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Author: Brian S McGowan, PhD

MANUSCRIPT: Creativity, Self-Directed Learning and the Architecture of Technology Rich Environments

So, how do institutions and designers develop environments that support self-directed learning? A majority of current research focuses on internal characteristics of self-directed learners. Yet gradually, we are  beginning to understand that external factors have an impact as well. Guglielmino (1977) noted that certain learning contexts are more effective at promoting self-directed learning. Learning environments that use technology in meaningful ways may have an important impact on self-directed learning, as they connect students to resources in ways that were not previously available (Candy, 2004). We can also look to “real-world” learning applications or problem-based learning environments, which allow “learners to engage in their own problems, by providing contextualized support, and by exploiting breakdowns as opportunities for learning” (Fischer and Scharff, 1998).

http://punya.educ.msu.edu/wp-content/uploads/2013/01/Mishra-Fahnoe-Henriksen-2013.pdf

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MANUSCRIPT: Use of SMART Learning Objectives to Introduce Continuing Professional Development Into the Pharmacy Curriculum

Abstract

OBJECTIVE:

To determine whether a 2-year continuing professional development (CPD) training program improved first-year (P1) and second-year (P2) pharmacy students’ ability to write SMART (specific, measurable, achievable, relevant, and timed) learning objectives.

DESIGN:

First-year students completed live or online CPD training, including creating portfolios and writing SMART objectives prior to their summer introductory pharmacy practice experience (IPPE). In year 2, P1 and P2 students were included. SMART learning objectives were graded and analyzed.

ASSESSMENT:

On several objectives, the 2011 P1 students (n = 130) scored higher than did the P2 cohort (n = 105). In 2011, P2 students outscored their own performance in 2010. In 2011, P1 students who had been trained in online modules performed the same as did live-session trainees with respect to SMART objectives.

CONCLUSION:

With focused online or live training, students are capable of incorporating principles of CPD by writing SMART learning objectives.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355288/

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ABSTRACT: Impact of online education on intern behaviour around joint commission national patient safety goals: a randomised trial — Shaw et al. 21 (10): 819 — BMJ Quality and Safety

Abstract
Purpose To compare the effectiveness of two types of online learning methodologies for improving the patient-safety behaviours mandated in the Joint Commission National Patient Safety Goals (NPSG).

Methods This randomised controlled trial was conducted in 2010 at Massachusetts General Hospital and Brigham and Women’s Hospital (BWH) in Boston USA. Incoming interns were randomised to either receive an online Spaced Education (SE) programme consisting of cases and questions that reinforce over time, or a programme consisting of an online slide show followed by a quiz (SQ). The outcome measures included NPSG-knowledge improvement, NPSG-compliant behaviours in a simulation scenario, self-reported confidence in safety and quality, programme acceptability and programme relevance.

Results Both online learning programmes improved knowledge retention. On four out of seven survey items measuring satisfaction and self-reported confidence, the proportion of SE interns responding positively was significantly higher (p<0.05) than the fraction of SQ interns. SE interns demonstrated a mean 4.79 (36.6%) NPSG-compliant behaviours (out of 13 total), while SQ interns completed a mean 4.17 (32.0%) (p=0.09). Among those in surgical fields, SE interns demonstrated a mean 5.67 (43.6%) NPSG-compliant behaviours, while SQ interns completed a mean 2.33 (17.9%) (p=0.015). Focus group data indicates that SE was more contextually relevant than SQ, and significantly more engaging.

Conclusion While both online methodologies improved knowledge surrounding the NPSG, SE was more contextually relevant to trainees and was engaging. SE impacted more significantly on both self-reported confidence and the behaviour of surgical residents in a simulated scenario.

via Impact of online education on intern behaviour around joint commission national patient safety goals: a randomised trial — Shaw et al. 21 (10): 819 — BMJ Quality and Safety.

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MANUSCRIPT: Towards comprehensive syntactic and semantic annotations of the clinical narrative — Albright et al. — Journal of the American Medical Informatics Association

Abstract
Objective To create annotated clinical narratives with layers of syntactic and semantic labels to facilitate advances in clinical natural language processing (NLP). To develop NLP algorithms and open source components.

Methods Manual annotation of a clinical narrative corpus of 127 606 tokens following the Treebank schema for syntactic information, PropBank schema for predicate-argument structures, and the Unified Medical Language System (UMLS) schema for semantic information. NLP components were developed.

Results The final corpus consists of 13 091 sentences containing 1772 distinct predicate lemmas. Of the 766 newly created PropBank frames, 74 are verbs. There are 28 539 named entity (NE) annotations spread over 15 UMLS semantic groups, one UMLS semantic type, and the Person semantic category. The most frequent annotations belong to the UMLS semantic groups of Procedures (15.71%), Disorders (14.74%), Concepts and Ideas (15.10%), Anatomy (12.80%), Chemicals and Drugs (7.49%), and the UMLS semantic type of Sign or Symptom (12.46%). Inter-annotator agreement results: Treebank (0.926), PropBank (0.891–0.931), NE (0.697–0.750). The part-of-speech tagger, constituency parser, dependency parser, and semantic role labeler are built from the corpus and released open source. A significant limitation uncovered by this project is the need for the NLP community to develop a widely agreed-upon schema for the annotation of clinical concepts and their relations.

Conclusions This project takes a foundational step towards bringing the field of clinical NLP up to par with NLP in the general domain. The corpus creation and NLP components provide a resource for research and application development that would have been previously impossible.

via Towards comprehensive syntactic and semantic annotations of the clinical narrative — Albright et al. — Journal of the American Medical Informatics Association.

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ABSTRACT: The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals — Wu et al. — Journal of the American Medical Informatics Association

Abstract
Background Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness.Objectives To describe the effects of different communication interventions and their problems.Design Prospective observational case study using a mixed methods approach of quantitative and qualitative methods.Setting General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals.Participants Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards.Methods Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010.Results We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories.Conclusions Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

via The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals — Wu et al. — Journal of the American Medical Informatics Association.

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MANUSCRIPT: How is a search system used in work task completion?

Abstract
Typically studies of information retrieval and interactive information retrieval concentrate on the identification of relevant items. In this study, rather than stop at finding relevant items, we considered how people use a search system in the completion of a broader work task. To conduct the study, we created 12 tasks that required multiple queries and document views in order to find enough information to complete the task. A total of 381 people completed three tasks each in a laboratory setting using the wikiSearch system that was embedded into WiIRE. Results found that two-thirds of time spent on the task was spent after finding a relevant set of documents sufficient for task completion, and that time was mainly spent reviewing documents that had already been retrieved. Findings suggest that an open-source information retrieval system, such as Lucene, was adequate for this task. However, the ultimate challenge will be in building useful systems that aid the user in extracting, interpreting and analysing information to achieve work task completion.

 

http://jis.sagepub.com/content/39/1/15.full.pdf html

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MANUSCRIPT: Academic self-efficacy: from educational theory to instructional practice [Perspect Med Educ. 2012] – PubMed – NCBI

Abstract
Self-efficacy is a personal belief in one’s capability to organize and execute courses of action required to attain designated types of performances. Often described as task-specific self-confidence, self-efficacy has been a key component in theories of motivation and learning in varied contexts. Furthermore, over the last 34 years, educational researchers from diverse fields of inquiry have used the notion of self-efficacy to predict and explain a wide range of human functioning, from athletic skill to academic achievement. This article is not a systematic review of the empirical research on self-efficacy; instead, its purpose is to describe the nature and structure of self-efficacy and provide a brief overview of several instructional implications for medical education. In doing so, this article is meant to encourage medical educators to consider and explicitly address their students’ academic self-efficacy beliefs in an effort to provide more engaging and effective instruction.

via Academic self-efficacy: from educational t… [Perspect Med Educ. 2012] – PubMed – NCBI.

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ABSTRACT: Federated queries of clinical data repositories: the sum of the parts does not equal the whole — Weber — Journal of the American Medical Informatics Association

Abstract
Background and objective In 2008 we developed a shared health research information network (SHRINE), which for the first time enabled research queries across the full patient populations of four Boston hospitals. It uses a federated architecture, where each hospital returns only the aggregate count of the number of patients who match a query. This allows hospitals to retain control over their local databases and comply with federal and state privacy laws. However, because patients may receive care from multiple hospitals, the result of a federated query might differ from what the result would be if the query were run against a single central repository. This paper describes the situations when this happens and presents a technique for correcting these errors.

via Federated queries of clinical data repositories: the sum of the parts does not equal the whole — Weber — Journal of the American Medical Informatics Association.

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ABSTRACT: Harnessing the cloud of patient experience: using social media to detect poor quality healthcare.

Abstract
Recent years have seen increasing interest in patient-centred care and calls to focus on improving the patient experience. At the same time, a growing number of patients are using the internet to describe their experiences of healthcare. We believe the increasing availability of patients’ accounts of their care on blogs, social networks, Twitter and hospital review sites presents an intriguing opportunity to advance the patient-centred care agenda and provide novel quality of care data. We describe this concept as a ‘cloud of patient experience’. In this commentary, we outline the ways in which the collection and aggregation of patients’ descriptions of their experiences on the internet could be used to detect poor clinical care. Over time, such an approach could also identify excellence and allow it to be built on. We suggest using the techniques of natural language processing and sentiment analysis to transform unstructured descriptions of patient experience on the internet into usable measures of healthcare performance. We consider the various sources of information that could be used, the limitations of the approach and discuss whether these new techniques could detect poor performance before conventional measures of healthcare quality.

via Harnessing the cloud of patient experience: usi… [BMJ Qual Saf. 2013] – PubMed – NCBI.

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