2013 Fall: Times are Changing: Evolution and Revolution in Medical Education

Learning in context, clinical decision making, self-directed learning, asynchronous teaching, etc., etc. We've heard the buzz words of new approaches to clinically-oriented teaching and testing, but how do we as instructors learn to apply these skills? This webcast series will provide how-to sessions on some of these approaches. Developing focused clinical cases for teaching may not be intuitive for non-clinicians or clinicians. Our first session will introduce and illustrate how basic and clinical principles of disease and treatment can be constructed into clinical cases for lectures, PBL /TBL sessions and NBME-style exam questions. There are defined principles and useful resources to employ, and pitfalls to avoid, that will help us all with this skill. How about testing? Are we confident that students can retain and apply knowledge and skills in an increasingly sophisticated manner? A subsequent session will discuss progress testing in which repeated measures of standards can document student progress and highlight remaining deficiencies over time. Script concordance is another new approach by which students must make value judgments of clinical data and apply new information to the next decision step. This approach helps mold and measure the everyday decision pathway that clinicians must travel. Finally, there are new approaches to teaching and learning that are more difficult to monitor and measure. Curricula are mandated to have active and independent learning time. What does this really mean? Is it "efficient"? Our last two sessions will focus on independent learning. We will discuss effective use, pros and cons, and best approaches to using learning time as well as the use of social media in teaching. This final presentation of the series will explore roles, ethics, age differences, documentation, and effectiveness as challenges and opportunities with this approach to medical education.

Back to Archives

September 12, 2013 at 12:00 pm

Learning in Context: Developing Case Scenarios for the Preclinical Curriculum

Presenter: Chuck Eldridge

Chuck EldridgeJ. Charles Eldridge, Ph.D., Professor of Physiology & Pharmacology, has been at the Wake Forest School of Medicine for 35 years as a leader and innovator in both medical and graduate school education. He was a founder and eventually co-director of the problem-based, case-based Parallel Curriculum, used as the pre-clinical phase by a portion of Wake Forest medical classes in the 1980’s-90’s. He then became an architect of the present integrated curriculum, serving as overall director of the first two blocks (28 weeks), and as director of the faculty-facilitated small group course now known as Case-Centered Learning (CCL). He has also received numerous teaching awards from student classes for his instructional series in endocrine pharmacology.

Dr. Eldridge has authored or co-authored more than 40 cases used in CCL, another dozen cases at the core of the Wake Forest graduate school curriculum on bioethics, professionalism, and responsible conduct of research, and more than a dozen published papers and invited chapters in education. He has provided educational consultation to many medical, veterinary, and graduate schools, and has participated in more than 60 presentations on education at national and international conferences. His many presentations at IAMSE meetings include a plenary debate at the very first conference in 1993.

Dr. Eldridge is a member of the AAMC Southern Group on Educational Affairs and the Research in Medical Education group, and was a charter member of IAMSE. He has served as adjunct faculty for the Harvard Macy Program for Medical Educators, an advisor to the Baylor College of Medicine FIPSE Team Learning Project, a member of the Association of Professors of Gynecology & Obstetrics project on Women’s Health Care Competencies, and as an item committee member for the USMLE Step 1.

Professional training programs typically begin with a study of fundamental underlying principles, followed by apprenticeship experiences of skill refinement. Indeed, the Flexner report on medical education, published a century ago, stressed the need for adequate basic science education by medical schools as a prelude to clinical training. However, as managers and instructors of present-day preclinical phases struggle to squeeze in the essentials of an exploding catalog of biomedical information, a further problem seems too often ignored: helping students learn to use what they’ve been taught. Clinical practice is an active, decision-making profession that relies on transduction of facts and concepts to resolve clinical problems. But how can non-clinician scientists promote this next step? Where can one gather pertinent clinical applications of molecular interactions or complex fundamental concepts? How can one phrase useful clinical scenarios in an accurate fashion? The purpose of this session is to provide some approaches to developing these clinical illustrations and applications of basic science principles. A variety of strategies will be elaborated, including insertion of clinical pearls into platform lectures, large-group sessions of active learning or review discussion with a case context, case-based small group tutorials and learning environments, and the case-oriented assessment process.

Seminar Archive
September 19, 2013 at 12:00 pm

Script Concordance Assessment of Clinical Reasoning in Medical Students, Five Years Out

Presenter: Mary T. Johnson

Mary T. JohnsonDr. Johnson is Associate Dean for Academic Affairs and Professor of Microbiology and Immunology at the Des Moines University College of Osteopathic Medicine. She is responsible for assisting the faculty as they implement all aspects of the curriculum, in the classroom, through technology, and in the medical sciences laboratories. Dr. Johnson has more than 20 years of experience as a basic sciences educator and course director for medical microbiology and infectious diseases. She has been a leader in the evaluation of competency-based medical education for over a decade. Dr. Johnson graduated with a Ph.D. in Life Sciences from Indiana State University in 1991, and then completed a post-doctoral fellowship in molecular virology at Indiana University School of Medicine. She received a faculty appointment there and served as Statewide Competency Director for Problem-Solving as well as course director for medical microbiology at the IUSM-Evansville and IUSM-Terre Haute campuses. In 2009, Dr. Johnson moved to the Florida State University College of Medicine, Tallahassee, where she served as Assistant Dean for Faculty Development, and later Associate Dean for Medical Education. She moved to Des Moines, IA in 2012.

Part of a clinician’s competence is the capacity to solve problems that deal with the complex and ambiguous nature of patient care. The Script Concordance Test (SCT) is a method for evaluating data interpretation, one of the measurable dimensions of problem-solving skill. Developed as a collaborative project between two large allopathic medical schools, this preclinical SCT has been used for a number of years as a benchmark for student learning. New data from two additional medical schools will be presented, along with a practical approach to utilizing outcomes.

This presentation will allow participants to:

  1. Discover the SCT, an innovative competency-based assessment.
  2. Consider the application of this tool for the evaluation of clinical reasoning in medical learners.
  3. Appreciate the SCT as a validated assessment instrument for differentiating among students along a continuum of learners from medical novice to resident physician to expert clinician.
Seminar Archive
September 26, 2013 at 12:00 pm

Progress Testing – concept, history, and recent developments

Presenter: Arno M.M. Muijtjens

Arno M.M. MuijtjensArno Muijtjens was trained in Electrical Engineering (Measurement and Control) at the Eindhoven Technical University and has a PhD in Medical Informatics from Maastricht University. In 1999 he joined the Dept. of Educational Development and Research with a major interest in methodology and statistics in educational research, educational measurement, and assessment. More specific areas of interest are progress testing and computer based testing.

He is a psychometrical consultant for student assessment at the Faculty of Health, Medicine and Life Sciences, and for the Interuniversity Progress Test in Medicine. He is a consultant on quantitative methods for Research in Education, the research programme of the School of Health Professions Education (SHE), and is involved with supervising several PhD candidates.

He participates in research projects within and outside SHE, and is author/co-author of more than 100 publications in international peer reviewed scientific journals. He teaches quantitative research methods within the Master of Health Professions Education programme, in post-graduate workshops and in courses on research in medical education. As a project manager he is involved with externally funded projects on the advanced computer based development of progress testing.

Progress testing was developed simultaneously at both sides of the Atlantic Ocean in the 1970s. We will outline how the concept came to birth as a tool aimed to solve the problem of discongruency between a new instructional method (problem based learning) and traditional assessment methods.

A progress test is aimed at the end objectives of an educational program, and repeatedly measures the students’ knowledge with respect to the complete domain of interest of the program. Thus, it enables to monitor the growth of knowledge of individual students and the average growth of cohorts of students across time. Individual growth patterns indicate whether a student is performing well or needs to improve, while average growth patterns provide information on the performance of the educational program. We will demonstrate how this information is provided and how it can be used for benchmarking and to improve education.

Certain requirements should be fulfilled for a progress test to be viable, the corresponding organizational and logistic requirements may be demanding, (lack of) item relevance is a returning issue, the use of a ‘don’t know’ option and negative marking may have its drawbacks, and the efficiency of the measurement may be questioned. In addition to the achievements of progress testing, we will discuss these issues and some attempts to solve them.

Seminar Archive
October 3, 2013 at 12:00 pm

Challenges and Opportunities of Independent Learning

Presenter: Robert Noiva & Douglas Gould

Robert NoivaRobert Noiva has been the Associate Dean for Medical Education and Associate Professor of Biomedical Science at the Oakland University William Beaumont School of Medicine for the past three years. He oversees all aspects of the medical student curriculum at OUWB, including course planning and evaluation, managing schedules and educational resources, student and faculty assessment as well as continuing to stay active in the classroom teaching Biochemistry. Dr. Noiva spent 18 years in the Division of Basic Biomedical Sciences at the University of South Dakota Sanford School of Medicine where he taught Medical Biochemistry and Molecular Biology and ran several K-12 science outreach programs. Following his position in South Dakota, Noiva served as Director of Medical Biochemistry at Lake Erie College of Osteopathic Medicine, where he contributed to the lecture/discussion and independent studies curricular pathways.


 

Douglas GouldDouglas Gould is currently a Professor and Vice-Chair of the Department of Biomedical Sciences at the Oakland University William Beaumont School of Medicine (OUWB) in Rochester, MI. He serves as the course director for the first year medical student neuroscience course. Dr. Gould has a longtime interest in the creation and evaluation of ancillary tools for independent learning – including 3 texts, a programmed learning tool for neuroscience, flashcards and a host of software packages. He has received a number of awards for teaching, including the excellence in teaching award from Ohio State University College of Medicine and all 5 Abraham Flexner Teaching Awards from the University of Kentucky College of Medicine. In the past he has served as the Editor-in-Chief of JIAMSE; completed the Aspire, Achieve, and Lead Leadership Development Program as part of his role as Chair of the Anatomical Sciences Section of the American Dental Education Association; and most recently has been appointed to the OUWB School of Medicine Management Committee.

Healthcare education programs are challenged with developing mechanisms to address the ever-increasing volume of medical knowledge, the desire of students to take ownership of their learning process, and a mandate from accrediting agencies to develop independent learners with life-long learning skills. Systems such as online micro lectures, e.g. the Khan Academy, programmed instruction texts and web-based modules often focus on providing a definable curriculum, while offering the flexibility to allow students to progress at their own pace. Students benefit by having control of their learning, being able to set the pace and remediate any self-assessed deficiencies. Such flexibility in learning methods is often accompanied by a decrease in integration of material and an overall lack of less tangible qualities that are difficult to measure. While students are adept at leveraging technology for their learning, the onus is on the healthcare educational institution to help students:

  • move beyond program-dictated sequential podcasts and web-based curricula to help students develop the life-long learning skills;
  • integrate and coordinate multiple disciplines in a self-paced independent curriculum towards a more comprehensive understanding of concepts;
  • develop skills in communication, teamwork and collaborative thinking in an independent learning curriculum;
  • assess competency, especially noncognitive skills and attitudes and higher-order thinking skills, in an independent learning curriculum.
Seminar Archive
October 10, 2013 at 12:00 pm

Social Media Competencies for Medical Educators

Presenter: Martha S. Grayson & Katherine Chang Chretien

Martha S. GraysonMartha S. Grayson, MD, received her MD from the Albert Einstein College of Medicine, and completed the Residency Program in Social Internal Medicine at Montefiore Hospital in the Bronx. She completed the Michigan State University Primary Care Faculty Development Fellowship Program and the Executive Leadership in Academic Medicine (ELAM) Fellowship for Women at MCP. She was the PI for several grants which focused on training medical students, residents and community physicians in the fundamental competencies needed for the practice of high quality primary care. Dr. Grayson’s research interests include analyzing factors which determine medical student career choice, and on the assessment of educational programs. She currently serves as the Senior Associate Dean for Medical Education and Professor of Clinical Medicine at Albert Einstein College of Medicine. Her responsibilities include the oversight and management for the four year curriculum leading to the MD, assessment of learners, and evaluation of program effectiveness. She also provides oversight for faculty development programs for medical educators. She is a member of her institution’s task force that is creating a new curriculum on social media and related faculty development activities.


 

Katherine ChretienDr. Katherine Chretien earned her medical degree from Johns Hopkins School of Medicine, where she was inducted to Alpha Omega Alpha and Phi Beta Kappa. After completing her internal medicine training at the Johns Hopkins Hospital in 2003, she joined the academic hospitalist group at the Washington DC VA Medical Center where she is currently Chief of the Hospitalist Section. She has held the role of medicine clerkship director since 2005. In 2007, she completed the Master Teacher Leadership Development Program, a graduate-level year-long certificate program for medical educators through George Washington University. She is associate professor of medicine at George Washington University. Katherine’s research interests include social media, professionalism, narrative medicine, and medical education. Her educational focus is on using innovation and technology to promote learning, reflection, and professional development. She is the recipient of the 2012 Charles H. Griffith III Educational Research Award from Clerkship Directors in Internal Medicine and the 2013 Women Leaders in Medicine Award from the American Medical Student Association. She is an associate editor of the Journal of Graduate Medical Education.

The popularity of social media websites (Twitter, Facebook, YouTube, etc.) has grown dramatically in the last decade providing powerful methods to communicate and establish new connections based on common interests and needs. The vast majority of today’s medical students and residents are part of the millennial generation, the first generation that has grown up with digital technology. They have been labeled “digital natives.” There are currently four generations of faculty members at US medical schools, the “Millennials,” “Generation X,” “Baby Boomers,” and the “Silent Generation. The latter three did not grow up with digital technology, and if they utilize it, do so with more difficulty. These generations are labeled as “digital immigrants” as using digital technology is analogous to learning a new language later in life. In addition to differing levels of competency, faculty and students also differ in their perception of professionalism boundaries on social media sites. This webinar is designed to explore the social media competencies needed by faculty to work with medical students and residents who utilize social media on a regular basis. The types of competencies needed, opportunities for training, and professionalism issues that arise from the use of social media will be discussed.

Seminar Archive