1 Lectures in which fellows had outstanding and poor grades: fellows obtained poor grades in lectures on congenital hear
really good stuff 1 Lectures in which fellows had outstanding and poor grades: fellows obtained poor grades in lectures on congenital heart disease and outstanding grades in lectures on subjects such as mitral stenosis and pericarditis. Poor performance may have reflected the lack of emphasis on congenital disorders. 2 Individual fellow performance: two fellows were informed that their grades were inadequate; one fellow dramatically improved by self-study and the other required faculty intervention. 3 Eleven questions were found to be ambiguous or unfair and were not graded. 4 The comprehension of essential core knowledge (milestones): comprehension of milestones is important for assessing the competency of medical education. Two faculty cardiologists agreed that about one-third of the questions covered core essential information. Fellows achieved significantly higher grades on these milestone questions (mean ± standard deviation [SD]: 83.1 ± 5.3%) than on all questions (mean ± SD: 72.8 ± 8%). This indicated that the introductory lectures were effective in delivering the core material. 5 Testing at a pivotal time-point: testing knowledge using audience response technology in the review lectures provided fellows with ample time to address deficiencies prior to the in-training examination. 6 Fellow feedback: fellows strongly felt that audience response technology promoted interactivity and had educational value. In addition, grading by the technology was not intrusive, distracting or intimidating. Evaluation of results and impact The information generated about our lecture series is relevant only to our fellowship since each programme is unique in its structure and strengths and weaknesses. However, the value of our strategy is universal. This education technology may be invaluable for monitoring and improving the curriculum and training at all levels of medical education. The scope of post hoc analysis is unlimited. For example, in audiences of medical students and residents, post hoc analysis could reveal demographic differences in knowledge that might be useful for tailoring lectures to the needs of these diverse groups. Correspondence: Dr Paul Schick, Department of Internal Medicine, Hahnemann University, Broad and Vine Streets, Mail Stop 412, Philadelphia, Pennsylvania 19102, USA. E-mail:
[email protected] doi: 10.1111/j.1365-2923.2011.04084.x
1158
Social media in medical education: two innovative pilot studies Daniel R George & Cheryl Dellasega Context and setting Within emerging online environments, conventional blogging sites, as well as micro-blogging tools such as Twitter, have become integrated into pedagogical efforts. Social networks such as Facebook, content-sharing sites such as YouTube, cloud storage sites such as Flickr and Google Docs, as well as Internet-based communication software (Skype), have helped students join learning communities quickly and access course materials more readily than traditional classroom methods. Why the idea was necessary Creative applications of these technologies are burgeoning at universities around the world and yet there are few examples of their implementation in graduate training for medical students. What was done This project evaluated the integration of Twitter, YouTube, Flickr, blogging and Skype in two elective courses offered to Year 4 medical students. As part of their curriculum, Year 4 medical students at Penn State College of Medicine must take a final elective in humanities. These intensive, monthlong electives are developed by faculty staff based on their personal interest in an aspect of the humanities that they feel is important for students to explore. In the spring of 2010, two faculty members in the Humanities Department designed courses using social media. The first, ‘Creative Writing for Medicine’, used Twitter to provide students with brief writing prompts from the instructor in a shared class blog for writing assignments. Skype connected students with the well-known author of a short story read and discussed during the class. In the second course, ‘Narratives of Ageing: Exploring Creative Approaches to Dementia Care’, Twitter was used to allow for real-time communication between the students and instructor during visits to a locked unit at a care facility for people with Alzheimer’s disease. YouTube was used to stream videos made by Alzheimer’s disease advocacy groups from multiple countries and Skype was used to connect with and talk to various experts. The instructor took digital pictures of students and residents interacting as they co-authored stories and uploaded the images to the website Flickr, on which cloud storage functionality made them available to any student with access to the Internet. Several students used these pictures for a creative final
Blackwell Publishing Ltd 2011. MEDICAL EDUCATION 2011; 45: 1131–1162
really good stuff project which resulted in a scrapbook that was given to the residents. One student submitted her final creative project – a stop animation film adapted from one of the stories co-authored by a group of assistedliving residents – to the instructor via YouTube (http:// www.youtube.com/watch?v=BOxdpyB0g1I). Evaluation of results and impact Students rated both courses highly, mentioning the helpfulness of the social media resources. Their narrative comments expressed their satisfaction with the integration of social media into coursework and their opinion that this integration augmented learning and collaboration. Others identified challenges, including: demands on time outside the classroom; concerns about privacy, and lack of facility with technology. Integrating social media tools into class activities appeared to offer a variety of benefits over traditional classroom methods, including real-time communication outside the classroom, connections with medical experts, collaborative opportunities, and enhanced creativity. Social media can augment learning opportunities in many medical schools, and help students acquire tools and skill sets for problem solving, networking and collaboration in the 21st century. The command of such technologies will be increasingly important to the practice of medicine in the 21st century. Correspondence: Daniel R George, Department of Humanities, Penn State Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, Pennsylvania 17033, USA. Tel: 00 1 216 470 7154; Fax: 00 1 717 531 3894; E-mails:
[email protected],
[email protected] doi: 10.1111/j.1365-2923.2011.04124.x
Using high-fidelity human patient simulators to teach physiology Judy R Harris, Richard J Helyer & Eugene Lloyd Context and setting We use high-fidelity human patient simulators (HPSs) to provide dynamic demonstrations of the principles of cardiorespiratory physiology. Simulation sessions are integrated with laboratory practical classes, lectures and tutorials for approximately 900 Year 1 and 2 medical, dental, veterinary and medical science undergraduates. Why the idea was necessary Our laboratory classes using human subjects provide undergraduates with a rich environment for learning about the functions of the human body, but are limited to the study of healthy subjects using non-invasive techniques and safe interventions such as moderate exercise. The
HPS introduces students to invasive monitoring of variables such as central venous pressure and cardiac output, and allows them to investigate safely the effects of stressors such as hypoxia, hypercapnia and hypovolaemia. What was done We identified key physiological concepts, such as the control of blood pressure and ventilation, which cannot be illustrated in laboratory practical classes. We then developed scenarios to demonstrate those concepts using the HPS as the experimental ‘subject’. The scenarios are delivered in a problem-based learning format to groups of 15–20 students who observe the manikin’s physical signs and record data such as arterial pressure, central venous pressure and haemoglobin saturation from a display that emulates a clinical monitor. An additional numerical display provides real-time data for alveolar and arterial blood gases, and arterial pH. Interventions include: graduated haemorrhage; administration of hypoxic gas mixtures, and bagvalve-mask ventilation following neuromuscular blockade. Following the simulation sessions, students complete tasks that require them to analyse and interpret their observations. For example, they plot a graph of central venous pressure against stroke volume to illustrate Starling’s law of the heart. These tasks encourage deeper understanding of the underlying physiology. The outcomes from each simulation session are then integrated with material from lectures, laboratory classes and tutorials in a facultyled plenary session. We validated the data generated by the HPS against published in vivo data and, when necessary, made adjustments (e.g. to the gain of the baroreceptor reflex) to improve the fidelity of the base physiological model. Evaluation of results and impact We found good correspondence between the physiological model and corresponding in vivo data.1 Feedback from all undergraduate cohorts is very positive. Students particularly value seeing physiological changes happening in real time and the fact that simulation can provide vivid illustrations of theoretical concepts taught in lectures. We conducted an electronic survey of 238 Year 2 medical students: 74% of respondents agreed or strongly agreed that the simulation sessions helped them to understand the physiological principles of homeostasis and negative feedback; 79% agreed that simulation helped them to understand the relationship between cause and effect; 79% reported that simulation-based teaching integrated well with other parts of the curriculum, and 70% reported that they learned more from the sessions than from practical classes.
Blackwell Publishing Ltd 2011. MEDICAL EDUCATION 2011; 45: 1131–1162
1159
