Автор неизвестен - Mededworld and amee 2013 conference connect - страница 35

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Take-home messages: An e-learning is an effective way to teach medical students to work with professional interpreters.

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Evaluating the Utility of the Pain Education e-Tool: A Mixed-Methods Study with Medical Students and Educators

Pierre-Paul Tellier (McGill University, Family Medicine, 1925 Tupper Street, Montreal H3H1N6, Canada) Emmanuelle Belanger (McGill University, Family Medicine, Montreal, Canada) Charo Rodriguez (McGill University, Family Medicine, Montreal, Canada)

Nancy Posel (McGill University, Family Medicine, Montreal, Canada)

Mark A Ware (McGill University, Family Medicine/Anaesthesia, Montreal, Canada)

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

Background: This study reports on feedback obtained from second-year medical students and educators reviewing the Pain Education e-Tool (PEET), two virtual patient cases designed to integrate chronic and acute pain management within undergraduate medical education.

Summary of work: Mixed-methods exploratory study. Data sources included 80 questionnaires and 2 focus groups with students, as well as 9 interviews with educators.

Summary of results: Convergent and divergent themes were identified. Both students and educators agreed that the tool was innovative, but that the navigation could be improved. The students added that the PEET was more enjoyable than traditional didactic teaching modalities; 71% of them reported that they would like to use similar web-based methods to learn about other medical issues. According to the educators, the tool was comprehensive and offered an excellent model to support learning about the specifics of therapeutic communication about pain. The feedback gathered is being integrated into the latest version of the PEET. Conclusions: There was unanimous support for virtual patient cases as a comprehensive and innovative way to integrate pain in undergraduate medical curricula. The involvement of medical students and educators in the improvement of the PEET contributes to its acceptability and usability. The use of virtual patient cases is a promising avenue for increasing the quality of undergraduate medical education about pain. Take-home messages: This utility study involved end users in the preliminary assessment of the PEET, demonstrating the utility of virtual patient cases to teach undergraduate students about pain management.

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GeriatriX, a serious game for medical students to teach complex medical reasoning. Let's play!

Joep Lagro (University Nijmegen Medical Centre,

Department of Geriatric Medicine, Reinier Postlaan 10,

Nijmegen 6524 EJ, Netherlands)

Annalies Laan (Radboud University Nijmegen Medical

Centre, Department of Geriatric Medicine, Nijmegen,

Netherlands)

Michelle Veugelers (Radboud University Nijmegen Medical Centre, Institute for (bio) Medical Education, Nijmegen, Netherlands)

Fanny Huijbregts-Verheyden (Radboud University Nijmegen Medical Centre, Institute for (bio) Medical Education, Nijmegen, Netherlands) Noor Christoph (Academic Medical Centre, Center for Evidence-Based Education, Amsterdam, Netherlands) Marcel Olde Rikkert (Radboud University Nijmegen Medical Centre, Department of Geriatric Medicine, Nijmegen, Netherlands)

Background: The current medical curriculum is disease-oriented and less focused on patient-oriented preferences. Students should be better trained in multimorbidity and learn to question the standard diagnostic and therapeutic approach and weigh it's

appropriateness in the context of the individual patients with their specific preferences and multimorbidity. Summary of work: To train students this complex medical decision making in an attractive and safe way, we multidisciplinary developed the serious game GeriatriX. Students weigh in GeriatriX the following criteria: 1) patient preferences, 2) appropriateness and 3) costs of medical care. We chose for a serious game because it is fun and fits in with an active, playful and experiential learning method in an authentic context. Summary of results: GeriatriX was developed in a short period of six months. It contains the same medical problem (anemia) in three different elderly patients (context). This challenges students to explore different diagnostic and therapeutic strategies and gives insight in the consequences and costs of their choices. While playing they automatically receive feedback on their choices with respect to patient centeredness, medical appropriateness and costs of medical care. Preliminary results in 29 students showed that they found GeriatriX fun (3.9±0.6; mean ± standard deviation; 5 point Likert-scale). They were satisfied with the given feedback (3.4±0.9) and after playing they were more aware of the weighing of different aspects in medical decision making in geriatric patients (4.0±0.8).

Conclusions: GeriatriX is an innovative, challenging and promising educational tool. The next step is implementing GeriatriX in the medical curriculum and research its merits.

Take-home messages: GeriatriX. Let's play medical decision making!

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Learning Analytics in Screen Based Simulation of Radiograph Interpretation

Martin V Pusic (New York University, Office of Medical Education, 545 First Ave, Ste 6R, New York 10016, United

States)

Martin Pecaric (Contrail Consulting, Toronto, Canada) Kathy Boutis (University of Toronto, Pediatrics, Toronto, Canada)

Background: Radiology simulations allow deliberate practice using hundreds of image-based clinical cases. Learning analytics can be defined as "the use of learner-produced data and analysis models for predicting and advising people's learning." In this study, we apply learning analytics to a screen-based simulation of radiograph interpretation. Objective: To investigate candidate learning analytic parameters for radiograph interpretation using an expert-novice comparison. Summary of work: We recruited low experience (LE) medical learners including 20 medical students and 18 residents, and a high experience (HE) group which included 5 attending emergency physicians and 3 radiologists. Using a web-based program that simulated the clinical presentation of 234 ankle radiographs in an emergency department, participants classified cases as normal or abnormal; if "abnormal" was selected, they specified the location of the abnormality. Immediate feedback on the diagnosis was provided. The system

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

recorded the following process measures: total time on case, time on each radiograph view, number of radiograph views examined, and frequency of re-review of the case history.

Summary of results: The mean (SEM) time on each case

for the LE and HE groups were 35.8 (0.45) and 52.6 (1.3)

seconds, respectively (p<0.0001). The LE spent an average of 4.0 (0.09) seconds on each view, while the HE group spent 7.2(0.23) seconds, p=0.02. The LE aggregate toggled amongst the views an average of 4.00 (0.02) times per case, while the HE group performed this 4.9 (0.05) times per case, p=0.04. The HE group was 1.7 times as likely as the LE group to re-review a case, although this was not found to be statistically significant

(p=0.13).

Conclusions: Process data collected from an online radiograph interpretation simulation correlate with Expert-Novice differences.

Take-home messages: Simulation environments have the advantage of providing rich process information which, when combined with performance measures, can provide insight into the learner's interpretation process.

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Optimizing the process of eLearning development

Anne-Petra Rozendal (University Medical Center Utrecht, Center for Research and Development of Education, Utrecht, Netherlands)

Ellen Torfs (University Medical Center Utrecht, Center for Research and Development of Education, P.O. Box 85500, HB4.05, Utrecht 3508 GA, Netherlands) Sape Van Der Werf (University Medical Center Utrecht, Directorate of Technology, Utrecht, Netherlands)

Background: The Education&ICT programme at the University Medical Center Utrecht aims at enabling ubiquitous learning for students and employees. In this programme a large number of high quality eLearning modules are being developed. Summary of work: To produce eLearning more efficiently we wanted to improve the development process. All steps in the process and the roles and responsibilities of people involved were described, points for improvement were identified, and the process was redesigned. We further optimized the process during the development of two proof-of-concept eLearning modules. This process has now been applied successfully to develop eLearning on a variety of medical subjects.

Summary of results: The development process consists of five phases: 1) design and pre-production 2) production 3) testing 4) implementation and 5) evaluation. During the design phase the learning goals and content are defined and the functional, graphic, and technical aspects are described. A storyboard (text, questions, and multimedia elements) is written by subject-matter experts in close collaboration with an educational advisor. During the production phase, multimedia elements are produced, the graphic design is applied and the module is built using the authoring tool. Next, the module is tested by subject-matter experts,

developers, and users. The module is further improved based on the test results and then made available to users via the virtual learning environment. Finally, users evaluate the module via an online questionnaire. Take-home messages: eLearning can be developed more efficiently by first describing and optimizing the development process and clearly defining roles and responsibilities of the people involved.

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Medical Education in a Digital Age: Sociomaterial Considerations

Anna MacLeod (Dalhousie University, Division of Medical Education, 5849 University Avenue, Clinical Research Centre Room 112A, Halifax B3H4R2, Canada) Cathy Fournier (Dalhousie University, Faculty of Arts and Social Science, Halifax, Canada)

Olga Kits (Dalhousie University, Research Methods Unit, Halifax, Canada)

Background: The undergraduate curriculum in the Faculty of Medicine at Dalhousie University is becoming increasingly digital. Examples include the largely paperless delivery of the program and the simultaneous distribution of the program to campuses that are 400 kilometers apart. In light of these developments, we're conducting a qualitative study to explore the question: How is technological renewal experienced by students, faculty and staff?

Summary of work: Our three-year ethnographic study explores the experiences of faculty, staff and students during a time of intense technological renewal. Our methods include: 1. textual analyses of documents and policies related to technologies; 2. observations of technologically-mediated events (lectures, small-group learning, committee meetings, etc.); and, 3. in-depth interviews and focus groups with faculty, staff and students.

Summary of results: We are learning that materials (tools, technologies, objects, etc.) and material conditions (availability of mobile devices, access to internet connections, barriers imposed by firewalls, etc.) have a significant influence on medical education. Conclusions: An individual learner is enmeshed in a network of influential factors, both human and non-human. Optimizing digital medical education requires an understanding of this network of influences. Take-home messages: While the importance of social learning in medical education has been acknowledged, material conditions have been largely ignored. Our research is demonstrating that both social (relationships) and material (technological) contexts have an influence on learning.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

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Understanding medical students' self-regulated learning in traditional classroom and online learning context: a mixed method study with cluster analysis

Fremen Chih-Chen Chou (China Medical University

Hospital, Department of Education, #2, Yu-de Rd. North

District Taichung 40447, Taiwan)

Sheng-Chang Yang (China Medical University Hospital,

Department of Education, Taichung, Taiwan)

Walter Chen (China Medical University, School of

Medicine, Taichung, Taiwan)

Hsiao-Chuan Lin (China Medical University Hospital,

Department of Education, Taichung, Taiwan)

Background: Not every student benefited from the self-regulated online learning context. It is crucial to investigate what latent traits of both students and learning contexts (traditional or online) make this difference.

Summary of work: 300 students in junior clerkship rotation experienced both complementary learning contexts of "traditional" and "online." Every student answered the self-regulated learning questionnaire and attendant rate of both learning contexts as well as three qualitative questions about why and how in which learning context the student feel competent with, preferred and actual performing better self-regulated learning. Cluster analysis according to attendance in both learning contexts divided the students into four clusters with both high, both low and high attendance in each context.

Summary of results: Exploratory factor analysis revealed consistent results within the two learning contexts with identical 4 pre-proposed factors. The overall alphas were 0.96 and 0.95, respectively. The repeated-measure ANOVA utilizing factor scores revealed a single significant effect on the interaction between clusters and learning contexts. Post hoc comparisons indicated the factor "goal-setting and time management" (GT) play a major role. Content analyses for the four clusters' qualitative responses revealed total 13 themes emerged from 47 pattern codes. The pattern differences of the qualitative responses support the quantitative results and also identified the role of students' motivation. Conclusions: GT and motivation influence the self-regulation in different learning contexts. Take-home messages: When learning motivation of students is extremely high or low, the learning context doesn't make a difference in self-regulated learning. However, when motivation is in between, perceived GT help students to identify the suitable learning context.

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Thinking outside the classroom: social media and undergraduate medical education

Matthew Mak (University College London, Department of Medical Education, Royal College of Physicians, 11 St. Andrew's Place, London NW1 4LE, United Kingdom)

Background: Social media has the potential to be a powerful tool for learning and teaching. Modern technology has the ability to accomplish the goals of a social constructivist classroom and the internet provides such a forum for debate and dialogue, and the social construction of meaning. Boulos and Wheeler (2007) argue that Web 2.0 can 'promote active and engaged learning, where participants themselves construct their own knowledge through social interaction and exploration'

Summary of work: A structured online questionnaire was posted using Google Forms for 30 days between February and March 2013. Invitations to complete the survey were sent via e-mail, Twitter, Facebook and other online forums. Respondents were asked to answer sixteen questions on their use of social media platforms and attitudes towards social media. This is a report of the medical student responses. Summary of results: 1090 respondents completed the survey of which 290 were medical students. 70% of medical students felt social media contributed to their learning at least weekly and 75% of students agreed that they found social media helpful in developing their clinical education. However, 65% of medical students did not agree with the statement that they learnt more from social media than lectures and 76% disagreed with the fact that social media had replaced the traditional methods of learning in medicine. Conclusions: Social media promotes tacit knowledge transfer but there remains a role for traditional teaching methods.

Take-home messages: Medical schools and educators should embrace social media as a useful adjunct to deliver 21st Century medical education.

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Student resistance to new technology

Vicki Langendyk (University of Western Sydney, School of Medicine, Locked Bag 1797, Campbelltown Campus, Penrith, Sydney 2751, Australia) Glenn Mason (University of Western Sydney, School of Medicine, Sydney, Australia)

Shaoyu Wang (University of Western Sydney, School of Medicine, Sydney, Australia)

Background: The content management system of the University of Western Sydney does not allow students to maintain a continuous record of their work from one year to another. Nor does it facilitate the provision of timely formative feedback as students work develops. Records of student learning are static finalised products to be uploaded for assessment, not dynamic documents which can be changed upon further reflection or in response to feedback provided by teachers and peers. At the School of Medicine we decided to introduce an electronic learning platform called Pebblepad to enable our first and second year medical students to develop a portfolio to record and reflect on their professional development across the 5 years of their undergraduate education.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

Summary of work: Pebblepad is a fully web-based electronic portfolio which provides a private space for learners to plan, record and reflect on their activities, and an institutional space for learners to reveal their work to teachers for feedback. Students can store their reflections/work in Pebblepad across their undergraduate education and beyond, encouraging a view of learning as a continuous and lifelong process. We redesigned the curriculum and the assessment to promote reflective practice, and provided extensive technological support for both staff and students. Summary of results: Technologically savvy students and technologically challenged teachers struggled to develop the skills required for Pebblepad. However, teachers embraced the pedagogical possibilities, whilst students remained unconvinced.

Conclusions: We underestimated student resistance to the adoption of new technology.

Take-home messages: Is student resistance a reluctance to engage in the reflective mode of learning which Pebblepad requires?

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Motivation to use e-Learning resources is associated with greater learning achievements in medical students

Chien-Da Huang (Chang Gung Memorial Hospital and Chang Gung University, Department of Medical Education and Thoracic Medicine, 199 Tun Hua N. Road, Taipei 105, Taiwan)

Shang-Hung Chang (Chang Gung Memorial Hospital and Chang Gung University, Department of Cardiology, Taipei, Taiwan)

Han-Pin Kuo (Chang Gung Memorial Hospital and Chang Gung University, Department of Internal Medicine and Thoracic Medicine, Taipei, Taiwan) Ji-Tseng Fang (Chang Gung Memorial Hospital and Chang Gung University, Department of Nephrology, Taipei, Taiwan)

San-Jou Yeh (Chang Gung Memorial Hospital and Chang Gung University, Department of Medical Education and Cardiology, Taipei, Taiwan)

Background: The aim of this study was to investigate whether motivation to use an e-Learning resource (AccessMedicine) is associated with better educational achievements among medical students. Summary of work: During the 2012 academic year, 76 fifth-year medical students in the clerk program of Internal Medicine in Chang Gung Memorial Hospital were recruited to this study. Levels of motivation to use e-Learning were classified as complete, partial or no motivation according to the use of nine AccessMedicine custom e-Learning modules. Assessment of learning achievements included the results of 1st stage medical license examinations, written multiple-choice questions (MCQ) and formative assessment for Internal Medicine. Summary of results: Motivation to use e-Learning resources is significantly higher in students that pass the 1st stage medical license examination, compared to those that fail (84.2% vs. 68.4% respectively, p=0.010).

There was also a significant association between motivation and attendance at morning meetings (p=0.019). Success in the written MCQ and formative assessment was significantly higher among the 61 students that completed the AccessMedicine modules compared to the 8 students that only partly completed the modules and the 7 students that did not complete any (for the MCQ: 67.2±6.3% vs. 62.5±5.6% vs. 61.4±9.0% respectively; for the formative assessment:

92.0±2.2% vs. 89.6±1.9% vs. 85.9±3.0% respectively; p<0.05).

Conclusions: Students' motivation to use E-Learning resources has a positive association with their learning achievements. Formulating effective educational strategies to motivate students to use e-Learning resources may improve their achievements. Take-home messages: Motivation to use e-Learning has a positive association with learning achievements of medical students.

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A novel e-learning module: Ear and temporal bone 3D anatomy and surgical approaches

Horace Cheng (Western University, Schulich School of Medicine and Dentistry, 38 Bromleigh Ave, London N6G 1T9, Canada)

Nikolas Blevins (Stanford University, Department of Otolaryngology - Head and Neck Surgery, Stanford, California, United States)

Robert Jackler (Stanford University, Department of Otolaryngology - Head and Neck Surgery, Stanford, California, United States)

Sumit Agrawal (Western University, Department of Otolaryngology - Head and Neck Surgery, London, Ontario, Cape Verde)

Background: A good understanding of ear anatomy is important for medical students as it relates to the pathophysiology of otologic diseases. Likewise, a firm understanding of the anatomy and surgical approaches of the ear and temporal bone is essential to the training of otolaryngology residents. However, communicating the complex anatomy of these structures in traditional print medium has proved to be a challenge for medical educators and learners.

Medical trainees of all levels have increasingly sought to enhance their learning experiences by the use of interactive computer based anatomy models. Attempts to create computer-generated, interactive, 3D models of the ear and temporal bone have been made but the widespread adoption of these useful learning aids have been hampered by the single-user delivery and technology-compatibility issues. Summary of work: This novel e-learning module is the result of collaboration between Western University and Stanford University. It is developed as an e-learning tool for medical students and otolaryngology residents. This module is uses a flashed-based platform specifically designed to be accessible online and compatible with all major browsers and tablet devices, thus overcoming the major limiting factors in delivery of material to learners.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

The material presented is an amalgamation world-class learning resources: 3D models from the award-winning Temporal Bone Dissector, contents from authoritative reference textbook, and digitally-recorded surgical videos.

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