2015, 17, Early Online

An online app platform enhances collaborative

medical student group learning and classroom
management
JUSTIN G. PEACOCK1 & JOSEPH P. GRANDE2
1
San Antonio Uniformed Services Health Education Consortium, USA, 2Mayo Clinic College of Medicine, USA

Abstract
Purpose: The authors presented their results in effectively using a free and widely-accessible online app platform to manage and
teach a first-year pathology course at Mayo Medical School.
Methods used: The authors utilized the Google Blogger, Forms, Flubaroo, Sheets, Docs, and Slides apps to
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effectively build a collaborative classroom teaching and management system. Students were surveyed on the use of the app
platform in the classroom, and 44 (94%) students responded.
Results: Thirty-two (73%) of the students reported that Blogger was an effective place for online discussion of pathology topics
and questions. 43 (98%) of the students reported that the Forms/Flubaroo grade-reporting system was helpful. 40 (91%) of the
students used the remote, collaborative features of Slides to create team-based learning presentations, and 39 (89%) of the
students found those collaborative features helpful. Docs helped teaching assistants to collaboratively create study guides or
grading rubrics. Overall, 41 (93%) of the students found that the app platform was helpful in establishing a collaborative, online
classroom environment.
Conclusions: The online app platform allowed faculty to build an efficient and effective classroom teaching and management
system. The ease of accessibility and opportunity for collaboration allowed for collaborative learning, grading, and teaching.
For personal use only.

Introduction Practice points

Healthcare is increasingly moving towards technological  Online app platforms, like Google Apps, facilitate
advances in medicine and team-based, patient-care models collaborative online classroom environments.
(Sisk 2011). The challenge for undergraduate medical educa-  Google Forms can be used to simply create class-
tion is developing curricula that focus on these changes, while room assessments and audience response systems.
ensuring that the fundamentals of medicine continue to be  Blogger can be used as a forum for classroom
taught. Medical education is also moving towards more rapid announcements, discussions, and question/answer
and portable means of education, including mobile apps sessions online.
(Wong et al. 2003; John 2007; Burdette et al. 2008; Wiecha  Google Slides or Google Docs allow for students
et al. 2010; Payne et al. 2012; Wallace et al. 2012; Sampognaro to collaborate remotely on team-based learning
et al. 2013). activities.
In the United States, with recent changes in the healthcare  Flubaroo is a macro that can be used with Google
laws, there is an increased need for multiple healthcare Forms to automatically grade assessments and send
professionals working together in coordinated medical teams out grading results instantly.
to provide care for patients. Collaborative group learning
(CGL) is a relatively new teaching methodology in medical
education that promotes the collaboration of a group of curriculum, CGL can also be performed remotely outside of
students working together as a team to solve problems (Nieder the classroom.
et al. 2005; Sisk 2011; Hrynchak & Batty 2012). Beyond Many new technologies are being created to promote
teaching students to work together in teams, preliminary technology, with a strong emphasis on mobile technologies
studies on CGL show that CGL promotes student satisfaction, (Cain & Fox 2009; Payne et al. 2012; Wallace et al. 2012;
participation, and academic achievement (Nieder et al. 2005; Sampognaro et al. 2013). Among the companies developing
Parmelee et al. 2009; Sisk 2011). While CGL is commonly mobile, educational tools is Google, which has designed an
performed in small groups as a part of a larger classroom entire platform of mobile, cloud-based apps or apps that can

Correspondence: Justin G. Peacock, Department of Graduate Medical Education, San Antonio Uniformed Services Health Education Consortium,
3551 Roger Brook Dr., Fort Sam Houston, TX 78234, USA. Tel: (507) 398-4304; E-mail: [email protected]
ISSN 0142-159X print/ISSN 1466-187X online/15/0000017 2015 Informa UK Ltd. 1
DOI: 10.3109/0142159X.2015.1020290
 J. G. Peacock & J. P. Grande

be used in the educational environment (Barlow & Lane 2007; Google Drive is useful for storing and
Oishi 2007; Adams 2008; Herrick 2009; Khmelevsky & organizing class materials
Voytenko 2010; Schneckenberg et al. 2011; Tan & Kim 2011;
Google Drive was used as the repository for class material,
Railean 2012). The advantages of online app platforms, such as
including lecture powerpoints and videos, pathology slides,
Google Apps, for classroom management and CGL are that
video resources, CGL presentations, the course syllabus,
they are mobile and free, can be used on many different types
assessments and grades. We created a secured faculty/
of devices, allow for remote team collaboration on projects,
teaching assistant folder that was only accessible by email
can be secured, and can be configured to perform all required
invitation from the course director, and we created a separate,
classroom functions (Oishi 2007; Adams 2008; Tan & Kim
student folder with secure access for students, faculty, and
2011; Railean 2012).
teaching assistants. The benefits of Google Drive were that it
We wanted to explore the use of the Google-based online
was universally accessible via the internet on a wide range of
app platform in a first-year pathology course at Mayo Medical
devices, but it was secure and access to certain folders was
School. We wanted to establish the entire classroom manage-
regulated by invitation to specific individuals. The universal
ment system, including announcements, presentations, assess-
access also meant that faculty or teaching assistants could
ments, and collaborative CGL activities on the app platform.
ensure that lecture materials were up-to-date, even at the last
We present the methods for how we utilized the app platform
minute. Eighty-seven percent of students responded positively
in the course and the results of a student survey regarding the
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in favor of Google Drive as a storage location for course

platform at the end of the course.
materials (Table 1).

Google Forms together with Flubaroo can be

Methods used to quickly and simply create and grade
We used Google Apps (www.google.com/edu/apps) to setup assignments and assessments
the classroom management and online learning environment Google Forms was used during the course to create daily
for the Mayo Medical School first-year pathology course. quizzes, assessments, surveys, and weekly course assign-
Otherwise, the course continued to have standard, large ments. The app allows for a wide-range of question types and
classroom lectures and small group sessions with the teaching
For personal use only.

allows faculty to simply insert graphics or video directly from

assistants. The apps included Blogger, Google Drive, Google the internet (Figure 2). The faculty also had direct control of
Forms, Google Sheets, Google Slides, and Google Docs. We access to the assessments with a simple on/off button. Google
also used Flubaroo (www.flubaroo.com) in connection with Forms also allows faculty a type of audience response system
Google Sheets for grading assignments and assessments through a display responses option, which shows the per-
during the course. At the end of the course, we used Google centages of students choosing a given answer for a particular
Forms to create a student survey on the use of Google Apps in question. Google Forms stores responses in a Google Sheet,
the course. Forty-four out of the 47 students completed the which can be utilized similar to other spreadsheet programs.
survey (94% completion). Another benefit of Google Forms is the myriad of macros
and add-ons that can be installed to assist with the app. We
used Flubaroo (www.flubaroo.com), which is a free program
Results that will automatically grade assessments created in Google
Forms. The faculty member simply needs to input the answer
Blogger as a platform for online class key, and Flubaroo will grade the students assessments. If
discussions emails are included as a question on the assessment, then
Flubaroo will also email the students their individual scores
We used the Blogger app to create a classroom blog that could
along with a link to the questions that they missed. Hundred
be used by all faculty, students, and teaching assistants. The
blog contained classroom announcements and permitted a percent of the students reported that the Google-based
space for online classroom discussion among students, faculty, assessment platform was easy or very easy to use and 98%
and teaching assistants (Figure 1). Here students could pose of the students responded favorably to the Flubaroo grade
questions from class lecture or small group. Teaching assistants email system (Table 1).
could post questions, answers, and resources that they had
Google Slides allow for remote collaboration
seen or used in their small group sessions. Faculty were able to
on CGL presentations
remotely respond to the questions that students posed and
facilitate discussion on challenging topics. New topics were Google Slides can be utilized for any classroom presentation,
introduced as posts on the blog with comments or answers including lectures, study sessions, and CGL presentations.
listed as replies to the post. In the student survey, 91% reported While we did not use it for lectures, it is a simple program for
using the course blog multiple times per week and 61% creating lectures. We primarily used Google Slides for CGL
reported leaving a comment on the blog (Table 1). Eighty-eight presentations. In the CGL presentations, students were given a
percent of students responded positively to the blog as a place set of pathology slides and a brief clinical history, from which
for class announcements, and 73% responded positively to the they were supposed to figure out the disease that the patient
blog as a place for online class discussions. suffered from and develop a presentation about the pathology
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 App platform enhances medical education
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For personal use only.

Figure 1. Class announcements and discussion using Blogger. (A) Example of Blogger used to for class announcements. (B)
Example of blog used for question and answers with the professor. (C) Example of blog used for discussion following a group
presentation.

and disease process. They then would teach the rest of the Google Docs can be used to create living,
class about the disease from the presentation that they had collaborative written documents
created. The benefit of Google Slides over conventional
presentation programs was that it allowed for a team-based We used Google Docs throughout the course, including for
collaborative effort. Pathology case assignment descriptions, for the syllabus, for
Google Slides allowed multiple students to work on the teaching assistant study guides, and for creating collaborative
same presentation remotely simultaneously or at different TA grading rubrics. Like Google Slides, Google Docs allowed
times. Previous edits were saved and could be viewed in the for multiple users to collaborate on a common document.
revision history. Revision history not only let the students see Again, revision history recorded changes to the documents,
the changes that were made, but it allowed faculty to see who including who made the changes. Teaching assistants would
was making revisions. From the revision history, faculty were collaboratively design a study guide after each small group
able to see if all the students were contributing equally to the session for the students to study from (Figure 3). Teaching
presentation. The survey revealed that the majority (91%) assistants also used Google Docs to create a collaborative
worked remotely on the presentation at different times (Table grading rubric for assignments throughout the course. On the
1). Eighty-nine percent of students found the collaborative grading rubric, as teaching assistants came across answers that
capabilities of Google Slides helpful or very helpful in creating they felt did or did not deserve credit, they could post those
their CGL presentation, and 73% indicated that creating answers and their grading rationale for other teaching assist-
presentations in Google Slides was easy or very easy (Table 1). ants to comment on. Through this process, they were able to
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 J. G. Peacock & J. P. Grande

Table 1. Medical student survey responses.

How often did you use the course blog during the block?
Daily 23 Times per week Once per week Once per class Never
39% 52% 9% 0% 0%
Did you ever leave a comment on the course blog?
Yes No
61% 39%
How did you find the course blog as a place for posting course announcements or assignments?
Very useful Useful Neutral Unuseful Very unuseful
27% 61% 5% 2% 5%
How did you find the course blog as a place for discussions regarding questions from small group or lecture?
Very useful Useful Neutral Unuseful Very unuseful
25% 48% 20% 5% 2%
How did you find the Google Drive as a repository for up-to-date class lecture materials?
Very useful Useful Neutral Unuseful Very unuseful
55% 32% 5% 2% 7%
How did you find the Google-based platform for taking assessments?
Very easy to use Easy to use Neutral Difficult to use Very difficult to use
75% 25% 0% 0% 0%
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How did you find the personally emailed grade results from the assessments?
Very helpful Helpful Neutral Unhelpful Very unhelpful
75% 23% 2% 0% 0%
Did your group formulate the case presentation altogether at one time or did you use the editing features to contribute to the presentation at different times?
Altogether (1 time) Separately (Different times)
9% 91%
How did your group find the collaborative capabilities of using Google Slides software to create a joint presentation?
Very helpful Helpful Neutral Unhelpful Very unhelpful
39% 50% 9% 2% 0%
How easy or challenging was it to create a presentation using Google Slides?
Very easy Easy Neutral Difficult Very difficult
For personal use only.

39% 34% 20% 7% 0%

How did you find the overall Google/Blog platform for classroom management, assessment, and collaboration?
Very helpful Helpful Neutral Unhelpful Very unhelpful
50% 43% 5% 0% 2%
Would you like to see the same Google/Blog platform used in other blocks during your first two years?
Yes Maybe No
73% 25% 2%

come up with a uniform and consistent grading methodology technology-driven, and team-based approaches to medical
(Figure 4). education. While Google Apps have been used in other
educational institutions, this is the first published instance, to
Google Apps can be used to facilitate CGL our knowledge, of Google Apps being used in a medical
and help manage a medical student course school course (Oishi 2007; Barlow & Lane 2007; Adams 2008;
Herrick 2009; Nevin 2009; Railean 2012).
As an overall assessment of the online app platform, students
Overall, the student survey revealed that students had
were asked about how helpful they found the app platform for
favorable opinions of the online app platform. They particu-
course management, assessment and collaboration (Table 1).
larly appeared to appreciate the ease of assessments and the
Fifty percent found the platform very helpful and 43% found
ability to receive immediate email results (Table 1). Students
the platform helpful, for a total positive response of 93%
did seem to indicate that while the blog was helpful for
(Table 1). When asked about using the app platform in other
announcements and class discussion, there could be improve-
pre-clinical courses, 73% said they would like to see it in other
ments with regards to the discussion aspects (Table 1).
courses, with 25% saying maybe they would like to see it in
Another online app that we did not use was Google Groups
other courses (Table 1).
(groups.google.com), which allows for group discussions and
may allow for more participation and better discussion.
In the future, we could employ Wiki pages, such as Google
Discussion
Wiki pages (sites.google.com), for the CGL projects. The Wiki
In this paper, we have shown how we were able to pages would allow students to create not just presentations,
successfully use a free, widely-accessible online app platform, but also web pages to teach the information. We would also
Google Apps, to encourage collaborative CGL and effectively like to incorporate the ability for students, including those not
manage a first-year pathology course at Mayo Medical School. presenting, to comment on and even revise the CGL presen-
The online apps provide an excellent platform for medical tations, for possible future course use. We would also like to
education, given the increasing demand for mobile, study the impact of the online app learning platform on
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 App platform enhances medical education
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For personal use only.

Figure 2. Google Forms used for assignments and assessments. (A) Example of a Google Form for a differential diagnosis
assignment. (B) Example of a daily quiz question created using Google Forms. (C) Post-quiz sample output for (B) that can be used
as an audience response system to show what answers were given in class.

Figure 3. Google Docs used to create teaching assistant study guides. Example of how Google Docs was used to create a
collaborative teaching assistant study guide for the medical students to use.

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 J. G. Peacock & J. P. Grande
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For personal use only.

Figure 4. Google Docs used to create collaborative grading rubrics for assignments. (A) Example of a differential case
assignment given to the students. (B) Example of a section of the grading rubric for (A). In the cases, students were asked to come
up with differential diagnoses for the case presented to them using the broad VITAMIN CDE diagnoses categories. Teaching
assistants were able to collaboratively come up with the best way to uniformly grade the assignments. Comments could be left in
different text colors by the different teaching assistants.

outcomes not assessed in the current study, including The views expressed herein are those of the authors and do
academic and clinical proficiency and teamwork. not reflect the official policy or position of Brooke Army
Medical Center, the U.S. Army Medical Department, the U.S.
Army Office of the Surgeon General, the Department of the
Conclusion Army, the Department of the Air Force and Department of
We have presented the use of a free, online app platform to Defense or the U.S. Government. The appearance of name-
effectively manage and improve collaborative CGL in a first- brand products, like Google, in this article does not constitute
year pathology course. Students surveyed after the course endorsement by Brooke Army Medical Center, the U.S. Army
overwhelmingly felt positively about the online app platform Medical Department, the U.S. Army Office of the Surgeon
for the course and would like to see it used in other medical General, the Department of the Army, the Department of the
school courses. Air Force and Department of Defense or the U.S. Government
of the information, products, or services contained therein.

Notes on contributors
Dr. JUSTIN G. PEACOCK, MD, PhD, is a Transitional Intern at San Antonio
Uniformed Services Health Education Consortium (SAUSHEC) entering a
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