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Author: Brian S McGowan, PhD

ABSTRACT: Social media and anatomy education: Using twitter to enhance the student learning experience in anatomy

Neuroanatomy is a difficult subject in medical education, with students often feeling worried and anxious before they have even started, potentially decreasing their engagement with the subject. At the University of Southampton, we incorporated the use of Twitter as a way of supporting students’ learning on a neuroanatomy module to evaluate how it impacted upon their engagement and learning experience. The #nlm2soton hashtag was created and displayed (via a widget) on the university’s virtual learning environment (VLE) for a cohort of 197 Year 2 medical students studying neuroanatomy. Student usage was tracked to measure levels of engagement throughout the course and frequency of hashtag use was compared to examination results. Student opinions on the use of Twitter were obtained during a focus group with eleven students and from qualitative questionnaires. The hashtag was used by 91% of the student cohort and, within this, more students chose to simply view the hashtag rather than make contributions. The completed questionnaire responses (n = 150) as well as focus group outcomes revealed the value of using Twitter. A negligible correlation was found between student examination scores and their viewing frequency of the hashtag however, no correlation was found between examination scores and contribution frequency. Despite this, Twitter facilitated communication, relieved anxieties and raised morale, which was valued highly by students and aided engagement with neuroanatomy. Twitter was successful in creating and providing a support network for students during a difficult module

via Social media and anatomy education: Using twitter to enhance the student learning experience in anatomy. – PubMed – NCBI.

MANUSCRIPT: Accuracy and readability of cardiovascular entries on Wikipedia: are they reliable learning resources for medical students?

Objective To evaluate accuracy of content and readability level of English Wikipedia articles on cardiovascular diseases, using quality and readability tools.Methods Wikipedia was searched on the 6 October 2013 for articles on cardiovascular diseases. Using a modified DISCERN (DISCERN is an instrument widely used in assessing online resources), articles were independently scored by three assessors. The readability was calculated using Flesch-Kincaid Grade Level. The inter-rater agreement between evaluators was calculated using the Fleiss κ scale.Results This study was based on 47 English Wikipedia entries on cardiovascular diseases. The DISCERN scores had a median=33 (IQR=6). Four articles (8.5%) were of good quality (DISCERN score 40–50), 39 (83%) moderate (DISCERN 30–39) and 4 (8.5%) were poor (DISCERN 10–29). Although the entries covered the aetiology and the clinical picture, there were deficiencies in the pathophysiology of diseases, signs and symptoms, diagnostic approaches and treatment. The number of references varied from 1 to 127 references; 25.9±29.4 (mean±SD). Several problems were identified in the list of references and citations made in the articles. The readability of articles was 14.3±1.7 (mean±SD); consistent with the readability level for college students. In comparison, Harrison’s Principles of Internal Medicine 18th edition had more tables, less references and no significant difference in number of graphs, images, illustrations or readability level. The overall agreement between the evaluators was good (Fleiss κ 0.718 (95% CI 0.57 to 0.83).Conclusions The Wikipedia entries are not aimed at a medical audience and should not be used as a substitute to recommended medical resources. Course designers and students should be aware that Wikipedia entries on cardiovascular diseases lack accuracy, predominantly due to errors of omission. Further improvement of the Wikipedia content of cardiovascular entries would be needed before they could be considered a supplementary resource.

via Accuracy and readability of cardiovascular entries on Wikipedia: are they reliable learning resources for medical students? — Azer et al. 5 (10) — BMJ Open.

ABSTRACT: E-Learning in Urology: Implementation of the Learning and Teaching Platform CASUS

BACKGROUND:
E-learning is playing an increasing role in medical education, supporting a problem-based and practical oriented education without putting patients at risk and compensating for the decrease in instructor-centered teaching. Not much research has been done concerning learning effects and reaction on behalf of the students.
METHODS:
We created computer-based cases for four important diagnoses in urology using the authoring system CASUS®. Fourth-year medical school students were randomized into two groups: (1) the CASUS® group, using the online cases for preparation, and (2) the book group, using a textbook. A multiple-choice test referring to the prepared topic had to be completed at the beginning of each lecture and the results were analyzed. Evaluation of the students concerning the acceptance of the program was done at the end of the semester.
RESULTS:
Members of the CASUS® group scored significantly higher with an average of 20% better test results than students using textbooks for preparation. Evaluation regarding the program showed a highly positive rating. Limitations include the small study population and the possibly biased test performance of the students.
CONCLUSION:
Computerized patient cases facilitate practice-oriented teaching and result in an interesting and engaging learning model with improved learning outcomes.

via E-Learning in Urology: Implementation of the Learning and Teaching Platform CASUS® – Do Virtual Patients Lead to Improved Learning Outcomes? A Rand… – PubMed – NCBI.

ABSTRACT: A Survey of Simulation Utilization in Anesthesiology Residency Programs in the United States

Given the evolution of competency-based education and evidence supporting the benefits of incorporating simulation into anesthesiology residency training, simulation will likely play an important role in the training and assessment of anesthesiology residents. Currently, there are little data available regarding the current status of simulation-based curricula across US residency programs. In this study, we assessed simulation-based training and assessment in US anesthesiology programs using a survey designed to elicit information regarding the type, frequency, and content of the simulation courses offered at the 132 Accreditation Council of Graduate Medical Education-certified anesthesiology training programs. The response rate for the survey was 66%. Although most of the responding programs offered simulation-based courses for interns and residents and during CA-1 orientation, the curriculum varied greatly among programs. Approximately 40% of responding programs use simulation for resident assessment and remediation. The majority of responding programs favored standard simulation-based training as part of residency training (89%), and the most common perceived obstacles to doing so were time, money, and human resources. The results from this survey highlight that there are currently large variations in simulation-based training and assessment among training programs. It also confirms that many program directors feel that standardizing some components of simulation-based education and assessment would be beneficial. Given the positive impact simulation has on skill retention and operating room preparedness, it may be worthwhile to consider developing a standard curriculum.

via A Survey of Simulation Utilization in Anesthesiology Residency Programs in the United States. – PubMed – NCBI.

ABSTRACT: Toward Data-Driven Radiology Education-Early Experience Building Multi-Institutional Academic Trainee Interpretation Log Database (MATILDA)

The residency review committee of the Accreditation Council of Graduate Medical Education (ACGME) collects data on resident exam volume and sets minimum requirements. However, this data is not made readily available, and the ACGME does not share their tools or methodology. It is therefore difficult to assess the integrity of the data and determine if it truly reflects relevant aspects of the resident experience. This manuscript describes our experience creating a multi-institutional case log, incorporating data from three American diagnostic radiology residency programs. Each of the three sites independently established automated query pipelines from the various radiology information systems in their respective hospital groups, thereby creating a resident-specific database. Then, the three institutional resident case log databases were aggregated into a single centralized database schema. Three hundred thirty residents and 2,905,923 radiologic examinations over a 4-year span were catalogued using 11 ACGME categories. Our experience highlights big data challenges including internal data heterogeneity and external data discrepancies faced by informatics researchers

via Toward Data-Driven Radiology Education-Early Experience Building Multi-Institutional Academic Trainee Interpretation Log Database (MATILDA). – PubMed – NCBI.

ABSTRACT: Comparison of the learning curves and frustration level in performing laparoscopic and robotic training skills by experts and novices

INTRODUCTION:
Robotic assistance may provide for distinct technical advantages over conventional laparoscopic technique. The goals of this study were (1) to objectively evaluate the difference in the learning curves by novice and expert surgeons in performing fundamental laparoscopic skills using conventional laparoscopic surgery (CLS) and robotic-assisted laparoscopic surgery (RALS) and (2) to evaluate the surgeons’ frustration level in performing these tasks.
METHODS:
Twelve experienced and 31 novices in laparoscopy were prospectively evaluated in performing three standardized laparoscopic tasks in five consecutive, weekly training sessions. Analysis of the learning curves was based on the magnitude, rate, and quickness in performance improvement. The participant’s frustration and mood were also evaluated during and after every session.
RESULTS:
For the novice participants, RALS allowed for shorter time to task completion and greater accuracy. However, significant and rapid improvement in performance as measured by magnitude, rate, and quickness at each session was also seen with CLS. For the experienced surgeons, RALS only provided a slight improvement in performance. For all participants, the use of RALS was associated with less number of sessions in which they felt frustrated, less number of frustration episodes during a session, lower frustration score during and after the session, and higher good mood score.
CONCLUSION:
The advantages of RALS may be of most benefit when doing more complex tasks and by less experienced surgeons. RALS should not be used as a replacement for CLS but rather in specific situations in which it has the greatest advantages.

via Comparison of the learning curves and frustration level in performing laparoscopic and robotic training skills by experts and novices. – PubMed – NCBI.

ABSTRACT: Novel Uses of Video to Accelerate the Surgical Learning Curve

Surgeons are under enormous pressure to continually improve and learn new surgical skills. Novel uses of surgical video in the preoperative, intraoperative, and postoperative setting are emerging to accelerate the learning curve of surgical skill and minimize harm to patients. In the preoperative setting, social media outlets provide a valuable platform for surgeons to collaborate and plan for difficult operative cases. Live streaming of video has allowed for intraoperative telementoring. Finally, postoperative use of video has provided structure for peer coaching to evaluate and improve surgical skill. Applying these approaches into practice is becoming easier as most of our surgical platforms (e.g., laparoscopic, and endoscopy) now have video recording technology built in and video editing software has become more user friendly. Future applications of video technology are being developed, including possible integration into accreditation and board certification.

via Novel Uses of Video to Accelerate the Surgical Learning Curve. – PubMed – NCBI.

ABSTRACT: Rapid Development and Deployment of Ebola Readiness Training Across an Academic Health System: The Critical Role of Simulation Education, Consulting, and Systems Integration

In this article, we describe an Ebola preparedness initiative with implementation across an academic health system. Key stakeholder centers of various disciplines and clinical experts collaborated in the development and design. Subject matter experts in the areas of Centers for Disease Control and Prevention and World Health Organization protocols for personal protective equipment donning and doffing conducted initial train-the-trainer sessions for program instructors. These trainers represented a cross-section of key clinical responders and environmental services. Through a parallel development process, a blended learning curriculum consisting of online modules followed by on-site training sessions was developed and implemented in both the simulation laboratory and the actual clinical care spaces in preparation for a Department of Health inspection. Lessons learned included identification of the need for iterative refinement based on instructor and trainee feedback, the lack of tolerance of practitioners in wearing full-body personal protective equipment for extended periods, and the ability of a large system to mount a rapid response to a potential public health threat through leveraging of expertise of its Simulation Program, Center for Quality, Safety and Innovation as well as a wide variety of clinical departments.

via Rapid Development and Deployment of Ebola Readiness Training Across an Academic Health System: The Critical Role of Simulation Education, Consultin… – PubMed – NCBI.

ABSTRACT: Improving Depression Care Through an Online Learning Collaborative

Depression is a leading cause of disability worldwide, and many internists diagnose and treat depression. This study aimed to examine the impact of a practice improvement intervention on screening and managing patients with depression in primary care. This pre–post study design included a physician practice survey designed to capture what the physicians believed they were doing in practice, a chart audit tool to capture what physicians were actually doing in practice, and an intervention that included an evidence-based educational program, online toolkit, and practice improvement coaching conference calls that promoted group learning. Following completion of the intervention, participants increasingly used the Patient Health Questionnaire-9 to detect, diagnose, and gauge treatment success for depression and reported increased use of guidelines and team-based care. Although barriers to improving depression care exist, this study suggests that evidence-based quality improvement programs can positively affect practice.

via Improving Depression Care Through an Online Learning Collaborative.