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Save the Date for the Winter 2019 WAS Series!

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Winter 2019 – Series Theme: Learning Environment in Health Sciences Education

January 10 – Overview & introduction of the Learning Environment – Larry Gruppen
January 17 – The Learning Environment: An International Perspective – Sean Tackett
January 24 – The Learning Environment During Residency – John Co
January 31 – Learning Environment Panel featuring discussions from Osteopathic, Nursing and PA perspectives – Luke Mortensen, Cindy Anderson and Karen Hills
February 7 – System and Case Studies – Dan Harrington

The 2019 winter series of the IAMSE webinar program will focus on the role of the learning environment in health science education. The significance and importance of the learning environment is based on the assumption that a poor environment is associated with poor student performance, burn-out and stress. Numerous reports of students experiencing increased levels of unprofessional behavior and mistreatment on the part of faculty, residents, staff and other students have raised concerns about student well being, professional development, and accreditation requirements. As a result, a major emphasis on the part of health science educators today is to evaluate the learning environment, identify areas of concern, and take measures to address these issues.

The goal of this series is to raise awareness of the importance of ensuring a positive learning environment across health sciences education and to provide examples of systems and programs that have addressed this issue in an impactful manner. The introductory session will discuss the challenges in developing a conceptual framework for the learning environment, current limitations in measuring the learning environment, and initiatives designed to improve the learning environment. The remainder of the sessions will examine the current state of affairs in a variety of different health science settings. A panel will discuss these issues from the perspective of osteopathic, nursing and physician assistant educational programs.

We will gain insight into the issues and research being conducted on the global learning environment from some selected schools outside of the United States. We will explore the learning environment in graduate medical education (ACGME) and will conclude with an in-depth practical approach of how one medical school created a robust system to monitor the learning environment which will include case studies. It is anticipated that at the end of the series the audience will be more in-tuned with the importance of maintaining a healthy learning environment and be better equipped with practical applications for their educational programs.

Registration for the Winter Webcast Audio Seminar Series is opening soon! 

IAMSE – Medical Science Educator Call for Manuscripts

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Medical Science Educator, the peer-reviewed journal of the International Association of Medical Science Educators (IAMSE), publishes scholarly work in the field of health sciences education. The journal publishes four issues per year through Springer Publishing. We welcome contributions in the format of Short Communication, Original Research, Monograph, Commentary, and Innovation. Please visit our website www.medicalscienceeducator.org for a more detailed description of these types of articles.

We look forward to receiving your submissions!

IAMSE Fall 2018 WAS Session 5 Highlights

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[The following notes were generated by Mark Slivkoff.]

 IAMSE Webinar Series, Fall 2018

Speaker: Stanley J. Hamstra, PhD
VP, Milestones Research and Evaluation
Accreditation Council for Graduate Medical Education (ACGME)
Title: Realizing the Promise of Big Data: Learning Analytics in Competency-Based Medical Education
Series: Evolution and Revolution in Medical Education: Technology in the 21st Century

    • Hamstra outlined the following for his webinar:
      • A Review of Milestones
      • Learning Analytics
      • Future Directions
    • Overall, the use of milestones is important because their use helps health professionals remain accountable for the education of our students

     

    A Review of Milestones

    • A special report on milestones was published by Nasca et al. in The New England Journal of Medicine (366:1051-6; 2012).
      • A main point expressed by its authors was that there had been a significant amount of variability in the quality of resident education (graduate medical education, GME)
      • The ACGME, founded in 1981, responded appropriately and the quality of GME has increased over the past 30 years
    • A competency-based approach was necessary to combat the variability characteristic of the traditional model (curriculum with educational objectives and assessments).
    • In a competency-based education model, the health needs and systems are analyzed, then the competencies are built.
    • Competence is multi-dimensional and allows faculty to ask residents:
      • What do they know? (Medical Knowledge)
      • What can they do? (PatientCare)
      • How do they conduct themselves? (Interpersonal and Communication Skills, Professionalism)
      • Are they critical and reflective? (Practice-based Learning and Improvement, Systems-based Practice)
    • Milestones were modeled on the five stages outlined in the Dreyfus Developmental Model of Learning (Novice, Advanced beginner, Competent, Proficient, and Expert).
    • Some of the key points regarding milestones:
      • Articulate shared understanding of expectations
      • Describe trajectory from a beginner in the specialty to an exceptional resident or practitioner
      • Set aspirational goals of excellence
      • Organized under six domains of clinical competency
      • Used as one indicator of a resident’s educational progress
    • Various studies have been done on the effectiveness of milestones. One article considered in the webinar was Conforti et al. (J Surg Educ. 2018;75(1):147-55), who focused on the benefits to the residency Program Director:
      • Changes in the remediation process can be implemented
        • Catching struggling residents earlier
        • Targeted improvements for individual learners
        • Identifying gaps in otherwise high performers
      • Structuring of learning goals
      • Making defensible decisions
        • Milestones provide “built-in”documentation which potential helps mitigate resident’s fighting their evaluation
      • There are numerous sub-competencies (~22) spread across over 130,000 residents, thus crunching the data is a significant task since the number of data points approaches about 3.2 million!

     

    Learning Analytics

    • Learning analytics was broken down into three pieces:
      • Concepts
      • Examples
      • Implementation
    • The purpose of the introduction of milestones revolves around entrustability: can we develop a system to ensure residents and fellows are ready for unsupervised practice by graduation?
    • S. Department of Education describes learning analytics as such: the interpretation of a wide range of data produced by and gathered on behalf of students in order to assess academic progress, predict future performance, and spot potential issues”
    • Hamstra described a Generic Milestones Template
      • Five levels
      • Emphasis placed on Level 4, What does a graduating resident look like? This level serves as the main target for graduation for most specialties, however, is NOT a requirement for graduation
    • The Data: Cross-sectional analysis at the specialty level…
      • Hamstra noted that his favorite data set, his favorite graph, is the “Proportion of Residents Attaining Level 4 or Higher: PC Sub-Competencies (June 2015) – Neurological Surgery”
        • Data makes sense, according the feedback from residency directors
        • In order of attainment, with PC08 at about 95% and PC03 at about 72%:
          • PC08: Traumatic Brain Injury
          • PC02: Critical Care
          • PC01: Brain Tumor
          • PC06: Spinal Neurosurgery
          • PC05: Pediatric Neurological Surgery
          • PC07: Vascular Neurosurgery
          • PC04: Pain and Peripheral Nerves
          • PC03: Surgical Treatment of Epilepsy and Movement Disorders
        • Conclusion: Pain and Peripheral Nerves, Epilepsy and Movement Disorders are not getting covered at specific sites
        • Change in curriculum design and assessment can be addressed
      • The Data: Longitudinal analysis at the individual level…
        • Various graphs were presented which showed milestone “trajectories” (entrance to graduation) within various specialties including:
          • Surgery, pathology (MK01 competency)
          • Wound management
        • Hamstra discussed the Odds Ratio (OR) for residents not attaining Level 4 under threshold. Students at level 1.5 or above during their first assessment (year 1) have a much greater chance at attaining Level 4 than those who score lower.
      • QUALITATIVE RESEARCH: How do Raters Make Decisions?
        • The phenomenon of “straight-lining” has been extensively looked at as well. Straight-lining is when an evaluator, such as a busy physician, gives the same score for each milestone. This, of course, is not good to do.
        • Hamstra’s group is working on how best to mitigate this phenomenon by combing through lots of specialty and sub-specialty data

    Future Directions

    • Version 2.0 of milestones are currently underway.
    • Overall, the new version (new tables) contain milestones which are more refined

    Questions asked after seminar:

    (Note that some questions and/or answers have been reworded for clarity.)

    How do these measures play in to the overall evaluation process? Some teachers do not want to personally evaluate or judge residents, and residents may take their evaluations personally.
    A couple ways to mitigate the personal nature of evaluations. First, evaluations can be done by groups rather than by individual faculty. Second, as evaluator you can have a conversation with the resident in the beginning, letting them know that they will start at level 1.

    What about the variability between residencies?
    We’re looking at the data to help us address a few questions. Do milestone ratings as a whole differ between large and small residencies? Does the size of the program matter? What is the low hanging fruit, that is, what explains the differences?

    What is a good way to ask for feedback on milestones?
    The “O” score assessment which can be applied to other specialties and skills. We’ve created a form called the OCAT (Ottawa Clinical Assessment Tool). Overall, when building forms for evaluation, you need to keep them simple.

    Do you think that the milestones should reflect the Dreyfus model?
    Dreyfus models seems to be the best fit for designing and building milestones.

    If a student finishes the milestones early, do they finish the program early?
    This is a good question and is a key debate right now. Again, milestones are used to supplement evaluations of program directors. But the gist of competency education is that if you are comfortable in graduating someone early, then go for it. Jury is still out, but in theory we’d strive for this.

    Do you have qualitative data on which students make it to Level 4 earlier?
    We do not, but we also want to ask why didn’t those residents make it to Level 4.

    How can a student reach a level of 2.5 when 2.5 is not defined?
    Half-levels are defined. I didn’t talk about this but there are specific instructions on giving a 2.5. The scale is actually a 9-point scale (1 to 5, in 0.5 increments).

    What software do you use to analyze your data?
    We use SAS, but programmers use other programs as well.

    Dr. Hamstra can be reached at shamstra@acgme.org

IAMSE Featured Member: Amber Heck

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Our association is a robust and diverse set of educators, researchers, medical professionals, volunteers and academics that come from all walks of life and from around the globe. Each month we choose a member to highlight their academic and professional career, and see how they are making the best of their membership in IAMSE. This month’s Featured Member is Amber Heck, PhD.

IAMSE Featured Member Amber Heck

In 2013 when I first joined IAMSE, I was still a new faculty member with three years of classroom experience under my belt. Already feeling uninspired by the lack of diversity of teaching modalities and experiences our learners were being offered, I sought out professional development experiences outside of the institution.  I was introduced to IAMSE by a respected colleague and I jumped at the opportunity, attending the ESME course at the 2013 Annual Conference in St. Andrews, Scotland. Through this course I was suddenly exposed to a whole new world of medical education. One in which teachers act as researchers and make decisions based on peer-reviewed literature. In which medical educators share experiences and work together toward establishing best practices. That week, I became part of a community of practice.

Opportunity begets opportunity, and through the ESME course I found the IAMSE Medical Educator Fellowship. Through my participation in the Fellowship, I was introduced to an inspiring group of educators. I am continually learning from and modeling myself after the intellectual curiosity and collaborative spirit that I appreciate in my colleagues and mentors on the Educational Scholarship Committee. By inviting me to become a member of the Committee, they showed confidence in me that has propelled me forward. As a member of this team, I am privileged to provide support and create opportunities for aspiring and accomplished medical education researchers.

What I love most about IAMSE is the collaborative environment. IAMSE members foster teamwork, encourage innovation, leverage each other’s strengths, and recognize, reward and celebrate these behaviors in others. In academia, it is imperative that we recognize that no man is an island, and one simply cannot grow to one’s full potential without the support and intervention of others. Mentorship should not be a solitary relationship between two individuals, but a dynamic network of associates. There is no such thing as too many mentors, as they each serve a unique purpose at different times in one’s life. Through the mentorship I receive here at IAMSE, I have discovered that I can combine all of my interests; a respect for the scientific method, a love for biologic mechanisms, and a passion for teaching, into a successful career in medical education.

Want to learn more about IAMSE Fellowship and Grant Opportunities? Visit our website here!

IAMSE Fall 2018 WAS Session 4 Highlights

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[The following notes were generated by Mark Slivkoff.]

 IAMSE Webinar Series, Fall 2018

Speaker: Douglas Danforth, PhD
The Ohio State University College of Medicine, Columbus, Ohio
Title: Virtual Reality and Augmented Reality in Medical Education
Series: Evolution and Revolution in Medical Education: Technology in the 21st Century

  • The objectives of Dr. Danforth’s discussion included:
    • Define and describe virtual reality (VR), augmented reality (AR), and mixed reality (MR)
    • Go through a history of VR, AR, and MR in medical education
    • Describe current technologies
    • Opportunities and examples
    • Describe challenges and future directions
  • VR is the computer-generated simulation of a three-dimensional image or environment that can be interacted with in a seemingly real or physical way by a person using special electronic equipment, such as a helmet with a screen inside or gloves fitted with sensors.
    • Advantage is that you can create simulations that are impossible in the real world
    • VR can be created via software, or by using special video cameras with 360 degree angles
  • In contrast to VR, AR is a technology that superimposes a computer-generated image on a user’s view of the real world
    • Advantage is that it augments experiences in the physical world
  • MR, also referred to as hybrid reality, is the merging of real and virtual worlds to produce new environments and visualizations where physical and digital objects co-exist and interact in real time.
  • The history of VR and AR dates back decades:
    • Morton Hellig created the Sensorama in 1957
    • Before this there was the ViewMaster in 1939
    • Flight simulator came out in 1966
    • The term VR was popularized by a VPL scientist, Jaron Lanier, in 1987
  • In medical education, VR and AR has their roots at the University of Chicago with CAVE, Cave Automatic Virtual Environment
    • Use of rear projection screens that surround the user
    • User wears 3D glasses
    • University of Toledo and The Ohio State University both have CAVE
    • CAVE environments are expensive
  • Second Life (software), also used in medical education, was started in the early 2000s.
    • Used by many academic institutions
    • Danforth used the software to design a testis through which you could fly and learn about all the relevant anatomy and physiology
    • 2007 was the heyday of Second Life’s use, with over 1000 users/month added
    • Not used any more at many institutions
  • Current VR technologies include:
    • Google Cardboard
      • Advantages: inexpensive ($10), uses your smartphone, and it’s entry level
      • Disadvantages: low resolution, you can’t walk around in the environment, you can only turn your head with limited to no interaction
      • It’s a great way to expose folks to VR, especially the rollercoaster ride
      • Use with YouTube’s Virtual Reality channel
    • Samsung Gear VR and Google Daydream
      • Advantages: inexpensive, use your smartphone, some interaction
      • Disadvantages: low resolution, stationary VR
    • Oculus Go (and the Quest which just got released)
      • Advantages: relatively inexpensive ($200), built-in display and sound, allows for interaction
      • Allows for 6 degrees of freedom (up, down, right, left, forward, backward)
    • HTC Vive, PlayStation VR, Oculus Rift and Samsung Odyssey
      • Advantages: high resolution, smooth video, allows interaction, mobile VR
      • Disadvantages: expensive ($400 to $800), requires a powerful computer that you have to be tethered to, can be challenging to set up
      • Danforth uses an HTC Vive
    • Current AR technologies: Google Glass, Microsoft HoloLens
      • Advantages: not isolated from surroundings, good for training, access to real time schematics
      • Disadvantages: expensive ($3000), requires a powerful computer (but not too expensive these days…$1500)
      • Microsoft’s Holo Anatomy put to use
    • Opportunities and Examples
      • Anatomy education is the most obvious discipline to target
      • Surgery applications
      • Microsoft HoloLens, HoloAnatomy: https://www.youtube.com/watch?rel=0&start=35&v=SKpKlh1-en0
        • Case Western is extensively using HoloLens
      • Voxel Bay at Nationwide Children’s Hospital: https://www.youtube.com/watch?rel=0&showinfo=0&start=35&v=uVRilk_6UWI
        • The Ohio State U. collaborates with them
        • Used by pain researchers to distract kids from pain
      • Mass Casualty Training at the Ohio State University
      • Conan Visits YouTube’s VR Lab (hilarious, if you enjoy Conan’s humor): https://www.youtube.com/c126d7c3-4fa3-4c75-a3dc-d35ea8ad155a
      • Visual standardized Patients: https://youtu.be/mvXIruMt9Ek
        • High fidelity, simulated “real” standardized patient
        • Conversational, can understand and respond to student questions
        • Easy to use, require little or no training
        • Soon students will wear VR goggles
      • Challenges of VR and AR
        • Fatigue, disorientation and vertigo
        • headsets are heavy, and there’s usually a lag when watching
        • Difficult to scale, to do multiplayer VR
        • Movement in virtual space
        • Lack of haptic tools
        • Limited interoperability, but software is allowing for some cross-platform compatibility
      • Future of VR and AR
        • Portability
        • Untethered systems
        • Smaller more comfortable headsets
        • Fidelity
        • Higher resolution displays/increased framerates
        • Haptic feedback
        • Multiplayer
        • Team based simulations
        • Interoperability
        • Build once – deploy everywhere
      • Upcoming in Content and Applications
        • Surgical simulation
        • Patient specific simulations
        • Remote surgery
        • Virtual Patients
        • Practice history taking, physical exam skills, differential diagnoses
        • Automated assessment
        • Team training
        • Emergency medicine, surgical stimulation

Questions asked after seminar:
(Note that some questions and/or answers have been reworded for clarity)

Do you suggest any starter tools to get your feet wet in the technology?
Recommend that you collaborate (with gaming folks, the software folks). It’s simple to get started with 360 degree camera. Higher end creation requires software such as Second Life. And you’ll need a programmer who knows Unity or Unreal Engine (software).

How do everyday operating systems (Oss) figure into all this?
Apple has some VR labs but they don’t compare to what I’ve discussed. Some material can be ported to operating systems such as iOS.

Where is the market going?
Single software use for all purposes. Hardware includes the newly released Oculus Quest.

How are your students at The Ohio State University Evaluated?
Pre and Post Tests are administered. Working on building the mass casualty training system similar to games in that there are various difficulty levels. Must pass one level before moving to the next.

Have you received any pushback from certain populations (e.g. students who get sick)?
There has been very little pushback but we have to have alternatives. Enhances in technology should mitigate the sickness factor.

Has VR or AR been mapped to high fidelity mannequins?
Not yet, but someday it is bound to happen. Companies are trying to merge the two. Seeing different things inside the same mannequin is an example.

What about procedural skills such as suturing or lobotomy?
This is much further down the road. The main problem is that there are no commercially available gloves yet that allow for haptic feedback.

You showed a couple VR anatomy simulations. What were they?
3D Orgnan VR Anatomy and Microsoft HoloLens Anatomy.

You showed the Google Cardboard. What’s the entry point for medical education?
Invest in Oculus Rift or HTC Vibe, plus the computer. But Google Cardboard is a great starting point. We’ve recently attended a conference and had a bunch of headsets at our poster.

Related links supplied by audience:
https://link.springer.com/article/10.1007%2Fs10916-016-0459-8

Educational Scholarship Grant Applications Due January 15

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The International Association of Medical Science Educators (IAMSE) wishes to encourage and support scholarship in medical science education, and therefore announces the 2019 educational scholarship grant program. IAMSE will award research grants up to the amount of $5000 for a 2-year grant period.

All IAMSE members are eligible to submit a grant proposal. Preference will be given to new projects, and must be relevant to the mission of IAMSE. The results of funded projects must be presented at a future IAMSE meeting. The initial funding award will be announced via email, and at the 2019 IAMSE meeting.

Applications are to be submitted via the online application form here by January 15, 2019.

All information regarding the IAMSE Educational Scholarship Grant, including the application process, eligibility, proposal format, and evaluation criteria can be found on the IAMSE website here.

IAMSE Fall 2018 WAS Session 3 Highlights

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[The following notes were generated by Mark Slivkoff.]

 IAMSE Webinar Series, Fall 2018

Speakers: Kirsten Brown, PhD, MA and Katherine Chretien, MD – The George Washington University, Washington, DC
Title: Using Social Media as an Educational Tool
Series: Evolution and Revolution in Medical Education: Technology in the 21st Century

  • Brown and Chretien set out to cover the following agenda:
    • State of social media use
    • Why use social media
    • Overview of social media in medical education
    • Buff and Blue Instagram case study
    • Reflective writing class blog case study
  • Approximately 69% of the American public uses some aspect of social networking sites (Pew Research Center, 2017)
  • Although young adults were among the earliest of the social media adopters, older adult usage has also surged (Pew Research Center, 2017)
  • Approximately 55% of accredited medical schools also have current student groups on Facebook (Kind, Genrich, Sodhi, & Chretien, 2010)
  • Most used platform is YouTube, followed by Facebook, Snapchat, and Instagram
  • The latter three platforms are far more popular among the younger crowd (18-24 year olds)
  • Why use social media in medical education?
    • Enhance social learning, connection, community
    • Harness power of social media as interactive, communication tools
    • Optimize its benefits for education (e.g., Bialy and Jalai, 2015; Hennessey et al., 2016; Jaffar, 2013; Pickering and Bickerdike, 2016)
  • Social media platforms offer an untapped potential for medical education
  • The most relevant learning theory (Ileris, 2007) resides with Social Connections:
    • Social Learning Theory (Bandura, 1977, 1978)
    • Communities of practice (Wenger, 2000)
    • Connectivism (Siemens, 2005)
  • Recent reviews by Cheston et al. (2013) and Sterling et al. (2017) offer much insight into the use of social media in medical education
  • If you’re interested in using social media, where do you start? You need to ask yourself some questions:
    • What are my educational goals?
    • What social media platform do I want to use?
    • How will this add value to the traditional approach?
    • What outcomes will I measure?
  • When considering the platform, you must address:
    • Its strengths and features
    • Is the site going to be public or private?
    • Who will be the moderator?
    • Who commonly uses the platform?
    • Do you have experience with the platform?
  • Brown, an anatomist, uses Twitter to supplement her coursework. Her site is “Buff and Blue Anatomy”
  • She asked herself the same questions mentioned above before beginning her journey:
    • The goal was to the bridge the gap in formal instructional time
    • The platform was of choice was Instagram
    • The value to be added was novel, instant feedback, formative assessment
  • The details of her work, and the students’ perception of it, were covered in detail and will be described in her ongoing study. She needs one more batch of data after this Fall of 2018 before completing her manuscript. She did report that:
    • Instagram was a useful supplement to traditional anatomical instruction
    • Content and timing of the posts are important for student engagement
    • Most popular posts were those of encouragement and candid photos of faculty (and not of quizzes)
  • Brown described her main lessons learned to date:
    • Respondents overwhelmingly found that the @BuffBluetAnat Instagram was a useful supplement to traditional anatomical instruction.
    • Those that viewed and interacted with the account more frequently rated it significantly more useful than those who viewed and interacted it with rarely
    • Instagram enables interactions and connections between users that can foster learning by tapping into informal educational opportunities and maintaining student motivation
  • Chretien also described her use of a WordPress blog a few years ago.
  • She also addressed the same questions before she started:
    • Her goals were centered on reflection, student professional development, and discussion
    • The social medial platform of choice was a blog
    • The value added includes asynchronous learning, issues can be discussed as they happen, active dialogue, and anonymity
    • The desired outcomes included satisfaction, engagement, and reflectivity
  • Chretien discussed the instructions which she gave to her clinical students which provided a sufficient synopsis of her project:
    • “Requirement: A minimum of two reflective posts per 4- week rotation, with the first post within the first 2 weeks to ensure classmates have a chance to read and respond to your writing. There is no length or subject requirement, but the posts must be reflective, that is, not just telling a story but reflecting on how this experience affects you or changes the way you think about something. Commenting on other classmates’ posts is encouraged. The facilitator will read every post and give feedback in the form of comments. Participation is required but not graded.”
  • Her evaluation of the experiences were detailed in a paper (Chretien et al. 2008). Some of the major points:
    • 91 students participated, 177 posts. 1/3 left comments
    • 53% chose anonymous name
    • Most students enjoyed writing posts, reading posts, and found instructor’s comments helpful.
    • Post themes: being humanistic, professional behavior, understanding caregiving relationships, being a student, clinical learning, dealing with death and dying.
    • 8/177 posts not reflective
  • And some of her described lessons learned:
    • Participation was variable
    • Students wrote about sensitive issues
    • Hidden curriculum elements revealed, discussed
    • Burden of logistics
    • Not true anonymity in many cases
    • Faculty comments could spur deeper reflection
    • No professionalism or patient privacy issues
  • To wrap up, Drs. Brown and Chretien reminded us of the important considerations when it comes to the use of social media in medical education:
    • Public versus private
    • Outcome measures
    • Patient privacy
    • Professionalism
    • Expertise in the platform
    • Learner buy-in
  • Encouraged all of us to innovate!

Questions asked after seminar:
(Note that some questions and/or answers have been reworded for clarity)

Can a learning management system (LMS) such as Blackboard provide the same experience as social media platforms?
No. Students already use Blackboard for email, and we wanted to use other software that was different. The built in blog in Blackboard is not unique as well. Furthermore, programs like Instagram are driven by apps which makes use easier.

Are quizzes and examinations still administered via traditional means?
Yes, they are. All quizzes in Instagram are purely supplemental.

Do you recycle the content, or new you create new material each year?
Brand new sites/content are posted yearly. Old posts may show up but they are captured as images and placed appropriately.

Have you run into professionalism issues?
No. There have been some minor issues in Blackboard and Wikis, but overall there have been no major issues.

Do you get any pushback from students regarding the WordPress blog? Do they ask questions such as “how does this help me get into residency”?
There has been very little pushback. If anything, students appreciate not having to express themselves face-to-face. Blogging is a better alternative.

Can you share your list of references?
Yes! We will send out after this presentation.

How much time do you spend on your social media “work”?
About 1 hour per day but of course this varies depending on the week. Overall, it takes a considerable amount of time.

 How do you get academic credit doing this work, outside of publications?
The work is related to the scholarship of teaching and learning, with an emphasis on innovating educational technology.

Board of Director Nominations Now Welcomed Until November 20

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It’s time once again to begin thinking about selection of those to serve on the Board of Directors of the International Association of Medical Science Educators (IAMSE).

IAMSE is currently seeking self-nominations and alternate nominations of candidates from across the membership. International members are particularly invited.

The Board of Directors is the governing body that determines the direction of IAMSE and all our various programs and activities.

This Spring, four of the Director positions become subject to election and the formal “job descriptions” for IAMSE Director are posted here.

What is the role of a Board Member? The Board Member is expected to be an advocate for the organization and to bring fresh ideas to IAMSE. In addition, each Director will be in charge of an IAMSE-sponsored project.

What is the time commitment for the Board Member? The term is for three years, renewable once. Board meetings are held via conference call every two months, with additional business conducted through e-mail.

If this opportunity to expand your influence in medical education while advancing the work of IAMSE fits your personal career goals, then the Nomination Committee invites you to submit your nomination for Board of Director.

We look forward to hearing from the IAMSE membership and thank you for your continued commitment to the IAMSE mission.

Thank you,
Cathy Pettepher, Chair
IAMSE Nomination Committe

IAMSE Fall 2018 WAS Session 2 Highlights

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[The following notes were generated by Mark Slivkoff.]

IAMSE Webinar Series, Fall 2018

Speakers: Instructional Design Team of The University of New England including Christopher Malmberg, Olga LaPlante, Wendy DiBrigida, David Bass-Clark
Title: The Role of Instructional Design in Health Science Course Development
Series: Evolution and Revolution in Medical Education: Technology in the 21st Century

  • The University of New England (UNE) offers numerous online courses in which thousands of students enroll.
  • This presentation focused on the role of the Instructional Design Team (ID Team), specifically related to the university’s Science Prerequisites for Health Professions (SPHP) online program (https://online.une.edu/science-prerequisites/courses/).
  • SPHP is a fully online option at UNE. Enrollment is open, and approximately 4,500 students enroll per year.
  • SPHP:
    • Includes 17 health science and math courses which run for 16 weeks
    • Enrolls non-matriculated students
    • Is fully online, self-paced, and asynchronous (rolling student enrollment)
  • The presenters (4 of the 8 members of the Instructional Design Team) set off to cover the following objectives:
    • Outline the course development process
    • Discuss design challenges
    • Discuss strategies for active learning in the online environment
    • Show the value of Instructional Designers
    • Illustrate some of the research-based innovations
  • Two specific courses were discussed in this presentation: Pathophysiology and Medical Physiology.
  • Each 16-week course takes 32 weeks to develop. The process ends with the launch of the course.
  • Various Subject Matter Experts (SMEs) are involved in course development, including medical professionals, offline and online teaching faculty.
  • During design and development there is great attention devoted to curriculum standards:
    • The course must be authentic and rigorous.
    • Offline and online courses must be equal (pathophysiology = pathophysiology).
  • There are challenges in ensuring the equality of courses. Outcomes, activities and assessments must be the same.
  • Outcomes are addressed first by both the Subject Matter Experts and the Instructional Design Team.
  • The outcomes are vetted by a separate committee, then the SMEs and ID Team order the outcomes into learning activities.
  • There is thus a “backward” design when building these self-paced health science courses, and well stated learning objectives are a must.
  • There are challenges specific to the self-paced nature of these courses:
    • Customizable experience
    • Peer interactions
    • Time management
  • The customizable experience is about being able to track the student’s progress. This is done by:
    • Providing assignments which allow for immediate feedback.
    • Having tasks that must be completed before moving forward (Adaptive Released)
    • Building in numerous self-tests and practice quizzes
    • Providing study guides
  • The challenge of the lack of peer interactions is addressed by having the students present via video. Students must upload video presentations, the content which varies by course.
  • Time management, another challenge, is addressed through the following mechanisms:
    • Courses are 16 weeks
    • Suggested timelines are in the syllabus and course modules
    • Reminders about the pace of the course are sent out with assignments
  • The lack of in-person laboratories also poses a challenge in online courses.
  • It is imperative therefore that there are engaging activities along the way. UNE approaches this challenge by including the following in their courses:
    • Virtual, dynamic lab experiments (through third party vendors)
    • Physical lab experiments with materials delivered directly to students’ houses (through a third party vendor)
    • Media-rich scenarios and case simulations (including comic cases)
    • Student presentations (which are also used to alleviate the lack of peer-to-peer interactions, as noted above)
  • There is a continuous development cycle for all online courses taught at UNE. Redesign allows for opportunity to implement research-based solutions.
  • Innovative examples that have been implemented include:
    • Memory Palaces and the Method of loci
    • Virtual reality and 3D Space
    • Interactive Narratives (Articulate Storyline software used)

Questions asked after seminar:
(Note that some questions and/or answers have been reworded for clarity)

Can you elaborate on the video assignments?
Videos are about 5 minutes and do not need any accompanying media to elaborate on concepts. Students are encouraged to speak as if they are talking “at the moment” .

Do you think that any kind of learning can occur in an online environment, or are there limitations?
Labs are challenging, but some things are actually easier online due to the asynchronous learning.

In the virtual labs, do all the students get the same results?
Not necessarily since there are questions within the assignments requiring subjective answers. Students get pointed in the same direction. (Pearson’s PhysioEx lab simulation software provides such assignments.)

How do you do summative assessments?
Examinations, video presentations, PowerPoint presentations. Medical Physiology incorporates readings. And so forth.

How do you incorporate remediation?
Students must connect with their instructors. (This question wasn’t really addressed by the ID Team) 

How many hours do you dedicate to interaction with the Subject Matter Experts?
Depends on the course. In the SPHP, the SMEs are assigned to a particular course. During the 32 weeks of course development, the SMEs work together (via shared docs or other means).

Can you elaborate on the anatomy dissection?
Hands On Learning, a third party vendor, supplies materials and pre-fabricated dissections to the students. Students are prompted to take pictures during the dissections. These pictures are uploaded.

How does curriculum design development differ between your online and offline (traditional) courses?
Main difference is that you have to be very aware of the social dynamics that don’t happen online. A benefit about online design is that you don’t have to worry about scheduling rooms and times.

Did you develop the labs?
No. One example of third party vendor is Pearson (PhysioEx).

What software is used for student recordings?
Many students and faculty use Screencast-O-Matic, which is free. Many students use their phones and respective software on their computers to edit (Mac = QT; Windows = Movie Maker). We are starting to use the built-in tools of Zoom as well.

Do online courses require more faculty time?
Course planning takes a lot of time, but once the course launches the workload greatly decreases. You hope that the course almost runs itself.

IAMSE Fall 2018 WAS Session 1 Highlights

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[The following notes were generated by Mark Slivkoff.]

In case you missed the first session in the Fall Webcast Audio Seminar Series last week, here is a quick recap!

IAMSE Webinar Series, Fall 2018
Speaker: Jill Jemison of The University of Vermont Larner College of Medicine
Title: They said “flip” and we said “How high”?
Series: Evolution and Revolution in Medical Education: Technology in the 21st Century

  • Larner College of Medicine, one of the oldest medical schools in the nation, is transitioning to a curriculum which will be lecture free by 2019.
  • Full reporting on the curriculum will be completed by 2020, in time for an LCME visit in 2021.
  • The major players involved in this transition include:
    • Senior Associate Dean for Education
    • Medical Curriculum Committee (curriculum implementation)
    • Office of Medical Student Education (operations)
    • Active Learning Task Force (“Larner Methods”, SOPs, policy)
    • Active Learning Team (pedagogical change and instructional design)
    • Teaching Academy (evaluation, assessment, and scholarship)
    • Technology Services
  • Technology Services, led by the Chief Information Officer (Jill Jemison, who presented this webinar) is “laying the track in front of train”. In 2013, LCME recognized this group as being a strength of the institution.
  • Specifically, Technology Services of this large university medical school (budget of about $3.5 million) is focused on:
    • Infrastructure
    • Applications
    • Database
    • Education Technology
    • Audio Visual
    • Technicians
    • Support
  • The technology plan is evolutionary, not revolutionary; changes have been and will continue to be based heavily on data and analytics.
  • Education infrastructure includes:
    • Blackboard as the Learning Management System (LMS), Oasis for scheduling, and ZAP for admissions
    • Extensive “homegrown” systems including those used for examinations, curriculum management, peer assessments, preceptor assessments, competency tracking and generation of medical student performance evaluations (MSPEs)
  • Major philosophy of Technology Services focuses on the aforementioned homegrown systems in addition to always owning their data.
  • The college’s data is stored in a data warehouse (COM DATA Warehouse) which serves as the only data hub for all in house and external software.
  • There is a strong focus on course evaluations which form of large part of the data.
  • There is heavy use of colorful, detailed course calendars. Colors differentiate pre-work activities, sessions, workshops, laboratories, independent learning, et cetera. Highlighting (clicking on) events in the calendar brings up a side panel which displays relevant objectives, facilitators, and other information.
  • This extensive mapping allows for the calculation of contact hours which, after being added to preparation time (more preparation time for flipped sessions), further allows for a value in $ to be totaled for each faculty member.
  • The $ amount ostensibly demonstrates that teaching is valuable. [Currently, this “financial side” of the new curriculum is only being presented to the department chairs.]
  • Faculty members from all sites (main campus and clinical sites) have access to a teaching “kit” which includes all the necessary components for video recording and editing:
    • Microsoft Surface Pro 4
    • Android tablet (for clerkships)
    • Microphone and headphones
    • Office 365 including OneNote
    • Camtasia
  • The student learning environment consists of rooms which have been rebuilt for active learning.
  • Some final words on vendors. When contemplating various software solutions (marketed by vendors), be sure to keep the following in mind:
    • Don’t duplicate tasks, and be careful of companies who say they can do everything
    • Go into vendor discussions with a clear purpose
    • Test, test, and retest the software in real world situations
    • Always own your data

Questions & Answer Session

What product do you use to map?
None, but they are looking at a third party.

Do you use the teaching incentives and contact hours in the clerkships?
No, only in preclinical settings.

Do the prep hours differ between sessions?
Multiplier is higher for active learning.

How often do students work asynchronously?
Not often, only during indepedent prepping. And attendance is mandatory.

Do you do cadaver dissection?
Yes. Team A teaches Team B on opposite days.

Was the faculty involved in developing the flipped classrooms? Have they published the changes?
A number of faculty have papers, and many have presented at IAMSE.

How much has all this cost?
Been a 20 year effort. Overall budget for IT is $3 million.

Have there been any negative fallout from the disbursement ($) model?
Currently, the numbers are only being rolled out to the chairs.

Can you share with us the process of faculty development?
Teaching academy identifies scholars and excellent teachers (including outiside speakers).

Do you supply Pathoma or Kaplan or other board prep programs?
Library has some, but Osmosis is the main one used.

Know of Any Can’t-Miss Events? Share Them in Medical Science Educator

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If you organize or know of a workshop, symposium or educational activity that might be of interest to our educator community, share it  with Medical Science Educator.

In every issue of Medical Science Educator, we publish an announcements section. In this section we share information that is of interest to the readership of the journal. Individual IAMSE members wishing to post medical education related announcements in the Journal are invited to send their requests to the Editorial Assistant at journal@iamse.org. Announcements may be IAMSE-related, announcements from other medical education organizations, medical education conference information or international issues affecting medical education. Announcements will be published at the Editors discretion.

Deadline for inclusion in the December issue: October 1, 2018