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 firstname.lastname@example.org
Eleni Katsoulas email@example.com
Rachel Bauder firstname.lastname@example.org
Zooming our way through pandemic remote teaching
On March 23 – coincidentally immediately after our students’ March Break – Queen’s UGME moved its classroom-based teaching to all remote learning to comply with social-distancing measures put in place as a result of the COVID-19 pandemic..
This also coincided with the majority of faculty, and administrative and support staff moving to working from home, except for those deemed essential to university operations.
By the end of May, we’d conducted close to 250 learning events via Zoom that would have ordinarily been taught in our classrooms by dozens of faculty members. The Meds Video Conferencing (MedsVC) team, led by Peter MacNeil were instrumental in making this possible, providing technical support for every learning event.
Lectures were recorded to accommodate students who found themselves in different time zones (many having travelled home for March Break and subsequently stayed there rather than engage in unnecessary travel) and those with family responsibilities, for example.
Instructors faced the same challenges most have read about regarding online conferencing. As Dr. Jenna Healey, Chair in the History of Medicine, describes: “Technical issues, navigating the software, making sure there were no interruptions on my end—like my very loud cat meowing!”
Faculty sought creative solutions to previously-scheduled in-class sessions. For example, in MEDS 246 Psychiatry, there were two expanded clinical skills sessions scheduled which each included a Standardized Patient actor (SP) to help demonstrate aspects of psychiatric interviews. Course Director Dr. Nishardi Wijeratne led both sessions – the first before the switch to remote delivery and the second one via Zoom. Each session was 50 minutes.
“Having taught both at the SOM and fully zoom, I did not find a significant difference between the two as a teacher,” Dr. Wijeratne says. “Given that my clinical practice as psychiatrist has moved to mostly virtual care right now, the Zoom version actually felt closer to my daily clinical practice right now.”
She noted three aspects that helped greatly with the session:
- MedVC staff to help with tech issues
- Connecting with the SP about 10 minutes before the session to discuss goals and structure
- Assigning tasks to the students ahead of the session to maintain engagement thoughout the 50-minute classes. Students observed the psychiatric interviews and documented mental status, identified risk factors, and considered possible differential diagnoses.
In addition to his own teaching, MEDS122 Pediatrics Course Director Peter MacPherson pitched in with a solution to a Clinical Skills session – about half the class missed their opportunity to complete a toddler observation session because of the pandemic restrictions.
“Usually, the medical students get down on the floor and play with a toddler while they infer the child’s real age based on their developmental achievements,” he explains. “We were able to cover the same curricular objectives remotely. The students were able to observe and interact with my toddler via Zoom in his ‘natural environment’ (aka our playroom) and do a similar assessment.
“It was a lot of fun to teach while playing dress up with my child!”
One part of the classroom experience that’s more challenging to achieve remotely is direct interaction with students as a class. “In particular, it is rather difficult to judge the level of understanding of the class,” MEDS245 Neurosciences Course Director Stuart Reid notes. “It cannot provide the personal contact that comes with in real life interaction.”
“On the other hand, it has been an invigorating challenge. We introduced more online learning modules and sought creative approaches to making distance learning both active and interactive,” he adds. One such creative approach was a “Jeopardy” style game in place of a hands-on expanded clinical skills session. It didn’t replicate the face-to-face session, but it actively engaged students in the session.
Dr. Healey echoes Dr. Reid’s comments about missing that face-to-face factor. “I very much miss interacting with my students in class. As an instructor, what I have found most challenging is not being able to see student’s faces. I didn’t realize how much I relied on non-verbal communication to adjust my pacing or gauge the level of student’s interest or understanding.”
Dr. Healey started encouraging students to use the Zoom “raise hand” function more often in her classes. “I want students to feel comfortable interrupting me if they have questions or comments.”
Dr. Reid speaks for all of us at UG when he notes that the students were a key factor in the success of our remote curriculum delivery: “They have been patient, accommodating, and enthusiastic enablers of our altered circumstances. Many thanks to them!”
At the end of the semester, the Education Team conducted several focus groups with Year 1 and Year 2 students to get additional feedback on what worked well, what didn’t, and suggestions for improving this type of remote learning. This, combined with the course evaluations (which included additional questions about the new required remote learning activities) will be used to inform teaching decisions in the coming academic year, as the COVID-19 pandemic situation continues to evolve.
CanMEDS roles in action during COVID-19
By Dr. Gray Moonen
Welcome to the Medical Residency Twilight Zone: There are no medical students. Academic half-days are virtual. Research projects are delayed indefinitely. Your oral presentation at the conference is cancelled. The entire conference is cancelled. Oh, that’s because flights are also cancelled. Licensing examinations are delayed. Clinics are cancelled. Where did all the patients go? You can hear a pin drop in the emergency department.
My hands are raw. No, I am not moisturizing them during the day and, yes, they are showing cracks. I am turning reptilian. These masks make me so hot, I can barely breathe. My glasses are constantly foggy. Oh hey, I didn’t recognize you with the mask on. Leaving the hospital and coming home are newly ritualized. Wash hands (arms, neck?), then take off scrubs, then take off shoes, wash hands again, put street clothing on… wait did I miss a step? Did I contaminate myself? Will I contaminate my home? Get my wife sick? I don’t know. I have internal monologues about how often to sanitize my equipment. Is my cell phone going to survive all this virox? It is the least of my worries right now, but it would really suck if I broke it.
I end every email with “stay safe”.
I’ve been reading about how to stay resilient and accept the inevitable stress. The evidence is sound, but it seems distant. “Focus on the things you can control”…that’s part of the day-to-day challenge as a resident. We often lack the clinical knowledge, experience, and confidence to control our clinical encounters. We require evaluations; all our work and research projects are supervised and graded in some capacity. We require licensing exams to proceed to be independent practitioners. These are the many things out of our control that all draw on our attention and make a crisis like the COVID-19 pandemic even more anxiety provoking. Not to mention our most pressing concern – for the deluge of illness and suffering this will cause patients.
And yet…. what a privilege it is to be a resident.
We are guided by a seven-pillar competency-based framework: “CanMEDS” or “CanMEDS – Family Medicine”. Although it may seem like everything is up in the air, I think there are equal, if not greater opportunities to develop our competencies during this crisis compared to usual times. Instead of going through the motions of learning objectives, checking off an Entrusted Professional Activity, receiving an In-Training Evaluation Report, instead we are actively motivated to do the things that need doing, because it simply needs to be done. Doing it well and thoughtfully, because it matters. A lot.
I have seen residents and staff physicians working side by side, tirelessly advocating for change at the individual, community and broader societal level. Grassroots campaigns are successfully encouraging people to stay home, and wash their hands; we’re advocating for PPE procurement. The trust, respect and unity being displayed across healthcare workers has enabled genuine collaborative efforts; “we are truly all in this together”. Residents are also liaising with public health, government agencies and the public to find innovative solutions, not to apply for a grant or win an award. It’s because this needs to be done.
I’ve noticed many residents become leaders and lean in to their voices, providing calm, measured and sound advice to their patients, peer groups, junior learners, family and friends, organizing systems to let patients know where to reach out to for help if they feel ill. Residents are stepping up and covering call shifts for ill or quarantined colleagues, offering to work COVID19 clinics or be redeployed to other services.
As developing professionals, we are sacrificing time, energy and our health in this evolving pandemic. Managing the competing demands of training such as patient care, evaluations, research and the stress of having academic requirements delayed or cancelled is unique, but I have observed grace inspired action rather than a compromise in integrity or overt displays of frustration.
As scholars we are staying informed on the emerging evidence and synthesizing this information for patients, peers and the broader public. As medical experts, we are not only maintaining many of our skills within our developing scope of practice, but actually expanding our skillset as we prepare to participate in more critical care, triaging, counselling and telemedicine.
Uncertainty and anxiety are undeniable. We are concerned we will not reach our training milestones or develop the competencies to practice independently. Yet, despite these dark times, I believe there are silver linings. We will all become better physicians and community members as a result of this crisis, and Canadians will benefit in the long term.
Gray Moonen, PGY1 in Family Medicine at the University of Toronto, graduated from Queen’s School of Medicine in 2019. He is also a past-president of the Aesculapian Society.
This column originally appeared on the CMAJ blog and is used here with Dr. Moonen’s permission.
“Meducators” aim to help healthcare and other essential workers’ children with 1:1 online tutoring
Editor’s Note: Medical students (and many other Queen’s Faculty of Health Sciences students) are volunteering their time during the COVID-19 pandemic in a number of different capacities. This is in addition to continuing with course work responsibilities, as much of the UGME curriculum is now being delivered online. This post highlights one of these student-led volunteer initiatives.
By Angie Salomon and Kiera Liblik (Meds 2023)
To hardworking healthcare professionals, and all others providing essential services to our community during COVID-19: WE WANT TO HELP!
Queen’s “Meducators” are a group of Health Sciences students at Queen’s University who want to support the educational success of students of healthcare (and other essential) workers in our community through a free, one-on-one tutor program via on-line video conferencing. Our tutors can provide informal tutoring services for children of all ages and grades (K-12) across core subjects (math, science, English, French). The service may range from simply supporting the student virtually while they complete their homework, to creating full-on lesson plans to aid their learning. If this is of interest to you or your family, please submit a request using the following link: https://forms.gle/k3mdo6cLYZtULmYF6
If you are a Health Sciences student (Medicine, Nursing or Rehabilitation Therapy) who would like to volunteer as a tutor, please sign up here: https://forms.gle/Ly8d2xmXax47iGDM7
If you have any questions, please don’t hesitate to contact Angie Salomon (email@example.com) or Kiera Liblik (firstname.lastname@example.org).
Five tips for working and learning from home
We’re now into Week 3 of delivering our UGME curriculum (as much of it as possible, at least) via online teaching and learning as part of Queen’s response to the COVID-19 pandemic response mandates. As well, most staff are also working from home. You may still be trying to find your groove in this new configuration of teaching, learning and working without direct in-person contact with colleagues. With this in mind, I’ve begun making notes on tips for working and learning from home. Here are my initial five:
1. Negotiate your space carefully.
This is especially important if you have housemates. In some households, working-from-home space may be at a premium. In my home, there are four of us working and learning from home – my husband, my Grade 10 son, my graduate student daughter who has de-camped from McMaster, and I are competing for space in our townhouse. I’m in what I call the “basement bunker” – it’s a corner of the basement, near the foot of the stairs. It’s windowless but has everything I need: my desk, electrical outlets, and my three computers I’m using to check-in on multiple learning events. My daughter is at the opposite end of the basement, near a teeny-tiny window.
My husband got the kitchen table—he has a window and is closer to the tea kettle—but I don’t have to pack everything away for lunch and supper. My son is migrating from place to place.
2. Make friends with Zoom.
While there are multiple on-line options for course delivery and meetings, for UGME we’ve been using Zoom predominantly for courses and meetings. Like any other online platform, it has its quirks and protocols. It helps to become familiar with the key commands, like “raise hand”, share screen, chat, and how to “unmute” yourself. Remembering to use these things in a timely way is another story.
What we’ve all discovered over the last two weeks is that online is more exhausting than face-to-face. My Education team colleagues and I coined a new term – “zammed” as in “I’m zammed” meaning fatigued from back-to-back-to-back zoom session as in: “I’m zammed” in place of “I’ve done six hours of zoom today and I am SOOOO done.”) And, yes, we’ve all voiced the Brady Bunch and Hollywood Squares comparisons.
3. Look away!
In regular office work (and classrooms, too), we naturally change from focusing on “up close” versus mid and far. With so much of our work and learning lives moved online, we’ve upset this balance. To help combat screen fatigue, use the 20-20-20 rule: Every 20 minutes, take 20 seconds to look (out the window, across the room) and focus on something about 20 feet away. (To avoid looking disinterested in a Zoom meeting, turn off video before attempting the 20-20-20 exercise (see #2, above). (For more on the 20-20-20 rule, click here: https://www.healthline.com/health/eye-health/20-20-20-rule#definition)
4. Be flexible and patient with each other and with yourself.
We’re all on a pretty steep learning curve and lots of people are juggling extra responsibilities in an environment that isn’t as conducive to learning and working as our on-campus spaces are. (Not to mention our faculty who continue with clinical responsibilities, some of the front-lines with the COVID-19 response). Meetings and classes may start a couple of minutes late; somebody will have lost a link or have an old one; sharing screens may not launch exactly how we want. And everyone has forgotten that mute/unmute button at least once so far (Again, see #2). As much as possible, take things in stride. If you’re caring for children or sharing tech, you may need to reschedule how/when you do certain tasks. Our recording and posting of all learning events (as quickly as possible) is one tool we have to help with any learners who need to “time shift”.
5. Remember working from home isn’t working 24/7.
With the line blurred between home and school/work, it can be easy to lose track of any boundaries. Make time for something besides your work/studying. I don’t mean you have to be super-productive at something like some of the memes going around—just get away from your computer and thinking about work/school at intervals. (In the first week, some nights I dreamt about zoom meetings. I woke up feeling like I’d put in overtime). Turn off your brain. Whether that’s some fluff television (insert your poison of choice here… I hear there’s something on Netflix about a tiger?), an online Zumba class, knitting, meditation, or a vicious game of Bears-versus-babies with your housemates….