USING iBOOK TECHNOLOGY IN PROFESSIONAL ATHLETIC TRAINING
EDUCATIONAL PROGRAMS

A THESIS
Submitted to the Faculty of the School of Graduate Studies
and Research
of
California University of Pennsylvania in partial
fulfillment of the requirements for the degree of
Master of Science

by
Meredith Moore

Research Advisor, Dr. Thomas F. West
California, Pennsylvania
2016

ii

iii

ACKNOWLEDGEMENTS
First I would like to thank my committee. Dr. Thomas
West, Dr. Jodi Dusi, and Dr. Mike Meyer I could have not
done this without your help. You all have put in so much
time reading and editing what I write and answering all of
my questions. It all meant so much to me to have your
support. Especially Dr. Dusi, thank you for stepping up
during the past couple weeks during unfortunate
circumstances and helping me finish my thesis. I truly
could not have gotten here without your help. I also need
to thank Dr. DiCesaro for helping me figure out my data
analysis. I would have spent hours trying to figure it all
out if not for your help.
Next I have to thank my parents and the rest of my
family. You all have continued to support me while I have
continued my education and throughout this journey I have
found myself on. I could not have accomplished any of my
goals this year without your help.

iv
TABLE OF CONTENTS
Page
SIGNATURE PAGE

. . . . . . . . . . . . . . . ii

AKNOWLEDGEMENTS . . . . . . . . . . . . . . . iii
TABLE OF CONTENTS
LIST OF TABLES

. . . . . . . . . . . . . . iv

. . . . . . . . . . . . . . . vi

LIST OF FIGURES . . . . . . . . . . . . . . . vii
INTRODUCTION
METHODS

. . . . . . . . . . . . . . . . 1

. . . . . . . . . . . . . . . . . . 3

Research Design
Subjects

. . . . . . . . . . . . . . 3

. . . . . . . . . . . . . . . . . 3

Preliminary Research. . . . . . . . . . . . . 4
Instruments . . . . . . . . . . . . . . . . 4
Procedures

. . . . . . . . . . . . . . . . 5

Hypothesis (or Hypotheses). . . . . . . . . . . 7
Data Analysis
RESULTS

. . . . . . . . . . . . . . . 7

. . . . . . . . . . . . . . . . . . 8

Demographic Data . . . . . . . . . . . . . . 8
Hypothesis Testing

. . . . . . . . . . . . . 10

Additional Findings . . . . . . . . . . . . . 11
DISCUSSION . . . . . . . . . . . . . . . . . 16
Discussion of Results . . . . . . . . . . . . 16
Conclusions . . . . . . . . . . . . . . . . 21
Recommendations. . . . . . . . . . . . . . . 23

v
REFERENCES . . . . . . . . . . . . . . . . . 24
APPENDICES . . . . . . . . . . . . . . . . . 26
APPENDIX A: Review of Literature

. . . . . . . . 26

Introduction . . . . . . . . . . . . . . . . 28
Professional Athletic Training Programs . . . . . 29
Technology. . . . . . . . . . . . . . . . . 37
Summary . . . . . . . . . . . . . . . . . . 46
APPENDIX B: The Problem . . . . . . . . . . . . 48
Statement of the Problem . . . . . . . . . . . 49
Definition of Terms . . . . . . . . . . . . . 50
Basic Assumptions . . . . . . . . . . . . . . 50
Limitations of the Study . . . . . . . . . . . 51
Significance of the Study

. . . . . . . . . . 51

APPENDIX C: Additional Methods . . . . . . . . . 54
IRB: California University of Pennsylvania (C1) . . 55
Pre-Survey (C2). . . . . . . . . . . . . . . 57
Post-Survey (C3). . . . . . . . . . . . . . . 61
References. . . . . . . . . . . . . . . . . . 66
ABSTRACT

. . . . . . . . . . . . . . . . . 70

vi
LIST OF TABLES
Table

Title

Page

1

Comfort Level using Technology

2

Value of iBook Statistics

3

Satisfaction with iBook Statistics . . . . 13

4

General Questions about iPad
and iBook Statistics
. . . . . . . . . 14

. . . . . 9

. . . . . . . 12

1

INTRODUCTION

Technology in athletic training education has been a
topic of research since the 1990s without a conclusion on
its effectiveness. The 2014 ECAR Study of Undergraduate
Students and Information Technology Report stated that out
of the 99% of students who own internet-capable devices, 8%
own just one device, 92% own at least two devices, and 59%
own three or more devices, showing the popularity of these
devices.1 These mobile devices give people the ability to
access information from almost anywhere using wireless
internet connections and various apps2 with research showing
that using a device, such as an iPad, as a part of an
educational course can contribute to learning and
engagement in the course.3 As the popularity of these
devices increases so does the popularity of applications or
“apps”. Between Apple and Android devices and their
associated app stores approximately 50 billion apps were
downloaded in 2012 alone.4,5
Today’s generation of students have grown up with
constant access to various forms of technology and
therefore have been described to be very confident, and

2
find it necessary to use technology in all aspects of life.6
Having instant access to information and contact with other
people leaves this generation of students looking for
interactive, collaborative, and authentic learning
opportunities.6,7 Yet some instructors are finding mobile
devices distracting to students and more often than not
banning their use in classroom altogether.1,8 However if
professors have the knowledge of student’s learning styles,
especially for these Millennial Students, its advantageous
as it allows them to design courses, integrating various
modes of technology, to maximize benefits for students.9
Since Wiksten et al published their study in 1998,
other research has been conducted without concrete results
that an Interactive Athletic Training Education Curriculum
method is, or is not, better than traditional lecture.
Therefore, the purpose of this study is to attempt to fill
in informational gaps by examining the use of a created
iBook on an iPad in a professional Athletic Training
General Medical course to determine if the students find
this mode an effective and valuable learning tool. The
combination of devices plus access to information via
wireless internet, or wifi, creates a unique opportunity to
change the way we teach.

3

METHODS

The primary purpose of this study was to investigate
students’ perceived value and satisfaction with iBook
integration into their General Medical course. This section
will include the following subsections: Research Design,
Subjects, Instruments, Procedures, Hypotheses, and Data
Analysis.

Research Design

This research primarily utilized a descriptive design.
The dependent variables that were measured in this study
were the reported measure of value and satisfaction. These
measures were assessed before and after implementation.

Subjects

The subjects utilized for this study were volunteer
students in spring of their second year of a professional
phase of a CAATE accredited athletic training program.
subjects were enrolled in a General Medical Course, ATE

All

4
315. Subjects indicated consent to participate by
completing the project surveys. The project was approved by
the CalU Institutional Review Board prior to any contact
with potential participants. (Appendix C1)

Preliminary Research/Project Development

A pre-survey (Appendix C2) and post-survey (Appendix
C3) were used to measure the participant’s perceived level
of satisfaction and value with the iBook. These surveys
were modified from previously completed unpublished
research studies. Once completed the surveys were reviewed
by a panel of experts before being distributed to the
participants.

Instruments

The primary instruments were a pre-survey (Appendix
C2) and post-survey (Appendix C3) that were modified from
previous related research studies. The pre-survey was
approximately 30 questions. Question content included
demographic information, personal technology use, and
information on how they think the iPad could be useful. The

5
final set of questions used a five point Likert scale to
answer survey questions.
The post-survey was approximately 40 questions.
Question content included demographic information, personal
technology use, and questions evaluating their perceived
value and satisfaction with the iBook in the General
Medical course. These last questions were asked using a
five point Likert scale.

Procedure

The first step was the development of the iBook
content. The researcher was responsible for gathering
material in order to develop the iBook. Materials included
anatomy textbooks, narrated Power Point presentations,
YouTube videos, and NATA position statements in order to
develop a comprehensive and interactive iBook on pulmonary
anatomy and physiology. All YouTube videos used in the
iBook met the current National Athletic Trainers’
Association (NATA) competencies. During this process the
pre-survey and post-survey were developed based on
previously used surveys in order to test the hypotheses.
Once completed the surveys were reviewed by the committee
to establish its validity.

6
One week prior to the start of the pulmonary unit in
ATE 315, participants completed an in-class instructional
session. Led by the primary researcher, instructions
included how to sign out the iPads, instructing
participants on how to access the iBook, content of the
iBook, and what was expected from them during the study.
During this time the pre-survey was distributed, completed
by the participants, and collected. The participants were
instructed to utilize the iBook during the week before the
pulmonary unit was scheduled to be taught in the classroom.
It was up to the individual how often they consulted the
iBook before the unit began. The course instructor also
encouraged participants to utilize the iBook. Once the unit
began there were assignments and videos they were asked to
view as part of the course. Participants had access to the
iBook for the entirety of the pulmonary unit and were
encouraged to look through the iBook as often as they felt
was necessary. At the end of the unit, approximately one
week from the beginning of the unit, the iPads were
collected and the post-survey was administered, filled out,
and then collected.

7

Hypotheses

The following hypotheses were based on previous
research and the researcher’s intuition based on a review
of the literature.
1.

The subjects will find increased value in the
iBook and iPad.

2.

The subjects will find increased satisfaction
with the iBook and iPad.

Data Analysis

All data was analyzed by SPSS version 22.0 for windows
at an alpha level of 0.05. Descriptive variables were
calculated for all survey questions. A paired t-test was
used to analyze the pre-survey and post-survey mean values
for value and satisfaction questions.

8

RESULTS

As previously stated the primary the purpose of this
study was to investigate students’ perceived value and
satisfaction with iBook integration into their General
Medical course. This section contains the study’s findings
and is distributed among three subsections: Demographic
Information, Hypothesis Testing, and Additional Findings.

Demographic Information

A total of 10 participants in the General Medical
course at California University of Pennsylvania
participated in this study. The iPads with the iBook were
given to participants to utilize for a week before the
start of the pulmonary unit, and during the week of the
pulmonary unit. The participants were encouraged to utilize
the iPads for purposes other than just the iBook. The
subjects were 7 females and 3 males. The subject’s average
age was 21.2 y (+/- 3.12).
The subjects were asked a series of questions about
their use of personal technology (iPhones, iPads, other

9
smartphones and tablets) and their comfort level using
technology. The results are showed in Table 1.

Table 1: Comfort Level using Technology
Question
Pre-Survey: How would you rate your
comfort level with technology?

Mean
1.556

Std
Deviation
.7265

Post-Survey: How would you rate your
comfort level with technology?

1.400

.6992

1= Very Comfortable; 2= Comfortable; 3=Uncomfortable; 4= Very
Uncomfortable

In the post-survey subjects were asked how often they
used the iBook. One question asked how many days a week
they spent looking at the iBook in the last two weeks. Two
subjects answered 0-1 days a week, seven subjects answered
2-3 days a week, and one subject answered they did not look
at the iBook.
A second question from the post-survey asked subjects
how many minutes per day they spent looking at the iBook in
the last two weeks. Five subjects answered 0-30 minutes per
day and four subjects answered 31-60 minutes per day. One
subject did not answer this question. This was the subject
who answered they did not look at the iBook in the previous
question.

10
Hypothesis Testing

The following hypotheses were tested in this study.
All hypotheses were tested with a level of significance set
at α = 0.05. A paired-sample t-test was conducted to
compare the means and standard deviations for the presurvey and post-survey questions for satisfaction and
value.

Hypothesis 1: The subjects will find increased value
in the iBook and iPad.

Conclusion: Subjects reported a pre-iPad experience
(question 28) mean of 3.800 (sd=.6325) and a post-iPad
experience (question 8) mean of 3.400 (sd=.2211) for the
questions regarding value. The paired t-test concluded that
there was no statistical significance between these means
(t(9)=1.177, p>.05).

Hypothesis 2: The subjects will find increased
satisfaction with the iBook and iPad.

Conclusion: Subjects reported a pre-iPad experience
(question 27) mean of 4.000 (sd=.2108) and a post-iPad

11
experience (question 7) mean of 3.700 (sd=.3350) for the
questions regarding satisfaction. The paired t-test
concluded that there was no statistical significance
between these means (t(9)=.758, p>.05).

Additional Findings

A series of questions were asked using a Likert Scale
to determine how valuable the iBook was to the subjects
during the pulmonary unit. Table 2 shows the average score
for each of the survey questions regarding value.

12
Table 2: Value of iBook Statistics

Question
The use of the iBook to review pulmonary
anatomy and physiology added VALUE to
the course
The use of the iBook to review pulmonary
exercise physiology added VALUE to the
course
The use of the iBook to learn about
pulmonary illnesses/disorders added
VALUE to the course
The use of the iBook to view skills
videos (using a meter-dose inhaler,
nebulizer, and pulse oximeter) added
VALUE in this course

Mean
3.700

Std.
Deviation
.8233

3.800

.9189

3.600

.8433

4.000

1.5041

1=Strongly Disagree; 2=Disagree; 3=Neutral; 4=Agree; 5=Strongly Agree

A series of questions were asked using a Likert Scale
to determine subject’s satisfaction with the iPad and iBook
during the pulmonary unit. Table 3 shows the average score
for each of the questions that inquired about the subject’s
satisfaction level.

13
Table 3: Satisfaction with iBook Statistics

Question
The use of the iBook to review pulmonary
anatomy and physiology increased my
SATISFACTION in this course
The use of the iBook to review pulmonary
exercise physiology increased my
SATISFACTION in this course
The use of the iBook to learn about
pulmonary illnesses/disorders increased
my SATISFACTION in this course
The use of the iBook to view skills
videos (using a meter-dose inhaler,
nebulizer, and pulse oximeter) increased
my SATISFACTION in this course
The use of the Internet during class via
the iPad increased my SATISFACTION in
this course

Mean
4.100

Std.
Deviation
.7379

3.800

.9189

3.600

.6992

4.000

1.0541

4.100

.9944

1=Strongly Disagree; 2=Disagree; 3=Neutral; 4=Agree; 5=Strongly Agree

A series of general questions were asked using a
Likert Scale to determine how subjects viewed the iBook and
iPads during the pulmonary unit. Table 4 shows the average
score and standard deviation for each general question
asked in the post-survey.

14
Table 4: General Questions about iPads and iBook Statistics

Question
If given the opportunity to take a
course utilizing the iPad or iBook
again, I would choose to do so
I will perform better on the test due
to utilization of the iBook in the
course
I will consider using the iPad to add
media (pictures, video, etc.) to
future projects
The iPad helped me develop
technological skills that will help me
in the future
I think this course should continue
using iPads and iBooks in the future
I think more athletic
training/physical therapist assistant
courses should utilize the iPad and
iBooks during instruction
The value the iBook had in my learning
as used in class exceeded my
expectations

Mean
4.100

Std.
Deviation
.9944

4.300

.8498

4.100

1.1972

3.600

1.0750

4.100

.9944

4.300

.8233

3.700

1.1595

1=Strongly Disagree; 2=Disagree; 3=Neutral; 4=Agree; 5=Strongly Agree

Subjects were able to give feedback on the open ended
questions at the end of the post-survey. Nine subjects gave
feedback on the question on what they liked about the iPad.
Three subjects answered they liked how “easy it was to
access the internet and information.” Others responded they
liked how portable and lightweight the iPad was. One
subject commented that they disliked the iPad, calling it a
distraction. Eight subjects commented that the iBook had

15
good, organized information and they liked that it was
located in one place. One subject commented that they
disliked how the iBook was hard to figure out at first.

16

DISCUSSION

The purpose of this research was to examine the level
of satisfaction and value of the iBook in the General
Medical course. This section is distributed among three
subsections: Discussion of Results, Conclusions, and
Recommendations.

Discussion of Results

The General Medical students at California University
of Pennsylvania were asked to utilize an iBook on an iPad
to determine satisfaction and level of value in the
technology. The iPads with the iBook were integrated into
the class a week before the start of the pulmonary unit for
the students to use the week before and during the unit. At
this time subjects took the pre-survey. At the end of the
unit the subjects took the post-survey answering questions
about their perceived level of satisfaction and value of
the iPads and the created iBook.
The first research hypothesis stated that the students
will find increased value in the iPad and the iBook. A
paired samples t-test concluded that there was no

17
statistical significance between the pre-iPad experience
and the post-iPad experience level of value. The mean from
the pre-survey was 3.800 (sd=.6325) and the mean from the
post-survey was 3.400 (sd=.6992). Both of these questions
were answered using a Likert Scale, 1=Strongly Disagree;
2=Disagree; 3=Neutral; 4=Agree; 5=Strongly Agree.
Therefore, the subjects were slightly more agreeable that
the iPad and the iBook held value during the unit. Although
the perception of value did not change significantly from
pre-survey to post-survey, subjects did find value with the
experience. When looking at individual questions regarding
value (Table 2) subjects did find value in the experience
indicating a trend towards agreement in all questions.
Interestingly, subjects found increased value with the use
of iBook to view skills videos (mean 4.0, sd=1.5041).
Our results are similar to Edgar’s study where
students were agreeable that the iPad held value.11 Edgar’s
study showed that 45% of the 15 participants reported the
iBook and iPad was very valuable.11 There were differences
to suggest that subjects in this study thought the iBook
was more valuable. In Edgar’s study one survey question
asked “How valuable were the videos in the iBook?”.
Subjects reported a mean of 2.30 (sd=.949) using a Likert
Scale of 1=Not at all valuable; 2=slightly valuable;

18
3=somewhat valuable; 4=very valuable; 5=extremely
valuable.11 A similar question from this study asked about
the use of the iBook to view video skills to add value to
the course. Subjects reported a mean of 4.00 (sd=1.5041).
This suggests that student’s found the iBook content more
valuable in this study. This could also be due to a smaller
sample size in this study, 10 subjects, compared to the 15
subjects in Edgar’s study.
The second research hypothesis stated that subjects
will find increased satisfaction with the iPad and the
iBook. A paired samples t-test concluded that there was no
statistical significance between the pre-iPad experience
and the post-iPad experience regarding satisfaction. The
pre-survey was 4.000 (sd=.667) and the post-survey mean was
3.700 (sd=1.0593). Both questions were answered using a
Likert scale. Therefore, subjects were agreeable that they
were satisfied with the iPad and the iBook at pre-survey
and post-survey. When looking at individual questions
regarding satisfaction (Table 3) subjects showed higher
levels of satisfaction when asked “The use of the iBook to
review pulmonary anatomy and physiology increased my
SATISFACTION in this course” and “The use of the Internet
during class via the iPad increased my SATISFACTION in this
course”. Subjects were also agreeable to the question

19
regarding the use of iBook videos increased my satisfaction
(mean 4.00, sd=1.0541). When compared to the result from
the question regarding the value of the iBook skills
videos, the results were similar. One reason for this could
be that this generation of students tend to want to observe
and visualize skills before performing.7 Having easy access
to the videos on the iPad in the iBook allowed students to
view them multiple times before performing the skill.
However, unlike Edgar’s study, our subjects reported
higher levels of satisfaction. In both studies there was no
significant difference between pre-iPad experience and
post-iPad experience indicating that satisfaction levels
did not change from pre-survey to post-survey. However, the
mean scores post-experience were overall higher. In Edgar’s
study, which had participants utilize iPads, and associated
apps in a collegiate Anatomy and Physiology course, the
mean for satisfaction was 3.75 (sd=.87) before introducing
iPads and 3.42 (sd=1.08) after iPad integration.11 Both
studies support the conclusion that this generation of
students are experiencing agreeable levels of satisfaction
with mobile technology in their classes.
The results from this study also support the results
from previous research. Subjects in the current study
stated that they liked how portable the iPad was, which

20
Payne et al reported as the greatest benefit of this type
of technology.12 One student’s comment that the iPad was a
distraction is one of the biggest drawbacks to this type of
technology. As Ali et al discusses, due to the internet
capability of these devices, students are able to access
anything on the web at any time there is a connection.8
During lectures students potentially could be missing
important notes and material. However, Miller et al states
that the iPad contributions to learning and engagement in
the course outweigh that drawback.3
Finally, subjects were asked a series of general
questions about using the iPads and the iBook (Table 4).
These questions were asked using a Likert Scale, 1=Strongly
Disagree; 2=Disagree; 3=Neutral; 4=Agree; 5=Strongly Agree
to gauge the effectiveness of the iPads and the iBook.
Subject’s responses were agreeable to the questions “I will
perform better on the test due to utilization of the
iBook in the course” with a mean of 4.30 (sd=.8498) and
“I think more athletic training/physical therapist
assistant courses should utilize the iPad and iBook
during instruction” with a mean of 4.30 (sd=.8233). These
results indicate that students may have increased academic
confidence with use of this interactive learning style.
This conclusion is supported by both Bracy et al and

21
Mazerolle et al in that both articles discuss Millennial
students having increased confidence and enjoyment of
interactive learning.6,7 This is due to having instant
access to information with these web connected devices.

Conclusions

There has been very little research done with iPad
integration in education, with very little performed in
athletic training education. However, this study begins to
shed light on the implications of iPad and iBook
integration within the athletic training curriculum.
Therefore, this study used previous research studies about
technology in general and a research thesis done by
previous graduate students from California University. The
purpose of this study was to add to previously performed
research and to guide further research. The present study
found no statistical significant change between before and
after iPad integration in the General Medical pulmonary
unit for satisfaction and value.
Yet, the lead researcher was able to detect trends in
the data upon examination of individual questions, along
with subject comments, to determine that subjects in the
study found the iPads and iBook to be slightly agreeable in

22
both value and satisfaction. Further research should be
conducted on the topic with the desired outcome of
continued support for increased technology integration into
higher education. As mobile technology, mainly tablets and
iPads, advance and are more available it is possible other
collegiate educational programs will adapt courses to
include appropriate apps to aid in learning.
In the future iBooks should continue to be used in the
General Medical course. Based on the student feedback from
the post-survey alone the benefits, or what they liked,
outweighed what they disliked about this technology.
Collecting information and adding supporting videos from
youtube.com creates an informational package that is easy
to use, especially for a generation of students that are
known for being comfortable with technology.6 iBooks are
tools that can be given to students in the beginning of the
course and viewed as many times as they desire. With many
different interactive options while creating the iBook
students can have access to the class information even if
they are absent from class.

23

Recommendations

One recommendation for the future would be to utilize
a larger sample size. This study was limited to a small
sample size due to the low number of students enrolled in
the course. A larger sample size would allow for more data
and there would be potential to determine if there would be
significant changes between pre-iPad/iBook integration and
post-iPad/iBook integration.
One other recommendation would be to utilize the iBook
technology in multiple units in the General Medical course,
or even other courses in the Undergraduate Athletic
Training program. Utilizing the iPads and multiple iBooks
throughout different units, even consecutive units, in a
class could determine if there is a statistical
significance in student’s attitudes using mobile
technology. This could also help determine if it would be
beneficial to incorporate iPads into other program at
California University of Pennsylvania.

24
REFERENCES
1.

Eden D, Bichsel J. ECAR study of undergraduate students
and information technology. Educause Center for
Analysis and Research. 2014. Date Accessed July 31,
2014. Available from http://www.educause.edu/ecar.

2.

Gagnon K, Sabus C. Professionalism in a digital age:
opportunities and considerations for using social media
in health care. Phys Ther. 2015; 95(3): 406-414.

3.

Miller, W. iTeaching and learning: collegiate
instruction incorporating mobile tablets. Libr Technol
Rep. 2012: 48(4); 54-59.

4.

Fincher LA, Wright KE. Use of computer-based
instruction in athletic training education. J Athl
Train. 1996; 31(1): 44-49.

5.

Keeley K, Potteiger K, Brown CD. Athletic training
education: there’s an app for that. Athl Train Educ J.
2015: 10(3): 190-199.

6.

Bracy C, Bevill S, Roach TD. The millennial generation:
recommendations for overcoming teaching challenges.
Proceedings of the Academy of Educational Leadership.
2010; 15(2): 21–25. Date Accessed July 31, 2015.
Available from
http://www.alliedacademies.org/public/proceedings/Proce
edings27/AEL%20Proceedings%20Fall%202010.pdf#page=27.

7.

Mazerolle SM, Bowman TG, Benes SS. Reflective
observation in the clinical education setting; a way to
promote learning. Athl Train Educ J. 2015; 10(1): 3238.

8.

Ali A, Papakie M, McDevitt T. Dealing with the
distractions of cell phone misuse/use in the classroom
-- a case example. Competition Forum. 2012; 10(2): 22023.

9.

Brower KA, Stemmans CL, Ingersoll CD, Langle DJ. An
investigation of undergraduate athletic training

25
students’ learning styles and program admission
success. J Athl Train. 2001; 36(2): 130–135.
10. Wiksten DL, Patterson P, Antonio K, De La Cruz D,
Buxton BP. The effectiveness of an interactive computer
program versus traditional lecture in athletic training
education. J Athl Train. 1998; 33(3): 238-243.
11. Edgar T. Effectiveness and satisfaction of iPad
integration in the undergraduate classroom. California
University of Pennsylvania Thesis collection. 2013: 174.
12. Payne KFB, Goodson AMC, Tahim A, et al. Using the iBook
in medical education and healthcare setting – the iBook
as a reusable learning object; A report of the author’s
experience using iBooks Author software. Journal of
Visual Communications in Medicine. 2012: 35(4); 162169.

26

APPENDICES

27

APPENDIX A
Review of Literature

28

REVIEW OF LITERATURE

Athletic training was first established in the 1950s
but it was not until 1990 that athletic training was
recognized as an allied health care profession by the
American Medical Association (AMA).1 Since the establishment
of the National Athletic Trainers’ Association (NATA) the
profession has and continues to constantly change in
attempt to raise standards similar to other allied health
professionals. Change is occurring in multiple areas, with
increases in technology use and changes to competencies,
and curriculum to name a few.
Athletic training educators have been attempting to
use technology in education for several decades. One of the
first studies on technology in education was published in
1996 by Fincher and Wright via a survey to program
directors asking about technology use in their programs,
and attitudes about using technology in their classrooms. A
majority of program directors answered in the survey that
further research is needed to identify if computer based
instruction is effective and what makes it effective in

29
athletic training programs.2 At the conclusion of their
article Wiksten et al, published in 1998, the authors
called for additional research to investigate the
effectiveness of using a combination of lecture and
interactive computer instruction.3
The purpose of this Review of Literature is to
enlighten the reader on previous work examining technology
use in education.

This will be accomplished in the

following sections: Professional Athletic Training
Programs, and Technology.

The literature review will end

with a summary of the research performed to date.

Professional Athletic Training Programs

Technology in Education
In 1998 Wiksten et al. investigated the effectiveness
of an Interactive Athletic Training Education Curriculum
(IATEC) program versus a traditional lecture method. It was
also reported that there were no studies that have
determined the effectiveness of the IATEC program versus
traditional lecture instruction in attaining cognitive
knowledge and practical assessment skills.3 The authors
suggested that additional research on the topic of

30
electronic based learning programs versus traditional
lecture was warranted in order to investigate all facets of
the issues that this new tool presented. Since then other
research has been conducted without concrete results that
this method is, or is not, better than traditional lecture.
Cook et al. reported that increase use in internet-based
learning for health professions had some evidence
suggesting some effectiveness.4
One area in athletic training where internet and
online technology is being heavily used is to assist in
teaching athletic training students about evidence based
practice, also referred to as evidence based medicine. One
of the main goals of athletic training is to provide the
optimal healing environment for patients.5 Evidence based
practice uses current literature as evidence to make sound
clinical and educational decisions.6 Which for students in
entry-level health professions programs it is essential
that they be familiar with technology in order to be
comfortable using technology as a means to help make these
decisions in the workplace.7 Yet most evidence based
practice teaching takes place in the classroom setting.8
Based on the results of a qualitative study athletic
trainers in both educational and patient care roles
appeared to value the need for evidence based practice in

31
the profession.5

Another study completed by Hadley, Kulier,

and Zamora found that their trial demonstrated that both a
standard classroom teaching approach and an
electronic/internet learning approach lead to an
improvement in evidence-based practice knowledge.

The Millennial Generation
The Millennial Generation, or Generation Y, have been
defined as those born between 1982 to 2000.9,10 Monaco and
Martin have listed unique characteristics of this
generation as “lack of professional boundaries influenced
by socialization, a need to have immediate feedback, a
sense of entitlement, lack of critical thinking skills,
unrealistic expectations, high level of parental
involvement, and an expected ‘how to’ guide to succeed in
and out of the classroom”.9 They have also been described as
the largest and most diverse generation that are now
attending colleges.9 This generation has grown up with
technology in their lives and therefore are very confident,
and find it necessary, to use technology in all aspects of
life.10
Having instant access to information and contact with
other people leaves this generation of students looking for

32
interactive, collaborative, and authentic learning
opportunities.10,11 As a result, this generation seeks to
work in groups rather than individually, as the risk of
failure when working in a group is smaller.9 In both the
classroom and clinical settings direct contact and
mentoring of Millennial students have the impact of
increasing motivation and engagement in patient care.9,11 For
success in the classroom academically, and in the clinical
setting practically, Millennial students require feedback
in a timely manner in order to gauge self-knowledge both
academically and in their practical skill level.9 For
educator success with Millennial Students, the researchers
recommend using a variety of technology (PowerPoints™,
videos, online games, etc.) combined with lecture, guest
speakers, and group assignments to satisfy these student’s
need for technology use and their need for team work.9,10

Styles of Learning for the Millennial Generation
It is estimated that more than half of athletic
training students’ educational experiences are spent in the
clinical setting.12 Evidence suggests that athletic training
students today do not always express a dominant learning
style preference.12,13 This generation of athletic training

33
students, members of the Millennial Generation, prefer to
actively engage and experiment to learn in the clinical
setting. In the classroom setting students express being
most engaged with hands-on learning, with practical and
action-oriented situations.12 However, some admit to wanting
to observe in the beginning until they understand the
concept.11 Observation allows the student to visualize the
expectations of their chosen field, and retain that
information, before having to perform the tasks on their
own.11 The results of a study conducted by Brower et al. on
undergraduate athletic training student’s learning style
and program admission showed that learning style had little
effect on academic success, while academic factors seem to
have a substantial effect on academic performance in terms
of success on the certification examination.

National Athletic Trainers’ Association (NATA):
The National Athletic Trainers’ Association (NATA) was
formally established in 1950.1 To monitor athletic training
education the NATA formed the NATA Professional Education
Committee (NATA-PEC) after the first education curriculum
was developed and introduced by the NATA Committee on
Gaining Recognition in 1959.2,14 However it was not until the

34
1970s that athletic training education began to take formal
shape. The NATA-PEC developed a list of behavioral
objectives for desired learning outcomes based on 11
required courses for athletic training students.1,14 By 1983
the NATA published a document titled Guidelines for
Development and Implementation of NATA Approved
Undergraduate Athletic Training Education Program to
further organize formal athletic training education.14 This
committee had approved 97 athletic training education
programs by 1996; 84 undergraduate programs and 13 graduate
programs.11 By 2005 there were 325 accredited programs.14
This program increase was partially due to the elimination
of the internship route in 2004 in an effort to align
athletic training with the standards of other allied health
care professions.1,14

Commission on Accreditation of Athletic Training Education
(CAATE)
The behavioral objectives that were developed by the
NATA-PEC during the 1970s became the concept framework for
the first edition of Competencies in Athletic Training that
were constructed in 1983.1 The NATA-PEC wanted to encourage
programs to become more flexible for students by
rearranging content of courses and clinical proficiencies.14

35
Competencies are so engrained into courses that each course
serves as a pre-requisite for the next course forcing
students who fail, or had other issues, to wait almost a
full academic year to retake the course.14

An article

published in 2012 suggest incorporating a cohort model as a
method of improving flexibility within athletic training
program curriculums.14

At the time of the study the authors

found no previous existing research on the effectiveness of
a standardized cohort athletic training curriculum design.14
The authors found that the benefits of the cohort model
included its popularity and corresponding ease of use, the
ease of documentation within the current CAATE competency
matrix, and a set approach to the curriculum that relies
upon the uniformity of coursework to provide a finished
product of a reliable quality.14
Another large portion of an athletic training
student’s education is the clinical hours that are
required. As previously mentioned it is estimated that more
than half of athletic training students’ educational
experiences are spent in the clinical setting.12 One study
found that entry level certified athletic trainers perceived
that approximately 53% of their entry-level professional
development came from their clinical education.1 The idea of
clinical education has stemmed from the medical-education

36
paradigm that has been used to train future physicians.
Other allied health professions adopted this concept to
train other entry-level professionals.2 For athletic
training the Approved Clinical Instructor (ACI) were
approved in 2001 by the Commission on Accreditation of
Allied Health Education Programs. Currently called
preceptors, these individuals are tasked with guiding
clinical learning of athletic training students.2
However, in September 2015 the CAATE announced that
the official athletic training degree was going to change
from a bachelor’s degree to a master’s degree.15 This change
will become effective in the year 2022.15 This will also
lead to a change in competencies that are being developed
and also change requirements to sit for the Board of
Certification (BOC) exam.

Board of Certification for Athletic Trainers (BOC)
The BOC was established in 1989 to provide
certification and recertification services for the athletic
training profession.16 In the past, to qualify for the
certification exam a certain number of clinical experience
hours was required. However, that is no longer the case,
and completion of the outlined clinical proficiencies is
now required.1 Employers were surveyed for a research study

37
in 2012, where evidence from the results shows that
employers are satisfied with student preparation for entrylevel positions despite the first-time pass rate of the BOC
exam.14 Potteiger, Brown, and Kahanov state that the BOC
exam first-time pass rate is still below the first-time
pass rates of other health care professions. The
Examination Report for the 2014-2015 Testing year for the
BOC exam shows a first-time pass rate for the 2014-2015
testing year is 80.65%.16 This statistic has decreased from
the first-time pass rate from the 2013-2014 testing year
which was 82.85%.16

Technology

Back in 1996 Fincher and Wright documented a variety
of forms of technology used in education as computer-based
instruction, computer-assisted instruction and interactive
video.2 In this study the authors also defined each form of
technology used and identified that professors were
starting to use computer-based technology but there was no
percentage documented for the actual number of people.2
Fincher and Wright defined Computer Based Instruction as
“to include any form of instruction that uses the computer
to present instructional information, with computer-

38
assisted instruction and interactive video being two
distinct forms of computer-based instruction”. Computer
Assisted Instruction (CAI) differs from interactive video
in that it incorporates computer-generated graphics and
text.2 CAI has been shown to enhance computer literacy,
facilitate decision-making skills, and improve student
achievement.3 Whereas interactive video also uses computer
generated graphics and text but also adds features of
sound, realistic photos and full motion videos.2
Since then technology has rapidly developed, becoming
more advanced and mobile. In doctor’s offices physicians
input patient information on laptops or iPads where it is
electronically stored.7 The 2014 ECAR Study of Undergraduate
Students and Information Technology Report stated that out
of the 99% of students who own internet-capable devices, 8%
own just one device, 92% own at least two devices, and 59%
own three or more devices, showing the popularity of these
devices.17 An effect of this development is new technology
in the form of applications for new mobile devices.
Applications, or apps, have been defined as programs
written specifically for mobile phones or devices that have
specific functions based on the program.2,18 While mobile
technology has been defined as handheld transmitting
device(s) with multi-functional capabilities.19 One

39
capability being able to store, transmit and receive health
information and has user control over the access to the
health information.19

Computers and Internet Access
As the digital age continues and the volume of
information accessible today is greater than at any time in
the past,20 more things have been moved from a paper format
to being accessed on the internet. Before internet was
accessible to the public people needed to physically look
up information in a directory or phone book, for example.21
However, the internet has made it simple to find a doctor,
a physical therapist, etc. and find ratings created by
consumers and users with relative ease.21
The internet has also made it easier to communicate
with people via social media. Social media websites were
created for users to share information and communicate with
other users, with the most popular sites being Facebook and
Linkedln.21 Many organizations and groups, such as
hospitals, doctors’ groups, health organizations have
created Facebook pages for users to “like” and leave
reviews. These reviews have such an impact that Gangon and
Sabus cited a recent study in the American Journal of

40
Medical Quality that showed for a group of New York
hospitals, there was a one percentage point decrease in 30day mortality rate for every 93 “Likes” on the hospitals’
Facebook pages.21 However many organizations have updated
their ethical and professional codes to include policies
dealing with social media conduct to maintain
professionalism and ethical practices over the internet. In
2010, the American Medical Association (AMA) became the
first health care professional body to adopt social media
guidelines with the AMA policy: Professionalism in the Use
of Social Media.21

Tablet Computers
The iPad is a trademark mobile device product produced
and distributed by Apple.7 Since then other companies have
produced similar products but Apple remains the leader in
educational technology, offering over 10,000 apps in the
Education App store.7 These devices are used to download and
run apps. Currently, specific literature regarding the use
of apps in athletic training is lacking.2 Between Apple and
Android app stores approximately 50 billion apps were
downloaded 2012 alone.2,18 Keeley et al, Brown et al, and
Potteiger et al discuss different applications that are

41
usable in the athletic training field. The purpose of these
apps are vast, ranging from help with anatomy and clinical
examinations to safely communicating with students and
organizing responsibilities to even evaluating weather
conditions.18,22,23
Research shows that using a device, such as an iPad,
as a part of an educational course can contribute to
learning and engagement in the course.24 These devices are
being used to run apps that help to develop topics and
ideas. DelGaudio researched participant value and
satisfaction after a lab in collegiate Kinesiology using
the Dartfish program. The results determined that 60% of
participants stated that they agreed or strongly agreed
that the iPads increased their satisfaction with the
course.25 Another study conducted by Edgar that used the
program iBook in a collegiate Anatomy and Physiology course
also measured participant sense of value and satisfaction.
Results from that study concluded that there was no
significant difference in the change of satisfaction with
the use of iPads but 45% answered that they were very
valuable.26 Payne et al highlights the ease of creating and
implementing iBooks.27

42
Other types of Technology
Outside of mobile devices and apps other forms of
technology are available to educators and students. One
such method is cloud computing. The National Institute of
Standard and Technology’s define cloud computing as “a
model for enabling ubiquitous, convenient, on-demand
network access to a shared pool of configurable computing
resources (e.g., networks, servers, storage, applications,
and services) that can be rapidly provisioned and released
with minimal management effort or service provider
interaction”.28 In the article Perkely stated benefits of
cloud computing for both educators and athletic training
students. Educators could benefit from this service by
logging on with a special password and entering and
updating a student’s progress. Athletic training students
could benefit from cloud computing by entering and updating
competencies, clinical hours, and other evaluations
performed.28
Other forms of technology that are integrated in the
class room are the internet/digital course material and
smartboards. In a study performed by Cook et al. results
showed that effects of internet-based learning compared to

43
traditional lecture methods are similar and effectiveness
of both methods are also similar.4

Effects of Technology
As technology has advanced, the benefits of using
technology have increased. With today’s technology people
have the ability to access the Internet almost anywhere
anytime using wireless Internet and mobile devices.21
Different apps and programs allow for different benefits
for the users. Such benefits for patients are, but not
limited to, monitoring symptoms and pain levels of injuries
or diseases, monitor effectiveness of interventions and
even improve medication adherence.19 People are also using
this technology to get fit. Programs and apps have been
designed to assist and motivate people during exercise and
in eating properly.29
Athletic trainers can benefit from apps that are
designed to monitor and check weather conditions and apps
that can assist with clinical evaluations.22,30 These apps
are becoming very popular to assist in evaluating and
diagnosing head injuries as they help with documentation of
evaluations, can be consulted when deciding return-to-play
timelines. This could especially be helpful in order to try

44
and avoid the potential legal litigation surrounding head
injuries that is prevalent in today’s society.22 In the
clinical setting preceptors are able to keep apprised of
what their students are learning in the classroom through
technology such as iPads, apps, and push notifications.7
This allows preceptors to better help the athletic training
students apply classroom knowledge into the clinical
setting.
Despite the increase use of technology in education
and our daily lives there are some drawbacks to its uses in
educational settings. Previously there were few programs
that an institution or educator could choose from. There
was also the previous drawback of 2-Dimensional graphics
that some argued hindered the ability to facilitate
learning.3 However today that is no longer the case, as
there are many different programs available with better
graphics and simulations, yet the overall quality of some
programs is called into question.20 One study conducted
Wiksten, Spanjer and LaMaster looked at the effectiveness
of one multimedia program versus traditional lecture in
athletic training.31 The results of this study were
different than other studies previously done by Wiksten et
al and Voigt et al. The authors speculated that the
specific program selected for the study did not have an

45
impact on the students as it did in the other studies the
results were compared to.32,33 This is an example of how
proper selection and quality of programs are necessary to
have an impact on student response and attitude toward
certain forms of technology.
Institutions and programs have other challenges before
picking and choosing which apps and software programs to
make available to athletic training students in class. One
major factor is cost. Upon download some apps require a fee
while some also require a paid subscription for continual
use.23,29 For some programs these subscription fees are not
feasible due to certain budgets, making them unavailable to
students unless the student were to pay the fee.2,22 There is
also the fact that not all professors and clinicians are
familiar with these programs. Therefore, they are unable to
adequately incorporate them into teaching or practice for
them to become effective.22 This lack of experience can
create feelings of anxiety and stress for professors when
attempting to use computer and mobile device programs and
apps in front of a class.3 One last major drawback for some
is that certain apps can only function on certain operating
systems. Depending on the device purchased decides which
operating system the device runs on; Apple devices, such as
the iPad, run on the iOS system while other devices are

46
considered Androids.23 Mobile devices also have a certain
amount of storage space available for apps.23
Drawbacks concerning mobile technology, i.e. cell
phones, are discussed as this form of technology is in
every high school and collegiate student’s hands. In
education instructors are finding mobile devices
distracting to students and more often than not banning
their use in class altogether.17,34 There are concerns when
these mobile devices are used to store health information.
Richardson and Reid cited that the Health Information
Portability and Accountability Act (HIPAA) does not apply
to mobile health data that is stored on mobile devices,
unless the information is stored on an electronic health
system

Summary

Technology, in the forms of iPads with apps, and
online course work, are being incorporated into educational
and clinical settings as a means to ease some of the burden
and stress that are often placed on athletic trainers.
Since the 1990s when technology in education has been
studied, especially in athletic training education, results
have been either non-conclusive or contradictory to other

47
results from other research studies. There is a constant
need for research of technology in education as all forms
of technology continue to advance and develop. It is
important to determine if this method is the most
beneficial and effective with today’s student population in
order for them to be successful.

48

APPENDIX B
The Problem

49
STATEMENT OF THE PROBLEM

During the four years of in athletic training programs
students, learn the knowledge and skills that are required
of an entry level athletic trainer. Technology use has
increased as it becomes more accessible and available to
the public. The Millennial Generation is the first
generation that has grown up with constant access to
personal technology, a factor contributing to its increased
use. Studies have shown that the integration of technology
in education can have value to both students and educators
but the exact methods of implementation into classes still
require further research.
The purpose of this study is to examine the use of the
iPad, and specifically the iBook app, in a professional
athletic training education program and to determine if
students find value find satisfaction in the implementation
in the General Medical class. The results of this study
will benefit both athletic training professors and
preceptors as it would help them tailor their teaching to
enable students to reach their full learning potential. The
promise of technological aids, such as iPads and their
“apps”, include increased access to information as the iPad
offers mobility to users. However, it is up to the educator

50
to incorporate these devices appropriately for students to
gain the benefits that mobile devices can offer.

Definition of Terms
The following definitions of terms will be defined for
this study:
1)

iPad – tablet computer created by Apple Computer, Inc.
in 2010. It is a touchscreen, portable computer that
has the capability to aid its owner in multiple uses,
such as personal use, education, business, medical
documentation, etc.

2)

iBook – an app created for Apple Computer Inc.
products. Using iBooks Author users can gather
information with interactive images, media, and links
in one place.

3)

Satisfaction – fulfillment of the participant’s
expectations.

4)

Value – what the participant’s view as important to
their learning

Basic Assumptions
The following are basic assumptions of this study:
1)

The subjects will be honest when they complete their
demographic sheets and surveys.

51
2)

The subjects will use the iBook before coming into
class.

Limitations of the Study
The following are possible limitations of the study:
1)

There is a low number of subjects for this study.

2)

Subjects can be inconsistent in responses.

3)

Subjects level of experience can vary depending if
they previously own an iPad or another tablet.

Significance of the Study
The goal of professional athletic training programs is
to prepare students with the necessary knowledge and skills
that are required of an entry level athletic trainer. One
study performed by Mazerolle et al revealed that more than
one half of athletic training students’ educational
experience is spent in a clinical setting.12 According to
the BOC Role of Delineation Study, four out of the five
domains listed in the study require direct contact and
hands-on work with patients.35 Previous studies have shown
that athletic training students are hands-on, visual
learners with early observation from a preceptor or
mentor.11,12 The purpose of this study is to examine if
incorporating mobile technology such as an iPad with “apps”

52
has a beneficial effect for students in overall academic
success in professional athletic training education
programs.
Traditionally college professors would use
chalkboards, lectures, and upon its creation PowerPoint™
slides, to get the main points across during a class.
However, as technology becomes more accessible and
available to the public it has become more essential in our
social lives and education. The current generation, often
called the Millennial Generation, is the first generation
that has grown up with easier access to technology,
creating both positive and negative effects on learning.9
Monaco and Martin suggest that to maximize benefits for
these Millennial Generation students, professors should not
limit learning to direct lecture with PowerPoint slides.
Instead they recommend using a variety of methods that
actively engage students.
The results of this study will provide more
information as to how valuable and how satisfied students
are with technology being incorporated into their class,
specifically in this case the use of iBooks in a General
Medical course. The information gathered from this study
could also help determine better methods of delivering
course information to students to facilitate better

53
learning and course content retention.

54

APPENDIX C
Additional Methods

55

APPENDIX C1
Institutional Review Board –
California University of Pennsylvania

56
Institutional Review Board
California University of Pennsylvania
Morgan Hall, Room 310
250 University Avenue
California, PA 15419
instreviewboard@calu.edu
Robert Skwarecki, PhD, CCC-SLP, Chair

Dear Ms. Moore:
Please consider this email as official notification
that your proposal titled “Using iBook Technology in
Professional Athletic Training Programs” (Proposal #15-040)
has been approved by the California University of
Pennsylvania Institutional Review Board as submitted.
The effective date of the approval is 02/17/2016 and the
expiration date is 02/16/2017. These dates must appear on
the consent form.
Please note that Federal Policy requires that you notify
the IRB promptly regarding any of the following:
(1)
Any additions or changes in procedures you might wish
for your study (additions or changes must be approved by the
IRB before they are implemented)
(2)
Any events that affect the safety or well-being of
subjects
(3)
Any modifications of your study or other responses
that are necessitated by any events reported in (2).
To continue your research beyond the approval expiration
date of 02/15/2017 you must file additional information to
be considered for continuing review. Please contact
instreviewboard@calu.edu
Please notify the Board when data collection is complete.
Regards,
Robert Skwarecki, PhD, CCC-SLP
Chair, Institutional Review Board

57

Appendix C2
Pre-Survey

58
California University of Pennsylvania
Department of Health Science

Please take a moment to complete this survey evaluating the potential utilization of technology in
your college courses. This information will allow us to make informed choices as to how to use
technology in the future. Your responses are confidential and appreciated.

Demographic Information
What is your gender?

□
□

Female
Male

Age ____________________
Which of the following personal technology
items do you currently own?

□
□
□
□
□
□

iPad
iPhone
iPod touch
Android smart phone

How would you rate your comfort level with
technology?

□
□
□
□

Very comfortable
Comfortable
Uncomfortable
Very uncomfortable

Other tablet computer _____________________
Other _____________________________

If you currently have a handheld mobile device (smartphone or tablet), how do you use this device?

□
□
□
□
□
□
□
□
□

Access Desire2Learn
Access the internet
Access the internet for academic
purposes
Download/access to podcasts
Download/access to course lectures
Download/access to other videos for
academic purposes
Download/access eBooks
Download/access eBooks for academic
purposes
Play games

□
□
□
□
□
□
□
□
□
□

Send and receive email
Use camera to take and share pictures
Use camera to take and share videos
Edit/add effects to pictures
Edit/add effects to videos
Record voice messages/memos
Access maps
Track fitness activities
Track nutritional intake
Other uses (please list)

59

Strongly
disagree

Disagree

Neutral

Agree

Strongly
agree

Please indicate your agreement with the following statements.
I believe that the iPad COULD be very valuable to me in the following
areas.
Brainstorming / generating ideas

1

2

3

4

5

Finding research articles

1

2

3

4

5

Organizing information

1

2

3

4

5

Patient treatment/rehab record keeping

1

2

3

4

5

Analyzing information

1

2

3

4

5

Presenting information

1

2

3

4

5

Collaborating and working with classmates

1

2

3

4

5

Accessing the internet to find information

1

2

3

4

5

Recording audio for educational/clinical purposes

1

2

3

4

5

Recording video for educational/clinical purposes

1

2

3

4

5

Creating documents

1

2

3

4

5

Reviewing course materials

1

2

3

4

5

Communicate with other students via video conferencing software

1

2

3

4

5

Apply course content to solve problems

1

2

3

4

5

Produce projects to enhance learning

1

2

3

4

5

Learn course content

1

2

3

4

5

Participate in course activities in ways that enhance my learning

1

2

3

4

5

Connect course related ideas and concepts in new ways

1

2

3

4

5

Develop skills that apply to my academic career and professional life

1

2

3

4

5

I will be more motivated to participate in course activities that utilize the
iPad when compared to activities that do not.

1

2

3

4

5

Communicate with professors via video conferencing software

1

2

3

4

5

60

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Instructional Technology – Please indicate how strongly you
agree with the following statements in regards to your satisfaction
with the technology and value it had to your learning. Please use
the following definitions of satisfaction and value:
Satisfaction – fulfillment of expectations
Value – importance to your learning
1.

The use of the iPad will increase my SATISFACTION in this course

1

2

3

4

5

2.

The use of the iPad will add VALUE to the course

1

2

3

4

5

Please list any other areas where you believe an iPad could be valuable to you in this course:

61

Appendix C4
Post-Survey

62
California University of Pennsylvania
Department of Health Science

Please take a moment to complete this survey evaluating the utilization of technology in
your ATE 315 course this semester. This information will allow us to make informed
choices as to how to use this technology in the future. Your responses are confidential
and appreciated.

Demographic Information
What is your gender?

□
□

Female
Male

Age ____________________
Which of the following personal
technology items do you own?

□
□
□
□
□
□

iPad
iPhone
iPod touch
Android smart phone

How would you rate your comfort level
with technology?

□
□
□
□

Very comfortable
Comfortable
Uncomfortable
Very uncomfortable

Other tablet computer
Other _____________________________

The next few pages will assess the use of the iBook class to do assignments. The
researchers in this project created an iBook, provided on iPads, to allow students to
review information on an interactive platform. The students reviewed the iBook material
at their own pace with the ability to view online videos and to retrieve other material
through web links. In addition to the specific tasks, the researchers are also interested in
the students’ SATISFACTION and VALUE of the technology used in this course as a
whole. Please provide your honest opinion in response to the questions.

63
How many days a week did you spend looking at the iBook in the last 2 weeks? Please circle one
response.
0-1 days a week

2-3 days a week

4-5 days a week

6-7 days a week

I did not look at the
iBook

How many minutes per day, on average, did you spend looking at the iBook in the last 2 weeks?
Please circle one response.
0-30 minutes per day

31-60 minutes per
day

61-120 minutes per
day

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Instructional Technology – Please indicate how strongly you
agree with the following statements in regards to your satisfaction
with the technology and value it had to your learning. Please use
the following definitions of satisfaction and value:
Satisfaction – fulfillment of expectations
Value – importance to your learning

More than 120 minutes
per day

3.

The use of the iPad increased my SATISFACTION in this course

1

2

3

4

5

4.

The use of the iPad added VALUE to the course

1

2

3

4

5

5.

The use of the iPad increased my interest in the course

1

2

3

4

5

6.

The use of the iBook to review pulmonary anatomy and physiology
increased my SATISFACTION in this course

1

2

3

4

5

The use of the iBook to review pulmonary anatomy and physiology
added VALUE to the course

1

2

3

4

5

The use of the iBook to review pulmonary anatomy and physiology
increased my interest in the course

1

2

3

4

5

The use of the iBook to review pulmonary exercise physiology increased
my SATISFACTION in this course

1

2

3

4

5

10. The use of the iBook to review pulmonary exercise physiology added
VALUE to the course

1

2

3

4

5

11. The use of the iBook to review pulmonary exercise physiology increased
my interest in the course

1

2

3

4

5

12. The use of the iBook to learn about pulmonary illnesses/disorders
increased my SATISFACTION in this course

1

2

3

4

5

13. The use of the iBook to learn about pulmonary ill nesses/disorders
added VALUE to the course

1

2

3

4

5

7.

8.

9.

64
14. The use of the iBook to learn about pulmonary illnesses/disorders
increased my interest in the course

1

2

3

4

5

15. The use of the iBook to view skills videos (using a meter-dose inhaler,
nebulizer, and pulse oximeter) increased my Satisfaction in this course.

1

2

3

4

5

16. The use of the iBook to view skills videos (using a meter-dose inhaler,
nebulizer, and pulse oximeter) added Value in this course.

1

2

3

4

5

17. The use of the Internet during class via the iPad increased my
SATISFACTION in this course

1

2

3

4

5

Strongly
disagree

Disagree

Neutral

Agree

Strongly
agree

Please indicate how strongly you agree with the following
statements in regards to your experience with iPad use in class
this semester.
18. If given the opportunity to take a course utilizing the iPad or iBook
again, I would choose to do so.

1

2

3

4

5

19. I will perform better on the test due to utilization of the iBook in the
course.

1

2

3

4

5

20. I will consider using the iPad to add media (pictures, video, etc) to
future projects.

1

2

3

4

5

21. The iPad helped me develop technological skills that will help me in the
future.

1

2

3

4

5

22. I think this course should continue using iPads and iBooks in the future.

1

2

3

4

5

23. I think more athletic training/physical therapist assistant courses
should utilize the iPad and iBooks during instruction.

1

2

3

4

5

24. The value the iBook had in my learning as used in class exceeded my
expectations.

1

2

3

4

5

Strongly
disagree

Disagree

Neutral

Agree

Strongly
agree

Please indicate your agreement with the following statements.
I believe that the iPad COULD be very valuable to me in the
following areas.
25. Brainstorming / generating ideas

1

2

3

4

5

26. Finding research articles

1

2

3

4

5

27. Organizing information

1

2

3

4

5

28. Patient treatment/rehab record keeping

1

2

3

4

5

65
29. Analyzing information

1

2

3

4

5

30. Presenting information

1

2

3

4

5

31. Collaborating and working with classmates

1

2

3

4

5

32. Accessing the internet to find information

1

2

3

4

5

33. Recording audio for educational/clinical purposes

1

2

3

4

5

34. Recording video for educational/clinical purposes

1

2

3

4

5

35. Creating documents

1

2

3

4

5

36. Reviewing course materials

1

2

3

4

5

37. Communicate with other students via video conferencing software

1

2

3

4

5

38. Communicate with professors via video conferencing software

1

2

3

4

5

What did you like
and dislike about
each of the
technologies
utilized in this
course?
iPad

Like

Dislike

iBook

Do you have any other comments or suggestions for using iPads or iBooks in the future?

66

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13.

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ABSTRACT
TITLE:

USING IBOOK TECHNOLOGY IN ATHELTIC TRAINING
EDUCATIONAL PROGRAMS

RESEARCHER:

Meredith Moore LAT, ATC

ADVISOR:

Thomas F. West PhD, LAT, ATC

CONTEXT:

Technology use has increased as it becomes
more accessible and available to the public.
This generation of students, referred to as
the Millennial Generation, is the first
generation that has grown up with constant
access to personal technology. Previous
research has shown that the integration of
technology in education can have value to
both students and educators but the exact
methods of implementation into classes still
require further research

OBJECTIVE:

This study examined perceived value and
effectiveness of iPad/iBook integration into
General Medical course using survey
questions pertaining to satisfaction, value
and general effectiveness of the iPad and
the iBook.

DESIGN:

This study was primarily a descriptive
study.

SETTING:

General Medical course at California
University of Pennsylvania. Participants: 10
subjects, 7 females and 3 males, who were
enrolled in the course.

INTERVENTIONS: Once the iBook was created and the
researcher received IRB approval an
instructional session was held 1 week prior
to the start of the pulmonary unit. Subjects
were instructed on their role and
expectations of the study and assigned an
iPad with the created iBook. The pre-survey
was completed at this time. At the end of

71
the pulmonary unit, approximately one week
later, the iPads were collected and the
post-survey was distributed, completed and
collected.
MAIN OUTCOME MEASURES:
Subjects will answer questions using a
Likert Scale that pertain to satisfaction,
value, and general satisfaction with the
iPad and iBook.
RESULTS:

Completed surveys concluded no significant
different between pre-iPad and post-iPad
integration for both hypotheses. Hypothesis
1 showed (t(9)=1.177, p>.05). Hypothesis 2
showed (t(9)=.758, p>.05). Additional
results were found for questions pertaining
to value and satisfaction along with general
questions regarding the effectiveness of
iPad/iBook integration.

CONCLUSION:

This study found no significant change from
pre-iPad integration to post-iPad
integration. However, trends in the data
based on examination of individual survey
questions, along with subject feedback,
concluded that subjects were satisfied and
found value in the created iBook and iPad
when integrated into the General Medical
course.

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