RESEARCH REPORT

A Usability Study of Users’ Perceptions Toward a Multimedia

Computer-Assisted Learning Tool for Neuroanatomy
Douglas J. Gould,1* Mark A. Terrell,2 Jo Fleming3
1
Division of Anatomy, Ohio State University College of Medicine, Columbus, Ohio
2
Department of Anatomy and Medical Education, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania
3
ORCCA Technology, Seattle, Washington

This usability study evaluated users’ perceptions of a multimedia prototype for a new e-
learning tool: Anatomy of the Central Nervous System: A Multimedia Course. Usability
testing is a collection of formative evaluation methods that inform the developmental
design of e-learning tools to maximize user acceptance, satisfaction, and adoption. Sixty-
two study participants piloted the prototype and completed a usability questionnaire
designed to measure two usability properties: program need and program applicability.
Statistical analyses were used to test the hypothesis that the multimedia prototype was
well designed and highly usable, it was perceived as: (1) highly needed across a spectrum
of educational contexts, (2) highly applicable in supporting the pedagogical processes of
teaching and learning neuroanatomy, and (3) was highly usable by all types of users.
Three independent variables represented user differences: level of expertise (faculty vs.
student), age, and gender. Analysis of the results supports the research hypotheses that
the prototype was designed well for different types of users in various educational con-
texts and for supporting the pedagogy of neuroanatomy. In addition, the results suggest
that the multimedia program will be most useful as a neuroanatomy review tool for
health-professions students preparing for licensing or board exams. This study demon-
strates the importance of integrating quality properties of usability with principles of
human learning during the instructional design process for multimedia products. Anat Sci
Ed 1:175–183, 2008. © 2008 American Association of Anatomists.

Key words: usability study; neuroanatomy; e-learning; multimedia; computer assisted

instruction

INTRODUCTION by nonacademic responsibilities and time commitments (Rei-

denberg and Laitman, 2002). Anatomy instructors are chal-
Computer-assisted instruction (CAI) is being used with increas- lenged by having to teach more clinically relevant content
ing frequency by anatomy educators to supplement traditional using more active and learner-centered teaching methods (Ter-
classroom instruction (e.g., McNulty, et al., 2000, 2006; Fore- rell, 2006) while concomitantly facing a reduction in the cur-
man, et al., 2005). This increase is due to improved technolo- ricular hours anatomy is taught in the basic sciences (Drake
gies and rising instructional needs, induced by changes in stu- et al., 2002). Also, anatomy instruction is strained by a reduc-
dent characteristics, challenges facing instructors, and dimin- tion in local resources and expertise as budgets are cut and
ishing local resources and expertise. Contemporary students well-experienced anatomists retire, resulting in a shortage of
are becoming increasingly technology dependent and burdened qualified anatomy faculty (McCuskey et al., 2005; Granger
et al., 2006). Together, these instructional challenges create a
*Correspondence to: Dr. Douglas J. Gould, 279 Hamilton Hall, 1645 strong need for an effective teaching and learning tool to
Neil Avenue, Columbus, OH 43210. E-mail: [email protected] enhance the traditional anatomy classroom experience.
Grant sponsor: National Institutes of Health; Grant number: The advent of multimedia CAI offers anatomy educators a
1R41NS40588. means for addressing these instructional problems. Multime-
Received 22 May 2008; Revised 5 June 2008; Accepted 5 June 2008. dia CAI is an integrated form of CAI that combines two or
Published online 23 July 2008 in Wiley InterScience (www.interscience. more components into an electronic learning environment,
wiley.com). DOI 10.1002/ase.36 including text, audio narration, photographic images,
graphics, video, animation, and 3D visualization. This com-
© 2008 American Association of Anatomists bined format makes information management faster, more

Anatomical Sciences Education JULY 2008 Anat Sci Ed 1:175–183 (2008)

efficient, more extensive, and in some cases, may enable matched with the selected content. The third major activity
activities that could not be performed any other way (Berner was the production and evaluation of a prototype module of
and Boulware, 1996; Gorman et al., 2000; Trelease and Ros- one of the content areas. The limbic system was selected to
set, 2008). produce as the prototype module for evaluation because our
Numerous studies have analyzed the efficacy of multimedia initial information gathering indicated that this system was
CAI to health-sciences education by comparing differences in particularly difficult to teach, would lend itself well to multi-
student performance between multimedia-based learning and media enhancement as it is relatively well-compartmentalized,
traditional education methods. Although results vary, test per- and it contained sufficient depth and difficulty so that the
formances with CAI were equal or superior to those obtained multimedia elements were representative of all multimedia
with traditional methods including lectures or textbooks elements to be contained in the final program.
(Mayer and Anderson, 1992; Bachman et al., 1998; Lynch The purpose of this study was to evaluate users’ percep-
et al., 2001; Shomaker et al., 2002; Fleming et al., 2003; Sea- tions about the usability of a multimedia prototype for learn-
bra et al., 2004; Thatcher, 2006). Learning efficiency with CAI ing the limbic system in neuroanatomy in order to determine
increased significantly, indicated from a reduction in study whether the multimedia design is effective or deficient in its
time by up to 70% (Kulik et al., 1994; Jewett et al., 1998; usability properties. Usability testing is an important forma-
Shomaker et al., 2002). Students perceived multimedia CAI as tive evaluation technique that is based on a detailed analysis
an interactive, useful, and beneficial learning tool (Lilienfield of user perceptions and is used to guide the development and
and Broering, 1994; Waugh et al., 1995; Chou, 2003; Maag, design process of an e-learning product or tool (Koohang and
2004; Foreman et al., 2005). Also, students preferred its cost du Plessis, 2004). Usability is the degree to which users can
effectiveness and ease of distribution, increasing student acces- easily and efficiently use an e-learning product or tool to sat-
sibility to content expertise and clinical applications regardless isfy the goals and needs of learners (Koohang, 2004a). User
of geographic location or time of day (Gorman et al., 2000; perception is defined as the process by which individuals
Lieberman et al., 2002; Cheng et al., 2003). These studies sug- select, organize, and recognize their sensory impressions in
gest that multimedia CAI can be an effective learning tool. order to interpret and understand their learning environment
The authors began developing an interactive 3D multime- (Robbins, 2001) and is influenced by the use of appropriate
dia learning tool for neuroanatomy: Anatomy of the Central and necessary usability properties in designing an e-learning
Nervous System: A Multimedia Course, which is divided into tool (Koohang and Ondracek, 2005). When an e-learning
seven systems—limbic, motor, sensory, chemical, auditory/ves- tool is well designed, user perception contributes to higher
tibular, visual, and higher association. We began developing motivation for, positive attitudes toward, and greater interest
this program because the structure of the human central nerv- in, using the e-learning tool, which increases the probability
ous system (CNS) has spatial and functional relationships for user satisfaction and successful learning experiences (Koo-
between cells, tissues, organs, and systems that are difficult hang, 2004b,c).
for many students to visualize and learn. Spatial visualization
ability requires a unique group of cognitive functions and
aptitudes relevant to spatial tasks that are essential for learn-
ing anatomy and for achievement in medical surgery and en- EXPERIMENTAL PROCEDURES
gineering (Wang et al., 2007). Research Questions and Hypotheses
The latest multimedia technologies were incorporated into
the program. These technologies include Quicktime Virtual This study examined whether users perceived that the proto-
Reality (QTVR) Objects, which gives a detailed view of the type for the Interactive 3D Multimedia Learning Tool in Neu-
external features of a structure or region with 3608 rotation, roanatomy was highly usable. Two categorical dependent var-
Hot Spots with Labeling, which highlights anatomical regions iables were selected to represent users’ perceptions about the
on QTVR Objects and displays corresponding labels, and prototype’s usability: (1) program need—users’ perceived
Component Dissection, which allows the user to ‘‘strip’’ views regarding the need for the multimedia prototype across
away structures to perform virtual dissection and reassembly a wide range of educational contexts and (2) program applic-
tasks that are unachievable in the traditional laboratory. ability—users’ perceived views about the role of the multime-
These technologies assist the program in serving as a stand- dia prototype in supporting the teaching and learning of neu-
alone programmed-learning tutorial or simulating an in-class roanatomy (Table 1).
learning experience through its interactivity with course con- In addition to determining whether users perceived that
tent, built-in self-testing features, response-based feedback, the multimedia prototype was usable, this study attempted to
and sets of lesson plans. Students can follow the lesson plans answer the following question: Does the perception of proto-
in the same way they would be led through a particular topic type usability vary between different types of users? Three
by an instructor. The correct pathway and associated links categorical independent variables were selected to represent
are highlighted, making navigation through the lesson different types of prototype users: expertise, age, gender.
obvious to the user. Each lesson plan contains links to the These variables were selected because they may influence fac-
appropriate ‘‘dissection’’ using the Quicktime VR described tors that affect user’s perceptions toward the usability of the
earlier, as well as links to the program’s testing element, multimedia prototype (Koohang and Ondracek, 2005). Level
which contains a laboratory practical exam, a written test of expertise (faculty versus student) was selected as a variable
with feedback, and 3D reconstructions. because users with different degrees of expertise in spatial
Development efforts of the Interactive 3D Multimedia ability are likely to hold different attitudes toward multime-
Learning Tool in Neuroanatomy included three major activ- dia learning (Huk et al., 2003). Age was selected as a variable
ities. First, a content-analysis study was conducted to identify because older students (X > 35 years old) are less likely to have
and select content to be included in the complete program. experience with CAI compared to younger students (X < 35
Second, instructional strategies and multimedia elements were years old) who grew up in the information-technology age

176 Gould et al.

Table 1.
Instrument Items from the Usability Questionnaire (Appendix) that Measure the Neuroanatomy Prototype’s Usability Properties
of Need and Applicability

Need for Prototype in Various Educational Contexts

How would you rate the need of this program for:

1. High school students?

2. University students without prior knowledge of anatomy?

3. University students currently enrolled in an anatomy course?

4. University Health professions students reviewing anatomy for professional licensing exams?

5. Faculty teaching anatomy courses?

6. Practicing health-care providers?

Rating Scale: 1 5 not needed; 2 5 marginally need; 3 5 modestly needed; 4 5 greatly needed; 5 5 absolutely needed.

Applicability of Prototype to Pedagogical Processes of Neuroanatomy

This program would be useful to:

1. Help students learn the course material.

2. Help students integrate course material with other aspects of the nervous system.

3. Help students improve exam performance in a neuroscience course.

4. Supplement a textbook.

5. Supplement a lab.

6. Supplement a course.

7. Supplement the teaching of neuroanatomy over traditional methods of teaching.

8. Replace a neuroanatomy textbook when learning course content.

9. Replace a neuroanatomy course as a stand-alone program.

Rating Scale: Agree or Disagree.

(Koohang, 1989). Since prior experience with e-learning has pendix), administered after using the multimedia prototype.
been shown to increase user acceptance of technology in gen- This usability questionnaire was adapted from designs by
eral (Koohang, 1989; Koohang and Weiss, 2003), different Reisman (1994) and the Questionnaire for User Interface Sat-
age levels may have different perceptions toward the usability isfaction, Version 6.0 (Chin et al., 1988). The first component
of our prototype. Gender was selected as a variable because of the usability questionnaire consisted of a 15-item survey
male users may (Ong and Lai, 2004) or may not have (Koo- instrument that measured two properties of usability: pro-
hang and Weiss, 2003) a slightly higher preference for e- gram need and program applicability (Table 1). User percep-
learning compared with females. Therefore, the authors of tion of ‘‘program need’’ was measured by six questions con-
this study hypothesize that the multimedia prototype was cerning the need for the prototype in various educational con-
well designed and highly usable if it is perceived as being: (1) texts, arranged by increasing level of complexity. Responses
needed across a wide range of educational contexts, (2) appli- to these questions were recorded using a Likert-scale such
cable in supporting the processes of teaching and learning that: absolutely needed 5 5, highly needed 5 4, modestly
neuroanatomy, and (3) usable (needed and applicable) to a needed 5 3, marginally needed 5 2, and not needed 5 1.
similar extent by different types of users. User perception of ‘‘program applicability’’ was measured by
nine positively worded statements arranged into three catego-
Study Design ries of increasing applicability (Table 1). Items 1–4 measured
user perception of the prototypes’ ability to support learning
The design of the usability study consisted of three major of neuroanatomy, Items 5–7 measured the perception of the
components incorporated into a usability questionnaire (Ap- prototypes’ ability to supplement teaching of neuroanatomy,

Anatomical Sciences Education JULY 2008 177

and Items 8–9 measured the perception of the prototypes’ Respondents
ability to replace traditional instructional methods for neuro-
anatomy. Responses to these nine positively worded state- The total number of respondents who returned the completed
ments measuring applicability were dummy coded such that 1 questionnaire was 62; 35 were students and 27 were faculty.
5 agree and 0 5 disagree. The faculty response rate for returning completed question-
The second component of the usability questionnaire naires was 43%. States represented in the faculty sample
requested users to provide written comments to specific prop- included: Texas, New York, Michigan, Iowa, New Mexico,
erties of usability, including visual presentation, simplicity Massachusetts, Louisiana, Missouri, Hawaii, Kentucky, and
(ease-of-use), and content (accuracy and relevancy). The third Pennsylvania. A large majority of the faculty participants
element of the usability questionnaire requested feedback on taught in medical schools (88%, N 5 22); while some faculty
the perceived difficulty level of 20 potential topics to be taught in allied-health professions schools (N 5 3), a dental
included in the complete program and the opinions as to school (N 5 1), and a graduate program (N 5 1). Concern-
whether a computer program using advanced multimedia ing age, nearly all faculty participants (93%, N 5 25), were
techniques would help in learning and/or teaching each topic. older than age 35, with over half of these faculty (N 5 13)
exceeding age 50; only two faculty participants were younger
than age 35. Concerning gender, most of the faculty partici-
Study Participants pants were male (78%, N 5 21). Nearly all (95%) male fac-
The survey instrument was administered to faculty and stu- ulty participants taught in medical schools. Of the female fac-
dents from a host of institutions across the country (see ulty participants (N 5 6), four taught at medical schools and
results; N 5 62; 35 students and 27 faculty). Faculty were the remaining two taught in allied-health professions schools.
initially contacted by an email, distributed using the Ameri- Thirty-five students enrolled in graduate-level neuroscience
can Association of Clinical Anatomists listserv, requesting for courses in Kentucky and Florida returned completed the
faculty volunteers to participate in the usability study. Partici- usability questionnaire. Most of the student participants
pant selection criteria required that faculty be currently teach- (80%, N 5 28) were enrolled in medical schools, while the
ing or have previously taught professional-level neuroscience remaining students were enrolled in graduate programs (N 5
courses. The faculty participants signed the consent form, 6) or other (N 5 1). Concerning age, nearly all student par-
reviewed the Limbic System prototype, and completed the ticipants (94%, N 5 33) were less than age 35; only two stu-
usability questionnaire. Student participants were enrolled in dent participants were older than age 35. Concerning gender,
graduate-level neuroscience courses in Kentucky (University slightly more than half of the student participants (N 5 20)
of Kentucky; University of Louisville) and Florida (Nova were male, and the remaining were female (N 5 15).
Southeastern University), volunteered to participate in the
usability study, signed the consent form, reviewed the Limbic Usability Study
System prototype, and completed the usability questionnaire.
All study participants were given the rationale for their Results from the descriptive analyses of users’ views concern-
involvement in the study and were assured that their ing the prototype’s usability are shown in Tables 2 and 3. Six
responses would remain anonymous and confidential. An IRB items in the usability questionnaire measuring users’ percep-
exemption was granted by the University of Kentucky Inter- tions of the prototype’s need for use in various educational
nal Review Board for this study. contexts had a total mean of 3.3 and ranged between 2.7 and
3.7 on a five-point Likert scale. The highest perceived need
Data Analysis for the prototype was for it to serve as an anatomy review
tool for university health-professions students preparing for
Descriptive and inferential statistical analyses were used to professional licensing or board exams. The lowest perceived
analyze users’ characteristics (expertise, age, gender) and per- need for the prototype was for practicing health-care profes-
ceptions about the usability (need and applicability) of the sionals. No mean scores measuring user perceptions concern-
multimedia prototype. Means of user responses to item state- ing the need for the prototype for any educational context
ments in the usability questionnaire were computed. T-tests investigated fell below the midpoint of the five-point Likert
were used to identify differences between each independent scale (Table 2).
variable (user expertise, age, and gender) when measured Nine items in usability questionnaire measured users’ per-
against each dependent variable (need and applicability). This ceptions of the prototype’s applicability in supporting the
statistical procedure tested the null hypothesis that all types processes of learning and teaching neuroanatomy (Table 3).
of users perceive the multimedia prototype as equally usable. Nearly all users (92.1%) agreed with positively worded state-
The predetermined alpha P  0.05 was chosen as the level of ments about the prototype’s applicability to support student
significance for this study. learning of and to supplement the teaching of neuroanatomy
(Table 3, Items 1–7). However, less than one-third of the
users perceived that the multimedia prototype had the ability
RESULTS to replace a neuroanatomy textbook or a neuroanatomy
course (Table 3, Items 8–9).
Evaluating the usability of a prototype for the Interactive 3D Statistical results for the independent variables of exper-
Multimedia Learning Tool in Neuroanatomy was investigated tise, age, and gender, each measured separately against the
through a detailed analysis of five selected variables: two de- dependent variable ‘‘program need,’’ are shown in Table 4.
pendent variables representing prototype usability (need and There were no statistical differences between the means of
applicability) and three independent variables representing responses from users of different levels of expertise (faculty
different types of users that varied on levels of expertise, age, versus student) concerning their views about the program’s
and gender. need in most educational settings, except for the need for the

178 Gould et al.

Table 2.
Descriptive Statistics of User Perceptions toward the Need For the Neuroanatomy Multimedia Prototype
in Various Educational Contexts

How would you rate the need of this program for? N Mean SD

1. High school students? 56 3.1 1.13

2. University students without prior knowledge of anatomy? 51 3.6 1.32

3. University students currently enrolled in an anatomy course? 52 3.3 1.14

4. University health professions students reviewing anatomy for professional licensing exams? 56 3.7 1.02

5. Faculty teaching anatomy courses? 58 3.5 1.02

6. Practicing health care Professionals? 57 2.7 1.06

Combined average mean of need for prototype – 3.3 –

Rating Scale: 1 5 not needed; 2 5 marginally needed; 3 5 modestly needed; 4 5 greatly needed; 5 5 absolutely needed.

program in high schools (Table 4, Item 1). Faculty partici- the views of male and female users regarding the need for the
pants perceived a higher need for the program in high schools program in any educational setting (Table 4).
compared with student participants. Similarly, although there Statistical results for the independent variables of exper-
were no statistical differences between the means of responses tise, age, and gender, each measured separately against the
from users of different age concerning the program’s need in dependent variable ‘‘applicability of the program,’’ are shown
most educational settings, users above the age of 35 years in Table 4. There were no statistical differences between the
perceived a higher need for the program in high schools (Ta- means of responses from users of different levels of expertise
ble 4, Item 1). There were no statistical differences between (faculty versus student) concerning their perceptions about

Table 3.
Descriptive Statistics of User Perceptions toward the Applicability of the Multimedia Prototype to Pedagogical Processes
of Teaching and Learning Neuroanatomy

This program would be useful to: N % who agreed w/the statement

1. Help students learn the course material. 57 93.0

2. Help students integrate course material with other aspects of the N.S. 56 94.6

3. Help students improve exam performance in a neuroscience course. 56 85.7

4. Supplement to a textbook. 57 93.0

5. Supplement to a lab. 57 89.5

6. Supplement to a course. 57 91.2

7. Supplement the teaching of neuroanatomy over traditional methods. 56 97.5

Mean% who agreed with statements 1–7 – 92.1

8. Replace a neuroanatomy textbook when learning course content. 57 29.8

9. Replace a neuroanatomy course as a stand-alone program? 57 31.6

Mean% who agreed with statements 8–9 – 30.6%

Mean% who agreed with all statements (1–9) – 78.4%

Rating Scale: Agree or Disagree.

Anatomical Sciences Education JULY 2008 179

180
Table 4.
Students’ t-Tests Comparing Differences between Different Types of Users Groups of Expertise, Age, and Gender as Independent Variables against Dependent Variables
of Need and Applicability, all Considered Separately

Dependent variables Independent variables

Expertise Age Gender

Faculty Student t-Test <35 >35 t-Test Male Female t-Test

Survey
Item #a N x N x Sig. N x N x Sig. N x N x Sig.

Need 1 21 2.90 35 2.17 0.022 36 2.14 20 3.00 0.007 41 2.15 21 2.20 0.899

2 17 3.35 34 3.91 0.149 35 3.94 16 3.25 0.077 40 4.26 21 3.47 0.056

3 17 3.35 35 3.14 0.527 36 3.25 16 3.12 0.712 41 3.35 21 2.87 0.186

4 21 3.67 35 3.74 0.786 36 3.75 20 3.65 0.725 41 3.75 21 3.73 0.961

5 23 3.26 35 3.69 0.119 36 3.67 22 3.27 0.152 41 3.75 21 3.60 0.633

6 22 2.82 35 2.51 0.297 36 2.53 21 2.81 0.339 41 2.65 21 2.33 0.393

N %Y N %Y Sig. N %Y N %Y Sig. N %Y N %Y Sig.

Applicability 1 25 92 34 94 0.754 35 94 24 92 0.700 40 100 21 93 0.107

2 24 88 34 100 0.035 35 100 23 87 0.028 40 100 21 100 –

3 25 80 33 91 0.240 34 91 24 79 0.198 40 90 21 93 0.748

4 25 88 34 97 0.177 35 94 24 92 0.700 40 95 21 100 0.382

5 25 88 34 91 0.696 35 91 24 88 0.631 40 90 21 93 0.704

6 25 92 33 91 0.886 35 91 24 92 0.975 40 90 21 93 0.704

7 23 83 35 91 0.322 36 92 22 82 0.272 41 90 21 93 0.737

8 24 21 35 37 0.188 36 42 23 13 0.020 41 45 21 27 0.280

9 25 40 34 29 0.405 35 31 24 38 0.634 40 32 21 27 0.764

a
Refer to Table 1 for the worded item statements in the Usability Questionnaire.

Gould et al.
the prototype’s applicability in supporting most pedagogical learning of neuroanatomy, but is deficient to supersede tradi-
processes of teaching and learning neuroanatomy, except for tional educational methods of neuroanatomy.
the perception of the prototype’s ability to help students with The third hypothesis that the multimedia prototype was
course-content integration (Table 4, Item 2). All student par- similarly perceived as usable by different types of users was
ticipants responded favorably about the ability of the proto- supported by the statistical analysis in Table 4. Concerning
type to help students integrate course materials with other the usability property program need, male and female users
aspects of the nervous system, compared with only 88% of had similar perceptions (Table 4) about the need for the pro-
faculty responding favorably. Similarly, although there were totype to all six educational contexts described in the usabil-
no statistical differences between the means of responses from ity questionnaire (Table 1). Faculty and student users and
users of different age concerning their perceptions about the younger and older users had similar perceptions about the
program’s applicability in supporting most pedagogical proc- need for the prototype to five out of six educational contexts
esses of teaching and learning neuroanatomy, users below the listed in the usability questionnaire. Although the overall
age of 35 years responded more favorably to the ability of the need for the prototype for practicing health-care professionals
program to help students integrate course materials with other was relatively low (Table 2), faculty and older users tended
aspects of the nervous system and to the ability of the program to perceive a greater need for the prototype for practicing
to replace a neuroanatomy textbook for learning course con- health-care professionals compared with perceptions of stu-
tent (Table 4, Items 2 and 8). There were no statistical differ- dent and younger users, respectively (Table 4, Item 1). This
ences between male and female user perceptions toward the finding reflects the inherent autocorrelation between the age
applicability of the program in supporting any pedagogical of the user and the level of expertise—older users tended to
process of teaching and learning neuroanatomy (Table 4). be faculty, both of which tended to view the prototype as
more applicable to practicing health-care professionals. This
increased level of perception may be related to the experience
faculty have regarding the need for continuing education or
DISCUSSION the need to cognitively maintain active anatomical knowledge
for their careers.
The purpose of this study was to measure users’ perceptions Concerning the usability property program applicability,
toward the usability of the multimedia prototype giving spe- male and female users had similar perceptions (Table 4) about
cial attention to users’ level of expertise, age, and gender. The the applicability of the prototype to all nine pedagogical tech-
main hypothesis that the multimedia prototype is usable was niques described in the usability questionnaire (Table 1). Fac-
supported by the evidence from different types of users who ulty and student users and young and older users shared simi-
consistently viewed the prototype as being highly needed lar perceptions about the prototype’s applicability for eight
across a wide range of educational contexts and applicable in out of nine pedagogical techniques listed in the usability ques-
supporting various pedagogical techniques associated with tionnaire, suggesting a high degree of similarity between differ-
the teaching and learning of neuroanatomy. ent types of users concerning prototype applicability. The
The first hypothesis that the multimedia prototype was questionnaire item that differed significantly between faculty
perceived as being highly needed across a wide range of edu- and student users and older and younger users was the applic-
cational contexts was supported by the descriptive analyses ability of the prototype to help students integrate course mate-
of the usability property ‘‘program need’’ (Table 2). The com- rials with other aspects of the nervous system. Student users
bined Likert-scale mean of 3.3 suggests that the overall user and younger users tended to perceive the prototype as more
perception of the prototype was positioned between modestly useful compared with faculty and older users, respectively.
needed to highly needed. The narrow range in mean Likert- This finding reflects the inherent autocorrelation between the
scores in Table 2 suggests that only small differences in the age of the user and the level of expertise—younger users
perceived need for prototype exists between various educa- tended to be students, both of which tended to view the proto-
tional contexts in which the prototype could be used. Also, type as more applicable to integrating course content. This
the data in Table 2 suggest that the prototype would be increased level of perceived applicability by younger users and
highly needed and most useful as an anatomy review tool for student users may be related to their level of cognitive under-
health-professions students preparing for licensing or board standing of neuroanatomy—faculty are experts who already
exams; but, modestly needed or least useful for career-estab- possess a deep understanding of neuroanatomy, whereas stu-
lished practicing heath-care professionals. dents are novices who are in the earlier phases of content inte-
The second hypothesis that the multimedia prototype was gration, and thus perceive that their prototype will be of great
perceived as highly applicable in supporting pedagogical tech- assistance with neuroanatomy content integration.
niques that supplement the teaching and learning of neuroan- This usability study demonstrates the importance of involv-
atomy was supported by the descriptive analyses of the usabil- ing the inclusion of usability properties that are based on user
ity property ‘‘program applicability’’ (Table 3). An average of involvement (Koohang, 2004b,c) and are connected with prin-
92% of the users perceived that the prototype was applicable ciples of learning (Koohang and du Plessis, 2004; Terrell,
to question items 1–7 in Table 3, suggesting that the prototype 2006) into the multimedia CAI development and design pro-
would support student learning of neuroanatomy and would cess. Incorporation of users’ experiential and perceptual feed-
supplemental well the teaching of neuroanatomy. However, back to inform the multimedia development process will
the majority of the users (69%) did not perceive that the pro- increase the probability of creating a successful multimedia
totype was applicable to Items 8–9 in Table 3, suggesting that CAI tool. As college student enrollments are predicted by the
the prototype’s current design is inadequate in its capacity as a US Department of Education to surpass 20 million by the year
replacement tool for a neuroanatomy textbook or for an entire 2010 (Cardenas, 1998), well-designed multimedia tools will
neuroanatomy course. Consequently, these results suggest that play an increasingly important role in distance learning pro-
prototype is designed well as an adjunct to the teaching and grams of higher education (Koohang and Weiss, 2003).

Anatomical Sciences Education JULY 2008 181

182 Gould et al.
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