The rapid adoption rate and integration of mobile technology (tablet computing devices and smartphones) by physicians is reshaping the current clinical landscape. These devices have sparked an evolution in a variety of arenas, including educational media dissemination, remote patient data access and point of care applications. Quantifying usage patterns of clinical applications of mobile technology is of interest to understand how these technologies are shaping current clinical care. A digital survey examining mobile tablet and associated application usage was administered via email to all ACGME training programs. Data regarding respondent specialty, level of training, and habits of tablet usage were collected and analyzed. 40% of respondents used a tablet, of which the iPad was the most popular. Nearly half of the tablet owners reported using the tablet in clinical settings; the most commonly used application types were point of care and electronic medical record access. Increased level of training was associated with decreased support for mobile computing improving physician capabilities and patient interactions. There was strong and consistent desire for institutional support of mobile computing and integration of mobile computing technology into medical education. While many physicians are currently purchasing mobile devices, often without institutional support, successful integration of these devices into the clinical setting is still developing. Potential reasons behind the low adoption rate may include interference of technology in doctor-patient interactions or the lack of appropriate applications available for download. However, the results convincingly demonstrate that physicians recognize a potential utility in mobile computing, indicated by their desire for institutional support and integration of mobile technology into medical education. It is likely that the use of tablet computers in clinical practice will expand in the future. Thus, we believe medical institutions, providers, educators, and developers should collaborate in ways that enhance the efficacy, reliability, and safety of integrating these devices into daily medical practice.
When we set out to transform online learning in medicine through a data driven e-learning delivery and assessment model we knew that, if successful, our educational partners would need an even more effective and efficient way to manage activity creation and data analyses. Thanks to the success of our educational partners, we have accelerated a series of key product enhancements to meet their increased needs as education powered by ArcheMedX has grown at a frenetic pace.
After months of planning and design, we are delighted to announce the release of an all new ArcheViewer Administrative Interface. The most visible changes appear with the addition of Dashboards, which are designed to serve as the data-centric nervous system of the administrative experience and the highlights below offer a quick glimpse into many of the enhancements included in our product release:
- Instantly see the most meaningful learner data rolled up at the Provider, Initiative, Activity, or population level for a holistic view across all of your education
- Quickly assess educational impact by correlating novel engagement scores, assessment data, and detailed learning action metrics at every level
- Drill down from each level to access interactive reports, edit settings, and manage Activities and learners via a single click to easily control one Activity or one hundred
Enhanced Activity Creation
- More easily build and refine Activities through a streamlined interface
- Save time creating Activity details using new HTML content editors and multi-select picklists, build and manage your Resource Library in fewer steps
- New preview options make it easier to design, validate, and QC activities before launch
- Administrators can now adjust Activity settings
- Customize the look and feel of each Activity using simple color pickers
- Establish and update SSO settings and end of Activity messaging
Updated Reporting and Online Help
- Improved access to data and downloadable reports thanks to an all new metrics engine
- Access detailed online help including best practices and tutorial videos
Join a Webinar to Learn More
To take a deeper dive into the ArcheViewer’s redesign and latest features, we are holding an introductory webinar on January 29th at 12:30 EDT. Please register for the webinar by clicking on this registration link.
In the meantime, you can explore a few of the highlights in this brief Video Tour:
It is with great pride that we accept the 2015 ACEHP Award for Innovation in CPD, awarded for the work we have been doing over the past year with our Journey to the Center of CE project. Below you will find detailed information on the project as was recently published in the Journal for Continuing Education in Nursing. And further below you can download a version of the ACEHP Storyboard (poster) that was created for the 2015 Alliance meeting.
Or you can click play below for an audio tour of the poster:
Flipping the Classroom:
A Data-Driven Model for Nursing Education
AUTHORS: Brian S. McGowan, PhD; Jann T. Balmer, PhD, RN; and Kathy Chappell, PhD, RN
Dr. McGowan is Chief Learning Officer, ArcheMedX, Charlottesville; Dr. Balmer is Director, Continuing Medical Education, University of Virginia School of Medicine, Charlottesville, Virginia; and Dr. Chappell is Vice President, Accreditation Program and Institute for Credentialing Research, American Nurses Credentialing Center, Silver Spring, Maryland.
J Contin Educ Nurs. 2014;45(11):477-478
Structured, blended learning models have been developed to help participants more actively engage in learning experiences, as opposed to traditional didactic sessions. A flipped classroom model allows learners to build on self-directed online prework in an interactive and collaborative learning laboratory.
Adults come to the learning environment with different learning preferences, expertise, and experience, creating significant challenges for educators. Educational research recently has explored innovative approaches to addressing these challenges. One model that has gained significant traction in the past few years is the flipped classroom (McLaughlin et al., 2014).
In a flipped classroom, content and learning tasks are assigned to learners prior to attending a live classroom experience. Learners explore this content at their own pace to improve their overall understanding of the subject matter and maximize learning opportunities in the “live” experience (Klegeris & Hurren, 2011). Keys to the flipped classroom model are ensuring that:
- Prework is prepared and completed in ways that support learning and better inform educational planners.
- Learning data from the prework is effectively gathered, explored, and leveraged to support the live experience.
- The live classroom experience creates a learning laboratory that fosters dialogue among learners and facilitators, providing opportunities for integrating context into the application of content.
To better understand the applicability of this model to support nursing education, a flipped classroom model was chosen for the 2014 American Nurses Credentialing Center (ANCC) Annual Symposium on Continuing Nursing Education. The goals of the project was to maximize learning opportunities in a 1-day conference, expose nurse educators to the flipped classroom model as a potential tool for their own use, and to expand the number of contact hours by combining prework with classroom experience.
PLANNING AND IMPLEMENTATION
For this project, prework included a series of videos created to introduce the science of continuing education. In all, 11 videos ranging in length from 6 to 11 minutes were produced. Learners were given access to the e-learning environment 1 month before the symposium. During that month, they received weekly notifications to encourage participation.
To enable planners and facilitators to capture data about learning and engagement in the prework, an innovative e-learning technology, the ArcheViewerSM (McGowan, 2014) was used. This novel technology creates an immersive and engaging online learning environment by allowing educators to define distinct learning moments, build a searchable library of related resources, and highlight these resources and engage learners at predefined moments. In addition, within the learning environment, learners have the ability to take notes, set reminders, search through related resources, and ask questions of faculty. For example, leading up to the live symposium, 102 learners took 178 notes, set 408 reminders, and searched through a library of nearly 100 collated and related resources.
Analysis of the use of these learning actions helped facilitators prepare the live classroom experience to complement the prework. Anticipated questions and areas of concern were identified, and facilitators were able to focus on critical learning opportunities for attendees. Case studies at the live session enabled learners to apply information from the prelearning experience. An audience response system was used during the live session to collect additional assessment data and validate learners’ level of understanding of the topics addressed in the prework.
WHAT WAS LEARNED
The flipped classroom model and novel e-learning technology provided an overall learning experience where outcome data and learner engagement allowed planners to refine and focus structured scenarios for application of the content. This educational design incorporated both the individualized learning experience and group learning dynamics.
Of the 124 participants who attended the live session, 82% participated in the online video series prior to attending the live symposium. Of those who participated, 74% self-reported watching more than 10 videos in the 11-part series. This high level of participation was encouraging because 73% of respondents acknowledged that this was their first flipped classroom learning experience. Completion rates for the videos were greater than 85% on average, and the average viewer completed more than 95% of each video started.
In aggregate, 47% of learners said they were comfortable with the individual topics before beginning each video lesson (n = 431). After completion of each video, 55% of learners stated that they were more confident with the topic or were ready to make changes in their practice (n = 358). Before the online lessons began, there was tremendous variation in confidence levels across the topics, ranging from greater than 90% comfort with adult learning theory to less than 15% comfort with the implementation sciences. Following the online lessons, although some variation persisted, there was far greater homogeneity in terms of comfort with the topics. Finally, across all ArcheViewerSM-powered prework, 11% of learners stated that they were ready to change their practice related to one of the topics presented. This commitment was made prior to arriving at the live symposium and therefore can be seen as a clear predisposition for change.
At the symposium, 76% of respondents claimed that by viewing the online series, they were better prepared to engage with symposium faculty and to be more active learners. In addition, the majority of respondents felt that the flipped classroom model was an effective educational strategy.
A flipped classroom educational design was used to educate and support nurses in conjunction with the 2014 ANCC Annual Symposium on Continuing Nursing Education. Although this project was not designed to be statistically rigorous, several conservative conclusions can be drawn:
- Learners participating in a flipped learning experience perceive themselves as being more prepared to participate and engage in live or classroom-style learning.
- Four weeks of weekly notifications seemed sufficient to drive high levels of participation, although many participants noted that they waited until the final 96 hours to ensure the content was fresh in their minds.
- Although not all learners will participate in prework, with clear and effective communication, a more structured and engaging online learning experience, and sufficient incentives (such as additional continuing education credits), it is possible to surpass 80% participation.
- Connecting the flipped video series to the final planning of the onsite symposium appears to be a critical success factor. However, this seems to depend largely on access to timely and accurate learning analytics (such as those provided within the ArcheViewerSM e-learning technology), permitting planners and faculty to create a more rewarding live learning experience.
Klegeris, A., & Hurren, H. (2011). Impact of problem-based learning in a large classroom setting: Student perception and problem-solving skills. Advances in Physiology Education, 35, 408-415.
McGowan, B.S. (2014, February 12). How great is the impact of ArcheMedX-powered education? [Web log message]. Retrieved from https://www.archemedx.com/blog/great-impact-archemedx-powerededucation
McLaughlin, J.E., Roth, M.T., Glatt, D.M., Gharkholonarehe, N., Davidson, C.A., Griffin, L.M., . . . Mumper, R.J.. (2014). The flipped classroom: A course redesign to foster learning and engagement in a health professions school. Academic Medicine, 89, 236-243.
In the following brief mp3 – I discuss the Flipped Classroom project and provide a quick tour of the storyboard.
Please click here to download the poster file: ACEHP15 poster – Flipping the Classroom – A Data-Driven Model for Nursing Education – Final
If you are interested in getting a complete copy of the original Flipping the Classroom: A Data-Driven Model for Nursing Education article, please send an email to email@example.com
Chunking refers to the strategy of breaking down information into bite-sized pieces so the brain can more easily digest new information. The reason the brain needs this assistance is because working memory, which is where we manipulate information, holds a limited amount of information at one time.
Why We Chunk Content
George A. Miller formulated the chunk concept in 1956, as he presented evidence that working memory is limited in capacity. Although Miller stated that working memory could hold seven (plus or minus two) chunks of information at once, it is now thought that the number is closer to four, maybe five bits of information. Also, cognitive researchers now know that the capacity of working memory depends on the type of information, the features of the information and the abilities of the person under experimentation.
The pearl of wisdom here is that if a learner’s working memory is full, the excess information will just drop out—as in disappear. That’s a big challenge for a course designer. It means that if you are explaining something complex and the learner must hold several factors in mind to understand it, you’ll need to chunk information into bite-sized pieces.
MANUSCRIPT: Evaluating the Guideline Enhancement Tool (GET): an innovative clinical training tool to enhance the use of hypertension guidelines in general practice
BackgroundThis project aims to evaluate the effectiveness of an innovative educational intervention in enhancing clinical decision making related to the management of hypertension in general practice. The relatively low level of uptake of clinical practice guidelines by clinicians is widely recognised as a problem that impacts on clinical outcomes. This project addresses this problem with a focus on hypertension guidelines. Hypertension is the most frequently managed problem in general practice but evidence suggests that management of Hypertension in general practice is sub-optimal.Methods/designThis study will explore the effectiveness of an educational intervention named the `Guideline Enhancement Tool (GET)?. The intervention is designed to guide clinicians through a systematic process of considering key decision points related to the management of hypertension and provides a mechanism for clinicians to engage with the hypertension clinical guidelines.The intervention will be administered within the Australian General Practice Training program, via one of the regional training providers. Two cohorts of trainees will participate as the intervention and delayed intervention groups.This process is expected to improve clinicians? engagement with the hypertension guidelines in particular, and enhance their clinical reasoning abilities in general. The effectiveness of the intervention in improving clinical reasoning will be evaluated using the `Script Concordance Test?.DiscussionThe study design presented in this protocol aims to achieve two major outcomes. Firstly, the trial and evaluation of the educational intervention can lead to the development of a validated clinical education strategy that can be used in GP training to enhance the decision-making processes related to the management of hypertension. This has the potential to be adapted to other clinical conditions and training programs and can benefit clinicians in their clinical decision-making. Secondly, the study explores features that influence the effective use of clinical practice guidelines. The study thus addresses a significant problem in clinical education.
By Benedict Carey, author of “How We Learn: The Surprising Truth about When, Where, and Why It Happens.”
Check out MindShift’s article about the book.
1) You have assigned students to write an essay on “How Neurons Communicate,” based on reading a book chapter, but you know many of them will squirm. They may try to focus, but find the material will not yield. What to advise them, if they get stuck?
A. Tough it out, nobody said this was easy.
B. Get out of the house, and take the book with you: to the coffee shop, the park, the library. Put on some music. Have at it.
C. Eliminate all distractions from your work space. Concentrate.
D. Quit for now, and come back to it later.
ANSWER: B. There’s a large body of research showing that changing “context” while you’re learning — and this includes location, time of day, mood, environment, even background music — deepens learning. It also allows you to put your restlessness to good use.
2) You have scheduled a Spanish test one week from today, and you’ve advised students to allot four hours to study. How best can they use that time?
A. Put in one concentrated, four-hour study session three days before the test.
B. Stay up late, cramming, the night before the exam so the material is fresh.
C. Study one hour a night for four consecutive nights in the coming week.
D. Do two hours tonight and two tomorrow night.
ANSWER: D. Distributing or “spacing” study time can double the amount of material we retain. For a test in a week, the ideal schedule is: tonight and tomorrow, or tonight and the day after tomorrow. The optimal interval depends on when the test is.
A Sample System
Here’s what a system for a book could look like:
- Read book. Make notes in margins and highlight or mark segments. Wait a week.
- Re-open book, type up notes and related quotes in Evernote and tag with an occasion I might need the information for e.g., negotiating or its relevant field of expertise e.g., marketing, business.
- If the book is related to an article idea or theme that you’re exploring, write out related quotes or print them on index cards and tag them appropriately in software or add them to your commonplace book.
- Add calendar entry for four months from now to review book or related information e.g., negotiating.
- If a point resonates with you, print it out and tape it onto your wall. In order to keep these quotes free of noise, try to have no more than two or three quotes up there at any time.
Cognitive Load Theory (CLT) builds upon established models of human memory that include the subsystems of sensory, working and long-term memory. Working memory (WM) can only process a limited number of information elements at any given time. This constraint creates a “bottleneck” for learning. CLT identifies three types of cognitive load that impact WM: intrinsic load (associated with performing essential aspects of the task), extraneous load (associated with non-essential aspects of the task) and germane load (associated with the deliberate use of cognitive strategies that facilitate learning). When the cognitive load associated with a task exceeds the learner’s WM capacity, performance and learning is impaired. To facilitate learning, CLT researchers have developed instructional techniques that decrease extraneous load (e.g. worked examples), titrate intrinsic load to the developmental stage of the learner (e.g. simplify task without decontextualizing) and ensure that unused WM capacity is dedicated to germane load, i.e. cognitive learning strategies. A number of instructional techniques have been empirically tested. As learners’ progress, curricula must also attend to the expertise-reversal effect. Instructional techniques that facilitate learning among early learners may not help and may even interfere with learning among more advanced learners. CLT has particular relevance to medical education because many of the professional activities to be learned require the simultaneous integration of multiple and varied sets of knowledge, skills and behaviors at a specific time and place. These activities possess high “element interactivity” and therefore impose a cognitive load that may surpass the WM capacity of the learner. Applications to various medical education settings (classroom, workplace and self-directed learning) are explored.
ABSTRACT: A novel approach to needs assessment in curriculum development: going beyond consensus methods
Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed.
This paper showcases a more practice-grounded needs assessment approach.
A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings.
Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2’s practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation.
This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs.
ABSTRACT: How do physicians and trainers experience outcome-based education in “Rational prescribing”?
Continuing medical education (CME) is compulsory in Iran, but has shown limitations in terms of educational style and format. Outcome-based education (OBE) has been proposed internationally to create links to physicians’ actual practices. We designed an outcome-based educational intervention for general physicians in primary care (GPs). Positive outcomes on GPs’ knowledge, skills and performance in the field of rational prescribing were found and have been reported.The specific purpose of this study was to explore the perceptions of the GPs and trainers, who participated in the outcome-based education on rational prescribing.
All nine trainers in the educational programme and 12 general physicians (out of 58) were invited to individual interviews four months after participation in the CME program. Semi-structured open-ended interviews were carried out. Qualitative content analysis was used to explore the text and to interpret meaning and intention.
There was a widespread agreement that the programme improved the participants’ knowledge and skills to a higher extent than previously attended programmes. Trainers emphasized the effect of outcome-based education on their educational planning, teaching and assessment methods, while the general physicians’ challenges were how to adapt their learning in the real work environment considering social and economical barriers. Self-described attitudes and reported practice changed towards more rational prescribing.
Outcome-based CME seems attractive and additionally useful for general physicians in Iran and could be an effective approach when creating CME programmes to improve general physicians’ performance. Similar approaches could be considered in other contexts both regionally and globally.