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Author: Brian S McGowan, PhD

ABSTRACT: Medical students’ online learning technology needs

Purpose
This study investigated medical students’ online learning technology needs at a medical school. The study aimed to provide evidence-based guidance for technology selection and online learning design in medical education.

Methods
The authors developed a 120-item survey in collaboration with the New Technology in Medical Education (NTIME) committee at the Southern Illinois University School of Medicine (SIUSOM). Overall, 123 of 290 medical students (42%) at the medical school participated in the survey. The survey focused on five major areas: students’ hardware and software use; perception of educational technology (ET) in general; online behaviours; perception of ET use at the school; and demographic information.

Results
Students perceived multimedia tools, scheduling tools, communication tools, collaborative authoring tools, learning management systems and electronic health records useful educational technologies for their learning. They did not consider social networking tools useful for their learning, despite their frequent use. Third-year students were less satisfied with current technology integration in the curriculum, information sharing and collaborative learning than other years. Students in clerkships perceived mobile devices as useful for their learning. Students using a mobile device (i.e. a smartphone) go online, text message, visit social networking sites and are online during classes more frequently than non-users.

Conclusions
Medical students’ ET needs differ between preclinical and clinical years. Technology supporting ubiquitous mobile learning and health information technology (HIT) systems at hospitals and out-patient clinics can be integrated into clerkship curricula.

via Medical students’ online learning technology needs – Han – 2014 – The Clinical Teacher – Wiley Online Library.

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Flipped Classrooms in Medical Education: A Resource Kit for Starters

Over the past 18 months our team has been exploring innovations in medical education with a keen eye directed to the emergence of flipped classrooms. This has allowed me to collate, filter, and identify what I think might be the top 12 resources one might need to begin to grasp the flipped experience both as it relates to students and faculty.

  1. San Jose State U. Says Replacing Live Lectures With Videos Increased Test Scores – Wired Campus – The Chronicle of Higher Education
  2. RESOURCE: The Flipped Classroom Guide for Teachers
  3. RESOURCE: Five Best Practices for the Flipped Classroom
  4. RESOURCE: 6 Expert Tips for Flipping the Classroom — Campus Technology
  5. MANUSCRIPT: Vodcasts and Active-Learning Exercises in a “Flipped Classroom” Model of a Renal Pharmacotherapy Module
  6. MANUSCRIPT: The Effect of the Flipped Classroom on Student Achievement and Stress 
  7. RESOURCE: Using the “flipped classroom” model to re-imagine medical education | Scope Blog (great video included and re-purposed below)
  8. RESOURCE: ‘Flipping’ Classrooms May Not Make Much Difference PLUS RESOURCE: Comment from member of research team on USA Today flipped classroom article
  9. RESOURCE: Gathering Evidence that Flipping the Classroom can Enhance Learning Outcomes | Emerging Education Technology
  10. RESOURCE: The MOOC School of Medicine
  11. Education and Healthcare Embrace a Digital and Interconnected World
  12. ABSTRACT: PBL and Beyond: Trends in Collaborative Learning

Beyond what I have shared above, there are 100’s of great resources available to you and your teams if you have the time to search them out, but beginning here should help you set a course, conceive a pilot, or understand the barriers to success.

In a separate post, I will be describing my recent experience Chairing a flipped workshop in conjunction with the Alliance for Continuing Education in the Health Professions entitled, “Journey to the Center of CE” – this was a tremendously successful and profitable endeavor for the Alliance, and the lessons learned should go a long way to giving you even more motivation to begin to leverage these types of innovations within your own programs.

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Surgical training 2.0: How contemporary developments in information technology can augment surgical training.

BACKGROUND:
The current surgical trainee is faced with reduced training time compared to predecessors as a result of changes in working practices. The past decade has seen marked developments in the information technology sector. This editorial will review how modern technological innovations could augment current surgical training.
METHODS:
We review the literature and summarize important developments in information technology that could assist the modern surgical trainee. We also look at some of the challenges faced by use of this technology.
FINDINGS:
Developments in mobile internet connectivity will improve access to online resources for the surgical trainee. Web 2.0 will revolutionise the way trainees interact with textbooks, journals, webpages and each other. Simulators could help to fill gaps created by reduced operating hours. To maximize the effectiveness of these resources they need to be accessible and incorporated into training in a structured way, ensuring patient safety and accuracy of information.
CONCLUSION:
Contemporary developments in technology offer benefits to the surgical trainee and could fill gaps left by reduced operating times. In order to ensure efficient use of technology and patient safety, bodies such as the Royal Colleges and Training Programmes must embrace these developments.

via Surgical training 2.0: How contemporary developments… [Surgeon. 2013] – PubMed – NCBI.

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Social media: the way forward or a waste of time for physicians?

Social media is everywhere; its use has grown exponentially over recent years. The prevalence of these outlets for communication raises some interesting and potentially risky issues for physicians. On the one hand, some believe that physicians should have a strong social media presence and can benefit greatly from access to a global community of peers and leaders through blogs, online forums, Facebook, Twitter and other communication channels. Dr Anne Marie Cunningham provides a strong case for the advantages of developing networks and figuring out who and what to pay attention to online. On the other hand however, others believe that the use of social media places doctors at a professional and ethical risk and is essentially a waste of time for the already time-pressured physician. Professor DeCamp argues that the risks of social media outweigh their benefits. It makes it more difficult to maintain a distinction between private and professional personas, and as we have seen, one mistyped or inappropriate comment can have potentially negative consequences when taken out of context. With an already time-pressured day, the priority should be patients, not tweets. Whatever your thoughts on the benefits and risks of social media, it is here to stay. Specific guidelines and guidance are needed to ensure that physicians who decide to join an online community reap the benefits of global communication, rather than regret it.

via Social media: the way forward or a… [J R Coll Physicians Edinb. 2013] – PubMed – NCBI.

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Basic steps in establishing effective small group teaching sessions in medical schools

Small-group teaching and learning has achieved an admirable position in medical education and has become more popular as a means of encouraging the students in their studies and enhance the process of deep learning. The main characteristics of small group teaching are active involvement of the learners in entire learning cycle and well defined task orientation with achievable specific aims and objectives in a given time period. The essential components in the development of an ideal small group teaching and learning sessions are preliminary considerations at departmental and institutional level including educational strategies, group composition, physical environment, existing resources, diagnosis of the needs, formulation of the objectives and suitable teaching outline. Small group teaching increases the student interest, teamwork ability, retention of knowledge and skills, enhance transfer of concepts to innovative issues, and improve the self-directed learning. It develops self-motivation, investigating the issues, allows the student to test their thinking and higher-order activities. It also facilitates an adult style of learning, acceptance of personal responsibility for own progress. Moreover, it enhances student-faculty and peer-peer interaction, improves communication skills and provides opportunity to share the responsibility and clarify the points of bafflement.

via Basic steps in establishing effective small gr… [Pak J Med Sci. 2013] – PubMed – NCBI.

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American board of medical specialties maintenance of certification: theory and evidence regarding the current framework

The American Board of Medical Specialties Maintenance of Certification Program (ABMS MOC) is designed to provide a comprehensive approach to physician lifelong learning, self-assessment, and quality improvement (QI) through its 4-part framework and coverage of the 6 competencies previously adopted by the ABMS and the Accreditation Council for Graduate Medical Education (ACGME). In this article, the theoretical rationale and exemplary empiric data regarding the MOC program and its individual parts are reviewed. The value of each part is considered in relation to 4 criteria about the relationship of the competencies addressed within that part to (1) patient outcomes, (2) physician performance, (3) validity of the assessment or educational methods utilized, and (4) learning or improvement potential. Overall, a sound theoretical rationale and a respectable evidence base exists to support the current structure and elements of the MOC program. However, it is incumbent on the ABMS and ABMS member boards to continue to examine their programs moving forward to assure the public and the profession that they are meeting expectations, are clinically relevant, and provide value to patients and participating physicians, and to refine and improve them as ongoing research indicates.

via American board of medical specialt… [J Contin Educ Health Prof. 2013] – PubMed – NCBI.

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The royal college experience and plans for the maintenance of certification program

The Royal College of Physicians and Surgeons of Canada, in 2001, implemented a mandatory maintenance of certification (MOC) program that is required for fellows to maintain membership and fellowship. Participation in the MOC program is one of the recognized pathways approved by provincial medical regulatory authorities in Canada by which specialists can demonstrate their commitment to continued competent performance in practice. This article traces the historical beginnings of the MOC program, highlighting the educational foundation and scientific evidence that influenced its philosophy, goals, and strategic priorities. The MOC program has evolved into a complex system of continuing professional development to facilitate and enable a “cultural shift” in how we conceptualize and support the continuing professional development (CPD) of specialists. The MOC program is an educational strategy that supports a learning culture where specialists are able to design, implement and document their accomplishments from multiple learning activities to build evidence-informed practices. In the future, the MOC Program must evolve from assisting fellows to use effective educational resources “for credit” to enable fellows, leveraging a competency-based CPD model, to demonstrate their capacity to continuously improve practice. This will require innovative methods to capture learning and practice improvements in real time, integrate learning during the delivery of health care, expand automation of reporting strategies, and facilitate new sociocultural methods of emergent learning and practice change. Collectively, these directions will require a research agenda that will generate evidence for how transformative cultural change in continuing professional education of the profession can be realized.

via The royal college experience and p… [J Contin Educ Health Prof. 2013] – PubMed – NCBI.

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What do primary care practitioners want to know? A content analysis of questions asked at the point of care

INTRODUCTION:
Assessing physician needs to develop continuing medical education (CME) activities is an integral part of CME curriculum development. The purpose of the present study was to demonstrate the feasibility of identifying areas of perceived greatest needs for continuing medical education (CME) by using questions collected electronically at the point of care.
METHODS:
This study is a secondary analysis of the “Just-in-Time” (JIT) information librarian consultation service database of questions using quantitative content analysis methods. The original JIT project demonstrated the feasibility of a real-time librarian service for answering questions asked by primary care clinicians at the point of care using a Web-based platform or handheld device. Data were collected from 88 primary care practitioners in Ontario, Canada, from October 2005 to April 2006. Questions were answered in less than 15 minutes, enabling clinicians to use the answer during patient encounters.
RESULTS:
Description of type and frequency of questions asked, including the organ system on which the questions focused, was produced using 2 classification systems, the “taxonomy of generic clinical questions” (TGCQ), and the International Classification for Primary Care version 2 (ICPC-2). Of the original 1889 questions, 1871 (99.0%) were suitable for analysis. A total of 970 (52%) of questions related to therapy; of these, 671 (69.2%) addressed questions about drug therapy, representing 36% of all questions. Questions related to diagnosis (24.8%) and epidemiology (13.5%) were also common. Organ systems questions concerning musculoskeletal, endocrine, skin, cardiac, and digestive systems were asked more than other categories.
DISCUSSION:
Questions collected at the point of care provide a valuable and unique source of information on the true learning needs of practicing clinicians. The TGCQ classification allowed us to show that a majority of questions had to do with treatment, particularly drug treatment, whereas the use of the ICPC-2 classification illustrated the great variety of questions asked about the diverse conditions encountered in primary care. It is feasible to use electronically collected questions asked by primary care clinicians in clinical practice to categorize self-identified knowledge and practice needs. This could be used to inform the development of future learning activities.

via What do primary care practitioners… [J Contin Educ Health Prof. 2013] – PubMed – NCBI.

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Palliative care education in US medical schools

CONTEXT:
Medical educators in the USA perceive the teaching of palliative care competencies as important, medical students experience it as valuable and effective, and demographic and societal forces fuel its necessity. Although it is encouraged by the Association of American Medical Colleges, the only palliative care-related mandate in US medical schools is the Liaison Committee on Medical Education directive that end-of-life (EoL) care be included in medical school curricula, reinforcing the problematic conflation of EoL and palliative care.
FINDINGS:
A review of US medical school surveys about the teaching of palliative and EoL care reveals varied and uneven approaches, ranging from 2 hours in the classroom on EoL to weeks of palliative care training or hospice-based clinical rotations.
IMPLICATIONS:
Palliative care competencies are too complex and universally important to be relegated to a minimum of classroom time, random clinical exposures, and the hidden curriculum.
RECOMMENDATIONS:
Given the reality of overstrained medical school curricula, developmentally appropriate, basic palliative care competencies should be defined and integrated into each year of the medical school curriculum, taking care to circumvent the twin threats of curricular overload and educational abandonment.

via Palliative care education in US medical schools. [Med Educ. 2014] – PubMed – NCBI.

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Quality of care of patients with non-small-cell lung cancer: a report of a performance improvement initiative

BACKGROUND:
Lung cancer is the leading cause of cancer deaths in the United States. In recent years, significant advancements have been made in the molecular characterization of tumors, and the availability of new agents to treat non-small-cell lung cancer has increased. Despite these achievements, optimal care of patients with this condition remains less than ideal. Although national quality measures and guideline recommendations provide the necessary framework for patient care, routine self-assessment of adherence to these measures is required for physician practice improvement. To this end, a performance improvement initiative that met national continuing medical education standards was designed.
METHODS:
Focusing on non-small-cell lung cancer patient care, oncologists underwent a three-step process that included a self-assessment of predetermined performance measures, the development and implementation of an actionable plan for improvement, and a second round of assessment to measure practice change.
RESULTS:
A total of 440 unique patient charts were reviewed by 22 practicing oncologists. Participants demonstrated high baseline performance levels of established quality measures, such as inclusion of the patient’s pathology report and assessment of smoking history. Significant gains were observed in the areas of supportive care, including assessment of the patient’s emotional well-being and the use of molecular markers in diagnostic and treatment decision making.
CONCLUSIONS:
Data from this study support the value of performance improvement initiatives to help increase physician delivery of evidence-based care to patients.

via Quality of care of patients with non-small-ce… [Cancer Control. 2014] – PubMed – NCBI.

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