A mobile technology-based cooperative learning platform for undergraduate biology courses in common college classrooms

As a high-impact educational practice, cooperative learning uses a structured group study to promote students' active learning. Currently, it lacks economical yet effective tools to facilitate the interactive nature of structured cooperative learning in regular classrooms. Here, we have established a mobile technology-based cooperative learning (MBCL) platform that comprises the 2018 iPad, Apple Pencil, LiveBoard, Google Forms, and Google Drive. We tested the MBCL platform in multiple undergraduate biology courses. During semester-long MBCL studies, the students engaged in cooperative learning to discuss a real-life issue or chapter-based contents. With the MBCL platform, the students' group study processes were shown on shared, visible electronic whiteboards that were updated in real-time, generating visible thinking and instant, interactive communication. The instructor was able to guide the students promptly to conduct knowledge integration and knowledge synthesis using tables and diagrams. The deep learning outcome was evident in the examples and quantitative analyses of students' whiteboard study results and team presentations. Thus, integrating innovative mobile technologies into high-impact teaching practices, exemplified by the MBCL platform, promotes deep learning in higher education.

Support, technology and mental health: correlates of trainee workplace satisfaction

INTRODUCTION

Low physician workplace satisfaction may negatively impact patient care. Dissatisfaction may begin during residency training, where trainees face lower autonomy and less control over work conditions. The theoretical and empirical literature on trainees is couched mainly in terms of burnout. Theories of satisfaction, a different construct, are derived from studies of independent physicians. Identifying specific correlates of trainee satisfaction may be a clearer path to preparing a sustainable physician workforce.

METHODS

We surveyed 3300 residents and fellows (response rate of 7.2% to 46,574 surveys sent) across multiple specialties and institutions in the US. The instrument was adapted from a previous large-scale survey of physician satisfaction, with changes reflecting factors theorized to specifically affect trainee satisfaction. We applied generalized linear regression to identify correlates of higher satisfaction.

RESULTS

A total of 1444 (44%) residents/fellows reported they were very satisfied and 1311 (40%) reported being somewhat satisfied. Factors associated with satisfaction included positive perceptions of supporting clinical staff, the electronic health record, and stability of personal mental health. Surprisingly, a strong negative perception of completing insurance and/or disability forms was also associated with higher satisfaction. Factors often presumed to correlate with satisfaction, such as duty hours, debt load, and specialty, did not show significant associations.

DISCUSSION

Multiple workplace factors are correlated with trainee satisfaction, but they are not the factors (such as financial debt) that we initially hypothesized. The factors we identified, including clinical staff support and personal mental health, may be targets for further study and/or pilot interventions aimed at improving satisfaction.

Assessing the Role of Screencasting and Video Use in Anatomy Education

The subject of anatomy, commonly taught with applied clinical focus on medical programmes, is frequently brought to life alongside art, imagery and visualization. Yet, despite being continually hailed as the cornerstone of medicine, the cyclic revalidation of its curricula has often found its educators in the unenviable position of maintaining knowledge standards in the face of reduced contact time. However, the gravity of such challenges has created an opportunity for creative and innovative solutions to these problems. The ease by which educational technology can now be used by non-experts is constantly increasing and the use of technology enhanced learning has now become universal within Higher Education. Many anatomical science educators have turned to building bespoke interactive and engaging online supplementary material which can be blended with face to face delivery as a way to circumvent the time pressure issues. Today's students appear to have a growing preference for visualising moving images and audio explanations as opposed to older traditional static resources, underpinned by vast pages of unattractive dense text and pictures. One such technique being used to provide flexible and student-centred learning is screencast videos. These digital recordings of screen captured drawings, with accompanying narration are overwhelmingly popular with students and on the ascendance. However, as new tools emerge, it becomes increasingly important to determine their impact on both the student experience and knowledge gain. It is also valuable for educators to share their classroom experiences or instructional techniques to optimise their use for learning. This chapter explores the rise of this application in anatomy education and discusses the evidence available investigating student engagement and learning outcomes in the context of well-established learning theories.

Effect of student-directed solicitation of evaluation forms on the timeliness of completion by preceptors in the United States

PURPOSE

Summative evaluation forms assessing a student's clinical performance are often completed at the end of a clinical experience from a faculty preceptor. In our institution, despite the use of an electronic system, completion timeliness has been suboptimal potentially limiting our ability to monitor student progress. The aim of the present study was to determine if a student-centered approach to summative evaluation form collection at the end of a pediatrics clinical experience will enhance timeliness of completion for third year medical students at Pennsylvania State College of Medicine.

METHODS

This was a pre- and post-intervention educational quality improvement project focused on 156 (82 pre-intervention, 74 post-intervention) third year medical students at Pennsylvania State College of Medicinecompleting their four-week pediatric clerkship. Utilizing Research Electronic Data Capture (REDCap) informatics support, student-directed evaluation form solicitation was encouraged. Wilcoxon rank sum test was applied to compare pre-intervention (May 1, 2017 to March 2, 2018) and post-intervention (April 2, 2018 to December 21, 2018) percentages of forms completed before rotation midpoint.

RESULTS

Seven hundred and forty evaluation forms were submitted during the pre-intervention phase and five-hundred and seventeen were submitted during the post-intervention phase. Form completion percentage before rotation midpoint increased after implementation of student-directed solicitation (9.6% versus 39.7%, P<0.05).

CONCLUSION

Our clerkship relies on subjective summative evaluations to track student progress, employ improvement strategies, and determine criteria for advancement; however, our preceptors struggled with timely submission. Allowing students to direct the solicitation of evaluation forms enhanced the timeliness of completion at our institution and should be considered in clerkships with similar difficulties.

Blockchain Technology: A Data Framework to Improve Validity, Trust, and Accountability of Information Exchange in Health Professions Education

Health professions educators face multiple challenges, among them the need to adapt educational methods to new technologies. In the last decades, multiple new digital platforms have appeared in the learning arena, including massive open online courses and social-media-based education. The major critique of these novel methods is the lack of the ability to ascertain the origin, validity, and accountability of the knowledge that is created, shared, and acquired. Recently, a novel technology based on secured data storage and transmission, called blockchain, has emerged as a way to generate networks where validity, trust, and accountability can be created. Conceptually, blockchain is an open, public, distributed, and secure digital registry where information transactions are secured and have a clear origin, explicit pathways, and concrete value. Health professions education based on blockchain will potentially allow improved tracking of content and the individuals who create it, quantify educational impact on multiple generations of learners, and build a relative value of educational interventions. Furthermore, institutions adopting blockchain technology would be able to provide certification and credentialing of health care professionals with no intermediaries. There is potential for blockchain to significantly change the future of health professions education and radically transform how patients, professionals, educators, and learners interact around safe, valid, and accountable information.

Evidence-Based Principles for Using Technology-Enhanced Learning in the Continuing Professional Development of Health Professionals

Increasingly, health professional training involves the use of educational technologies through what is broadly termed "Technology-Enhanced Learning" (TEL). TEL includes hardware, such as computers and mobile devices, and software, such as software applications (apps), learning management systems, and discussion boards. For many years, TEL has formed an integral part of health professional programs and is growing in acceptance, if not expectation, in postgraduate training and continuing education. TEL generally aims to be flexible, engaging, learner focused and interactive, and may involve collaboration and communication. It offers many benefits for learning and teaching, whether used on its own or in conjunction with face-to-face teaching through blended learning. The ubiquity of mobile devices in clinical settings means TEL is ideal for busy clinicians, both as learners and teachers. TEL enables participants to learn at a time and place that is convenient to them, so learners living in geographically dispersed locations can access standardized courses. To realize these potential benefits, we recommend that those developing TEL programs for health professionals take a systematic approach to planning, development, implementation, and evaluation. To that end, we propose 10 principles: clarify purpose and conduct a needs assessment; allocate adequate time and technology; incorporate proven approaches to improve learning; consider the need for a skills component; enable interaction between learners and with others; create different resources for different groups; pilot before implementing; incorporate measures to retain learners; provide opportunities for revision to aid retention; and evaluate learning outcomes, not just satisfaction.

Experiences of Using Prezi in Psychiatry Teaching

OBJECTIVE

Prezi is a presentation software allowing lecturers to develop ideas and produce mind maps as they might do on an old-style blackboard. This study examines students' experience of lectures presented using Prezi to identify the strengths and weaknesses of this new teaching medium.

METHODS

Prezi was used to present mental health lectures to final-year medical and physiotherapy students. These lectures were also available online. This cross-sectional study used a questionnaire to assess students' experience of the software.

RESULTS

Of students approached, 75.5 % (74/98) took part in the study. A majority, 98.6 % (73/74), found Prezi to be a more engaging experience than other styles of lecture delivery. The overview or "mind map" provided by Prezi was found to be helpful by 89.2 % (66/74). Problems arose when students used Prezi in their personal study, with 31.1 % (23/74) reporting some difficulties, mostly of a technical nature.

CONCLUSION

This study highlights the potential of Prezi for providing students with an engaging and stimulating educational experience. For Prezi to be effective, however, the lecturer has to understand and be familiar with the software and its appropriate use.

The Use of Simulation to Teach Suicide Risk Assessment to Health Profession Trainees-Rationale, Methodology, and a Proof of Concept Demonstration with a Virtual Patient

OBJECTIVE

There is increasing use of educational technologies in medical and surgical specialties. Described herein is the development and application of an interactive virtual patient (VP) to teach suicide risk assessment to health profession trainees. We studied the effect of the following: (1) an interaction with a bipolar VP who attempts suicide or (2) completion of a video-teaching module on interviewing a bipolar patient, on medical students' proficiency in assessing suicide risk in standardized patients. We hypothesized that students who interact with a bipolar VP will be at least as likely to assess suicide risk, as their peers who completed a video module.

METHODS

In a randomized, controlled study, we compared the frequency with which second-year students at the Medical College of Georgia asked suicide risk and bipolar symptoms questions by VP/video group.

RESULTS

We recruited 67 students. The VP group inquired more frequently than the video group in 4 of 5 suicide risk areas and 11 of 14 other bipolar symptomatology areas. There were minimal to small effect sizes in favor of the VP technology. The students preferred the video over the VP as an educational tool (p = 0.007).

CONCLUSIONS

Our study provides proof of concept that both VP and video module approaches are feasible for teaching students to assess suicide risk, and we present evidence about the role of active learning to improve communication skills. Depending on the learning context, interviewing a VP or observation of a videotaped interview can enhance the students' suicide risk assessment proficiency in an interview with a standardized patient. An interactive VP is a plausible modality to deliver basic concepts of suicide risk assessment to medical students, can facilitate individual preferences by providing easy access and portability, and has potential generalizability to other aspects of psychiatric training.

Transforming students into digital academics: a challenge at both the individual and the institutional level

BACKGROUND

Little is known of students' Information and Communication Technology (ICT) readiness in a learning context. Information about students' capabilities and resources is an important prerequisite for designing meaningful teaching and learning activities that engage and motivate students. To learn about health science students' usage of digital equipment, familiarity with software, online behavior and communication with the university, we have conducted a survey focusing on these areas.

METHODS

A digital questionnaire was sent to 9134 health science students, of whom 1165 responded (12.8%).

RESULTS

Almost all students owned a laptop (98.3%) and a smartphone (86.5%) and used these for internet access. The students were most familiar with typical office programs like word processing and spread sheets. Students used social media in their private lives but to a lesser extent in relation to their studies; they also experienced that their teachers made limited use of these media. The most commonly used tool for working with fellow students was email (80%) and for communication, SMS (47.6%). An age difference was found in relation to the way students communicated with each other. The mean age of chat users was 23.8 (Standard deviation 3.7) years, SMS users, 25 (Standard deviation 4.2) years and email users, 27.9 (Standard deviation 6.5) years. Over half of the students (53.4%) found that the degree of ICT incorporated in the teaching and learning activities was insufficient to provide them with the skills necessary in their future profession.

CONCLUSIONS

Although a large percentage of the students had access to the internet, reported familiarity with basic software and used online services in their private lives, they were unfamiliar with the software and services they were expected to use in their studies. The students experienced that teachers did not use internet resources, which apparently influenced their perception of the importance of, and thereby their usage of, these services. The way the younger students communicate differs from the way communication takes place at the university, and it is recommended that the institutions should look into how they can meet the students in ways they are familiar with.

The relationship between involvement in and use of evaluation in multi-site evaluations

This research explores the relationship between participation in evaluation and the use of evaluation findings and processes within three large-scale multi-site evaluations. Using canonical correlation analysis and a collection of 20 interviews, this study describes and tests the relationship between these two critical conceptual powerhouses in evaluation. Using data that were collected as a part of the NSF-funded research Beyond Evaluation Use (Lawrenz & King, 2009), this study found that some theories and beliefs about participatory evaluation contribute to use and influence in similar ways as in single-site evaluations. The differences identified in this research highlight potential planning and implementation considerations that might allow multi-site evaluators and funders of multi-site evaluation to enhance use and influence of multi-site evaluations.

Building connections through teletechnologies to augment resident training in psychodynamic psychotherapy

OBJECTIVE

This report describes the utilization of teletechnologies for training in psychodynamic psychotherapy in a residency training program. This includes the development of a unique psychodynamic psychotherapy case conference for residents, education in a particular model of short-term dynamic psychotherapy through distance education, and the use of web-based technologies to provide individual case supervision.

METHODS

Evaluation forms and verbal feedback from trainees have been used as a preliminary evaluation of this program.

RESULTS

Experience with educational models using web-based technologies have greatly enhanced the learning experience for residents beginning training in psychodynamic psychotherapy

CONCLUSION

Web-based technologies can be used effectively to augment resources in a residency training program and might be considered to link programs to share resources.

Integration or transformation? Looking in the future of Information and Communication Technology in education in Vietnam

Over the last two decades, crucial factors for Information and Communication Technology (ICT) in education have improved significantly in Vietnam. Nevertheless, it is clear that, as in other countries, no educational revolution is taking place. We argue that there is a need for a broad dialogue on the future of ICT in education in Vietnam as discussion of ideas about future possibilities can be instrumental in rationalizing and generating educational change. We explore how a group of key players representing the public and private sector as well as development partners in the field look at the future of ICT in education in the country. Following the Delphi method, these key players assessed in different survey rounds the current situation of ICT in education, identified a series of targets and were asked to assess these targets in respect of their importance. The key players reached a consensus that the purpose of technology integration is to achieve learning goals and enhance learning. However, there is more controversy on targets that could potentially transform education practice in Vietnam. We discuss the value of the Delphi technique and argue for increased participation of all involved stakeholders in policy development on ICT in education.

ICT Learning Technologies for Disabled People: Recommendations for Good Practice

The use of ICT in education is becoming increasingly important and has potential advantages to disabled learners if the technologies are appropriately designed, including for accessibility and usability, and used. This paper presents the first sets of recommendations for learning technologies for disabled people aimed at disabled learners, teachers, developers and educational institutions respectively. They were developed as part of the work of the Enable Network for ICT Learning for Disabled People and involved input from both experts and end-users. The concise format facilitates production in a variety of formats and languages for accessibility and wide distribution. The paper discusses the recommendations and their relationship to existing guidelines.

The awareness and attitudes of students of one indian dental school toward information technology and its use to improve patient care

BACKGROUND

Many obstacles need to be overcome if digital and electronic technologies are to be fully integrated in the operation of dental clinics in some countries. These obstacles may be physical, technical, or psychosocial barriers in the form of perceptions and attitudes related to software incompatibilities, patient privacy, and interference with the patient-practitioner relationship. The objectives of the study are to assess the perceptions of Indian dental students of one school toward the usefulness of digital technologies in improving dental practice; their willingness to use digital and electronic technologies; the perceived obstacles to the use of digital and electronic technologies in dental care setups; and their attitudes toward Internet privacy issues.

METHODS

The study population consisted of 186 final year undergraduate dental students from the A. B. Shetty Memorial institute of Dental Sciences, Rajiv Gandhi University of Health Sciences, Mangalore, India. Survey data were analyzed descriptively .

RESULTS

Most students indicated that information technology enhances patient satisfaction, the quality of dental record, diagnosis, treatment planning, and doctor-doctor communication. Cost of equipment and need for technical training were regarded as major obstacles by substantial proportions of respondents.

DISCUSSION

Most dental students at our school feel that the information technology will support their decision making in diagnoses and devising effective treatment plans, which in turn increase patient satisfaction and quality of care. Students also perceived that lack of technical knowledge and the high cost of implementation are major barriers to developing information technology in India.

[The use of video as preparation for the objective structured clinical examination in medicine and surgery]

The objective structured clinical examination (OSCE) is a tool for measuring the dimensions of clinical competences. OSCE differs from traditional oral or written examination and results should not be influenced by lack of knowledge of the testing type. We prepared a video describing the practical aspects. On a Likert scale from 1 to 7 our video was rated 4 (interquartile range (IQR): 4-6). An informatory lecture was rated 4 (IQR: 3-5) and a rehearsal OSCE was rated 6 (IQR: 5-7). Video use peaked in the days up to OSCE. Accessibility should be improved by reaching out using the appropriate tools. We encourage the use of video for preparation to new examination types.

Promoting professionalism via a video-based educational workshop for academic hospitalists and housestaff

BACKGROUND

Unprofessional behavior can compromise care and detract from the hospital learning environment. Discrepancy between professional behaviors formally taught and what is witnessed has become increasingly evident.

METHODS

With funding from the American Board of Internal Medicine Foundation, a workshop was developed to address unprofessional behaviors related to inpatient care previously identified in a multi-institution survey. The aims were to utilize video-based education to illustrate unprofessional behaviors, how faculty play a role in promoting such behaviors, and facilitate reflection regarding motivation for and prevention of these behaviors. Hospitalists and housestaff at 3 Chicago-area academic hospitals and 1 community teaching affiliate participated. Videos were debriefed, identifying barriers to professional behavior and improvement strategies. A postworkshop survey assessed beliefs on behaviors and intent to change practice.

RESULTS

Forty-four (53%) faculty and 244 (68%) residents (postgraduate year 1 and greater) participated. The workshop was well received, with 89% reporting it "useful and effective." Two-thirds expressed intent to change behavior. Most (86%) believed videos were realistic and effective. Those who perceived videos as "very realistic" were more likely to report intent to change behavior (93% vs 53%, P = 0.01).

CONCLUSIONS

Video-based education is a feasible way to promote reflection and address unprofessional behaviors among providers and may positively impact the learning environment.

[Teaching therapeutic disciplines: vectors of modernization]

The paper discusses approaches to improving educational technologies in therapeutic disciplines taught at higher medical education institutes according to the basic curricula in Therapeutics (060101).

Interactive distance learning in orthodontic residency programs: problems and potential solutions

Sharing resources through distance education has been proposed as one way to deal with a lack of full-time faculty members and maintain high-quality content in orthodontic residency programs. To keep distance education for orthodontic residents cost-effective while retaining interaction, a blended approach was developed that combines observation of web-based seminars with live post-seminar discussions. To evaluate this approach, a grant from the American Association of Orthodontists (AAO) opened free access during the 2009-10 academic year to twenty-five recorded seminars in four instructional sequences to all sixty-three orthodontic programs in the United States and Canada. The only requirement was to also participate in the evaluation. Just over half (52 percent) of the U.S. programs chose to participate; the primary reason for participating was because faculty members wanted their residents to have exposure to other faculty members and ideas. The non-participating programs cited technical and logistical problems and their own ability to teach these subjects satisfactorily as reasons. Although participating distant faculty members and residents were generally pleased with the experience, problems in both educational and technical aspects were observed. Educationally, the biggest problem was lack of distant resident preparation and expectation of a lecture rather than a seminar. Technically, the logistics of scheduling distant seminars and uneven quality of the audio and video recordings were the major concerns of both residents and faculty members. Proposed solutions to these educational and technical problems are discussed.

Academic performance in a pharmacotherapeutics course sequence taught synchronously on two campuses using distance education technology

OBJECTIVE

To compare the academic performance of campus-based students in a pharmacotherapeutics course with that of students at a distant campus taught via synchronous teleconferencing.

METHODS

Examination scores and final course grades for campus-based and distant students completing the case-based pharmacotherapeutics course sequence over a 5-year period were collected and analyzed.

RESULTS

The mean examination scores and final course grades were not significantly different between students on the 2 campuses.

CONCLUSIONS

The use of synchronous distance education technology to teach students does not affect students' academic performance when used in an active-learning, case-based pharmacotherapeutics course.

Instructor satisfaction with a technology-based resource for diabetes education

OBJECTIVES

To evaluate instructor use patterns and satisfaction with DM Educate, a comprehensive, Web-based diabetes course.

METHODS

Instructors completed a post-course survey instrument to assess their use of course materials and components, as well as satisfaction with the course content, design, and technology utilized, and to solicit their suggestions for additional content areas.

RESULTS

Thirty-eight percent of respondents utilized DM Educate as a standalone elective and 62% had integrated materials into existing courses. The pharmacotherapy module was the most utilized at 91% and slide sets were the most utilized course components at 63%. All instructors stated that they would use the course again the following year. Suggestions for improvement included incorporation of more active-learning activities and patient cases.

CONCLUSION

Instructors' were highly satisfied with the course materials and technology used by DM Educate, a Web-based diabetes education course, and indicated they were able to customize the course materials both to establish new courses and supplement existing courses. All instructors planned to use the course again.

An educational game for teaching clinical practice guidelines to Internal Medicine residents: development, feasibility and acceptability

BACKGROUND

Adherence to Clinical Practice Guidelines (CPGs) remains suboptimal among internal medicine trainees. Educational games are of growing interest and have the potential to improve adherence to CPGs. The objectives of this study were to develop an educational game to teach CPGs in Internal Medicine residency programs and to evaluate its feasibility and acceptability.

METHODS

We developed the Guide-O-Game(c) in the format of a TV game show with questions based on recommendations of CPGs. The development of the Guide-O-Game(c) consisted of the creation of a multimedia interactive tool, the development of recommendation-based questions, and the definition of the game's rules. We evaluated its feasibility through pilot testing and its acceptability through a qualitative process.

RESULTS

The multimedia interactive tool uses a Macromedia Flash web application and consists of a manager interface and a user interface. The user interface allows the choice of two game styles. We created so far 16 sets of questions relating to 9 CPGs. The pilot testing proved that the game was feasible. The qualitative evaluation showed that residents considered the game to be acceptable.

CONCLUSION

We developed an educational game to teach CPGs to Internal Medicine residents that is both feasible and acceptable. Future work should evaluate its impact on educational outcomes.

Sharing innovation: the case for technology standards in health professions education

Information technologies have provided fertile ground for innovation in healthcare education, but too often these innovations have been limited in scope and impact. One way of addressing these limitations is the development of common and open technology standards to scale innovation across organizational boundaries. Research on the diffusion of standards indicates that environmental forces, such as regulatory changes, top-down management support, and feasibility are key determinants of standards adoption. This paper describes the perspective and work of MedBiquitous, the only internationally recognized standards body in healthcare education. Many innovators are implementing MedBiquitous healthcare education standards to effect change within and across organizations. In a resource-constrained and knowledge intensive domain such as healthcare education, collaboration is an imperative. Technology standards are essential to raise the quality of healthcare education and assessment in a cost-effective manner.

Review of ICT-based services for identified unmet needs in people with dementia

Some of the needs that people with dementia and their informal carers currently perceive as insufficiently met by regular care and support services might be alleviated, or even be met, using modern Information and Communication Technology (ICT). The study described in this paper was designed to provide an insight into the state of the art in ICT solutions that could contribute to meet the most frequently mentioned unmet needs by people with dementia and their informal carers. These needs can be summarized as (1) the need for general and personalized information; (2) the need for support with regard to symptoms of dementia; (3) the need for social contact and company; and (4) the need for health monitoring and perceived safety. Databases that were searched include: PubMed, Cinahl, Psychinfo, Google (Scholar), INSPEC and IEEE. In total 22 websites and 46 publications were included that satisfied the following criteria: the article reports on people with dementia and/or their informal carers and discusses an ICT-device that has been tested within the target group and has proven to be helpful. Within the first need area 18 relevant websites and three studies were included; within the second need area 4 websites and 20 publications were included. Within the third and fourth need area 11 and 12 publications were included respectively. Most articles reported on uncontrolled studies. It is concluded that the informational websites offer helpful information for carers but seem less attuned to the person with dementia and do not offer personalized information. ICT solutions aimed at compensating for disabilities, such as memory problems and daily activities demonstrate that people with mild to moderate dementia are capable of handling simple electronic equipment and can benefit from it in terms of more confidence and enhanced positive effect. Instrumental ICT-support for coping with behavioral and psychological changes in dementia is relatively disregarded as yet, while support for social contact can be effectively realized through, for example, simplified (mobile) phones or videophones or (entertainment) robots. GPS technology and monitoring systems are proven to result in enhanced feelings of safety and less fear and anxiety. Though these results are promising, more controlled studies in which the developed ICT solutions are tested in real life situations are needed before implementing them in the care for people with dementia. It is recommended that future studies also focus on the integration of the current techniques and solutions.

Peer reviewing e-learning: opportunities, challenges, and solutions

Peer review is the foundation of academic publication and a necessary step in the scrutiny of any scholarly work. Simply defined, peer review is the attentive, unbiased assessment of any scholarly work that is submitted for formal scrutiny. Although medical school faculty increasingly use technology in clinical teaching, e-learning materials are often not subjected to a rigorous peer review process. The authors contrast peer review of e-learning materials with that of print materials, describe peer review issues regarding e-learning materials, propose approaches to address the challenges of peer review of e-learning materials, and outline directions for refinement of the e-learning peer review process. At its core, the peer review of e-learning materials should not differ substantially from that of traditional manuscripts. However, e-learning introduces new demands that impel reviewers to consider aspects that are unique to educational technology, including pedagogy, format, usability, navigation, interactivity, delivery, ease of updating, distribution, and access. Four approaches are offered to ease the burden and improve the quality of e-learning peer review: develop peer review training, embrace multidisciplinary peer review, develop guidelines, and provide incentives and compensation. The authors conclude with suggestions about peer review research.

Virtual patient simulation at US and Canadian medical schools

PURPOSE

"Virtual patients" are computer-based simulations designed to complement clinical training. These applications possess numerous educational benefits but are costly to develop. Few medical schools can afford to create them. The purpose of this inventory was to gather information regarding in-house virtual patient development at U.S. and Canadian medical schools to promote the sharing of existing cases and future collaboration.

METHOD

From February to September 2005, the authors contacted 142 U.S. and Canadian medical schools and requested that they report on virtual patient simulation activities at their respective institutions. The inventory elicited information regarding the pedagogic and technical characteristics of each virtual patient application. The schools were also asked to report on their willingness to share virtual patients.

RESULTS

Twenty-six out of 108 responding schools reported that they were producing virtual patients. Twelve schools provided additional data on 103 cases and 111 virtual patients. The vast majority of virtual patients were media rich and were associated with significant production costs and time. The reported virtual patient cases tended to focus on primary care disciplines and did not as a whole exhibit racial or ethnic diversity. Funding sources, production costs, and production duration influenced the extent of schools' willingness to share.

CONCLUSIONS

Broader access to and cooperative development of these resources would allow medical schools to enhance their clinical curricula. Virtual patient development should include basic science objectives for more integrative learning, simulate the consequences of clinical decision making, and include additional cases in cultural competency. Together, these efforts can enhance medical education despite external constraints on clinical training.

Substance use and young people: the potential of technology

There is widespread concern about alcohol and drug use and abuse among young people in the United Kingdom, Europe and the United States. Evaluations of current drug and alcohol education approaches have mixed findings and some methodological difficulties. This paper reports on exploratory research to explore the potential of technology to provide information and support to young people regarding substance use and abuse. Eight focus groups were conducted with young people (n = 78) and three with key informants (n = 22). The findings revealed that technology has potential to provide information on this topic, and that young people are critical of some of the more traditional methods of provision. The young people were prepared to experiment with technology, felt competent to do so, and made suggestions of information they would like. These findings are discussed and recommendations made for future research in the area.

Developing practical criteria for evaluating online patient simulations: a preliminary study

Online patient simulations are increasingly used in medical education. However, uniform criteria for evaluating simulations don't exist. This study explored expert opinion regarding the essential components of online simulations. Preliminary criteria were examined through a survey of 22 medical educators and follow-up interviews with nine educators. Features involving routine tasks and the teaching of problem solving skills-histories, physicals, labs, and differential diagnoses were highly rated. Features conveying realism such as time constraints and the use of multimedia were ranked lower. Interviewees noted three impediments to wider use of simulations: time required to develop content, limits of current technology and the absence of usable authoring tools.

Rehabilitation professionals' satisfaction with continuing education delivered at a distance using different technologies

This paper examines learner satisfaction with technologies used for distance delivery of continuing education across 10 Canadian sites: nine within the province of Alberta and one in Nunavut Territory. The technologies were satellite (or videotapes of) broadcasts, videoconferencing, and web-based technology. Learner satisfaction was evaluated using questionnaires. A survey on general issues related to continuing education was developed and mailed to random samples of health professionals and a convenience sample of stakeholders. The learners (n = 1,141) represented 20 types of health service providers who had attended at least one session delivered via satellite, videotape, or videoconferencing. Seven individuals completed the web-based course. Overall, the majority of participants were satisfied or very satisfied. In general, satellite delivery was received more favorably compared with videotapes of the same content. A total of 350 (33% response rate) health professionals and 37 (50% response rate) stakeholders returned the surveys. Nearly 50% of health professionals thought that clinical case presentations (rounds) were valuable to them, but over half of the stakeholders perceived that videotapes, rounds, and research seminars were valuable to health professionals. Ratings for the web-based course varied, indicating different learner characteristics. We conclude that it is possible to utilize multiple technologies to meet the continuing education needs of an interdisciplinary group of health service providers, but future research is needed to develop a framework for evaluating the usability of multiple existing and emerging technologies for distance education.

A randomized trial comparing digital and live lecture formats [ISRCTN40455708

BACKGROUND

Medical education is increasingly being conducted in community-based teaching sites at diverse locations, making it difficult to provide a consistent curriculum. We conducted a randomized trial to assess whether students who viewed digital lectures would perform as well on a measure of cognitive knowledge as students who viewed live lectures. Students' perceptions of the digital lecture format and their opinion as whether a digital lecture format could serve as an adequate replacement for live lectures was also assessed.

METHODS

Students were randomized to either attend a lecture series at our main campus or view digital versions of the same lectures at community-based teaching sites. Both groups completed the same examination based on the lectures, and the group viewing the digital lectures completed a feedback form on the digital format.

RESULTS

There were no differences in performance as measured by means or average rank. Despite technical problems, the students who viewed the digital lectures overwhelmingly felt the digital lectures could replace live lectures.

CONCLUSIONS

This study provides preliminary evidence digital lectures can be a viable alternative to live lectures as a means of delivering didactic presentations in a community-based setting.

Using information technology for patient education: realizing surplus value?

Computer-based patient information systems are introduced to replace traditional forms of patient education like brochures, leaflets, videotapes and, to a certain extent, face-to-face communication. In this paper, we claim that though computer-based patient information systems potentially have many advantages compared to traditional means, the surplus value of these systems is much harder to realize than often expected. By reporting on two computer-based patient information systems, both found to be unsuccessful, we will show that building computer-based patient information systems for patient education requires a thorough analysis of the advantages and limitations of IT compared to traditional forms of patient education. When this condition is fulfilled, however, these systems have the potential to improve health status and to be a valuable supplement to (rather than a substitute for) traditional means of patient education.

Meeting the computer technology needs of community faculty: building new models for faculty development

OBJECTIVE

We aimed to identify the evolving computer technology needs and interests of community faculty in order to design an effective faculty development program focused on computer skills: the Teaching and Learning Through Educational Technology (TeLeTET) program.

METHODOLOGY

Repeated surveys were conducted between 1994 and 2002 to assess computer resources and needs in a pool of over 800 primary care physician-educators in community practice in East Texas. Based on the results, we developed and evaluated several models to teach community preceptors about computer technologies that are useful for education.

RESULTS

Before 1998, only half of our community faculty identified a strong interest in developing their technology skills. As the revolution in telecommunications advanced, however, preceptors' needs and interests changed, and the use of this technology to support community-based teaching became feasible. In 1998 and 1999, resource surveys showed that many of our community teaching sites had computers and Internet access. By 2001, the desire for teletechnology skills development was strong in a nucleus of community faculty, although lack of infrastructure, time, and skills were identified barriers. The TeLeTET project developed several innovative models for technology workshops and conferences, supplemented by online resources, that were well attended and positively evaluated by 181 community faculty over a 3-year period.

CONCLUSIONS

We have identified the evolving needs of community faculty through iterative needs assessments, developed a flexible faculty development curriculum, and used open-ended, formative evaluation techniques to keep the TeLeTET program responsive to a rapidly changing environment for community-based education in computer technology.

When redundant on-screen text in multimedia technical instruction can interfere with learning

It is frequently assumed that presenting the same material in written and spoken form benefits learning and understanding. The present work provides a theoretical justification based on cognitive load theory, and empirical evidence based on controlled experiments, that this assumption can be incorrect. From a theoretical perspective, it is suggested that if learners are required to coordinate and simultaneously process redundant material such as written and spoken text, an excessive working memory load is generated. Three experiments involving a group of 25 technical apprentices compared the effects of simultaneously presenting the same written and auditory textual information as opposed to either temporally separating the two modes or eliminating one of the modes. The first two experiments demonstrated that nonconcurrent presentation of auditory and visual explanations of a diagram proved superior, in terms of ratings of mental load and test scores, to a concurrent presentation of the same explanations when instruction time was constrained. The 3rd experiment demonstrated that a concurrent presentation of identical auditory and visual technical text (without the presence of diagrams) was significantly less efficient in comparison with an auditory-only text. Actual or potential applications of this research include the design and evaluation of multimedia instructional systems and audiovisual displays.

Developing children and multicultural attitudes: the systemic psychosocial influences of television portrayals in a multimedia society

Television can be an important medium for the teaching and learning of the developing child. This article explores how social learning theory and the cross-cultural images and portrayals on television might influence the multicultural attitudes, values, and beliefs of children.

A comparison between three electronic media and in-person learning for continuing education in physical rehabilitation

We produced continuing education material in physical rehabilitation using a variety of electronic media. We compared four methods of delivering the learning modules: in person with a computer projector, desktop videoconferencing, Web pages and CD-ROM. Health-care workers at eight community hospitals and two nursing homes were asked to participate in the project. A total of 394 questionnaires were received for all modalities: 73 for in-person sessions, 50 for desktop conferencing, 227 for Web pages and 44 for CD-ROM. This represents a 100% response rate from the in-person, desktop conferencing and CD-ROM groups; the response rate for the Web group is unknown, since the questionnaires were completed online. Almost all participants found the modules to be helpful in their work. The CD-ROM group gave significantly higher ratings than the Web page group, although all four learning modalities received high ratings. A combination of all four modalities would be required to provide the best possible learning opportunity.

Considering theory in assessing quality of web-based courses

There are significant implications to jumping on the Internet-course bandwagon, and several questions should be answered before offering or enrolling in such a course. This article provides information on how quality has been assessed with online education, reviews the theoretical framework used in conducting such research, and provides a recommendation on which theory is most promising in evaluating the quality of Internet courses.

Technology available in nursing programs: implications for developing virtual end-of-life educational tools

BACKGROUND

To overcome insufficient attention to end-of-life (EOL) care in nursing education, the authors are developing the "Toolkit for Nursing Excellence at End-of-Life Transition" (TNEEL).

METHOD

An evidence-based design process was used to create a computerized (CD-ROM) multimedia toolkit of instructional aides. An online survey of all U.S. undergraduate nursing programs was conducted to identify their current technologic infrastructures available for innovative teaching aides. Expert review process guided pedagogic decisions.

RESULTS

Survey findings enabled TNEEL development to be responsive to nurse educators' needs and preferences.

CONCLUSION

Educators can use TNEEL to actively engage students in meaningful learning about EOL care.