Teaching microbiology with hypertext: first steps towards a virtual textbook

Computer-assisted learning materials for medical microbiology were developed using hypertext-authoring software (Folio 3.1). Two versions of a text-only introductory tutorial (detailed, read only, and read-write noteform) were then evaluated in a prospective, randomized trial. Evaluation was by pre- and post-exposure multiple choice questions, and by self-administered questionnaire. There was a small difference in outcome between the two groups; the read-write group scoring higher, and students who used either software performed better than those who did not (P = 0.014). Responses to the post-test questionnaires showed that many students regarded the read-only software as an electronic handout, more frequent users requesting the addition of illustrations, self-assessment questions, and greater interactivity. A small group of students made use of the read-write version of the tutorial as a 'virtual textbook' by adding extra material to the starter file. Our experience suggests that the low-cost option of text-only hypermedia produces only modest learning gains for medical undergraduates.