You Tube: A Tour of Medical Simulators

Podcast: My teaching philosophy

For my podcast, I chose to record my teaching philosophy. I see this as a strategy educators can use to introduce themselves virtually to new learners. Reading an educator's philosophy via text is one thing...hearing them explain their philosophy in their own voice is a horse of a different color. I believe delivering my philosophy to my students in this format adds a personal touch.

(Note: The introduction references the tag line, "reflections of an educator and learner", from my comprehensive blog at www.elizabethmarlowe.wordpress.com. I intend to add personal reflection podcasts using this same introduction to my existing posts about my professional activities and pursuits.)

Podcast - test

My Jing-a-Ling

To access full-size presentation, click on the monitor icon in the lower right corner of the above presentation or click here.

# Le@rn!ng @ New L@ngu@ge # *sighs*

When did I become my parents?!?! When did I lose the capacity to expand with and embrace new technologies? When did frustration replace excitement when working with new online tools? If I had to pinpoint a time, I would estimate it was about the time I checked my newly-created Twitter for the third or fourth time.

What's with ALL THE SYMBOLS (e.g., @ and #)??? What's with the RANDOM STINGS OF LETTERS that follow http:// in links? What's with the random EXCHANGES between users? I find it all distracting. I find it all annoying. I don't like deciphering symbols. If I did, I would study Cuneiform, ok?

I thought the point of Twitter was to share thoughts in brief posts. I thought the art of tweeting was to condense your thoughts into bite-sized statements that would engage readers. I was wrong. It appears to me, from my brief experience, that Twitter is just a platform to direct people to websites through links and allow users to spy on conversations (replies) between users. I'm struggling to see the value and will try to have an open mind as I continue to use this tool.

My experiences with Google Reader

I set up my Google Reader account in hopes of streamlining my information consumption process. After our class discussion regarding RSS feeds, I realized I could save time by subscribing to feeds instead of navigating to each site of interest. I subscribed to feeds both professional (education-related) and personal (celebrity gossip-related). Below I outline some unforeseen benefits and pitfalls:

- I can quickly skip over duplicate information! Many of my "personal" feeds report on the same stories. I found the Google Reader format to be very helpful in allowing me to quickly scan headlines and skip over duplicates.

- I don't have to click down into deeper layers of sites. The Google Reader format does not require me to click on links to "read the entire entry" like the original website. This results in higher efficiency when skimming info!

- I miss the varied appearances of websites. The Google Reader format standardizes the format/appearance of text. In some cases, I found myself missing the varied "looks" of the individual websites. In particular, one of the blogs I follow in my "personal" category institutes a new masthead each month. The page headers are creative and visually stimulating. Using Google Reader, I miss seeing the masthead.

- I'm not distracted by ads. The Google Reader format eliminates the flashing ads from the margin. Many times, while viewing sites, I accidentally scroll over or inadvertently click on the stubborn ads that won't go away easily or provide countless pop-up windows. In the reader, I can avoid this hassle!

Social Bookmarking in medical education

A quick search of PubMed revealed 19 results relevant to social bookmarking and use of Web 2.0 tools in education. Of the 20 results:
- 12 came from the field of Nursing Education
- 2 came from the UK
- 2 came from Italy
- 1 came from US Anesthesiology
- 1 came from US Radiology
- 1 came from US Chemistry
I'm left to wonder...why is undergraduate medical education not represented in these results???

From noun to verb - the great and powerful Google

When you transition from being a noun to a verb, you've made it big. Congrats, Google.

Last night's discussion about Google and searching was supremely enlightening. I use Google consistently, constantly, and worst of all...unconsciously. Prior to the presentation last night, I had no idea how Google searches supplied returns. The realizations I discovered as a result of the class search activities left me dumbfounded and a bit embarrassed. I consider myself to be a somewhat educated and rational person. So, how could I blindly rely on on a search engine, naively rely on it's results, and never question how? I don't know, but that's where I found myself during and after last night's topic.

While the class discussed how Google worked, I actually googled Google. (The last part of that sentence makes me laugh...I verbed a noun.) I found this link detailing Google's PigeonRank to be a great supplement to the wikipedia entry on PageRank. So, I thought I would share.

I have a confession. I teach medical students how to search medical databases. I know how search results in PubMed are returned and how articles are indexed. I know how to effectively and efficiently search UpToDate, MDConsult, FirstConsult, and the Cochrane Library. The worst part of all...my class is called "Beyond Google" and I never had a good reason for why. I always approached the class with a "let's move beyond the familiar Google and use more complex search techniques to dig into reputable resources" and did so with a Star Trek theme, referencing the final frontier as being skilled in Evidence-Based Medicine and search techniques.

As I reflect on last night's discussion, particularly the part about the Deep Web, I may consider keeping the name of my class, but changing the theme. During next year's EBM class, the students may go on a deep sea diving adventure instead of a voyage to the final frontier. And, I may include a portion about exactly how Google searches work and how, as clinical practioners, they'll need to dive into the deep.

Who knows...maybe they'll be as surprised as I was to learn the actual mechanics of Google!

To blog, or not to blog (in medical education)

A quick search of the literature revealed only a handful of relevant articles which address blogging in medical education. This did not surprise me. Web 2.0 tools just recently entered into the realm of medical education and their implementation has been very recent; therefore, analyses of the effects of Web 2.0 tools in various medical education setting would be few.

As noted in my teaching philosophy, I believe in the powerful learning gained from self-reflection. Medical students constantly engage in non-reflective learning, particularly in courses where students learn the material through memorization and the instructors evaluate students solely on the recall of information. As we transform these courses, the addition of case-based learning tasks would encourage reflection, particularly if the students were working in small groups and the instructor built in time for reflection.
I also believe there are valuable opportunities for reflection during the clerkships where students benefit from hands-on learning with real patients as part of a medical team. After clinical encounters, students could reflect on not only the clinical skills employed, but also the interpersonal aspects of the interaction such as the team dynamics and process and how they treated the patient with integrity and respect.

However, I’m not convinced that blogs are the answer. I also believe in evidence-based education, so I thought I would look to the literature to see what effects others have observed after implementing blogs and other Web 2.0 tools.

Exhibit A

“The rising popularity of digital applications, such as social networking, media share sites, and blogging, has significantly affected how medical trainees interact with educators, colleagues, and the public. Despite the increased popularity and use of such applications amongst the current generation of trainees, medical educators have little evidence or guidance about preventing misuse and ensuring standards for professional conduct. As trainees become more technologically savvy, it is the responsibility of medical educators to familiarize themselves not only with the advantages of this technology but also with the potential negative effects of its misuse. Professionalism, appropriateness for public consumption, and individual or institutional representation in digital media content are just some of the salient issues that arise when considering the ramifications of trainees' digital behavior in the absence of established policies or education on risk. In this commentary the authors explore the rising use of digital media and its reflection of medical trainees' professionalism. To address possible issues related to professionalism in digital media, the authors hypothesize potential solutions, including exploring faculty familiarity with digital media and policy development, educating students on the potential risks of misuse, and modeling professionalism in this new digital age.”

Farnan JM, Paro JA, Higa JT, Reddy ST, Humphrey HJ, Arora VM. Commentary: The relationship status of digital media and professionalism: it's complicated. Acad Med. 2009 Nov;84(11):1479-81.

Exhibit B

“PROGRAM DESCRIPTION: Students were asked to contribute two reflective postings to a class web log (blog) during their rotation. They were able to read each other's postings and leave feedback in a comment section. An instructor provided feedback on entries, aimed to stimulate further reflection. Students could choose anonymous names if desired.
PROGRAM EVALUATION: Ninety-one students wrote 177 posts. One-third of students left feedback comments. The majority of students enjoyed the activity and found the instructor's feedback helpful. Assessment of the posts revealed reflections on experience, heavily concerned with behavior and affect. A minority were not reflective. In some cases, the instructor's feedback stimulated additional reflection. Certain posts provided insight to the hidden curriculum.
DISCUSSION: We have discovered that blogs can promote reflection, uncover elements of the hidden curriculum, and provide opportunities to promote professional development.”

Chretien K, Goldman E, Faselis C. The reflective writing class blog: using technology to promote reflection and professional development. J Gen Intern Med. 2008 Dec;23(12):2066-70. Epub 2008 Oct 2.

Exhibit C

“If effectively deployed, wikis, blogs and podcasts could offer a way to enhance students', clinicians' and patients' learning experiences, and deepen levels of learners' engagement and collaboration within digital learning environments. Therefore, research should be conducted to determine the best ways to integrate these tools into existing e-Learning programmes for students, health professionals and patients, taking into account the different, but also overlapping, needs of these three audience classes and the opportunities of virtual collaboration between them. Of particular importance is research into novel integrative applications, to serve as the "glue" to bind the different forms of Web-based collaborationware synergistically in order to provide a coherent wholesome learning experience.”

Boulos MN, Maramba I, Wheeler S. Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education. BMC Med Educ. 2006 Aug 15;6:41.

After reviewing these pieces of evidence, I’m convinced that blogging can and should have a place in medical education. While there are certainly issues such as professionalism, HIPAA guidelines, and institutional representation that need attention, there are limitless opportunities to enhance learning. As noted, there is a need for more research. Maybe I'll encourage our course to implement the use of blogs for reflection and report findings...

Week 1 Reflection

When reading Michael Wesch’s 2009 article, From Knowledgable to Knowledge-able: Learning in New Media Environments, for ADLT 641, I recognized numerous relevant parallels to Eduard Lindeman’s 1926 work, The Meaning of Adult Education, which I was introduced to in ADLT 702.

Lindeman notes:
Many educators who have come to realize that most of their subject-matter disappears from the minds of students shortly after graduation fall back upon the consolation that at least students have been disciplined – they will know how to find knowledge even if they do not possess it.
Wesch notes:
As we increasingly move toward an environment of instant and infinite information, it becomes less important for students to know, memorize, or recall information, and more important for them to be able to find, sort, analyze, share, discuss, critique, and create information.
As evidenced by these two assertions, well-honed skills of a life-long learning remain relevant and necessary. In this case, Wesch builds upon Lindeman’s observations.

Lindeman notes:
Preoccupation with the content of education has so far overbalanced pedagogical thought that schoolmen now find their center of interest in curriculum-making: the process of transforming the school into a department-store bargain counter.
Wesch notes:
Usually our courses are arranged around “subjects.” Postman and Weingartner note that the notion of “subjects” has the unwelcome effect of teaching our students that “English is not History and History is not Science and Science is not Art . . . and a subject is something you ‘take’ and, when you have taken it, you have ‘had’ it.”
As evidenced by these two comments, content delivered by subject remains pervasive in education. In this case, Wesch echoes Lindeman’s sentiments.

Lindeman notes:
Authoritative teaching, examinations which preclude original thinking, rigid pedagogical formulae – all of these have no place in adult education. “Friends educating each other” says Yeaxlee…
Wesch notes:
For at the base of this “information revolution” are new ways of relating to one another, new forms of discourse, new ways of interacting, new kinds of groups, and new ways of sharing, trading, and collaborating.
As evidenced by these two notations, the hierarchical top-down transmission of content from expert to novice is not successful in adult education and a more successful strategy involving peer-to-peer discussion can be implemented with new technologies. In this case, Wesch offers an answer to Lindeman’s assertion.

Considering these works were composed/published more than 80 years apart, how far have we come?