The University of Chicago Comer Children's Hospital

 

 

Web-based Medical Education  for Students

                    -Applicability for Clinical Practice

                                                            Jina Youn, MS III

 

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Internet-based medical education: a realist review of what works, for whom and in what circumstances

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Progress in the capture, manipulation, and delivery of medical media and its impact on education, clinical care, and research

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Improving education in primary care: development of an online curriculum using the blended learning model

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Web-based learning strategies in combination with published guidelines to change practice of primary care professionals

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The Internet as an adjunct for pediatric primary care

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Development of a Web-based question database for students' self-assessment

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Measuring medical student preference: a comparison of classroom versus online instruction for teaching PubMed

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BMC Med Educ. 2010 Feb 2;10(1):12.  

Internet-based medical education: a realist review of what works, for whom and in what circumstances.

Wong G, Greenhalgh T, Pawson R.

ABSTRACT: BACKGROUND: Educational courses for doctors and medical students are increasingly offered via the Internet. Despite much research, course developers remain unsure about what (if anything) to offer online and how. Prospective learners lack evidence-based guidance on how to choose between the options on offer. We aimed to produce theory driven criteria to guide the development and evaluation of Internet-based medical courses. METHODS: Realist review - a qualitative systematic review method whose goal is to identify and explain the interaction between context, mechanism and outcome. We searched 15 electronic databases and references of included articles, seeking to identify theoretical models of how the Internet might support learning from empirical studies which (a) used the Internet to support learning, (b) involved doctors or medical students; and (c) reported a formal evaluation. All study designs and outcomes were considered. Using immersion and interpretation, we tested theories by considering how well they explained the different outcomes achieved in different educational contexts. RESULTS: 249 papers met our inclusion criteria. We identified two main theories of the course-in-context that explained variation in learners' satisfaction and outcomes: Davis's Technology Acceptance Model and Laurillard's model of interactive dialogue. Learners were more likely to accept a course if it offered a perceived advantage over available non-Internet alternatives, was easy to use technically, and compatible with their values and norms. 'Interactivity' led to effective learning only if learners were able to enter into a dialogue - with a tutor, fellow students or virtual tutorials - and gain formative feedback. CONCLUSIONS: Different modes of course delivery suit different learners in different contexts. When designing or choosing an Internet-based course, attention must be given to the fit between its technical attributes and learners' needs and priorities; and to ways of providing meaningful interaction. We offer a preliminary set of questions to aid course developers and learners consider these issues.

PMID: 20122253 [PubMed - as supplied by publisher]

 

J Vet Med Educ. Spring;32(1):21-30.

Progress in the capture, manipulation, and delivery of medical media and its impact on education, clinical care, and research.

Bernardo TM, Malinowski RP.

College of Veterinary Medicine, A227A Vet Med Center, Michigan State University, East Lansing, MI 48824, USA. tbernard@cvm.msu.edu

In this article, advances in the application of medical media to education, clinical care, and research are explored and illustrated with examples, and their future potential is discussed. Impact is framed in terms of the Sloan Consortium's five pillars of quality education: access; student and faculty satisfaction; learning effectiveness; and cost effectiveness. (Hiltz SR, Zhang Y, Turoff M. Studies of effectiveness of learning networks. In Bourne J, Moore J, ed. Elements of Quality Online Education. Needham, MA: Sloan-Consortium, 2002:15-45). The alternatives for converting analog media (text, photos, graphics, sound, video, animations, radiographs) to digital media and direct digital capture are covered, as are options for storing, manipulating, retrieving, and sharing digital collections. Diagnostic imaging is given particular attention, clarifying the difference between computerized radiography and digital radiography and explaining the accepted standard (DICOM) and the advantages of Web PACS. Some novel research applications of medical media are presented.

PMID: 15834817 [PubMed - indexed for MEDLINE]

 

BMC Med Educ. 2009 Jun 10;9:33.

Improving education in primary care: development of an online curriculum using the blended learning model.

Lewin LO, Singh M, Bateman BL, Glover PB.

Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA. llewin@peds.umaryland.edu

BACKGROUND: Standardizing the experiences of medical students in a community preceptorship where clinical sites vary by geography and discipline can be challenging. Computer-assisted learning is prevalent in medical education and can help standardize experiences, but often is not used to its fullest advantage. A blended learning curriculum combining web-based modules with face-to-face learning can ensure students obtain core curricular principles. METHODS: This course was developed and used at The Case Western Reserve University School of Medicine and its associated preceptorship sites in the greater Cleveland area. Leaders of a two-year elective continuity experience at the Case Western Reserve School of Medicine used adult learning principles to develop four interactive online modules presenting basics of office practice, difficult patient interviews, common primary care diagnoses, and disease prevention. They can be viewed at (http://casemed.case.edu/cpcp/curriculum). Students completed surveys rating the content and technical performance of each module and completed a Generalist OSCE exam at the end of the course. RESULTS: Participating students rated all aspects of the course highly; particularly those related to charting and direct patient care. Additionally, they scored very well on the Generalist OSCE exam. CONCLUSION: Students found the web-based modules to be valuable and to enhance their clinical learning. The blended learning model is a useful tool in designing web-based curriculum for enhancing the clinical curriculum of medical students.

PMID: 19515243 [PubMed - in process]

 

Br J Gen Pract. 2009 Feb;59(559):104-9.

Web-based learning strategies in combination with published guidelines to change practice of primary care professionals.

Robson J.

NHS Education for Scotland, Glasgow. jean.robson@nhs.net

BACKGROUND: Published clinical guidelines need to be combined with effective educational interventions to produce change in practice. Problem-based learning (PBL) groups are effective; however, research studies have not looked at change in practice following PBL that is independent of group interaction. AIM: To determine whether clinical guidelines combined with modified PBL e-learning modules, in which dialogue between learners is replaced by interaction with a computer, could increase knowledge, result in changes in practice, and be acceptable to participants as a mode of modifying practice. DESIGN OF STUDY: Quantitative and qualitative methods. SETTING: Web-based application. RESULTS: Online PBL modules were studied by 45 primary care clinicians. Replacement of group functions by interaction with the computer was found to be an acceptable form of learning, and resulted in reported changes in practice among GPs choosing this method of study. This study shows that changes were independent of demonstrable knowledge gains. CONCLUSION: Online PBL modules could complement other arms of guideline-implementation strategies. More work is needed to determine which groups would benefit most.

PMID: 19192374 [PubMed - indexed for MEDLINE]

 

Curr Opin Pediatr. 2009 Dec;21(6):805-10.

The Internet as an adjunct for pediatric primary care.

Kind T.

Division of General and Community Pediatrics, Children's National Medical Center, The George Washington University School of Medicine, Washington, DC, USA. tkind@cnmc.org

PURPOSE OF REVIEW: This review highlights recent publications on the use of the Internet as it relates to pediatric primary care, including its application to the pediatrician, teen, pediatric patient, and patients' parents. A brief overview of early work is introduced. RECENT FINDINGS: The Internet has become a tool to expand the reach of preventive interventions, including school-based online pediatric health education. Although research continues to describe barriers to the adoption of online resources, recent reports highlight newer applications, including user-generated content (i.e. social networking sites), and the impact on teens and their health. There are concerns and benefits of Web 2.0 and the teen population, with adolescents at risk online yet also learning about their health online. Internet referrals, prescriptions for information, and online assessment methods have had varied success to date. There have been some studies of e-learning and online continuing medical education having an impact on clinical decision making, but there is a need for more research on the electronic medical record as it relates to the practicing pediatrician and the Internet at the point of care. SUMMARY: The Internet is more than an information repository and continues to affect the lives and health of the pediatric population, parents, and providers. The growth of and changes to the Internet over time bring online innovations that have yet to be studied.

PMID: 19726990 [PubMed - in process]

 

Acad Med. 2002 Sep;77(9):925.

Development of a Web-based question database for students' self-assessment.

Hammoud MM, Barclay ML.

Department of Obstetrics and Gynecology, University of Michigan Hospital, University of Michigan Medical School, Ann Arbor, 48109-0276, USA. immaya@umich.edu

OBJECTIVE: Computer-based testing (CBT) for the purpose of the national licensure examination has increased interest among medical students in this modality of testing. The advent of Web-based question-delivery systems for self-assessment and learning has made it possible for students to practice this technology and participate in self-directed learning. Test Pilot(TM) is a Web-based program that provides a fast and easy tool for the development and deployment of online testing. Our objectives for introducing the program were to (1) develop a large database of questions for students' practice and self-assessment; (2) include multimedia tools such as illustrations and short videos to enhance learning; (3) provide a feedback tool for clerkship and site directors regarding student performance; and (4) evaluate this tool in terms of students' frequency of use, students' satisfaction, and its potential effectiveness in enhancing learning. DESCRIPTION: The Obstetrics and Gynecology clerkship at the University of Michigan is held at four different sites. In the past, students have been provided with access to floppy disks that contain about 500 self-assessment questions. These questions have been reformatted, updated, and transferred to Test Pilot. Visual illustrations have been added to the questions along with more varied formats, including extended matching, fill-in, and essay questions. The questions are divided into ten-question quizzes. The students get immediate feedback after answering each question and a summary of performance at the end of each quiz. Security, access, and analysis are facilitated because the questions and responses are stored centrally. In addition, Test Pilot captures information regarding individual and collective students' performances. At the end of the rotation, students fill out a form evaluating the Test Pilot program and comparing it with the quiz disks. In addition, we are collecting data regarding the actual use of Test Pilot, which will be compared with the students' surveys and final exam scores. DISCUSSION: Test Pilot has many benefits, including access control, immediate feedback, automated scoring, interactive learning, and data analysis. The enhancement of material permitted by a Web-based system increases the depth and variety of the learning experience by adding perceptual dimensions. Test Pilot also provides the clerkship director with the capability to obtain improved measurements of student performance and captures the student's self-learning and testing process. It can potentially identify weaknesses or inconsistencies across the different sites and recognize students who may need additional help early in the rotation. Over a one-year period, most students have switched from the quiz disks to Test Pilot. The students reported satisfaction with the Web-based format and found it user friendly. They especially liked the immediate feedback. The students have requested more questions and multimedia options be added. We plan to continue the development and assessment of this learning tool.

PMID: 12228094 [PubMed - indexed for MEDLINE]

 

J Med Libr Assoc. 2008 Jul;96(3):217-22.

Measuring medical student preference: a comparison of classroom versus online instruction for teaching PubMed.

Schimming LM.

Gustave L. and Janet W. Levy Library, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574, USA. laura.schimming@mssm.edu

OBJECTIVE: The research analyzed evaluation data to assess medical student satisfaction with the learning experience when required PubMed training is offered entirely online. METHODS: A retrospective study analyzed skills assessment scores and student feedback forms from 455 first-year medical students who completed PubMed training either through classroom sessions or an online tutorial. The class of 2006 (n = 99) attended traditional librarian-led sessions in a computer classroom. The classes of 2007 (n = 120), 2008 (n = 121), and 2009 (n = 115) completed the training entirely online through a self-paced tutorial. PubMed skills assessment scores and student feedback about the training were compared for all groups. RESULTS: As evidenced by open-ended comments about the training, students who took the online tutorial were equally or more satisfied with the learning experience than students who attended classroom sessions, with the classes of 2008 and 2009 reporting greater satisfaction (P<0.001) than the other 2 groups. The mean score on the PubMed skills assessment (91%) was the same for all groups of students. CONCLUSIONS: Student satisfaction improved and PubMed assessment scores did not change when instruction was offered online to first-year medical students. Comments from the students who received online training suggest that the increased control and individual engagement with the web-based content led to their satisfaction with the online tutorial.

PMID: 18654658 [PubMed - indexed for MEDLINE]