MANUSCRIPT: Survey of e-learning implementation and faculty support strategies in a cluster of mid-European medical schools
Survey of e-learning implementation and faculty support strategies in a cluster of mid-European medical schools
MANUSCRIPT: Evaluation in medical education: A topical review of target parameters, data collection tools and confounding factors.
Evaluation in medical education: A topical review of target parameters, data collection tools and confounding factors.
ABSTRACT: Competency based medical education in gastrointestinal motility
raditional apprenticeship-based medical education methods focusing on subjective evaluations and case-volume requirements do not reliably produce clinicians that provide high-quality care in unsupervised practice. Consequently, training approaches are shifting towards competency based medical education, which incorporates robust assessment methods and credible standards of physician proficiency. However, current gastroenterology and hepatology training in the US continues to utilize procedural volume and global impressions without standardized criteria as markers of competence. In particular, efforts to optimize competency based training in gastrointestinal (GI) motility are not underway, even though GI motility disorders account for nearly half of outpatient gastroenterology visits. These deficiencies compromise the quality of patient care. Thus, there is a great need and opportunity to shift our focus in GI motility training towards a competency based approach. First, we need to clarify the variable rates of learning for individual diagnostic tests. We must develop integrated systems that standardize training and monitor physician competency for GI motility diagnostics. Finally, as a profession and society, we must create certification processes to credential competent physicians. These advances are critical to optimizing the quality of GI motility diagnostics in practice.
via Competency based medical education in gastrointestinal motility. – PubMed – NCBI.
MANUSCRIPT: Using the Flipped Classroom to Bridge the Gap to Generation Y
BACKGROUND:
The flipped classroom is a student-centered approach to learning that increases active learning for the student compared to traditional classroom-based instruction. In the flipped classroom model, students are first exposed to the learning material through didactics outside of the classroom, usually in the form of written material, voice-over lectures, or videos. During the formal teaching time, an instructor facilitates student-driven discussion of the material via case scenarios, allowing for complex problem solving, peer interaction, and a deep understanding of the concepts. A successful flipped classroom should have three goals: (1) allow the students to become critical thinkers, (2) fully engage students and instructors, and (3) stimulate the development of a deep understanding of the material. The flipped classroom model includes teaching and learning methods that can appeal to all four generations in the academic environment.
METHODS:
During the 2015 academic year, we implemented the flipped classroom in the obstetrics and gynecology clerkship for the Ochsner Clinical School in New Orleans, LA. Voice-over presentations of the lectures that had been given to students in prior years were recorded and made available to the students through an online classroom. Weekly problem-based learning sessions matched to the subjects of the traditional lectures were held, and the faculty who had previously presented the information in the traditional lecture format facilitated the problem-based learning sessions. The knowledge base of students was evaluated at the end of the rotation via a multiple-choice question examination and the Objective Structured Clinical Examination (OSCE) as had been done in previous years. We compared demographic information and examination scores for traditional teaching and flipped classroom groups of students. The traditional teaching group consisted of students from Rotation 2 and Rotation 3 of the 2014 academic year who received traditional classroom-based instruction. The flipped classroom group consisted of students from Rotation 2 and Rotation 3 of the 2015 academic year who received formal didactics via voice-over presentation and had the weekly problem-based learning sessions.
RESULTS:
When comparing the students taught by traditional methods to those taught in the flipped classroom model, we saw a statistically significant increase in test scores on the multiple-choice question examination in both the obstetrics and gynecology sections in Rotation 2. While the average score for the flipped classroom group increased in Rotation 3 on the obstetrics section of the multiple-choice question examination, the difference was not statistically significant. Unexpectedly, the average score on the gynecology portion of the multiple-choice question examination decreased among the flipped classroom group compared to the traditional teaching group, and this decrease was statistically significant. For both the obstetrics and the gynecology portions of the OSCE, we saw statistically significant increases in the scores for the flipped classroom group in both Rotation 2 and Rotation 3 compared to the traditional teaching group. With the exception of the gynecology portion of the multiple-choice question examination in Rotation 3, we saw improvement in scores after the implementation of the flipped classroom.
CONCLUSION:
The flipped classroom is a feasible and useful alternative to the traditional classroom. It is a method that embraces Generation Y’s need for active learning in a group setting while maintaining a traditional classroom method for introducing the information. Active learning increases student engagement and can lead to improved retention of material as demonstrated on standard examinations.
via Using the Flipped Classroom to Bridge the Gap to Generation Y. – PubMed – NCBI.
MANUSCRIPT: Flipping Radiology Education Right Side Up
RATIONALE AND OBJECTIVES:
In flipped learning, medical students independently learn facts and concepts outside the classroom, and then participate in interactive classes to learn to apply these facts. Although there are recent calls for medical education reform using flipped learning, little has been published on its effectiveness. Our study compares the effects of flipped learning to traditional didactic instruction on students’ academic achievement, task value, and achievement emotions.
MATERIALS AND METHODS:
At three institutions, we alternated flipped learning with traditional didactic lectures during radiology clerkships, with 175 medical students completing a pretest on general diagnostic imaging knowledge to assess baseline cohort comparability. Following instruction, posttests and survey examinations of task value and achievement emotions were administered. Linear mixed effects analysis was used to examine the relationship between test scores and instruction type. Survey responses were modeled using ordinal category logistic regression. Instructor surveys were also collected.
RESULTS:
There were no baseline differences in test scores. Mean posttest minus pretest scores were 10.5% higher in the flipped learning group than in the didactic instruction group (P = 0.013). Assessment of task value and achievement emotions showed greater task value, increased enjoyment, and decreased boredom with flipped learning (all P < 0.01). All instructors preferred the flipped learning condition.
CONCLUSIONS:
Flipped learning was associated with increased academic achievement, greater task value, and more positive achievement emotions when compared to traditional didactic instruction. Further investigation of flipped learning methods in radiology education is needed to determine whether flipped learning improves long-term retention of knowledge, academic success, and patient care.
via Flipping Radiology Education Right Side Up. – PubMed – NCBI.
ABSTRACT: Musculoskeletal Ultrasound Training for Radiology Residents: Lecture Versus Interactive Learning Module
RATIONALE AND OBJECTIVES:
A prospective randomized study was conducted to assess whether an electronic learning module was as effective as a didactic lecture to teach musculoskeletal ultrasound to radiology residents.
MATERIALS AND METHODS:
Thirty-three residents were randomized into a module group versus a didactic group. All residents took a written “pretest” to assess baseline knowledge. Subsequently, the 17 residents in the didactic group attended a live didactic session delivered by a subspecialist musculoskeletal radiology faculty member. The 16 residents in the module group completed an electronic learning module that contained similar content to the live didactic session. Finally, all residents completed a written “posttest,” which served as the outcome measure.
RESULTS:
Mean score significantly improved between pre- and posttest by 10.6 ± 11.2% in the didactic group (DG; P = 0.002) and 14.0 ± 8.2% in the module group (MG; P < 0.001), with a nonsignificant difference between groups (P = 0.4). Mean pretest scores (75.6 ± 9.4% DG and 73.7 ± 9.2% MG, P = 0.6) and posttest scores (86.2 ± 9.7% DG and 87.7 ± 5.2% MG, P = 0.5) were not significantly different. The adjusted mean difference in posttest scores between groups was -1.9% (95% confidence interval: -7.2 to 3.5%).
CONCLUSION:
If didactic training was better than electonic module training, the difference was relatively small (<5%). A similar web-based, interactive module could be employed to teach American Board of Radiology Core Examination and Accreditation Council for Graduate Medical Education (ACGME) Diagnostic Radiology Milestone musculoskeletal ultrasound learning objectives to radiology residents. An electronic module could reduce demands on faculty staff time invested in musculoskeletal ultrasound training and be more widely available to residents.
MANUSCRIPT: eLearning to facilitate the education and implementation of the Chelsea Critical Care Physical Assessment: a novel measure of function in critical illness
OBJECTIVE:
To evaluate the efficacy of eLearning in the widespread standardised teaching, distribution and implementation of the Chelsea Critical Care Physical Assessment (CPAx) tool-a validated tool to assess physical function in critically ill patients.
DESIGN:
Prospective educational study. An eLearning module was developed through a conceptual framework, using the four-stage technique for skills teaching to teach clinicians how to use the CPAx. Example and test video case studies of CPAx assessments were embedded within the module. The CPAx scores for the test case studies and demographic data were recorded in a secure area of the website. Data were analysed for inter-rater reliability using intraclass correlation coefficients (ICCs) to see if an eLearning educational package facilitated consistent use of the tool. A utility and content validity questionnaire was distributed after 1 year to eLearning module registrants (n=971). This was to evaluate uptake of the CPAx in clinical practice and content validity of the CPAx from the perspective of clinical users.
SETTING:
The module was distributed for use via professional forums (n=2) and direct contacts (n=95).
PARTICIPANTS:
Critical care clinicians.
PRIMARY OUTCOME MEASURE:
ICC of the test case studies.
RESULTS:
Between July and October 2014, 421 candidates from 15 countries registered for the eLearning module. The ICC for case one was 0.996 (95% CI 0.990 to 0.999; n=207). The ICC for case two was 0.988 (0.996 to 1.000; n=184). The CPAx has a strong total scale content validity index (s-CVI) of 0.94 and is well used.
CONCLUSIONS:
eLearning is a useful and reliable way of teaching psychomotor skills, such as the CPAx. The CPAx is a well-used measure with high content validity rated by clinicians.
ABSTRACT: Exploring the potential uses of value-added metrics in the context of postgraduate medical education
CONTEXT:
Increasing pressure is being placed on external accountability and cost efficiency in medical education and training internationally. We present an illustrative data analysis of the value-added of postgraduate medical education.
METHOD:
We analysed historical selection (entry) and licensure (exit) examination results for trainees sitting the UK Membership of the Royal College of General Practitioners (MRCGP) licensing examination (N = 2291). Selection data comprised: a clinical problem solving test (CPST); a situational judgement test (SJT); and a selection centre (SC). Exit data was an applied knowledge test (AKT) from MRCGP. Ordinary least squares (OLS) regression analyses were used to model differences in attainment in the AKT based on performance at selection (the value-added score). Results were aggregated to the regional level for comparisons.
RESULTS:
We discovered significant differences in the value-added score between regional training providers. Whilst three training providers confer significant value-added, one training provider was significantly lower than would be predicted based on the attainment of trainees at selection.
CONCLUSIONS:
Value-added analysis in postgraduate medical education potentially offers useful information, although the methodology is complex, controversial, and has significant limitations. Developing models further could offer important insights to support continuous improvement in medical education in future.
ABSTRACT: Connectivism: A knowledge learning theory for the digital age?
BACKGROUND:
The emergence of the internet, particularly Web 2.0 has provided access to the views and opinions of a wide range of individuals opening up opportunities for new forms of communication and knowledge formation. Previous ways of navigating and filtering available information are likely to prove ineffective in these new contexts. Connectivism is one of the most prominent of the network learning theories which have been developed for e-learning environments. It is beginning to be recognized by medical educators. This article aims to examine connectivism and its potential application.
CONTENT:
The conceptual framework and application of connectivism are presented along with an outline of the main criticisms. Its potential application in medical education is then considered.
CONCLUSIONS:
While connectivism provides a useful lens through which teaching and learning using digital technologies can be better understood and managed, further development and testing is required. There is unlikely to be a single theory that will explain learning in technological enabled networks. Educators have an important role to play in online network learning.
via Connectivism: A knowledge learning theory for the digital age? – PubMed – NCBI.
ABSTRACT: Charting a Key Competency Domain: Understanding Resident Physician Interprofessional Collaboration (IPC) Skills.
BACKGROUND:
Interprofessional collaboration (IPC) is essential for quality care. Understanding residents’ level of competence is a critical first step to designing targeted curricula and workplace learning activities. In this needs assessment, we measured residents’ IPC competence using specifically designed Objective Structured Clinical Exam (OSCE) cases and surveyed residents regarding training needs.
METHODS:
We developed three cases to capture IPC competence in the context of physician-nurse collaboration. A trained actor played the role of the nurse (Standardized Nurse – SN). The Interprofessional Education Collaborative (IPEC) framework was used to create a ten-item behaviorally anchored IPC performance checklist (scored on a three-point scale: done, partially done, well done) measuring four generic domains: values/ethics; roles/responsibilities; interprofessional communication; and teamwork. Specific skills required for each scenario were also assessed, including teamwork communication (SBAR and CUS) and patient-care-focused tasks. In addition to evaluating IPC skills, the SN assessed communication, history-taking and physical exam skills. IPC scores were computed as percent of items rated well done in each domain (Cronbach’s alpha > 0.77). Analyses include item frequencies, comparison of mean domain scores, correlation between IPC and other skills, and content analysis of SN comments and resident training needs.
RESULTS:
One hundred and seventy-eight residents (of 199 total) completed an IPC case and results are reported for the 162 who participated in our medical education research registry. IPC domain scores were: Roles/responsibilities mean = 37 % well done (SD 37 %); Values/ethics mean = 49 % (SD 40 %); Interprofessional communication mean = 27 % (SD 36 %); Teamwork mean = 47 % (SD 29 %). IPC was not significantly correlated with other core clinical skills. SNs’ comments focused on respect and IPC as a distinct skill set. Residents described needs for greater clarification of roles and more workplace-based opportunities structured to support interprofessional education/learning.
CONCLUSIONS:
The IPC cases and competence checklist are a practical method for conducting needs assessments and evaluating IPC training/curriculum that provides rich and actionable data at both the individual and program levels.
