Executive Summary. Abstract:

Transcription

1 Executive Summary Title: Creating an Active Learning Environment in Undergraduate Medical Education: Integrating Lecture Tools into a Second-Year Clinical Skills Course Abstract: A newly designed second-year undergraduate medical education course, Introduction to Clinical Medicine II (MD 821), will begin August, 2013, as part of the UKCOM curricular revision. The year-long course, which focuses on physical exam and diagnosis skills, is built around clinical cases. The weekly course format includes: (1) a case introduction; (2) the delivery of case-related topics by content experts through mini-lectures (in class or as Echo personal capture recordings); and (3) student presentations. Essential to this redesign and, hence, the planned integration of Lecture Tools (LT) - was the intent of enhancing student engagement in the classroom sessions. Indeed, LT offers the opportunity for real time interaction through the use of questions, identification of items, and opportunities for students to pose questions via the LT platform, anonymously, in real time. University of Kentucky College of Medicine, Office of Medical Education Detailed Overview The newly-revised curricular is the outcome of a six-year planning process that brought together clinical and basic science faculty members, students, and administrators whose mission was to create a curriculum to prepare students to succeed in the complex world of medicine as leaders, problem solvers, team players, and lifelong learners. UKCOM built its new curriculum on a hybrid structure, which retains selected disciplinebased courses (e.g., Anatomy, Biochemistry) alongside more integrated, systems-based courses (e.g., Cardiovascular, Renal). The new M1 course structure began in AY , with the new M2 courses beginning in August, Prior to the M2 curricular revision, the second-year undergraduate medical curriculum included two successive clinical skills courses: one which focused on learning physical exam skills, and the second, which focused on diagnosis skills. Both courses were didactic in nature, with all lectures captured and posted on the Echo 360 portal review for students to view at will. The Echo technology was so well received that all lectures in required undergraduate medical education courses are now captured using Echo 360. As a result, in-class attendance has declined in many courses. As part of the curricular revision, the two clinically focused M2 courses were combined into a new, year-long course. Medical education involves not only knowledge acquisition but also awareness and adoption of attitudes and aptitudes deemed necessary by the Liaison Committee for Medical Education (LCME), the accrediting body for all U.S and Canadian allopathic medical schools. (Standard ED5-A, emphasis added): A medical education program must include instructional opportunities for active learning and independent study to foster the skills necessary for lifelong learning Similarly, The curriculum of a medical education program must include specific instruction in communication skills as they relate to physician responsibilities, including communication with patients and their families, colleagues, and other health professionals (Standard ED-19, emphasis added).

2 With these accreditation standards in mind, the new M2 clinical skills course stresses learners comprehension in the contexts of related opportunities to practice patient interviewing, develop clinical-decision making skills, and cultivate an appreciation for evidence-based medicine and research. Creation of an active learning should enhance student engagement in the course. Lecture Tools, then, will be used as a primary presentation platform beginning in January, We will continue to use Echo 360 to capture all classroom activities. Design Given the extended length of the M2 clinical skills course - and the lack of relevant baseline measures from which to build our proposed demonstration and evaluation will take place entirely during the upcoming AY session. For the first half of the course (from September-December, 2013), the newly-designed course will proceed as planned but without supplemental LT-delivered content. Beginning after students return from holiday break, the course will resume (January, 2014) and continue to the end (April, 2014) as before, but with one crucial change: Selected course content will now be delivered via LT. Outcomes/Metrics In assessing the impact of LT-delivered content on both the educational environment and medical students engagement in the class, a number of key pre- (T1) and post-course (T2) data points will be gathered. First, the Dundee Ready Educational Environment Measure (DREEM) will be used to document any discernible changes in the educational environment. This scale has been commonly used in health professions education, and uses students perceptions to gauge the conduciveness of a particular environment to the learning process. Second, student engagement will be measured by monitoring several student and instructor behaviors: (1) questions posed by the instructor; (2) questions posed by the students; and (3) class attendance. Items #1 and #3 will be routinely monitored by an OME staff person who will personally attend each of the weekly large-group activities. LT analytics will provide accurate, real time data capture of student activity. Lastly, a supplemental instrument will be developed to assess any changes in students self-reported study, testing, or group participation behaviors. To promote honesty of student responses, all data will be anonymous in nature - and will be collected via a variety of electronic and hard-copy platforms. Given this design, all analyses will be between-subjects comparisons of aggregate statistics; no paired or matched (within subjects) comparisons will be done. To bolster response rates, incentives to participate will be offered at both T1 and T2. It is anticipated that the accompanying study protocol will be exempted under current human subject research guidelines.

3 Table 1. Project Metrics and Data Sources DREEM T1: Data Collection Non-LT Presentations September, December, 2013 DREEM T2: Data Collection LT Presentations January, April, 2014 Student attendance (in class) observer Student attendance (in class) observer Student attendance (out of class) LT analytics # oral instructor questions observer # oral instructor questions observer # typed instructor questions LT analytics # oral student questions (in class) observer # oral student questions (in class) - observer # typed student questions (in class) LT analytics # typed student questions (out of class) instructor # typed student questions (out of class) LT analytics # oral student questions (out of class) observer/inst # oral student questions (out of class) observer/inst Students behaviors/attitudes self-report survey Students behaviors/attitudes self-report survey Dissemination: Internal communication via Presentation at October 2013 Curriculum Retreat Grand Rounds Presentation- UK College of Medicine April 2014 Submit abstract to AAMC national and regional annual conferences for Required Appendices Project Coordinator: Mary Jane Lesshafft, MAE Curriculum Consultant Senior UK COM, Office of Medical Education Lexington, KY mjlesshafft@uky.edu Key Collaborators Christopher Feddock, MD Assistant Dean, Curriculum UK College of Medicine, Office of Medical Education Lexington, KY R. Scott Morehead, MD Course Director MD 821 Introduction to Clinical Medicine II Department of Internal Medicine, UK College of Medicine

4 Terry Stratton, PhD Assistant Dean, Assessment and Quality Management UK College of Medicine Stephen Welch Director of Technology, UK College of Medicine Scott Pappas Educational Computing Support UK College of Medicine Dorcas D. Beatty Center for Excellence in Medical Education UK COM Office of Medical Education Marlene Sauer, MFA Curriculum Director UK COM Office of Medical Education Lexington, KY About the UKCOM Office of Medical Education: In AY , the University of Kentucky College of Medicine (UKCOM) began the first phase of major revision of the M1-M2 curriculum moving from a traditional discipline-based model of teaching foundational sciences to one in which content is integrated vis-à-vis its application to clinical medicine. This ongoing curricular revision is the outcome of a six-year planning process that brought together clinical and basic science faculty members, students, and administrators whose mission was to create a curriculum to prepare students to succeed in the complex world of modern medical practice as leaders, problem-solvers, team players, and lifelong learners. The Office of Medical Education supports, guides, and promotes the undergraduate medical education mission of the University of Kentucky College of Medicine. About the UK College of Medicine An academic medical institution dedicated to providing superior education and training in order to produce highly qualified, caring physicians to serve the people of Kentucky and the nation. About the University of Kentucky The University of Kentucky is a public, land grant university dedicated to improving people's lives through excellence in education, research and creative work, service, and health care. Project Plan

5 September 2013 Begin attending MD 821 lectures to collect data. Develop student survey items October 2013 Lecture Tools demo Orientation session for Part II lecturers November 2013 December 2013 January 2014 Focus group 1 for faculty Focus group 1 for students Survey of students Begin using Lecture Tools as presentation platform in MD 821 all presentations Lecture Tools Orientation session for students February 2014 Collate data collected from September through December 2013 March 2014 April 2014 May 2014 June 2014 July 2014 Survey of faculty: satisfaction with LT Student Focus Group Grand Rounds Presentation from UK Faculty using LT in course Survey of Students Joint Focus Group Collation of collected data Course planning for MD 821 for fall 2014 Faculty Instructional session for LT for 1415 AY August 2014 Lecture Tools Instructional session for students in MD 821 September 2014 Student Focus Group Faculty Focus Group October 2014 Develop abstract for submission to SGEA for April 2015

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