A collaborative approach for improving information literacy skills of dental hygiene students

ORIGINAL ARTICLE

SJ Cobban

LN SealeA collaborative approach for

improving information literacy

skills of dental hygiene students

Authors’ affiliations:

Sandra J Cobban, Department of Dentistry,

University of Alberta, Canada

Linda N Seale, John W. Scott Health Sciences

Library, University of Alberta, Canada

Correspondence to:

Sandra J Cobban

Dental Hygiene Program

Department of Dentistry

Faculty of Medicine and Dentistry

2032B Dentistry-Pharmacy Centre,

University of Alberta

Edmonton, AB, T6G 2 N8,

Canada

Tel.: þ1 780 492 1325

Fax: þ1 780 492 8552

E-mail: [email protected]

Abstract: Background: Evidence-based practitioners need to

develop proficiency in locating and evaluating necessary

information from a variety of sources, a concept known as

information literacy. One potential source of information is the

World Wide Web; however, the wide range in the quality of

information available through the Internet indicates a need

for strong critical appraisal skills. Objectives: To facilitate

development of these skills in dental hygiene students, dental

hygiene faculty collaborated with a librarian to implement a

project to improve information literacy skills and integrate the

use of the Internet into dental hygiene course work. Methods:

Students were required to develop a scenario about an

aspect of dental hygiene practice, such as client health concern,

practice management, or selection of an appropriate dental

hygiene therapy. Students were to search the Internet, locate

and evaluate a website that could address their scenario,

and post this information and additional comments to a

text-based computer conferencing section of a class

website. WebCT software, particularly the computer

conferencing function, was used to support asynchronous

online activities. Student evaluation of the assignment was

conducted using a 5-point Likert scale. Results: Mean ratings

for structure variables ranged from 3.94 to 3.81. Slightly lower

mean ratings for process variables, ranging from 3.74 to 3.21,

suggest room for improvement to activities. Mean ratings for

outcome variables, ranging from 4.42 to 3.29, suggest

achievement of the desired learning outcomes. Conclusion:

Evaluation results warrant the continued inclusion of

asynchronous online activities in conjunction with face-to-face

classroom instruction.

Key words: MeSH; dental hygienists; education; computer

literacy; information management; evaluation studies; Internet;

librarians; educational technology

Dates:

Accepted 11 January 2002

To cite this article:

Int J Dent Hygiene 1, 2003; 49–56

Cobban SJ, Seale LN:

A collaborative approach for improving information

literacy skills of dental hygiene students

Copyright # Blackwell Munksgaard 2003

ISSN 1601-5029

Introduction

The Canadian Dental Hygienists Association proposed in 1998

that ‘dental hygiene education programs must design a curricu-

lum that enables the graduate of the education program to be

capable of lifelong learning, professional development, and con-

tinuing education’ (1). The Pew Health Professions Commission

in the USA had earlier expressed a similar view (2). The increas-

ingly rapid growth of information, coupled with advances in

information technology, has contributed to the need for practi-

tioners to develop skills as lifelong learners (3). Haque and

Gibson (4) have suggested that biomedical informatics education

and mastery of information technology are highly desirable goals

for health care in general and students in particular.

Students, however, may feel unprepared to seek learning with

little or no guidance. One study revealed that only 40% of a

random sample of USA and Canadian pharmacists agreed that

their undergraduate pharmacy education adequately prepared

them to become independent learners, that is to seek learning

with minimum or no guidance in the selection/learning process

(5). Comfort and skill in the use of computers also play a role in

students’ preparedness to approach the task of seeking informa-

tion from different sources. Studies have shown that students

with varied skill levels and backgrounds in computing (including

typing skills, programming experience, length of time using

computers, school computer courses) can achieve similar skill

and competency levels when computer use is required in a course

(6, 7). Gender differences can also be mediated when the com-

puter use is structured into the course. As early as 1989, Arch and

Cummins (7) found that at the end of courses where computer use

was required, students were using computers at the highest level

and felt most positive about the machines and their skills,

regardless of previous experience. Initial gender differences also

diminished. Shumacher points out that students without com-

puter and Internet skills will be disadvantaged economically and

educationally (6).

Stammler, Thomas and McMahon (8) developed an assign-

ment to introduce nursing students to computer skills, the most

beneficial proving to be the use of search engines to find websites

for patient education. Stammler et al. (8) and Clark (9) also found

that nursing students who had searched for and evaluated a

website relevant to nursing practice as part of course work

retained the necessary computer and searching skills after gra-

duation and were able to apply them in practice settings.

Dental hygiene programs can take the opportunity to incorpo-

rate development of these skills into the curriculum. This paper

describes the process and outcomes of collaboration between the

Dental Hygiene Program and the Library at the University of

Alberta to provide graduating dental hygiene students with

information literacy skills to find and evaluate information

obtained from the Internet.

Many skills relevant to lifelong learning, professional devel-

opment, and continuing education are embodied in the concept

of ‘information literacy’, widely promoted by librarians and

defined by Marshall as ‘the ability and knowledge to locate

and use information from any source critically and productively’

(10). Graduating students need these skills to become lifelong

learners and evidence-based practitioners. Graduates equipped to

meet future health needs will have the ability to ‘anticipate

changes in health care and respond by re-defining and maintain-

ing professional competence throughout practice life’ (2). Devel-

opment of the skills and abilities to evaluate sources of

information, including websites, will provide the graduating

health professional with practical experience in skills they are

likely to use multiple times in their future practice.

Information literacy is particularly relevant when using the

Internet as a source of information. The Internet, including the

World Wide Web, provides access to a seemingly unlimited

volume of information of many levels of complexity and relia-

bility. It is readily accessible to health practitioners, their clients,

and the general public. It is constantly expanding, mostly unme-

diated, and largely unorganised.

The role of academic health sciences librarians has greatly

expanded in recent years to include the teaching of information

literacy skills to both students and practitioners (3). These skills

were critical to develop and implement the information literacy

curriculum content for Dental Hygiene students. Given the huge

volume of information on the Internet and that only 3% of sites

relate to health (11), it was the task of the librarian to help

students find and evaluate that 3%. The liaison librarian for

dental hygiene participated in the development and implemen-

tation of this project.

Study population and methodology

The assignment and activities in this collaboration were imple-

mented in the fall term 2001 in DH317 ‘Ethics, Practice and

Leadership’, a third-year course in the Dental Hygiene Program

at the University of Alberta, Edmonton, Alberta, Canada. The

project included classroom instruction, a computer lab session,

and text-based asynchronous computer-mediated conferencing.

The project collaborators received ethics approval from the

University’s Health Research Ethics Board to conduct an evalua-

tion of the structure, process, and outcomes of this project.

Early in the course, the liaison librarian conducted an informa-

tion literacy class in a hands-on computer laboratory session. The

Cobban and Seale. Improving information literacy skills of dental hygiene students

50 | Int J Dent Hygiene 1, 2003; 49–56

session stressed the importance of analysing a problem, formulat-

ing a soundly constructed question from which relevant concepts

and keywords can be selected, searching in appropriate sources,

and evaluating the results of the search. Information sources used

were the library website, the PubMed database, and other Inter-

net resources. This was part of a sequence of classroom-based

instruction on critical appraisal of published literature.

A software program, Web Course Tools or WebCT, was

selected as appropriate to support the process and outcomes of

the project. WebCT is available and supported by Computing

and Network Services at the University of Alberta. It is readily

accessible, both on and off campus, via the Internet. The primary

tools used were the course information tool, where text related to

the assignment was posted, and the conferencing tool, where

students participated in asynchronous text-based communica-

tion. Figure 1 shows the course home page. The use of WebCT

was demonstrated in class and a student guide to use of the

conferencing tool in WebCT was prepared and distributed at the

start of the project.

During the hands-on computer laboratory session, the librarian

presented an introduction to search engines, focusing on the

various categories of search engines, the type of information that

each covers, and the need for rigorous critical appraisal and

evaluation of websites. Support materials were provided in the

form of a detailed tip sheet and the library website (http://

www.library.ualberta.ca) provided online access to several library

guides for evaluating Internet resources and citing electronic

resources. The librarian was available for student consultation

by e-mail and telephone, or by appointment. All students had

access to well-equipped computer laboratories on campus and to

WebMail, an Internet-based e-mail system.

The students were assigned to develop a scenario from one of

the three broad areas of dental hygiene practice including infor-

mation that could answer a client’s question about a health

concern, information about a facet of practice management (such

as setting up a recall system), or information that a dental

hygienist may wish to consider when determining an appropriate

course of therapy for a client (such as may be found through a

database search). Students were to use the World Wide Web to

locate a valid source of information that could address this

scenario, and to evaluate the website using a ‘Worksheet for

Assessment of Websites’ (see Fig. 2), designed for this assign-

ment. This worksheet required that they identify the type of site,

the target audience, and that they critique the contents.

Students were then required to post the scenario and the

corresponding website address in the computer conferencing

section of the class WebCT site, and also to post at least one

comment regarding other websites posted by classmates. Being

accessible via the Internet, this conferencing section enabled

students to enter their text-based comment at any time or location

that was convenient to them. The course instructors, including

the librarian, also posted messages in the form of reminders and

explanations about procedures, answers to requests for assistance,

and comments on student postings. As a secondary part of the

assignment, students were to prepare a brief written evaluation of

the website and e-mail it to the instructor as an attachment.

Fig. 1. Class website home page.

Int J Dent Hygiene 1, 2003; 49–56 | 51


At the end of the assignment, they were asked to participate in

an evaluation of the activities of the assignment. On the day the

assignment was completed, an administrative staff member, not

connected with the project, distributed an evaluation form and

cover letter to students in class. The cover letter advised students

that their responses were completely confidential and that they

were under no obligation to participate in the evaluation.

The evaluation form listed statements in three categories: (i)

support variables, (ii) process variables, and (iii) outcome vari-

ables. They were assigned responses using a 5-point Likert scale

from 1 (strongly disagree) to 5 (strongly agree). Thirty-one forms

were returned from a class of 40 students for a response rate of

78%. Data entry and analysis were completed using the Statistical

Package for the Social Sciences (SPSS) software program.

Fig 2. Worksheet for assessment of websites.



Frequency distributions and measures of central tendency were

calculated.

Results

Structure variables were those associated with the structure of the

assignment and academic support available to the students for the

duration of this learning experience. Mean rating scores for

support/structure variables ranged from 3.81 to 3.94. A total of

74.2% agreed or strongly agreed that instructor support was

adequate, while 77.4% agreed or strongly agreed that sufficient

information was provided, and that the weight and amount of

time for the assignment were adequate. Table 1 illustrates the

mean ratings and frequency distributions for student ratings of

support variables.

Process variables were those that related to the quality of the

learning experience throughout the various activities. Mean

scores for the process variables ranged from 3.21 to 3.74, possibly

suggesting less satisfaction with the process. While 67.8% of

respondents found the ‘Worksheet for Assessment of Websites’

(Fig. 2) to be a useful tool, they were less enthusiastic about the

overall learning experience, with 45.1% agreeing or strongly

agreeing that it was satisfactory. Still, 67.8% agreed or strongly

agreed that technical difficulties did not compromise their ability

Fig 2. continued



to complete the assignment. Further, 51.7% agreed or strongly

agreed that the online communication forum enhanced their

experience with this process and 25.8% reported feeling neutral

about the value of the forum. Table 2 illustrates the mean ratings

and frequency distributions of responses to process variables.

Outcome variables were those related to the successful

achievement of the learning outcomes of the project. These

statements were structured so that the student could agree or

disagree that they had achieved the desired outcome, and indi-

cate their perception of the value of the activities. Mean scores

for the outcome variables were generally higher than for support

or process variables, ranging from a high of 4.42 to a low of 3.29.

All of the assigned tasks, including searching, finding a website,

and writing up and e-mailing the assignment, were perceived by

the students as successful, with over 93% agreeing or strongly

agreeing with the statements. Students were somewhat less

confident in their ability to evaluate a website as 57.1% agreed

or strongly agreed with this statement. All of the mean rating

scores above 4 related to the tasks the students were to accom-

plish, and all of the scores below 4 related to the perceived value

of the activities. The outcome variables relating to perceived

value also had the greatest range of frequency distributions, as

shown in Table 3. The greatest range of frequency distributions

was associated with the perception of the value of computer

conferencing. Although nearly half, 48.4%, agreed or strongly

agreed that it was useful, 29% were neutral, and 22.6% were

negative towards it.

The students were required to post their scenario and a link to

their website, and to post a comment to somebody else’s website.

Only two students did not post the minimum requirements, and

many students went well beyond the minimum. WebCT has

several course management features, one which enables instruc-

tors to monitor the number of hits to the conferencing section of

the site, the number of items read by each person, and the

number of postings by each student. These varied tremendously,

ranging from a low of 13 hits to that section of the site to a high of

152 hits. Items read ranged from a low of 4 to a high of 118. The

number of postings ranged from a low of 1 to a high of 15. The

librarian participated actively with 49 postings.

Discussion

Faculty members consider development of skills to locate and

evaluate information, or information literacy, to be important for

lifelong learning. All of the learning activities associated with this

project contribute to the development of these skills. Faculty

Table 1. Mean ratings and frequency distributions of structure variables

Mean ratings Frequency distributions

Variable n Mean SD

Strongly

disagree

(%)

Disagree

(%)

Neutral

(%)

Agree

(%)

Strongly

agree

(%)

The instructor provided adequate support for this assignment 31 3.94 1.00 – 12.9 12.9 41.9 32.3

The weight of this assignment (10% of the total grade) was

appropriate for the time and effort required to complete it

31 3.87 0.67 – 3.2 19.4 64.5 12.9

The amount of time allocated for this assignment was adequate 31 3.87 0.92 – 12.9 9.7 54.8 22.6

Sufficient information related to search engines was

provided in class

31 3.81 0.79 – 9.7 12.9 64.5 12.9

Table 2. Mean ratings and frequency distributions of process variables


Variable n Mean SD

Strongly

disagree

(%)

Disagree

(%)

Neutral

(%)

Agree

(%)

Strongly

agree

(%)

The worksheet for assessment of website was a useful

tool for evaluating websites I came across while searching

31 3.74 0.68 – 3.2 29.0 58.1 9.7

Technical difficulties related to accessing WebCT did not

compromise my ability to complete this assignment

31 3.61 1.12 6.5 9.7 19.4 45.2 19.4

Having an online communication forum enhanced

my experience with this course/assignment

31 3.29 1.16 9.7 12.9 29.0 35.5 12.9

The learning experience in this portion of the course

has been satisfactory

29 3.21 0.94 – 29.0 19.4 41.9 3.2



members also considered evaluation of educational innovation to

be important, so sought ethics approval to conduct the evaluation.

Evaluation data are used to improve the project for use in future

years, and to warrant continuation or discontinuation of the

activities.

Mean ratings for some outcomes, especially those related to the

use of information technology, were very high. It should be noted

that some students likely had some of these skills prior to this

course, and that skills in the use of MS Word and electronic mail

were not taught. With the exception of computer conferencing,

the majority of students agreed or strongly agreed with the

outcome statements, suggesting that requiring the use of these

skills by dental hygienists leads to similar levels of comfort and

skill, as found by Schumacher (6) and Arch and Cummins (7).

There was evidence of students supporting each other through

the learning process by assisting classmates to obtain Hotmail

accounts, and by posting positive supportive comments into the

computer conferencing forum. There was evidence that students

found value in this assignment that could aid them in other areas

of their course work and one student commented:

Hey (student name) Thank you! Thank you! Thank you!

This is an awesome website. I know, you are probably

thinking I am a little too excited but really I’m not. My

case presentation client has fibromyalgia and this website has

helped me tremendously. Thanks for your contribution

(student name).

Another student, with the apparent intention of continuing the

information sharing started by this assignment, suggested:

. . .setting up a website or something like this conference

room we’re all in right now. The main purpose is in longterm

(sic), we could all communicate to each other once we

graduate.

The instructors responded as quickly as possible when student

comments were posted into the conferencing forum, in order to

provide immediate individualised feedback during the process,

not just outcome feedback:

Hi (student name), just a reminder to put the http:// in front

of your www address so that it is linked and you just have to

click on it to go there. That way everybody who is interested

in checking this site out can do that. Good topic area, lots of

interest in xerostomia (instructor).

The instructor observed that students who were less vocal in

the classroom setting communicated readily in the conferencing

setting.

A previous version of this assignment used a text-based e-mail

system, PINE, which students found frustrating. Fewer frustra-

tions were expressed in this assignment using the web-based e-

mail system, WebMail. Previously, this project had been con-

ducted later in the term, but student evaluation suggested mov-

ing it earlier, and current evaluation responses to the timing

suggest that it is well placed, with the majority agreeing that it

is fine at this point, although 29% suggest moving it still earlier.

The worksheet for evaluation of websites used in the previous

version was re-designed to make it more user-friendly and 67.8%

agree or strongly agree that it is useful. This form may also be

useful for dental hygiene instructors and for practising dental

hygienists as a guide for evaluating websites for their own use.

The project will continue to form an important component of

this course, as mean ratings for the outcome variables are gen-

erally high, and the learning outcomes are important to future

methods of practice. Annual evaluation of the structure, process,

and outcome variables will continue to be carried out in order to

improve the mean ratings, particularly of the process variables.

Improvements under consideration for the future include

Table 3. Mean ratings and frequency distributions of outcome variables


Variable n Mean SD

Strongly

disagree

(%)

Disagree

(%)

Neutral

(%)

Agree

(%)

Strongly

agree

(%)

I was able to send the assignment as an

attachment to the instructor

31 4.42 0.56 – – 3.2 51.6 45.2

I was able to find a website that could

address an aspect of practice

31 4.39 0.62 – – 6.5 48.4 45.2

I was able to use MS Word to complete the assignment 31 4.39 0.62 – – 6.5 48.4 45.2

I was able to send an e-mail message to the instructor 31 4.39 0.62 – – 6.5 48.4 45.2

I was able to successfully use at least one search engine 31 4.32 0.54 – – 3.2 61.3 35.5

I feel confident that I can now evaluate

the credibility of a website

31 3.52 0.81 – 12.9 29.0 51.6 6.5

The skills I learned in the web search exercise

will benefit me in my future practice

31 3.42 0.96 – 22.6 22.6 45.2 9.7

The computer conferencing was a useful means

of sharing information with classmates

31 3.29 1.16 9.7 12.9 29.0 35.5 12.9



conducting a preliminary student self-assessment of skill levels

with computer use, and then offering an additional section geared

to those with lesser skill levels prior to moving into the course

activities. This may improve the ratings for the process variables.

Overall, this collaboration was considered to be very successful

with dental hygiene students and, as suggested by the literature

from nursing and other college programs, it has application for

other disciplines. Through this assignment, students acquired

information literacy skills that will remain with them throughout

their professional careers, and were provided with tools to facil-

itate becoming evidence-based practitioners and lifelong lear-

ners. These skills may possibly benefit professional roles in other

ways, as they may be used for asynchronous communication for

cross-country or international committee work or other collabora-

tions.

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A collaborative approach for improving information literacy skills of dental hygiene students