Curricular integration of online learning resources
Good afternoon. Welcome to um week three of the osmosis webinars.
Today's topic is curricular integration of uh online learning resources. So, I'm joined by uh Amir Azam and Sean Tackett and I'm Catherine Johnson, uh Senior Director of Institutional engagement at osmosis.
Excellent. So today's agenda, um We'll do introductions.
Uh We're gonna base today's presentation on the six steps for curriculum development in medical education. Many of you have probably seen uh this book and then we're gonna talk about how to apply them to integrating online curricular resources into your curriculum.
Uh At the end, we will include some Q and A and hopefully have time for a pretty robust discussion as a reminder for participation guidelines.
Keep your mic from muted. I believe you've already been added as a muted participant.
Um Cameras are disabled unless you will be sharing. So um if you would like to share a story, raise your virtual hand and we'll call you uh when we get to that part of the show here to share your stories and we'll enable your cameras.
In the meantime, please post your questions to chat and uh my colleague Jack Kaufman will be moderating So, as I mentioned, today's presenters are Amina Zam, who's associate professor um at UCSF Berkeley and Sean Tackett, who is an assistant professor at Hopkins Bayview.
All right. So a little scenario for us as we get started, imagine that you're teaching a course to health profession students and you have a mix of traditional lectures and small group discussions and supplemental coursework.
Um So students have stopped coming to lectures or e lectures and they're only joining these small group discussions as attendance is required.
Um One of your key objectives is for students to become the lifelong learners. And you're not sure really how to do this or what resources to add.
You start researching um options and become aware of some e-learning technologies, but you're not sure how to apply them and added to that you are doing this largely alone.
Begs the question, how are you gonna administer this remotely? How are you going to evaluate whether this worked and how are you going to do this all in the context of COVID-19 or any sort of emergency that forces things to be remote?
So I think this is a really good framework for us to think about as we talk about curriculum development and online learning.
So with that, I'm gonna turn it over to Shawn, who's going to talk about a framework that can help us do exactly this. And uh you know, you saw this last slide, we started with two was that a mistake, the captain make a mistake.
Uh She, she did not, I mean, so clearly, uh these are kind of aligned with the six steps and so we'll proceed. Um But you know, the six steps for uh um a six step approach for curriculum development for medical education, uh it was uh actually developed at Bayview um by Dave Curran and, and some others.
And so now II teach in the course uh with Dave and Blenda. And so I'll kind of walk you through the six steps briefly and then we'll just, just for definitions, purposes and understand the logic behind it.
And then we'll um get into how each of the steps can apply to remote learning. So first, I think it's helpful to start on the same page with what is a curriculum.
There are we talk to 10 different people in education, you'll probably get 10 different answers. And so the definition that we use in the six step approach is that it is a planned educational experience, so planned, not unplanned, um educational, not some other kind of experience and that there has to be an experiential component to it.
Um So a curriculum in our mind is like, is not a book or a syllabus that, you know, curriculum is actually requires an experience.
And when we talk about curricula, we consider that, you know, clearly they can vary in their content and breath and depth.
Uh They can be five asynchronous or a mix. Uh It can be sort of one, you can apply the six steps to one session like today's session.
And we, we hope that we did, uh we, you know, you'll see that we, we've kind of done a needs assessment objectives, uh strategies, implementation evaluation, or there can be like very long um and encompassed complete programs like four year medical school programs.
Um Also to articulate the assumptions to underlie the six step approach which make it sort of unique to health professional education.
Um So, first, learning is everywhere, whether or not the goals are explicit. So again, we talked about the hidden curriculum which is unplanned.
Um And so there's learning that happens as part of the hidden curriculum. Uh and you may not like the learning that happens.
And so it's better if you kind of take, take control and, and plan things out. Um Health professionals, health professions, educators in particular have an obligation to meet the needs of patients and society.
Um And we need to be accountable for uh doing our jobs well. And then we think that being systematic in your approach to developing curricula, ensures that you actually meet that obligation to the patients in society and that you can influence health uh for, for better.
So these are the six steps. Uh we'll go, we'll go right through them.
So step 10 and you, we'll come back to this diagram. Um So step one is the one that really makes the model unique.
Um So this is termed problem identification journal, needs assessment and problem, I mean healthcare problem. So, and all of all educational interventions in healthcare setting should have influence health, how they do that can vary, but that's what they should be doing.
And so the in step one, we ask, so what is the healthcare problem that we're trying to address and what's the role of education in addressing the healthcare problem?
Uh So, for example, you know, there are a lot of people who talk about, we don't have enough health workers in the world.
Uh We need to train more doctors and, and maybe that's actually not the right solution for the health problems that exist when you look at, especially in developed countries where, um you know, maybe there's more of a public health intervention that needs to be taken to reducing obesity, to um to reduce it and all the comorbidities come with that in a sedentary lifestyle, um lack of sleep and so on.
So, and maybe we actually don't need more doctors, maybe we need more, more people taking care of themselves and not, and so they don't need doctors uh to prescribe the medications that um otherwise when the, when they had prescribed.
So, so for so step one, what's the healthcare problem? What's the role of education and then what's the gap between what's currently being done and what ideally should be done.
Step two gets into, you know, once you've identified that this is worth doing, how will you do it? Um And so this is, you know, who are the right people to teach to have an impact on the problem?
Uh What are their needs and preferences? Uh And then what's available in the environment in the learn so called learning environment that can support or impair your ability to effectively teach these folks.
And, and, and you, you know, when we're talking about remote environment that becomes especially complex because there's so many different environments, each learner and uh educator has their own environment and then there's a virtual environment.
And, you know, so those are things to consider as part of step two, right? Um So once you've gone through these sort of two needs assessment steps, then you are set up to have goals and objectives that are prioritized.
Um And that are feasible. So, uh and just to throw out 11 bit of terminology here, so in, in the six step approach, um goals are general and broad and there aren't really rules for how we write them.
Uh It's just the idea is to kind of identify the scope of the, of the curriculum and mainly identifying what you're not gonna teach.
Um Whereas objectives are what people usually think of when they think the learning objectives or learning outcomes and they are intended to be specific and measurable and kind of guide uh the curriculum along the way.
And so once you've taken uh great things often to write very well crafted objectives, then you're set up for what comes after.
And so strategies um come follow from your objectives. And um and when we say strategies, that's a very deliberate term and it, it includes both what you wanna teach.
So the content as well as how you're gonna teach it, which are, are the specific methods. Um Step five, technically in this framework is implementing.
So once you identify a strategy, implement them, uh and then this, this involves sort of harnessing the resources that you identified or, or available to you in the, in the targeted needs assessment and learning environment.
Um and then bring them to bear on the curriculum. And other special considerations about implementation are, you know, how will you administer the curriculum while it's actually happening that often takes extra resources?
Um And again, in particularly when we think about remote learning, you know, like it support, for example, like that's a key consideration during the implementation.
Step. Another, another element here is whether or not uh you can, you, you have the opportunity to pilot uh and try some things out before you on a friendly audience, we'll give you feedback and then scale up versus like you just have to put the whole thing out there um regardless.
So, and then again, conceptually, once you've implemented something, then you can evaluate it and So again, in our, our parlance um evaluation refers to both the assessment of individuals and evaluation of the program or curriculum.
Uh It also incorporates uh formative assessment so as assessment for learning um and summative assessment assessment of learning.
Um and then, you know, often we also recommend like qualitative and quantitative metrics as part of this process. Uh And I'm drastically simplifying what I step six just giving you a definition because uh the funny part about the six step approach is within step six, there are 10 tasks.
Um So we won't go there today and then, uh you know, this is a, a diagram that most people have probably seen. Um and just to point out some of these characteristics and why it's, it's uh quite a, quite an elegant thing.
Um So, you know, I've talked you through the six steps as though it's obvious and it goes one through six just like that.
Um uh You know, this diagram points out that it's even if after you go through the, the six steps, um it's all curriculum development and cyclical in nature.
So, um you know, one thing that, that, that means that's a good thing I think is that there's no such thing as a perfect curriculum.
And so everything is slightly imperfect and everything is like on the road to getting better. Um There's all these other crazy arrows as part of the diagram and that indicates that every step it has an impact on every other step.
And so you really can't think of one without thinking of all the rest, even though II tried to make it simple for you. Um And then at the top is step one.
And so that's intentional. So, you know, again, all cur development should be oriented to health needs and not what I want uh to teach or what even what learners want to learn necessarily.
It's more about what, what are the needs of uh what are the broader needs? So I said it's cyclical, it's really nonlinear process and remains oriented healthy.
All right. So now moving on to how does this work for online resources?
Again, we're gonna go pretty quickly through this and just give you some examples and then, you know, hope to hear kind of how you adapt uh adapted to fully online, assuming that probably all of you are doing that or, and, and had to adapt.
So, um I'll start with step one and we'll kind of pass it around to Katherine and the mean as we go. So, yeah, beginning with the healthcare problem.
Uh you know, all these courses that were, they existed before COVID. Um you know, they, they presumably had a logic to them.
They, they presumably should have existed just the way that they were. Um And so to take, take that first step and just pause and say, well, what, what, what were the health care problems that the curriculum existed to address, um you know, we were teaching medical students or nurses or pharmacists or whomever like we teaching this, teaching them this because we had to.
Um and so, you know, to, to pause and make sure that that remains in focus and also considering, you know, the way we were teaching it before, um was that the ideal way to have an impact on their learning and non health care?
Um Maybe it wasn't and, and maybe actually this, this thing is creating new opportunities for you. Um You know, and so just some examples of things you might have been teaching you the, the role, what you were teaching might have had it in uh improving health is, you know, providing AAA solid knowledge foundation for learners who are gonna get out and, and practice.
Um you know, a lot of small group discussions and like problem based learning. They, they talk about developing communication and teamwork skills and you know, how, how can you, if that was the, the health issue that you were trying to address, then, you know, how can you make sure that that continues to be addressed in an online environment?
And then there are other like other things out there like health system, science and just all all kinds of myriad um uh goals you may have had with your curriculum that had a legitimate reason for being.
Um and, and um I improving your learner's ability to impact health. So now I'll go to a mean and also allow him to introduce himself in the mean.
But do you want me to keep clicking or do you want me to give you the mouse too? No, you keep clicking when I say next slide.
Thanks Sean. So next.
So um so here before we move in directly in a step to a couple of global comments. First of all, my name is Amin Azam.
I'm a faculty member at UCSF from the School of Medicine and a couple of other Bay Area Health Science Universities. Um And I wanted to acknowledge, I am thrilled that we're using this framework for curriculum development because in some ways, II like in this book to like a, a holy book um depending upon your sort of uh your prefer.
Uh uh because it really is a tremendously useful guide for curriculum development across all health professions and across the levels of learners and whatnot.
Um We have used it at UCSF uh regularly in training our faculty around curriculum development and um and I had forgotten.
Uh but when Shawn reminded us of the iterative of nature of curriculum development and how the cycle repeats when you get back up to six from 6 to 1, um I'm reminded that we used to say uh that the Golden Gate Bridge has never done being painted because you, when you, you start at one end and you work your way all the way through.
And when you get to the other end, you've got to start again to continuously iterate. And so I think no curriculum, no school is worth its name if you're not continuously improving your curriculum, and this framework gives you a wonderful framework to do that.
So having said that now move on to step two. So, um so we're thinking about your targeted needs assessment.
So this individual faculty member at at uh uh has done a local needs assessment and realized that his local second year nursing students need to learn the physiology of breathing.
So with that needs assessment in place, he's now starting to say, well, how do I assess online resources? Uh Next slide Shan um you can see you would want to be asking yourself specifically, are there online resources for this specific challenge?
And when you think about online resources, there's a framework we wanna add here which is on the y axis uh from low to high, there's the degree of implementation difficulty, you know, so it could be easy to implement some online resources that can be much harder to implement others.
And on the X axis there, you have the amount of integration within your formal curriculum. And so that could also be low integration or high.
You can think of all sorts of examples here. We won't bog down in examples here because we wanna hear your thoughts and examples when we get to the discussion uh Q and A portion.
But the key point on this slide is just to really choose deliberately because we are actually in an era where we have more online resources than we have time in our curricula.
So which is a great thing to be in. And that means that you have to choose very carefully about what resources to use.
Um uh I think I'm turning it over to step three to Catherine. Excellent.
Thank you. So that's a nice segue.
So step three again is about setting goals and objectives and asking w what do we want our curriculum uh to achieve? So, uh goals could be cognitive, they could be um attitude based or skill based.
Um But the important thing to remember is that the goals and objectives are really helping to determine uh the curricular content and the learning methods that ultimately inform our evaluation at the end.
Um So in thinking about online resources, um one goal might be improving student self directed learning skills. So at the end of this course, you know, what will my students be able to do?
Um So I'm gonna follow that example so broadly, if it's improving self directed learning skills and identifying there are learning gaps.
If I were going to use osmosis to meet that goal, it would be um using osmosis as a vehicle to provide learners, flash cards, multiple choice questions and videos so that they can begin to do that self directed uh online learning.
Um So you could apply that to any online resource, right? Just making sure that those meet up with your um with your goals, which is a really good segue to step four, which is about strategies.
So um in thinking about these online resources, um not only do we need to consider them with go goals and objectives, but they are in some ways a strategy.
So following that same example, um what is the strategy? I'm going to ask my students to review X amount of videos and complete those assessment items and reflect on what they learned.
Uh But we should be asking that question about anything. Does this resource and the strategy serve our serve our need?
I think I'm up for step five. So, so uh implementation.
So here's where the actual curriculum gets delivered. Uh And so in this example, here, um this educator has decided to pilot a specific online resource with current students to see if it works in the current context.
So when you're thinking about whatever those online resources are uh next image, um A again, you wanna ask yourself carefully, does my institution have the mechanism to successfully engage with this specific tool or resource?
So, you know, online youtube videos are great because they're free and they're easy to link out to. Um But um if you think about other kinds of resources, there may be some institutional uh hurdles or uh specific context that you need to think of in the context of your courses or your programs or school.
Next slide. So once again, if we come back to that sort of implementation versus integration, sort of table, next image, think carefully about what you might want to uh integrate or innovate.
Uh And so these are three question marks at three different places of this field. Um And you all know your local context about what your bandwidth is, both your individual bandwidth, either as an individual faculty member or as a course director or as a program director or as a curriculum director.
Uh But you also know the context of your teams. So, you know, do you have the institutional resources?
Uh the it support, do your students have the capacity to use and engage these online resources? So you wanna this framework helps you think carefully about what do I want to launch now?
And that segues into step six, which I think Shawn takes over. Yeah.
So step six, as I mentioned, it's about assessment and evaluation and you know, again, online um when you think about how do we assess learning?
Um I think that's it, you know, there are common common issues with online. So like assessing learning program evaluation, I think in this particular circumstance if you had to position rapidly to online, II think, you know, it's, it'd be worth evaluating what might have been unexpected uh versus what went expect what was expected.
And then the key question I think all of us should be asking ourselves is, you know, all these changes that we made, which of those should we sustain?
And so here, you know, um so to be specific about certain types of resources that are out there because they are actually a ton of online resources for assessment and evaluation.
Um So performative assessment, the examples would be like flash cards, multiple choice questions. Uh these dashboards analytics that are provided by lots of different um products.
The Summit of Assessment uh gets a little more tricky because there are consequences tied to those. And um so there have been a bunch of discussions I've seen on, on the doctor Lister about how do we do this.
Um And the NBA I think is trying to figure out how to do this too uh for shelf exams. And um you know, so the idea of sort of a remote proctoring option.
And so there are, there are fancy versions of that that are, I guess more expensive that you can purchase. Um and then there are sort of low fi options, so to speak, uh where, you know, you just have everybody sitting on a zoom chat and you just watch them and then, you know, hope that they're not chatting with their friends or texting on their phone.
Um Some people uh suggest that if you ask a student to uh sign a uh an honor code saying they won't cheat that, that makes them less likely to cheat, who knows if that's true or not.
Um, so that's, you know, sort of the, the cognitive exams, I mean, and then there are other resources out there, like the for, for clinical skills and for us and there are other, other ways to do um, both formative and summative um assessment of skills.
Um And in terms of evaluation, you know, evaluation methods don't really change that much when you go online. Um Because you can still do program course evaluations through surveys, uh which is probably the most common way of doing it.
You can still have discussion synchronously with different students and so on. Um And so, um so that's usually not quite as inhibited.
II feel like again, the special considerations when it comes to evaluation would be um what, what, what, what um what should we be doing?
What should we keep doing in our program beyond like this crisis? Um And then I think, you know, not to lose track of the fact that we need to learn from this experience as much as we possibly can.
And uh and so that involves looking for opportunities to disseminate whatever we're doing, especially if it's working. Um And if it's not working, disseminated too uh to, to say why it's not working.
So other people don't make the same mistakes. Um and, and to engage in, in tru truly deliberate scholarship um Then again, it is gonna be mo most useful to, to others in, in the community.
So I think that's what I wanted to say there. And then I think now we go back to Catherine to Maus and Sean is raising, I mean, is raising his hand.
That's pretty funny that you mix the two of us, us, Catherine, we'll laugh about that. Um I did wanna make a couple of points um just to be transparent with you all and then uh feel free to start putting your questions in the chat.
And Jack will moderate for us to sort of uh help sort of uh open up the dialogue for these Q and A. Um the, the three points I wanted to make.
Uh first was we wanted to make this webinar explicitly platform agnostic today. Um And so we wanna be transparent with you that that's why we chose to do that.
And II think the reason we explicitly felt that we wanted to go that route today was because online resources are often nonspecific to programs or institutions, right?
They're, they may be designed with specific learning objectives, but they, they may only be thinking globally about a target student audience but not the local context for each of you.
So, so we wanted to be deliberate about that in today's webinar. The other thing I wanted to say is just like Sean pointed out that last point there about scholarship and dissemination um we used this six step framework when we were designing this entire webinar series.
And so each of these webinars is an evaluation that we want to learn from you all about what worked and what didn't. And part of our goal there is to disseminate to the larger health professions, education community so that others can improve on the on the ground work we've done with this webinar and do a better job.
Uh Then, oh, well, we all build on each other's shoulders basically, like share the knowledge, share the understanding so we can all do that global needs assessment of what health care problem are we trying to address?
So those are some comments I wanted to make and then uh Jack, we're ready for you to guide us. Thanks.
I mean, we don't yet have any questions. So if you have a question, please uh add it in the chat or raise your hand and we'll be happy to have you ask it via audio and video while we're waiting for that.
I suppose, Catherine and Sean and I can just uh uh Catherine there is um Well, I think you had an idea of a potential hypothetical example.
We do have a hypothetical example that we can work through on the next uh next slide if you can get us there, Sean. All right.
So imagine this is a case. So we can continue to talk hypothetically um an unexpected uh public health emergency.
Uh completely upends our curriculum, right? We have no projected return date for normal students are displaced, faculty are displaced, but everyone has access to computers and Wi Fi.
So, um uh there's a, you know, there's an opportunity for e-learning. So the program had con had considered moving to online learning and introducing them before the current emergency.
But now that timeline has moved up and you are in charge of uh research and development. Uh So these six questions here uh line up pretty well with the uh the current items.
What is the health care problem? Who are the learners and needs?
And um we can begin to talk through um how, how we might approach these with uh with e learning. Although I see we now have five things in the chat.
So, yep, we have a few questions. The first uh comes from Colleen Chancellor who asks for case study development.
Is there a known website that has written incomplete patient case scenarios? So I think what we'll do is all three of us can just respond to that question.
Um So the Med ed portal is an online repository from the Association of American Medical Colleges that has cases in online resources that you can query that it has reasonably robust, sort of a search and filtering capacity to see whether the curricular materials might be useful in your local context.
Um And each of those repositories or each curricular um opportunity within the database or the repository declares the authors declare how you can use it.
So they have some specific creative commons licensing around uh whether you can use uh derivative work and how you must uh how you can and cannot use their materials.
So that would be the one that comes to mind immediately. Um I will add that from a commercial perspective.
There's um the med U aquifer cases which are um pretty highly used in uh clinical settings at a variety of schools. Um mcgraw Hill has the case files, collections of books, there's 21 of these available in print as well as online.
Um And back in the day when I was the editor many, many moons ago for these uh faculties to hide them in their desks to do case based education and use them um for case examples.
So uh perhaps using those as a as a basis for creating some other case studies. Yeah.
And I, and the only thing I would add is that um if, if it's the intention for this question is coming from like the need for uh students to learn it clinically um while they're, while they're not in the clinic that um the double AMC as a so called I Collaborative um which will, which has like it's a website they, where they, they're curating um all kinds of different things uh that, that, that um relate to clinical learning.
Jack. All right.
Thank you all so much. Next question is from Angus um uh Kreb and I apologize if I mispronounced, uh your name.
And the question is how do you relate the outcome based and or curricular driven education? So I think this question um is getting at sort of uh I correct me if I'm wrong.
But um there's been that longstanding within global uh at least health professionals education, medical education, narrowly like the core competencies.
And the US has the six A C GME core competencies. And uh the UK has the sort of tomorrow's doctor, I think in Canada has the Can meds framework.
So these are competency based frameworks for um what graduates can do when they graduate from medical school or training or from their residencies.
And there have been subsequent to that global movement, an epa or entrust professional uh um activities, subsequent movement.
That's uh less penetrant globally. But I know that it is um um making the rounds and being coming a part of medical education.
And so I think I like to think of those two as like a table that has just been turned sideways or as sort of frameshift.
Um There, we are still trying to achieve the same outcomes here. It's just do we define it based on activities that students do or do we define it based on a competency that they can demonstrate capacity to do?
So that's my initial reaction to that. I guess we'll just sequentially go, I mean, Catherine Shan, in that order just to keep us moving efficiently.
Catherine, I don't have anything to add, but I appreciate that you brought up uh the EPA S and the core EPA S for entering residency in, in the US.
Although they're certainly not um mandatory at this point. Yeah.
Um And then the role of, yes, so there's, there's always tension between um mission focused curricula and flexibility versus standardization and accreditation and so on.
And um and I think in this current state, like the accrediting bodies are being pretty or signaling flexibility. Um And actually what they are saying is, you know, we have standards that say all the schools need to have objectives and all the schools need to assess whether the students meet those objectives.
And so if as long as you're, that's, that's happening in your school, then you're good. Um And so, you know, I was thinking it kind of so, so II think that's maybe another other angle of answering that question.
Um I can also put a plug in. I saw at least one of the things we, we were hoping to try at, at a minimum and maybe do a whole lot of this having participants uh get on the video and speak to everybody else and um, you know, make you known to each other and have less of us answering questions uh that, you know, we, we know, we know what we know, right?
But um we don't know everything. So, um, so can I put a plug in to maybe go to the person who raised their hand and see if they wanna get on a video?
Agreed, Jack will promote you. So Jack, if you wanna sort of invite each, each question, ask her to become a Panelist and show us their faces and ask the question in their own voices, then we'll do our answering, but we'll follow Jack's lead.
Uh Yup. So I just invited uh Sylvia Wood to be a Panelist.
Sylvia. Would you like to share your question uh for the group?
There we go. Hi.
Um I was interested to know in, you know, your experience with a lot of online learning situations where you would recommend synchronous versus asynchronous uh presentation of content um in developing curriculum.
If you had any thoughts about that? Great question.
Um So I would come back to the framework and ask yourself what are your specific learning objectives that you're trying to achieve um for the session, right?
And then uh that helps you get a better sense for whether you wanna do synchronous activities or asynchronous. Um I also um there's a another two by two table of synchronous versus asynchrony and in person versus distance.
And you can put any educational strategy or activity into one of those four buckets and thinking again about what you're trying to achieve will help you decide the balancing act between synchronous, asynchronous in person and remote when we can do in person.
That is uh I guess we're gonna go to Catherine and then sure that that is an excellent question. And so in my 25 years of working with med students, um the first, my experience has been that the first time they're exposed to material, they prefer that that in many ways be be asynchronous, right?
They want the ability to pause and digest and make those connections on their own. Um But my opinion is the reason that we have health profession schools um is because we need to be modeling behaviors for them professional identity formation.
Um Those things certainly are, are much better done in real time and also to help scaffold learning and connect things that feel disconnected.
Um If we were able to learn on our own, um we wouldn't need schools. Um But we do need, we do need expert faculty to show us um how to put things together and what is important.
And again, another case where I think having that synchronous time, even if it's virtual uh is really important, Sean. Thank you.
Um Yeah, my answer is uh you know, we, I feel like one way to think about it is that um cognitive objectives like knowledge kind of lend themselves maybe better to asynchronous versus, you know, if you're looking for any kind of skill based objective and you almost always, you, well, you often need synchronous or certainly easier to do in a synchronous setting.
Um So, you know, so that's another way to think about is what, along with what it means that, you know, making sure it's congruent with the objectives.
I also wanna thank you, it's nice to like see the person who was asking the question uh on our side, you know, I hopefully the participants kind of feel that way.
And the, and the other thing, I'll, I'll so thanks for being uh brave enough to put yourself. Um And then the other other thing you know, to note is that uh again, it's, we, we appreciate the questions and hopefully our answers are gonna be useful.
Um But if, if any of you have tips to share, uh we're all years too. So, um if you, you know, if, if you've had a, if you've had a challenging or good experience adapting or with, with online learning, please feel free to, you know, raise your hand and, and share.
But uh yeah, before we let Sylvia go, can we ask you to introduce yourself and tell us where you are? And Oh, sure.
Um I'm faculty at Stony Brook University School of Nursing. I've done some online teaching prior to my tenure there and um and just learning my toolbox and this has really put us.
So we, we do have an online program, although this has really now put the whole program totally online. So we're all trying to um improve wherever, you know, we have been learning as we go like everybody else.
So, back to you, Jack, thanks Sylvia for introducing yourself for being on camera. Sure.
Thank you. Thanks Sylvia.
Uh The next question comes from uh Jackie and she's asked, we have an all digital curriculum, but I know our faculty tend to rely heavily on textbooks.
Any advice on how to encourage them to find a variety of resources to support different learning types. Um I will go first on, on this one.
I think the question probably gets down to entrust ability, right? Um I think that that for many of us things that are in writing textbooks, we feel like there is peer review to them, we feel like they're very reliable and um it, it may be difficult for people to reach beyond that.
But uh I think having those models of maybe asking a asking students and knowing um giving people access to more curated resources so that they are not picking things off of youtube um without knowing whether they can trust them is, is really the part of the question and many schools have fantastic, I don't know if there's librarians on this call, but many schools have really fantastic libraries with librarians who are excellent at curating print and digital resources and are very well informed and more than happy to partner with faculty to help them find other resources.
So uh I'm glad you went first, Catherine, you, you triggered some thoughts for me. Um uh the entire academic enterprise of RRI publish has historically been predicated on proximity to books, right?
So that's why libraries are in the center of university campuses, historically, but in the era we live in now that is irrelevant.
You don't need proximity to physical books, you need access to online information. So if you think about it, we we live in an era where we have now access to more information than all of our professors brains combined, right?
Therefore, we need to think about faculty as content curators, not content creators anymore. And so I think that um as we as we curate and as we use our content expertise to assess the quality of online resources and to decide whether those are worthy enough of exposing our students to them.
Shawn. Yeah, I think, right.
Um It's just hard to change old ways of doing things right back when you learn from the textbook is good enough for them.
It's good enough for people that are teaching. Uh I remember uh I'm, I guess old enough to, to say that I remember the skepticism uh with up to date whenever up to date first was coming out and coming popular and everybody's like, oh, I can't believe you need to go to the peer review, you go to the original literature and forget up to date and now everybody uses up to date and then there's like the gold standard for any kind of point of care learning.
Um And, you know, and so I think change, so one answer is just change is hard and it takes time. Um But, but also, you know, maybe um encouraging your faculty to be aware of like what the students are already using.
Um And then, and then reviewing it and you know, and, and kind of looking at like looking at it with skepticism. Um but understanding that there are plenty of good resources out there, um and that it's just more a matter of becoming familiar with them to the point that you trust them enough to, to use them in your teaching and, and sorry, one more thing I'll add um uh because change is hard.
One way to help motivate faculty to change is to encourage them, remind them why they're doing it in the first place, right?
You want to teach, you enjoy teaching, you feel fulfillment in teaching as you get older every year and your students stay the same age, um you need to remain relevant to your students lives.
And so the way to remain relevant is for you to grow as an educator to move past your textbooks, to stretch and grow into new things and platforms and domains that you didn't know existed before.
So osmosis is a great example because like, I love it because it's all so many different things combined, but none of us had ever had a product like this when we were learning.
So it's, it's not pigeonholed into one of those categories of test, prep or video resources or formative assessment or blah, blah, blah.
So we got to teach our faculty how to continuously be lifelong learners as educators. All right, the next question uh comes from Ian Mug and he has graciously agreed to ask it uh for the group uh or allowed to the group.
So I uh you should, let's see. I and whenever you're ready, feel free to ask your question.
OK, buddy. Whoa, I'm really in the dark now.
I'm like flushed out by the light. Sorry about that.
Um So I lost, let me pull the chat back up. So I have something to go by here from my question.
Um So we're not, we're definitely not moving to an online or a hybrid model. But one of the things that we're doing uh at Geisinger Commonwealth uh School of Medicine, Scranton Pennsylvania is we're looking at prioritizing our curriculum.
Um We would like the ability to be able to kind of flip a switch if we need to, to do hybrid learning to do online learning as necessary.
But one of the things that the benefits that we're finding is uh I use the term buts and seats. So we're limiting the buts and seats time uh of what we can do as far as de delivering the curriculum.
So, for example, we have um a case based learning courses. We have one in the first year and one in the second year we're looking at doing those online and we probably would have never thought about that before.
Um But being part of the Geisinger health system doing those online, gives us access to our doctors to lead cases from their offices as opposed to driving the hour from our main hospital to our school in order to lead the cases.
So I guess my question for the group then in my long winded way is um what are some strategies that the panel or anyone else in the in the call uh would use when prioritizing curriculum?
OK. So um I'll go first on that one.
Thanks for the question. Thanks for sharing and reminding us where you are.
Um My immediate answer when you talked about sort of uh remote synchronous faculty discussions, I think is what I think you're talking about um is uh from the UC Berkeley UCS of joint Medical Program where I have uh all, it's an all problem based learning curriculum and the faculty were in the classroom with small group students uh before COVID-19 and now it's all on Zoom.
And so absolutely, there's an opportunity here to decrease commute time to um still continue with synchronous distance, collaborative and small group learning.
So, but in terms of how you um fractionize that is the way I phrase that. I think this is where you wanna think about your global program objectives.
Uh And think about like what fraction of my curricular time is dedicated to topic ABC and what educational strategies should I use to address those learning objectives?
Right? And so, so that will give you a better sense.
I think of how do we, I mean, you said flip the switch, you know, move from buts and seats, but it's really a dimmer switch.
It's not an on off, it's really how do we transition or cross taper them. Those are my initial thoughts.
Uh Catherine next, um going back to the resourcing question as part of the, the six steps. Um I appreciate the, the saving on, on commute time and, and maybe in some ways that that increases the resources.
Um There's also the the factor of student time, right? Like how much active learning time are we asking such that they can balance those in person synchronous activities which are really so important with their own, um with their own self directed learning and that, that foundational knowledge time.
Um And really thinking about, you know, in that context, applying flipped classroom methodologies or some preparedness for the students in, in the way that, that the weekly curriculum is, is lined up.
Um, you know, whether that's through, through active online lectures or asynchronous work or, or independent work. So just things to think about balancing, balancing that time.
So students do show up prepared. Um I I've seen some um some research or some data that, that says that the more we do that um as not isolated courses but at a curricular level um that it's very easy for students to get overwhelmed and fall behind.
Um and they start to show up less prepared for those sessions. So just to think about as we move from instructional design to instructional systems design to bear in mind the time commitment for student learning.
Yeah. And so my, my purest answer would be yes, step one and step two, help you prioritize um you know, based on the local health care needs and then uh the resources you have at your disposal, you know, it's like it's one of the big issues is that it just takes students, it's a waste of time for students.
All these students have to drive uh that far to get to the school or to get to wherever they're going, right? And this is much more efficient in general to do as much online as you possibly can.
Then, I mean, there are models out there that kind of demonstrate that um you can do a lot online and almost everything um even in, in medical school and indefinitely in nonclinical settings.
Um So, for example, um you know, in Wisconsin, um Medical College of Wisconsin has different campuses and this is, I mean, there are actually numerous examples.
This is one of the most I've been there. But in Green Bay they've got AAA campus that's a three year accelerated curriculum and to try to produce generalists.
Um And it's, it's hooked in with the main campus in Milwaukee. And so they actually at their school there's just like a conference room where they do entirely remote synchronous sessions with the Milwaukee students.
Um you know, and they have a local group of faculty. Um but almost none of that really needs to be done in person, but they have created a space for it.
And then, and then of course, I mean, there are tons of online nursing programs. There is um at least one but probably more than one um online physician assistant program where they only come on site like twice a year to mainly to build community and get to know each other.
Um And then they all go home, which is like the first across the country across the United States. Um And then they even have a set up where they're able to do their clinical rotations close to home.
Um And without having to travel all the way to this is Yale, the program I'm talking about all the way to. So, yeah, so those are other, some other questions.
Great. Thank you so much Ian for asking that question.
Uh The next question is from uh re Rebecca Greenblatt and Sh uh she'll be asking this question via audio uh Rebecca the Floss.
Hello. Um My name is Rebecca Greenblatt.
I teach microbiology and immunology at Suny Upstate Medical University in Syracuse New York. And so far I have been spared having to do too much emergency planning for our current situation, but we're getting ready for the upcoming MS one year which begins in the middle of August and making contingency plans about what we'll do in case we are either pro prolonged blocks or just intermittently doing online learning.
So I wanted to tap some of uh your more experienced folks about how to do post test activity activities for discrete chunks of material as you go along.
You know, obviously we can do quizzes, they're secure, they're easy, we already have a bunch of them created. Um But they don't have a lot of value on top of the existing content that we would have in videos and uh problem solving sessions.
Um One idea I had was to ask students to create interactive presentations, but that's a lot of time in what else works. OK.
I'll, I'll nibble first. Um Thanks for the question and good luck with the the forthcoming changes.
My brain immediately went to both Shan's earlier comments as a assessment of learning versus for learning or formative or summative.
And what are we trying to achieve in pro quizzes for students? Right?
The goal there generally, the quizzes don't count for a lot or the goal is gonna be, how do we help our students assess their learning and determine that they're where they need to be.
They're making the milestones as we move through as we move through your course. So, you know, uh lots of question banks exist out there.
Osmosis has one that's one of many. But um I like to think about the Fantasy Future Day When we can move away from high stakes summit of exams to continuous formative assessment, we get to that place.
We know that our learners are achieving what they need to. Then we don't need those high stakes proctored remote exams because we could prove they could prove to us.
So look at how much they've learned. So I think the more formative assessment that you can create opportunities for them, the more the students will see that they're learning what they need to or where they need to be.
You might need to think carefully about what, what scale do you want to set? What percentage of correct questions are you thinking?
Uh Is the right thing for your level of learners in your local context in the context of your course. But that's where my brain went to to answer that.
Uh I think Catherine goes second. Sure.
Um And I'll be quick in the interest of time. Um There are a lot of uh there are a couple of programs that I know who uh who take some of those quiz items, uh especially our student performance has been um more strained and uses active uh active class time to walk through those items and help students break down.
Uh the the reason for why someone didn't perform, right? So if the value this gets back to, you know, what is, what is or one of the goals, if, if one of the goals is teaching students how to walk through board style items and modeling how to rule in and out different answer options, then doing that as a group um is essential.
I also know that the reason um uh one of the reasons the M BM E moved to including answer explanations with their items.
As you may recall, they used to only be questions and um and a score report is because students learn from the explanations and many times they will read through explanations um perhaps not even necessarily doing the the questions results.
Um So there is a lot of value add in walking students through the the why something is right and why, why something else is wrong?
OK. Yeah, I think I covered kind of what I would suggest to is that the tests are important, performing purposes, um feedback also extremely useful.
Um And uh you know, maybe maybe if students participated in their own questions, um writing, writing explanations and taking leadership of kind of the post test educational session would be another way to kind of engage them and make it more useful to them.
Mhm mhm. All right.
Thank you so much, Rebecca for asking that question. The next question comes from, hold on one moment.
Uh Margaret Maimone, and the question is the biggest barrier I had to overcome in my online teaching was technical finding a way to generate a whiteboard that I could write on during our live class discussions.
I can't draw it easily with a mouse or a trackpad. And I use Max, I ended up using an ipad and Stylus, but it wasn't ideal given the very small size of the screen, any other suggestions?
Um I literally bought white board paint for my house. The there was a wall in my kitchen that is the biggest wall where I could paint the white board paint on it and I have those expo markers at home so I can draw there.
The other short quick answer is uh one of the reasons why I think osmosis videos are so popular is because they've got that authentic whiteboard style.
And so decide what you need to teach and decide what online resources might also do the same teaching and then you can narrate or pause and discuss beyond those videos.
Catherine Gosh, I mean, I love that suggestion. I'm a huge fan of low tech, high tech.
Um So I, you know, I think that's brilliant. Maybe the answer isn't that we need to call academy style things in, in technological time.
Um So great suggestion. Yeah.
II, I'm, I'm really not into technology either. So, uh I mean, like I said, II, II, would I think you've heard the best advice already that does get to resourcing though, doesn't it, if we wanna um use our last three minutes to, to do a little wrap up?
Um You know, that that's the importance of the needs assessment, right. And, and is that really is the virtual chalkboard really essential?
Yep. I have a colleague who does very low fidelity simulations because the learning is higher when it's low fidelity rather than high fidelity.
Do mannequins need to throw up when you're teaching? CPR?
No, because that decreases learning. Um But go ahead, Catherine, I think you're right that we should transition to the wrap up.
So, uh if you have other questions, uh Sean, do you wanna take us to the next slide? Um So we hope you'll join us next week um which will actually be a very nice continuation, I think from the conversation we began today, which is what have we learned during COVID-19 and how can we sustain these innovations moving ahead?
Um uh So, Rebecca Greenblatt, I hope that you'll join us to talk about uh talk about that as you plan for see me up next year and everyone um and next slide um send us your questions if you had a question and we didn't address it um send an email to Catherine at osm.org and uh we'll get back to you.
Uh Also a plug that we do have a Listserve um that uh Amine Amine moderates and it is a, a group of uh the same people who are invited to these webinars.
So if you would like to be added and ask your question there, uh also send me an email and we'll make sure that you get added.
Please also keep an eye out for a uh post webinar survey which will come to you. Yeah, we would love there to be a high response rate of our evaluation of this webinar.
So we can scholarly disseminate and do that continuous iterative six step model Sean. I give you the last word, my good friend and colleague.
Oh, yeah, thank you. And thank especially thanks to those folks who, who got um uh who allow themselves to be seen.
Although I understand if you, if you, if you weren't in a position to, to be seen uh given that, you know, we're all kind of working at home in our in different uh clothes.
The funny one is the bears. I know you guys seen the bear seen bears versus uh Yogi bear versus um care bearers or something like that where different stages of, of change and working from home, the clothes that you wear anyway, look it up uh or but um but uh yeah, a big plug again to please fill out the evaluation.
Um You know, we hope to do more of these, want them to be maximally useful. Um And there'll be probably a version of this.
It will be converted to a workshop we'll have really after for this patient will be exercise based. So you can um you know, hopefully apply whatever you take away directly to your learning.
But again, please, please do the evaluation. Hopefully, let's do this better.
But thank you again, everyone for joining and uh we look forward to seeing you again. Stay well for more info, visit our medical educator page at osmosis.org/educators.
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