MENUCLOSE

 

Connect with us

Author: Brian S McGowan, PhD

MANUSCRIPT: Identifying high quality medical education websites in Otolaryngology: a guide for medical students and residents

BACKGROUND:
Learners often utilize online resources to supplement formalized curricula, and to appropriately support learning, these resources should be of high quality. Thus, the objectives of this study are to develop and provide validity evidence supporting an assessment tool designed to assess the quality of educational websites in Otolaryngology- Head & Neck Surgery (ORL-HNS), and identify those that could support effective web-based learning. METHODS: After a literature review, the Modified Education in Otolaryngology Website (MEOW) assessment tool was designed by a panel of experts based on a previously validated website assessment tool. A search strategy using a Google-based search engine was used subsequently to identify websites. Those that were free of charge and in English were included. Websites were coded for whether their content targeted medical students or residents. Using the MEOW assessment tool, two independent raters scored the websites. Inter-rater and intra-rater reliability were evaluated, and scores were compared to recommendations from a content expert.
RESULTS:
The MEOW assessment tool included a total of 20 items divided in 8 categories related to authorship, frequency of revision, content accuracy, interactivity, visual presentation, navigability, speed and recommended hyperlinks. A total of 43 out of 334 websites identified by the search met inclusion criteria. The scores generated by our tool appeared to differentiate higher quality websites from lower quality ones: websites that the expert “would recommend” scored 38.4 (out of 56; CI [34.4-42.4]) and “would not recommend” 27.0 (CI [23.2-30.9]). Inter-rater and intra-rater intraclass correlation coefficient were greater than 0.7.
CONCLUSIONS:
Using the MEOW assessment tool, high quality ORL-HNS educational websites were identified.

via Identifying high quality medical education websites in Otolaryngology: a guide for medical students and residents. – PubMed – NCBI.

Backward Planning, Adult Learning Theory, and the Learning Actions Model

Over the past few years I have been working on the theory that learning IS a behavior – in other words, not only does learning lead to behavior changes (as classically believed), but learning requires learners to take actions (behaviors) that allow them to learn. To be clear, the idea that learning IS a behavior is not quite the same thing as active learning, which is understood to be a cognitive concept. My work instead suggests that there are physical (and necessary) actions that learners must take to support the learning process.

Once you acknowledge that learning IS a behavior then you should immediately recognize a new universe of greater complexity that challenges learning and teaching. For everything we know about adult learning theory, there is little doubt that behavior change has got its own challenges – you’d be hard pressed to find someone that can’t share a lifetime of stories of struggling to commit to healthy or productive behaviors (vs the unhealthy and unproductive ones). On the other hand, once you acknowledge that learning IS a behavior then you can immediately benefit from decades of research about human behavior and behavioral economics (e.g., irrationality, mindfulness, and nudges, etc…).

My professional curiosity and scholarly exploration of adult learning theory AND behavioral science is what lead me to originally envision the Learning Actions Model and eventually co-found ArcheMedX allowing me to first establish and then extend this science over the past five years.

Connecting the dots
The Learning Actions Model allows faculty and educational planners to connect backward educational planning, adult learning theory, AND behavioral science to simplify and accelerate learning. It serves to address a critical missing piece of andragogy and suggests that learners, though self-directed, struggle to efficiently and effectively take the actions that support the process of learning. For this reason, the Learning Actions Model is both complimentary and necessary.

Undoubtedly, both the backward educational planning process and adult learning theory are essential to effective educational interventions. Identifying desired outcomes, then deconstructing gaps, needs, and objectives should point an educational planner in the right direction. Likewise, understanding that learners are self-directed, emotionally driven, and skeptical; and that knowledge is formed by connecting new information to prior experiences; should help direct the narrative of the educational content. However the long-held belief that backward educational planning process and adult learning theory are the cornerstones of education and training has proven incomplete. The Learning Actions Model has demonstrated that once presented with educational content, learners struggle to structure the information and take the actions that catalyze (and underpin) the process of learning.

During an educational experience – whether live, online, mentored, or even informal – a learner must take notes, set reminders, search for related information; and they must do so in a way that mitigates extraneous load – but they don’t. We have now demonstrated this reality across tens of thousands of learners.

Here is your take-away message: Learners desperately need help learning. They try, they struggle… and our educational interventions rarely achieve our desired results. As with so many of the behavioral struggles we each face, as learners we don’t always make the right choices or take the right actions at the right time. In short, learners need to be nudged to take action, to have their attention reset, to be made mindful of what is ultimately most important. We can no longer assume that these ‘learning moments’ are natural, or intuitive, or conspicuous – they aren’t.

Without the Learning Actions Model shaping the learning experiences we plan, develop, and deliver; we are relying on a learner skillset that we have demonstrated IS NOT readily available.

Without the Learning Actions Model shaping the learning experiences we plan, develop, and deliver; we are (in)effectively operating with one arm tied behind our back.

Instead, once we commit to connect the backward educational planning process and adult learning theory to the Learning Actions Model we now have three cornerstones to build on.

ABSTRACT: Examining the July Effect: A National Survey of Academic Leaders in Medicine

BACKGROUND:
Whether the “July Effect” affects perspectives or has prompted changes in US Internal Medicine residency programs is unknown.
METHODS:
We designed a survey-based study to assess views and efforts aimed at preventing harm in July. A convenience sampling strategy (email listserv and direct messages to program leaders via the Electronic Residency Application Service) was used to disseminate the survey.
RESULTS:
The response rate was 16% (65/418 programs); however, a total of 262 respondents from all 50 states where residency programs are located were included. Most respondents (n = 201; 77%) indicated that errors occur more frequently in July compared with other months. The most common identified errors included incorrect or delayed orders (n = 183, 70% and n = 167, 64%, respectively), errors in discharge medications (n = 144, 55%), and inadequate information exchange at handoffs (n = 143, 55%). Limited trainee experience (n = 208, 79%), lack of understanding hospital workflow, and difficulty using electronic medical record systems (n = 194; 74% and n = 188; 72%, respectively) were reported as the most common factors contributing to these errors. Programs reported instituting several efforts to prevent harm in July: for interns, additional electronic medical record training (n = 178; 68%) and education on handoffs and discharge processes (n = 176; 67% and n = 108; 41%, respectively) were introduced. Similarly, for senior residents, teaching sessions on how to lead a team (n = 158; 60%) and preferential placement of certain residents on harder rotations (n = 103; 39%) were also reported. Most respondents (n = 140; 53%) also solicited specific “July attendings” using a volunteer system or highest teaching ratings.
CONCLUSION:
Residency programs in Internal Medicine appear to have instituted various changes to mitigate harm in July. Further evaluation to understand the impact of these interventions on trainee education and patient safety is necessary.

via Examining the July Effect: A National Survey of Academic Leaders in Medicine. – PubMed – NCBI.

MANUSCRIPT: Resource format preferences across the medical curriculum

Objective: This research study sought to determine the formats (print or electronic) of articles and book chapters most-preferred by first-year medical students, third-year medical students entering clinical clerkships, and incoming residents and to determine if these preferences change during the course of the medical curriculum. These trends will enable academic health sciences libraries to make appropriate collection development decisions to best cater to their user populations.

Methods: First-year medical students, third-year medical students, and incoming medical residents were asked to complete a paper survey from September 2014 to June 2015. The survey consisted of five multiple-choice questions, with two questions given space for optional short answers. Quantitative and qualitative responses were collected and calculated using Microsoft Excel.

Results: First-year students, third-year students, and incoming residents all preferred to read journal articles and book chapters in print, except in cases where the article or book chapter is under ten pages in length. Although print is preferred, demand for electronic articles and book chapters increases as students progress from undergraduate medical education into residency. The only category where a majority of incoming residents chose an electronic resource was which format they would give to a colleague, if the article or book chapter was critical to the care of an individual patient.

Conclusions: The preference for print resources is strong across the medical curriculum, although residents show an increased preference for electronic materials when compared to first- and third-year students. Academic health sciences libraries should take these preferences into account when making decisions regarding collection development.

To access the full article, click here….

 

MANUSCRIPT: Continuing Medical Education Speakers with High Evaluation Scores Use more Image-based Slides

Introduction: Although continuing medical education (CME) presentations are common across health professions, it is unknown whether slide design is independently associated with audience evaluations of the speaker. Based on the conceptual framework of Mayer’s theory of multimedia learning, this study aimed to determine whether image use and text density in presentation slides are associated with overall speaker evaluations.

Methods: This retrospective analysis of six sequential CME conferences (two annual emergency medicine conferences over a three-year period) used a mixed linear regression model to assess whether postconference speaker evaluations were associated with image fraction (percentage of image-based slides per presentation) and text density (number of words per slide).

Results: A total of 105 unique lectures were given by 49 faculty members, and 1,222 evaluations (70.1% response rate) were available for analysis. On average, 47.4% (SD=25.36) of slides had at least one educationally-relevant image (image fraction). Image fraction significantly predicted overall higher evaluation scores [F(1, 100.676)=6.158, p=0.015] in the mixed linear regression model. The mean (SD) text density was 25.61 (8.14) words/slide but was not a significant predictor [F(1, 86.293)=0.55, p=0.815]. Of note, the individual speaker [χ2 (1)=2.952, p=0.003] and speaker seniority [F(3, 59.713)=4.083, p=0.011] significantly predicted higher scores.

Conclusion: This is the first published study to date assessing the linkage between slide design and CME speaker evaluations by an audience of practicing clinicians. The incorporation of images was associated with higher evaluation scores, in alignment with Mayer’s theory of multimedia learning. Contrary to this theory, however, text density showed no significant association, suggesting that these scores may be multifactorial. Professional development efforts should focus on teaching best practices in both slide design and presentation skills.

 

Access to the full article here….

RESOURCE: Learning Styles: A Misguided Attempt to Highlight Individual Differences in Learners

In today’s blog post, I would like to give a summary of a review paper by An and Carr (2) that was recently published and that caught my attention. I find their review interesting because they highlight an important and new criticism of the learning styles approach: They state that “learning styles theories are a blend of borrowed constructs or measures from other, better-developed theories”. They further claim that within the learning styles framework, these borrowed constructs are misused and incorrectly interpreted leading to detrimental and useless recommendations. In this review, an attempt is made to connect existing learning styles concepts back to actual evidence-based concepts of human cognition and tie them to helpful recommendations for teachers. It acknowledges that there are individual differences between learners, but not as conceptualized by the learning styles approach.

via Learning Styles: A Misguided Attempt to Highlight Individual Differences in Learners — The Learning Scientists.

ABSTRACT: Audio-visual aid in teaching “fatty liver”

Use of audio visual tools to aid in medical education is ever on a rise. Our study intends to find the efficacy of a video prepared on “fatty liver,” a topic that is often a challenge for pre-clinical teachers, in enhancing cognitive processing and ultimately learning. We prepared a video presentation of 11:36 min, incorporating various concepts of the topic, while keeping in view Mayer’s and Ellaway guidelines for multimedia presentation. A pre-post test study on subject knowledge was conducted for 100 students with the video shown as intervention. A retrospective pre study was conducted as a survey which inquired about students understanding of the key concepts of the topic and a feedback on our video was taken. Students performed significantly better in the post test (mean score 8.52 vs. 5.45 in pre-test), positively responded in the retrospective pre-test and gave a positive feedback for our video presentation. Well-designed multimedia tools can aid in cognitive processing and enhance working memory capacity as shown in our study. In times when “smart” device penetration is high, information and communication tools in medical education, which can act as essential aid and not as replacement for traditional curriculums, can be beneficial to the students.

via Audio-visual aid in teaching “fatty liver”. – PubMed – NCBI.

ABSTRACT: Twelve tips for developing and delivering a massive open online course in medical education

Massive open online courses (MOOCs) are a novel mode of online learning. They are typically based on higher education courses and can attract a high number of learners, often in the thousands. They are distinct from on-campus education and deliver the learning objectives through a series of short videos, recommended readings and discussion fora, alongside automated assessments. Within medical education the role of MOOCs remains unclear, with recent proposals including continuing professional development, interprofessional education or integration into campus-based blended learning curricula. In this twelve tips article, we aim to provide a framework for readers to use when developing, delivering and evaluating a MOOC within medical education based on the literature and our own experience. Practical advice is provided on how to design the appropriate curriculum, engage with learners on the platform, select suitable assessments, and comprehensively evaluate the impact of your course.

via Twelve tips for developing and delivering a massive open online course in medical education. – PubMed – NCBI.

ABSTRACT: Twelve tips for reducing production time and increasing long-term usability of instructional video

The use of instructional video is increasing across all disciplines and levels of education. Although video has a number of distinct advantages for course delivery and student learning, it can also be time-consuming and resource-intensive to produce, which imposes a burden on busy faculty. With video poised to play a larger role in medical education, we need strategies for streamlining video production and ensuring that the video we produce is of lasting value. This article draws on learning research and best practices in educational technology, along with the author’s experience in online education and video production. It offers 12 practical tips for reducing the initial time investment in video production and creating video that can be reused long into the future. These tips can help faculty and departments create high-quality instructional video while using their time and resources more wisely.

via Twelve tips for reducing production time and increasing long-term usability of instructional video. – PubMed – NCBI.

ABSTRACT: A systematic review of the effectiveness of flipped classrooms in medical education

CONTEXT:
There are inconsistent claims made about the effectiveness of the flipped classroom (FC) in medical education; however, the quality of the empirical evidence used to back up these claims is not evident. The aims of this review are to examine the scope and quality of studies on the FC teaching approach in medical education and to assess the effects of FCs on medical learning.
METHODS:
A literature search was conducted using the major electronic databases in 2016. Peer-reviewed papers were screened and reviewed according to explicit inclusion criteria. The scope and quality of all resultant studies were evaluated. Studies identified as using controlled designs were further synthesised to assess the effects of FCs on learning.
RESULTS:
A total of 118 articles were obtained. Full texts of 82 articles were reviewed. Nine of the included 46 articles used a controlled design when examining the effects of the FC. There were generally positive perceptions of the FC approach. However, the effects of FCs on changes in knowledge and skills were less conclusive as the effect sizes ranged from d = -0.27 to 1.21, with a median of 0.08. The varying direction and magnitude of the effect sizes, together with their 95% confidence interval, which contained zero, suggested the lack of strong evidence for the effectiveness of FCs in promoting knowledge acquisition above and beyond the traditional learning methods.
CONCLUSIONS:
There has been a recent increase of research rigor and variety in measures of effectiveness in studies on the FC in medical education. The FC is a promising teaching approach to increase learners’ motivation and engagement. More solid evidence on its effect on changes in knowledge and skills are warranted. Further studies should also examine the long-term effects of FCs with regard to knowledge retention and transfer of knowledge to professional practice and patient care.

via A systematic review of the effectiveness of flipped classrooms in medical education. – PubMed – NCBI.