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Author: Brian S McGowan, PhD

ABSTRACT: Associations between teaching effectiveness and participant self-reflection in continuing medical education.

Effective medical educators can engage learners through self-reflection. However, little is known about the relationships between teaching effectiveness and self-reflection in continuing medical education (CME). We aimed to determine associations between presenter teaching effectiveness and participant self-reflection in conference-based CME. This cross-sectional study evaluated presenters and participants at a national CME course. Participants provided CME teaching effectiveness (CMETE) ratings and self-reflection scores for each presentation. Overall CMETE and CME self-reflection scores (five-point Likert scale with one as strongly disagree and five as strongly agree) were averaged for each presentation. Correlations were measured among self-reflection, CMETE, and presentation characteristics. In total, 624 participants returned 430 evaluations (response, 68.9%) for the 38 presentations. Correlation between CMETE and self-reflection was medium (Pearson correlation, 0.3-0.5) or large (0.5-1.0) for most presentations (n = 33, 86.9%). Higher mean (SD) CME reflection scores were associated with clinical cases (3.66 [0.12] vs. 3.48 [0.14]; p = 0.003) and audience response (3.66 [0.12] vs. 3.51 [0.14]; p = 0.005). To our knowledge, this is the first study to show a relationship between teaching effectiveness and participant self-reflection in conference-based CME. Presenters should consider using clinical cases and audience response systems to increase teaching effectiveness and promote self-reflection among CME learners.

via Associations between teaching effectiveness and participant self-reflection in continuing medical education. – PubMed – NCBI.

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ABSTRACT: Continuing professional development: putting the learner back at the centre.

Continuing professional development (CPD) is changing. Once seen as flexible on the basis of personal choice and mainly consisting of conferences and lecture style meetings, it is now much more likely to be specified, mandatory and linked to specific regulatory or quality improvement activities. This may not be well aligned with how adult professionals learn best and the evidence of resulting change in practice is limited. Also there is a danger of losing out on serendipity in learning by pushing experienced professionals into focusing excessively on mandatory activities that seem to be increasingly ‘ticking the box’. However, the previous impression of flexibility may have hidden poor education practice. This paper defines CPD and asks whether there are problems with CPD. It looks at how adults are thought to learn and places this in the context of current practice. It considers practical models of how to deal with a series of common challenges met by those who provide and undertake CPD.

via Continuing professional development: putting the learner back at the centre. – PubMed – NCBI.

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ABSTRACT: Why assessment in medical education needs a solid foundation in modern test theory.

Despite the frequent use of state-of-the-art psychometric models in the field of medical education, there is a growing body of literature that questions their usefulness in the assessment of medical competence. Essentially, a number of authors raised doubt about the appropriateness of psychometric models as a guiding framework to secure and refine current approaches to the assessment of medical competence. In addition, an intriguing phenomenon known as case specificity is specific to the controversy on the use of psychometric models for the assessment of medical competence. Broadly speaking, case specificity is the finding of instability of performances across clinical cases, tasks, or problems. As stability of performances is, generally speaking, a central assumption in psychometric models, case specificity may limit their applicability. This has probably fueled critiques of the field of psychometrics with a substantial amount of potential empirical evidence. This article aimed to explain the fundamental ideas employed in psychometric theory, and how they might be problematic in the context of assessing medical competence. We further aimed to show why and how some critiques do not hold for the field of psychometrics as a whole, but rather only for specific psychometric approaches. Hence, we highlight approaches that, from our perspective, seem to offer promising possibilities when applied in the assessment of medical competence. In conclusion, we advocate for a more differentiated view on psychometric models and their usage.

via Why assessment in medical education needs a solid foundation in modern test theory. – PubMed – NCBI.

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Irrationality – undermining learning for millennia

This past Tuesday was March 14th – or 3/14 – otherwise known as Pi Day. Here in the Northeast US, Pi Day was wretched, bringing 10-30 inches of snow, layered with three inches of sleet. As I write this there is a 3-foot tall, nearly concrete, pile of ice at the end of my driveway and a 8-foot tall mound of  brownish-gray ice at the end of my cul de sac…it has been an unexpected (and unwanted) reminder of harsh realities of winter…and humanity…and vulnerability…

As one does in such circumstances, I used this ‘down’ time to reflect on the science of learning 😉

I have written previously about ‘nudges’ here, here, and here – as well as exploring the idea of ‘learning as a behavior‘…but given the irrationality of Pi Day, I am not sure I set up the foundational reality of these ideas – so let me take a moment to do just that:

“We usually think of ourselves as sitting the driver’s seat, with ultimate control over the decisions we made and the direction our life takes; but, alas, this perception has more to do with our desires-with how we want to view ourselves-than with reality” – Dan Ariely, Predictably Irrational: The Hidden Forces That Shape Our Decisions

To ultimately understand why learning is undermined without supporting the Learning Actions Model, one needs to come to grips with the reality that learners (humans) often have a limited control over their decisions (behaviors). We are victims of a myriad of biases that mislead us and result in us being ‘predictably irrational’.

“We all want explanations for why we behave as we do and for the ways the world around us functions. Even when our feeble explanations have little to do with reality. We tell ourselves story after story until we come up with an explanation that we like and that sounds reasonable enough to believe. And when the story portrays us in a more glowing and positive light, so much the better.” ― Dan Ariely, The Honest Truth About Dishonesty: How We Lie to Everyone – Especially Ourselves

Just like we all know that exercise is a rational behavior (in our best interests), we struggle to exercise regularly. And, just like committing to a good diet is a rational behavior (in our best interests), we struggle to eat healthy. So it is true with the natural learning actions – the universal and necessary actions of learning are clearly ‘in our best interests’ and yet our research demonstrates that learners (humans) often fail to commit effectively to these behaviors. As a result, learning is undermined…over and over and over again.

Importantly, this is NOT a damning statement about failed learners – it is a simple recognition of human irrationality – and more than that, it is an eye-opening opportunity.

This is why the learning architecture that we have engineered is so critical to supporting effective educational experiences – quite simply, the irrationality of learners prevents them from effectively committing to the learning actions that are in their best interests…and understanding this empowers educators to ensure that the structure and nudges for better learning behaviors are always available.

 

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RESOURCE: Some CME experts remain skeptical on social media

SPEED, COST, and ACCESSIBILITY

What makes social media an attractive CME tool is its accessibility and low cost, not to mention the speed with which it prompts immediate interaction, notes Brian McGowan, cofounder and chief learning officer of ArcheMedX, a healthcare e-learning company. Michael Leis, SVP, social strategy at Digitas Health LifeBrands, agrees, noting the excitement that comes with creating a live community.

At the same time, CME experts remain somewhat skeptical, not merely about the Facebook Live CME course, but about the value and effectiveness of social media-driven CME in the bigger picture.

“If I’m an accredited provider, I could go onto Facebook and run a one-hour educational program on the repeal of Obamacare, and the course could be up and live within minutes. I love that,” McGowan notes. “But you can’t lose sight of the fact there’s no evidence that it’s really effective.”

via Some CME experts remain skeptical on social media – Medical Marketing and Media.

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RESOURCE: Trends Redefining Higher Education in 2017

This post is about the trends that are going to redefine higher education for the year 2017. After a lot of research, I am picking the top trends that may leave an impact on the higher education sector and make it better for the community as whole.

Check it out!

1. Increased Demand of Online Admission, Marketing and Enrollment by Colleges & Universities

Seeing the growth of the digital world, institutions are under obligation to catch parents and students’ eyeballs where they are spending most of their time; which is why media agencies as well as several edtech startups have grabbed the opportunity to focus on higher education to manage their brands and marketing online. Based on our talks with startups like NoPaperForms, ‘student scouting’ which many digital marketing companies and agencies are solving for institutions is not the only thing in demand but managing the complete admission and enrollment process is a pain which a startup like this is trying to solve based on the feedback collected across the country.

2. Increased Use of Big Data to Measure Student Performance:

Big data is the thing for 2017. Sit back and watch faculty analyzing real-time data to measure, improve and predict how their students perform. This whole thing allows faculty to meet individual needs of the students and tailor curriculum to meet online students’ needs and provide support. Also, the advent of eLearning has made it possible for faculty members to be able to see whether or not a student has logged in, whether or not a student has participated that week, can really help them in assessing whether a student is on track or not.

“Because online students complete their coursework virtually, course providers and universities are collecting data “in really kind of remarkable quantities,” says Richard DeMillo, executive director of Georgia Institute of Technology’s Center for 21st Century Universities, which tracks technology innovations in higher education.

….

To read more: Trends Redefining Higher Education in 2017 – EdTechReview™ (ETR).

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MANUSCRIPT: Use of Videos Improves Informed Consent Comprehension in Web-Based Surveys

Background: Web-based surveys are increasingly used to capture data essential for human immunodeficiency virus (HIV) prevention research. However, there are challenges in ensuring the informed consent of Web-based research participants.
Objective: The aim of our study was to develop and assess the efficacy of alternative methods of administering informed consent in Web-based HIV research with men who have sex with men (MSM).
Methods: From July to September 2014, paid advertisements on Facebook were used to recruit adult MSM living in the United States for a Web-based survey about risk and preventive behaviors. Participants were randomized to one of the 4 methods of delivering informed consent: a professionally produced video, a study staff-produced video, a frequently asked questions (FAQs) text page, and a standard informed consent text page. Following the behavior survey, participants answered 15 questions about comprehension of consent information. Correct responses to each question were given a score of 1, for a total possible scale score of 15. General linear regression and post-hoc Tukey comparisons were used to assess difference (P<.001) in mean consent comprehension scores. A mediation analysis was used to examine the relationship between time spent on consent page and consent comprehension.
Results: Of the 665 MSM participants who completed the comprehension questions, 24.2% (161/665) received the standard consent, 27.1% (180/665) received the FAQ consent, 26.8% (178/665) received the professional consent video, and 22.0% (146/665) received the staff video. The overall average consent comprehension score was 6.28 (SD=2.89). The average consent comprehension score differed significantly across consent type (P<.001), age (P=.04), race or ethnicity (P<.001), and highest level of education (P=.001). Compared with those who received the standard consent, comprehension was significantly higher for participants who received the professional video consent (score increase=1.79; 95% CI 1.02-2.55) and participants who received the staff video consent (score increase=1.79; 95% CI 0.99-2.59). There was no significant difference in comprehension for those who received the FAQ consent. Participants spent more time on the 2 video consents (staff video median time=117 seconds; professional video median time=115 seconds) than the FAQ (median=21 seconds) and standard consents (median=37 seconds). Mediation analysis showed that though time spent on the consent page was partially responsible for some of the differences in comprehension, the direct effects of the professional video (score increase=0.93; 95% CI 0.39-1.48) and the staff-produced video (score increase=0.99; 95% CI 0.42-1.56) were still significant.
Conclusions: Video-based consent methods improve consent comprehension of MSM participating in a Web-based HIV behavioral survey. This effect may be partially mediated through increased time spent reviewing the consent material; however, the video consent may still be superior to standard consent in improving participant comprehension of key study facts.

via JMIR-Use of Videos Improves Informed Consent Comprehension in Web-Based Surveys Among Internet-Using Men Who Have Sex With Men: A Randomized Controlled Trial | Hall | Journal of Medical Internet Research.

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ABSTRACT: Upgrading a Social Media Strategy to Increase Twitter Engagement During the Annual Meeting

Microblogs known as “tweets” are a rapid, effective method of information dissemination in health care. Although several medical specialties have described their Twitter conference experiences, Twitter-related data in the fields of anesthesiology and pain medicine are sparse. We therefore analyzed the Twitter content of 2 consecutive spring meetings of the American Society of Regional Anesthesia and Pain Medicine using publicly available online transcripts. We also examined the potential contribution of a targeted social media campaign on Twitter engagement during the conferences. The original Twitter meeting content was largely scientific in nature and created by meeting attendees, the majority of whom were nontrainee physicians. Physician trainees, however, represent an important and increasing minority of Twitter contributors. Physicians not in attendance predominantly contributed via retweeting original content, particularly picture-containing tweets, and thus increased reach to nonattendees. A social media campaign prior to meetings may help increase the reach of conference-related Twitter discussion.

via Upgrading a Social Media Strategy to Increase Twitter Engagement During the Spring Annual Meeting of the American Society of Regional Anesthesia an… – PubMed – NCBI.

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MANUSCRIPT: Interprofessional Training: Not Optional in Good Medical Education

Interprofessional education is a vital part of medical education, and students should not be permitted to exempt themselves from it. Physicians are part of a team, and the importance of teamwork will only increase as physician shortages continue and medical care becomes more complex. To learn to be good physicians in this emerging environment, students must appreciate the skills, strengths, and vocabularies of other professions. It is shortsighted to think that the best educators of future physicians can only be other physicians.

via Interprofessional Training: Not Optional in Good Medical Education, Sept 16 – AMA Journal of Ethics.

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ABSTRACT: Patients with heart failure as co-designers of an educational website: implications for medical education

OBJECTIVES:
To identify the learning needs of patients with heart failure between outpatients follow-up visits from their perspective and to ascertain what they emphasize as being important in the design of an educational website for them.
METHODS:
We conducted a two-step qualitative study at Aarhus University Hospital, Denmark. Twenty patients with heart failure participated either in focus group interviews, diary writing, or video-recorded design sessions. Data on learning needs were collected in step 1 and analyses, therefore, helped develop the preliminary prototypes of a website. In step 2, patients worked on the prototypes in video-recorded design sessions, employing a think-aloud method. The interviews were transcribed and a content analysis was performed on the text and video data.
RESULTS:
Patients’ learning needs were multifaceted, driven by anxiety, arising from, and often influenced by, such daily situations and contexts as the medical condition, medication, challenges in daily life, and where to get support and how to manage their self-care. They emphasized different ways of adapting the design to the patient group to enable interaction with peers and professionals and specific interface issues.
CONCLUSIONS:
This study provided insights into the different learning needs of patients with heart failure, how managing daily situations is the starting point for these needs and how emotions play a part in patients’ learning. Moreover, it showed how patient co-designers proved to be useful for understanding how to design a website that supports patients’ learning: insights, which may become important in designing online learning tools for patients.

via Patients with heart failure as co-designers of an educational website: implications for medical education. – PubMed – NCBI.

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