New Material and a New Way to Learn: Students as Teachers on Grief.
Recently in a second year meds class, we were debriefing the experience our 2015 meds students had with their “First Patient Project.” During that debriefing class, we had relatively unique and very engaging learning experience about a serious and under-reported topic. My thanks to Dan Corazolla, Soniya Sharma, Lindsay Bowman, Aaron Wynn, Heather Johnston, and Mason Curtis, all Meds 2015 for their help with this article.
The First Patient Project is an 18 month project which begins right in September of medical students’ first year and continues until after December of their second year. Students in pairs follow a chronically ill patient, attending health care appointments and visiting with them in their home. The students also interact with community and faculty physicians and complete critical analysis reports about their learning.
This day, on April 30, we heard from six “student teachers.” Having students teach a formal session is reasonably unique in our medical school and the topic of their teaching was also reasonably unique in medical literature: How do physicians deal with grief, on the loss of a patient? How do they recover and go on…down the hall to the next ward room with another patient in it, to another clinic room, to home?
Six of our students encountered death over the program…two of our “Patient Teachers” sadly have died over the past two years. And another pair of students lost their patient as she was the spouse of one of the patients who passed away and could not continue with the program.
The six students met with a clinical faculty member to discuss the experience, and individual discussion/counseling was made available to them. But they also continued with the project by doing research on three areas: 1. How physicians help families when a family member dies 2. How physicians can help themselves when a patient dies, and 3. How medical literature and medical education literature give insight on how to bring this up in medical education.
Their research and presentations were excellent! I thought I’d share, with their permission, some of their findings:
From Soniya Sharma and Dan Corazolla, came these concepts in how physicians can help their patients deal with grief: the differences between “normal grief” and “abnormal grief”, the tasks of grieving, the family as a resource, and the role of the physician. They consulted nine current references to expand upon these concepts to their classmates and to link up with previous sessions on this topic in their first year classes.
The title of Lindsay Bowman’s and Aaron Wynn’s talk was “Wearing your heart on your jacket: Patient death and the importance of physician grief. “ They pulled from fifteen diverse sources from Military Medicine (great article on resilience-building) to Vasalius, (How to cope with disaster loss and mourning: Galen’s paper which was lost for centuries) to more traditional medical and medical education journals. One particular source I found intriguing was J. Shapiro’s article in Perspective: Does Medical Education Promote Professional Alexithymia? A Call for Attending to the Emotions of Patients and Self in Medical Training. Acad Med 2011;86:326-332.
Lindsay and Aaron taught convincingly about the factors that make patient death difficult to deal for physicians, why grief education is important and relevant to physicians and medical trainees, the current state of grief education in our curriculum and that of other medical schools and where it could and should be represented in undergraduate and postgraduate medicine.
The third partnership to teach about this topic consisted of Heather Johnson and Mason Curtis. Their teaching centred around healthy strategies for physicians in dealing with grief. Both Heather and Mason conducted surveys or interviews. Heather’s survey inquired into when and how we should teach about physician loss and grief in our curriculum. She gave practical strategies and a model on how to move through loss and grief and created a “grief curriculum” whose components could be shared with faculty as well as students.
Interestingly both Heather and Lindsey focused on an article that, in their words, “if you had to read only article on this topic,” this would be it: The inner life of physicians and the care of the seriously ill by Meier, D.E. et al in JAMA 2001, 286(23): 3007-14. I’ve just read it too and let me chime in—a very thorough and insightful article on this topic.
Mason had interviewed physicians and created a model of grief approaches from three perspectives. He also spoke movingly about how he had responded to his grandfather’s death at a time when in medical school he was learning about oncology, palliative care and the elderly.
Students in the class afterward said that it was really positive to learn this material from their classmates. The work was solid, the literature review broad, and the points very clearly and thoroughly presented with good handouts.
The students who taught were positive too…tho’ some had not been initially Some were hesitant to teach their classmates, and concerned that it would not be well received. They were really buoyed up by the great feedback from their peers and from faculty Dr. Sanfilippo and Dr. Leslie Flynn, Kathy Bowes, Program Coordinator, Erin Matthias, Program Assistant, and patients in the room.
What’s the next step? Well, the students and I can see a need for further exploration of this subject in clerkship and residency. As well, I hope the students will put together a poster about this for CCME.
My take on this aspect of the project is this: our six student teachers were excellent teachers! They were well-prepared, and had done a thorough job in finding out in different modes and in some cases ferretting out literature on a topic that seems to be localized in only a few aspects of medicine and medical education. They were clear speakers, and had great teaching points. Their slides were excellent and they had a good beginning, middle and end to their talks. They were convincing, authoritative, and had much to share. Turning some of the teaching over to students teaches those who teach, and their classmates. We already do student small group teaching in our Community Based Projects and our Nutrition Projects—maybe some large group teaching is in order?
Beyond the teaching method, the students taught us all about a part of medicine that appears to be kept somewhat quiet. About the culture of a “stiff upper lip” that could pervade in some medical cultures. About how may physicians act differently about their own grief than they would advise a patient to act. They gave us all a lesson in how to cope in a healthy way, when you have to move on…to the next patient, the next room, the next door and all the way home.
Are you interested in the reference lists from the students? Or would you like to contact them to find out more about their talk and what surprised them? Write back here, or write to them via email addresses on MEdTech.
Why go to conferences?
Why go to conferences… In which Sheila Pinchin offers a purely personal viewpoint of the CCME Conference (13) .
Well, here I am at the Canadian Conference on Medical Education (CCME) in Quebec City, along with a great number of faculty from Queen’s, 15 meds students from Queen’s (some came up to volunteer!) Matt Simpson, Lynel Jackson from MEdTech and Andrew dos Santos from IT. As well, many staff are here (Kathy Bowes, and Jen Saunders), and our faithful Educational Team members, Eleni Katsoulas and Theresa Suart are here, too. Dean Richard Reznick, Associate Dean Tony Sanfilippo, Vice Dean Leslie Flynn, Associate Dean Ross Walker and Associate Dean Karen Smith are here. Suzanne Maranda, our head of Bracken Library is also here. And now I’m going to stop naming people as I know I’ll miss some. But these are just some of the people I’ve seen in the past day or two!
On the train up to Quebec City, we got a lot of work done, with people dropping by and talking about ideas and challenges. Dr. Sue Moffatt and we managed to squeeze in an entire planning session for the next Course Directors’ Retreat! We think the train back will offer a similar opportunity—all of us together for seven odd hours. This is a consultant’s dream: Captive faculty all in one space! ☺
I enjoy this conference so much! When I first started in Medical Education 7 years ago, I was one of the few, if not the only, Educational Developer at the conference. Now there are many more of us, and several Educational Researchers too. I don’t feel as odd, and I also feel more at home with all the faculty that come. And when you mix Ed Devs, clinical faculty, technologists and health education librarians together as we did in the workshop Lindsay Davidson, Lynel Jackson and I gave, you get powerful results! Flipped learning has never been so creative–thanks to Lynel’s wonderful graphics, and Lindsay’s really ingenious puzzle pieces activity!
Networking is happening with our faculty here—Tony Sanfilippo and Hugh MacDonald got together with their counterparts from across the country, as did Andrea Winthrop and countless others who were in interest groups and business meetings. Many other faculty were involved in formal meetings and symposia.
But informal networking has happened at mealtime breaks, and at other times, when you could see two or more heads bowed over computers or papers in the lobby and other places where you could sit. Memorably several people were sitting on the floor near the buffets– the better to be connected—to the electrical plugs in the wall and to each other, I presume.
In addition to networking, our Ed Team members (Eleni Katsoulas, Theresa Suart and I) also roam the poster aisles (we greedily snap up the mini versions), chat with people at the booths (hello CMPA Good Practice Modules, and MedicAlert Bracelet Free Curriculum!), and divide up and conquer when it comes to attending moderated poster, oral and workshop sessions. That means we’re synthesizing all this knowledge and bringing it home for everyone here—and do we have some terrific ideas!
I can’t forget to mention the White Coat Warm heART exhibit showcasing student and faculty artwork and a place of peace and provocation in a bustling conference. Here’s a shot of Dr. Carol Ann Courneya from UBC who’s been running the art exhibit since 2010 (with thanks to Dr. Ali L. Jalali for this photo from Twitter)
Kudos to the many Queen’s faculty, staff and students who gave oral presentations, poster presentations and workshops! One reason we come to conferences is to celebrate this scholarship and efforts of our educational community.
So it’s a real pleasure to celebrate and congratulate Paxton Bach, Meds 2013, on being awarded the Sandra Banner Student Award for Leadership. This prestigious award from the Canadian Resident Matching Service (CaRMS), consists of up to $5,000 annually to be given to a medical student or resident who demonstrates an interest in or an aptitude for leadership among their peers. Congratulations Paxton!
And here, Kathy Bowes and I are standing in front of our poster (with Tony Sanfilippo) about the First Patient Program telling the world (well some of it) that Queen’s is the first Canadian medical school to bring this kind of longitudinal learning from patients to years 1 and 2 students in medical education. This was a great idea Tony Sanfilippo brought back from an AAMC conference two years ago. I wonder what great ideas he’ll be bringing back from this conference!
Eve Purdy, Meds 2015, wrote this for our UG blog:
“For me the highlight was the huge social media at the conference allowing for faculty and students across the country to engage whether or not they could make it to Quebec City. It became evident that the efforts of Queen’s students and faculty to model online professionalism are significant and unique. We’re among those leading the charge! This blog is great evidence of those efforts. Having the opportunity to interact with online mentors, people from all over the country having significant impact on my medical education, in real life was well worth the trip (Dr. Jalali, Dr. Yiu and Deirdre Bonnycastle to name a few)!”
Here is a sample of faculty from U of T and Ottawa U tweets to Eve.
For stats on Social Media use at the conference see:
Ben Frid, also Meds 2015 and Aesculapian Society President, wrote this for us:
“Here is a photo of the Queen’s CFMS delegates, all of whom stayed in Quebec City an extra day and a half to attend the first part of CCME and the Dean’s reception.”
Ben continues, “One highlight for me was a fascinating presentation on Hidden Curriculum by a PGY-4 from McGill. She was exploring factors and common experiences amongst clerks that lead to hostile learning environments. She was very clearly advocating for medical students and progressive medical education, and it was inspiring to see another resident speak up at the end of the talk to lend his full support as well. I think residents are in a uniquely favourable position to mediate and collaborate between medical students and attending physicians and it was terrific to see these residents take up this important cause.
Another highlight was the Dean’s reception last night. It’s always fun to interact with faculty in an informal setting, and when I looked around the room I saw a mix of students, faculty, administrative staff, and alumni all enjoying each other in lively conversation — a shining example of Queen’s collegiality! Queen’s pride was abounding and amidst the Queen’s tartans and flags, I’m quite sure I saw the classic Queen’s pin on every lapel in the room. I had the chance to shake hands and share stories with John Ruedy, Aesculapian Society President in 1955, who has spent his time since then making incredible strides in transforming clinical and academic medicine across Canada. A very neat experience indeed!”
Theresa Suart, our new Educational Developer, who used her journalist’s background to ferret out literally every learning opportunity, says, “What’s really amazing is how so many people are working so hard to educate our future physicians! The energy is amazing and very inspiring.” Eleni Katsoulas, our new Assessment and Evaluation Consultant, who attended eighteen oral sessions, nine moderated poster debriefs, and one workshop, all on assessment, says she learned a lot. “But what sticks out in my mind is how important and energizing the networking is—so many helpful and collaborative people!”
I entitled this blog, “Why go to conferences?” They are a lot of hard work, a lot of travel, long hours, and a lot of time away from home, family and work.
But they also mean a great deal of learning about the best and latest in our fields, great ideas for helping our students, the ability to peer forward into the future, new people to connect and work with, a chance to do some thinking, a chance to drink in knowledge, and a chance to celebrate scholarship from our own institution as well as inhale that from others.
Don’t take my word for this! Go into Twitter and see the scope of the learning that went on at #CCME13.
Next CCME is in Ottawa—see you there!
My thanks to Eve Purdy for most of the photos and the comments, Ben Frid for the CFMS Delegates’ photo and comments, Dr. Jalali for the twitter photo of Dr. Courneya and her poster, Theresa Suart and Eleni Katsoulas for the company and the great quotes, and Dr. Sanfilippo for sending us here!
Do you have any CCME 13 experiences to share? Post them here!
Flipped Learning: “Turning learning on its head”
Here’s a scenario of an innovative educational method that is sweeping through the halls of academia: Imagine…students are hard at work at home accessing captured lectures, PowerPoint slides, audio or video casts, reference books, or other resources to learn about foundational factual material. They then go to class to spend the teaching/learning time on applied cases, projects, or problems where they can question the teacher, and work with their classmates on solutions and discoveries. Sound familiar? This is an example of “Flipped Learning”. I’d like to show you that we at Queen’s Meds are way ahead of the curve—we’re practicing “flipped learning” in “flipped classrooms already!”
A brief history of the Flip:
In 2000, J.W. Baker presented on a “Classroom Flip” where he used technology to allow students to read and learn at home, and became the “guide on the side” for them in class.
Formally defined in the literature by Lage, Platt and Treglia (2000) as the “Inverted Classroom”, the authors, from the Economics Department at Miami University, outlined a multimedia strategy for teaching that “appeals to a broad range of learning styles, without violating the constraints faced by instructors at most institutions.” (p. 31). By inverting the teaching and learning that took place inside and outside their economics classroom, the teachers gained more time to address diverse learning styles and challenges. They allowed groups and individual students to do their “homework” in the classroom, and reserved traditional lectures for outside the classroom.
In 2007, two high school chemistry teachers, Bergmann and Sams, recorded their PowerPoint lecture presentations using then newly developed screen capture software. Bergmann and Sams had built the videos for absent students to catch up, but found that students who had been present accessed the material to study and review. This left them time to spend in a classroom, on inquiry, and “deeper learning.” According to Bergmann, the Flipped Classroom “took off like a rocket!” (Bergmann, 2012.)
In March 2011, at Ted Talk, Salman Khan, spoke about flipping the homework/lecture equation. A hedge fund manager with multiple degrees in math and science from MIT Khan created the Khan Academy (www.khanacademy.org/), from his original math tutorials for his niece, to a very successful and free source of over 2,600 online tutorials covering everything from math, chemistry and even medicine. (Kahn, 2011). “Khan asserts that teachers in a traditional classroom spend five percent of their time actually working with students, while spending the other 95 percent lecturing, creating lectures or grading. Using Khan’s free online math tutorials, teachers flipped this equation, using technology to “humanize the classroom.” (Huston and Lin, 2012).
The growth in acceptance of this method is evidenced by, among many things, the best selling Bergman and Sams (2012) ISTE publication “Flip Your Classroom: Reach Every Student in Every Class Every Day.”
So, that’s what the “flip” is all about. What are we doing here in Queen’s Meds and what are some of the challenges we have to overcome in our use of “flipping”?
If you’re teaching in Undergraduate Medical Education (UGME), chances are you’ve come across our “SGL’s” or “Small Group Learning” sessions. With Dr. Lindsay Davidson’s example to guide us, we in UGME have adapted Team Based Learning (TBL) for these sessions. Here, we provide students with what had previously been the purview of the lecture: foundational facts through readings or other resources, from textbook chapters with reading guides, to online modules, complete with interactive quizzes, videos, etc. Students are provided with some “homework” time in our Directed Independent Learning sessions and are expected to come to class prepared to engage in inquiry through group work, with cases, or problems where they can apply their learning. The faculty member, often with a colleague, (other faculty, residents or fellows), facilitates the session, but notes that if he/she is talking more than 25% of the time, he/she is straying into the other side of the flip and not focusing on the student learning.
Why did we do this? For the same reasons that the flipped classroom is reaching so many teachers and students.
Here’s what Jon Bergmann has to say about this type of learning:
- Flipped Learning transfers the ownership of the learning to the students.
- Flipped Learning personalizes learning for all students
- Flipped Learning gives teachers time to explore deeper learning opportunities and pedagogies with their students (PBL, CBL, UDL, Mastery, Inquiry, etc)
- Flipped Learning makes learning (not teaching) the center of the classroom.
- Flipped Learning maximizes the face to face time in the classroom. (Bermann, 2012)
Now, what are some of the challenges? And how can we address them?
- It’s important that the students have prepared before coming to class. We do this by a. appealing to students’ sense of responsibility and professionalism, b. appealing to students’ common educational sense (they have to prepare if they are going to work on the applications) c. tying the preparation to assessment and grades into the preparation, d. using Readiness Assessment Process (lovingly known as RATs) which allow for enhanced group learning of concepts.
- Flipped Classrooms came about through innovations in technology that allowed for Lecture Capture, Narrated PowerPoint, and other technological tools. The key is not to get carried away with the technology but focus on the value of what is being offered to students: on guiding them through the learning and then inextricably weaving it with what is going to happen in class. One indispensible factor is quality: the captured lecture, online module, or even textbook chapter must have been carefully selected and/or crafted the way any good teaching tool would be.
- There really isn’t anything revolutionary about a video lecture. A recorded lecture is still just a lecture. What’s critical here is guiding of the learning. We are advocating Reading Guides for chapters or articles, quizzes and interactive questions for online modules, and short (5 minute) captured lecture bursts to guide readings, etc. Can the students learn from a captured lecture? Yes. Can they learn better with additional or with other tools? Absolutely. Bergmann cautions that flipped learning is NOT “a synonym for online videos. When most people hear about the flipped class all they think about are the videos. It is the interaction and the meaningful learning activities that occur during the face-to-face time that is most important.”(Bergmann et al, 2011.)
- Are lectures “bad”? Absolutely not! Flipping makes room for another teaching method, or several of them. But lectures have a place in medical education, especially for introducing a concept, generating excitement in a topic, providing a framework for learning, and other suitable purposes.
- It’s still about what happens in the classroom. I used the word “inextricably” above—the independent student learning must be closely linked to what happens in class. The class time is used to check on the student learning, clear up any questions, and work through well-thought-out and well-crafted group activities. Student intra-group discussion, student inquiry, students debriefing to the whole class, and instructors providing feedback to students about their learning are important activities. There is still a lot for an instructor to do in helping students to learn; it’s just been “flipped.”
Do you have questions or comments about “flipping”? Write back to the blog.
Baker, J.W. (2000). The Classroom Flip’: Using Web Course Management Tools to Become the Guide by the Side. Selected Papers from the 11th International Conference on College Teaching and Learning (11th, Jacksonville, Florida, April 12-15, 2000). Chambers, J.A., ed.
Bergmann, J. (2011). The history of the flipped class: How the flipped class was born [Web log post]. Retrieved March 24, 2013, from http://blendedclassroom.blogspot.com/
Bergmann, J. (2012). The Flipped Class as a Way TO the Answers. Flipped Learning. Retrieved March 24, 2013 from http://flipped-learning.com/
Bergmann, J. (2012). Flip your classroom : reach every student in every class every day. Eugene, Or. Alexandria, Va: International Society for Technology in Education ASCD.
Bergmann, J., Overmyer, J. & Willie, B. (2011). The Flipped Class:
What it is and What it is Not. Retrieved March 24, 2013 from http://www.thedailyriff.com/articles/the-flipped-class-conversation-689.php
Houston, M. & Lin, L. (2012). Humanizing the Classroom by Flipping the Homework versus Lecture Equation. In P. Resta (Ed.), Proceedings of Society for Information Technology & Teacher Education International Conference 2012 (pp. 1177-1182). Chesapeake, VA: AACE. Retrieved from http://www.editlib.org/p/39738.
Kahn, S. (2011). Let’s use video to reinvent education. Speech presented at TED2011. Retrieved March 24, 2013, from http://www.ted.com/talks/salman_khan_let_s_use_video_to_reinvent_education.html
Lage, M.J., Platt, G. J., Treglia, M. (2000). Inverting the classroom: a gateway to creating an inclusive learning environment. Journal of Economic Education.
Team Based Learning Collaborative. Getting Started. . Retrieved March 24, 2013 from http://www.teambasedlearning.org/starting.
Thompson, C. (2011, August.). How Khan Academy Is Changing the Rules of Education. Wired. Last retrieved on March 24, 2013 from http://www.wired.com/magazine/2011/07/ff_khan/
Zappe, S., Leicht, R., Messner, J., Litzinger, T., Lee, H., (2009). “Flipping” the Classroom to Explore Active Learning in a Large Undergraduate Course. American Society for Engineering Education.
Answers to questions about small group learning
We’ve received a lot of questions about how to make small group learning work smoothly for students and faculty. Here’s one with some answers gleaned from the literature and from experience:
I always seem to end up talking a lot in sgl. How can I let students talk more?
- Learn to “teach with your mouth shut.” (Finkel, 2000). Let the students do the work in their groups and let them take care of the debrief as much as possible.
- As soon as students are in their groups, get them going on the tasks. Stop talking.
- Have faith in the students’ ability to get it, or to help others in the group get it.
- Plan to speak about 25% of the time, and let groups take the rest of the 75% of the time.
- In debrief, assign groups to answer.
- Don’t respond to student answers in debrief, except to say “Thank you.”
- Ask other groups for agreement, for other suggestions, for challenges or rationales. If a wrong answer is given, ask the class or other groups if the answer is correct.
- If there are questions, “Park them” for later discussion on the whiteboard, or to post answers to the MEdTech Discussion Board later that day in the session.
- If it’s someone showing off their own knowledge by asking a question irrelevant to the class, ask to discuss after class. “That question shows you have a great deal of background in this subject. The question is not relevant to the what the class needs to know but I’d be very glad to discuss it with you…Will you stay after class, or get in touch with me?”
- Plan for a mini-lecture time slot (say 5-7 minutes) for you to explain denser or misunderstood topics.
- Make sure that your activities for the group are challenging yet give the opportunity to learn.
Do you have more answers or other questions? Please respond to this post!
Finkel, Donald L. & Finkel, Susan. (2000). Teaching with your mouth shut. Heinemann.
Using I.C.E. to build objectives and activities
It’s snowy and icy out–a perfect time to learn to use I.C.E. to build your learning objectives and activities for your courses and individual sessions. The I.C.E. model stands for “Ideas, Connections and Extensions,” and was developed by Dr. Sue Fostaty-Young and Dr. Bob Wilson here at Queen’s. When you’re planning a session or a course, use the concepts of building from Ideas (or facts and recall), to Connections (higher order thinking processes of analysis and application) and to Extensions (even higher order thinking processes of evaluation and creation). These will help you design activities that lend themselves to different levels of thinking and doing.
The I.C.E. Model:
| Understanding how and why”
And, after planning the types of learning activities, here are some helpful verbs that will assist you in determining the learning objectives:
Verbs for I.C.E.
Adapted from Fostaty Young, S. & Wilson, R.J. (2000). Assessment and learning: The ICE approach. Winnipeg, MB: Portage and Main Press.
Erickson, L. B. & Strommer, W.D. (1991). Knowing, understanding and thinking: The goals of freshman instruction. In Teaching college freshman (pp.65-80). San Francisco: Jossey-Bass.
Blogs our medical students are using to learn: by Eve Purdy (Meds 2015) and Sheila Pinchin
When you think of medical students learning about medicine, you might think about lectures, textbooks, labs, small group study and even online learning modules. BUT, did you know that our students are also learning through blogs?
Blogs, or “web logs” consist of postings by a person in chronological order with the ability for others to respond. You’re reading a blog right now. Our students read them too for all kinds of reasons and to access all kinds of material. See below for Eve Purdy’s picks and some reasons our students are blogging through medical school. For a great video on social media (blogging, twitter, etc.) see the Harvard Panel on Social Media at https://www.youtube.com/watch?v=_OdaDJ2PLmQ
What are your thoughts on learning through blogs?
Why are our students learning through blogs?
Blogs are ENGAGING and allow for knowledge sharing, reflection and debate not simply dissemination of facts
Blogs break down traditional hierarchies in which a medical student might feel intimidated to challenge a resident or attending on a concept or idea. Blogs not only prevent students from feeling intimidated but they create an environment where all are equals
Many good blogs will have links to primary literature that can help answer practical questions that come up in clinic; blogs written by learners often address the same questions other students ask and then point in the direction of some good background papers
Blogs help students see the same information in different ways. They allow learners to find ways to engage in ways that are most meaningful to them. By seeking out their own resources students find they are able to remember and recall information because they were responsible for going through the method to get there.
Often, the colloquial and entertaining way blogs are written make reading them easy and actually quite fun (urinalysis voodoo: http://boringem.com/2012/12/12/urinalysis-voodoo/)
Blogs are often inspiring, remind learners and faculty why we are doing what we are doing
Students turn to blogs to address some needs that are not always met or to augment resources in the curriculum (ie learner wellness http://wellnessrounds.org)
People who write blogs generally aren’t getting much (or any) scholarly credit which means they are doing it because they WANT to. Bloggers take a great deal of pride in presenting information in new, helpful ways and once they find a target audience or niche are very good at what they do. They are quick to adapt to feedback and to incorporate/synthesize new information in ways that traditional outlets (journals and textbooks) cannot.
Examples of students learning through blogs: Eve Purdy’s gives us some picks:
– I’m in the ER and see a patient with something that might be atrial flutter but isn’t quite sure so I pull up this quick, easy to reference article on atrial flutter from “life in the fast lane” (one of the best blogs out there) http://lifeinthefastlane.com/ecg-library/atrial-flutter/ It gives a nice, simple review of information quickly without having to log in to my queensu/bracken library account (something that takes about 30 seconds- an amount of time that doesn’t seem like much written down but makes a big difference if you are referencing a bunch of things throughout the day)
-Learn the same topic through multiple lenses. For example….a student is interested in learning more about a patient with chest pain. If you prefer clinical cases check out (http://lifeinthefastlane.com/education/clinical-cases/) or you like videos like the Khan academy use (http://academiclifeinem.blogspot.ca/2013/01/patwari-academy-videos-low-risk-chest.html). There are many resources to turn to and the people who keep blogs generally like to teach so the format is student friendly.
-Students don’t just read blogs to learn about content. The advantages of reading blogs goes much deeper and serves to address much of the hidden curriculum, thoughts about careers, tips and tricks for medical school success, health policy and once in a great blog post while inspire us to be better medical students and doctors in ways that traditional resources cannot. I think this is probably the most common reason that students read blogs. There are a bunch of examples but a few are:
social issues in medicine (http://emergencycarecanada.com/2013/01/14/non-urgent-patients-in-the-er-a-non-problem/)
Congratulations to Drs. Ted Ashbury and Heather Murray
Congratulations to Dr. Ted Ashbury (Anesthesia) and Dr. Heather Murray (Emergency), both of whom are very involved in Medical Education! They have been awarded the Canadian Association for Medical Education (CAME) Certificate of Merit, which promotes, recognizes and rewards faculty committed to medical education in Canadian medical schools.
In Undergraduate Medical Education, Ted has developed and is the Course Director for Professional Foundations 2 and 3, pre-clerkship courses which teach about the intrinsic or non-medical expert roles of a physician. He has also served as the Competency Lead for the Professionalism Role since the inception of the Competency Lead Role. Ted has also served as a founding member of the UGME Curriculum Committee.
In Undergraduate Medical Education, Heather developed and is the Course Director of Critical Appraisal, Research and Learning (CARL) and the Critical Enquiry Course in pre-clerkship UGME. She is also the Competency Lead for the Scholar role from years 1-4 and serves on the UGME Curriculum Committee.
These deserving colleagues will be recognized at the upcoming CAME Annual General Meeting which is held in conjunction with the Canadian Conference on Medical Education (CCME) in Québec, QC on Sunday, April 21, 2013 at 17:30 at the Hilton Hotel Québec. Please join us in congratulating these individuals for their commitment to medical education in Canada.
Many thanks for tremendous work: Farewell but not goodbye
Dr. Stephanie Baxter, has moved from her position as Co-Course Director for Neurology and Ophthalmology in Undergraduate Medical Education to serve as the new Residency Program Director for the Department of Ophthalmology. She has also therefore left her position on the UGME Teaching and Learning Committee of which she was an inaugural member.
It’s difficult to express all that Stephanie has quietly accomplished in undergraduate medicine–from piloting the extremely successful Ophthalmology Skills Fair to complete course revision as she acted as one of the first exemplars of creating balanced teaching methods. Stephanie has served the Teaching and Learning Committee well for 5 years, representing clinical teaching and supporting initiatives through her own teaching practice.
Perhaps most telling, however, is Stephanie’s contribution to student learning. She is the recipient of the 2011 Aesculapian Society’s Lectureship Award, and has already made an impact with her work in teaching residents, winning the Garth Taylor Resident Teaching Award of 2012, both attesting to the way Stephanie is able to interact with students to help them learn.
We wish Stephanie well in her work in Post Graduate Medical Education, and hope that our undergraduate students will still have the benefit of her teaching. Many thanks Stephanie, for all your tremendous work!
What do p and R-values mean anyhow? : Understanding how to interpret multiple-choice test scores using statistics.
Have you ever wondered whether or not your multiple-choice questions (MCQs) are too easy? The answer to this question can be found in the p-values or item difficulty: the percentage of students who answered correctly. The difficulty of a MCQ can range from 0.00 to 1.00; the higher the p-value, the easier the question. What we should be concerned with are high difficulty questions with p-values less than 0.3.
Have you ever wondered which questions tricked students who otherwise performed well on a test overall? The R-value or item discrimination looks at the relationship between how well students performed on a question and their total score. Item discrimination indicates students who know the tested material and those who do not. The higher the R-value, the more discriminating the test question. We should try to remove questions on the test with discrimination values (R-values) near or less than 0.3. This is because students who did poorly on the test did better on this question than students who performed better overall.
Did you Know?
Multiple-choice questions that use words in the stem such as best, most, first, or most correct require higher-level thinking but often confuse students because they are ambiguously worded. Our students have struggled lately with ambiguity in the wording of MCQs on RATs and exams such as “Which is the most likely….”. They assume “most likely” to be “most common”, whereas the most likely answer could be an uncommon situation. It’s important to word the question clearly so that students are not confused. So for example, the question could state, “In light of the clinical information provided above, which diagnosis would you make?
You can also ask students about “most common”, “most concerning”, or “what is the first test you would perform” etc. but it is always good to anchor these stems by referring to the data presented previously. Then the key is to require them to choose, evaluate, interpret, judge, infer from data, solve problems, and apply principles.
Did you Know?
The Student Assessment Committee has posted several articles, checklists and PowerPoint slides to assist you with Multiple Choice Questions.
For more guidance on writing high-quality multiple-choice questions refer to MCQ Guidelines and Writing MCQ’s in School of Medicine Faculty and Staff Resources at:
Queen’s School of Medicine: Faculty and Staff Resources.
Translating students’ comments on course evaluations
Navigating students’ comments could be one of the most challenging aspects of interpreting course evaluations. In an article in Innovative Higher Education, Linda Hodges and Katherine Stanton (2007) suggest using these comments as “windows into the process of student learning and intellectual development” rather than as reviews of “how they have been entertained” by an instructor.
Hodges is Director of the Harold W. McGraw, Jr. Center for Teaching and Learning at Princeton University; Stanton is the center’s assistant director. They point out that sometimes students’ comments stem from “students’ expectations of or prior experiences with college classes” that “entail teachers standing in front of the room ‘telling.’”
For example, is a comment like “I did not learn in this class because the teacher did not teach” evidence of a lack of effective teaching, or evidence that the style of teaching – including lots of team-based work – wasn’t what the student was expecting? Reframing student comments in this light can ultimately help improve teaching, Hodges and Stanton suggest.
“We may see our evaluations less as judgments of our performance and more as insight into our students’ intellectual growth—insight that may engage us in intellectual growth as teachers and scholars.”
Hodges, L.C., and Stanton, K. (2007). “Translating comments on student evaluations into the language of learning” in Innovative Higher Education 31:279-286.