therefore, we decided to revisethe contents of the program by surveying postgraduates’ feelings and requests as well as teacher’s awareness and opinions, aimed at improving our distanceeducation program. To clarify the program’s effectiveness, a questionnaire survey was designed andconducted for teaching faculty and graduate students
using it. Based on the results of this survey, revisions
and upgrades of the program contents were carriedout in order to improve the system.
Abbreviations: CD, compact disk; DVD, digital versatile disk;
USB, universal serial bus

69

D. Houri et al.

Fig. 1. Satisfaction rate of distance education and reasons for dissatisfaction.

age” (43.6%; Fig. 1). The reasons for dissatisfaction
with the system were roughly divided into 3 categories: “contents”, “system” and “student reports”.
• Contents: There were many comments about content relevance such as “The contents are too old for
graduate lectures (even on subjects from 2 yearsago)”.
• System: i) The voice on the CD/DVD was hard tounderstand. ii) There was insufficient explanation
given in the PowerPoint notes and voice input. iii)
There was 1 case where trouble occurred due to thepassword necessary to open the CD. iv) The qualityof the contents could be improved if an evaluationof each content unit was installed.
• Student reports: There were many comments suchas “The work only of examination and summary ismeaningless for graduate students”, “To write opinions and hypotheses about hard-to-answer questions
is effective” and “Reports could be excellent after
graduate students read and summarize a number oftextbooks and scientific papers” (Fig. 1).

Materials and Methods
The subjects of this study were 138 graduate students (50 from doctoral programs in Medical Science, 33 from 1st- and 2nd-term doctoral programsin Life Science, 51 from 1st- and 2nd-term doctoral
programs in the Institute of Regenerative Medicine
and Biofunction, and 4 from Clinical Psychology)
as well as 108 faculty from the Graduate School of
Medical Sciences, Tottori University.
The questionnaire form was distributed to, andcollected from, teaching faculty and graduate students in the fields of life science, clinical psychology, and function science of regenerative medicine
using the university’s campus mail delivery system.
Students majoring in medicine were sent the formby the public postal system, because of the large
number of these students living off-campus. Theforms were sent back unsigned. The collection rateof graduate students was 64.5%, while that of teachers was 81.7%. The questionnaire dealt with the subjects’ satisfaction, program contents and problems
concerning distance education and the e-learning
system.
The questionnaire data were analyzed for statistical significance by means of the chi-squared
test. Differences were considered significant at P <0.05.

When asked “Are you satisfied with the kindand number of content units?”, 65% of graduate students answered “Yes” and 5.2% “No” (Fig. 2). Whenasked “Do you think the contents were designed ina way that stimulates intellectual curiosity?”, 23.8%of teachers answered “Yes” while 31.2% of graduate
students answered, “No”. There was thus a significant
difference (P = 0.0001) in opinion between teachersand graduate students (Fig. 2). When asked “Do youthink that the contents are old?”, about 60% of teachers and graduate students answered, “Yes” or “Yes, alittle”, and there was no significant difference (Fig. 2).

Results
For the item “Satisfaction rate of distance education”,
a large number of graduate students answered, “aver70

Survey of the distance education system

Fig. 2. Subject responses about e-learning contents. NS, not significant.

was observed here in opinions between teachersand students.

When asked “Do you think that students write
good reports at graduate level after understanding
the contents thoroughly?”, the ratio of teachers who
replied “Yes, I do” and “Yes, a little” was 1.8 times
greater than that of students (Fig. 3). There was asignificant difference (P = 0.0002) in opinion between teachers and students.
The reasons why teachers didn’t think that
graduate students write good reports at graduatelevel can be classified into 3 areas (Fig. 3).
i) Their motivation and zeal are insufficient (“Students’ originality cannot be felt at all” and “Although the quality and quantity of their written
reports are not high enough, graduate students
think these are good enough to present”).
ii) Students don’t study enough (“There is no description of subjects examined by students themselves” and “Little consideration was based on thescientific literature”).
iii) The Copy and Paste problem: When asked “ Do
you think it is appropriate to study 7–8 content
units and submit 3 reports for each credit?”, about
60% of teachers and students answered, “It’s justright” (Fig. 3). The ratio of students who answered“That’s too much” was more than twice that ofthe teachers. A significant difference (P = 0.0109)

The teachers took 8 days on average to prepare
each unit. The graduate students studied 1 content
unit in 0.8 h, and wrote a report in 1.6 days (Table 1).
Discussion
Three years have passed since the introduction ofe-learning by CD/DVD into the graduate study program of the Faculty of Medicine in Tottori University. The questionnaire survey described here wasconducted to learn about the effectiveness of thisdistance education program. The opinions of teachers and graduate students were analyzed, and thecontents were revised accordingly.
For the item “Satisfaction with distance education and the e-learning system”, 67.9% of graduates
indicated that they were not dissatisfied. The ratioof students satisfied with the type and number ofcontents was 64.9%. Graduate students and teachers agree that it is appropriate to study 7–8 content
units and submit 3 reports for each credit. Thus,
graduate students seemed to think that this distanceeducation system is adequate and are satisfied to a71

D. Houri et al.

Fig. 3. Subject responses about e-learning student reports.

degree above average. However, 32.1% of graduateswere dissatisfied.
Both teachers and graduate students indicatedthat the contents are too old for graduate lectures(even content units on subjects of 2 years ago). To
address this, teachers were requested to revise andupgrade their contents.
As for dissatisfaction with the system, an old
microphone for recording voices, no specificationof the USB hub of the main current at the time, anda teacher unaccustomed to putting voice to PowerPoint are thought to be responsible. Attempts weremade to resolve the password problems by putting
a password to each folder with 7–8 content units,instead of to each content unit. A quick support system is necessary for graduate students to maintaintheir motivation and to enhance their learning. Thiskind of support system involves preparation andpresentation of a well-maintained learning environment (Tanaka et al., 2007). For this, it is necessary
to evaluate each content unit. However, issues suchas how evaluation results should be given to teachers and how teachers should evaluate themselves
based on survey results are problems that need tobe addressed in the future. Graduate students’ opinions about written reports were taken into account.

When the program’s contents were revised, teachers were requested to improve their content units
so that the level of the contents is higher than thatof lectures for undergraduate students. Moreover,it was felt that the topics for student reports should
not be easily available on the Internet. The reports
should require the inclusion of graduate students’
own ideas.
On the other hand, 73.8% of teachers felt thatthe contents were written in a way that stimulated
intellectual curiosity. However, the number of students who answered, “No, I don’t (think so)”, was
3.8 times more than that of teachers, showing thata significant difference is present between teachersand students. It is regrettable that graduate students
didn’t understand that it took 8 days for teachers todevise each content unit on average. However, there
must obviously be some differences among contentunits, some being good and others less good.
Recently, techniques and ideas for writing
student reports have greatly changed, with thedevelopment and general use of the computing environment. The problem of students plagiarizing
documents from the Internet (“Copy and Paste”)
also exists. In 1 recent opinion poll (Fujimoto et al.,2009), more than 65% of students did not feel guilty
72Survey of the distance education system

Table 1. Time for teachers to create contents and for students to study these
Subject
Time required for teachers to create 1 content unit(d)Time students spent watching CD or DVD to study 1 content unit (h)Time required for students to write 1 report(d)Mean ± SE

n7.98 ± 1.29
0.80 ± 0.14
1.58 ± 0.26

80
7072

CD, compact disk; DVD, digital versatile disk.

about using “Copy and Paste” for writing student
reports. In a related result, 12.4% did not feel guilty
about cheating in examinations. Despite this misbehavior, “Copy and Paste” is felt by students to be farless serious than cheating in examinations.
There were many teachers who feel that students write good reports at graduate level after understanding the contents thoroughly. This indicatesthat student reports may seem to reach the level thatteachers expect. However, these seemingly respectable reports might be a result of “Copy and Paste”.
Because their reports may have been made via“Copy and Paste”, the students themselves might
not consider them good reports. Given the amountof time (1.6 days) that it took for graduate students
to write their reports, and considering that the students themselves don’t think their reports are good,
there are strong reasons to believe that their reports
contain unreferenced quotations from the Internet
and even “Copy and Paste” writing.
Research using an online report submitting
system has shown that students easily plagiarize
parts of reports written by other students (Ueta andTominaga, 2010). To determine whether a given
report was written by students themselves, the degree of similarity of reports should be ascertained,
and reports evaluated by an examination to see ifmaterials learned are included in student reports.
However, a great deal of time is necessary to carryout this task accurately and impartially. Althougha report evaluation support system is available, noteacher at Tottori University has been reported touse this.
Collectively, although examination problems
requiring knowledge to solve might be necessary,harder-to-answer problems that require individual
students’ hypotheses and opinions may be muchbetter.

This questionnaire survey on e-learning wasconducted for the first time. Based on results fromthe survey, we carried out revisions and upgrades ofthe contents in order to improve the system and ourdistance education program. We are still at an earlystage in the development of our e-learning system,
but are pushing ourselves forward to improve this in
anticipation of increasing use of web learning modalities in future.
Acknowledgments: This research was partially carried out
as part of the “Research on Improving E-Learning Education in Tottori University Graduate School of MedicalSciences” project, supported by the university president’s
discretionary funds for “Promoting Improvement of Education and Research at Tottori University”.
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Received September 10, 2012; accepted October 29, 2012
Corresponding author: Daisuke Houri, PhD73