Summing things up: wrapping up case-based learning sessions effectively

We often spend a lot of time planning our learning events, especially our case-based small group learning (SGL) sessions. We tailor our sessional learning objectives to the course objectives that have been assigned, selected solid preparatory materials, build great cases and craft meaningful questions for groups to work through.

This makes sense, as the small group learning (SGL) format used in Queen’s UGME program is modeled on Larry Michaelsen’s team-based learning (TBL) instructional strategy that uses the majority of in-class time for decision-based application assignments done in teams.

One comment we often read on course evaluation forms and hear directly from students, however, is that sometimes they walk away from an SGL session and still aren’t sure what’s important.

Much of the focus in the literature on TBL is on the doing – setting things up, building great cases, asking good questions to foster active learning. There’s not as much written about how to finish well.

Wrapping up your SGL session should be as much a planned part of your teaching as preparing the cases themselves. If you build the time into your teaching plan, you won’t feel like you’re shouting to learners’ backs as they exit the classroom, or cut off as the next instructor arrives. Nor will you find yourself promising to post the “answers” to the cases on Elentra. Sometimes it’s not the answers that are important, but the steps students take to get there.

Wallace, Walker, Braseby and Sweet remind us that the flipped classroom we use for SGL (preparation before class, application in class) is one “where students adopt the role of cognitive apprentice to practice thinking like an expert within the field by applying their knowledge and skills to increasingly challenging problems.” One such challenge is figuring out what the key take-away points are from an SGL session. With this in mind, it’s a good idea to plan your session summary, but then have students take the lead since “the expert’s presence is crucial to intervene at the appropriate times, to resolve misconceptions, or to lead the apprentices through the confusion when they get stuck.”[1]

So, have your own summary slide ready – related to your session objectives – but keep it in reserve. In keeping with the active-learning focus of SGL, save the last 10 minutes or os of class to have the groups generate the key take-away points, share them, and fill in any gaps from your own list.

Here’s a suggested format:

  1. Prompt the groups to generate their own study list: “Now that we’ve worked through these three cases, what are the four key take away points you have about this type of presentation?”
  2. Give the groups 3-4 minutes to generate their own lists
  3. Have two groups share with each other
  4. To debrief the large group, do a round up of four or five groups each adding one item to a study list.
  5. Share your own list – and how it relates to the points the student raised. This is a time to fill in any gaps and clarify what level of application you’ll be using on assessments.
  6. If you’d like, preview an exam question (real or mock): “After these cases, and considering these take-away points, I expect that you could answer an exam question like this one.” This can make the level of application you’re expecting very concrete.

Why take the time to wrap up a session this way? Students often ask (in various ways) what the point is of a session. With clear objectives and good cases, they should also develop the skills to draw those connections themselves. This takes scaffolding from the instructor. As Maryellen Weimer, PhD, writes in Faculty Focus, “Weaning students from their dependence on teachers is a developmental process. Rather than making them do it all on their own, teachers can do some of the work, provide part of the answer, or start with one example and ask them for others. The balance of who’s doing the work gradually shifts, and that gives students a chance to figure out what the teacher is doing and why.”


If you would like assistance preparing any part of your SGL teaching, please get in touch. You can reach me at theresa.suart@queensu.ca


[1] Wallace, M. L., Walker, J. D., Braseby, A. M., & Sweet, M. S. (2014). “Now, what happens during class?” Using team-based learning to optimize the role of expertise within the flipped classroom. Journal on Excellence in College Teaching, 25(3&4), 253-273.

Posted on

Honing skills for writing learning objectives

Many people – from award-winning educators to rookies and everyone in between – find writing learning objectives a challenge. The typical advice of write out who will do what under what conditions is vague, so it’s often not very helpful.

Decorative image of laptop, pen and post-it note with message "objective" in bold, red font

“General” learning objectives – from our UGME Competency Framework, aka the Red Book* – are already assigned to your course, and possibly to your session by your course director. (The Red Book’s 7th edition is forthcoming; the link will be updated automatically).

The key task for instructors is to take these general objectives and annotate them with specific objectives for their sessions, including what level of learning, such as comprehension, application or analysis. (This is from something called “Bloom’s Taxonomy”, if you’re interested in the research behind this).

A natural starting point is: What do you want your learners to take away from your session? (Or, if you’re creating an independent learning plan, as in the case of the new Scholar block in Clerkship: “ What do I want to accomplish in this block?”)

Frequently the response is:

  •  “I want them to know….”  / “I want to know…”
  •  “I want them to understand….”   /  “I want to understand…”
  •  “I want them to be able to…”   /  “I want to be able to…”

Once you’ve wrestled something like this into sentences, I realize it’s disheartening to have someone like me come along and say, “Uh, no, that’s not up to scratch.”

What’s wrong with “know” and “understand”? Isn’t that exactly what we’d like learners to walk away with – knowledge, understanding, skills? Absolutely. The challenge with these so-called “bad objective verbs” is that we can’t measure them through assessment. How do we know they know?

That’s the starting point for writing a better learning objective. If you want to assess that learners know something, how will you assess that?

For example, while we can’t readily assess if a learner “understands” a concept, we can assess whether they can “define”, “describe”, “analyze”, or “summarize” material.

Here’s my “secret” that I use all the time to write learning objectives – I can’t memorize anything to save my life, so I rely on what I informally call my Verb Cheat Sheet. The one I’ve used for many years was published by Washington Hospital Centre, Office of Continuing Medical Education. It list cognitive domains (levels) and suggests verbs for each one. There are many such lists available on the Internet if you search “learning objectives” (here’s another one that’s more colourful than my basic chart, below).

Screen shot 2017-01-16 at 2.43.06 PM

Well-written learning objectives can help learners focus on what material they need to learn and what level of mastery is expected. Well-written objectives can assist instructors in creating assessment questions by reminding you of the skills you want students to demonstrate.

Here’s my quick three step method to annotating your assigned objectives on your Elentra Learning Event page with your learning-event specific objectives:

  1. Start with writing your know or understand statements: what do you want learners to know or understand after your session?
  2. Think about what level of understanding you want students to demonstrate and how you would measure that (scan the verb chart for ideas)
  3. Write a declarative sentence of your expectation of students’ abilities following your session. In your draft, start it off with “The learner will”. For example: The learner will identify the bones of the hand on a reference diagram. Your objective would be: “Identify the bones of the hand on a reference diagram.”

As a fourth step, feel free to email your draft objectives to me at theresa.suart@queensu.ca for review and assistance (if needed). I’m happy to help.


Table excerpted from Washington Hospital Center, Office of Continuing Medical Education’s “Behavioral Verbs for Writing Objectives in the Cognitive, Affective and Psychomotor Domains” (no date).

* The “Red Book” got its name because for the first edition (we’re now on the fourth), the card stock used for the cover was red. Over time, everyone started calling it the “Red Book”.

A version of this post was originally available in 2017… but writing learning objectives is an ongoing challenge for all!

Posted on

What are those learning event types, anyway?

Tucked on the right-hand side of every Learning Event Page on Elentra are notations about the date & time and location of the class, followed by the length of the session and then the “Breakdown” of how the time will be spent. In other words: the learning event type.

Person writing in a notebook or planner. Only hands and notebook are showing.

After the last 18 months of learning event types being broadly divided into “Zoom” and “not-Zoom”, it’s worth having a look at what these notations (really) mean as we get back to more face-to-face on-campus teaching.

We use 18 learning event types* in the Queen’s UGME program. The identification of a learning event type indicates the type of teaching and learning experience to be expected at that session.

Broadly speaking, our learning event types can be divided into two categories: Content Delivery and Content Application.

For content delivery, students are presented with core knowledge and/or skills with specific direction and/or commentary from an expert teacher. Content delivery learning events include:

  • Directed Independent Learning (DIL) — these are independent learning sessions which are assigned curricular time. Typically, students are expected to spend up to double the assigned time to complete the tasks – i.e. some of the work may occur in “homework time”. DIL’s have a specific structure and must include:
    • Specific learning objectives
    • A resource or set of resources chosen by the teacher
    • Teacher guidance indicating the task or particular focus that is required of students. This may be a formal assignment, informal worksheet or study guide.
    • The session must link to a subsequent content application session.
    • Formative testing in the form of MCQ or reflective questions are an optional component of DILs

While students have nicknamed these “do it later”, it’s important that learners complete the assigned material prior to the related in-class sessions in order to be ready for what comes next. DILs aren’t an alternative delivery of material covered elsewhere, but essential curricular delivery.

  • Lecture – Whole class session which is largely teacher-directed. We encourage the use of case illustrations during lectures, however these alone do not fulfil the criteria for content application or active learning.
  • Demonstration – Session where a skill or technique is demonstrated to students.

For content application (sometimes described as “active learning”), students work in teams or individually to use and clarify previously-acquired knowledge, usually while working through case-based problems. These learning event types include:

  • Small group learning (SGL): Students work in teams to solve case-base problems which are revealed progressively. Simultaneous reporting and facilitated inter-team discussion is a key component of this learning strategy which is modeled on Team-Based Learning. SGL cases may be preceded by in class readiness assessment testing (RAT) done individually and then as a team. This serves to debrief the preparation and provide for individual accountability for preparation.
  • Facilitated small group learning (FSGL)Students work in teams and with a faculty tutor to solve case-base problems which are revealed progressively. While there is structure to FSGL cases, students are encouraged to seek out and share knowledge based on individual research.
  • Simulation: Session where students participate in a simulated procedure or clinical encounter.
  • Patient or Panel Presentation (PPP): Session where students interact with guest patients and/or health care providers who share their experience. Builds on prior learning and often includes interactive Q+A component.
  • Laboratory: Hands-on or simulated exercises in which learners collect or use data to test and/or verify hypotheses or to address questions about principles and/or phenomena, such as Anatomy Labs.

The other learning event types we use don’t fit as neatly into the content delivery/content application algorithm. These include:

  • Clerkship seminar – instruction provided to a learner or small group of learners by direct interaction with an instructor. Depending on design, clerkship seminars may be either content delivery or content application.
  • Self-Directed Learning (SDL) is scheduled time set aside for students to take the initiative for their own learning. A minimum of eight hours per week (pro-rated in short weeks) is designated SDL time. (This is referred to as “Independent Learning” or “IL Time” in the UGME Policy Governing Curricular Time).
  • Peer Teaching is learner-to-learner instruction for the mutual learning experience of both “teacher” and “learner” which includes active learning components. This includes sessions that require students to work together in small groups without a teaching, such as Being a Medical Student (BAMS) sessions, the Community Based Project and some Critical Enquiry sessions.
  • Career Counseling sessions, which provide guidance, direction and support; these may be in groups or one-on-one.

Two other notations you’ll see are “Other-curricular” and “Other—non-curricular”. Other—curricular is used for sessions that are directly linked to a course but that are not included in calculations of instructional methods. This includes things like examinations, post-exam reviews, and orientation sessions. Other—non-curricular are sessions of an administrative nature that are not directly linked to a particular course and are outside of curricular time, for example, class town hall meetings and optional events or conferences.

Incorporating a variety of learning event types in each course is important to ensure a balance of knowledge acquisition and application. Course plans are set by course directors with their year director, in consultation with the course teachers and with support from the UG Education Team.


*In 2015, Queen’s UGME adopted the MedBiquitous learning event naming conventions to ease sharing of data amongst institutions. For this reason, some learning event type categories may be different from ones used here prior to 2015, or ones used at other, non-medical schools or medical schools which have not adopted these conventions.

Posted on

Small connections matter

My Dad died last week in New Brunswick.

I write that not as an invitation to sympathy (but, thank you), but to share a few thoughts from the patient’s family perspective – not on death during a pandemic, although that intensified and complicated things, so much as death in general.

Dad had a stroke nearly four years ago and his memory wasn’t what it once was. I’ll leave parsing out what was effects of the stroke versus medication versus dementia to course case studies. When he fell two weeks ago and broke his hip, the cause of his cognitive difficulties didn’t matter so much as the fact that he was an old man who was scared who was in hospital with visitor restrictions. That is: no visitors at all, unless the patient had palliative status (and Dad didn’t until his last day). Dad didn’t really understand the pandemic, and sometimes forgot what was really going on with his care – doing such things as trying to pull out his IV and catheter, for example. He was scared and in pain and confused.

One bright part of these terrible days was the day his nurse was from Miramichi, his hometown. He was so delighted to talk with her and talk about the places of his boyhood with someone who knew where he was talking about. Who shared the same connection to the River, to the place, to home.

This reminded me of decades ago and my last visit with my maternal grandmother in a Moncton, NB hospital a week before she died. My grandmother was Acadian but lived most of her life in a predominately English community. Her children spoke English. Her grandchildren were truly assimilated with only classroom-based, mediocre French. One of my indelible memories from that last visit was that her conversations with the nurses were always in French. And she seemed so happy to be able to do that. That her first language mattered; that she mattered.

I don’t want to suggest that for meaningful connections healthcare professionals need to share hometowns and language with all of their patients. This is both unrealistic and absurd. These connections highlight just that: connections. Those two nurses, decades apart, connected with scared, dying patients by honoring their shared humanity. My father wasn’t a broken hip; my grandmother wasn’t a failed kidney.

When my mother-in-law was in palliative care in a Toronto hospital in 2010, one of the volunteers did music therapy with the patients. When I arrived for a visit one of the last afternoons, there was a Rachmaninov CD on the table with a Post-It note: “When she wakes up, play track 4 for Sylvia”. He hadn’t had one in his kit and she had spoken about it with him; she was sleeping when he came back with it. (We still have the CD, as he wanted us to keep it).

There isn’t always time in busy clinics and wards to make substantial connections with each and every patient – especially for students who are wrestling with mounds and mounds of material to learn, remember, apply. I’d argue that small connections are just as meaningful. Small moments matter – a shared favourite song, listening to reminiscing. Dignity and connections matter.

None of those things I mentioned were “medical care” for Dad, Nanny, or Sylvie, but it was medicine in the compassion, the care, and the connections. And it’s these connections which give comfort to those of us left behind.


If you want to read a bit about my Dad, check out this link: https://nble.lib.unb.ca/browse/n/michael-o-nowlan

Posted on

Revisiting Brainstorming

Have you ever used brainstorming in your teaching? If you want groups of students to come up with a variety of ideas quickly, brainstorming is one tried-and-true way to get creative juices flowing.

Since the concept was introduced in Alex Osborn’s 1953 Applied Imagination, brainstorming has caught on in business, education, volunteer organizations and elsewhere to generate ideas and solve problems. Brainstorming, as set out by Osborn, is designed to produce a large quantity of ideas in a short space of time, in order to encourage creativity. He had four simple rules for brainstorming sessions:

  1. Don’t allow criticism
  2. Encourage wild ideas
  3. Go for quantity
  4. Combine and/or improve on others’ ideas

A few years ago, some writers recast “brainstorming” as “brainwriting”. This is a new name for a familiar best practice: brainstorming works best when it’s planned, not haphazard, and it starts with the individual, not the group.

As described by Patrick Allan (citing work of Leigh Thompson and Loran Nordgren) brainwriting avoids the brainstorming pitfall of anchoring: where an early idea streams all other suggestions in a particular direction. “Brainwriting” gives individual team members time to write down their own ideas free of others’ influences.

Osborn himself advocated this (although he didn’t use the term brainwriting), asserting that the best ideas come from a blend of individual and group work. Classroom brainstorming shouldn’t be unplanned: students should have prep and thinking time. As Robert Sutton notes in “Eight Tips for Better Brainstorming”: “Skilled organizers tell participants what the topic will be before a brainstorm.”

Barbara Gross Davis also encourages individual preparation in Tools for Teaching. She suggests posing an opening question and having students spend five minutes writing a response. This “gives students time to think and enriches subsequent discussion.”

Here are some other ideas to encourage better brainstorming in your classes:

  • Assign roles within the brainstorming group. Groups need a moderator (to guide discussion, keep the group on topic, and encourage wide participation), a scribe (or two) to capture the ideas (using either flip charts, Post-It notes, computers or consider audio recording), and members (to contribute and build ideas).
  • MindTools advises that the moderator can help keep the team on task and can help the team avoid narrowing its path too soon. “As the group facilitator, you should share ideas if you have them, but spend your time and energy supporting your team and guiding the discussion. Stick to one conversation at a time, and refocus the group if people become sidetracked.”
  • Remember, the students who are the moderators and scribes aren’t actively brainstorming while they’re attending to their key roles. Encourage teams to share these tasks throughout a term, so it’s not always the same couple of people who end up taking notes rather than contributing their ideas.

And, yes, even with Zoom: with all the above, you may think this is a post-pandemic teaching tool. With a bit of planning and creativity (and the right tools), you can use brainstorming even in our online (synchronous or asynchronus environments. You can use online tools such as PollEverywhere’s “Q&A” function – once students provide initial ideas, classmates can vote up or vote down a suggestion. You can also use Zoom’s built-in white board as a brainstorming wall. (This takes a bit of set-up to get right, but could be worth it for the right topic).

And, what to do with all those ideas the groups generate? Sutton points out that brainstorming should “combine and extend ideas, not just harvest them,” so have a plan for what you want students to do next.

The next steps are sorting and follow-up. In Small Group and Team Communication, Harris and Sherblom recommend an “ACB Idea Sorting Method”:

  • Assign an A to the best one-third of the ideas
  • Assign a C to the least usable one-third
  • The middle one-third automatically receive a B
  • Go back to the B’s and separate them into the A or C category
  • Store the C category ideas for later use
  • Prioritize the A list in terms of item importance, urgency, or applicability to the problem at hand.

The Education Team can help you with incorporating brainstorming and other techniques in your teaching. Contact me to arrange for one-on-one coaching or to facilitate a workshop for your team.


References

7 Tips on Better Brainstorming. (n.d.). OpenIDEO. Retrieved August 12, 2014, from https://openideo.com/blog/seven-tips-on-better-brainstorming

Allan, P. (n.d.). Use “Brainwriting” Instead of Brainstorming to Generate Ideas. Lifehacker. Retrieved August 12, 2014, from http://lifehacker.com/use-brainwriting-instead-of-brainstorming-to-generate-1615592703?rev=1407126541539&utm_campaign=socialflow_lifehacker_twitter&utm_source=lifehacker_twitter&utm_medium=socialflow

Brainstorming: Generating Many Radical, Creative Ideas. (n.d.). Brainstorming. Retrieved August 12, 2014, from http://www.mindtools.com/brainstm.html

Davis, B. G. (2009). Tools for teaching (2. ed.). San Francisco, Calif.: Jossey-Bass.

Harris, T. E., & Sherblom, J. (2011). Small group and team communication (5th ed.). Boston: Pearson/Allyn and Bacon.

Johnson, D. W., & Johnson, F. P. (2009). Joining together: group theory and group skills (10th ed.). Upper Saddle River, N.J.: Pearson/Merril.

Sutton, R. (2006, July 25). Eight Tips for Better Brainstorming. Bloomberg Business Week. Retrieved August 12, 2014, from http://www.businessweek.com/stories/2006-07-25/eight-tips-for-better-brainstorming

An earlier version of this post was shared in August 2014

Posted on

5 Tips: Coping with learning in COVID Times

I’m writing this from what I dubbed my “basement bunker” back on March 23 when we started our remote teaching and learning. At the time, it was a way of injecting some humor into a stressful, face-paced pivot to working from home and supporting teaching and learning online. Six months later, I’m still here, but conscious that a few quips won’t get us through the potential tedium and distractions of working and learning from home.

Picture is of a narrow basement window, looking out at a thin strip of "outdoors" beyond a metal window well. This is to illustrate the author's limited view of the outdoors from her desk.
The lone window in my basement bunker…

As we all settle in for a semester unlike any other (are you tired of “unprecedented times” yet?), the Education Team offers these 5 additional learning strategies to help during COVID-Times:

1. Carve out spaces: Staying home for most of the semester’s classes (except for your short “Red Zones” with small-cohorted face-to-face instruction) could make it difficult to focus and concentrate. One strategy to break up the day is to carve out more than one “school” space where you’re living: one for “class” and one for “homework”. Simply moving to the other side of the room can signal your brain that you’re switching activities. If you have a roommate and limited spaces (say, one desk and the kitchen table), maybe trade off your class and study spaces.

2. Get up and move: There’s a reason FitBit buzzes every hour when you wear one, and it’s not just marketing. Too much sitting is bad for everybody. At least once an hour, turn off your camera and walk around a bit, do some standing yoga stretches, or a few jumping jacks – you can still listen! Pro-tip: make sure this isn’t when you might need to turn on your mic. I was on the far side of my (admittedly small) basement bunker on a walking break during a meeting, when the chair said: “Theresa, what do you think?”

3. Pack your lunch: This one may seem silly, but I’m serious. You don’t have to go to the extreme of putting everything in a lunch bag, but think about prepping your lunch either the evening before, or while you’re making breakfast – just like you would if you had to take it to campus. Chances are, you’ll eat healthier that way. After a morning of zooming, and facing an afternoon of more, if you have nothing prepped, you may be tempted to gobble that leftover pizza, or half-finished bag of chips instead of the great lunch you (would have) packed.

Picture shows a streetscape with trees, grass, and sidewalk. Purpose is to illustrate that getting outside is a good idea.
Walking around my neighbourhood at lunchtime helps shake off the feel of the basement bunker.

4. Get outside: Whether it’s after class or during, make sure you get outside at least once a day. While the weather is still nice, if you have access to an outdoor space and your Wi-Fi extends that far, consider setting up outdoors for your afternoon classes. (I saw a few of our students on a couple of Zoom classes last week doing this). Keep social-distancing rules in mind, but get some fresh air to wake up your brain.

5. Do something social: Don’t get bogged down in “just” doing schoolwork – schedule something social. It’s good to connect with people outside your program. Again, keep social-distancing rules in mind, but book time for something fun. Schedule a Zoom story time with nieces and nephews, set up a walking phone visit with a pal, or sign up for a non-academic class or activity. Lots of organizations are getting creative about programming. My sister (a high school teacher in Toronto) and I signed up for the Kingston-based Cantabile Choirs “Virtual Voices” season of weekly online voice lessons.  Not only do we each now have a scheduled “fun” activity, we’re doing it together while apart. Think outside the box for planned not-school-work! (If you like singing, there’s still time to check out Virtual Voices, which begins Wednesday evening: https://cantabilechoirs.ca/virtual-voices/)


Do you have a learning from home tip? Share your advice in the comments!


~ With thanks to my teammates Rachel Bauder and Eleni Katsoulas for their contributions to this post.

Posted on

Including learners with “remote” patient encounters

We’ve been focusing on classroom-based teaching tips in recent blog posts, this week, we focus on some practical tips for clinical teaching for clinicians working with learners while using telephone and computers for patient appointments.

By Debra Hamer, MD FRCPC, and Theresa Suart, MEd

Image is an overhead view of a laptop computer, smart phone, coffee cup and stethoscope.

Since March and continuing for some patient populations, physicians have shifted to “remote” technologies to conduct patient encounters, which used to take place face-to-face. This has complicated how to readily include learners – clinical clerks and residents – in those encounters.

First – let’s just put this out there – we don’t like the word “virtual” to describe working with patients using telephone or computer interfaces. This is not simulated care, it’s actual care!

Whether you’re using telephone appointments or a computer-facilitated patient interface, it can be a challenge to incorporate learners. We’re providing some suggestions based on telephone and OTN (in this case); these can be modified for your own tech situations. (As always, feel free to reach out to the UG Education team for help brainstorming solutions.)

The tasks associated with each can be divided into three parts: before, during, and after. These are things you likely do automatically with in-clinic or in-hospital patient visits that include learners because you’ve been doing it for years. Working with “remote” technologies just requires a bit of deliberate thought to what that preparation, appointment, and debrief looks like.

Depending on what social distancing is in effect, you may be in the same room as your learner, or you, the learner, and the patient may be in three different locations. The suggestions below assume you are in three different locations. If you and the learner can be in the same room, this will be simplified.

Telephone Appointments

(You may book your appointments yourself or have an administrative assistant who does so.)

Prior to Encounter:

  • When the patient’s appointment is booked, ask if a learner can be involved with the appointment.
  • If there’s a reminder call, include a reminder that a learner will be involved (if they said yes, of course!)
  • Make sure you’re in a room by yourself with no intrusions or distractions. This might seem self-evident, but work-from-home situations can change day-by-day.
  • Ensure your phone is set up to block your caller ID. On an iPhone, you need to deselect this under settings.
  • Ten minutes before the patient call, call the learner and review the referral and any pertinent information from the chart, since students won’t have access to the chart if they are not physically in the clinic. At that point, you can answer any questions or concerns the learner has

The encounter:

  • If you’re using a phone with “conference” capabilities (adding a participant) you can keep the learner on the phone while you initiate the call with the patient. (On iPhone, this is “add a call, put in the patient’s number, then press merge calls).
  • Once the patient answers, check to ensure both the patient and learner are on the call. All three participants should be able to hear each other.
  • In the greeting, you can remind the patient of the learner’s role on the call.
  • Make sure the patient understands the potential privacy issues with cell phones and consents to continue, then outline what to expect during the appointment.
  • Proceed with the patient interview/discussion/assessment as you would do ordinarily.
  • Depending on the learner’s stage, at this point they may be listening in; if not, let the patient know you will mute yourself and unmute yourself near the end to join back in. (If the learner is going for too long or going off the rails, you don’t need to wait until the end, simply unmute yourself and redirect them, as you would in a face-to-face encounter).
  • At the end of the appointment, if you haven’t already, you can unmute yourself, ask any questions and finish off.

The debrief:

  • After ending the call with the patient, call the learner back and debrief the encounter.
  • If it’s a senior learner, you may take the option to call the patient back – talk to the learner, find out a diagnosis and plan and then call back together with this. This will vary on the learner’s level. (Be sure the patient knows you are going to do this!)

Variation:

  • With a more senior learner, with the patient’s consent, you could use a three-step appointment: the learner initiates the call with patient, then ends that call to confer with you (by phone or other means), then the learner or you calls the patient back with the plan for going forward.

Pro-tip: If you use headphones, then there’s less reverberation and you can use your hands while you’re listening to the phone calls.

Computer-mediated appointment:

(Dr. Hamer uses OTN, you may use another platform. These instructions assume the patient has agreed to an internet-mediated appointment and has received the log-in instructions by email).

Preparation

  • Make sure your computer is set up with a neutral background with nothing to distract the patient.
  • Also, make sure you’re in a room by yourself with no intrusions or distractions.
  • Telephone the learner 10 minutes before the appointment time and review the case with them. End this call

The appointment:

  • Launch the appointment with the patient. (In OTN, this is either “make a video call” or clicking on the link from your schedule). Use your program’s function to add the learner. (On OTN, it’s “add a guest”
  • Ensure the patient still consents to continue with the appointment online, and outline how the appointment will go. Then mute yourself and block your video so it’s just a black box at the bottom of the screen. The learner and patient will just see each other. (This is less distracting)
  • Re-enter as needed (similar to the telephone suggestions above).
  • If there is time available on the appointment, ask the patient to stand by for a few minutes. You and the learner both mute and block your video and have a telephone discussion about the case.
  • Come back to the call to see the patient. (Make sure the gap is no more than five minutes).

Debrief

  • Once the computer-mediated appointment has finished, call the learner back to talk about the case.

Do you have advice or suggestions for facilitating learning with these types of patient encounters? Share your advice in the comments.

Posted on

Five non-pedagogical things to do to get ready to teach using Zoom

The UGME Education Team has prepared “how to” documents that outline the technical aspects (with such things as downloading the Zoom app, and things like checking that your microphone works). And we’ve previous written with tips about how to engage students in a virtual classroom which might seem rather unfriendly. This post is about other practical things – things we don’t need to think about, or just do automatically – when going to teach in a physical classroom with students there face-to-face.

Here’s our top-five non-pedagogical things to keep in mind before teaching live on Zoom:

1. Look behind you! Give a bit of thought to what’s behind you when your camera is on. Most things are fine, but consider if there’s a lamp that’s coming out of your head like an antennae or something equally distracting. Think about any privacy concerns, if you’re teaching from your home. My work-from-home space is in my basement all-purpose room. If I’m situated in one direction, you’ll see my husband’s degrees on the wall; another you’ll see a collection of elephant figurines (yes, there’s a story to that), and a third shows my Nancy Drew, Cherry Ames, and LM Montgomery books from my childhood. Most stuff is innocuous, but think about if you want to share those things with everyone.

Zoom virtual backgrounds are, of course, an option for an instant non-personal look. Keep in mind, however, that the green-screen technology isn’t perfect. If you move around or (like me) talk with your hands, you may have visual blips of hands or your head momentarily disappearing.

2. Turn off all things that beep, buzz, or whirr Just like in a movie theatre (remember those?!), it’s helpful if you can turn off sounds that are within your control – like your cellphone or email notifications. Also, any environmental noises you can control. My home workspace is adjacent to the laundry room. At the exact moment I was typing this sentence, the dryer buzzer went off (loudly!). It’s also helpful to remind housemates that you’ll be teaching so they can make good noise-related choices.

3. Refreshments, anyone? If you’re settling in for a two-hour session, that could be a lot of talking. It’s good to have a glass of water handy, or throat lozenges nearby. Or, if you’re teaching an 8:30 class: COFFEE. Also, tissues or paper towels perhaps – you likely don’t want to dig into a pocket while sitting down for a sneeze or spill of aforementioned coffee.

4. Office supplies, what office supplies? If you typically take notes of questions students have or keep track of which groups you’ve already called on, make sure you have pen and paper on your desk. Also, do you have any small props you want to show? Figure out where in your teaching space you can put these to keep them nearby, but out of the way of things like your refreshments (above) to avoid needing the tissues or paper towels.

5. Time, please. It’s easy to get caught up in teaching material and lose track of the time. Keep your eye on the clock on your computer, or set a timer (this sound we’ll allow) so you finish on time. There will likely be another instructor waiting to begin their session right after yours and you won’t have the usual visual cue of your colleague appearing at the back of 032 or 132.


Keep in mind, this is real life, real time teaching, not a Hollywood film. Things will happen and it will be fine – paging, for example, is unavoidable if you’re teaching in your hospital office. Also, you won’t be the first of our instructors (or students) who’ve had a child or pet wander into camera range. (I routinely warn of random “teen boy” appearances when I’m on Zoom calls. He wandered in while I was drafting this, too).

Are there things you would add to this list? Use the comments box below to share your tips.


For a different (more humorous, maybe more accurate?) take on preparing your environment for online teaching, check out this video by Dr. Andrew Ishak at Santa Clara University. https://vimeo.com/447645552?fbclid=IwAR3lKAaNY0zCPgVJWdPUjog-AD0g7FjsSNBtUL5HAEdcFlUgWaUHi–7JqU

Posted on

Three ways to think about student engagement in remote curriculum delivery

While you’re preparing to deliver our UGME fall curriculum for Years 1, 2 and 3 predominantly via remote technologies (and some of that asynchronously), the challenge of keeping student engaged and involved may be top of mind. Three strategies (useful in any teaching, not just pandemic-restricted scenarios) are useful to keep in mind.

1. Set expectations early For many – students and teachers alike – remote teaching using a platform like Zoom is a new way to learn, so it helps to set the expectations when you start. In face-to-face teaching, this is sometimes done formally, but more often informally. A learner sitting alone in front of their computer can’t “read the room” to know what’s ok. If you’d prefer that students use the Zoom “raise hand” function to ask questions, let them know this at the start of class. If you’d rather they unmute their microphones to interrupt, set this as your norm. If you invite students to email you with questions after your session, set a reasonable time-frame for response. If you expect them to have downloaded a worksheet from Elentra ahead of time, make sure this is in your learning event’s “required preparation” section, since you can’t have a handout ready as back-up. Be clear, so no one gets frustrated.

2. Use tools effectively All the tools available in the classroom are also available in remote teaching – they just sometimes need a bit of tweaking to use effectively. For example, one really low-tech engagement tool is silence. In my early days teaching at the University of New Brunswick, I had a Post-It note on my lecture notes which said: “shut up, Theresa!” This was a succinct reminder to myself to give students time to hear and process questions before I went ahead and answered them myself. With remote teaching, we need to factor in time for student to click on their “raise hand” button or hit “unmute” along with that processing time. Silence can be uncomfortable for instructors as we think we should be filling every moment, however, using questioning and dialogue effectively remotely requires becoming comfortable with longer intervals waiting.

Most other tools you use routinely face-to-face can continue to be used via Zoom. For example, Poll Everywhere and videos were also used quite easily during the spring term. Do you sometimes use “show of hands” to get a response? Both the “raise hand” function and the “reactions” one can be used for this purpose. Some in-class tools might take a bit of strategic thinking and planning to rework for remote classes. If you have something in particular in mind, reach out for brainstorming and to capitalize on collective wisdom.

3. Assign roles Whether you’re in a Zoom class, or assigning asynchronous work, it can be helpful to proactively assign roles to individual students to keep everyone engaged and participating equitably. Whether it’s the randomizer app used by Dr. Gilic and Dr. Simpson in MEDS 115 to call on individual students for responses, or a “Someone from group X” call-out, these can all be tailored for Zoom.

If you’d like some Zoom-mediated face-to-face feedback, ask that one student from each SGL group be “on camera” during the class. Not everyone’s internet supports using video throughout, but teaching to a sea of names in black boxes makes it hard to gauge responses. Using a rotation within groups will share this responsibility. (And get more camera-shy students used to being “on” in a low-stakes way).

If you’d like a student to monitor the chat box for questions, create a roster of students who are willing to do it and share that task through the term.

If you’re using discussion boards for asynchronous teaching, break up the tasks needed to meet the learning outcomes of the discussion: have one or two students assigned to pose a discussion question based on the preparatory materials, another to moderate, someone else to write a one-paragraph summary of the discussion to share with the large group. You could also assign a student or two from each group to write multiple choice questions based on the assigned material. (If you’re interested in using discussion boards on Elentra, get in touch and we can set it up for you).


It’s true we’re in somewhat uncharted waters for teaching this way, but there are solutions to the teaching challenges. If you’re stumped or frustrated, please reach out – we can find some solutions together. Reach me best by email (theresa.suart@queensu.ca).

Posted on

Planning your teaching in uncertain times

Summer is upon us and, with it, planning for fall semester teaching. There’s a lot of uncertainty in the world these days vis-à-vis the COVID-19 pandemic – which has contributed to some uncertainty in planning for curricular delivery. At the School of Medicine, we have permission to run some learning activities face-to-face (such as clinical skills) with new restrictions in place to maintain social-distancing, but our traditional classroom-based teaching will be impacted as well.

The Education Team is here to support Course Directors and all teaching faculty as we face these new challenges. While we don’t have all the answers yet about room assignments and scheduling, there are still many things we can do right now to help with your planning and preparation for both your synchronous (all students learning at an appointed time, either in a classroom or via Zoom) or asynchronous teaching (students provided with learning materials that need to be completed by a certain deadline, but otherwise, they can learn on their own schedule and own pace). If we don’t have solutions to your queries, we’ll help find them.

Things we can help you with now:

  • Discovering options for asynchronous teaching

Course Directors have been asked to consider different avenues for asynchronous learning. While this already exists in many courses in the form of Directed Independent Learning electronic modules, there are other options, too. If you would like to increase the amount of asynchronous learning in your course – or just explore possibilities – we can help with this.

  • Learning techniques for interactive teaching via Zoom

We learned a lot from our two-and-a-half months of remote teaching using Zoom from March – May. If you’re concerned about how to keep your teaching engaging and interactive while “talking to a box”, we can help with this – and provide some practice opportunities, too, so it’s not so intimidating. Tools you may already be using in the classroom, such as videos and polling, are easily leveraged on the Zoom platform.

  • Exploring approaches to assessment

Your current assessment plan may be just fine, but there may be things you’d like to tweak given the logistics of remote delivery. We’ve sorted out quizzes, graded team assignments (GTAs), and proctored exams already, so we can address these and any other concerns you have and make any appropriate modifications.

  • Guiding you to resources

We can point you towards Faculty of Health Sciences and campus-wide faculty development opportunities and services that are available and talk about which approaches already fit with the UG program, and navigate through other possibilities.

  • Brainstorming and problem solving

While the landscape may have changed with the COVID-19 pandemic, our goals as your Education Team remain the same: we’re here to help you prepare for, deliver, and improve your teaching and assessment.

Please get in touch:

Theresa Suart theresa.suart@queensu.ca

Eleni Katsoulas eleni.katsoulas@queensu.ca

Rachel Bauder rachel.bauder@queensu.ca

Posted on