MENUCLOSE

 

Connect with us

Author: Brian S McGowan, PhD

MANUSCRIPT: A real-time locating system observes physician time-motion patterns during walk-rounds: a pilot study

BACKGROUND:
Walk-rounds, a common component of medical education, usually consist of a combination of teaching outside the patient room as well as in the presence of the patient, known as bedside teaching. The proportion of time dedicated to bedside teaching has been declining despite research demonstrating its benefits. Increasing complexities of patient care and perceived impediments to workflow are cited as reasons for this declining use. Research using real-time locating systems (RTLS) has been purported to improve workflow through monitoring of patients and equipment. We used RTLS technology to observe and track patterns of movement of attending physicians during a mandatory once-weekly medical teaching team patient care rounding session endorsed as a walk-rounds format.
METHODS:
During a project to assess the efficacy of RTLS technology to track equipment and patients in a clinical setting, we conducted a small-scale pilot study to observe attending physician walk-round patterns during a mandatory once-weekly team rounding session. A consecutive sample of attending physicians on the unit was targeted, eight agreed to participate. Data collected using the RTLS were pictorially represented as linked points overlaying a floor plan of the unit to represent each physician’s motion through time. Visual analysis of time-motion was independently performed by two researchers and disagreement resolved through consensus. Rounding events were described as a sequence of approximate proportions of time engaged within or outside patient rooms.
RESULTS:
The patient care rounds varied in duration from 60 to 425 minutes. Median duration of rounds within patient rooms was approximately 33% of total time (range approximately 20-50%). Three general time-motion rounding patterns were observed:a first pattern that predominantly involved rounding in ward hallways and little time in patient rooms; a second pattern that predominantly involved time in a ward conference room; and a third balanced pattern characterized by equal proportions of time in patient rooms and in ward hallways.
CONCLUSIONS:
Observation using RTLS technology identified distinct time-motion rounding patterns that hint at differing rounding styles across physicians. Future studies using this technology could examine how the division of time during walk-rounds impacts outcomes such as patient satisfaction, learner satisfaction, and physician workflow.

via A real-time locating system observes physician … [BMC Med Educ. 2014] – PubMed – NCBI.

ABSTRACT: How we “breathed life” into problem-based learning cases using a mobile application

Background: Problem-based learning (PBL) has been widely adopted in medical education. Learners become bored with paper-based cases as they progress through their studies. Aim: To breathe life (i.e. develop virtual patients) into paper-based PBL cases. Methods: The “patients” in paper-based PBL cases in one Year 2 were transformed into virtual patients by simulated patients role-playing and the videos and associated patient data uploaded to Bond’s Virtual Hospital, a mobile Application. In unsupervised “clinical teams”, second-year students undertook “ward rounds” twice a week, prompted by a virtual consultant and registered nurse. Immediately following the “ward rounds”, they met with a clinician facilitator to discuss their “patients”. Results: Apart from some minor technical issues, the experience was rated positively by students and clinical facilitators. They claimed that it provided students with a sense of what happens in the real world of medicine. The group work skills students had developed during PBL stood them in good stead to self-manage their “clinical teams”. Conclusions: This more authentic PBL experience will be extended to earlier semesters as well as later in the curriculum as the virtual hospital can be used to expose learners to a profile of patients that may not be guaranteed during hospital rounds.

via How we “breathed life” into problem-based learning… [Med Teach. 2014] – PubMed – NCBI.

ABSTRACT: Motivating student learning using a formative assessment journey

Providing formative assessment opportunities has been recognised as a significant benefit to student learning. The outcome of any formative assessment should be one that ultimately helps improve student learning through familiarising students with the levels of learning required, informing them about gaps in their learning and providing feedback to guide the direction of learning. This article provides an example of how formative assessments can be developed into a formative assessment journey where a number of different assessments can be offered to students during the course of a module of teaching, thus utilising a spaced-education approach. As well as incorporating the specific drivers of formative assessment, we demonstrate how approaches deemed to be stimulating, interactive and entertaining with the aim of maximising enthusiasm and engagement can be incorporated. We provide an example of a mixed approach to evaluating elements of the assessment journey that focuses student reaction, appraisal of qualitative and quantitative feedback from student questionnaires, focus group analysis and teacher observations. Whilst it is not possible to determine a quantifiable effect of the assessment journey on student learning, usage data and student feedback shows that formative assessment can achieve high engagement and positive response to different assessments. Those assessments incorporating an active learning element and a quiz-based approach appear to be particularly popular. A spaced-education format encourages a building block approach to learning that is continuous in nature rather than focussed on an intense period of study prior to summative examinations.

via Motivating student learning using a formative assessm… [J Anat. 2014] – PubMed – NCBI.

ABSTRACT: Fun, collaboration and formative assessment: Skinquizition, a class wide gaming competition in a medical school with a large class.

Background: Formative assessments are tools for assessing content retention, providing valuable feedback to students and teachers. In medical education, information technology-supported games can accommodate large classes divided into student teams while fostering active engagement. Aim: To establish an innovative stimulating approach to formative assessments for large classes furthering collaborative skills that promotes learning and student engagement linked to improvement of academic performance. Methods and results: Using audience response technology, a fast-paced, competitive, interactive quiz game involving dermatology was developed. This stimulating setting, provided on the last day of class, prepares students for high-stakes exams to continue their medical education while training collaborative skills as supported by survey outcomes and average class scores. Summary and conclusions: Educational game competitions provide formative assessments and feedback for students and faculty alike, enhancing learning and teaching processes. In this study, we show an innovative approach to accommodate a large class divided into competing teams furthering collaborative skills reflected by academic performance.

via Fun, collaboration and formative assessment: Skinq… [Med Teach. 2014] – PubMed – NCBI.

MANUSCRIPT: OnlineTED.com – a novel web-based audience response system for higher education. A pilot study to evaluate user acceptance.

Background and aim: Audience response (AR) systems are increasingly used in undergraduate medical education. However, high costs and complexity of conventional AR systems often limit their use. Here we present a novel AR system that is platform independent and does not require hardware clickers or additional software to be installed. Methods and results: “OnlineTED” was developed at Technische Universität München (TUM) based on Hypertext Preprocessor (PHP) with a My Structured Query Language (MySQL)-database as server- and Javascript as client-side programming languages. “OnlineTED” enables lecturers to create and manage question sets online and start polls in-class via a web-browser. Students can participate in the polls with any internet-enabled device (smartphones, tablet-PCs or laptops). A paper-based survey was conducted with undergraduate medical students and lecturers at TUM to compare “OnlineTED” with conventional AR systems using clickers. “OnlineTED” received above-average evaluation results by both students and lecturers at TUM and was seen on par or superior to conventional AR systems. The survey results indicated that up to 80% of students at TUM own an internet-enabled device (smartphone or tablet-PC) for participation in web-based AR technologies. Summary and Conclusion: “OnlineTED” is a novel web-based and platform-independent AR system for higher education that was well received by students and lecturers. As a non-commercial alternative to conventional AR systems it may foster interactive teaching in undergraduate education, in particular with large audiences.

via OnlineTED.com – a novel web-based audience… [GMS Z Med Ausbild. 2014] – PubMed – NCBI.

ABSTRACT: National standards in pathology education: developing competencies for integrated medical school curricula

Context.-Medical school education has evolved from department-specific memorization of facts to an integrated curriculum presenting knowledge in a contextual manner across traditional disciplines, integrating information, improving retention, and facilitating application to clinical practice. Integration occurs throughout medical school using live data-sharing technologies, thereby providing the student with a framework for lifelong active learning. Incorporation of educational teams during medical school prepares students for team-based patient care, which is also required for pay-for-performance models used in accountable care organizations. Objective.-To develop learning objectives for teaching pathology to medical students. Given the rapid expansion of basic science knowledge of human development, normal function, and pathobiology, it is neither possible nor desirable for faculty to teach, and students to retain, this vast amount of information. Courses teaching the essentials in context and engaging students in the learning process enable them to become lifelong learners. An appreciation of pathobiology and the role of laboratory medicine underlies the modern practice of medicine. As such, all medical students need to acquire 3 basic competencies in pathology: an understanding of disease mechanisms, integration of mechanisms into organ system pathology, and application of pathobiology to diagnostic medicine. Design.-We propose the development of 3 specific competencies in pathology to be implemented nationwide, aimed at disease mechanisms/processes, organ system pathology, and application to diagnostic medicine. Each competency will include learning objectives and a means to assess acquisition, integration, and application of knowledge. The learning objectives are designed to be a living document managed (curated) by a group of pathologists representing Liaison Committee on Medical Education-accredited medical schools nationally. Conclusions.-Development of a coherent set of learning objectives will assist medical students nationally to gain the basic competencies in pathology necessary for clinical practice. Having national standards for competencies preserves schools’ independence in specific curriculum design while assuring all students meet the evolving needs of medical practice.

via National standards in pathology educatio… [Arch Pathol Lab Med. 2014] – PubMed – NCBI.

MANUSCRIPT: The effectiveness of continuing medical education for specialist recertification

Evolving professional, social and political pressures highlight the importance of lifelong learning for clinicians. Continuing medical education CME facilitates lifelong learning and is a fundamental factor in the maintenance of certification. The type of CME differs between surgical and non-surgical specialties. CME methods of teaching include lectures, workshops, conferences and simulation training. Interventions involving several modalities, instructional techniques and multiple exposures are more effective. The beneficial effects of CME can be maintained in the long term and can improve clinical outcome. However, quantitative evidence on validity, reliability, efficacy and cost-effectiveness of various methods is lacking. This is especially evident in urology. The effectiveness of CME interventions on maintenance of certification is also unknown. Currently, many specialists fulfil mandatory CME credit requirements opportunistically, therefore erroneously equating number of hours accumulated with competence. New CME interventions must emphasize actual performance and should correlate with clinical outcomes. Improved CME practice must in turn lead to continuing critical reflection, practice modification and implementation with a focus towards excellent patient care.

via The effectiveness of continuing medical edu… [Can Urol Assoc J. 2013] – PubMed – NCBI.

RESOURCE: Study: Massive Online Courses Enroll An Average Of 43,000 Students, 10% Completion

Massively Open Online Courses are becoming more mainstream, as more top-tier universities give the public access to their courses. A new study demonstrates continued wide-spread popularity with part-time students looking to substitute otherwise cat-video-filled downtime with ivy league lectures.

Examining public data from 279 courses from the most popular MOOC providers Udacity, Coursera, edX, researcher Katy Jordan finds that the average course enrolls about 43,000 students. About 6.5% of those stick around ’til the end. When looking at the number of students who engaged at least a little bit with course materials, the number of completion jumps to 9.8%.

via Study: Massive Online Courses Enroll An Average Of 43,000 Students, 10% Completion | TechCrunch.

EdTechReview’s ‘149 Amazing Google Tricks to Increase Effectiveness of your Search’

Here is a great resource that we might consider building CE around as a means of supporting the lifelong, natural learning actions of clinicians (and I bet you will want to share this with your colleagues too):

EXCERPT:
Google is the most popular search engine and most of the people use it daily for a variety of
purposes. People simply enter what they’re looking for and sift through the results to find
the desired information. A lot of them are unaware of how really powerful the Google
search engine is and that there are a myriad of tricks and tips that will help them get better
and faster results and save their time and efforts. I have compiled 149 amazing Google
149 Google Tips Thumbnailtricks to increase effectiveness of your search. Here’s [some highlights from] the list:

2. Find public data: Google stores public data like data about population or employment
rate. Enter what you need to find along with the name of your country and Google will
display accurate results.

4. Search within a site: Narrow down your results within a site by searching for (search
query) site: (domain).

9. Search specific file types: Search for PDF, doc, Power Point files by adding a filetype: ‘type’ modifier to your search string.

12. Use Google as a calculator: Google has a built-in calculator function. Enter a calculation into the search box, and you’ll get the answer.

16. Get rid of unwanted search results: If you get irrelevant results for a certain term, you can exclude that term by minusing it from the term you want to look for. Enter, your term–unwanted term.

18. Search by voice: Speak out words after tapping the microphone button on your Google search box, to search by speech.

21. Keep finding great sources: If you like a particular website, and would like to find more of the type, just do a related search on Google. Enter “related:site address” and it will direct you to other such similar sites.

26. Stop stalking the FedEx guy: Track packages from USPS, FedEx, and UPS just by typing your tracking number directly into Google.

33. Search within a url: Discover information within a URL just by using, ‘inurl:urladdress’.

There is so many amazing tips in this review and they are each linked to additional information that should allow you to implement the tip without much effort…download the full list of tips here

Hope this helps,

Brian

ReachMD Interview with ArcheMedX CLO, Dr. Brian S. McGowan

I had the pleasure of being interviewed on ReachMD as a part of their lifelong learning series. In this short interview topics range from Khan Academy to coaching to personal learning networks to doom loops in learning.

(And please pardon the unsightly picture of my throat, apparently SoundCloud’s embed functionality is acting up!)

You can access this interview, as well as the complete ReachMD series on lifelong learning, by registering or logging into ReachMD HERE.

My thanks go out to Lawrence Sherman and the team at ReachMD for the opportunity and for their professional approach to supporting these endeavors.