Providing large numbers of undergraduate students in scientific disciplines with engaging, authentic laboratory experiences is important to promote inquiry-based, conceptual learning [1], but challenging in terms of resourcing [2]. Constraints in a real lab (wet-lab) setting include limited and out-dated laboratory equipment, unavailable materials and difficulties in demonstrating techniques due to large class sizes resulting in student crowding [3]. These resourcing issues have implications for cost, health and safety as well as efficacy of teaching and learning. Such issues have affected the Muscle Diseases practical class within Musculoskeletal Diseases, an undergraduate Pathology course for 3rd year Science students at UNSW Australia. Student enrolments in the Musculoskeletal Diseases course have risen markedly over the past 5 years. This has made it logistically very difficult to teach technical and diagnostic laboratory elements and the use of protein analysis apparatus (Western Blotting) in that practical class. Such technical skills are linked to conceptual frameworks that underpin the diagnosis of muscular dystrophy. Furthermore, the use of Western Blotting apparatus in a real lab setting is time-consuming and cumbersome and tends to detract from the diagnostic aspect of the practical class [4].

Moreover, the focus of the labs is on acquiring technical and diagnostic skills, and the cognitive load imposed by learning to use real lab apparatus is possibly redundant to that goal [5]. This is not to say that the lab equipment is redundant overall, but creates extraneous load when trying to acquire diagnostic skills, as the focus of attention may be on mastering the technical aspects of the apparatus instead of understanding the protein expression patterns that underlie the diagnosis of muscular dystrophy. Hence, the concern was that learners may be distracted by focussing on equipment use in wet labs, rather than learning important concepts such as disease diagnosis in muscular dystrophy. Therefore, one potential benefit of virtual laboratories (vLABs) is that they allow for the separation of mastery of technical equipment from the acquisition of diagnostic skills. Another clear advantage of vLABs is the potential cost savings on consumables and laboratory demonstrators. In this context, vLABs are a potential means to enable cost-effective, safe and efficient, interactive learning experiences [6].

We opted to employ a vLAB format to overcome constraints with the real laboratory experience and to enable students to focus on difficult concepts more effectively, such as the threshold concept that underpins how changes in protein expression result in manifestation of disease at the gross anatomical level [4, 7]. Threshold concepts are those key concepts that transform thinking irreversibly but are often difficult to understand and acquire. Once acquired they may even seem simple and self-evident [8]. vLABs have already been trialed successfully within an Engineering context to improve the teaching of Mechanical Engineering threshold concepts [9]. Using well guided instructional techniques such as those described previously [10], vLABs also have the potential to reduce complexity [11] by providing increased opportunities for remediation and practice, as well as guided feedback [12]. They also allow for increased exposure and practice with threshold concepts. The Adaptive eLearning Platform (AeLP) [13, 14] can be used to develop vLABs that are adaptively sequenced to meet students’ individual learning needs, provide adaptive feedback to students on misconceptions, as well as tracking students’ interactions within the virtual environment. The key advantage of using the AeLP to create the Western Blotting vLAB was retention of pedagogical control over the laboratory environment and ‘in-the-moment’ feedback or adaptation to student interactions with the Western Blotting vLAB. Thus, there is emerging evidence that virtual laboratory environments are useful for learning threshold concepts. The AeLP is an innovative way of teaching such concepyts by providing adaptive feedback to students and addressing their needs as they progress through the vLAB.

We are not aware of any previous reports of evaluative data regarding the use of vLABs for Western Blotting, or similar molecular diagnostic techniques. To investigate whether such vLABs are acceptable and effective for learning, we developed a vLAB to demonstrate the process of analysing protein expression by muscle cells, which is a necessary step in the real-world diagnosis of muscular dystrophy and implemented it in a blended learning teaching environment. Hence, the focus of the Western Blotting vLAB was to teach principles of sodium-dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western Blotting of dystrophin protein to analyse altered protein expression patterns in patients with disease.

Our anecdotal observations from earlier versions of the Muscle Diseases practical class that used the real lab alone, showed that students needed more guidance in the area of diagnosis of disease using laboratory techniques. This is important, as students need to understand that the quality of how laboratory techniques are performed can impact on the quality of the generated results and therefore outcomes of disease diagnosis. The aims of implementing the vLAB in this study were to: 1) improve students’ understanding of how differences in molecular signatures or altered protein expression patterns could be linked to microscopic or macroscopic changes in diseases such as muscular dystrophy; and 2) evaluate whether students perceived the vLAB as being more or less useful than the real lab in teaching concepts and skills related to Western Blotting.

Studies regarding the effectiveness of eLearning versus face-to-face teaching have been conducted in a wide variety of contexts [6]. Reasons for improved learning outcomes include guided instructional formats with customised feedback, increased exposure to threshold concepts [8], increased student interactivity, increased student opportunities for practice, customised remediation and revision, as well as the potential to reduce redundancy and split attention both of which can lead to cognitive overload [22]. Use of the AeLP has been shown to lead to more effective student learning in many contexts already [9, 15, 23, 24]. To our knowledge, this is the first study of an eLearning intervention utilising a Western Blotting virtual laboratory.

Quantitative and qualitative data obtained from questionnaires indicate that the vLAB improved student perceptions of some aspects of their learning of Western Blotting, and was at least equivalent to the real lab in all aspects evaluated. The efficacy of the vLAB might have been in part due to the provision of an individualised Western Blotting laboratory experience, in contrast with provision of a focussed, yet limited real lab environment within the same practical class [6]. The overarching conceptual framework and technical environment provided by the vLAB appeared to provide a more comprehensive learner experience, whereby students felt better prepared for the real lab experience upon completion of the vLAB.

Students rated the Western Blotting vLAB favourably for interpreting Western Blotting for diagnosis of disease, compared with the real lab in 2011. The vLAB and real lab had equivalent effects on interpreting Western Blotting data for diagnosis of disease in 2012 and 2013. It could be that the novelty of the vLAB approach was responsible for the perceived benefits in the 2011 cohort.

Diagnostic skills are key in underpinning learning of concepts related to the molecular basis of muscular dystrophy. Student feedback demonstrated that they enjoyed being able to use the vLAB to prepare for real lab ‘hands on experience’ and generally enjoyed the interactivity and immediate feedback that the vLAB provided at each step. These data indicate that the vLAB has the capacity to facilitate learning of concepts at least as well as the real lab, according to students' perceptions. This was achieved without requiring extra resourcing or a significant extra investment of student time as judged by the time taken to achieve the learning objectives within the two-hour practical class. This suggests that the design of the vLAB provided students with a time-efficient learning experience.

This vLAB allowed students to learn concepts and techniques via dovetailing ‘real or wet’ and ‘virtual’ laboratories [4, 20, 25]. It has been shown previously that Science students have a greater understanding of best practice and diagnostic outcomes when learning by doing [24, 26]. The technical aspect of the practical class on muscle diseases was therefore important for understanding protein expression status in patients with muscular dystrophy. Students appeared to have a perceived improvement in some aspects of understanding following engagement with the Western Blotting vLAB, particularly the application of knowledge to diagnose changes in protein expression that underlie muscular dystrophy. It might be that exposing students to the vLAB allowed students to focus on the acquisition of diagnostic skills, separate from learning the technical skills of how to physically use equipment in a real lab.

The high level of interactivity and feedback provided by the vLAB, in comparison with the real lab, might have contributed to improved efficacy of delivery of diagnostic content to support learning of laboratory based concepts. This effect has been demonstrated in previous successful eLearning interventions [16, 23, 27]. Multiple studies have found that targeted eLearning environments which embed technical aspects within an overarching conceptual framework, are generally more effective than generic online texts and simulations [4, 14, 19, 28]. When considering implementation of eLearning for undergraduate students, interactivity and feedback are important for both student engagement and learning impact [12, 16, 29, 30].

The present study focuses on student perceptions, rather than objective assessment of diagnostic skills. Further studies are needed to determine whether exposure to vLABs results in equivalent skill development compared to real labs.

This is the first study to report use and evaluation of an interactive virtual laboratory environment using Western Blotting in Pathology. The vLAB was perceived by students to be at least as helpful for learning as the real lab. It is envisioned that the Western Blotting vLAB could be adapted for a range of learning activities across a range of learners, undergraduate and graduate, in which a deeper understanding of protein expression patterns is required. The concepts relating to the creation of vLABs are likely to be generalisable to other domains as well. We believe that this study has important implications for the design of future vLABS to support learning of laboratory technical and diagnostic skills. Further studies of vLABs are required to elucidate the impact of vLABs on students' learning.