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Author: Brian S McGowan, PhD

MANUSCRIPT: Point of care information services: a platform for self-directed continuing medical education for front line decision makers

The structure and aim of continuing medical education (CME) is shifting from the passive transmission of knowledge to a competency-based model focused on professional development. Self-directed learning is emerging as the foremost educational method for advancing competency-based CME. In a field marked by the constant expansion of knowledge, self-directed learning allows physicians to tailor their learning strategy to meet the information needs of practice. Point of care information services are innovative tools that provide health professionals with digested evidence at the front line to guide decision making. By mobilising self-directing learning to meet the information needs of clinicians at the bedside, point of care information services represent a promising platform for competency-based CME. Several points, however, must be considered to enhance the accessibility and development of these tools to improve competency-based CME and the quality of care.

via Point of care information services: a platform for self-directed continuing medical education for front line decision makers. – PubMed – NCBI.

ABSTRACT: FOAMSearch.net: A custom search engine for emergency medicine and critical care

The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician-oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find relevant, high-quality online resources for emergency medicine and critical care (EMCC) clinicians. Using Google™ algorithms, it searches a vetted list of >300 blogs, podcasts, wikis, knowledge translation tools, clinical decision support tools and medical journals. Utilisation has increased progressively to >3000 users/month since its launch in 2011. Further study of the role of CSEs to find medical resources is needed, and it might be possible to develop similar CSEs for other areas of medicine.

via FOAMSearch.net: A custom search engine for emergency medicine and critical care. – PubMed – NCBI.

MANUSCRIPT: Moving Knowledge Acquisition From the Lecture Hall to the Student Home: A Prospective Intervention Study

BACKGROUND:
Podcasts are popular with medical students, but the impact of podcast use on learning outcomes in undergraduate medical education has not been studied in detail.
OBJECTIVE:
Our aim was to assess the impact of podcasts accompanied by quiz questions and lecture attendance on short- and medium-term knowledge retention.
METHODS:
Students enrolled for a cardio-respiratory teaching module were asked to prepare for 10 specific lectures by watching podcasts and submitting answers to related quiz questions before attending live lectures. Performance on the same questions was assessed in a surprise test and a retention test.
RESULTS:
Watching podcasts and submitting answers to quiz questions (versus no podcast/quiz use) was associated with significantly better test performance in all items in the surprise test and 7 items in the retention test. Lecture attendance (versus no attendance) was associated with higher test performance in 3 items and 1 item, respectively. In a linear regression analysis adjusted for age, gender, and overall performance levels, both podcast/quiz use and lecture attendance were significant predictors of student performance. However, the variance explained by podcast/quiz use was greater than the variance explained by lecture attendance in the surprise test (38.7% vs. 2.2%) and retention test (19.1% vs. 4.0%).
CONCLUSIONS:
When used in conjunction with quiz questions, podcasts have the potential to foster knowledge acquisition and retention over and above the effect of live lectures

via Moving Knowledge Acquisition From the Lecture Hall to the Student Home: A Prospective Intervention Study. – PubMed – NCBI.

ABSTRACT: Is there a need for a specific educational scholarship for using e-learning in medical education?

We propose the need for a specific educational scholarship when using e-learning in medical education. Effective e-learning has additional factors that require specific critical attention, including the design and delivery of e-learning. An important aspect is the recognition that e-learning is a complex intervention, with several interconnecting components that have to be aligned. This alignment requires an essential iterative development process with usability testing. Effectiveness of e-learning in one context may not be fully realized in another context unless there is further consideration of applicability and scalability. We recommend a participatory approach for an educational scholarship for using e-learning in medical education, such as by action research or design-based research.

via Is there a need for a specific educational scholarship for using e-learning in medical education? – PubMed – NCBI.

ABSTRACT: Effects of Mobile Learning in Medical Education: A Counterfactual Evaluation

The aim of this research is to contribute to the general system education providing new insights and resources. This study performs a quasi-experimental study at University of Salamanca with 30 students to compare results between using an anatomic app for learning and the formal traditional method conducted by a teacher. The findings of the investigation suggest that the performance of learners using mobile apps is statistical better than the students using the traditional method. However, mobile devices should be considered as an additional tool to complement the teachers’ explanation and it is necessary to overcome different barriers and challenges to adopt these pedagogical methods at University.

via Effects of Mobile Learning in Medical Education: A Counterfactual Evaluation. – PubMed – NCBI.

MANUSCRIPT: What makes a doctor a scholar: a systematic review and content analysis of outcome frameworks

BACKGROUND:
Many national outcome frameworks (OF) call for a sound scholarship education and scholarly behaviour of physicians. Educators however are known to interpret the scholar role in markedly different ways and at least one major initiative to unify several national outcome frameworks failed to agree on a common definition of the scholar role. Both circumstances currently limit the development of educational and assessment strategies specific for the scholar role. Given increasing physician mobility together with the global perspective inherent in a doctor’s role as a scholar, we were interested in what different OFs define as the scholar role and attempted to identify communalities and differences between them.
METHODS:
We conducted a systematic review for OF in medical education in PubMed and google. After in- and exclusion processes, we extracted all content listed under the scholar role (if present) and categorized it based on Boyer’s established model of scholarship. Next, we extracted all content related to scholarship from OFs not explicitly defining a scholar role and used it to validate the categories resulting from step one.
RESULTS:
From 1816 search results, we identified 13 eligible OFs, seven of which explicitly specified a scholar role. The outcomes only partly map onto Boyer’s definition of scholarship: Discovery, Integration, Application, and Teaching. We adapted and validated a model extending this definition to contain Common Basics (partly overlapping with Integration and Teaching), Clinical Application (specifying Application), Research (Discovery and partly Integration), Teaching and Education (partly overlapping with Teaching) and Lifelong Learning (no equivalent in Boyer’s model). Whereas almost all OFs cover Common Basics, Clinical Application, and Lifelong Learning, fewer and less specific outcomes relate to Research or Teaching.
CONCLUSIONS:
The need to adapt existing models of scholarship may result from the changing demands directed at medical scholars. The considerable differences identified between OFs may explain why educators have difficulties defining the scholar role and why the role is rarely assessed. We may have missed OFs due to our in- and exclusion criteria but the results provide a solid basis on which to build a common understanding of what makes a doctor a scholar.

via What makes a doctor a scholar: a systematic review and content analysis of outcome frameworks. – PubMed – NCBI.

MANUSCRIPT: Family physicians’ continuing professional development activities: current practices and potential for new options

BACKGROUND:
As part of needs assessment processes, our Faculty of Medicine (FOM) continuing professional development office investigated the differences between physicians who do and those who do not frequently participate in planned group learning to gain insight into their interest in new forms of continuing professional development (CPD).
METHOD:
We sent a 19 item questionnaire to 485 randomly selected physicians of the 1050 family physicians in Eastern Ontario. The questionnaire examined present participation and satisfaction with CPD activities and perceptions regarding the potential impact of those; and appetite for new opportunities to meet their learning needs.
RESULTS:
Of the 151 (31%) physicians responding, 61% reported attending at least one FOM group learning program in the past 18 months (attenders) and 39% had not (non-attenders). Non-attenders indicated less satisfaction (p = 0.04) with present opportunities and requested development in newer approaches such as support for self-learning, on-line opportunities, and simulation.
CONCLUSIONS:
Although there are high levels of satisfaction with the present CPD system that predominantly offers large group learning options, a substantial number of physicians expressed interest in accessing new options such as personal study and on-line resources.

via Family physicians’ continuing professional development activities: current practices and potential for new options. – PubMed – NCBI.

MANUSCRIPT: How do junior medical officers use online information resources? A survey.

BACKGROUND:
Online information resources function dually as important learning tools and sources of the latest evidence-based recommendations for junior medical officers (JMOs). However, little is currently known about how JMOs utilise this information when providing care for their patients. This study aimed to examine the usage and experience of online information resources amongst JMOs in South Australia to ascertain (i) the type of resources accessed, (ii) the frequency, (iii) the intended purpose, and (iv) the perceived reliability.
METHODS:
A survey instrument using multiple choices, five-point Likert scales and free-text comments was developed and distributed through SurveyMonkey to South Australian JMOs between 1 May 2014 and 30 June 2014.
RESULTS:
Of the 142 surveyed, 100 JMOs (70.4 %) used online information resources as their first approach over all other resources available. JMOs overwhelmingly (94.4 %, n = 134) used online information resources at least once per day, with the most frequent purpose for use being information regarding prescription medication (82.4 %, n = 117, reported ‘very frequent’ use). JMOs stated online resources were necessary to perform their work and, of the different types of information accessed, they rated peer-reviewed resources as the most reliable.
CONCLUSIONS:
JMOs strongly rely upon online clinical information in their everyday practice. Importantly, provision of these resources assists JMOs in their education and clinical performance.

via How do junior medical officers use online information resources? A survey. – PubMed – NCBI.

ABSTRACT: Teaching residents: critical appraisal of the literature using a journal club format

OBJECTIVES:
Critical appraisal of the literature is an integral and important part of surgical practice, but can this skill be taught to young doctors? The purpose of this study was to investigate the effect of formal instruction regarding critical review and appraisal of journal articles, using junior surgical residents followed over the course of a 10-week long programme.
METHODS:
First-year surgical residents who participated in the department of orthopaedic surgery’s compulsory journal club evaluated one article per week for 10 weeks, using the reviewer guidelines and a scoring system currently used by Arthroscopy. The article was selected by a senior consultant orthopaedic surgeon and was provided for assessment to each resident the week prior. The scores and evaluation recommendation (accept, revise and reject) of the residents were then compared against the senior surgeon’s assessment. A contingency table and Fisher’s exact test was used to compare the frequency of agreement between the decisions of the senior surgeon and the residents.
RESULTS:
Twenty residents were included. Agreement in overall total assessment scores increased significantly (p=0.0001) from 49.5% at session 1 to 82.5% at session 10. When comparing the mean percentage of agreement of the first five sessions (61%) with the second five sessions (95%), a significant (p=0.03) increase was observed. The percentage of agreement with the senior surgeon (whether the article should be accepted, revised or rejected) improved from 0% for the first session to 60% at the last session (χ2=7.2-11.2, p=0.02-0.04).
CONCLUSIONS:
The results strongly suggest that a structured approach to the review and appraisal of journal articles using the format of a journal club significantly improves critical reading skills for first-year surgical residents.

via Teaching residents: critical appraisal of the literature using a journal club format. – PubMed – NCBI.

ABSTRACT: The flipped classroom stimulates greater learning and is a modern 21st century approach to teaching today’s undergraduates

Many classrooms in higher education still rely on a transformative approach to teaching where students attend lectures and earn course grades through examination. In the modern age, traditional lectures are argued by some as obsolete and do not address the learning needs of today’s students. An emerging pedagogical approach is the concept of the flipped classroom. The flipped classroom can simply be described as students viewing asynchronous video lectures on their own and then engaging in active learning during scheduled class times. In this study, we examined the flipped classroom teaching environment on student learning gains in an Introduction to Equine Science course. Students (n = 130) were asked to view 7.5 h of recorded lectures divided into 8 learning modules, take online quizzes to enforce lecture viewing, take 3 in-class exams, and prepare to participate in active learning during scheduled class times. Active learning approaches included individual activities, paired activities, informal small groups, and large group activities. When compared to students in the traditional lecture format in earlier years, students in the flipped format scored higher on all 3 exams (P < 0.05), with both formats taught by the same instructor. Analysis of ACT scores demonstrated no intellectual capacity differences between the student populations. To evaluate any gains in critical thinking, flipped format students were asked to take the Cornell Critical Thinking Exam (version X). Scores improved from the pretest (50.8 ± 0.57) to the posttest (54.4 ± 0.58; P < 0.01). In the flipped course, no correlations were found with student performance and interactions with online content. Students were asked in class to evaluate their experiences based on a 5-point Likert scale: 1 (strongly disagree) to 5 (strongly agree). The flipped classroom was ranked as an enjoyable learning experience with a mean of 4.4 ± 0.10, while students responded positively to other pointed questions. In formal course evaluations, flipped format students ranked the following higher (P < 0.05): instructor availability to assist students; encouragement of independent, creative, and critical thinking; and amount learned. Overall, the flipped classroom proved to be a positive learning experience for students. As the classroom continues to modernize, pedagogical approaches such as the flipped classroom should be considered for many lecture-style courses taught in the animal sciences.

via The flipped classroom stimulates greater learning and is a modern 21st century approach to teaching today’s undergraduates. – PubMed – NCBI.