Evaluation of an audience response system for the continuing education of health professionals

Audience Response System (ARS) Use in the SCORE (Surgical Council on Resident Education) Surgery Training Curriculum: A Mixed Methodology Study

Background Audience Response Systems (ARS) could help overcome the limitations of traditional lectures by providing interactivity, engagement, and assessment. The perception of ARS use in surgical education is not well documented. Objective Examine the use of an ARS in teaching This Week In SCORE (Surgical Council on Resident Education)sessions to general surgery residents and medical students. Methods  ARS was used at weekly SCORE question sessions in a new general surgery residency program by four residents, 97 medical students, and 20 faculty. The study employed a mixed quantitative and qualitative method: two separate 10-question surveys for faculty and trainees (49% response rate) and a focus group discussion that included one faculty member, two residents, and two students. Results In 85 (85%) responses, the faculty favored the use of ARS in SCORE. Among the total of 510 responses from 51 residents and students, 57% agreed with the favorable use of ARS, while 28% were neutral and, in 14% of cases, negative. A greater proportion of faculty and learners preferred ARS over traditional lectures. The focus group content analysis showed a positive effect and preference from learners and faculty. Engagement, thinking stimulation, and group participation were the most common positive comments. No significant negative influence on ARS use was reported. Conclusions The use of an ARS in This Week In SCORE ​​​sessions were preferred by most of the faculty and a majority of learners. The benefits are ease of use and stimulation of discussion. ARS has the potential for more widespread utilization in additional educational settings.

Teaching medicine web-based with the help of interactive audience response systems

The COVID-19 pandemic confronted the medical community worldwide with numerous challenges, not only with respect to medical care, but also for teaching the next generation of physicians. To minimize the risk of infections patient-unrelated classes can be held digitally. Here we present a student initiated, web-based teaching approach, called "From symptom to diagnosis". In this seminar case reports of rare diseases were presented to the audience in a symptom-focused manner. The patients´ most significant symptoms were presented, followed by an in-depth discussion about differential diagnosis. First glance diagnosis pictures were shown to improve students´ ability to identify important clinical scenarios. We used chat functions as well as an audience response system to make the seminar more interactive. By this we attracted between 71 and 147 participants per session. The online seminar was very well perceived and 97% of the students saw an improvement of their diagnostic skills. In summary, we successfully established an interactive, web-based teaching format for medical students.

Learner engagement and teaching effectiveness in livestreamed versus in-person CME

INTRODUCTION

Engaging learners in continuing medical education (CME) is challenging. Recently, CME courses have transitioned to livestreamed CME, with learners viewing live, in-person courses online. The authors aimed to (1) compare learner engagement and teaching effectiveness in livestreamed with in-person CME and (2) determine how livestream engagement and teaching effectiveness is associated with (A) interactivity metrics, (B) presentation characteristics and (C) medical knowledge.

METHODS

A 3-year, non-randomised study of in-person and livestream CME was performed. The course was in-person for 2018 but transitioned to livestream for 2020 and 2021. Learners completed the Learner Engagement Inventory and Teaching Effectiveness Instrument after each presentation. Both instruments were supported by content, internal structure and relations to other variables' validity evidence. Interactivity metrics included learner use of audience response, questions asked by learners and presentation views. Presentation characteristics included presentations using audience response, using pre/post-test format, time of day and words per slide. Medical knowledge was assessed by audience response. A repeated measures analysis of variance (anova) was used for comparisons and a mixed model approach for correlations.

RESULTS

A total of 159 learners (response rate 27%) completed questionnaires. Engagement did not significantly differ between in-person or livestream CME. (4.56 versus 4.53, p = 0.64, maximum 5 = highly engaged). However, teacher effectiveness scores were higher for in-person compared with livestream (4.77 versus 4.71 p = 0.01, maximum 5 = highly effective). For livestreamed courses, learner engagement was associated with presentation characteristics, including presentation using of audience response (yes = 4.57, no = 4.45, p < .0001), use of a pre/post-test (yes = 4.62, no = 4.54, p < .0001) and time of presentation (morning = 4.58, afternoon = 4.53, p = .0002). Significant associations were not seen for interactivity metrics or medical knowledge.

DISCUSSION

Livestreaming may be as engaging as in-person CME. Although teaching effectiveness in livestreaming was lower, this difference was small. CME course planners should consider offering livestream CME while exploring strategies to enhance teaching effectiveness in livestreamed settings.

The use of innovative cost-saving audience response system in orthodontic case-based learning: A potential approach in distance learning

OBJECTIVE:

To provide a cost-saving innovative audience response system (ARS) that permits typing texts and compare its efficiency to the paper-based method in case-based learning (CBL).

MATERIALS AND METHODS:

Orthodontic clinical cases were presented to 149 undergraduate dental students for discussion among teammates. Responses were collected using ARS-based and paper-based. ARS was constructed from an online survey platform (Google forms) then QR code was created for easy and fast access. Students used their cellphones to scan code, view questions, discuss, type, and submit answers within 10 minutes. Feedbacks were collected using a feedback survey. Outcome measures included the number of words, spelling mistakes, time required by the instructor to read submissions, and activity time compliance.

RESULTS:

The average number of words submitted by females in ARS-based 47 ± 8 was significantly higher than 35 ± 16 paper-based, and male ARS-based 36 ± 18 (P < 0.05). ARS-based submissions required significantly less time to read compared to paper-based among whole group, females, males (P < 0.001, P < 0.05, P < 0.001), respectively. Spelling mistakes were lower 1 ± 1 in ARS-based compared to paper-based 2 ± 2. The ARS-based first submission was (-4.28) minutes before the deadline, while paper-based last submission was (+2.19) minutes after (P < 0.05). ARS-based submissions were 12.5 seconds faster to read than paper-based (P < 0.001). Out of 56.4% of respondents, 63.1% preferred using ARS-based and 80% agreed that it provided immediate feedback, with high overall satisfaction.

CONCLUSIONS:

This innovated ARS was found to facilitate CBL. It is superior in time and cost-saving to paper-based and other ARSs. It could be useful in distance learning especially during the COVID-19 pandemic.

Phone-based audience response system as an adjunct in orthodontic teaching of undergraduate dental students: a cross-over randomised controlled trial

BACKGROUND

The advent of electronic teaching facilities improves tutor-student communication. This study aims to explore the effectiveness of Phone-Based Audience Response System (PB-ARS), as an adjunctive pedagogy tool to enhance the retention of orthodontic information by dental students; and to explore the students' perception of PB-ARS.

METHODS

This cross-over clustered randomised control trial included 34 males who were in the final year of their undergraduate dental training. Participants were allocated to one of two event groups (G1 and G2) using computer-generated randomisation. Both groups simultaneously attended two different traditional lectures (L 1 and L2) a week apart. During L1, PB-ARS was used as an adjunct to conventional presentation to teach G1 participants, (PB-ARS group) while G2's participants acted as a control group (CG), and were taught using a traditional presentation. In the second week (L2), the interventions were crossed-over. Participants from both groups completed pre- and post-lecture multiple-choice questionnaires (MCQ) to assess their short-term retention of information. Their performance in the final MCQ exam (10 weeks following L2) was tracked to assess the long-term retention of the information. Participants also completed post-lecture questionnaires to evaluate their perceptions.

RESULTS

Twenty-nine and 31 participants from the CG and PB-ARS group completed this trial, respectively. Although 87.5% of students in the PB-ARS group showed an improvement in their immediate post-lecture scores compared with 79.3% for the CG, it was statistically insignificant (p = 0.465). Similarly, the intervention showed an insignificant effect on the long-term retention of the knowledge (p = 0.560). There was a mildly but favourable attitude of students towards the use of PB-ARS. However, the difference in the overall level of satisfaction between both groups was statistically insignificant (p = 0.183).

CONCLUSION

PB-ARS has a minimal and insignificant effect on the short- and long-term retention of orthodontic knowledge by male undergraduate dental students. PB-ARS was the preferred adjunct tool to conventional classroom teaching. Due to the limitations of this trial, a long-term randomised controlled trial with a larger sample size is recommended.

Challenges in Optimizing Medical Education for Rheumatologists

The field of rheumatology has expanded rapidly in recent years, and innovations in immunology, epigenetics, and bone metabolism continue at an astonishing pace. In this fast changing field, optimizing medical education for rheumatologists is vital for maintaining a competent workforce to meet the needs of patients with rheumatic diseases. Several key challenges lie ahead and efforts to optimize medical education for rheumatologists are discussed in this article.

HPV Knowledge and Attitudes Among American Indian and Alaska Native Health and STEM Conference Attendees

American Indian and Alaska Native women had approximately twice the incidence of cervical cancer as white women. Preventive measures for cervical cancer rely on screening and HPV vaccination. However, vaccine series completion and catch-up vaccinations for eligible adults are low across all racial/ethnic groups. Therefore, the aim of this study was to identify gaps in knowledge and evaluate the attitudes toward HPV and the vaccine among AIANs with various levels of training in the STEM and health-related fields. A survey was used to collect data from audience members at two national conferences geared towards American Indian and Alaska Natives in health and STEM fields in September 2017. A vignette study was administered via a live electronic poll to test knowledge (true/false questions), attitudes, and to collect demographic information. Respondents self-identified as primarily American Indian and Alaska Native (74%), pursuing or completed a graduate degree (67%), and female (85%). Most respondents (86%) were aware of HPV-associated cancer in men. However, most (48-90%) answered incorrectly to detailed true/false statements about HPV and available vaccines. After educational information was provided, opinions collected via vignettes highlighted mainly positive attitudes toward vaccination; specifically, that vaccines are safe and all eligible community members should be vaccinated (75% and 84%, respectively). We observed that our respondents with higher educational attainment still lacked accurate knowledge pertaining to HPV and the vaccine. Overall, continued education about HPV and the vaccine is needed across all levels of education including American Indian and Alaska Native community members and health professionals.

Waking up your lecture

A core method of educating radiology trainees and practicing radiologists is through digital lectures, using Microsoft PowerPoint, Keynote, Prezi, Sliderocket or any number of software versions. Careful consideration of both the material to be presented as well as the visual format by which it is presented is critical for a successful lecture. Adult learners benefit substantially in comprehension and retention of material when allowed to interact with the teacher and the content. This article provides the educator with recommendations for constructing and presenting an effective and worthwhile lecture.

Pharmacist Perception of a Mobile Application Audience Response System for Remote Pharmacy Continuing Education Participants

INTRODUCTION

Interactive audience response during continuing education (CE) in pharmacy practice increases audience involvement. However, remote-site participants may not have access to interactive technology. This study explores the perceptions of a mobile application audience response system (ARS) by remote pharmacy CE participants. Secondarily, we evaluatedinterest in continued use of ARS, as well as willingness to use as an assessment tool for CE effectiveness.

METHODS

Pharmacists participating in CE sessions remotely within a health system were provided a unique ARS session code to enter into a free mobile application. Participants then responded to ARS presentation questions. An online survey link was e-mailed to all potential remote participants inquiring about perceptions of ARS use.

RESULTS

Of the 52 potential remote users, 28 (53.8%) responded to the survey. The top 3 positive responses included the availability of free software (71.4%), anonymity (57.1%), and ease of use (53.6%). Top 2 barriers included slowing the process down (14.3%) and requiring the use of application software (14.3%).

DISCUSSION

Interactive software during pharmacy CE lectures for participants at remote locations within a health system was well accepted. ARS should be considered and further studied for CE lectures at institutions with remote participants.

Examining the impact of audience response systems on student performance in anatomy education: a randomised controlled trial

Background and aims Electronic audience response systems offer the potential to enhance learning and improve performance. However, objective research investigating the use of audience response systems in undergraduate education has so far produced mixed, inconclusive results. We investigated the impact of audience response systems on short- and long-term test performance, as well as student perceptions of the educational experience, when integrated into undergraduate anatomy teaching. Methods and results A cohort of 70 undergraduate medical students was randomly allocated to one of the two groups. Both groups received the same anatomy lecture, but one group experienced the addition of audience response systems. Multiple-choice tests were conducted before, immediately after the lecture and again 10 weeks later. Self-perceived post-lecture subject knowledge, confidence and enjoyment ratings did not differ between groups. Test performance immediately following the lecture improved when compared against baseline and was modestly but significantly superior in the group taught with audience response systems (mean test score of 17.3/20 versus 15.6/20 in the control group, p = 0.01). Tests conducted 10 weeks after the lecture showed no difference between groups (p = 0.61), although overall a small improvement from the baseline test was maintained (p = 0.02). Conclusions Whilst audience response systems offer opportunities to deliver novel education experiences to students, an initial superiority over standard methods does not necessarily translate into longer term gains in student performance when employed in the context of anatomy education.

Assessing the Association Between E-Cigarette Use and Exposure to Social Media in College Students: A Cross-Sectional Study

BACKGROUND

Social media platforms provide an indirect medium for encouraging e-cigarette use between individuals and also serve as a direct marketing tool from e-cigarette brands to potential users. E-cigarette users share information via social media that often contains product details or health-related claims.

OBJECTIVE

Determine whether e-cigarette use is associated with exposure to e-cigarettes on social media in college students.

METHODS

Data from a sample of 258 college students was obtained via a clicker-response questionnaire (90% response rate). Demographic, lifetime and current e-cigarette/cigarette use, and e-cigarette exposure via social media (peer posts or advertisements) were examined. Logistic regression was used to assess the relationship between lifetime and current e-cigarette use and viewing peer posts or advertisements on social media while adjusting for cigarette use and self-posting about e-cigarettes.

RESULTS

Overall, 46% of participants reported lifetime e-cigarette use, 16% current e-cigarette use, and 7% were current dual users of e-cigarettes and cigarettes. There were positive and significant associations between lifetime e-cigarette use and viewing peer posts (aOR = 3.11; 95% CI = 1.25-7.76) as well as advertisements (aOR = 3.01; 95% CI = 1.19-7.65) on e-cigarettes via social media after adjusting for cigarette use. Current e-cigarette use was only significantly associated with viewing peer posts via social media (aOR = 7.58; 95% CI = 1.66-34.6) after adjusting for cigarette use. Conclusions/Importance: Almost half of college students view peer posts and advertisements on e-cigarettes via social media. This exposure is associated with individual e-cigarette use. Continued efforts to examine online e-cigarette content are needed to help future interventions decrease e-cigarette use.

Audience-response systems for evaluation of pediatric lectures--comparison with a classic end-of-term online-based evaluation

AIM

Course evaluations are often conducted and analyzed well after the course has taken place. By using a digital audience response system (ARS), it is possible to collect, view and discuss feedback during or directly following a course or lecture session. This paper analyzes a student evaluation of a lecture course with ARS to determine if significant differences exist between the results of the ARS lecture evaluation and those of the online evaluation at the end of the semester. In terms of the overall evaluation, consideration is given to the level of students' prior knowledge, the presentation of the lecture material by the lecturers and the relevance of the lecture topic for students.

METHOD

During the 2011-12 winter semester, the lecture on Pediatrics at the Freiburg Center for Pediatric and Adolescent Medicine (Zentrum für Kinder- und Jugendmedizin (ZKJ) Freiburg) was evaluated using ARS. Thirty-four lectures were evaluated by an average of 22 (range 8-44) students, who responded to four questions each time an evaluation took place.

RESULTS

On a 6-point Likert scale (1=very good to 6=deficient), the students rated their level of preparedness with a mean of 3.18, the presentation of the lecture with 2.44, and the relevance of the lecture topic with 2.19. The overall evaluation of the lecture course by means of ARS resulted in 2.31. The online evaluation conducted at the end of the semester yielded a score of 2.45. Highly significant correlations were seen between the results of the ARS for the overall evaluation, assessment of prior knowledge, lecture presentation, and the estimated relevance of the lecture topic.

CONCLUSION

The use of ARS is suitable for immediate evaluation of lectures, in particular regarding timely feedback for the individual lecturer/lecturers. In comparison with an end-of-term evaluation, ARS yielded a better assessment.

An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system

PURPOSE

Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs.

METHOD

A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience. An audience response system was incorporated to promote interaction and evaluate knowledge before vs. after the educational session.

RESULTS

Up to 175 audience members, of 271 in attendance (129 (48%) physical therapists, 51 (19%) occupational therapists, 31 (11%) nursing, 14 (5%) physician, 46 (17%) other), completed both the pre- and post-test questions for each of the six unique patient cases. In four of six patient cases, there was a significant (p< 0.001) increase in identifying the correct answer regarding initiation of rehabilitation activities. This learning effect was similar irrespective of participants' years of experience and clinical discipline.

CONCLUSIONS

An interactive, case-based, educational session may be effective for increasing short-term knowledge, and identifying knowledge gaps, regarding clinical decision-making for safe rehabilitation of patients in ICUs. Implications for Rehabilitation Lack of knowledge regarding the safety considerations for early rehabilitation of ICU patients is a barrier to implementing early rehabilitation. Interactive educational formats, such as the use of audience response systems, offer a new method of teaching and instantly assessing learning of clinically important information. In a small study, we have shown that an interactive, case-based educational format may be used to effectively teach clinical decision-making for the safe rehabilitation of ICU patients to a diverse audience of clinicians.

An innovative approach to enhancing continuing education activities for practising pharmacists using clicker technology

OBJECTIVE

The objective of this study was to evaluate the use of an audience response system (i.e. clickers) as an engaging tool for learning and examine its potential for enhancing continuing education (CE) activities.

METHODS

Attendees at a symposium were invited to utilise and evaluate the use of clickers. Electronic data relating to participant demographics and feedback were collected using clickers during the symposium.

RESULTS

The 60 attendees who used the clickers were mostly pharmacists (76%) who worked in hospital pharmacy practice (86%). Attendees strongly agreed or agreed that clickers were easy to use (94%), enhanced interaction (98%), allowed comparison of knowledge with that of their peers (78%), brought to attention their knowledge deficits (64%) and should be used again (94%).

CONCLUSION

The innovative use of clickers at the symposium was very well received by all attendees and offered a number of benefits, including the ability to provide a more engaging and interactive CE activity.

Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education

BACKGROUND

There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM.

DESIGN/SETTING

This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014.

MEASUREMENTS

Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P < 0.05.

RESULTS

A total of 277 out of 368 participants (75.3%) completed evaluations for the 32 presentations. CMETE scores (mean [standard deviation]) were significantly associated with the use of audience response (4.64 [0.16]) versus no audience response (4.49 [0.16]; P = 0.01), longer presentations (≥30 minutes: 4.67 [0.13] vs <30 minutes: 4.51 [0.18]; P = 0.02), and larger number of slides (≥50: 4.66 [0.17] vs <50: 4.55 [0.17]; P = 0.04). There were no significant associations between CMETE scores and use of clinical cases, defined goals, or summary slides.

CONCLUSIONS

To our knowledge, this is the first study regarding associations between validated teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations.

Do questions help? The impact of audience response systems on medical student learning: a randomised controlled trial

BACKGROUND

Audience response systems (ARSs) are electronic devices that allow educators to pose questions during lectures and receive immediate feedback on student knowledge. The current literature on the effectiveness of ARSs is contradictory, and their impact on student learning remains unclear.

OBJECTIVES

This randomised controlled trial was designed to isolate the impact of ARSs on student learning and students' perception of ARSs during a lecture.

METHODS

First-year medical student volunteers at Johns Hopkins were randomly assigned to either (i) watch a recorded lecture on an unfamiliar topic in which three ARS questions were embedded or (ii) watch the same lecture without the ARS questions. Immediately after the lecture on 5 June 2012, and again 2 weeks later, both groups were asked to complete a questionnaire to assess their knowledge of the lecture content and satisfaction with the learning experience.

RESULTS

92 students participated. The mean (95% CI) initial knowledge assessment score was 7.63 (7.17 to 8.09) for the ARS group (N=45) and 6.39 (5.81 to 6.97) for the control group (N=47), p=0.001. Similarly, the second knowledge assessment mean score was 6.95 (6.38 to 7.52) for the ARS group and 5.88 (5.29 to 6.47) for the control group, p=0.001. The ARS group also reported higher levels of engagement and enjoyment.

CONCLUSIONS

Embedding three ARS questions within a 30 min lecture increased students' knowledge immediately after the lecture and 2 weeks later. We hypothesise that this increase was due to forced information retrieval by students during the learning process, a form of the testing effect.

Audience response systems as a data collection method in organizational research

Audience responses systems are electronic devices allowing audience interaction and they are increasingly being used in educational and business settings to enhance various pedagogical and practical processes. This paper discusses how ARS technology may be used as a method of collecting data for research purposes. Specifically, this paper demonstrates ARS technology's potential utility by duplicating findings from two organisational studies, it discusses how ARS technology may be used to address three prevalent data collection problems, and it suggests how ARS technology may provide scholars with increased access to certain organisational settings, as well as greater integration between research and service activities.

Enhancing Education Activities for Health Care Trainees and Professionals Using Audience Response Systems: A Systematic Review

INTRODUCTION

This review examines the effect of incorporating clickers within practice-based education sessions on educational outcomes of health care trainees and professionals.

METHODS

A systematic literature review was conducted on primary research studies published up until August 2014. Studies were identified by database searching (Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, and PsychInfo), citation searching, and reference list checking. Studies were restricted to those evaluating the use of clickers as part of the provision of postgraduate education or continuing education programs and were evaluated according to Kirkpatrick's four levels of training evaluation (reaction, learning, behavior, and results).

RESULTS

Seventeen studies met the eligibility criteria. Twelve studies assessed learner and/or speaker reactions, with feedback overwhelmingly positive in all studies. Reported learner benefits included increased attentiveness, engagement, and enjoyment of presentations. Speakers reported that using clickers engaged the audience and assisted in assessing audience comprehension. Eight studies assessed learning outcomes. Higher level evidence obtained from four randomized studies demonstrated significant improvements in knowledge with the use of clickers compared with traditional didactic presentations, but no differences when clickers were compared with an interactive lecture with integrated questions. No studies adequately assessed higher level educational outcomes (behavior and results).

CONCLUSION

Although the use of clickers improves learning environment and learner satisfaction, the limited high-quality data for improvements in learning and behavior outcomes make it uncertain whether the acceptance and implementation of clickers within routine practice-based education programs are warranted at this stage.

Enhancing continuing education activities using audience response systems: a single-blind controlled trial

INTRODUCTION

We investigated whether using an audience response system (ARS) as part of continuing education (CE) activities enhances immediate and long-term knowledge acquisition or learner reactions.

METHOD

A multicenter single-blinded controlled trial involving pharmacists at 2 metropolitan teaching hospitals was used for this investigation. Pharmacists were allocated to either (a) an interactive presentation incorporating multiple-choice questions (MCQs) answered using an ARS, or (b) the same, but noninteractive, presentation using summary points instead of MCQs. Baseline knowledge was evaluated using a 10-item questionnaire, which was also used to evaluate immediate and long-term (6 weeks later) knowledge acquisition. Learner reactions were evaluated through feedback questionnaires.

RESULTS

The control and ARS intervention presentations were attended by 44 and 35 pharmacists, respectively. The 6-week follow-up questionnaire was completed by 35 control (80%) and 27 (77%) ARS group participants. Baseline knowledge was similar across groups (5.0 ± 1.6 SD vs 5.2 ± 1.6; p = .44) with no differences in immediate (8.3 ± 1.5 vs 7.9 ± 1.5; p = 0.30) or long-term (7.0 ± 1.6 vs 7.0 ± 1.5; p = 0.93) knowledge acquisition. Feedback regarding the use of an ARS was overwhelmingly positive, with participants feeling more strongly that the ARS enabled them to compare knowledge to that of their peers (p < .001).

DISCUSSION

There was no observed benefit of an ARS in relation to immediate or long-term knowledge acquisition. The use of an ARS, however, appeared to facilitate enhanced interactivity and participant self-reflection of knowledge, with strong participant desire to continue their use in future CE activities.

Use of elaborate feedback and an audience-response-system in dental education

Introduction: The aim of the study was to examine the effect of an elaborate feedback and an audience response system (ARS) on learning success.

Methods: Students of the 1^st clinical semester were randomly assigned to a study and a control group. The randomization was carried out considering the factors of age, gender and power spectrum during preliminary dental examination. Within 10 lectures 5 multiple-choice questions were asked about the learning objectives and answered by the students using an ARS. Only the study group received an immediate comprehensive feedback on the results. A final exam at the end was carried out in order to evaluate whether the elaborate feedback leads to a successful learning. Furthermore the effect of the ARS on the lecture atmosphere was investigated.

Result: The results of the final exams showed no significant difference between the study and the control group regarding the learning success.

Conclusion: Although no significant effect on learning success was found, the ARS creates a more interactive, positive learning environment.

Using an audience response system to improve learning success in practical skills training courses in dental studies - a randomised, controlled cross-over study

INTRODUCTION

The aim of this study was to examine whether the use of an audience response system (ARS) in a high-quality study design, in a course in pre-clinical dentistry leads to an improvement in cognitive and psycho-motor performance.

MATERIALS AND METHODS

As part of the Phantom Course I, a randomised, controlled study in cross-over design with 63 students was conducted over 4 weeks. The intervention was carried out by means of an ARS (TurningPoint(®) ), while a verbal question-and-answer session was conducted within the control group. Differences in learning success were determined via a formative multiple-choice (MC) test (cognitive) and a summative practical test (psycho-motor).

RESULTS

Both groups achieved significantly better results in the MC tests with the use of the intervention, when compared with the control group (group A 11.6 vs. 9.5 and group B 13.7 vs. 12.1, maximum 16 points). A further analysis of the results showed that the overall effect was induced primarily by a marked improvement in below-average students. The practical tests showed no clear effect. Despite the careful selection and set-up of the conditions for the study in the regular course of the semester, a cohort effect emerged. This was due to varying degrees of performance between the two groups, because no adequate performance parameters were available, which could have been taken into account for the stratified randomisation.

CONCLUSIONS

The results indicate that the use of the ARS leads to better results in cognitive performance, especially where independent learning is required and should be encouraged. Weaker students in particular seem to benefit.

Improving community understanding of medical research: audience response technology for community consultation for exception to informed consent

INTRODUCTION

The Department of Health and Human Services and Food and Drug Administration described guidelines for exception from informed consent (EFIC) research. These guidelines require community consultation (CC) events, which allow members of the community to understand the study, provide feedback and give advice. A real-time gauge of audience understanding would allow the speaker to modify the discussion. The objective of the study is to describe the use of audience response survey (ARS) technology in EFIC CCs.

METHODS

As part of the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART), 13 CC events were conducted. We prepared a PowerPoint™ presentation with 4 embedded ARS questions,according to specific IRB guidelines to ensure that the pertinent information would reach our targeted audience. During 6 CCs, an ARS was used to gauge audience comprehension. Participants completed paper surveys regarding their opinion of the study following each CC.

RESULTS

The ARS was used with minimal explanation and only one ARS was lost. Greater than 80% of the participants correctly answered 3 of the 4 ARS questions with 61% correctly answering the question regarding EFIC. A total of 105 participants answered the paper survey; 80-90% of the responses to the paper survey were either strongly agree or agree. The average scores on the paper survey in the ARS sites compared to the non-ARS sites were significantly more positive.

CONCLUSION

The use of an audience response system during the community consultation aspects of EFIC is feasible and provides a real-time assessment of audience comprehension of the study and EFIC process. It may improve the community's opinion and support of the study.

Audience response techniques for 21st century radiology education

INTRODUCTION

Audience response system (ARS) provides an excellent tool for improving interactive learning in radiology residents. However, it is not the technology but the pedagogy that matters the most. It is long past time to upgrade our ARS teaching techniques to match our ARS technology.

DISCUSSION

In this article, several problems with current usage of ARS are discussed and several prescriptions for improving this are presented. Simplifying the ease of use of ARS will get this useful technology into more hands. Using ARS in a bidirectional manner will give us an even better idea of how and what our students are learning. Asking questions on the fly will obviate the usual tedium of multiple-choice questions and allow us to quiz our students in a much more natural manner. It is time to move on to more innovative ARS techniques that are well adapted to radiology and its different styles of learning.

Role of an audience response system in didactic attendance and assessment

BACKGROUND

The Residency Review Committee for Emergency Medicine mandates conference participation, but tracking attendance is difficult and fraught with errors. Feedback on didactic sessions, if not collected in real time, is challenging to obtain.

OBJECTIVE

We assessed whether an audience response system (ARS) would (1) encourage residents to arrive on time for lectures, and (2) increase anonymous real-time audience feedback.

METHODS

The ARS (Poll Everywhere) provided date/time-stamped responses to polls from residents, including a question to verify attendance and questions to gather immediate, anonymous postconference evaluations. Fisher exact test was used to calculate proportions.

RESULTS

The proportion of residents who completed evaluations prior to the institution of the ARS was 8.75, and it was 59.42 after (P < .001). The proportion of faculty who completed evaluations prior to using the ARS was 6.12, and it was 85.71 after (P < .001). The proportion of residents who reported they had attended the conference session was 55 for the 3 weeks prior to initiating the ARS, decreasing to 46.67 for the 3 weeks during which the ARS was used to take attendance (P  =  .46). The proportion of faculty who reported attending the conference was 5.56 for the 3 weeks prior to ARS initiation, decreasing to 4.44 for the 3 weeks while using the ARS (P  =  .81).

CONCLUSIONS

Audience response systems are an effective way to verify attendance and tardiness, eliminating the subjective effect of attendance takers' leniency and increasing completion of evaluations for didactic sessions.

Empowering Malaysian dentists to tobacco dependence treatment conduct

As a signatory to the World Health Organisation 2003 Framework Convention on Tobacco Control, Malaysia has policies in place and funded 300 public Quit clinics. Unfortunately, government dentists are not included to run tobacco dependence treatment. A cross-sectional exploratory survey was carried out to seek Malaysian dentists' opinion on their knowledge, perception and willingness to conduct tobacco dependence treatment. Participation was voluntary from those who attended a specially designed one-day, four-module workshop on tobacco cessation intervention. Data were collected using the Audience-Response-System equipment which tracked immediate responses covering four domains namely: smoking as a public health problem, smoking as an addiction, the role of dentists in the programme and confidence in conducting smoking cessation in the clinic. Sample comprised more female dentists (73.5%), mean age 33.6 (SD 8.99) years and with more than 3 years working experience. Findings indicated that the majority agreed Malaysia has a rising problem in the prevalence of smoking (71.6%) and predicted that it will affect mostly the young (81.9%). Only half of the dentists surveyed (58.9%) routinely recorded their patients' smoking habits. The majority (71.6%) believed that dentists are effective in helping their patient to stop smoking and 76.3% agreed that dentists should discuss the smoking habit with their patients; however, 60% agreed that doing so is too time consuming. In addition, only 24.7% knew of more ways to treat a smoking habit. The majority felt comfortable giving advice to patients about changing their habits (76.5%) or discussing treatment options (60.5%): 75% would opt for a combined programme of counselling and use of medication if they have to do, 15% would choose to go on counselling only, while 8% did not want to treat. In conclusion, the findings suggest that dentists have a strong potential to contribute significantly to providing smoking cessation treatment if adequately trained.

Motivating student learning using a formative assessment journey

Providing formative assessment opportunities has been recognised as a significant benefit to student learning. The outcome of any formative assessment should be one that ultimately helps improve student learning through familiarising students with the levels of learning required, informing them about gaps in their learning and providing feedback to guide the direction of learning. This article provides an example of how formative assessments can be developed into a formative assessment journey where a number of different assessments can be offered to students during the course of a module of teaching, thus utilising a spaced-education approach. As well as incorporating the specific drivers of formative assessment, we demonstrate how approaches deemed to be stimulating, interactive and entertaining with the aim of maximising enthusiasm and engagement can be incorporated. We provide an example of a mixed approach to evaluating elements of the assessment journey that focuses student reaction, appraisal of qualitative and quantitative feedback from student questionnaires, focus group analysis and teacher observations. Whilst it is not possible to determine a quantifiable effect of the assessment journey on student learning, usage data and student feedback shows that formative assessment can achieve high engagement and positive response to different assessments. Those assessments incorporating an active learning element and a quiz-based approach appear to be particularly popular. A spaced-education format encourages a building block approach to learning that is continuous in nature rather than focussed on an intense period of study prior to summative examinations.

The Need for Asthma Educators

The National Association of Pediatric Nurse Practitioners worked collaboratively with other pediatric health care provider organizations to develop and implement an innovative pediatric asthma program using a train-the-trainer model with a goal to increase the availability of pediatric asthma education in medically underserved areas/health care provider shortage areas. Course content was developed using the National Asthma Education and Prevention Program Expert Panel 3 guidelines. Participants in the program are now teaching pediatric asthma programs in their own communities and making an impact on pediatric asthma care.

The effects of audience response systems on learning outcomes in health professions education. A BEME systematic review: BEME Guide No. 21

BACKGROUND

Audience response systems (ARS) represent one approach to make classroom learning more active. Although ARS may have pedagogical value, their impact is still unclear. This systematic review aims to examine the effect of ARS on learning outcomes in health professions education.

METHODS

After a comprehensive literature search, two reviewers completed title screening, full-text review and quality assessment of comparative studies in health professions education. Qualitative synthesis and meta-analysis of immediate and longer term knowledge scores were conducted.

RESULTS

Twenty-one of 1013 titles were included. Most studies evaluated ARS in lectures (20 studies) and in undergraduates (14 studies). Fourteen studies reported statistically significant improvement in knowledge scores with ARS. Meta-analysis showed greater differences with non-randomised study design. Qualitative synthesis showed greater differences with non-interactive teaching comparators and in postgraduates. Six of 21 studies reported student reaction; 5 favoured ARS while 1 had mixed results.

CONCLUSION

This review provides some evidence to suggest the effectiveness of ARS in improving learning outcomes. These findings are more striking when ARS teaching is compared to non-interactive sessions and when non-randomised study designs are used. This review highlights the importance of having high quality studies with balanced comparators available to those making curricular decisions.

The audience response system and knowledge gain: a prospective study

INTRODUCTION

The introduction of an audience response system (ARS) in the obstetrics and gynaecology course for medical students at The University of Western Australia provided an opportunity to measure knowledge gain by ARS lecture formats compared with didactic lectures.

METHODS

The study was conducted over four obstetrics and gynaecology terms, alternating the ARS and didactic format between two selected lectures each term. Students completed multiple-choice quizzes immediately post-lectures and 5 weeks later.

RESULTS

Immediate post-lecture quiz mean scores for the ARS lectures were significantly higher compared with scores for the didactic lectures (7.5 vs. 6.7, p < 0.001). Pairwise comparisons between ARS and didactic lectures for each lecture topic showed significantly higher quiz scores for ARS lectures (preterm labour 8.3 vs. 7.4, p = 0.032; and prenatal diagnosis 6.9 vs. 6.0, p = 0.014). Quiz scores for the didactic preterm labour lecture were significantly higher than scores for the didactic prenatal diagnosis lecture (6.0 vs. 7.4, p < 0.001). Quiz results at 5 weeks showed no differences in scores between the ARS and the didactic lectures and no differences between lecture topics.

CONCLUSIONS

Use of the ARS in lectures appeared to improve knowledge gain immediately post-lecture but no difference was found after retesting at 5 weeks.

Effectiveness of an audience response system in teaching pharmacology to baccalaureate nursing students

It has been proposed that students' use of an audience response system, commonly called clickers, may promote comprehension and retention of didactic material. Whether this method actually improves students' grades, however, is still not determined. The purpose of this study was to evaluate whether a lecture format utilizing multiple-choice PowerPoint slides and an audience response system was more effective than a lecture format using only multiple-choice PowerPoint slides in the comprehension and retention of pharmacological knowledge in baccalaureate nursing students. The study also assessed whether the additional use of clickers positively affected students' satisfaction with their learning. Results from 78 students who attended lecture classes with multiple-choice PowerPoint slides plus clickers were compared with those of 55 students who utilized multiple-choice PowerPoint slides only. Test scores between these two groups were not significantly different. A satisfaction questionnaire showed that 72.2% of the control students did not desire the opportunity to use clickers. Of the group utilizing the clickers, 92.3% recommend the use of this system in future courses. The use of multiple-choice PowerPoint slides and an audience response system did not seem to improve the students' comprehension or retention of pharmacological knowledge as compared with those who used solely multiple-choice PowerPoint slides.

Effectiveness of an audience response system in teaching pharmacology to baccalaureate nursing students

It has been proposed that students' use of an audience response system, commonly called clickers, may promote comprehension and retention of didactic material. Whether this method actually improves students' grades, however, is still not determined. The purpose of this study was to evaluate whether a lecture format utilizing multiple-choice PowerPoint slides and an audience response system was more effective than a lecture format using only multiple-choice PowerPoint slides in the comprehension and retention of pharmacological knowledge in baccalaureate nursing students. The study also assessed whether the additional use of clickers positively affected students' satisfaction with their learning. Results from 78 students who attended lecture classes with multiple-choice PowerPoint slides plus clickers were compared with those of 55 students who utilized multiple-choice PowerPoint slides only. Test scores between these two groups were not significantly different. A satisfaction questionnaire showed that 72.2% of the control students did not desire the opportunity to use clickers. Of the group utilizing the clickers, 92.3% recommend the use of this system in future courses. The use of multiple-choice PowerPoint slides and an audience response system did not seem to improve the students' comprehension or retention of pharmacological knowledge as compared with those who used solely multiple-choice PowerPoint slides.

Perspective: delivering effective and engaging continuing medical education on physicians' disruptive behavior

Education about physicians' disruptive behavior is relevant for practicing physicians, who must demonstrate competence in professionalism for maintenance of certification. In addition, physicians need to know about newer regulatory standards that define disruptive behavior and mandated processes for dealing with such behavior, as health care organizations are now charged with having formal policies addressing this issue. There is a growing literature about dealing with disruptive behavior, but it has not addressed education, including continuing medical education (CME), aimed at reducing or preventing disruptive behavior. The authors suggest specific strategies for such CME educational programs, including knowing the audience before the presentation, avoiding potential pitfalls, defusing defensiveness, and increasing audience "buy-in." They present two viewpoints from which to approach the topic of disruptive behavior, depending on the audience: "rekindling of values" and "risk reduction." The authors also recommend interactive teaching methods designed to maximize audience participation and foster self-awareness and reflection.

Training the public health workforce from Albany to Zambia: technology lessons learned along the way

This article describes lessons learned by the University at Albany Center for Public Health Preparedness (UA-CPHP) in using three technologies to deliver preparedness training for public health professionals in New York State. These three technologies are: 1. Audience response system (ARS, or the "clicker" system)--Purchased to improve engagement of all participants in heterogeneous training audiences, it also markedly reduces staff time while improving training evaluation (cost: $4,500). 2. Satellite broadcast programs--UA-CPHP produced more than 50 broadcasts, which remain available as videostreams and/or podcasts. Viewership of archived programs sometimes surpasses that of the live event (cost estimate: $23,000 to $39,000). 3. Interactive online courses--Seventeen courses have registered more than 44,000 learners worldwide. The Pandemic Influenza course alone has reached more than 16,000 registrants from all 50 U.S. states and at least 56 other countries (cost estimate: $30,000 to $65,000). UA-CPHP's experience as a preparedness training center has confirmed that contemporary technology can be employed to improve and increase the reach of these training efforts. An additional finding was that, quite unintentionally, the intensive use of distance-based educational modalities designed to reach public health practitioners in New York State has afforded UA-CPHP a substantial national and international audience as well, and at no additional cost.

Engaging students in active learning: use of a blog and audience response system

Librarians provide instruction to medical students as part of a core course in the medical school curriculum. Instruction was provided, in part, through didactic sessions covering professional-level medical information resources, PubMed search skills, psychosocial information, and evidence-based medicine. Librarians redesigned instructional sessions with the goals of increasing student engagement and minimizing the lecture format, maximizing the number of students receiving feedback on their search and evaluation skills, and permitting students to see a variety of possible responses as well as engage in peer- and self-evaluation. Librarians integrated the use of a blog and an audience response system (ARS) into the instruction to help accomplish these goals.

The impact on medical practice of commitments to change following CME lectures: a randomized controlled trial

BACKGROUND

Self-reported commitment to change (CTC) could be a potentially valuable method to address the need for continuing medical education (CME) to demonstrate clinical outcomes.

AIM

This study determines: (1) are clinicians who make CTCs more likely to report changes in their medical practices and (2) do these changes persist over time?

METHODS

Intervention participants (N = 80) selected up to three commitments from a predefined list following the lecture, while control participants (N = 64) generated up to three commitments at 7 days post-lecture. At 7 and 30 days post-lecture, participants were queried if any practice change occurred as a result of attending the lecture.

RESULTS

About 91% of the intervention group reported practice changes consistent with their commitments at 7 days. Only 32% in the control group reported changes (z = 7.32, p < 0.001). At 30 days, more participants in the intervention group relative to the control group reported change (58% vs. 22%, z = 3.74, p < 0.01). Once a participant from either group made a commitment, there were no differences in reported changes (63% vs. 67%, z = <0.00, p = 0.38).

CONCLUSION

Integration of CTC is an effective method of reinforcing learning and measuring outcomes.

An audience response system may influence student performance on anatomy examination questions

This study integrated an in-house audience response system (ARS) in the human anatomy course over two years to determine whether students performed better on high-stakes examinations following exposure to similar interactive questions in a large lecture format. Questions in an interactive ARS format were presented in lectures via PowerPoint presentations. Students who chose to participate in the anonymous ARS sessions submitted answers via their personal wireless devices (e.g., laptops, smartphones, PDAs, etc). Students were surveyed for feedback. Student participation in ARS activities was greatest (65-80%) in the first lecture. The number of students who actively participated in ARS activities decreased over the next four sessions, and then slightly increased in the last two sessions. This trend was the same for both years. Use of the ARS did not dramatically enhance overall student performance on examination questions that dealt with content similar to content presented in the ARS sessions. However, students who scored in the lower quartile of the examination performed better on the examination questions after the ARS was implemented. Accordingly, our findings suggest that the effect of ARS to improve student performance on examinations was not uniform. The overall benefit of an ARS to enhance the lecture experience was confirmed by student surveys.

Evidence for teaching practice: the impact of clickers in a large classroom environment

As the number of nursing students increases, the ability to actively engage all students in a large classroom is challenging and increasingly difficult. Clickers, or student response systems (SRS), are a relatively new technology in nursing education that use wireless technology and enable students to select individual responses to questions posed to them during class. The study design was a quasi-experimental comparison with one section of an adult medical-surgical course using the SRS and one receiving standard teaching. No significant differences between groups on any measure of performance were found. Focus groups were conducted to describe student perceptions of SRS. Three themes emerged: Being able to respond anonymously, validating an answer while providing immediate feedback, and providing an interactive and engaging environment. Although the clickers did not improve learning outcomes as measured by objective testing, perceptions shared by students indicated an increased degree of classroom engagement. Future research needs to examine other potential outcome variables.

A controlled study of improvements in student exam performance with the use of an audience response system during medical school lectures

BACKGROUND

An audience response system (ARS) is an electronic classroom communication device. There are several educational justifications for using ARS. Our controlled study investigated whether ARS use was associated with improved performance on a course exam.

METHOD

This study used exam scores as the outcome and employed a switching replication design with a paired-samples t test analysis. The control and experimental groups differed only on whether students were expected to use ARS to enter data during lectures.

RESULTS

The average scores on questions when ARS was used were statistically similar to scores when ARS was not used. A sign test on difference scores confirmed the result. Statistical power was adequate to detect at least a small effect size.

CONCLUSIONS

Improvements in test scores found in previous studies may have been due to the inclusion of questions in the lecture rather than the use of ARS. Embedding questions into lectures is beneficial, either with or without ARS technology.

Neuroimmune pharmacology as a sub-discipline of immunology in the medical school curriculum

This article provides a description of a proposed sub-module and attendant syllabus for inclusion of neuroimmune pharmacology as a sub-discipline of an immunology course that is offered to medical students during the first year of medical school. Neuroimmune pharmacology is an area of study that integrates fundamental concepts in pharmacology, immunology, neuroscience, and infectious disease. This convergent disciplinary area is of increasing importance to the foundational training of medical students, especially in view of the recognition that a variety of neuropathological processes such as demyelinating disease, drug abuse, and viral encephalitis has an immunological component. A lecture sub-module that addresses this convergent topic is proposed for inclusion as a sub-discipline of an immunology course offered as a component of a Scientific Foundations curriculum that takes place during the first 6 months of medical school. It is proposed to revisit the neuroimmune pharmacology topic area in a more clinical setting during the subsequent 14 months of study when medical students would be presented with an organ system-based curriculum. In this instructional model, basic science teaching faculty would interface with clinical faculty in presenting the topical block material in the context of different organ systems. Discussion of clinical cases related to neuroimmune pharmacology would be integrated into the organ system-based curriculum in order to highlight a translational relevance to medical practice.

Effect of using an audience response system on learning environment, motivation and long-term retention, during case-discussions in a large group of undergraduate veterinary clinical pharmacology students

BACKGROUND

Teaching methods that provide an opportunity for individual engagement and focussed feedback are required to create an active learning environment for case-based teaching in large groups.

AIMS

A prospective observational controlled study was conducted to evaluate whether the use of an audience response system (ARS) would promote an active learning environment during case-based discussions in large groups, have an impact on student motivation and improve long-term retention.

METHODS

Group A (N = 83) participated in large group case discussions where student participation was voluntary, while for group B (N = 86) an ARS was used. Data collection methods included student and teacher surveys, student focus group interviews, independent observations and 1-year post-course testing.

RESULTS

Results indicated that the use of an ARS provided an active learning environment during case-based discussions in large groups by favouring engagement, observation and critical reflection and by increasing student and teacher motivation. Although final exam results were significantly improved in group B, long-term retention was not significantly different between groups.

CONCLUSIONS

It was concluded that ARS use significantly improved the learning experience associated with case-based discussions in a large group of undergraduate students.

Use of an audience response system during peer teaching among physical therapy students in human gross anatomy: perceptions of peer teachers and students

An audience response system (ARS) has become popular among educators in medicine and the health professions because of the system's ability to engage listeners during a lecture presentation. No one has described the usefulness of ARS technology during planned nonlecture peer teaching sessions in gross anatomy instruction for health professionals. The unique feature of each peer teaching session was a nongraded 12-15 item ARS quiz assembled by six second-year doctor of physical therapy (DPT) students and purposely placed at the beginning of the review session for those first-year DPT students in attendance. This study used a ten-item questionnaire and a five-point Likert scale in addition to three open ended questions to survey perceptions of both first-year and second-year DPT students about the usefulness of ARS technology implemented during weekly interactive peer teaching sessions during a semester course in Anatomy for Physical Therapists. First-year students overwhelmingly acknowledged the ARS system permitted each student to self-assess his/her preparedness for a quiz or examination and compare his/her performance with that of classmates. Peer teachers recognized an ARS quiz provided them an opportunity to: (1) estimate first-year students' level of understanding of anatomical concepts; and (2) effectively prepare first-year students for their weekly quizzes and future examinations. On the basis of the mutual benefits derived by both students/tutees and teachers/tutors, physical therapist educators may wish to consider using ARS technology to enhance teaching methods for a class in gross human anatomy.

Effectiveness, challenges, and perceptions of classroom participation systems

A technology-driven generation of students expects faculty to use innovative and interactive approaches to teaching. To address this issue, the authors discuss their use of one classroom participation system, the i>Clicker, and student outcomes.

An audience response system strategy to improve student motivation, attention, and feedback

OBJECTIVE

To implement an audience response system (ARS) to improve student motivation and attention during lectures and provide immediate feedback to the instructor concerning student understanding of lecture content in a Physiological Chemistry/Molecular Biology course.

DESIGN

Students used ARS devices to respond to strategically placed questions throughout physiological chemistry/molecular biology lectures. The instructor inserted 6 to 7 questions that promoted student/class interactivity into each of several 50-minute lectures to focus students' attention and provide feedback on students' comprehension of material.

ASSESSMENT

Ninety-eight percent of first-year pharmacy (P1) students (n = 109) reported that strategically placed ARS questions throughout lectures helped them maintain attention. Reports from an independent focus group indicated that students favored this strategy. Furthermore, ARS feedback helped the instructor gauge student comprehension and adjust lectures accordingly.

CONCLUSIONS

Focused, strategically placed ARS questions throughout lectures may help students maintain attention and stay motivated to learn. Feedback from these questions also allows instructors to adapt lectures to address areas of deficiency.

Audience response systems as a data collection method in organizational research

Audience responses systems are electronic devices allowing audience interaction and they are increasingly being used in educational and business settings to enhance various pedagogical and practical processes. This paper discusses how ARS technology may be used as a method of collecting data for research purposes. Specifically, this paper demonstrates ARS technology's potential utility by duplicating findings from two organisational studies, it discusses how ARS technology may be used to address three prevalent data collection problems, and it suggests how ARS technology may provide scholars with increased access to certain organisational settings, as well as greater integration between research and service activities.

Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities

Most physicians believe that to provide the best possible care to their patients, they must commit to continuous learning. For the most part, it appears the learning activities currently available to physicians do not provide opportunities for meaningful continuous learning. At the same time there have been increasing concerns about the quality of health care, and a variety of groups within organized medicine have proposed approaches to address issues of physician competence and performance. The authors question whether CME will be accepted as a full partner in these new approaches if providers continue to use current approaches to planning and assessing CME. A conceptual model is proposed for planning and assessing continuous learning for physicians that the authors believe will help CME planners address issues of physician competence, physician performance, and patient health status.

A Systems Approach to Teach Core Topics across Graduate Medical Education Programmes

Introduction: Core curricula including Ethics, Medico-legal issues, Socioeconomics, and Quality Improvement (QI) are relevant and significant for graduate medical education programmes, regardless of specialty. A lack of faculty expertise in these content areas is a frequently cited concern among specialty programmes in graduate medical education. We report the results of an institutional systems-approach to assist this challenge. Our institution has 86 post-graduate residency and fellowship training programmes serving 1068 learners. Directors of these programmes expressed the need for a centralised approach to teach learners about insurance systems and the basics of QI. Materials and Methods: Two subject matter experts in the fields of insurance systems and 1 expert in QI conducted 2 institution-wide didactics on each of the content areas, attended by 192 and 225 learners respectively. Results: Significant improvement in learner knowledge was noted for all 3 knowledge-based questions for both content areas (P <0.0001). Learner self-assessment of knowledge of insurance systems increased from a pre-session mean of 2.86 to a post-session mean of 3.80 (P <0.0001) and from 3.29 to a post-session mean of 4.17 (P <0.0001) for the QI didactics. Conclusion: Systems-wide didactic sessions for learners of different residencies has several advantages including the efficient use of content experts, prevention of resource burnout, and cost effectiveness. This strategy may also assist programmes directors in meeting external accreditation requirements. Key words: Audience response system, Quality improvement, Safety, Systems initiatives

A primer on audience response systems: current applications and future considerations

Audience response systems (ARSs) are an increasingly popular tool in higher education for promoting interactivity, gathering feedback, preassessing knowledge, and assessing students' understanding of lecture concepts. Instructors in numerous disciplines are realizing the pedagogical value of these systems. Actual research on ARS usage within pharmacy education is sparse. In this paper, the health professions literature on uses of ARSs is reviewed and a primer on the issues, benefits, and potential uses within pharmacy education is presented. Future areas of educational research on ARS instructional strategies are also suggested.