Supporting Assessment: Optimizing evaluation and remediation strategies with Elsevier

Oh A Yeah, terrific. Hi, everyone.

Welcome. Today, we're gonna be talking about supporting assessment with Elsevier's Medical Education Portfolio.

Um My name is Catherine Johnson, director of Educational Strategy and academic Engagement here at uh Elsevier and I'm joined by my colleague Severin Lancia Severine.

Do you wanna introduce yourself? Yes.

Hello. Hello, everyone.

Um So I'm the assessment lead for global medical education product and we're happy to talk about assessment. So, very excited for this session.

Thanks, Catherine. We're joined also by Chantelle win from our marketing department.

So Chantelle is going to keep us up and running here during our 30 minutes together and just some quick housekeeping before we start.

So we've opened up chat so that you can build community. Sadly, we don't have cameras on.

So we're just going to imagine your smiling faces and nodding heads as we so we talk together today, but please feel free to use the chat for some community building.

If you have questions that you would like uh us to address Severin and I please drop them into the Q and A so that we can separate those out because sometimes the chat gets a little bit busy.

All right. Um So with that, we've introduced ourselves already.

Um So I'm just gonna dive right in today as any good educational activity. Has we have some objectives from today?

So we want this to be really useful. By the end of today, we'd like you to be able to explain how elsevier's global medical education resources can be used as part of any programmatic assessment in your program and to support student success and leave with one strategy that you can put into place to improve student success, particularly among at risk learners in your program.

There are many factors not news to any of you, right? Influencing the medical education landscape from human considerations like burnout impacts on faculty and on students, the urgent need for more clinicians to even systematic ones like the really continued rapid pace of change in medical information and technology.

And those certainly present both opportunities and challenges. And as new models of education take hold, we're really asked collectively to think differently about assessment, including what and why we are assessing beyond just the how.

So here we are then with some really big questions about assessment and the curriculum. Um what are we assessing?

How do we assess, what are we measuring and why? And one key here is for us to figure out what to measure and how to measure it.

Um As we're looking at competency based assessment in particular, which Severin and I spend a lot of time talking about um particularly because humans are making judgment calls, there's really increased potential for bias and subjectivity and assessment of competency.

And figuring out what that standard is really matters, thinking about feedback quality. Is it actionable?

Does the feedback from faculty help students understand and improve their performance? And are students aware of how to make that feedback actionable whether that's coming from you or coming from resources?

Like elsevier's a piece of the puzzle is also student engagement. We often hear from faculty that students who would most benefit don't always self direct to the most appropriate resources and sustaining them with assessment tools and a culture that's stimulates what um Doctor Kirka from Amsterdam uh calls autonomous motivation, which we'll talk more about is really an important consideration in assessment for learning and in students reaching the outcomes that we want them to reach.

Um Here is that beautiful uh beautiful chart from uh Doctor SARS research. So then there are also the larger existential questions about what it means to be an educator today.

Are we teachers? Are we guides?

Are we coaches? Are we a blend of all of these things?

Um And how do we then with all of those balls in the air manage faculty workload to avoid burnout? Because I, I'm also cognizant that we want to be really good m role models for professional identity development with these learners and lastly, but certainly not least is compensation models for how we're valuing teaching, especially in the United States.

So this brings us um into some places. One of those learning objectives was about at-risk learners.

There are lots of different intervention points with respect to assessment and remediation for learners who we know might be at risk.

So certainly that student's journey begins even ahead of the first day of medical school or pa school or, or any health professions program.

And we often know even at the time of admission, who would most benefit from additional support. So in the US, we're seeing more and more interesting materials to support prematriculation and orientation programs.

And the hope certainly is that we can arm students for success from day one with the knowledge, academic skills and resource connections that they need to thrive.

Uh The second box here is those early failures and oftentimes uh students fail or low pass on those first early exams and targeted interventions can really help these students to get back on track.

The the worst of these cases is the students who really need to be decelerated or repeat course exams over breaks to catch up with the curriculum and creating remediation plans certainly can be intensive for faculty and it can set students behind academically while also adding stress and eliminating that needed wellness break that students really have to take to be successful.

Um So ideally, we catch all of these students early through some form of programmatic assessment I, I'm going to turn the presentation over to Severine now and to keep driving this uh powerpoint deck.

Thanks. Thanks a lot, Catherine.

So to go back to the act risks, learners to know how they're doing. We need assessment and not just one big sum high stake assessment when it's too late to intervene, but more problematic, continuous low stakes assessment.

And we do love this quote from Vander Roten when he talked about programmatic assessment in 2012, abstract about programmatic assessment.

And he was saying a key principle is that individual data points are maximized for learning and feedback value. Whereas high decisions are based on the aggregation of of many data points.

So many data points instead of just one big data point as in summative examination. Another if we move to the next slide, another uh thing that is really important when we talk about assessment is student motivation.

If we really want to support students and learning, we need to focus on assessment that drives what we call autonomous motivation.

As opposed to control motivation, control motivation is driven by external pressure like an eye examination and it drives service and strategic learning at the expense of learning out of interest and learning for future practice, which in turn undermines student engagement and learning autonomous motivation.

On the other end drives self regulation, mastery learning interest in the topic. And a deeper learning approach, it increases competence, confidence and student motivation, which is what we're looking we're looking for.

So at, at Elvir, our intention is to provide assessment with care, making sure that our assessment features promote autonomous motivation, which as we've just seen is a key driver for deep learning and student psychological well wellbeing.

Um we know that testing still has some negative connotation, you know, for both students and faculty, especially because of the high emphasis on summative high stick exam that can be of course stressful for students and time consuming for faculty to manage and implement the issue with testing is that it is often viewed as a vehicle for for assessment and not a vehicle for for learning.

And research shows that even when faculty intend for assessment to produce learning, students are often focusing on giving a performance and not really focusing on learning.

This is why in our education products, we try to make sure that we have assessment embedded everywhere so that students almost forget that it's an assessment and start thinking about assessment as just one piece of the learning process.

So we have those six pillars in our assessment strategy that should be in any assessment strategy because they promote autonomous motivation, deep learning and psychological well wellbeing.

So I'm just gonna go through those six pillars. The first one is assessment embedded in self directed learning activities, what we might also call embedded active learning assessment.

So every time students are doing some learning, they should be able to take a few questions to test their understanding and consolidate what they've been learning.

We know that embedded active learning assessment drives increased skills, increased confidence and also increased personal motivation.

Another pillar, the second one is faculty driven assessment. Faculty should be testing students all the time assessment should be introduced as part of instruction.

For example, you know, weekly assessment uh as weekly opportunities for students to get feedback and also for faculty to see how students are doing against the weak uh learning, learning, objective self directed assessment is also key for any assessment strategy.

We know that autonomy in learning motivates students, students are more driven by personal motivation when they can create customize their own ques, when they can choose their own topic, when they can choose when they take those assessments.

And in all of that, the key is timely and detailed feedback. Feedback is the reason why we should be testing all the time.

It makes students aware of what they know what they don't know and what they need to study. It reinforces learning and it sustains as well as students motivation.

All of this should be done continuously seamlessly, continuous, continuous, low stakes drive students engagement, wellbeing, long term and deep learning, but also assessment should have authenticity with practice.

This is what motivates students because it provides them with a big picture. It fosters clinical skills, professionalism.

So here you know, the six pillars of our assessment strategy and here what it looks like Catherine. If we move to the next slide here, we have a view of our portfolio.

Uh Our learning tool osmosis includes embedded active learning assessment with flashcards and high quality U SE type Mc Qs tied to the learning videos.

Our clinical key student product provides formative assessment capabilities. Faculty can customize and build assessment and students can also create their own assessment to test at their own pace.

And our latest product clinical cases provides authentic form of assessment with interactive clinical cases. I'm gonna go through uh another view of uh those products very quickly.

And then Catherine, we move to a a live demo to show us what it looks like uh within those product. Um So let's start with osmosis.

Osmosis is a great learning tool that can support at risk students doing a great job, you know, at promoting what we've discussed, autonomous motivation with embedded active learning assessment.

Osmosis provides those engaging videos, uh white sport style animated videos. Uh Yes, yes, that's thanks for moving in the slide.

We've got a few animation here and all those videos come with aligned uem side questions and flash cards to enable students to test, apply and consolidate what they've been learning in the video.

So a great learning tool with the video and the related questions, osmosis also provides confidence and accuracy reports to track students progress.

So it provides those learning loops, promoting active self directed learning and in the end, deep long term learning, sustaining student motivation we have here in.

Yes, if we move to the next slide, Catherine, because I think here, yes, we have a concrete example of creating self directed learning loops uh with osmosis um with, you know, identification, self assessment to identify learning needs.

And then students can identify the gaps they have in their knowledge or in their understanding and then we can create all of them or they can create their own learning plans and then learn review relevant information to close those learning gaps.

So this is osmosis complete learning loops. And then we have clinical students with clinical key student.

Faculty can customize and build customized assessment. Uh They can create individual questions.

We have a bag of about 5000 questions. So faculty can create their own quizzes.

Um And for each of those quiz, they get detailed feedback so they can see how students are doing on those assessment, they can see who is struggling, they can see what topic students are struggling with.

They get very specific uh specific analytics for this. Um And on top of all the formative question that faculty get to build those weekly or you know, four formative assessment, we will be soon providing prebuilt mock exam to enable students to practice in a safe environment for um um step one.

So this is coming uh very soon. So faculty can be a customized assessment for the students and students can also create their self assessment, own assessment.

Um and same students create their assessment, they get very detailed feedback with very detailed explanation, learning point.

And then we also give them studied recommendation and links to go back into book section from our textbook. So also to close that those gaps that they might have in knowledge or understanding.

Um So a great tool for formative assessment, both for faculty and students with detail feedback and a recommendation on where to go next.

And we have clinical cases, which is the last product joining the, the family. Um uh and, and, and, and, and clinical cases is about developing clinical reasoning.

Uh And I think Catherine, you might wanna say a few words about, about clinical cases. Um And if we have any question, we can also go back uh to, to, to that product.

But we're talking about more authentic assessment with authentic patient um scenarios um and same students, you know, can practice in a very safe uh environment um to develop clinical reasoning.

Yeah, thank you. And so as you've thanks Severin so much.

So as, as Severin uh just showed us, we, we really have this complementary resource of, of low stakes mids stakes and authentic assessments to create this package to really support you in the work that you're doing um in helping students uh become the clinicians that we want them uh that we want them to become.

So if we're ready. I'm gonna do a time check.

Oh Look, we're doing so well. We're gonna do a really high level demo.

Um If you're interested in learning more, please feel free to reach out to us, Chantelle. After this call, we'll, you'll, you'll get a probably a recording and a link for more information, but we're always happy to answer additional questions and if there's time.

Um and there are questions as we move through the demo, I can stop and answer them. So I'm going to begin here with osmosis.

Important to note that we have different flavors of osmosis for different products. So we have a USM um all us allopathic version.

We have an osteopathic version. We have an international medical education version right now.

Uh One's for nurse practitioners and pas and we also uh have a totally separate product for registered nurses. So if anyone here is teaching in prelicensure RN programs, please know that uh that there is a separate set of, of uh videos and assessment items for for that.

But today, just because we have a global audience, I'm really excited, I'm gonna show our medical education version. So you won't see um any, any USM le uh branded items.

So as Severin mentioned, I'm gonna use the example of hypertension today. Um We can search for videos.

So the example here would be students or faculty pointing uh pointing to a specific video, you see I searched here. So we can begin with the learning.

We're going to learn about hypertension and so we can watch this. Uh We can watch this video.

Um I'm not going to explain it, but what you'll see is that we can tick through. We have these gorgeous whitey white board style animated videos.

Each one has this transcript. So again, this is that first learning the beginning of that loop and these videos do have these um assessment items really built in.

I've taken these before. So I'm gonna press retake and just show you what these look like really friendly approachable interface.

Our intention here as Severin mentioned is autonomous motivation. We want this reward, we want it to not be scary.

So for those of you from the US, this does not look like the FRED interface, it's not timed. This is really a friendly engaging uh engaging interface.

All osmosis items are vignette style, multiple single best answer, multiple choice questions. So here we have if you're playing along from home, a 55 year old man brought to the ed with acute onset of diffuse headaches, blurry vision and nausea for a duration of two hours um has type two diabetes, hypertension and as a smoker um lung auscultation reveals bilateral crackles without wheezing, funduscopic exam reveals bilateral blurring of the optic disc margins.

The rest of the uh pe is within normal limits, which of the following is the most likely diagnosis. Well, I'm going with hypertensive emergency um which seems high.

But what you see here is we're rating our confidence as low, medium or high. And this is what we ask all the learners to do so that they could begin to know what they know and know what they don't know.

I rate my confidence is high and I love being right. We reward them.

You did it. It's correct.

Right. Excellent.

Positive reinforcement right there. If I thought that it was uh uh phenochromocytoma, I hope I said that right.

I can read about why each of these explanation is wrong. And we of course, provide a major takeaway and a more thorough explanation about hypertensive crises um in patients.

So that's um that's step one there with the osmosis uh question bank. And I did show you that preview of the analytics dashboard for uh schools that have osmosis and clinical key student for physicians.

We have what we're calling a synergies. Probably we need AAA different word for it, but it carries you through.

We wired this up to make it really easy for your learners and for you to navigate across products. So here we can go directly to this chapter in Robbins and Kumar on BP regulation.

So if I have watched this video and answer these questions and I want to learn more, I can click that link and you see I'm directed right here.

We're right in this section of the chapter to really immediately pick up that learning from uh from within this, within this section.

Beyond that, we can then uh hold on, we can then go to the home screen. And what you'll see with clinical key student is.

Well assessment is, is part of one of the stars of the show. Certainly the collection of curated textbook resources is another one.

So I'm logged in today as a student and you can see I have the books, images videos here. I'm gonna search again and show you what hypertension from this perspective that when I searched for key terms, search if they may not like me because I have Children.

There we go. Um That I can search results from saved books in my collection and that you'll see I get subsections.

I get a really nice uh quick access summary from various clinical advisor. Uh I also get related osmosis videos.

So we've wired this back to work the other direction, right? So there's that learning loop in action and so I can spin up quizzes this way as well.

Um I'm gonna go right there. So I'm logged in as a faculty again today.

So the interface looks slightly different. I'll toggle in a second and show you that student view.

But we have thousands of questions in the clinical key student bank that are distinct items from the ones and osmosis. So together you have many thousands of items that you can uh administer.

So I've already preseed for hypertension here and you see we have 244 items. Again, this is the faculty view, but you can go in perhaps you're interested in this, this second item here.

You can press view question details and you can see the entire item. This one is polycystic kidney disease.

Um You can see the p value which we display here for you based on um live student performance over um over the past I believe year, right?

So continuously updated uh here as well. And so you can preview what these items are.

Um And what the student experience would be for these items with the learning management system overlay that we offer with clinical key student.

It allows you to then assign these directly to students using your learning management system. So it's easy peasy for you to take students from self directed quizzing to the mid the more midstate version where you're assigning these items.

Um And as Severine mentioned and II wanna repeat, we have these items that are available for you and your students and coming shortly, a separate bank of mock exam for the students to do as a benchmark exam and a sequestered question bank for the USM le step one for you to be able to use those to assign items to your students that they have not seen on their own.

So I'm going to toggle my setting over and show you with our last few minutes together. What that student view looks like, so I'm gonna press home here.

All right. Um And I'm not sure that it did what I expected it to do.

Let me try that one more time. So once I toggle my setting properly and not have three windows open, it will take me to the student view, I'm going to submit it this time, which I did not do last time.

There we go. All right.

So now we're seeing the student view and across the top, you'll immediately notice we're leading with something really different, which is my progress.

So I'm logged into this particular environment as a allopathic students. So that's why I'm seeing progress against us MLA step one or I could toggle and look at my performance on us MLA step two items and we can see that I've answered seven of the 129 available repro items.

And that unfortunately, for me, I'm not doing terribly well here. You can see, I can get to the review books that I've saved to my account or any of the books that I've saved.

And I can from here create a test or continue an exam that I've already started. I'm gonna show you what that crea test looks like because this is the interface that is a little bit different.

And here I am at the learner able to create the exam. So obviously, we haven't given away the answer items, explanations in this uh version.

And from here again, osmosis being really low stakes and friendly. This being still friendly but mids stakes and more customizable.

Because here I can go into a study mode where I get that feedback as, as I'm learning or I can go into exam mode where I can queue up a few items.

I'm going to do cardiovascular system and you see I can change my physician task and I'm gonna go to diagnosis and I'm going to just you up five cause I wanna show you what this looks like.

And so now here I am in that scary Fred interface getting real practice, the beginning of some authentic assessment, authentic in terms of practicing for the USM le um versus the authentic physician practice that you would get with uh with the clinical cases.

So I'm gonna pause for a moment because I think there are questions. So, um Chantelle, yes, we have some questions in the Q and A and we have one in the chat about you with the Q and A.

Let's start with the Q and A. Um All right, I'll start at the top.

So it seems like a lot of the motivation is geared towards medical students. I'm wondering what your thoughts are on this application in terms of patient facing physician care.

Is this an area Sevier has uh look towards. So patient facing physician care.

Um So we have a separate, I'm gonna tag you Severin actually on this. We have uh two teams that we work with here at all severe and Severin and I sit in the global medical education team, not so much in the uh um in the clinical solution set.

But uh do you know anything about that or shall we follow up with doctor uh gli separately? I think we should follow up on this question of plan.

I think that makes sense. Um uh Motivation would work the same, right?

II II assume, you know, for continuous education, it would be the same mechanism, I assume. Uh But we can discuss a bit further.

Um That's a good question. It is a good question.

So, thank you for that. Yes.

And uh certainly something I'm really interested in as well as uh continuing medical education. Right?

What does it take for us to do hard things? Um So Doctor Tunick, thank you.

So for these self assessments and faculty driven assessments during learning, do the assessments need to be in the same M BM style as we use for the summative testing?

Um I would like us both to answer that question actually Severine. And um and I guess I'll start since I'm already talking.

I think it depends, right. If you're doing week, weekly quizzes or uh there's a school we work with uh a few schools that we work with that are doing weekly quizzing and they're doing it to catch those learners in real time and to also make sure that everybody in the cohort understands what's ha what, what they needed to understand the core takeaways before they moved on.

So, in those cases, I don't think it has to be in that really high stakes M BM style. I think it's ok for it to, to go through exams soft or, or whatever environment you want to use to administer those.

But if the goal is to prepare students to not feel anxiety on test day, that's the place where you want to give them the practice in that environment.

So I guess I would ask, it really depends on what you're, what you're, why you're assessing. Um What do you think Severine?

Yeah. And I think, you know, the most important thing is to take stuff out of your brain like, you know, retrieval practice.

So basically, whatever the format is, it, it should, it should work. Uh The only thing is that it like, you know, we know students love taking those questions you as so many type questions, right?

So they tend to be a little more engaged, you know, um taking those questions, but it hasn't, it doesn't have no, it doesn't have to be uh us so many side questions.

Uh We do provide this question because we know that that's super difficult and complex to write. Um But any retrieval practice, any, any form that helps you just stick, you know, things out of the brain is, is good after learning.

Um So Yes, great. There is another question.

Um Is there a way this is a severing question? I'll share my screen again.

Is there a way to filter questions by age group? For example, it is difficult to find pediatric questions on some topics.

So I'm gonna go back to clinical key student where you see my beautiful test results that I failed to show you um from my performance.

But if you go back to create a test, um let's go back to just create a test. So I think we do like go back, I think yes, if you go to step two, we've got it all.

So we've got it age. Yeah, look at that step two.

So we can do um Well, so childhood, adolescent adulthood, um I guess that's probably not super helpful for pediatrics if you're looking for neonatal versus toddler.

Um So uh doctor Dubas, if you have some specific age brackets that you'd love to see, please drop us a note in the chat and we'll uh we'll take that back to the development team as we think about how to even better improve.

I think she's curious about osmosis um as well as she put in the chat. Oh and osmosis as well.

So let's go there as well. OK, so let me exit out of this.

So I'm gonna show you quiz builder and I know we're over time. So if you have to drop, we're in the Q and A section, we'll keep going for a little while longer.

Uh But we will send this recording out. So with osmosis, there is also the ability to go to a quiz builder um for students and this is where they go.

So preclinical and clinical or you assembly step one step two, because you're asking about PD specifically, I'll go here um and we can go into subjects.

So I'm choosing pediatrics and from here, no, there is at present no way to sort by age range here. However, what I would suggest is uh we're in the process of writing out our, our brand new clinical sciences content for the pediatrics rotation.

Uh And when we do that, let's see if we framed it out yet. II imagine that we will have some.

There we go. So we have acutely ill, critically ill, well, child um as our organization here.

Um And so if there are some broken out uh videos here on specific um things like development, right? Uh development milestones for newborn and infants, the questions that go along with these videos are going to be on um developmental milestones um for, for that particular age rate.

So here we go. So we have these brand new three questions here that go with these early milestones.

So that would be a way to approximate that by using the videos uh as a as a way to group the questions together. All right, there is a question also which I um I'm not sure I can answer today.

The question is, do you have video cases and assessment tools for working with people who have aphasia, a speech language pathology?

Um And I do not know the answer to that. So we would love to circle back.

So again, feel free to send us a, a note directly uh um to the panelists and we will circle back with an answer to that.

Um Severin anything that comes to mind in clinical key student? No, no.

Yeah. Yeah, we'd have to circle back.

So thank you. Did I miss anything in the, is there a way up one more?

So is there a way to sort by prevalence of a disease? For example, heart disease, lung, breast and prostate cancer, diabetes versus less common diseases?

Um I think the answer is I'm going to answer that sort of uh right. I would say when we go to create a test from the faculty view and I know I'm not set up at the faculty view that you could use the search um applying your own lens about what the most prevalent conditions are.

I don't think we have a filter of show me questions that are only high yield. Hopefully all the questions are are appropriate for what students need to know um to, to be not only competent clinicians but to perform well uh well on the exam.

So that would be a place where I would say use your, use your expertise as a faculty member, Doctor Gregory and say right here we're gonna do uh exam on the most common pathologies for cardiopulmonary.

And here you go and spin up that quiz. Anything to add about that severing?

No, that's not. All right.

I think we have another question in the Q and A and we do have one more in the chat as well. All right, one more in the Q and A.

Let's go there. These are great questions everyone.

Thank you. Um Oh OK.

So, Leah, thank you so much. So, um we will um we will follow up with you uh directly about the speech pathology items and make, make sure that we capture that.

Mhm All right. Which one did I miss Chantelle?

Um from Donna. There's one right above the one from the oh, how often do we update our there?

It is, I'm looking right at how often do we update our information and how does this relate to boards? Boards may be behind by two years?

Uh The rub right, Donna, that um Doctor Doctor Smith, the, the rub of what you need to know to pass the boards versus what you need to know to be, to be a good doctor.

Uh I think the students are probably really happy that there's a little bit of a lag since uh sometimes it, you know, makes it easier to learn things.

You wouldn't wanna learn things as an M one and be sitting for step one as an M three and have, you know, the cheese be totally moved.

Um We have a for osmosis. I'll talk about specifically for osmosis.

We have a regular review scheduled for the videos. Uh We also are looking always at guideline changes and if there is a guideline change like a handful of years ago, right?

The, the colorectal cancer screening went from 50 to 45 in the US. So we went through and updated the videos when the CDC changed the guidelines around S TI we went in and it impacted quite a few videos as you might imagine.

And we went in and made those updates. So we are proactively doing that.

That's the benefit right of being digital first is that we can keep things um really, really pretty current um with respect to the uh the books on clinical key student, those item, those are updated as the books are published.

If there's AADA, we will release those, I believe severing as, as those as those updates come out as well. Um So we'll make the corrections to those digital um files for the questions since we're also talking about board prep, right?

Um I think the same thing goes right? If you see something, say something, I joke that I'm a recovery New Yorker and that was on the subways for years.

Uh But I think it goes for, you know, for anything met as Well, which is that if you see something, please let us know we are, um, uh, do our best to be really responsive uh as quickly as possible and we want to make sure our content is accurate and current and appropriate.

So, uh um, if you've spotted something, you see as a mistake or you think is out of date, please say something. If you wanna have a larger conversation around how you might do something differently.

Um I don't wanna speak for Severine, but I will always nerd out and indulge in those conversations uh about how something is taught because uh um yeah, you might have a better way and we, we'd like to hear it.

All right. Did I catch them all?

Chantelle? There is a question of how many resources or books are available.

I believe this was when you were in C KS uh Severine. OK.

So we have 1800 videos and osmosis and counting. And what about in C?

OK. So we've got in and we've got five, about 5000 new assembly, step one step two questions.

Uh We do have a lot of other questions. I don't have the specific numbers because we've got a lot uh the books, I don't know how many books we've got.

Uh But I think uh I feel like it's 100 and 80. It depends on where you are in the world if it sounds like we're being squirrely.

So there's different variations depending on the localization. Yeah, we do have local content for each, each country market, right?

So it's yeah, there is some variation. Um but please, yes, same.

We can answer offline, right? With specific numbers we can and if you're interested um Doctor Mohammed in, in a uh in a book list or a demo, we're happy to get on the phone and, and walk through.

So please, again, anyone is welcome to reach out to us and we can uh we can do a deeper dive into uh into the product. So um to really simplify it, I think that we want to cover the consensus curriculum of all the essential things with, with all of our, all of our products to make sure that we are arming students to be competent, confident uh caring clinicians and that, that is assessment as well as learning in conjunction with the really essential critical work that you all are doing as uh as educators.

So with that, thank you so much. I'm gonna stop sharing.

Thank you so much for joining us. Um Do we have uh any takeaways from you, Chantelle?

No, I think. Thank you so much um for posting this.

This is great. Um Yes, if we, if there are any other questions, feel free um to reach out, I will be sending out the presentation and the recording after the event wraps up.

Yeah. Wonderful.

Thank you, everyone. Have a wonderful day.

Thanks everyone. Bye-bye.

Bye.