2017 Meeting Posters – E-Learning

300 – Ongoing Development of Online Materials for Chemotherapy and Mechanisms of Action for Hematology Oncology Fellows
Dee Wu, Jordan M. Morton, Mohammad J. Cherry, Patrick J. Medina, and Marlee C. Reust
University of Oklahoma Health Sciences Center

PURPOSE : Hematology-Oncology fellows have intense workloads and find it challenging to learn and retain comprehensive information regarding the mechanisms/methods of action for chemotherapy. The Departments of Hematology-Oncology and Pharmacology have high expectations and seek to teach trainees how to write better chemotherapy orders and provide better patient management and counseling. We constructed digital materials to teach trainees and refresh knowledge, even in experienced clinicians.

METHODS: We received College of Medicine funding to develop a pilot module. A five-member team (3 faculty/2 students) developed an online curriculum. Our goal was to investigate, evaluate, and assess the quality of our instructional design. We distributed a short survey asking how the materials would 1) affect student satisfaction, 2) add value to learning, 3) be accessible and affect learning, and 4) provide authentic, real-world cases and materials. Answer formats included 4-point Likert scale and free text responses.

RESULTS: Student members were slightly more optimistic (mean_student=4 vs mean_faculty=3) about the importance of online materials (preliminary “trend” only, Mann Whitney U=6, as sample size is small). We had 30+ qualitative responses, including “insights” that the materials 1) “would appear to help ‘focus’ learners on key topics”, 2) “providing them with new perspectives and scaffolding may lead to easier understanding. Connecting with the real-world context will provide greater meaning and structure. If the goal is longer-term retention, then enduring content creation will be helpful, it will instill an opportunity for creating a space for exploring more critical thinking and enhance curiosity outside of pure didactic test driven content.”, and 3) “importance to have immediate access in a flexible timeline.”

CONCLUSIONS: Online curriculum, which is rising in popularity, can be available 24/7 and reach learners anywhere, any time. Trainees, experienced clinicians, and patients benefit from improved knowledge. This includes the development of skills to optimize clinical care, patient education, and patient engagement.

Rebecca Rowe, Kathryn Thompson, and Lori Koban
University of New England and University of Maine

PURPOSE: The purpose of this study is to determine “How do the MCAT scores of students who take their science prerequisite courses online compare to those of students who take their science prerequisite courses in a traditional classroom environment?”

METHODS: One sample consisted of students who completed three or more science prerequisite courses through an online program at a liberal arts university in the Northeast. Data was obtained from a survey that was sent electronically and anonymously using Survey Monkey. The second sample consists of students who applied to the medical school at the same university, all of whom took their science prerequisite courses in a traditional environment. The MCAT scores of these two groups were compared.

Two-sample t-tests were conducted to determine whether or not there is a significant difference between the mean MCAT scores of the two populations. Nonparametric testing compared the distributions of the MCAT scores. All identifiable data was secure and no personal identifiers were used.

RESULTS: When comparing the Biological and Physical sections of the MCAT for online students versus traditional students, there was no significant difference between the mean scores for the two groups (Biological p-value = .88; Physical p-value = .80). There was a significant difference between the mean verbal scores for the two groups (p-value < .0001); the online students scored higher than the traditional students.

CONCLUSIONS: For two of the three sections (Biological and Physical) of the MCAT, there was no significant difference in MCAT scores between the two student populations. For the verbal section of the MCAT, the students in the online environment scored higher than the students in the traditional environment.

Gail March
Boston University School of Medicine

PURPOSE: A digital badge is an electronic emblem embedded with the user’s name and achievements that acknowledges training in signature lines, CVs, and social media. The outcomes of two 2015 digital badge programs in medical education ignited the idea to provide guidance for future medical science digital badge programs. The goal of this study is to develop an implementation checklist for course designers to apply and award educational achievements with digital badges for medical science faculty, researchers, and students.

METHODS: To build the implementation checklist, an analysis of the 2015 digital badge programs added to a current review of literature on the emerging field of digital badges. Three new digital badge course directors piloted the checklist to design their different curricula and provided feedback.

RESULTS: The lessons learned from the 2015 digital-badge-programs outlined areas to avoid challenges. From a review of available digital badge articles and blogs, the checklist developed with questions on the digital badge significance, the institutional support, and the technology. All three new digital badge designers found the checklist very helpful in defining the basic components of their specific programs. They suggested more options for financial and technical information.

CONCLUSIONS: Awarding digital badges is successful in corporate training for better employee performance and is now in higher education to document achievements to future employers. Digital badges also provide an incentive for participants to dedicate time to complete online, self-directed sessions. There are too many meaningless certificates for simply attending training, whereas the digital badge specifies user’s competencies in metadata. The implementation checklist assists the program designers in establishing the value of the digital badge, the administration support, and the technical components. The impact of the checklist is to encourage others to apply a digital badge program for their online just-in-time learning, supplementary new topics, or milestones.

Joachim Neumann, Stephanie Simmrodt, Holger Teichert, and Ulrich Gergs
Institute for Pharmacology and Toxicology, Martin Luther University Halle-Wittenberg

PURPOSE: In the past, we have used voluntary online tutorials and quizzes to offer medical students the possibility of increasing and testing their knowledge in pharmacology. However, we noticed that voluntary online quizzes were poorly used by students (dropping to less than 20% of eligible students) and the knowledge of students was not covered adequately.

METHODS: First, we used a mock online examination at a single day (6 hours duration was offered) for all students from one semester. Participation was made attractive by offering a tangible academic incentive (up to two bonus marks on the final obligatory written examination). In the following semester, only 90 sec were available for each question (bonus marks were also offered, for comparison).

RESULTS: Because of the bonus marks always more than 90 % of the students participated. But in the first round, we were concerned about a skewed test with overestimation of the student knowledge (less than 1 % of students obtained less than 60 % of achievable marks) because 6 hrs. were available, the test was given online at home, and all kinds of resources for information were available. Next time, under more stringent conditions, students performed much worse (about 10 % obtained less than 60 % of maximum points). Listening to student groups revealed complaints that they had no time to use electronic resources to get better marks.

CONCLUSION: We conclude that online quizzes only make sense when tangible incentives are given (otherwise writing these quizzes is not time effective for students). Moreover, when reducing time available for answering questions, the difficulty of the test is greatly enhanced. It will be discussed which concept more faithfully reflects actual knowledge, which approach is more useful to induce learning and increase grades in obligatory written final examinations.

William Brooks and Mahmoud Elsayed
University of Alabama at Birmingham

PURPOSE: Preclinical medical students often feel that pharmacology is amongst the most difficult basic science disciplines due to the volume of information students are expected to master. Typically in an integrated, organ system-based preclinical curricular model, pharmacology is taught near the end of a course, weeks after the normal physiology underpinning it and days before the final exam. We have pursued a novel strategy that introduces students to brief, segmented pharmacology videos in the context of their physiology coursework earlier in each organ system course. This abstract describes the project and its outcomes.

METHODS: First-year medical school participants were provided with short, segmented pharmacology videos relevant to class material early in each course. An average of 3 videos were provided for each organ system course in the first year of medical school. Average video length was 16 minutes. Traditional pharmacology lectures were also provided near the end of each course as in previous years. Following each organ system course, study participants completed a survey and grade data was analyzed to assess the efficacy of segmenting pharmacology content.

RESULTS: Final results are still pending for this ongoing project. At the end of the fall semester, 75% of study participants felt that having segmented pharmacology videos in addition to traditional lectures was a more effective way of learning than traditional pharmacology lectures alone, and 88% felt it was a more enjoyable method of learning. Furthermore, 75% felt videos helped highlight important information during traditional lectures.

CONCLUSION: Brief, segmented pharmacology videos disseminated early in an integrated, organ system-based course may help reduce information overload with traditional pharmacology content delivery near the end of a course, improve student satisfaction, and improve academic outcomes.

Adam Rusch, Richard Tapping, and William Cope
College of Education, University of Illinois at Urbana-Champaign, College of Medicine at Urbana-Champaign, University of Illinois, College of Education

PURPOSE: Clinical cases require critical thinking that includes not only concepts and data, but judgment based on evidence that may be at times incomplete or whose interpretation may be a matter of professional opinion. Medical students also need to be able to work with their colleagues in a culture of professional collaboration. We have used an online system to facilitate this collaboration in ways that support case documentation and promote critical thinking.

METHODS: Students were asked to establish an account in the Scholar “social knowledge platform” developed at the University of Illinois. The participants in this study were first year medical students undertaking an immunization and vaccination module. The students were required to draft their case, peer review three other cases, then revise their case based on peer feedback. [See Appendix 1: Visualization of Scholar Writing Process and sample screenshot]

RESULTS: 123 students completed the module and 45 students participated in a survey instrument to provide feedback. While many students reported that they would have preferred the traditional lecture-exam model, they overwhelmingly agreed that were better able to explain complex clinical cases with the support of peer feedback. We believe this resistance can be mitigated through more practice, along with explanation of the importance of clinical reasoning and collaboration as key professional attributes. [See Appendix 2: Feedback Summary table]

CONCLUSIONS: Requiring students to explain clinical processes instead of or in addition to assessments where they answer empirical questions showed positive results. The Scholar platform was effective in facilitating student collaboration and displays of critical thinking skills. We are continuing this study with another Scholar module planned in the Spring 2017 semester.

Ali Alkhawaji, Thejodhar Pulakunta, and Gary Allen
Dalhousie University, KSAU-HS

PURPOSE: The use of computer-assisted instruction and learning in anatomy education has established basis for distant communication and provided accessibility to learning resources. Learning relying solely on educational technology has entailed a shift in learning paradigm toward directed self-learning approach. We surveyed students to explore the impact of this shift on student perceptions and attitude toward a group activity.

METHODS: In addition to a lecture component, the Basic Human Anatomy course uses a learning management system (BrightSpace) and a supplementary online environment (WileyPlus) to facilitate course delivery to more than a thousand students every year. The course instructor, recognizing the importance of fostering student-student interactions for enhanced learning, has planned and introduced an optional, out-of-classroom, group activity (DAL project). However, student participation was extremely poor. To interpret poor student participation in the activity, the students were surveyed for perceptions, attitudes and learning styles in the course.

RESULTS: In total, 175 responses were obtained. 88% of the total responses indicated that students were able to develop a personalized learning style through independent study of the course materials available on BrightSpace. 92.5% agreed that WileyPLUS was useful to stay engaged with course content and progression. 52.7% of the total responses attributed the poor participation in DAL project to the difficulty to find or make a group. while 24.6% disagreed, 43.7% of the total responses agreed with the statements: “Poor student participation in DAL project can be attributed to student hesitation or reluctance to communicate with each other; Student hesitation or reluctance can be associated with student ability to study and learn the course materials independently, which could suppress student motivation to interact with colleagues”.

CONCLUSION: Student hesitation or reluctance to communicate with each other can be associated with student ability to study and learn the course materials independently, which could inhibit student to interact with colleagues.

Victoria Nguyen, Kelly Kaneshiro, and Brion Benninger
Western University of Health Sciences COMP-Northwest, Medical Anatomy Center, Departments of Medical Anatomical Sciences, Neuromuscular Medicine, and Family Practice

PURPOSE: Drs SJ Vazirani 1960 and O J Akinosi 1977 described a closed-mouth high trigeminal nerve block (VA-B) as a method of anaesthetising the mandibular region. The VA-B is not to be confused with the open-mouth Gow Gates approach(GGB). Mandibular fractures are common and are associated with concussion. They present with a closed jaw, pain and distress. Opiates are contraindicated and anti-inflammatories are not sufficient pain relief. Therefore there is a need to provide pain relief to acquire ideal imaging and patient comfort. The objective of this study was to determine whether 1st year medical students (MS1) could learn the stereostructural anatomy, clinical value and perform via simulation a VA-B after viewing a 3-minute peer-led video tutorial.

METHODS: Literature search was conducted regarding training MS1 on VA-B. 104 MS1 dissected structures of the pterygomandibular region and were assessed during lab practical exam. Three months post-lab practical, MS1 had the option to volunteer viewing a 3-minute peer-created tutorial on VA-B which included needle positioning, procedure technique, surface landmark identification, and distinction from GGB. 24 hours post-tutorial, MS1 performed a VA-B on model cranium and were scored (8-point total) based on the criteria above and timed.

RESULTS: Literature search revealed no known studies. MS1(n=28) volunteers averaged 6.8±1.1 points and completed the procedure in 27±10s. 28/28 students scored full points on landmark identification, needle placement, and needle orientation. Primary and Acute Care physicians are not trained to perform VA-B, resulting in patients with mandibular fractures referred without adequate pain relief. Receiving VA-B training would expedite triage, pain relief and patient care.

CONCLUSION: This study regarding an important pain relieving procedural technique demonstrated MS1 could successfully perform VA-B’s after a follow-up 3-minute peer-led video tutorial, suggesting that medical schools could consider integrating this methodology into basic science curriculum.

Poster Award Nominee
Norma Perez, Berengaria Navarre, and Sarah Toombs Smith
University of Texas Medical Branch

PURPOSE: During a five-week summer program to prepare primarily underserved Hispanic undergraduates for the Medical College Admission Test (MCAT), we observed a gap between initial intent to prepare for the MCAT and actual time of taking the MCAT. We wanted to intensely mentor dedicated juniors during the spring semester before the MCAT, using an online format that allowed us to help students at various undergraduate institutions.

METHODS: Six cohorts of undergraduate premed students (N=49) have taken the online course, from February 2014 to May 2016. Premed advisors recommended their students for participation in the program. The program, offered online using Canvas Instructure, included online resources in subject matter, supporting subject links, and faculty coaching. Special lectures (online video with text provided) were produced to help students develop critical thinking skills and test taking strategies. Students were required to formulate a tailored study plan.

RESULTS: The 49 students were enrolled at 19 different universities in Texas and Arizona. Overall grade point averages (OGPAs) ranged 2.4-4.0 (average, 3.53) and science GPAs (SGPAs) ranged 2.0-4.0 (average, 3.44). Thirty-two (65%) reported a first language other than English. Of the 43 students who finished before 2016, 51% (22 students) have progressed in their medical careers. Of these, 16 students have entered medical school, 9 at UTMB and 7 elsewhere. Six entered other health-related fields (biomedical research, public health, EMT, etc.) Students rated their knowledge as Improved after the course and most rated aspects of the course as Very Good or Excellent. They praised both the video lectures and the mentoring.

CONCLUSIONS: A cost-effective online premed preparatory guide to the MCAT can impact the student’s chance of getting into medical school. The online premed coaching program, in particular, helps the student focus on tasks that increase the likelihood of acceptance into medical school.

Kelly Kaneshiro, Victoria Nguyen, and Brion Benninger
Western University of Health Sciences COMP-Northwest, Medical Anatomy Center, Departments of Medical Anatomical Sciences and Neuromuscular Medicine

PURPOSE: Common pathologies such as sinusitis, enlarged adenoids and otitis are associated with sinuses and other cavities associated with the skull and facial region. Sinuses connect into other cavities such as the middle ear, mastoid process, nasal cavity and pharynx. Often the sinuses are taught as a group and the cavities above are generally taught in silo fashion. The challenge for the student is creating a mental template connecting this system which yields volumes of common pathology. SECTRA Visualization Table (SVT) renders CT DICOM files into 3D interactive images with filter options to illuminate specific anatomy. The objective of this study was to assess the benefits of using SVT as an educational tool for sinus cavities in the cranium.

METHODS: Literature search was conducted regarding SVT as an educational tool teaching paranasal sinuses, associated cavities and neurovascular structures. 86 1st-year medical students(MS1) attended 10-minute SVT-3D tutorials in groups(6-8) interacting with paranasal sinuses, mastoid air cells, middle ear and nasopharynx. Students had access and encouraged to interact with SVT outside of formal hours 19/24hr. MS1 utilized their mental template to interact with SVT during head-neck exam and were scored based on their visual knowledge of morphology.

RESULTS: Literature search revealed no known studies. 86/86 MS1 were able to manipulate SVT to spatially optimize a viewing window which differentiated from surrounding structures to correctly identify specific sinus/cavity. 72/84 correctly described innervation responsible for pain. MS1 were able to synthesize their didactic, visual and spatial memory identifying a stereostructural space(100%), but more failed when asked to name a nerve not revealed on the 3D-image (despite verbal emphasis) which essentially required rote memorization recall(84%).

CONCLUSION: This study demonstrated SVT interactive 3D technology has a profound effect on visuospatial learning, suggesting it could successfully be integrated with a medical anatomy course providing awareness of an imaging form of “object (anatomical) permanence”.