A team of researchers from the Massachusetts Institute of Technology and Harvard University are using crowd-sourced conceptual outlines to help learners get more out of educational videos.
The outlines can work as navigation tools, so that “viewers already familiar with some of a video’s content can skip ahead, while others can backtrack to review content they missed the first time around,” according to a news release from MIT.
“That addresses one of the fundamental problems with videos,” said Juho Kim, an MIT graduate student in electrical engineering and computer science and one of the paper’s co-authors, in a prepared statement. “It’s really hard to find the exact spots that you want to watch. You end up scrubbing on the timeline carefully and looking at thumbnails. And with educational videos, especially, it’s really hard, because it’s not that visually dynamic. So we thought that having this semantic information about the video really helps.”
MANUSCRIPT: How can clinician-educator training programs be optimized to match clinician motivations and concerns?
Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns.
Review of medical education literature using the terms “attitudes”, “motivations”, “physicians”, “teaching”, and “undergraduate medical education” resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students.
A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability.
Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education.
Medical dramas are an incredibly popular TV genre especially amongst medical learners, and they have become an increasingly accepted resource in learning experiences. Educators have recognised their pedagogical value, as they allow a host of complex medical and psychosocial issues to be presented to learners in an engaging format. Care has to be taken however to appreciate and overcome their limitations including recognising ‘unexpected learning outcomes’. What is vital to their successful incorporation into teaching programme is the reflection component; which facilitates discussion and allows for a deeper learning experience.
ABSTRACT: Point of care information services: a platform for self-directed continuing medical education for front line decision makers
The structure and aim of continuing medical education (CME) is shifting from the passive transmission of knowledge to a competency-based model focused on professional development. Self-directed learning is emerging as the foremost educational method for advancing competency-based CME. In a field marked by the constant expansion of knowledge, self-directed learning allows physicians to tailor their learning strategy to meet the information needs of practice. Point of care information services are innovative tools that provide health professionals with digested evidence at the front line to guide decision making. By mobilising self-directing learning to meet the information needs of clinicians at the bedside, point of care information services represent a promising platform for competency-based CME. Several points, however, must be considered to enhance the accessibility and development of these tools to improve competency-based CME and the quality of care.
Abstract The concept of the learning landscape is used to explore the range of learning environments needed at multiple scales to better align with changes in the medical education curriculum. Four key scales that correspond to important types of learning spaces are identified: the classroom, the building, the campus and the city. “In-between” spaces are identified as growing in importance given changing patterns of learning and the use of information technology. Technology is altering how learning takes place in a wider variety of types of spaces as it is interwoven into every aspect of learning. An approach to planning learning environments which recognizes the need to think of networks of learning spaces connected across multiple scales is proposed. The focus is shifted from singular spaces to networks of inter-connected virtual and digital environments. A schematic model comprising the networked learning landscape, intended as a guide to planning that emphasizes relationships between the changing curriculum and its alignment with learning environments at multiple scales is proposed in this work. The need for higher levels of engagement of faculty, administrators and students in defining the briefs for the design of new kinds of medical education environments is highlighted.
The time-honoured tradition of Grand Round is firmly rooted in medical education, but has little evidence for its effectiveness or its impact on patient management. A mode of didactic teaching, Grand Round has lost its appeal in modern medical education with dwindling attendance at Grand Rounds worldwide. Once a platform for eminence-based medicine and a cross fertilisation of medical ideas, emphasis on sub-specialisation and clinical governance, combined with rota, trainee engagement and attendance failures has made Grand Round obsolete. To survive, Grand Round must have evidence for its effectiveness in medical education. It must be able to compete with other forms of teaching and adapt by using technology to reach trainees. Engaging the audience and encouraging participation needs to be woven into the fabric of the modern Grand Round, alongside learning clinical skills and developing clinical reasoning. Understanding the needs of today’s trainees and their involvement in formulating the Grand Round programme is vital. Attendance at Grand Round is a recognised measure of its success and will be used in its evaluation. Questions still remain regarding the future of Grand Round. Its survival will depend upon its ability to change with time and reclaim its place as a credible tool to promote learning.
We conducted a review of articles published in 2013 to identify high-quality research in medical education that was relevant to general medicine education practice. Our review team consisted of six general internists with expertise in medical education of varying ranks, as well as a professional medical librarian. We manually searched 15 journals in pairs, and performed an online search using the PubMed search engine for all original research articles in medical education published in 2013. From the total 4,181 citations identified, we selected 65 articles considered most relevant to general medicine educational practice. Each team member then independently reviewed and rated the quality of each selected article using the modified Medical Education Research Study Quality Instrument. We then reviewed the quality and relevance of each selected study and grouped them into categories of propensity for inclusion. Nineteen studies were felt to be of adequate quality and were of moderate to high propensity for inclusion. Team members then independently voted for studies they felt to be of the highest relevance and quality within the 19 selected studies. The ten articles with the greatest number of votes were included in the review. We categorized the studies into five general themes: Improving Clinical Skills in UME, Inpatient Clinical Teaching Methods, Advancements in Continuity Clinic, Handoffs/Transitions in Care, and Trainee Assessment. Most studies in our review of the 2013 literature in general medical education were limited to single institutions and non-randomized study designs; we identified significant limitations of each study. Selected articles may inform future research and practice of medical educators.
MANUSCRIPT: The future role of the family physician in the United States: a rigorous exercise in definition
As the U.S. health care delivery system undergoes rapid transformation, there is an urgent need to define a comprehensive, evidence-based role for the family physician. A Role Definition Group made up of members of seven family medicine organizations developed a statement defining the family physician’s role in meeting the needs of individuals, the health care system, and the country. The Role Definition Group surveyed more than 50 years of foundational manuscripts including published works from the Future of Family Medicine project and Keystone III conference, external reviews, and a recent Accreditation Council on Graduate Medical Education Family Medicine Milestones definition. They developed candidate definitions and a “foil” definition of what family medicine could become without change. The following definition was selected: “Family physicians are personal doctors for people of all ages and health conditions. They are a reliable first contact for health concerns and directly address most health care needs. Through enduring partnerships, family physicians help patients prevent, understand, and manage illness, navigate the health system and set health goals. Family physicians and their staff adapt their care to the unique needs of their patients and communities. They use data to monitor and manage their patient population, and use best science to prioritize services most likely to benefit health. They are ideal leaders of health care systems and partners for public health.” This definition will guide the second Future of Family Medicine project and provide direction as family physicians, academicians, clinical networks, and policy-makers negotiate roles in the evolving health system.
The construct of ‘preparation for future learning’ (PFL) is understood as the ability to learn new information from available resources, relate new learning to past experiences and demonstrate innovation and flexibility in problem solving. Preparation for future learning has been proposed as a key competence of adaptive expertise. There is a need for educators to ensure that opportunities are provided for students to develop PFL ability and that assessments accurately measure the development of this form of competence. The objective of this research was to compare the relative impacts of basic science instruction and clinically focused instruction on performance on a PFL assessment (PFLA).
This study employed a ‘double transfer’ design. Fifty-one pre-clerkship students were randomly assigned to either basic science instruction or clinically focused instruction to learn four categories of disease. After completing an initial assessment on the learned material, all participants received clinically focused instruction for four novel diseases and completed a PFLA. The data from the initial assessment and the PFLA were submitted to independent-sample t-tests.
Mean ± standard deviation [SD] scores on the diagnostic cases in the initial assessment were similar for participants in the basic science (0.65 ± 0.11) and clinical learning (0.62 ± 0.11) conditions. The difference was not significant (t = 0.90, p = 0.37, d = 0.27). Analysis of the diagnostic cases on the PFLA revealed significantly higher mean ± SD scores for participants in the basic science learning condition (0.72 ± 0.14) compared with those in the clinical learning condition (0.63 ± 0.15) (t = 2.02, p = 0.05, d = 0.62).
Our results show that the inclusion of basic science instruction enhanced the learning of novel related content. We discuss this finding within the broader context of research on basic science instruction, development of adaptive expertise and assessment in medical education.
Feedback should facilitate learning, but within medical education it often fails to deliver on its promise. To better understand why feedback is challenging, we explored the unique perspectives of doctors who had also trained extensively in sport or music, aiming to: (i) distinguish the elements of the response to feedback that are determined by the individual learner from those determined by the learning culture, and (ii) understand how these elements interact in order to make recommendations for improving feedback in medical education.
Using a constructivist grounded theory approach, we conducted semi-structured interviews with 27 doctors or medical students who had high-level training and competitive or performance experience in sport (n = 15) or music (n = 12). Data were analysed iteratively using constant comparison. Key themes were identified and their relationships critically examined to derive a conceptual understanding of feedback and its impact.
We identified three essential sources of influence on the meaning that feedback assumed: the individual learner; the characteristics of the feedback, and the learning culture. Individual learner traits, such as motivation and orientation toward feedback, appeared stable across learning contexts. Similarly, certain feedback characteristics, including specificity, credibility and actionability, were valued in sport, music and medicine alike. Learning culture influenced feedback in three ways: (i) by defining expectations for teachers and teacher-learner relationships; (ii) by establishing norms for and expectations of feedback, and (iii) by directing teachers’ and learners’ attention toward certain dimensions of performance. Learning culture therefore neither creates motivated learners nor defines ‘good feedback’; rather, it creates the conditions and opportunities that allow good feedback to occur and learners to respond.
An adequate understanding of feedback requires an integrated approach incorporating both the individual and the learning culture. Our research offers a clear direction for medicine’s learning culture: normalise feedback; promote trusting teacher-learner relationships; define clear performance goals, and ensure that the goals of learners and teachers align.