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Author: Brian S McGowan, PhD

ABSTRACT: The Impact of Undergraduate Education in Radiation Oncology.

Abstract
Many medical practitioners provide care to patients for whom radiotherapy [radiation oncology (RO)] is a recommended treatment or who have received radiotherapy treatment for cancer. A basic level of understanding about this modality is important to ensure a continuum of good patient care. This study aimed to explore the current teaching practices in RO across medical schools in Canada and understand the perception of RO as a career choice among final-year medical students. Ethics approval and/or consent was obtained from each medical school prior to sending an electronic survey to the Undergraduate Medical Education office and to the final-year medical school class. Only six of the 14 Canadian medical schools participated in the surveys. Four of the 14 refused external surveys. The response rate was 8 % (155/1,917) for all final-year medical students and 17 % (155/897) for students from participating medical schools. Didactic lectures are the primary means of delivering RO knowledge. One in five students reports that they did not receive any RO teaching, and 65 % received <2 h. The level of interest in RO as a career choice (scale of 1-5) was greater in students who received >2 h of RO teaching (2.85 vs. 3.18, p = 0.012) and those that took part in a RO elective (2.86 vs. 3.53, p < 0.001). This study confirms the underrepresentation of RO teaching within the Canadian undergraduate medical curriculum. Interest in this specialty is minimal but does appear to be influenced by exposure to RO teaching. It is important to highlight the limitations of conducting a survey study within the Canadian medical undergraduate system. Steps to conduct such studies in a more seamless fashion are required, in order to assist curriculum development in RO and enhance the understanding of the specialty as a career choice.

via The Impact of Undergraduate Education in Radia… [J Cancer Educ. 2013] – PubMed – NCBI.

MANUSCRIPT: Learning the facts in medical school is not enough: which factors predict successful application of procedural knowledge in a laboratory setting?

Abstract
ABSTRACT:
BACKGROUND: Medical knowledge encompasses both conceptual (facts or “what” information) and procedural knowledge (“how” and “why” information). Conceptual knowledge is known to be an essential prerequisite for clinical problem solving. Primarily, medical students learn from textbooks and often struggle with the process of applying their conceptual knowledge to clinical problems. Recent studies address the question of how to foster the acquisition of procedural knowledge and its application in medical education. However, little is known about the factors which predict performance in procedural knowledge tasks. Which additional factors of the learner predict performance in procedural knowledge?
METHODS:
Domain specific conceptual knowledge (facts) in clinical nephrology was provided to 80 medical students (3rd to 5th year) using electronic flashcards in a laboratory setting. Learner characteristics were obtained by questionnaires. Procedural knowledge in clinical nephrology was assessed by key feature problems (KFP) and problem solving tasks (PST) reflecting strategic and conditional knowledge, respectively.
RESULTS:
Results in procedural knowledge tests (KFP and PST) correlated significantly with each other. In univariate analysis, performance in procedural knowledge (sum of KFP+PST) was significantly correlated with the results in (1) the conceptual knowledge test (CKT), (2) the intended future career as hospital based doctor, (3) the duration of clinical clerkships, and (4) the results in the written German National Medical Examination Part I on preclinical subjects (NME-I). After multiple regression analysis only clinical clerkship experience and NME-I performance remained independent influencing factors.
CONCLUSIONS:
Performance in procedural knowledge tests seems independent from the degree of domain specific conceptual knowledge above a certain level. Procedural knowledge may be fostered by clinical experience. More attention should be paid to the interplay of individual clinical clerkship experiences and structured teaching of procedural knowledge and its assessment in medical education curricula.

via Learning the facts in medical school is not eno… [BMC Med Educ. 2013] – PubMed – NCBI.

ABSTRACT: Education and training of pain medicine specialists in the United States.

Abstract
Many pain patients present with a complex set of symptoms and comorbidities that defy the acumen of any one specific medical specialty; thus the knowledge and skills of the pain physician must, out of necessity cross specialty borders. The competency that comes from mastering essential skills is accomplished during the pain medicine training. The goal of pain medicine training in the United States is to provide the postgraduate trainee with the exposure to multiple disciplines of medicine, as well as multiple interventions, so that upon completion of training, the pain physician will have the necessary skill set to provide competent, appropriate, comprehensive care for the often medically complicated pain patient. In the United States, many training programs are governed by guidelines that have been established by the Accreditation Council for Graduate Medical Education (ACGME).

via Education and training of pain medici… [Eur J Phys Rehabil Med. 2013] – PubMed – NCBI.

RESOURCE: The Future Of Education Eliminates The Classroom, Because The World Is Your Class

We are moving away from the model in which learning is organized around stable, usually hierarchical institutions (schools, colleges, universities) that, for better and worse, have served as the main gateways to education and social mobility. Replacing that model is a new system in which learning is best conceived of as a flow, where learning resources are not scarce but widely available, opportunities for learning are abundant, and learners increasingly have the ability to autonomously dip into and out of continuous learning flows.

Instead of worrying about how to distribute scarce educational resources, the challenge we need to start grappling with in the era of socialstructed learning is how to attract people to dip into the rapidly growing flow of learning resources and how to do this equitably, in order to create more opportunities for a better life for more people.

via The Future Of Education Eliminates The Classroom, Because The World Is Your Class | Co.Exist: World changing ideas and innovation.

ABSTRACT: Health-related hot topic detection in online communities using text clustering.

Abstract
Recently, health-related social media services, especially online health communities, have rapidly emerged. Patients with various health conditions participate in online health communities to share their experiences and exchange healthcare knowledge. Exploring hot topics in online health communities helps us better understand patients’ needs and interest in health-related knowledge. However, the statistical topic analysis employed in previous studies is becoming impractical for processing the rapidly increasing amount of online data. Automatic topic detection based on document clustering is an alternative approach for extracting health-related hot topics in online communities. In addition to the keyword-based features used in traditional text clustering, we integrate medical domain-specific features to represent the messages posted in online health communities. Three disease discussion boards, including boards devoted to lung cancer, breast cancer and diabetes, from an online health community are used to test the effectiveness of topic detection. Experiment results demonstrate that health-related hot topics primarily include symptoms, examinations, drugs, procedures and complications. Further analysis reveals that there also exist some significant differences among the hot topics discussed on different types of disease discussion boards.

via Health-related hot topic detection in online commun… [PLoS One. 2013] – PubMed – NCBI.

MANUSCRIPT: Fixed or mixed? a comparison of three, four and mixed-option multiple-choice tests in a Fetal Surveillance Education Program

Background
Despite the widespread use of multiple-choice assessments in medical education assessment, current practice and published advice concerning the number of response options remains equivocal. This article describes an empirical study contrasting the quality of three 60 item multiple-choice test forms within the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Fetal Surveillance Education Program (FSEP). The three forms are described below.

Methods
The first form featured four response options per item. The second form featured three response options, having removed the least functioning option from each item in the four-option counterpart. The third test form was constructed by retaining the best performing version of each item from the first two test forms. It contained both three and four option items.

Results
Psychometric and educational factors were taken into account in formulating an approach to test construction for the FSEP. The four-option test performed better than the three-option test overall, but some items were improved by the removal of options. The mixed-option test demonstrated better measurement properties than the fixed-option tests, and has become the preferred test format in the FSEP program. The criteria used were reliability, errors of measurement and fit to the item response model.

Conclusions
The position taken is that decisions about the number of response options be made at the item level, with plausible options being added to complete each item on both psychometric and educational grounds rather than complying with a uniform policy. The point is to construct the better performing item in providing the best psychometric and educational information.

via BMC Medical Education | Abstract | Fixed or mixed? a comparison of three, four and mixed-option multiple-choice tests in a Fetal Surveillance Education Program.

What if learning, doing, and sharing were one action in healthcare?

I have gotten a lot of great feedback on a blog post I wrote last summer on my person blog, ‘I tweet because it simplifies learning.’

In that post I talk about what I call the 3R’s of adult learning: recording, reexposure, and redistribution and I talk about how we must build a learning architecture for ourselves that supports each of the R’s. It is a great feeling to know that more and more people are thinking about how social technologies accomplish this and can support professional development and learning. And, I received a lot of great examples of what people see as the strengths and the weaknesses of their own learning architectures.

But as I talked with these folks about the 3R’s and as I learned about how they are trying to leverage these lessons as individual learners and across their organizations, it struck me that learning is only the beginning of the story that I tell in my book, #socialQI: Simple Solutions for Improving Your Healthcare and folks need to stay open to the critical necessity of connecting learning to action.

Both the book and my personal blog are intended to explore QI, or ‘quality improvement’ and therefore they focus on the need to move beyond learning and to begin to understand how new learning  and knowledge management models might support healthcare quality and performance.

Remember my basic hypothesis: by exploring the intersection of social learning and behavior change science we can make new strides in quality improvement and healthcare outcomes.

At the heart of the #SocialQI model is the idea that by connecting the act of learning, doing, and sharing we can build a better ‘rapid learning healthcare system.‘ When stated this concisely perhaps the model seems more approachable, and maybe that is part of the secret – the elements of the model are not in and of themselves disruptive, instead it is the unwavering commitment to connect the elements that changes the game and it is the new vision for how we connect them that some may see as disruptive.

In medicine, the acts of learning, doing, and sharing are almost never linked to one another. Each act is discreet. ‘Learning’ is largely seen as an individual endeavor. ‘Doing’ is complicated by a myriad of system-based complications. And ‘sharing’…well sharing has never really been a key element of medicine.

But what happens when we have the systems in place and the healthcare culture has shifted to the point that learning, doing, and sharing can all become one action? Or, at least, when connected learning, doing, and sharing become the expectation and the norm? We are getting closer and closer to answering these questions everyday. Each day new technologies are engineered and each day new structured models systems are being piloted. ArcheMedx has engineered one such model, I explore several others in the book, but there are hundreds more from which to learn.

Importantly, we each have a role in this progress, and this is the take-away message of this post: You must begin to consider how you and your teams are connecting the acts of learning, doing, and sharing. Find opportunities to do so. Report back to the community.

If I have learned anything in the past year as I conceived and developed the SocialQI model and as Joel and I conceived and launched ArcheMedX its that the best solutions almost always arise from the collective intelligence of the community (thereby proving my hypothesis).

My hope is that we can find enough passionate participants to drive the changes we need in the healthcare system, before the next time any of us need the healthcare system we are trying to change.

RESOURCE: MOOC completion and drop-out rates

One of the main MOOC challenges: MOOC drop-out
As drop-out rates are one of the main MOOC challenges, this research is a gift. For insight in the drop-out rates can provide angles for improvement, increased retention … So, looking forward to follow Katy’s research. And have a look at the wonderful set of papers she has written, including using semantic web technologies… inspiring stuff!

To me, I feel that MOOCs are also a way to improve expert learning, so not necessarily linked to assessments and such. It is more about lifelong learning, getting information to enhance personal knowledge for professional reasons. But that … is another research all together. For at that point, you cannot look at assessments to indicate completion. For the expert MOOCs might have lurkers (= people that do not actively engage in MOOC interactions, but do follow what is going on) that actually have found what they were looking for, learning without interacting, and those lurkers would be part of the learners finishing the course (but how to analyse that?!).

via @Ignatia Webs: MOOC completion and drop-out rates.

RESOURCE: Online Learning and the Future of Residential Education | March 3-4, 2013 | Video

The Summit Program Committee recommends the following reading in advance of the event.

“The Particle Accelerator of Learning” (Inside Higher Ed, Peter Stokes, February 22, 2013)
“Four Professors Discuss Teaching Free Online Courses for Thousands of Students” (The Chronicle of Higher Education, Jeffrey Young, June 11, 2012)
“What We’re Learning from Online Education” (Daphne Koller, TED Talk, June 2012)
“Learning from MOOCS” (Inside Higher Ed, January 24, 3013)
“How Harvard’s CS50 Renewed My Hope for Online Education” (Modern Wanderlust blog, Erik Trautma, January 6, 2013)
“After the gold rush: MOOCs are augmenting rather than replacing formal educational models” (LSE Impact of Social Science, January 16, 2013)
“Beyond MOOCs Into Greater Openness” (Library Journal, Steven Bell, January 9, 2013)
“Online Courses Create New Learning Methods” (The Dartmouth, Stephanie McFeeters, January 17, 2013)
“Researchers, MOOCs, and Online Programs” (Inside Higher Ed, Joshua Kim, January 14, 2013)
“edX in the Community College: The MassBay Experience” (Campus Technology, Mary Grush, January 9, 2013)
“Revolution Hits the Universities” (The New York Times, Thomas Friedman, January 26, 2013)
“The Year of the MOOC” (The New York Times, November 2, 2012)
“Online Courses Look for a Business Model” (The Wall Street Journal, Melissa Korn and Jennifer Levitz, January 1, 2013)
“Public Universities to Offer Free Online Classes for Credit” (The New York Times, Tamar Lewin, January 23, 2013)
“California to Give Web Courses a Big Trial” (The New York Times, Tamar Lewin and John Markoff, January 15, 2013)
“Unishared: Revolution in Online Education Beyond Coursera, Edx, and Udacity” (Forbes, Ricardo Geromel, September 17, 2012)
“The MOOC Model: Challenging Traditional Education” (Educause, January 28, 2013)
“Massive Open Online Course (MOOC) Library” (Educause)
“Carnegie, the Founder of the Credit-Hour, Seeks its Makeover” (The Chronicle of Higher Education, December 5, 2012)
“Who Benefits from Online Ed?” (Inside Higher Education, February 25, 2013)
“The ‘Cost Disease’ in Higher Education: Is Technology the Answer?” (William G. Bowen, The Tanner Lectures, Stanford University, October 2012)

via Online Learning and the Future of Residential Education | March 3-4, 2013 | Video.

MANUSCRIPT: A student authored online medical education textbook: editing patterns and content evaluation of a medical student wiki.

Abstract
The University of Minnesota medical student wiki (UMMedWiki) allows students to collaboratively edit classroom notes to support medical education. Since 2007, UMMedWiki has grown to include 1,591 articles that have collectively received 1.2 million pageviews. Although small-scale wikis have become increasingly important, little is known about their dynamics compared to large wikis, such as Wikipedia. To better understand UMMedWiki’s management and its potential reproducibility at other medical schools, we used an edit log with 28,000 entries to evaluate the behavior of its student editors. The development of tools to survey UMMedwiki allows for quality comparisons that improve both the wiki and the curriculum itself. We completed a content survey by comparing the UMMedWiki with two types of rubric data: TIME, a medical education taxonomy consisting of 1500 terms and national epidemiological data on 2,100 diseases.

via A student authored online medical educat… [AMIA Annu Symp Proc. 2011] – PubMed – NCBI.