Active Learning with Osmosis from Elsevier

Good morning. Good afternoon.

Good evening. Wherever you are across the globe.

I see we have people from Brazil, from the United States, from uh from Lebanon, um from Mexico. So good to see the UK.

So a very global audience. Thank you everyone for joining um this morning, I'm going to close the chat.

Um But please, as Chantelle said, introduce yourself. We would love to build community.

I know we don't have cameras on. Um My name is Catherine Johnson.

I am Director of Educational Strategy and academic engagement here at El Sevier and delighted to be with you today. Uh Audio is available in English in Spanish and in Portuguese on the bottom of your zoom, you should be able to choose which language you want using the interpretation button.

So please go ahead and do that. And now that we are two minutes after the hour, I'm going to go ahead and get started.

So we just did our welcome and our introductions here today, we'll be talking about active learning what it is and why it matters.

And I will introduce you also to osmosis as well as providing some practical strategies for how you can use active learning with osmosis in your program, like any good educational session, we have learning objectives here.

So by the end of this session, you will have a uh ability to define active and passive learning if you don't already and you will hopefully leave with at least one strategy for promoting active learning in your program using osmosis promo.

So to start at the beginning when we think about learning and our brains, the logic here is that we are all different. We have different genes which are the blueprint for how we are as humans.

When we're born, we immediately begin to diverge and we become more different over time. Um We have different families, different parents, different social uh circumstances, uh different communities and different education and life experiences.

All of these things together influence our knowledge, our attitudes and our skills and they also manifest in unique brain structures and neural networks.

Now, this is important because learning is really us actively making changes to our brains and our bodies are always in a constant state of change.

So to clarify learning is changes in our brain directed towards an outcome. Um Typically that one outcome that makes us adapt better to our work and to our life.

And in this case, the study of medicine. So our identity is in our work as uh clinicians, physicians, physician assistants.

This is why we write learning objectives so that when we are learning, we can focus our changes in, in a desirable uh direction.

So you can imagine that if we all start with completely different and unique brains, the changes that are required to move from a starting point to that desired endpoint um are different.

So we can't directly change our own brain. Uh Someone else's brain wiring, teaching and education is the practice of indirectly facilitating these changes in our learners.

And they happen more efficiently when learners are actively engaged with new information and new experiences. For example, asking questions that let a learner link the response to something uh that they already have.

So a framework and neural network or an uh or answering a question that reinforces a fact um or allowing learners to explain things in their own terms.

So that's for, for those knowledge, we'll talk more about uh that for skills and attitude changes, we need people to be trying things um uh or feeling some emotion, right?

So all of these different ways that we connect learning and make those uh those things sticky um in our neural network. So passive learning.

Um Well, let's actually talk about this. So uh um we'll talk about active and learning really specifically, I want to say that all of this um session today is rooted in a constructionist learning theory with the idea that students build knowledge frameworks and continue to build those.

So what is active learning? Active learning is an instructional method that actively engages students in the learning process, they have to be active, right?

Our our brains need to be changed. So this looks like asking things, responding to questions, trying something new and reflecting or getting feedback, passive learning.

On the other side assumes that everyone is the same that we are sponges that we will soak up uh what's right in front of us.

So we think of the word in English as consuming um right, Consuming a video, consuming uh a lecture or absorbing. So it's really about watching um when we do active learning, we make those experiences our own.

So the goal of active learning and all learning is to promote skill development and higher order thinking that we want to take people from novice to expert as we move them along.

Now, there is a um a pyramid version of this which some of you will have seen. Um And uh it's based on doctor master's uh um work on the pyramid of learning in medical education.

So we think of learning as a continuum. So the passive learning is attending a lecture or doing a reading um or some audio visual or watching demonstrations.

So that is the model of C one. Then we have the do one, right, which is participating in a discussion or practicing something.

Uh The other piece of active learning at that highest level is teaching others. So when we think in in clinical settings, see one do one teach one that is the evolution the continuum of this learning for students.

So it's not hard to understand why active learning is better than passive learning for brain change efficiency. But then we will ask, well, what, what type of active learning is best?

Is it problem based learning or team based learning? Is it asking questions or making concept maps?

Is it uh deliberate practice or experiential learning? The answer here is more uh more nuanced but active learning is always better than less active learning.

What is really the most important factor is instructional alignment? So how well did we connect uh what's already what students have already learned with what we're asking them to do?

So let me back up one slide for a minute. So uh we need to consider what, where are students on this continuum?

Is it their first day of medical school or have they been in medical school now? They're on rotations or are, are some, is someone an experienced clinician?

Right? We're all learning all the time and we also need to consider what it is that we're teaching.

Are we teaching something? Um are we helping students with knowledge or helping students develop a skill?

And where are they in that continuum? So for example, new learners, if someone doesn't have a lot of experience or knowledge, then we need to help them in the very beginning to build that mental model, that neural structure that can support more complexity later on.

So, uh in this case, a well structured curated information resource is a really great resource to build on. And then we consider providing active learning opportunities to help, to, to add on to those extra layers of that scaffold for a large group.

It's important to think about how we can break that into smaller groups to allow more participation. So in a lecture hall, we can do a parent share, we can take a moment and say, turn to our partner and I can say Chantelle.

Um and we can, we, we can talk about uh what's happening in lecture, we can ask questions before lecture to frame it, we can ask questions during the lecture up on a screen.

Um And again, use that parents share and we can ask questions again after we teach something, using polls are a really good way or today using the online chat, right?

So that's, that's a way to make a one to many much more interactive. We also want to encourage our learners to set their own learning goals.

And the goal of that is to improve students ability to do self directed learning SDL um As we move ahead too, also with these new learners, we think about peer to peer learning or the idea that all learning is social.

And so learners can be co producers of learning, uh they can be teaching and presenting to each other. That's a very active way even for new learners um and they can help us as educators with curation of teaching resources.

If learners have um more experiences, we can, we can draw on that. So we can ask them to present a case.

Uh We can also ask them to do some reflective writing or to make a video blog. When we think also about um in health professions, the most advanced level of active learning is learning from our own clinical practice.

So this happens in the hospital um in clerkships in supervised uh clinical training. So wherever we are in the world and what that looks like, and it can happen by trying different approaches to each unique patient situation.

So we are active learning when we know that we are going to see a patient with a particular disease or disorder the next day.

Uh and watching, watching that patient's uh disease or disorder or patient interaction unfold and learning from what happens.

So that allows us to create adaptive expertise. Um This table is a really great review that summarizes the evidence for some really specific tips again, based on learning science evidence.

So by now, many of you are probably familiar with things like the testing effect or space repetition and distributed practice and how useful they are.

But I wanted to point this out as a reference. So elaborative interrogation.

So talking about things out loud, has pretty moderate utility, um explaining things to yourself or to others again, um moderate utility practice, testing and distributed practice, meaning doing things over time.

Um It has a very high um evidence for learning and for stickiness. So as a starting point, using that practice based testing, the distributed practice uh or space repetition might be another way that you've heard of.

This is a really good way to make learning sticky. And we'll talk about that with osmosis because we have that built right into the platform um for you and for your learners.

Um So what works as we get ready to jump into a demonstration of osmosis? I wanna prime you all with some evidence based tips that you can believe in and that you can leverage in your own programs to support um learning uh and to support active learning.

So number one multimedia. So, so you pictures and words together have a synergy.

Uh There's lots of principles available for guidance, but we do this really well with osmosis and you will see that the way the images show up on the screen and the way the text and the voice happens is designed to make learning really sticky, the testing effect.

Um This uh testing and priming with questions works before we've even taught anything. It's similar to a learning objective, right?

It it sets out what it is that we need to pay attention to spaced repetition, um repeating things, especially when we combine that with testing with multiple choice questions, very helpful to make learning sticky, interleaving is the idea of mixing things together, not blocking, not doing cardio and then respiratory and then renal, but mixing those and blending them together.

Um topics is really difficult to do and it's difficult to persist that as a learner. Um So short term that makes it really difficult but long term, it makes it very sticky.

So in the United States, we have a lot of uh programs that have um longitudinal integrated clerkship so that you are in the same placement for a lot longer and integrating say medicine and pediatrics.

Um You see that students retain that information for longer. We talked about elaborative interrogation.

And the goal here is to connect to new knowledge with existing knowledge. So we explain things or we draw things um and lastly binding concrete examples with abstract concepts which we're going to do together right now.

We're going to give you some concrete examples from osmosis um to connect this to the abstract concepts that we just talked about.

So let me um switch over and we'll talk about osmosis and I'm gonna do a time check. I think I'm good.

All right, super so very high level for those who are uh not familiar with osmosis. And uh if you have questions after this and you want to learn more, I want to invite you to please reach out to us, we'll include some contact information um so that you can learn more.

So osmosis is a uh longitudinal curricular support tool. So it's designed to support learning wherever you are on your learning journey.

And the backbone of that is our whiteboard style animated videos. When you log in, you see it says welcome back.

Um I am in a anonymized demo environment so I can show you student data and talk about active learning. But what I want to point out here um in this version is that we have basic sciences and clinical sciences videos all grouped together here.

Uh So no matter how you want to find a piece of information, if you are teaching anatomy, if you are teaching pharmacology, you can find all of that content here.

If you are teaching by organ system, you can find all of the cardiovascular anatomy, physiology, histology, uh pathology is all here.

Uh in the US, we also have the USM LE step one review. So this is the North American version um for um uh um MD granting institutions for clerkships.

We also have the content here um as well and this is again at a higher level. So what we uh we are showing you what to do here in terms of managing content.

So let me give you a very specific example. I'm going to type in hypertension.

You see, I've used the American abbreviation for hypertension here, but we have three different levels of learning here.

So back to what we just talked about for, for active learning. If somebody has never heard of hypertension before.

They would want to start with this video that thris us. So what is hypertension?

Right? Um Hypertension is high BP.

Great. The next level of learning is our pathology review series.

These pathology review videos are longer, they include um patient presentations. So we can compare and contrast to different patients with primary hypertension, secondary hypertension or hypertensive emergencies.

So we assume with these pathology review videos that somebody has had some exposure and then we have our Clinical sciences videos um which are designed for management and work up of this.

So you're seeing hypertension in pregnancy or idiopathic intracranial hypertension. So these uh these are much more advanced levels of videos that are designed for learners who have already been exposed.

I'm going to click into this pathology review video and it might take a minute. There we go.

Um And just show you that the star of the show here is this video at the top. I'm going to mute it.

Um But I'm just gonna play for a second and from the very beginning. So what you're seeing here is the patient presentations that I mentioned there's always a transcript.

So if you want to read something, uh you can read, we also have captions. I am going to turn Spanish captions on.

So for our friends in Laam here who are Spanish speaking, we have Spanish captions for all of our videos in osmosis. If you wanted to use these in class.

So I'll give you a practical active learning strategy. Here.

In real time, we had a program was doing a large group lecture, 100s of students in, in the lecture hall and on Zoom, they played this section with the patient cases and then they stopped it and they did parent share and they did breakout rooms.

Um so that students could talk about. What do you think this is?

What kind of hypertension do you think Alicia has? Um Right.

Is it, is it primary, is it secondary? And then they came back to this video at the end playing it in class um and watched the end of this video together where we talked about that.

What what was happening with these two patients? What was happening with Anthony?

What was happening with Alicia and how do we manage it? So this is a very good way for active learning in a large group setting.

We can also have students who are on rotations who maybe don't remember anything that they need to remember about hypertension.

They can come and watch these videos before they see a patient in the hospital setting or in the clinic. Another really good way to promote active learning.

So we talked about is testing. So all of our videos and osmosis have corresponding assessment items that are vignette based and we use confidence and accuracy for these.

So we can uh I'm not going to read this this whole question. Um But we are going to ask students to select their accuracy.

So what do they think this is? And to rate their confidence as low, medium or high?

I feel like I don't know this. So I'm glad I said low confidence because I was wrong.

I made a mistake here. There will always be an explanation for the incorrect answer option and a full discussion of each item, all of this will show up on a dashboard.

So let me just show you um what that dashboard looks like. So I'm gonna get out of this question, this uh question here before I move to dashboard, I wanna say it's very easy for students to find videos and to save them, they can create a playlist for themselves by creating a new playlist or you as a faculty can share a single video or, or make your own playlist.

Your own collection of videos sharing is as easy as copying the link and putting it in your learning management system, canvas, blackboard, mood, whatever you're using um or even emailing a link.

So if one of my classmates has a question, I can share this video, we can do that peer learning, that social learning um or if I am studying late at night and I have a question, uh I can go to office hours with my faculty member.

So if you find that you have students who are all asking you the same question. Rather than answering that question 30 times, you can send a video that answers that question.

So let me show you the admin analytics. So when a university purchases osmosis, uh you are able to have analytics.

So we are looking at real analytics data from a university, we can see um how often students are logging in? Are they watching videos?

Are they answering questions? But the very interesting thing is the ability to look at individual data student by student.

So I have a playlist here. You can see that the playlist has 12345 videos on it.

These are the videos and video by video, we can see what's happening. So um we see 110 students of this very big group of 180 100 and 10 of them have watched this video on blood components.

Uh We will always show you their first name, last name, how much of a video they watched, how many times they've watched it.

And what that most recent view is if there are questions that go along with them, we can also see performance student by student um or as a group.

So the whole group, all of the students here have watched um right. 100 and 10 have watched the video.

Um very few 3% of them have answered these questions, but the students who have answered them are answering them mostly, right?

So 67% accuracy, but uh their confidence is very high. So we are looking at the group performance.

So if you wanted to do just in time teaching, this is very helpful. And if you want to look at individual learners, we can see the student answered the question one wrong one, right?

Um with high confidence and they came back again uh and answered them a second time um until they got them all correct. So this analytics dashboard is a really handy place to have data around what your learners are doing and how well they are moving themselves from knowing what they know and knowing what they don't know um to getting things correct and supporting self directed learning um as well as having you have an ability to help them scaffold their learning and to be able to track what's happening.

All right, I'm going to pause here for a moment because I am at my five minute mark and I wanna make sure that we have time for questions, Chantelle.

Do we have many of these? Yes, we do have a question in the chat.

Um I'll go ahead and read it. Is it possible to use osmosis as a sole tool to cover a topic in a medical course?

Like should osmosis be used as a more of a compliment? Um or as a core material?

That's a great question. And if you've seen one medical school, you've seen one medical school, we have a wide variety of uses.

Uh, what I would say is there are times when, uh, it is a primer, there are times when it is a textbook replacement. Um, uh, certainly we cannot replace faculty, nor are we designed to do that?

Right. Your job is to help students put together concepts, disparate concepts, right?

If I could learn to be a doctor by watching videos and reading textbooks, I would have been a physician. uh many times over, I've been doing this for 30 years.

So I'm dangerous enough. But really, um we need you to help us with professional identity formation and to help us put those concepts together and to begin to care for patients.

So I would say the answer is yes and no. Um it is quite often used as primary content again to build on that learning.

So in a flipped classroom environment, you could ask the students to watch these videos on um you know, blood blood components and red blood cells and how does coagulation happen.

Um And then maybe they are going to watch this video on anatomy, clinical correlates of the heart so that we can understand what happens when something um when you get a blood blood clot in the heart.

So you can frame and prime that learning um with this and then the students can come to you and you can build on that learning in a really active way and help them move it into a more uh patient centered clinical approach.

So I hope that, I hope that answered that question, I did not say but we offer curricular alignment. So uh for programs that are considering purchasing osmosis or who are using osmosis, if you share your learning objectives with us and how you want to teach.

So if you say Catherine here are my objectives for this class and I want to flip the classroom or I want a supplement for reading.

Uh And you share that with us, we will give you some recommendations for how to get started a little more detail on that question.

Can osmos be used as a primary reference or a main uh bibliography for a medical course topic or should it be considered as a complementary resource to a main textbook?

Um I would say that this is pretty uh similar to what a textbook is, right? We have references just like textbooks have references.

Um You probably saw that in that hypertension video for customers who also uh subscribe to clinical key student um outside of the US or clinical key in the US.

We actually connect to those textbooks. So we've designed this to be synergistic, right that you can read or you can watch.

Um because there are times you want to watch multimedia multimodal learning does make it stickier. Uh And there are times we want to read, I know that not all students are very good readers.

Uh So oftentimes I will use an osmosis video first and I'll say just watch it, let it wash over you, right? Get it, create that neural network, create the structure, the foundation.

Uh and then you can come into your reading and you can be more efficient, then I can come to lecture, I can come to class and I have a model for understanding what we're going to be learning about that day.

And it, it is more efficient. Um It is not a replacement for primary literature for peer reviewed literature.

So again, like a textbook, textbooks are not primary literature, they, they reflect um uh an individual or group of individuals perspective on how to teach things, which is what makes them so great.

Uh We cover the consensus curriculum with osmosis. So we cover the majority of what every medical school um in the US and really across the world is teaching.

Um We cover the the majority of it but certainly not, not all of it. Got a question.

Does osmosis offer question banks for students? We do?

So as you saw each video has corresponding questions. If as a teacher, you want students to watch a video and answer the questions, we point them to this, we call it a learn page because we're here to learn about hypertension.

Uh The learners can also go to question banks themselves. So this is not able to be assigned.

Uh This is for students on their own. Again, I'm in the US version here.

Uh but we can, we can go in if I'm studying for the USM le step one, I can use this as a question bank. So I can say, ah, I really want to study um anatomy of the cardiovascular system.

So you see there are 23 questions and I can say, uh you know, here we go. I want these 10 questions and I can begin a quiz.

Um and all that is the way for me to work through. So yes, there is a question bank uh for the learners again, it's designed as a very low stakes self assessment of learning.

Um As students are using this from day one or another question. Does the osmosis platform carry basic and clinical resources?

Yes. So let me um I didn't click into the clinical resources, but I'm going to show you really quickly with our last few minutes here, our internal medicine.

Um I invite you no matter where you teach in the curriculum to check out these clerkship materials because we've broken these up into diagnosis, but also to clinical conditions, right?

We know we're teaching students about shortness of breath very early in the curriculum before they're seeing patients. Um So we have these videos even within uh within here that help me as a student understand what is shortness of breath, turn Spanish captions on um what is shortness of breath?

How do I think about this? How do I work a patient up and what you're going to see, I'm gonna slow it down now is that we take students into a beautiful algorithm to help them work this up.

So I'm gonna show you what that algorithm looks like. They can print these and put them in their pockets, you can use these in class.

So what we're learning here in this video with shortness of breath is how do I work up this patient? Are they stable?

Is it an emergency? Is the cause I know this is very small.

So let me make this a little bit bigger. Is this um is this cause respiratory right?

So is this pneumonia, is this chronic uh obstructive pulmonary disease? Is asthma?

Um is it cardiovascular? Are they having a heart attack?

Right? Um Is it metabolic?

So is it um a complication from diabetes? Uh is it a panic attack?

Right. So we've cast a very wide net here.

And so I think we do cover clinical conditions and we cover them in a variety of ways from uh from novice learners all the way to learners who maybe are pretty sure that they know what the disease is like.

Oh, I'm pretty sure this is hypertension. And so then these videos would be about how do I manage it.

We have kind of a follow up question to that. How does this align with clinical practice guidelines and current evidence um in the global guidelines.

It's a great question. So again, um you see here on the right hand side, evidence based guidelines.

So we have used us based guidelines, we have externalized these. So you can understand as a clinician, um what we're asking uh where we pulled this information.

So this is from this publicly available um guidelines from uh from a, a American Heart Association here. Um We've done that on purpose so that you don't have to just trust us that we are using the most uh the most recent guidelines.

In some cases, there are not us guidelines. Um And in those cases, we've gone to um say World Health Organization or appropriate guidelines.

So this is one of those places that we're hoping to localize over time. All right, we have one more question in here.

Thank you for sticking with us. We know we're over, we know we're over time here.

Yes. Um So, um if osmosis is used as a complementary resource, how can we deal with the possibility of discrepancies regarding diagnostic and treatment guidelines between the main course textbook and an osmosis video?

That is a great question. This is the million dollar question, right?

Uh It has always been a, it has always been a concern um even before osmosis, right? Uh So in 30 years of doing this, I think that's always been a question around.

Well, that's not what it says in first aid or that's not what it says in in cells um or that's not what my professor said.

And even um in, in working on content, if I bring um five cardiologists together, they are all going to give me slightly different versions of the same thing.

What, what I would say is, um, students are very sensitive, I think to when things don't agree, especially in those early stages, right?

They're not, they're, they're not as comfortable with things being um not black and white, but we know that medicine and patient care is, is gray.

Um This is a place I would say that as clinicians, as faculty, that we have a responsibility to guide our learners and to say that's a great question.

Let's look that up. So um we do try to keep things pretty aligned.

Um But uh we've made some decisions sometimes around, around how to approach something um or how to organize and scaffold that learning that may be different from how a textbook would do it or how you would do it in, in your class.

And in those cases, I would say, um directing students to particular places in videos or showing a snippet of a clip of a video in class um is, is a helpful way um to, to approach that.

So, not a black and white answer, but not a black and white question, right? OK.

All right. OK.

So I uh I appreciate everyone. Um Everyone joining today, we did go through all the questions.

Uh We'll probably share some version of this deck, but I wanted to point out these references and resources from the powerpoints here.

Um You're welcome to Screenshot this or as I said, we'll send it um which are really helpful uh around active learning. So, thank you so very much for joining Chantelle.

Do you want to bring us home? I hope this has been useful.

Yes. Thank you so much, Catherine for hosting.

Um We will share the presentation out with everybody via email after the event. Yeah.

Thank you for joining us. Appreciate everyone coming out.

Have a great day, everyone. Thank you.

Thank you.