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Remember When Books Were Printed on Paper?

Most of us grew up thinking of books as weighty...tactile... substantial...particularly when it came to textbooks and reference books. In some disciplines, books have been a kind of academic currency. But times have changed, and while still valuable, e-books are a virtual medium that have changed publishing and are changing education too.

 

How can e-books change medical education? Here is a fine example that I want to highlight. The e-book Clinical Teaching Guidebook by Deirdre Bonnycastle (University of Saskatchewan) was published in July 2013. The audience for this e-book is clinical faculty and the purpose of this e-book is to provide answers to seven common questions about clinical teaching:

• How do medical students learn?
• What does the clerk/resident need to know?
• How do I prepare my office for students?
• How do I help with the learning process?
• What technology might help me/my students?
• How do I assess how much the clerk/resident has learned?
• How do I evaluate my skills as a preceptor?

Although the book was designed to be used as a resource in a flipped classroom setting, many faculty, residents and community preceptors will find the content useful for their own self-directed learning in this area. I am sure others will see it as a gateway to the many possibilities of e-books for education and professional development.

 

There is a chapter dedicated to each of the questions above and the author presents information relevant to teaching medical students and residents. Each chapter outlines specific learning objectives and aside from text, the e-book takes advantage of a wide range of digital media. Many chapters include including links to relevant video content available on the internet, slide shows, embedded movie clips showing teaching examples, a built-in glossary, questions for reflection as well as interactive quiz questions.  The eight chapters address many basic and practical preceptor topics such as giving feedback, how to conduct effective debriefing, learner assessment, digital professionalism, common medical thinking errors, the 5-Minute Preceptor and teaching the differential diagnosis process.

 

The e-book is free-of-charge and can be downloaded to your computer or iPad at:

https://itunes.apple.com/us/book/clinical-teaching-guidebook/id681319811?mt=11  

 

Brian Mavis, PhD
Associate Professor and Director
Office of Medical Education Research and Development
College of Human Medicine  

  

- New MedEdPORTAL resource: OSTEs: Teaching Scenarios for Chief Resident Professional Development

OSTEs have been used as a faculty development strategy since the 1990's. In our efforts to prepare clinician educators for their roles with learners (students, residents or junior faculty) we must go beyond traditionally styled workshops on teaching and learning principles and skills to a more developmental model using active learning strategies. Access this resource now @ MedEdPORTAL.
 

 

Geraud Plantegenest

B-CLR Manager

Office of Medical Education Research and Development
College of Human Medicine 
517-353-2037 ext. 237

plantege@msu.edu 

 

Are Students Ready for Meaningful Use Requirements of Electronic Health Records

 

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified electronic health records (EHR) technology and use it to achieve specified objectives.

 

These objectives or meaningful use (MU) of EHRs is being implemented in three stages. Key objectives of first stage include electronic analysis of data entered into structured fields, using decision-support tools (e.g., checking drug-drug interactions [DDI]) and electronic information exchange. With EHRs becoming a central part of health care, preparing medical students for their use is an important educational objective.

 

Screenshot of the prompts for student use in identifying the potential drug-drug interaction within theCentricity playground.

CHM faculty in the basic internal medicine clerkship developed an online training program and assessed students' performance on 10 different MU tasks based on the first stage of implementing HITECH standards. A total of 222 students participated in a pilot study assessing this program. They reviewed 15 online tutorials covering MU competencies and were assessed on their ability to provide appropriate documentation in the chart of a virtual patient using a fully functional training EMR. This included their ability to enter a new problem, a new medication, an advanced directive, smoking status, the results of screening tests and ability to assess a DDI in which a major interaction was probable, and communicating a plan for this interaction.

 

Approximately 31% of the students had at least one error in the assessment, and about 14% had more than one error and as many as 6. Students with MU errors tended to perform slightly worse than other students on their end of clerkship professionalism assessments and gateway clinical performance exam. Despite the fact the tasks were fairly straightforward and even with training a significant number of students make errors attempting to document appropriately in an EMR. This suggests that these important skills not only need to be taught but adequately assessed and when needed, perhaps remedial training for some students.

 

One hypothesis for these findings is that errors in completing these relatively straightforward EMR tasks may reflect students' lack of attention to detail or lack of conscientiousness rather than the difficulty of the tasks or lack of adequate training. While there was only some antidotal evidence supporting this assumption, a number of researchers at other institutions have studied conscientiousness as a trait in medical trainees. Based on scales assessing conscientiousness as measured by the extent students complete basic required tasks, these studies have found conscientiousness to be a stable trait and the lack of conscientiousness to be potentially related to serious problems in advanced medical training and practice. This is an area for future exploration.

 

The work above was recently published in Medical Education Online:  

Ferenchick GS, Solomon DJ Mohmand A, Towfiq B, Kavanaugh K, Warbasse L, Addison J, Chames F. Are students ready for meaningful use? Med Educ Online 2013, 18: 22495  http://dx.doi.org/10.3402/meo.v18i0.22495    

With this issue of VitalSigns we begin a series of articles highlighting items from CHM Educator, OMERAD's website collection of teaching resources.

 

Found in the Community Preceptors section of CHM Educator

 

S-FED is a model for providing effective feedback to learners during a clinical encounter. S stands for self-assessment, F for feedback, E for encouragement and D for direction. To see the entire resource, click here.   

 

SNAPPS is a learner-centered technique for organizing case presentations. S stands for summarize, N for narrow, A for analyze, P for probe, P for plan, and S for select. To see the entire resource, click here.

DiffInE is a tool for teaching learners how to approach the Differential diagnosis, Interview, and Exam. It was developed by CHM faculty Julie Phillips, Robin DeMuth and Dianne Wagner. The resource comprises a 6.5-minute video explaining how to use the tool, and the tool itself, a card summarizing the model. The video can be found here and the tool here.

 

The CHM Educator contains links to resources for community preceptors, campus instructors and course and clerkship directors. The web address for it is http://omerad.msu.edu/chmeducator. Suggestions for additions to CHM Educator are welcome at sleightd@msu.edu.   

 

B-CLR Showcase 

An interactive gallery featuring examples of CHM blended and online learning projects by B-CLR.

  

DR-ED 

A medical education listserv maintained by OMERAD.

 

Medical Education Online (MEO)  

Peer-reviewed international open access journal for disseminating information on the education and training of physicians and other health care professionals.

 

Vital Signs Newsletter Archive

Click on the link to view past issues of our newsletter.

 

Medical Education Scholarship Group

Meets first Wednesday of each month in room A116 East Fee Hall from 1:30 pm-3:00 pm.For questions about this group contact Dr. Brian Mavis:mavis@msu.edu

 

OMERAD Technology Center (OTC)  

Units within the College of Human Medicine interested in sponsoring faculty and/or staff development programs in support of education and scholarship may request use of the room.

 

The OTC is located in A211 East Fee Hall. For questions about the OTC contact:

John Williamson (wmsonj@msu.edu)