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director
Director's Message: Medical Schools Learning Environments: May the Force Be With Us!
A forthcoming paper in Academic Medicine describes first year medical students' perceptions of their learning environment: 28 medical schools are participating in this longitudinal study sponsored by the AMA. The findings show that the specific campus where students were located accounted for more variance in the perceived learning environment than individual student characteristics. This included students' demographic attributes: gender, race/ethnicity, previous health experience, physician in the family, location growing up and marital status. It also included students' professional attributes: use of active and emotional coping strategies, tolerance for ambiguity, empathy and scores on a patient-practitioner orientation scale. School campuses had wide variability in the ratings of learning environment (see PDF) derived from the first year medical students.

 
 The AAMC also has a GME-focused initiative for optimizing the learning environment for learning, care and discovery. Their goal is to enhance our understanding of how people learn and care for themselves and others. It is the first step towards optimizing the environment for learning, care, and discovery.


The learning environment has a significant impact on learner well being as well as the development of characteristics commonly grouped together as professionalism. The learning environment can have supportive or deleterious effects on academic performance, such as USMLE Step 1. The stressfulness of medical school has become an expectation, and students are warned about the pace and volume of content they are expected to master. A recent study reported in JAMA, based on comics drawn by medical students, provides insights into how demoralizing and depersonalizing the experience can be for some students. Other sites are hosting comics drawn by medical students.

 
CHM adopted an annual student climate survey in 2006 in anticipation of the school expansion: doubling the class size to 200 students and the opening of the preclinical campus in Grand Rapids. The climate survey has allowed us to monitor the impact of the changes in CHM on students' experiences. The climate survey is currently being revised to provide a baseline prior to the implementation of the Shared Discovery Curriculum in August, and to align it with data collection efforts supported by the AAMC. The revised CHM version will include questions from the Medical School Learning Environment Survey currently used by the AMA study above as well as by the AAMC in their surveys of matriculating and second year medical students.

 
So what exactly is the learning environment? Learning environment refers to the diverse physical locations, contexts, and cultures in which students learn. The term also encompasses the culture of a school or class, the values of the organization as well as how individuals interact with one another. School policies, governance structures, and other features may also be considered elements of a learning environment.  The learning environment pervades the interaction of medical students, faculty, staff and curriculum; it provides context for interactions but also informs our interactions. Albeit on a smaller scale, the learning environment is not unlike the Force, described by Jedi Master Obi Wan Kenobi as that which gives a Jedi his power. It's an energy field; it surrounds us and penetrates us. It binds the galaxy together. It can be a tremendous source for good. Master Yoda observed that the Force can be negative and destructive. The dark side of the force feeds off emotions such as fear, anger, greed, pride, jealousy and hate. The learning environment is susceptible to the same temptations and emotions, and within that context, many of the same destructive consequences.
 
Brian Mavis, PhD 
Professor
Director, Office of Medical Education Research and Development
Director, CHM Learning Academy  
announcements
Announcements
- MSU Web Accessibility Policy  
MSU has updated its web accessibility Technical Guidelines to WCAG 2.0 AA. MSU departments and employees are asked to update their web pages, online course materials, and e-Texts used to conduct university business or academic activities to a minimum conformance level of AA.

CHM has numerous web pages that represent CHM, its departments, and units. In order to organize the CHM response to the university, and meet compliance, CHM is developing an inventory of sites and other pertinent information.
 
Geraud Plantegenest, B-CLR Manager in the CHM Office of Medical Education Research and Development (OMERAD) has been assigned as the college Web Accessibility Liaison and will be the lead person organizing the web accessibility policy compliance response to the university on behalf of all academic units within CHM with web-based media or digital content. In addition to gathering information from units, Mr. Plantegenest will work with the college leadership team, MSU IT Services and the university ADA coordinator to develop a five-year CHM response plan and to coordinate training and access to resources to help units understand what they will need to accomplish to achieve compliance.
 
For more information about MSU's web accessibility policy, visit  http://webaccess.msu.edu/. For questions about CHM's web accessibility compliance, please contact: Geraud Plantegenest at Geraud.Plantegenest@hc.msu.edu. 
 
bclr
B-CLR Featured Project: eLearning Psychiatry Mystery Module

The Department of Psychiatry at Michigan State University and the Blended Curricular Learning Resources group in OMERAD collaborated in the development of an online interactive patient-based learning module to increase and improve student knowledge on the diagnosis and management of adult psychiatric patients during their core Psychiatry clerkships. The module introduces students to Mary (a fictional psychiatric patient) and engages students along the way to assess Mary's conditions and to make informed decisions on her diagnosis and treatment. The mystery module is specifically designed to address the following key areas for student learning:

1) Be able to construct a comprehensive differential based on the patient's presenting psychiatric signs and symptoms;

2) Be able to differentiate between different organic, substance use, and psychiatric disorders with overlapping symptoms;

3) Be able to decide the most appropriate courses of action for the patient when confronted with comorbid conditions.

 Mary is interviewed after being
admitted to the ER  

The module integrates a variety of multimedia such as video
, images and animations, assessments with immediate feedback, and relevant links to curated online resources. The module is accessible online and can also be offered as a self-contained module downloadable to a computer for offline access, or to a mobile device. The module may be used individually, or in a small group setting with guided discussion by an instructor. 

Mary visits her outpatient psychiatrist for a follow-up interview after two months of alcohol detoxification 

The Psychiatry mystery module builds upon the framework of previous online modules developed and published thru the ADMSEP Clinical Simulation Initiative (CSI) and MedEdPORTAL. Data from previous CSI module evaluations points to the need for continuous innovation in eLearning module design and content delivery that incorporates shorter module duration, more board-style questions, motivational interviewing and integration of one or more psychiatric diseases in the same module, all of which this online module seeks to address in its design and delivery.

Mary's sends a note to her former psychiatrist about her current health state and shares what she has learned about her condition during her long journey to recovery 
 
Module evaluation: Currently, the research team is conducting an IRB-approved study with medical students in the core Psychiatry clerkships.
A number of pilot sessions have been scheduled with student volunteers from February thru June to evaluate the content quality and learning effectiveness of the interactive module. Students participating in the study are required to take a pre-test and post-test, fill out a module evaluation and participate in a brief focus group session with researchers. The module evaluation and group questions are focused on collecting information about the student's overall learning experience, module structure and usability, content, pace and navigation, length of module, multimedia use, integrated quizzes, and visual design.

Research Team:
Psychiatry: Brian Smith, MD, and Deb Wagenaar, DO, MS.
OMERAD: Geraud Plantegenest, MA
 
For more information about this study, or if you are interested in learning more about how to enhance and support your educational program and scholarship thru eLearning, please contact: Geraud Plantegenest at (Geraud.Plantegenest@hc.msu.edu).

resources
OMERAD Resources
An interactive gallery featuring examples of CHM blended and online learning projects by B-CLR.
 
Resources are arranged by topic, addressing issues common to educational scholarship, including definitions of scholarship, formulating resource questions, methodology and research design as well as dissemination via poster or publication. 
   
A medical education listserv maintained by OMERAD.
 
Peer-reviewed international open access journal for disseminating information on the education and training of physicians and other health care professionals.
 
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 (East Lansing) and 451 Secchia Center (Grand Rapids) from 1:30 pm to 3:00 pm. The purpose is to develop and support scholarship related to our educational program. Got an idea?  Need an inspiration?  Looking for collaborators? Join us! For questions about this group contact Dr. Brian Mavis:  mavis@msu.edu. 
 

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