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

Developing Teaching Tools and Measuring Learning Progress in New Ways

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.


Sep. 12 12:00 pm ET Chuck Eldridge Learning in Context: Developing Case Scenarios for the Preclinical Curriculum

Sep. 19 12:00 pm ET Mary T. Johnson Script Concordance Assessment of Clinical Reasoning in Medical Students, Five Years Out

Sep. 26 12:00 pm ET Arno M.M. Muijtjens Progress Testing - concept, history, and recent developments

Oct. 3 12:00 pm ET Robert Noiva & Douglas Gould Challenges and Opportunities of Independent Learning

Oct. 10 12:00 pm ET Katherine Chretien & Marti Grayson Social Media Competencies for Medical Educators



Learning in Context: Developing Case Scenarios for the Preclinical Curriculum

Presenter: Chuck Eldridge

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.

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

Presenter: Mary T. Johnson

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.

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Progress Testing - concept, history, and recent developments

Presenter: Arno M.M. Muijtjens

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.

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Challenges and Opportunities of Independent Learning

Presenter: Robert Noiva & Douglas Gould

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.


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Social Media Competencies for Medical Educators

Presenter: Martha S. Grayson & Katherine Chang Chretien

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.

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