LSI Pilot20110615 - USMLE Customized Assessment • Turning Point Team Competitions •...
Transcript of LSI Pilot20110615 - USMLE Customized Assessment • Turning Point Team Competitions •...
6/15/2011
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Asynchronous Learning – Lessons Learned
From a Curriculum Pilot
Doug Danforth, Ph.D.
Larry Hurtubise, M.A.
“What doesn’t kill us, makes us stronger”
Friedrich Nietzsche, 1888
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Endocrine and
Reproductive
Disorders
Gastrointestinal
and Renal
Disorders
Host
Defense
Clin
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Skin, Bone,
and Muscle
Disorders
Medical
Practice
and Patient
Care
Neurological
Disorders
Cardio-
pulmonary
Disorders
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Part One
Clinical Foundations
Part Three
Advanced Clinical
Management
Part Two
Clinical Applications
ProjectsSmall Group
Discussions
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Host
Defense
Part 1 Design Guidelines
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• Design learning resources around defined objectives
• Significantly reduce the standard lecture with a faculty
member and students in the lecture hall.
• Present (real time) turning-point sessions that have questions
covering the objectives.
• Utilize case based clinical correlates
• Utilize several TBL sessions as part of the block evaluation
process.
Additional Components
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• Longitudinal Anatomy Curriculum
• Collaborate with CAPS for Clinical Skills Sessions
• Wiki for course packet
• USMLE Customized Assessment
• Turning Point Team Competitions
• Student-generated question bank
• Twitter for class communication
Curriculum goal: Design learning resources around
defined objectives and provide multiple resources
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• Handout with all objectives and several resources for each
• Suggested study schedule
• Dedicated web site with answers to objectives
• eLearning Modules
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Curriculum goal: Design learning resources around
defined objectives and provide multiple resources
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• Outcomes:
– Studying from objectives vs lectures was challenging
– Multiple learning resources led to confusion
– On-line course packet was an unneeded change
– eLearning Modules were highly rated
• Require considerable time and effort
Bloom’s Taxonomy
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Curriculum goal: Reduce emphasis on lectures
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Curriculum goal: Reduce emphasis on lectures
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Face-to-face time
Face-to-face time
Curriculum goal: Reduce emphasis on lectures
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Learn first in class and go
home to review notes
Curriculum goal: Reduce emphasis on lectures
Study at home and come
to class prepared for a
higher level discussion
Shift in emphasis
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• Traditional lecture hours reduced from 32 � 10
• Of 22 hours removed
– 10h were replaced with TBL, CRIS, CPC
– 12h were deleted
• 2/3 basic science
• 1/3 clinical content
• Total in-class time was reduced from 34h � 22h
Curriculum goal: Reduce emphasis on lecturesReproduction and Development 2010
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Time Monday 3/8 Tuesday 3/9 Wednesday 3/10 Thursday 3/11 Friday 3/12
8:30 RD
Female
Reproductive
Pathology
Dr. N. Ramirez
(3 hrs)
RD
Physiology of
Pregnancy
Dr. D. Danforth
(2 hrs)
RD
Sexual Differentiation
Dr. D. Danforth (1 hr)
RD
Maternal Physiology in
Pregnancy
Dr. P. Samuels (1 hr)
RD
Gestational and
Placental Disorders
Dr. N. Ramirez (1 hr)9:00
9:30 RD
Fetal Development
Dr. M. Prasad (1 hr)
RD
Normal Labor
Dr. W. Trout (1 hr)
RD Developmental
Pathology
Dr. N. Ramirez
2 hrs10:00
10:30 RD
Control of
Reproduction
Dr. L. Keder (1.5 hrs.)
RD
Prenatal
Diagnosis/Genetics
Dr. B. Rink (1 hr)
RD
Obstetrical
Catastrophes
Dr. G. Essig (1 hr)11:00
11:30
12:00
12:30
1:00
1:30RD Small Groups
Group A: 1:00-2:30
Group B: 2:30-3:00
Graves Hall
classrooms as
assigned
CAPS
1:30 – 4:30
Small Group A
CAPS
1:30 – 4:30
Male and Female GU
As Assigned
RD Small Groups
Group B: 1:00-2:30
Group A: 2:30-4:00
Graves Hall
classrooms as
assigned
CAPS
1:30 – 4:30
Small Group B
CAPS
1:30 – 4:30
Male and Female GU
As Assigned
RD Small Groups
Group A: 1:00-2:30
Group B: 2:30-4:00
Graves Hall
classrooms as
assigned2:00
Reproduction and Development 2011
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Time Monday 3/7 Tuesday 3/8 Wednesday 3/9 Thursday 3/10 Friday 3/11
8:30 Introduction to Pregnancy
Dr. D. Danforth (1hr)
Normal Labor
Dr. W. Trout (1hr)Gestational and Placental
DisordersDr. N. Ramirez (1hr)
TBL Exercise
Group BSexual Differentiation
NO PODCAST9:00 CPC - Breast Disease
WestmanHitchcock
AckermanNO PODCAST
9:30 Maternal Physiology in
PregnancyDr. P. Samuels (1hr)
Prenatal
Diagnosis/GeneticsDr. B. Rink (1hr)
CRIS – Clinical Reasoning
and Integration Session
10:00
10:30
11:00
11:30
12:00
12:30
1:00 Anatomy lab
Female reproduction1:30
2:00
Clinical Skills
Demonstration and practice (CAPS)
(2:00 – 5:00)• Pelvic exam
• Breast exam
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• Outcomes:
– Significant challenge for students
• “Block seemed disorganized”
• Students struggled to identify important material
• Three questions per hour of lecture
– Significant challenge for faculty
Many issues specific to pilot
Curriculum goal: Reduce emphasis on lectures
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Curriculum goal: Provide interactive case-based
clinical correlates to emphasize clinical reasoning and
integration.
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Developed three Clinical Reasoning and Integration Sessions (CRIS)
1) Introductory lecture followed by quiz questions
2) Case-based approach following single individual throughout
reproductive lifespan
3) Students had to solve problems based around specific
physiological concept (oxygen delivery to fetus)
Utilized Turning Point Team Competitions
1. Students worked in existing TBL teams and competed
against classmates for fabulous prizes
2. No impact on grades
Curriculum goal: Provide interactive case-based
clinical correlates to emphasize clinical reasoning and
integration.
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Developed three Clinical Reasoning and Integration Sessions (CRIS)
1) Introductory lecture followed by quiz questions
2) Case-based approach following single individual throughout
reproductive lifespan
3) Students had to solve problems based around specific physiological
concept (oxygen delivery to fetus)
Utilized Turning Point Team Competitions
1. Students worked in existing TBL teams and competed
against classmates for fabulous prizes
2. No impact on grades
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Curriculum goal: Provide interactive case-based
clinical correlates to emphasize clinical reasoning and
integration.
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Outcomes:
1. CRIS Sessions were generally highly rated
2. Students wanted more questions during the sessions and
additional information before class to prepare
3. TPTC were relatively low-yield
Curriculum goal: Utilize several TBL sessions as part
of the block evaluation process.
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Approach
• Utilized three TBL sessions – one each week
• Traditional TBL format except that both the IRAT/GRAT and application
exercises were completed in one 90 minute session
Outcomes:
• Students enjoy TBL
• TBL during first week was challenging but effective
• TBL requires a minimum of 2 hours to effectively finish.
Other Curriculum Features
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• Exams
– USMLE Customized Assessment
– Faculty generated exam
• Clinical Skills Sessions
– Male GU
– Female GU
– Ultrasound
• Anatomy Sessions
– Male and female pelvic anatomy prosections
• Student-generated questions
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Part 1 Design Guidelines – How did we do?
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• Design learning resources around defined objectives
• Significantly reduce the standard lecture with a faculty
member and students in the lecture hall.
• Present (real time) turning-point sessions that have questions
covering the objectives.
• Utilize case based clinical correlates
• Utilize several TBL sessions as part of the block evaluation
process.
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Part 1 Design Guidelines – How did we do?
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Overall Evaluation
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2010 2011
Danforth Evaluation
LSI Pilot - How did the students do?
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• Overall class average = 87%
– Faculty exam = 82%
– NBME Customized Exam = 92%
– 2 failures
Summary
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Faculty/Block Leader challenges
• Designing cohesive block of IP/ISP approaches was difficult
• CRIS/TBL – good options for active learning but …
• Lecturers struggled
• Integration of knowledge and skills
Summary
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Student challenges
• Prioritizing from objectives vs lectures was challenging
• Multiple learning resources was confusing
Key Points and Implications for Implementation
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• Faculty change will be difficult
• Focus/limit learning resources
• Training and support for eLearning will be critical
• Standardization of content delivery may be important
• Integrating ISP and IP styles is challenging
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Bloom’s Taxonomy
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Explain the endocrinology of the male reproductive system and the physiological processes of testosterone
production and spermatogenesis
Learning Resources:
Rhoades and Bell (RB) Chapter 36
WebMic (WM) Study Unit 17 Male Reproductive Tract and Organs
Gartner and Hiatt, Textbook (H) pp. 481-510
Gartner and Hiatt, Atlas (G) Chapter 18
Second Life – Tour of the testis
Reproduction and Development Pilot Wiki – Male Reproduction/Endocrinology
Apseloff lecture – 3/2
Endocrine Regulation of Male Reproduction (RB 669-72)
Objectives:
1. List the important hormones of male reproduction and describe the functions of each. Describe the
intracellular signaling (second messenger) systems for Gonadotropin Releasing Hormone (GnRH,) the
gonadotropins, and testosterone.
2. Describe the regulation of luteinizing hormone (LH) and follicle stimulating hormone (FSH) secretion by
GnRH. Recognize that GnRH (and thus LH/FSH) secretion is pulsatile and that pulsatile GnRH secretion is
REQUIRED for physiological LH and FSH secretion.
CLINICAL CORRELATE – GnRH analogs are used clinically to control gonadotropin secretion. GnRH agonists are
engineered to bind to the GnRH receptors and stimulate LH/FSH secretion. They also have a very long half-life.
GnRH antagonists are designed to bind to the GnRH receptor but not stimulate gonadotropin secretion – they
compete with endogenous GnRH for GnRH receptors on the pituitary gonadotropes and thus inhibit LHG/FSH
secretion. QUESTION - What would be the long-term effects of GnRH agonist treatment on LH/FSH secretion?