Editorial board editor-in-chief

Fig. 5.
Comparison of students’ opinion on usefulness of the 
pathway and textbook
Fig. 6.
Students’ results in practical tests
Even though both educational material types were found 
understandable and appropriate for learning, students presented 
ambivalent attitude to the statement “
I have learned to evaluate 
dental age
” (mean for textbook 3,5; mean for pathway 3,7 out 
of 5). It seems that many students are not able to learn practical 
skills without any help from the teacher’s side. They are used 
to rote learning but do not know how to apply their knowledge 
in practice.
Fig. 7.
Comparison of students’ in practical tests for the 
experimental and control group
Many students in free-text questions underlined that the class 
concerning dental age was interesting and informative for them 
(mean 4,3 in 5-point scale) and that this was their irst encounter 
with this form of learning (only 3 students stated that they used 
educational decisions diagrams before). They claimed that they 
would like to have more lessons like that one in future. They 
also admitted that learning with computer was more interesting 
for them (mean value 4,5) and more effective (mean value 3,8) 
than learning from a textbook. In the free text comments some 
students stated that Internet access gives them the opportunity 
to learn anytime, anywhere and to reach interesting information 
just-in-time. However, there were also opinions supporting learn
-
ing from traditional textbook rather than using computers. Some 
students prefer textbooks because they can better concentrate 
on learning – they perceived computer as a tool for entertainment 
but not for learning.
Discussion
The obtained good effects in knowledge acquisition of human 
developmental age based on dentition could be reached by the 
application of appealing educational tools, such as virtual patients. 
Students were very interested in the presented case “Adaś” – they 
were studying eagerly and solved their tasks eficiently. The skills 
learned by students during self-study scenario were also satisfy-
ing regardless the type of applied learning material (textbook 
or pathway). Students in free-text answers underlined that the 
dental pathway helped them in systematization of knowledge 
and memorizing consecutive steps. 
Evidence showing effectiveness of different kind of dia-
grams was summarized in several reviews and meta-analyses 
(e.g. [3, 16, 20]). Graphic organizers are believed to pre-atten
-
tively convey information through spatial coniguration of com
-
ponents (a so-called visual argument) and the human ability to 
discriminate individual components (chunks of information) from 
each other [20]. A diagram can show at the same time many 
key concepts helping the learner to build a schema of what is 
to be learned. Relationships presented in the text are made by 
graphic organizers very concrete and visible. Spatial arrangement 
and verbal knowledge are transmitted by separate information- 

---

21
E-lear
ning
Educational decision diagrams in biomedical and life sciences…
-processing channels [13,17] and in that way the text, illustrated 
by graphic organizers, despite containing more information does 
not necessarily increase the cognitive load of the learner. Because 
verbal and visuospatial knowledge is believed to be stored in 
separate but potentially interlinked memory regions, the duality 
of encoding may provide an additional retrieval path for both 
kinds of information [16]. Despite these theoretical arguments 
we failed to demonstrate the superiority of graphic organizers 
over text description in this experiment. The reasons for that 
may be various: small sample size, briefness of the knowledge 
and skills evaluation or speciicity of the topic selected as source 
for the pathway.
Worth mentioning is the fact that students perceived the 
dental pathway rather as a good reminder of how to evaluate 
dental age than a resource helpful in learning the algorithm. 
Students claimed that they evaluated age of children easier 
and faster having access both to test images and the pathway 
at the same time. When it came to practical application of the 
knowledge without access to the pathway, some of the students 
failed to succeed. Both student groups – using pathways and 
using textbooks – were not convinced about their own proiciency 
in recognizing the dental age. On the one hand this observation 
shows lack of abilities to apply the acquired knowledge in prac-
tice, on the other hand it indicates a strong need of a personal 
contact between students and the teacher, who can emphasize 
practical aspects of the presented knowledge. 
The dental pathway discussed in this paper is just one exam-
ple of a series of pathways created using the Bit Pathways tool. 
Other pathways in ontogenesis and sport medicine inform about 
evaluation of the developmental age on the basis of skull sutures 
and skeletal ossiication procedures or allow gender recognition 
at different levels of body complexity (genetic gender, gonadal 
gender, genital gender, somatic and psychical gender). These 
pathways are still waiting to been veriied in practice.
Conclusions
The retaining effect of self-study was more visible in the theoreti-
cal part of the experiment than in the practical part. We did not 
observe signiicant differences in the level of knowledge and 
skills between tested learners studying from textbook and those 
using a dental pathway. Many students appreciate and prefer 
modern didactic methods accessible by computer, but it had 
no apparent effect on the learning outcome. We observed also 
students who gave priority to systematic learning from textbook 
over innovative techniques. 
References
1. Broniatowska E. (2009): Chemical pathways – Application 
to the Classiication of the Molecular Point Groups.
 
Bio- 
-Algorithms and Med-Systems 5(9), pp. 117-120.
2. Burdukiewicz A., Pietraszewska J., Pietraszewski B. 
(2001): Siła dynamiczna kończyn dolnych a morfologia 
ciała piłkarzy nożnych. In: A. Burdukiewicz (ed.): Zasto
-
sowanie antropologii w wychowaniu izycznym i sporcie. 
Studies and Monographies of AWF 59, Wrocław, pp. 17-26. 
3. Canas A. J. et al. (2003): A Summary of Literature Pertain
-
ing to the Use of Concept Mapping Techniques and Tech-
nologies for Education and Performance Support. Techni
-
cal report. The Institute for Human and Machine Cognition, 
Pensacola FL, USA.
4. D’Antoni A.v., Zipp G.P., Olson v.G. (2009): Interrater reli
-
ability of the mind map assessment rubric in a cohort of 
medical students. BMC Medical Education 9, p. 19.
5. Davidowitz B., Rollnick M. (2001): Effectiveness of Flow 
Diagrams as a Strategy for Learning in Laboratories. Aus
-
tralian Journal of Educational Chemistry 57, pp. 18-24.
6. DeMeo S. (2007): Constructing a Graphic Organizer in the 
Classroom: Introductory Students’ Perception of Achieve-
ment Using a Decision Map To Solve Aqueous Acid-Base 
Equilibria Problems. Journal of Chemical Education 84(3), 
pp. 540-546.
7. Kononowicz A.A., Holler T. (2008): The development of 
a tool for teaching and learning clinical pathways. Bio-Algo
-
rithms and Med-Systems
 
4(8), pp. 33-40.
8. Kononowicz A.A., Sałapa K. (2008): Building clinical path
-
ways by postgraduate students as a method of improving 
knowledge about the patient’s journey through a hospital. 
AMEE Conference, Prague, Czech Republic.
9. Kononowicz A.A., Roterman I. (2009): Chemical Pathways 
– Visualisation of Classical Analytical Procedures in Chem-
istry by the use of Flow Charts. Bio-Algorithms and Med-
-Systems 5(9), pp. 121-126.
10. Kononowicz A.A. (2010): Tworzenie komputerowych sche
-
matów ścieżek klinicznych jako metoda wspomagania pro
-
cesu edukacji medycznej. X Conference virtual University, 
Warszawa.
11. Łaska-Mierzejewska T. (1999): Antropologia w sporcie i wy
-
chowaniu izycznym. Warszawa, p. 12.
12. Malinowski A. (1997): Określenie wieku osobnika ze 
szczątków kostnych. In: A. Malinowski, W. Bożiłow (eds.): 
Podstawy antropometrii. PWN Warszawa-Łódź.
13. Mayer R.E. (2009): Multimedia Learning. Second Edition. 
Cambridge University Press.
14. Milde K., Tomaszewski P., Sienkiewicz-Dianzenza E., No
-
wicki D., Wiśniewski A., Stupnicki R. (2006): Odniesienie 
wyników prób sprawności izycznej niskorosłych chłopców 
do siatek centylowych dla wieku kalendarzowego i wzros-
towego polskiej populacji. Endokrynologia, diabetologia 
i choroby przemiany materii wieku rozwojowego 12(2), 
pp. 51-54.
15. Moore D.W., Readence, J.E. (1984): A Quantitative and 
Qualitative Review of Graphic Organizer Research. Journal 
of Educational Research 78(1), pp. 11-17.
16. Nesbit J.C., Adesope O.O. (2006): Learning with Concept 
and Knowledge Maps: A Meta-Analysis. Review of Educa
-
tional Research 76(3), pp. 413-448.
17. Paivio A. (1986): Mental representations: A dual coding ap
-
proach. Oxford University Press.
18. Sałapa K., Stanisz A. (2009): Statistical Pathways – 
A Method of visualization Statistical Rules. Bio-Algorithms 
and Med-Systems 5(9), pp. 127-131.
19. Stull A.T., Mayer R.E. (2007): Learning by Doing versus 
Learning by Viewing: Three Experimental Comparisons of 
Learner-Generated Versus Author-Provided Graphic Orga-

---

22
E-lear
ning