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Author: Brian S McGowan, PhD

ABSTRACT: Health-related hot topic detection in online communities using text clustering.

Abstract
Recently, health-related social media services, especially online health communities, have rapidly emerged. Patients with various health conditions participate in online health communities to share their experiences and exchange healthcare knowledge. Exploring hot topics in online health communities helps us better understand patients’ needs and interest in health-related knowledge. However, the statistical topic analysis employed in previous studies is becoming impractical for processing the rapidly increasing amount of online data. Automatic topic detection based on document clustering is an alternative approach for extracting health-related hot topics in online communities. In addition to the keyword-based features used in traditional text clustering, we integrate medical domain-specific features to represent the messages posted in online health communities. Three disease discussion boards, including boards devoted to lung cancer, breast cancer and diabetes, from an online health community are used to test the effectiveness of topic detection. Experiment results demonstrate that health-related hot topics primarily include symptoms, examinations, drugs, procedures and complications. Further analysis reveals that there also exist some significant differences among the hot topics discussed on different types of disease discussion boards.

via Health-related hot topic detection in online commun… [PLoS One. 2013] – PubMed – NCBI.

MANUSCRIPT: Fixed or mixed? a comparison of three, four and mixed-option multiple-choice tests in a Fetal Surveillance Education Program

Background
Despite the widespread use of multiple-choice assessments in medical education assessment, current practice and published advice concerning the number of response options remains equivocal. This article describes an empirical study contrasting the quality of three 60 item multiple-choice test forms within the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Fetal Surveillance Education Program (FSEP). The three forms are described below.

Methods
The first form featured four response options per item. The second form featured three response options, having removed the least functioning option from each item in the four-option counterpart. The third test form was constructed by retaining the best performing version of each item from the first two test forms. It contained both three and four option items.

Results
Psychometric and educational factors were taken into account in formulating an approach to test construction for the FSEP. The four-option test performed better than the three-option test overall, but some items were improved by the removal of options. The mixed-option test demonstrated better measurement properties than the fixed-option tests, and has become the preferred test format in the FSEP program. The criteria used were reliability, errors of measurement and fit to the item response model.

Conclusions
The position taken is that decisions about the number of response options be made at the item level, with plausible options being added to complete each item on both psychometric and educational grounds rather than complying with a uniform policy. The point is to construct the better performing item in providing the best psychometric and educational information.

via BMC Medical Education | Abstract | Fixed or mixed? a comparison of three, four and mixed-option multiple-choice tests in a Fetal Surveillance Education Program.

What if learning, doing, and sharing were one action in healthcare?

I have gotten a lot of great feedback on a blog post I wrote last summer on my person blog, ‘I tweet because it simplifies learning.’

In that post I talk about what I call the 3R’s of adult learning: recording, reexposure, and redistribution and I talk about how we must build a learning architecture for ourselves that supports each of the R’s. It is a great feeling to know that more and more people are thinking about how social technologies accomplish this and can support professional development and learning. And, I received a lot of great examples of what people see as the strengths and the weaknesses of their own learning architectures.

But as I talked with these folks about the 3R’s and as I learned about how they are trying to leverage these lessons as individual learners and across their organizations, it struck me that learning is only the beginning of the story that I tell in my book, #socialQI: Simple Solutions for Improving Your Healthcare and folks need to stay open to the critical necessity of connecting learning to action.

Both the book and my personal blog are intended to explore QI, or ‘quality improvement’ and therefore they focus on the need to move beyond learning and to begin to understand how new learning  and knowledge management models might support healthcare quality and performance.

Remember my basic hypothesis: by exploring the intersection of social learning and behavior change science we can make new strides in quality improvement and healthcare outcomes.

At the heart of the #SocialQI model is the idea that by connecting the act of learning, doing, and sharing we can build a better ‘rapid learning healthcare system.‘ When stated this concisely perhaps the model seems more approachable, and maybe that is part of the secret – the elements of the model are not in and of themselves disruptive, instead it is the unwavering commitment to connect the elements that changes the game and it is the new vision for how we connect them that some may see as disruptive.

In medicine, the acts of learning, doing, and sharing are almost never linked to one another. Each act is discreet. ‘Learning’ is largely seen as an individual endeavor. ‘Doing’ is complicated by a myriad of system-based complications. And ‘sharing’…well sharing has never really been a key element of medicine.

But what happens when we have the systems in place and the healthcare culture has shifted to the point that learning, doing, and sharing can all become one action? Or, at least, when connected learning, doing, and sharing become the expectation and the norm? We are getting closer and closer to answering these questions everyday. Each day new technologies are engineered and each day new structured models systems are being piloted. ArcheMedx has engineered one such model, I explore several others in the book, but there are hundreds more from which to learn.

Importantly, we each have a role in this progress, and this is the take-away message of this post: You must begin to consider how you and your teams are connecting the acts of learning, doing, and sharing. Find opportunities to do so. Report back to the community.

If I have learned anything in the past year as I conceived and developed the SocialQI model and as Joel and I conceived and launched ArcheMedX its that the best solutions almost always arise from the collective intelligence of the community (thereby proving my hypothesis).

My hope is that we can find enough passionate participants to drive the changes we need in the healthcare system, before the next time any of us need the healthcare system we are trying to change.

RESOURCE: MOOC completion and drop-out rates

One of the main MOOC challenges: MOOC drop-out
As drop-out rates are one of the main MOOC challenges, this research is a gift. For insight in the drop-out rates can provide angles for improvement, increased retention … So, looking forward to follow Katy’s research. And have a look at the wonderful set of papers she has written, including using semantic web technologies… inspiring stuff!

To me, I feel that MOOCs are also a way to improve expert learning, so not necessarily linked to assessments and such. It is more about lifelong learning, getting information to enhance personal knowledge for professional reasons. But that … is another research all together. For at that point, you cannot look at assessments to indicate completion. For the expert MOOCs might have lurkers (= people that do not actively engage in MOOC interactions, but do follow what is going on) that actually have found what they were looking for, learning without interacting, and those lurkers would be part of the learners finishing the course (but how to analyse that?!).

via @Ignatia Webs: MOOC completion and drop-out rates.

RESOURCE: Online Learning and the Future of Residential Education | March 3-4, 2013 | Video

The Summit Program Committee recommends the following reading in advance of the event.

“The Particle Accelerator of Learning” (Inside Higher Ed, Peter Stokes, February 22, 2013)
“Four Professors Discuss Teaching Free Online Courses for Thousands of Students” (The Chronicle of Higher Education, Jeffrey Young, June 11, 2012)
“What We’re Learning from Online Education” (Daphne Koller, TED Talk, June 2012)
“Learning from MOOCS” (Inside Higher Ed, January 24, 3013)
“How Harvard’s CS50 Renewed My Hope for Online Education” (Modern Wanderlust blog, Erik Trautma, January 6, 2013)
“After the gold rush: MOOCs are augmenting rather than replacing formal educational models” (LSE Impact of Social Science, January 16, 2013)
“Beyond MOOCs Into Greater Openness” (Library Journal, Steven Bell, January 9, 2013)
“Online Courses Create New Learning Methods” (The Dartmouth, Stephanie McFeeters, January 17, 2013)
“Researchers, MOOCs, and Online Programs” (Inside Higher Ed, Joshua Kim, January 14, 2013)
“edX in the Community College: The MassBay Experience” (Campus Technology, Mary Grush, January 9, 2013)
“Revolution Hits the Universities” (The New York Times, Thomas Friedman, January 26, 2013)
“The Year of the MOOC” (The New York Times, November 2, 2012)
“Online Courses Look for a Business Model” (The Wall Street Journal, Melissa Korn and Jennifer Levitz, January 1, 2013)
“Public Universities to Offer Free Online Classes for Credit” (The New York Times, Tamar Lewin, January 23, 2013)
“California to Give Web Courses a Big Trial” (The New York Times, Tamar Lewin and John Markoff, January 15, 2013)
“Unishared: Revolution in Online Education Beyond Coursera, Edx, and Udacity” (Forbes, Ricardo Geromel, September 17, 2012)
“The MOOC Model: Challenging Traditional Education” (Educause, January 28, 2013)
“Massive Open Online Course (MOOC) Library” (Educause)
“Carnegie, the Founder of the Credit-Hour, Seeks its Makeover” (The Chronicle of Higher Education, December 5, 2012)
“Who Benefits from Online Ed?” (Inside Higher Education, February 25, 2013)
“The ‘Cost Disease’ in Higher Education: Is Technology the Answer?” (William G. Bowen, The Tanner Lectures, Stanford University, October 2012)

via Online Learning and the Future of Residential Education | March 3-4, 2013 | Video.

MANUSCRIPT: A student authored online medical education textbook: editing patterns and content evaluation of a medical student wiki.

Abstract
The University of Minnesota medical student wiki (UMMedWiki) allows students to collaboratively edit classroom notes to support medical education. Since 2007, UMMedWiki has grown to include 1,591 articles that have collectively received 1.2 million pageviews. Although small-scale wikis have become increasingly important, little is known about their dynamics compared to large wikis, such as Wikipedia. To better understand UMMedWiki’s management and its potential reproducibility at other medical schools, we used an edit log with 28,000 entries to evaluate the behavior of its student editors. The development of tools to survey UMMedwiki allows for quality comparisons that improve both the wiki and the curriculum itself. We completed a content survey by comparing the UMMedWiki with two types of rubric data: TIME, a medical education taxonomy consisting of 1500 terms and national epidemiological data on 2,100 diseases.

via A student authored online medical educat… [AMIA Annu Symp Proc. 2011] – PubMed – NCBI.

ABSTRACT: Surgeons don’t know what they don’t know about the safe use of energy in surgery.

Abstract
BACKGROUND:
Surgeons are not required to train on energy-based devices or document their knowledge of safety issues related to their use. Their understanding of how to safely use the devices has never formally been tested. This study assessed that knowledge in a cohort of gastrointestinal surgeons and determined if key facts could be learned in a half-day course.
METHODS:
SAGES piloted a postgraduate CME course on the Fundamental Use of Surgical Energy™ (FUSE) at the 2011 SAGES meeting. Course faculty prepared an 11-item multiple-choice examination (pretest) of critical knowledge. We administered it to members of the SAGES board; Quality, Outcomes and Safety Committee; and FUSE Task Force. Postgraduate course participants took the pretest, and at the end of the course they took a 10-item post-test that covered the same content. Data are expressed as median (interquartile range, IQR).
RESULTS:
Forty-eight SAGES leaders completed the test: the median percent of correct answers was 59 % (IQR = 55-73 %; range = 0-100 %). Thirty-one percent did not know how to correctly handle a fire on the patient; 31 % could not identify the device least likely to interfere with a pacemaker; 13 % did not know that thermal injury can extend beyond the jaws of a bipolar instrument; and 10 % thought a dispersive pad should be cut to fit a child. Pretest results for 27 participants in the postgraduate course were similar, with a median of 55 % correct (IQR = 46-82 %). Participants were not told the correct answers. At the end of the course, 25 of them completed a different 10-item post-test, with a median of 90 % correct (IQR = 70-90 %).
CONCLUSIONS:
Many surgeons have knowledge gaps in the safe use of widely used energy-based devices. A formal curriculum in this area can address this gap and contribute to increased safety.

via Surgeons don’t know what they don’t know about t… [Surg Endosc. 2012] – PubMed – NCBI.

MANUSCRIPT: Advancing medicine one research note at a time: the educational value in clinical case reports.

Abstract
A case report–a brief written note that describes unique aspects of a clinical case–provides a significant function in medicine given its rapid, succinct, and educational contributions to scientific literature and clinical practice. Despite the growth of, and emphasis on, randomized clinical trials and evidenced-based medicine, case reports continue to provide novel and exceptional knowledge in medical education. The journal BMC Research Notes introduces a new “case reports” section to provide the busy clinician with a forum in which to document any authentic clinical case that provide educational value to current clinical practice. The aim is for this article type to be reviewed, wherever possible, by specialized Associate Editors for the journal, in order to provide rapid but thorough decision making. New ideas often garnered by and documented in case reports will support the advancement of medical science–one research note at a time.

via Advancing medicine one research note at a time… [BMC Res Notes. 2012] – PubMed – NCBI.

MANUSCRIPT: Medical students as human subjects in educational research.

Abstract
Introduction: Special concerns often arise when medical students are themselves the subjects of education research. A recently completed large, multi-center randomized controlled trial of computer-assisted learning modules for surgical clerks provided the opportunity to explore the perceived level of risk of studies where medical students serve as human subjects by reporting on: 1) the response of Institutional Review Boards (IRBs) at seven institutions to the same study protocol; and 2) the thoughts and feelings of students across study sites about being research subjects. Methods: From July 2009 to August 2010, all third-year medical students at seven collaborating institutions were eligible to participate. Patterns of IRB review of the same protocol were compared. Participation burden was calculated in terms of the time spent interacting with the modules. Focus groups were conducted with medical students at each site. Transcripts were coded by three independent reviewers and analyzed using Atlas.ti. Results: The IRBs at the seven participating institutions granted full (n=1), expedited (n=4), or exempt (n=2) review of the WISE Trial protocol. 995 (73% of those eligible) consented to participate, and 207 (20%) of these students completed all outcome measures. The average time to complete the computer modules and associated measures was 175 min. Common themes in focus groups with participant students included the desire to contribute to medical education research, the absence of coercion to consent, and the low-risk nature of the research. Discussion: Our findings demonstrate that risk assessment and the extent of review utilized for medical education research vary among IRBs. Despite variability in the perception of risk implied by differing IRB requirements, students themselves felt education research was low risk and did not consider themselves to be vulnerable. The vast majority of eligible medical students were willing to participate as research subjects. Participants acknowledged the time demands of their participation and were readily able to withdraw when those burdens became unsustainable.

via Medical students as human subjects in educat… [Med Educ Online. 2013] – PubMed – NCBI.

ABSTRACT: Twelve tips for making the best use of feedback.

Abstract
Background: Feedback is generally regarded as crucial for learning. We focus on feedback provided through instruments developed to inform self-assessment and support learners to improve performance. These instruments are being used commonly in medical education, but they are ineffective if the feedback is not well received and put into practice. Methods: The authors formulated twelve tips to make the best use of feedback based on widely cited publications on feedback. To include recent developments and hands-on experiences in the field of medical education, the authors discussed the tips with their research team consisting of experts in the field of medical education and professional performance, to reach agreement on the most practical strategies. Results: When utilizing feedback for performance improvement, medical students, interns, residents, clinical teachers and practicing physicians could make use of the twelve tips to put feedback into practice. The twelve tips provide strategies to reflect, interact and respond to feedback one receives through (validated) feedback instruments. Conclusions: Since the goal of those involved in medical education and patient care is to perform at the highest possible level, we offer twelve practical tips for making the best use of feedback in order to support learners of all levels

via Twelve tips for making the best use of feedback. [Med Teach. 2013] – PubMed – NCBI.