Open Access Research article

Communication and proximity effects on outcomes attributable to sense of presence in distance bioinformatics education

Craig Locatis1*, Eta S Berner2, Glenn Hammack3, Steve Smith4, Richard Maisiak5 and Michael Ackerman1

Author Affiliations

1 Office of High Performance Computing and Communications, National Library of Medicine, 8600 Rockville Pike, Bethesda, Maryland 20894, USA

2 Department of Health Services Administration, University of Alabama at Birmingham, 1675 University Boulevard, Room 534, Birmingham, Alabama 35294, USA

3 NuPhysicia LLC, 4625 Southwest Freeway, Suite 142, Houston, Texas 77027, USA

4 Medical Student Services, University of Alabama at Birmingham, Room 100, Volker Hall, 1670 University Boulevard, Birmingham, Alabama 25294, USA

5 Maisiak Associates, 5444 East Grovers Avenue, Scottsdale, Arizona 85254, USA

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BMC Medical Education 2011, 11:10  doi:10.1186/1472-6920-11-10

Published: 14 March 2011



Online learning is increasingly popular in medical education and sense of presence has been posited as a factor contributing to its success. Communication media influences on sense of presence and learning outcomes were explored in this study. Test performance and ratings of instruction and technology, factors influenced by sense of presence, are compared under four conditions involving different media and degrees of student physical presence: 1) videoconference co-located, 2) webcast co-located, 3) videoconference dispersed, and 4) webcast dispersed.


Eighty one first to forth year medical students heard a lecture on telemedicine and were asked to collaboratively search a telemedicine website under conditions where the lecture was delivered by videoconference or one way streaming (webcast) and where students were either co-located or dispersed. In the videoconference conditions, co-located students could use the technology to interact with the instructor and could interact with each other face to face, while the dispersed students could use the technology to interact with both the instructor and each other. In the webcast conditions, all students could use chat to communicate with the instructor or each other, although the co-located students also could interact orally. After hearing the lecture, students collaboratively searched a telemedicine website, took a test on lecture-website content and rated the instruction and the technology they used. Test scores on lecture and website content and ratings of instruction and technology for the four conditions were compared with analysis of variance and chi-square tests.


There were no significant differences in overall measures, although there were on selected ratings of instruction. Students in both webcast conditions indicated they were encouraged more to follow up on their own and felt instruction was more interactive than co-located videoconferencing students. Dispersed videoconferencing students indicated the highest levels of interaction and there was evidence they interacted more.


Results do not strongly support proximity as a sense of presence factor affecting performance and attitudes, but do suggest communication medium may affect interactivity.