Author: Theresa Suart
Online modules can enhance curriculum content delivery
Do you want to build an eModule?
Online modules, or eModules, are one of the content delivery methods available for use in our UGME curriculum.
As with any content delivery method, the teacher’s job is to define objectives, then organize and deliver new content to students. Online modules can deliver content efficiently and creatively but they’re not without potential pitfalls, so planning is key.
Unlike traditional lectures, online modules can curate other online content like a museum exhibit: you can select useful works from others and present these with guidance. The potential pitfall here is if not done carefully, modules can be information overload.
Modules can have interactivity, such as multiple choice questions with automated feedback. This can help keep students engaged as they work through the new content. Remember, though, for UGME, we aren’t building complete online courses – our eModules are prefaces to in-class interactive case/problem-based learning.
Carefully created eModules can be particularly useful where there is no resource appropriate for this level of learner.
Using an online module to deliver new content means you can use classroom time for interactive problem-solving: having completed the module, students come in prepared to apply their new knowledge.
Online modules are intended to be fully integrated with the rest of the UG curriculum – they don’t stand alone, but are one tool to deliver content students later apply in other settings, both classroom and clinical. Modules used to deliver new content in pre-clerkship can later be used by students as review during particular clerkship rotations, for example.
Here are some examples of the types of online modules in use in Undergraduate Medicine:
- Collaborative Leadership & Conflict Resolution
- Introduction to Social Determinants of Health & Advocacy
- An Approach to Lung Cancer
- Residents preparing to teach 1: Know your learner (This last one isn’t technically part of the UG curriculum; it’s for residents who teach our UG students).
We also have a newly-created MEdTech community “Queen’s UGME E-Curriculum” designed to provide links to all UGME online modules. (Requires MEdTech log-in to access). As it’s currently under construction, there may be a few modules missing at the moment.
To help avoid some of the pitfalls of online modules – such as content overload, not providing sufficient guidance for students, and lack of linkage to subsequent sessions, the Teaching, Learning, and Innovation Committee, the UGME Education Team, and EdTech have implemented a streamlined process for creating and adopting new eModules for the UGME curriculum.
The process starts with content creation and/or compilation, followed by design, then support and follow-up for incorporating the module in your teaching.
If you already have a good idea of what you’d like to do, you can use the form found here to start the process.
Fall Education Retreat set for December 6
The annual UGME Fall Education Retreat will be held December 6 with plenary and breakout sessions designed to help our faculty improve their teaching and assessment skills as well as to provide opportunities for networking and informal discussions.
The retreat brings together course directors from pre-clerkship and clerkship, unit leads, intrinsic role leads, and administrative staff who support the program. Session topics were developed based on course evaluation feedback, faculty team suggestions and accreditation priorities.
The full-day program will be held at the Donald Gordon Centre on Union Street.
New to the program, this year’s retreat will feature guest speaker Dr. Jay Rosenfield addressing the topic of The future of medical education in Canada and our places in it. Dr. Rosenfield is a professor of paediatrics (and former vice-dean, MD Program) at the University of Toronto and a Developmental Paediatrician at the Hospital for Sick Children and Holland-Bloorview Kids Rehab.
Associate Dean Dr. Tony Sanfilippo will provide an update on UGME news and initiatives and two other plenary sessions will address using a competency-based education lens to frame completion of Years 1 & 2 and incorporating principles of diversity in the curriculum.
Break-out workshops will address effective SGL sessions, Entrustable Professional Activities (EPAs) in clerkship, creating key features questions and improving resident teaching of clerks.
For more information and to register, click here.
- Credits for Family Physicians: This Group Learning program meets the certification criteria of the College of Family Physicians of Canada and has been certified by Queen’s University for up to 5 Mainpro+ credits.
- Credits for Specialists: This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of The Royal College of Physicians and Surgeons of Canada, and approved by Queen’s University, You may claim a maximum of 5 hours.
- Credits for Others: This is an accredited learning activity which provided up to 5 hours of Continuing Education
How much course evaluation feedback is “just right”?
How much feedback is too much feedback? How much is just enough?
That’s a question both the Course and Faculty Evaluation Committee (CFRC) and our students have been exploring.
At present, students are required to complete a 15-question course evaluation for each course as they complete it. As well, they’re required to complete faculty evaluations for each faculty member who taught at least four hours during that course. For our pre-clerkship students, this translates into 24 courses over the first two years of our program. Some courses are divided into units for evaluation, so that further increases the evaluation load.
As noted in a recent CFRC report to the Curriculum Committee: “Response rates have dropped significantly during the previous academic year on all course and faculty evaluations. It is assumed that a major contributing factor to the fall is the number of evaluations students are being asked to complete.”
We won’t ever do away with student course evaluations as these provide valuable feedback for curricular improvements. The CFRC is interested, however, in reducing the evaluation workload for students while still collecting solid feedback.
After consulting with the Aesculapian Society, the CFRC has proposed that only a subset of students will be asked to complete course and faculty evaluations for each course. Remaining students will have the option to complete evaluations. (In other words, students will always be able to comment on any of their courses and faculty if they want to provide additional feedback).
To determine if this will result in greater compliance (and data adequate for evaluation purposes), the CFRC will pilot this procedure on several Term 2 and 4 courses. The pilot project (Reduced number of targeted respondents for course and faculty evaluations), was approved by the Curriculum Committee at its November meeting.
For the pilot, students in both Meds 2019 and 2020 will be divided into randomized groups of 25 students each. One group of 25 students will be assigned to complete evaluations for each of the courses in the pilot.
Courses included in the pilot will be:
- Meds 121 Fundamentals of Therapeutics
- Meds 125 Blood and Coagulation
- Meds 127 MSK
- Meds 240 Genitourinary and Reproduction
- Meds 241 Gastroenterology and Surgery
- Meds 245 Neurosciences
- Meds 246 Psychiatry
All students will be asked to complete the term 2 and term 4 course and faculty evaluations for those courses not included in the pilot. Also, Course Directors for the targeted pilot courses will be asked to confirm if there are any faculty to be excluded from the reduced pool of respondents and included in a group to be completed by the entire class.
Results of the pilot will be reported to the Curriculum Committee in August 2017.
Applying decluttering principles to learning event planning
My family and I recently relocated from a 2300-square-foot, five-bedroom house to an under-1100-square foot, three-bedroom townhouse to be closer to my son’s school and my office at Queen’s. This has required divesting ourselves of a great many belongings. Some things were easy (no more guest room = get rid of bedroom suite of furniture), but now we’re down to what home organizers call decluttering.
Near the beginning of my downsizing project, a colleague passed along a copy of one such book, Marie Kondo’s The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing. (Yes, there was some irony in acquiring a new book when I was purging others, but that’s another story).
In this bestselling book, Kondo sets out principles for determining how to declutter. Since I’m immersed in decluttering (and unpacking can be a mind-numbing task) I started thinking about applying Kondo’s principles to learning events.
Decluttering principle: Uncover what you want your space to be
Learning Event translation: Uncover what you want your learning event to be
What underlies this principle is visioning: think about what it is you want your learning event to look like before you start making changes. What do you need and want to accomplish in your 60- or 120-minute session? What are your assigned learning objectives? Keep in mind this planning cannot be a solo activity as your events are connected to others – course directors need to balance topics and learning event types throughout a course, so check in with anyone impacted by changes you’re thinking about making. Do you want to add interactive components? Revise case studies? Improve group work? Streamline the order of MCC presentations?
Decluttering principle: Only keep those items that give you a “spark of joy”
Learning Event translation: Only keep those activities that spark learning
Take a good look at the activities and materials you’re using in your learning event: are these aligned with your objectives? Do they provide meaningful learning for your students? Are the points clear? How many cases are you using? Would it be better to have three well-constructed, in-depth cases, or the five you’re currently using? Are you being deliberate in what you’re including, or just force of habit?
Decluttering principle: Have a designated place for everything
Learning Event translation: Have a designated time for everything
Consider making a timeline plan for your learning event to keep everything “in its place.” This doesn’t have to be rigid to the last second, but can help keep things on track. If you have an outline that includes each topic or case, discussion/question time, breaks, wrap-up/summarizing time, it will help keep you on track and ensure finish on time. It also helps let you know when to wrap up discussions (no matter how interesting) to move onto the next important point.
* * * *
Not everyone can – or should – dive into decluttering their home (see this New York Times opinion piece which argues very clearly that there’s class politics involved in the decluttering movement). Likewise, not every learning event is in need of decluttering. However, if you’re frequently going over time, or find that you’re not meeting the learning objectives you have, or you’re just generally dissatisfied with your teaching sessions, decluttering may be a place to start.
One caveat: Decluttering can’t be done in a vacuum – either at home or for a learning event. For every fan of Kondo’s work, there are partners, children and other relatives who complain (rightly) that stuff they needed, wanted or sparked joy for them has been summarily tossed by an obsessive tidier. If you’re interested in decluttering your learning events on a larger scale (for example, does this MCC presentation even belong in my session?), that necessitates conversations and cooperation with your course director and fellow instructors and I’m happy to pitch in, too.
On boy doctors, girl doctors, and advocating for my son
“I hope it’s a boy doctor.”
It was the spring of 2014, and I was walking with my then-10-year-old son from our car to our family health team’s office. Our doctor is part of the Queen’s Family Health team, so we often see residents rather than our assigned physician. For this reason (and because I don’t ask about the schedule when I book appointments), we don’t always know the gender of the person who’ll be providing care on a specific day. (We can always ask to see our doctor, however, I’ve never done this. I’ve always bought into this model of medical education – even before I started working as an educational developer in the undergraduate medical program).
It had never mattered to my son. Until that day in April.
We were heading to an appointment about recurring rectal bleeding. He had first presented with this on New Year’s Day. The digital rectal examination at the child out patient clinic the next day was an uncomfortable experience that he now refers to as “the butt thing”.
If they’re going to do “the butt thing” again today he wants a boy doctor, he said.
“You know,” I said, matter-of-factly (or at least I attempted to be matter-of-fact), “at the Med School where I work they teach boy doctors and girl doctors all the same things. They all learn how to look after everybody.”
“Yeah, I know,” he said. “But if they do the butt thing, I want a boy doctor.”
My son has autism. He’s seen multiple physicians, therapists and interventionists in his short life. Until this point, he had never commented on their genders. This was a new request. I had until his name was called to sort out for myself what I would do.
There was a flurry of news reports the previous fall, in October 2013, about whether patients should have the right to choose their physician based on race, religion or gender. (See here and here for some of this coverage). The news hook was a position statement by The Society of Obstetricians and Gynecologists that argued its members should resist such requests in emergency and other after-hours situations.
Perhaps because the articles were focused on obs/gyn, much of the commentary that followed focused on women, immigrants, and others with religious concerns. I can’t recall any discussion about children and their preferences in the gender of a treating physician. Until that day in 2014, I’d never given it any thought myself. My kids have been “stuck” with whichever family physician I’ve found for us.
Until my son’s request for a “boy doctor.”
Is this a reasonable request? Is my job as his mother to convince him that physicians of either gender will provide him with great care and that he should feel comfortable with either gender? Or is my job to talk with the clinic staff, explain his concerns, and ask to see a male doctor on duty that day?
The resident we were scheduled with that day was, indeed, the “boy doctor” so I was let off the hook of having to ask to have the attending (male) physician replace the other (female) resident. As a woman, as an educator, I’m uncomfortable with the idea of that conversation. As a mother and my son’s advocate, I think it’s something I would have had to do to support him in his request for a “boy doctor” for this invasive examination.
While I was happy to be off the hook that day, I have yet to resolve this conundrum. Is it reasonable for patients (or parents of patients) to make such requests? If gender requests are OK, are other requests OK, too — race, religion, age? Are children a special case?
In my role as an educational developer, I take these mental musings further: What does this mean for medical education? Do our students need special instruction on how to address these patient concerns? Would I have more or fewer reservations speaking up on this for my child if I weren’t involved in medical education? Are there other parents who feel they can’t bring things like this up for other reasons? Is this a problem? How can this be addressed?
These are questions I’ve continued to wrestle with and I suspect I will for a long time. What do you think?
Pearls of wisdom, tearing up textbooks, and getting messy
We talk a fair bit about Pearls of Wisdom at the School of Medicine. The last class for the Class of 2016 ended with Pearls, presented by faculty selected by the class. Later this week, during orientation week, Pearls will be shared with our newly-minted class of 2020.
Pearls are succinct pieces of advice, aphorisms or other sage musings designed to guide, caution, or inspire.
Sometimes these pearls are explicitly stated as “here’s a pearl” as in those two learning events. Sometimes they are shared in a one-on-one feedback session during clerkship; or it’s that certain nugget of wisdom imparted during an FSGL session. Or the gem from an SGL case, or advice from a near-peer in a mentor group.
By their very nature, these Pearls of Wisdom are best experienced – in a true handing on of guidance in the moment, rather than as a bullet-list on a Post-it note. Given that medicine is both science and art, however (as made clear in many Pearls), we wondered if we could preserve these words of wisdom in a more permanent, concrete way while still maintaining the spirit of these fleeting sessions.
With this in mind, last spring, we started a different representation of these Pearls of Wisdom: a School of Medicine collage. Working with Kingston artist Nancy Douglas, participants selected images, situated them on a six-foot long canvass and used collage techniques to bring the images to life. The images came from old textbooks and journals — lots of tearing and gluing and hands-on creativity.
That first session in May was a start, but our collage is not finished!
The second creative session for the collage will take place Monday, September 12 from 4:30 – 8:30 p.m. in the Atrium of the School of Medicine building. Students, faculty and staff from all years of the program are encouraged to take part.
Bring your ideas about medicine, your journey in medical education, and the pearls of wisdom you’ve received from faculty (and others) along the way. Also, bring any old textbooks and journals you’re willing to rip up for the collage! This is hands-on, so be prepared to get your hands mucky. (Collage is a bit like casting – without a broken bone).
This is a drop-in event, so you don’t need to plan to be there for the whole four hours. Please come when you can. Refreshments will be served, too!
Creative Expressions of Learning is hosted by Dr. Lindsay Davidson (Director, Teaching, Learning and Integration), Vincent Wu (Meds 2018), Stephanie Chan (Meds 2019); and Sheila Pinchin (UGME Education Team Manager).
The event is funded by the Creative Expressions Grant from Queen’s Centre for Teaching and Learning.
Navigating multiple paths to service-learning projects
Anyone with their ear to the medical education ground in the past year will know that service learning is a very, very hot topic. Ever since the Committee on Accreditation of Canadian Medical Schools (CACMS) endorsed service-learning as an important (but optional) element of the education of future physicians, medical schools across the country have sought to incorporate this as a feature of their curriculum. However, service-learning, by its very nature, can leave students feeling uncomfortable: it’s structured but open-ended.
Consulting with community members to set goals and design projects is not always as straight forward as mastering the objectives of a standard medical course. Unlike other curricular and co-curricular activities, service-learning projects often start with pretty broad objectives. Add in consultation with multiple community stakeholders and the projects themselves can seem quite nebulous at the start.
We’ve written about service-learning on the blog before (here and here) as we’ve continued to develop our approach to encouraging and supporting our students in engaging in service-learning. Service-learning projects are one way our medical students (and pre-medical students, in the case of QuARMS) enhance their understanding of working with community members, explore intrinsic physician roles, and contribute in a very real way to our medical school’s social accountability to our communities.
On a national level, the Canadian Alliance for Community Service Learning (CACSL) provides support and networking opportunities for students, educators and communities engaged in these endeavors. At their recent biennial conference held in Calgary, multiple presenters addressed students’ issues with the ambiguity of service-learning projects compared to other learning activities.
When students have the autonomy to define what is happening with a project in cooperation with an organization, they can feel a little lost, one presenter, Chelsea Willness, an assistant professor at the Edwards School of Business at University of Saskatchewan, noted.
“Students are very uncomfortable with the ambiguity: ‘What do you mean, I don’t know what I’m going to be doing?’”
They want templates and checklists because that’s familiar, she added.
It’s clear that while many students are excited about the opportunity to engage with community partners, they both need and want support. Equally important is providing them with reassurances that each project will have its own path – which includes some levels of uncertainty.
Here’s the Queen’s UGME operational definition of service-learning (as there are multiple interpretations of this term):
“Service-learning is a structured learning experience that combines community service with preparation and reflection. Medical students engaged in service-learning provide community service in response to community-identified concerns and learn about the context in which service is provided, the connection between their service and their academic coursework, and their roles as citizens and professionals.”
One key word in that definition is structured. Providing as much structure as possible can help ease students’ discomfort with some of the ambiguous nature of service-learning. To that end, the Teaching, Learning, and Integration Committee (TLIC) has been assigned oversight of service-learning for undergraduate medical students and has implemented three possible avenues students may use to have a service-learning project recorded on their MSPR.
To launch this, a one-hour session on service-learning was added to the first-year Professional Foundations course earlier this year. This learning event included information on why we’re deliberately supporting extra-curricular and co-curricular service-learning activities as well as information on potential service-learning avenues. As part of this session, members of the Class of 2019 were polled to see what types of service-learning projects they might be interested in and how these might fit in the three paths.
Here are the three paths to a recognized service learning project:
- Participate in an existing student-led volunteer initiative and complete the additional tasks necessary to extend this to a service-learning project
- Complete an individual service-learning project, which meets the requirements (including consultation and reflection)
- Take part in a service-learning pilot project brokered by the TLIC
Dr. Lindsay Davidson (Director of the TLIC) and I have met with representatives from several established student groups whose existing activities were quite close to our service-learning definition and threshold to map out ways their participants could extend their volunteer service into a service-learning project (this is always optional). Typically, this meant documenting some form of consultation and implementing some form of reflection on learning. These groups include SwimAbility (formerly Making Waves) and Jr. Medics. Other groups can be added to this list (email me: firstname.lastname@example.org to set up a meeting about this if your group might fit).
The two initial pilot projects are with Loving Spoonful (an organization with the goal of enhancing access to healthy food) and the Social Planning Council (with a focus on social housing in the Kingston area). These will be longer-term projects with sequential groups of students completing phases of a larger, continuing project. (The first participants have already been identified through the PF class poll. Recruitment of UGME students will be through the TLIC, not through the agencies).
For each of the three paths, students must submit evidence of meeting the threshold for each aspect, using forms provided by the TLIC. These will be made widely available in September using a MEdTech community page. Here are the requirements for any project to be recognized:
- The project must serve the needs of a group in the wider community (i.e., not medical school-focused)
- Complete some form of consultation with community participants and/or stakeholders (this will look different depending on the type of project and service)
- Complete between 15-20 hours of service (with no more than 20% devoted to training)
- Completed a required reflection on learning
In the future, as more students engage in formal service-learning projects, students’ reflections on their learning may be presented at a service-learning showcase, similar to the Undergraduate Research Showcase that is held each year.
While having three different routes to recognized projects may seem to add to the ambiguity of “what does a service-learning project look like”, providing multiple avenues for recognition was important.
“Our students have many different interests and we wanted to leverage that by providing multiple avenues for service-learning projects to be completed and recognized by the school,” Dr. Davidson said.
We’re never going to completely eliminate the ambiguous nature of service-learning projects, but we’re working to put structures in place that can meet a variety of students’ interests and community needs.
With thanks to Dr. Davidson for her contributions to writing this post.
CCME 2016: We came, we saw, we presented!
It’s been a busy four days at the Canadian Conference on Medical Education in Montreal – five or six days for those involved in business meetings and pre-conference workshops that started on Thursday.
In addition to attending sessions, plenaries and business meetings, Queen’s contributors were lead authors, co-authors, supervisors, and collaborators with colleagues from other universities. We presented posters, led workshops, and gave oral presentations.
All told, close to 80 members of the Faculty of Health Sciences – faculty, administrative staff, and students – contributed to producing 36 workshops, oral presentations and posters. While not all of these people were in Montreal, Queen’s was well represented in the conference rooms.
We invited those participants to share information on their presentations as well as any thoughts they had about the conference itself. (Keep in mind that it’s been a jam-packed weekend and we weren’t able to track everybody down.) Here’s a sampling of what went on:
Alyssa Lip and Shannon Chun (MEDS 2017) gave an oral presentation on the progress of the Wellness Month Challenge which was developed by the Queen’s Mental Health and Wellness Committee. “This year, this challenge has expanded to 12 medical schools across Canada and reached 1085 medical students,” Alyssa noted. “In addition, we found a significant increase in resiliency in students surveyed before and after participation in the initiative.”
Laura Bosco and Jane Koylianskii (MEDS 2017) presented on the “Impact of Financial Management Module on Undergraduate Medical Students’ Financial Preparedness.”
“We created a novel web-based financial management educational module with the aim to educate medical students on the expenses of medical school, as well as the various sources of available funding, and outline the necessary steps to achieve the most financial support throughout undergraduate medical education,” Laura explained. “Our primary objective aimed to compare medical students’ financial stress prior to and following the completion of this financial management educational module. This issue is important because medical students often make residency and career decisions that are influenced by their accumulated financial debt, and we feel that the process of career selection and development should revolve around students’ interests, not financial barriers.”
Brandon Maser (MEDS 2016) presented a poster on the CFMS-FMEQ National Health and Wellbeing Survey. “The Canadian Federation of Medical Students and the Fédération médicale étudiante du Québec have worked together developing and implementing a national survey on medical student health and wellbeing at all 17 Canadian medical schools,” he said. “With approximately 40% national response, we now have a wealth of data on medical student health, and will be working with faculties and medical societies in order to elucidate risk and protective factors for medical student health, and to create recommendations for the improvement of supports and resources.”
Louisa Ho and Michelle D’Alessandro (MEDS 2017) presented on the Class of 2017’s Reads for Paeds project. “Reads for Paeds is a Queen’s medical student-led initiative that seeks to develop engaging, illustrated, and age-appropriate books for children with specific medical conditions,” Louisa explained. “Our study shows that participation in a student-developed and student-led service-learning project like Reads for Paeds can enhance students’ understanding and application of CanMEDS roles, thus benefitting their overall development as medical trainees.”
Jimin Lee (MEDS 2017) was one of several students who prepared the poster presention on Jr. Medics. “We evaluated the Jr. Medics program at Queen’s medical school as a service learning project,” she said. “We found that while engaging with the community by teaching basic first aid skills to local elementary school students, medical students developed competence in the CanMEDS roles as a communicator and professional. Our findings support the development of service learning opportunities for medical students with explicit learning values for students and quantifiable outcome in the community.”
Justin Wang (MEDS 2017) shared information on “SSTEPing into Clerkship”: A Technical Skills Elective Program for Second Year Medical Students, which was prepared with coauthors Tyson Savage, Peter (Thin) Vo, Dr. Andrea Winthrop, and Dr. Steve Mann“The Surgical Skills and Technology Elective Program is a 5-day summer elective program designed for second year medical students to teach and reinforce both basic and advanced technical skills ranging from suturing to chest tube insertion,” he said. “Anxiety as well as a lack of both knowledge and confidence in the performance of technical skills has been found to inhibit medical student involvement in real clinical settings. Our research found that anxiety was significantly decreased, confidence and knowledge were significantly increased, and objective technical skills were significantly improved immediately after program completion as well as 3-months later, demonstrating retention of these effects. These results support the use of a week-long surgical skills program prior to the start of clerkship for second year medical students.”
Alessia Gallipoli (MEDS 2017) presented her poster on an “”Investigation of the Cost of the CaRMS Process for Students”, completed with Dr Acker. “It looks at the average costs that graduating medical students can expect to pay in regards to different aspects of the residency application and interview process,” she said. “The results of this study may help students make informed decisions throughout the CaRMS process, to balance career ambitions with smart financial planning. It can also inform initiatives to support students both financially and with career planning throughout their training.”
Jason Kwok (MEDS 2017) presented on a novel method of teaching direct ophthalmoscopy to medical students in the current medical curriculum, where there is decreasing emphasis and time dedicated to ophthalmology. “Our learning method, which consists of a peer competition using an online optic nerve matching program that we created here at Queen’s University, effectively increases the self-directed practice, skill, and learning of direct ophthalmoscopy in medical students,” he said. “This learning exercise has been implemented in the first year Queen’s medical curriculum for the past two years with great success.”
Vincent Wu (MEDS 2018) noted, “The CCME serves as an avenue for us to present the accomplishments of the First Patient Program, as well as some of the unintended student learning themes. This research helps to further refine student learning within the undergraduate medical curriculum, in order to better understand healthcare delivery from the patient’s perspective.”
Adam Mosa (MEDS 2018) presented his research on using patient feedback for communication skills assessment in clerkship in a project entitled Sampling Patient Experience to Assess Communication: A Systematic Literature Review of Patient Feedback in Undergraduate Medical Education. “This project highlighted a paucity of studies on how to use patient feedback, which is an untapped source of learner-specific assessment of this fundamental CanMEDS competency,” Adam said. “CCME 2016 was a great place to meet like-minded educators. In particular, my suggestion for an “unconference” was chosen, and I spent time discussing the future of patient feedback with a diverse group of enthusiastic participants.”
Amy Acker (Pediatrics) presented a workshop with two other pediatric program directors (Moyez Ladhani and Hilary Writer from McMaster and Ottawa) to help give concrete suggestions for teaching and assessing some of the challenging non-medical expert competencies. “We came up with the idea and thought it was a session we would have liked to have attended when we started as PDs,” she explained. “We took participants through a blueprinting exercise to identify what they need to teach, resources they will need to teach and how to assess, in case-based format… hopefully everyone learned something!”
Catherine Donnelly (School of Rehabilitation Therapy) was the PI on the Compassionate Collaborative Care project, which was funded by AME “The Phoenix Project”. “The aim of the project is to support the development of compassionate care,” she said. “The output of the project was an online module intended for use by health care students, clinicians, educators and administrators. The module consists of 6 chapters that can be used independently or collectively. The modules have been pilot tested and evaluated with students and health care providers. The modules are open access and can be found here.
Karen Smith (Associate Dean, Continuing Professional Development), shared information on her team’s work: “I am here with my CPD and FD colleagues. We presented at the CPD Dean’s Business meeting on how to meet CACME accreditation standards. We will be sharing some of our scholarly work with posters and a workshop exploring aspects of what makes self-directed learning effective and what CanMEDS competencies are addressed in SDL and the impact of note-taking style on memory retention and reflection,” she said. “In addition to seeking the excellent feedback from our peers to advance our own work, we are learning from our peers. Networking and building relationships with others across Canada is key to our ongoing success.”
Sita Bhella (Department of Medicine) presented a usability study on an online module she designed and created with colleagues in Toronto aimed at improving the knowledge and comfort of general internal medicine residents in managing sickle cell disease on the wards and in outpatient settings. “Presenting at CCME introduced me to new ideas and research methodologies and I hope to continue to present my work there in the future,” she said in an email. “It was an honour to present my work at CCME and to interact and engage with colleagues across the country on research in medical education.”
Kelly Howse (Family Medicine) presented both a poster and workshop. The poster explored issues of Family Medicine Resident Wellness: Current Status and Barriers to Seeking Help.
“Residency training can be a very stressful time and may precipitate or exacerbate both physical and mental health issues. Residents, however, often avoid seeking help for their own personal health concerns,” she said. “The purpose of this study was to assess the current status of resident wellness in our Queen’s family medicine program, with particular attention to identifying barriers to seeking help.”
The Seminar she presented focused on Supporting Medical Students with Career Decisions: National Recommendations for Medical Student Career Advising. “Specialty decision-making and preparation for residency matching are significant sources of stress for medical students. Through the FMEC PG Implementation Project, Queen’s led the development of national recommendations regarding the guiding principles and essential elements of Medical Student Career Advising,” she said. “This workshop helped disseminate these recommendations nationally and will help guide the exploration of relevant career advising resources.”
In addition to presenting their own work, School of Medicine faculty served as mentors for the many student presentations. Lindsay Davidson (Director, Teaching, Learning & Innovation Committee) shared “This year, I’m proudly watching some of our second year students present the poster that we collaborated on, Pre-clerkship interprofessional observerships: evaluation of a pilot project. It has been a pleasure to watch the students come up with the idea, which grew out of their own experiences as participants in a new inter-professional shadowing initiative for first year students, develop the project and reach conclusions that are helping to shape our teaching here at Queen’s. In addition to providing students with experience in conducting educational research, the partnership of students and faculty on such projects is a strength of our UGME program.”
So that’s a bit of what we’ve been up to in Montreal. Oh, and the food was great, too!
With thanks to everyone who was able to make time to send me some information, and apologies to all I’ve left out, especially given that I sent my email request on Friday when many were already in Montreal or enroute. Feel free to send me information I can add as an update (the beauty of blog over print.)
Five great reasons to attend medical education conferences
This weekend many involved in undergraduate medical education at Queen’s are heading to Montreal for the annual Canadian Conference on Medical Education (CCME). From faculty, to students, to administrative staff, we’re attending as presenters, workshop facilitators, and in several other roles.
As described on its website, CCME is the largest annual gathering of medical educators in Canada. Attendees include Canadian and international medical educators, students, other health educators, health education researchers, administrators, licensing and credentialing organizations and governments. The goal is to “share their experiences in medical education across the learning continuum (from undergraduate to postgraduate to continuing professional development).”
This year’s conference in Montreal from April 16-19 is hosted by the University of Sherbrooke (other partners are the Association of Faculties of Medicine of Canada (AFMC), the Canadian Association for Medical Education (CAME), The College of Family Physicians of Canada (CFPC), The Medical Council of Canada (MCC), and The Royal College of Physicians and Surgeons of Canada (RCPSC).)
With the theme is Accountability: From Self to Society, the program includes workshops, posters, oral presentations and plenary sessions designed “to highlight developments in medical education and to promote academic medicine by establishing an annual forum for medical educators and their many partners to meet and exchange ideas.”
Here are five good reasons we take the time from busy spring schedules to take part in this conference:
To present innovations in medical education at Queen’s: We’re doing some great things here at Queen’s and it’s great to share these successes. From early-adoption of the flipped classroom to our First Patient Program, to our Accelerated Route to Medical School – CCME gives a forum to celebrate what we’re doing well.
To learn from colleagues from other Canadian and international medical schools. While we share our innovations, it’s equally beneficial to learn from our colleagues at other schools. We don’t always have to reinvent the wheel.
To wrestle with common issues and gain comfort from being in the same boat. There’s a synergy in working together to sort out challenging issues in medical education.
To network with colleagues from across the country and around the world – this is closely related to both #2 and #3 – networking may not be about a specific challenge at a specific time, it’s making connections with like-minded individuals involved in similar circumstances.
And the food. OK, so this might not be a “good” reason to commit to attend a conference, but it’s certainly a fun part of it. Combining #4’s networking with colleagues with exploring local cuisine is an added bonus.
If you can’t attend this year, consider it for next time. Also, explore conference options closer to home. Our own Queen’s Faculty of Health Sciences Celebration of Teaching, Learning and Scholarship is coming up on June 15.
Improving existing MCQs
By Theresa Suart & Eleni Katsoulas
Writing and editing test questions is an ongoing challenge for most instructors. Creating solid multiple choice questions (MCQs) that adequately address learning objectives can be a time-consuming endeavor.
Sometimes you may have existing questions that are pretty good, but not quite where you need them to be. Similar to a house reno versus new construction, sometimes it might be worth investing the time improve what you already have. How do you know which questions need attention and how can you rework them?
Previous exams are analyzed to determine which questions work well and which don’t. This can provide some guidance about questions that can be improved.
To select questions for an MCQ renovation, you can start with checking out the statistics from last year’s exams (available from your curricular coordinator or from Eleni).
Two statistics are useful indicators for selecting individual questions for tweaking, rewriting or other fixes: Item Difficulty and Discrimination Index.
Item difficulty is a check on if questions are too easy or too hard. This statistic measures the proportion of exam takers who answered the question correctly.
Discrimination index differentiates among text takers with high and low levels of knowledge based on their overall performance on the exam. (Did people who scored well on the exam get it right? Did people who scored poorly get it right?)
These two statistics are closely intertwined: If questions are too easy or too hard (see item difficulty), they won’t provide much discrimination amongst examinees.
If questions from previous years’ tests were deemed too easy or too hard, or had a low discrimination index, they’re ripe for a rewrite. Once you have a handful of questions to rewrite, where do you start? Recall that every MCQ has three parts and any of these could be changed:
- The stem (the set-up for the question)
- The lead-in (the question or start of the sentence to be finished with the answer)
- The options (correct answer and three plausible but incorrect distractors*)
The statistics can inform what changes could be necessary to improve the questions. For one-on-one help with this, feel free to contact Eleni, however, here are some general suggestions:
Ways to change the stem:
- Can you change the clinical scenario in the stem to change the question but use the same distractors? (e.g. – a stem for a question that asks students what the most likely diagnosis is based on a patient presenting with confusion with the correct answer being dementia, can be then re-written to change the diagnosis to delirium)
- Ensure the stem includes all information needed to answer the question.
- Is there irrelevant information that needs to be removed?
Ways to change the lead-in:
- Decide if the questions is to test recall, comprehension, or application.
- Recall questions should be used sparingly for mid-terms and finals (but are the focus for RATs)
- Verbs for comprehension questions include: predict, estimate, explain, indicate, distinguish. How can these be used with an MCQ? For example: “Select the best estimate of…” or “Identify the best explanation…”
- You can use the same stem, but change the lead in (and then, of course, the answers) – so if you had a stem where you described a particular rash and asked students to arrive at the correct diagnosis, you can keep the stem, but change the lead-in to be about management (and then re-write your answers/distractors).
Ways to change one or more distractors:
- Avoid grammatical cues such as a/an or singular/plural differences
- Check that the answer and the distractors are homogeneous to each other: all should be diagnoses, tests or treatments, not a mix.
- Make the distractors a similar length to the correct answer
- Ensure the distractors are reasonably plausible, not wildly outrageous responses
- Skip “none of the above” and “all of the above” as distractors
As you dig into question rewriting, remember the Education Team is available to assist. Feel free to get in touch.
Watch for MCQ Writing 2.0 later this spring.
* Yes, there could be more than three distractors, but not at Queen’s UGME. The Student Assessment Committee (SAC) policy limits MCQs to four options.