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Author: Brian S McGowan, PhD

ABSTRACT: Examining the July Effect: A National Survey of Academic Leaders in Medicine

BACKGROUND:
Whether the “July Effect” affects perspectives or has prompted changes in US Internal Medicine residency programs is unknown.
METHODS:
We designed a survey-based study to assess views and efforts aimed at preventing harm in July. A convenience sampling strategy (email listserv and direct messages to program leaders via the Electronic Residency Application Service) was used to disseminate the survey.
RESULTS:
The response rate was 16% (65/418 programs); however, a total of 262 respondents from all 50 states where residency programs are located were included. Most respondents (n = 201; 77%) indicated that errors occur more frequently in July compared with other months. The most common identified errors included incorrect or delayed orders (n = 183, 70% and n = 167, 64%, respectively), errors in discharge medications (n = 144, 55%), and inadequate information exchange at handoffs (n = 143, 55%). Limited trainee experience (n = 208, 79%), lack of understanding hospital workflow, and difficulty using electronic medical record systems (n = 194; 74% and n = 188; 72%, respectively) were reported as the most common factors contributing to these errors. Programs reported instituting several efforts to prevent harm in July: for interns, additional electronic medical record training (n = 178; 68%) and education on handoffs and discharge processes (n = 176; 67% and n = 108; 41%, respectively) were introduced. Similarly, for senior residents, teaching sessions on how to lead a team (n = 158; 60%) and preferential placement of certain residents on harder rotations (n = 103; 39%) were also reported. Most respondents (n = 140; 53%) also solicited specific “July attendings” using a volunteer system or highest teaching ratings.
CONCLUSION:
Residency programs in Internal Medicine appear to have instituted various changes to mitigate harm in July. Further evaluation to understand the impact of these interventions on trainee education and patient safety is necessary.

via Examining the July Effect: A National Survey of Academic Leaders in Medicine. – PubMed – NCBI.

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MANUSCRIPT: Resource format preferences across the medical curriculum

Objective: This research study sought to determine the formats (print or electronic) of articles and book chapters most-preferred by first-year medical students, third-year medical students entering clinical clerkships, and incoming residents and to determine if these preferences change during the course of the medical curriculum. These trends will enable academic health sciences libraries to make appropriate collection development decisions to best cater to their user populations.

Methods: First-year medical students, third-year medical students, and incoming medical residents were asked to complete a paper survey from September 2014 to June 2015. The survey consisted of five multiple-choice questions, with two questions given space for optional short answers. Quantitative and qualitative responses were collected and calculated using Microsoft Excel.

Results: First-year students, third-year students, and incoming residents all preferred to read journal articles and book chapters in print, except in cases where the article or book chapter is under ten pages in length. Although print is preferred, demand for electronic articles and book chapters increases as students progress from undergraduate medical education into residency. The only category where a majority of incoming residents chose an electronic resource was which format they would give to a colleague, if the article or book chapter was critical to the care of an individual patient.

Conclusions: The preference for print resources is strong across the medical curriculum, although residents show an increased preference for electronic materials when compared to first- and third-year students. Academic health sciences libraries should take these preferences into account when making decisions regarding collection development.

To access the full article, click here….

 

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MANUSCRIPT: Continuing Medical Education Speakers with High Evaluation Scores Use more Image-based Slides

Introduction: Although continuing medical education (CME) presentations are common across health professions, it is unknown whether slide design is independently associated with audience evaluations of the speaker. Based on the conceptual framework of Mayer’s theory of multimedia learning, this study aimed to determine whether image use and text density in presentation slides are associated with overall speaker evaluations.

Methods: This retrospective analysis of six sequential CME conferences (two annual emergency medicine conferences over a three-year period) used a mixed linear regression model to assess whether postconference speaker evaluations were associated with image fraction (percentage of image-based slides per presentation) and text density (number of words per slide).

Results: A total of 105 unique lectures were given by 49 faculty members, and 1,222 evaluations (70.1% response rate) were available for analysis. On average, 47.4% (SD=25.36) of slides had at least one educationally-relevant image (image fraction). Image fraction significantly predicted overall higher evaluation scores [F(1, 100.676)=6.158, p=0.015] in the mixed linear regression model. The mean (SD) text density was 25.61 (8.14) words/slide but was not a significant predictor [F(1, 86.293)=0.55, p=0.815]. Of note, the individual speaker [χ2 (1)=2.952, p=0.003] and speaker seniority [F(3, 59.713)=4.083, p=0.011] significantly predicted higher scores.

Conclusion: This is the first published study to date assessing the linkage between slide design and CME speaker evaluations by an audience of practicing clinicians. The incorporation of images was associated with higher evaluation scores, in alignment with Mayer’s theory of multimedia learning. Contrary to this theory, however, text density showed no significant association, suggesting that these scores may be multifactorial. Professional development efforts should focus on teaching best practices in both slide design and presentation skills.

 

Access to the full article here….

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RESOURCE: Learning Styles: A Misguided Attempt to Highlight Individual Differences in Learners

In today’s blog post, I would like to give a summary of a review paper by An and Carr (2) that was recently published and that caught my attention. I find their review interesting because they highlight an important and new criticism of the learning styles approach: They state that “learning styles theories are a blend of borrowed constructs or measures from other, better-developed theories”. They further claim that within the learning styles framework, these borrowed constructs are misused and incorrectly interpreted leading to detrimental and useless recommendations. In this review, an attempt is made to connect existing learning styles concepts back to actual evidence-based concepts of human cognition and tie them to helpful recommendations for teachers. It acknowledges that there are individual differences between learners, but not as conceptualized by the learning styles approach.

via Learning Styles: A Misguided Attempt to Highlight Individual Differences in Learners — The Learning Scientists.

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ABSTRACT: Audio-visual aid in teaching “fatty liver”

Use of audio visual tools to aid in medical education is ever on a rise. Our study intends to find the efficacy of a video prepared on “fatty liver,” a topic that is often a challenge for pre-clinical teachers, in enhancing cognitive processing and ultimately learning. We prepared a video presentation of 11:36 min, incorporating various concepts of the topic, while keeping in view Mayer’s and Ellaway guidelines for multimedia presentation. A pre-post test study on subject knowledge was conducted for 100 students with the video shown as intervention. A retrospective pre study was conducted as a survey which inquired about students understanding of the key concepts of the topic and a feedback on our video was taken. Students performed significantly better in the post test (mean score 8.52 vs. 5.45 in pre-test), positively responded in the retrospective pre-test and gave a positive feedback for our video presentation. Well-designed multimedia tools can aid in cognitive processing and enhance working memory capacity as shown in our study. In times when “smart” device penetration is high, information and communication tools in medical education, which can act as essential aid and not as replacement for traditional curriculums, can be beneficial to the students.

via Audio-visual aid in teaching “fatty liver”. – PubMed – NCBI.

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ABSTRACT: Twelve tips for developing and delivering a massive open online course in medical education

Massive open online courses (MOOCs) are a novel mode of online learning. They are typically based on higher education courses and can attract a high number of learners, often in the thousands. They are distinct from on-campus education and deliver the learning objectives through a series of short videos, recommended readings and discussion fora, alongside automated assessments. Within medical education the role of MOOCs remains unclear, with recent proposals including continuing professional development, interprofessional education or integration into campus-based blended learning curricula. In this twelve tips article, we aim to provide a framework for readers to use when developing, delivering and evaluating a MOOC within medical education based on the literature and our own experience. Practical advice is provided on how to design the appropriate curriculum, engage with learners on the platform, select suitable assessments, and comprehensively evaluate the impact of your course.

via Twelve tips for developing and delivering a massive open online course in medical education. – PubMed – NCBI.

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ABSTRACT: Twelve tips for reducing production time and increasing long-term usability of instructional video

The use of instructional video is increasing across all disciplines and levels of education. Although video has a number of distinct advantages for course delivery and student learning, it can also be time-consuming and resource-intensive to produce, which imposes a burden on busy faculty. With video poised to play a larger role in medical education, we need strategies for streamlining video production and ensuring that the video we produce is of lasting value. This article draws on learning research and best practices in educational technology, along with the author’s experience in online education and video production. It offers 12 practical tips for reducing the initial time investment in video production and creating video that can be reused long into the future. These tips can help faculty and departments create high-quality instructional video while using their time and resources more wisely.

via Twelve tips for reducing production time and increasing long-term usability of instructional video. – PubMed – NCBI.

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ABSTRACT: A systematic review of the effectiveness of flipped classrooms in medical education

CONTEXT:
There are inconsistent claims made about the effectiveness of the flipped classroom (FC) in medical education; however, the quality of the empirical evidence used to back up these claims is not evident. The aims of this review are to examine the scope and quality of studies on the FC teaching approach in medical education and to assess the effects of FCs on medical learning.
METHODS:
A literature search was conducted using the major electronic databases in 2016. Peer-reviewed papers were screened and reviewed according to explicit inclusion criteria. The scope and quality of all resultant studies were evaluated. Studies identified as using controlled designs were further synthesised to assess the effects of FCs on learning.
RESULTS:
A total of 118 articles were obtained. Full texts of 82 articles were reviewed. Nine of the included 46 articles used a controlled design when examining the effects of the FC. There were generally positive perceptions of the FC approach. However, the effects of FCs on changes in knowledge and skills were less conclusive as the effect sizes ranged from d = -0.27 to 1.21, with a median of 0.08. The varying direction and magnitude of the effect sizes, together with their 95% confidence interval, which contained zero, suggested the lack of strong evidence for the effectiveness of FCs in promoting knowledge acquisition above and beyond the traditional learning methods.
CONCLUSIONS:
There has been a recent increase of research rigor and variety in measures of effectiveness in studies on the FC in medical education. The FC is a promising teaching approach to increase learners’ motivation and engagement. More solid evidence on its effect on changes in knowledge and skills are warranted. Further studies should also examine the long-term effects of FCs with regard to knowledge retention and transfer of knowledge to professional practice and patient care.

via A systematic review of the effectiveness of flipped classrooms in medical education. – PubMed – NCBI.

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MANUSCRIPT: Big data in medicine is driving big changes

OBJECTIVES:
To summarise current research that takes advantage of “Big Data” in health and biomedical informatics applications.
METHODS:
Survey of trends in this work, and exploration of literature describing how large-scale structured and unstructured data sources are being used to support applications from clinical decision making and health policy, to drug design and pharmacovigilance, and further to systems biology and genetics.
RESULTS:
The survey highlights ongoing development of powerful new methods for turning that large-scale, and often complex, data into information that provides new insights into human health, in a range of different areas. Consideration of this body of work identifies several important paradigm shifts that are facilitated by Big Data resources and methods: in clinical and translational research, from hypothesis-driven research to data-driven research, and in medicine, from evidence-based practice to practice-based evidence.
CONCLUSIONS:
The increasing scale and availability of large quantities of health data require strategies for data management, data linkage, and data integration beyond the limits of many existing information systems, and substantial effort is underway to meet those needs. As our ability to make sense of that data improves, the value of the data will continue to increase. Health systems, genetics and genomics, population and public health; all areas of biomedicine stand to benefit from Big Data and the associated technologies.

via Big data in medicine is driving big changes. – PubMed – NCBI.

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MANUSCRIPT: Looking Through a Social Lens: Conceptualising Social Aspects of Knowledge Management for Global Health Practitioners

Knowledge management plays a critical role in global health. Global health practitioners require knowledge in every aspect of their jobs, and in resource-scarce contexts, practitioners must be able to rely on a knowledge management system to access the latest research and practice to ensure the highest quality of care. However, we suggest that there is a gap in the way knowledge management is primarily utilized in global health, namely, the systematic incorporation of human and social factors. In this paper, we briefly outline the evolution of knowledge management and then propose a conceptualization of knowledge management that incorporates human and social factors for use within a global health context. Our conceptualization of social knowledge management recognizes the importance of social capital, social learning, social software and platforms, and social networks, all within the context of a larger social system and driven by social benefit. We then outline the limitations and discuss future directions of our conceptualization, and suggest how this new conceptualization is essential for any global health practitioner in the business of managing knowledge.

via Looking Through a Social Lens: Conceptualising Social Aspects of Knowledge Management for Global Health Practitioners. – PubMed – NCBI.

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