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PAIN WEEK 2002 PAIN WEEK 2002 WEBSITE PORTALWEBSITE PORTAL

My.library & PPT Repository

UofT PAIN WEEK DESIGN EXPERIMENT: Interprofessional Knowledge Building for Knowledge Translation

2002 2003 Undergrad CE/KTP

Students Experts

Prof. Leila Lax

Iterative Design ExperimentIterative Design Experiment

Pain Week 2002Pain Week 2002 (KF2 & WebCT)(KF2 & WebCT) Interprofessional student E-Learning modelInterprofessional student E-Learning model

Pain Week 2003Pain Week 2003 (Blackboard & (Blackboard & KF4KF4)) Scaled-up (70 to 560 students) & fully integratedScaled-up (70 to 560 students) & fully integrated Development of KB/KF model for Development of KB/KF model for

Continuing Education/Knowledge Continuing Education/Knowledge Translation (experts)Translation (experts)

Pain Week KB GoalsPain Week KB Goals To engage learners in discourse about To engage learners in discourse about

the most cutting edge knowledge of pain the most cutting edge knowledge of pain mechanisms, assessment & mechanisms, assessment & management.management.

To create opportunities to connect To create opportunities to connect discourses within and between discourses within and between communities opening new possibilities communities opening new possibilities for barrier-crossing in interprofessional for barrier-crossing in interprofessional education & collaborative KB.education & collaborative KB.

Knowledge Building Knowledge Building Theoretical FrameworkTheoretical Framework

““Learning is an internal, unobservable Learning is an internal, unobservable process that results in changes of belief, process that results in changes of belief, attitude or skill. Knowledge building by attitude or skill. Knowledge building by contrast, results in the creation or contrast, results in the creation or modification of public knowledge...The goal modification of public knowledge...The goal is to advance the frontiers of knowledge (as is to advance the frontiers of knowledge (as they are currently perceived).” they are currently perceived).”

(Scardamalia, M. & Bereiter, C. (2002). Knowledge Building. In (Scardamalia, M. & Bereiter, C. (2002). Knowledge Building. In Encyclopedia Encyclopedia of Education, Second Edition.of Education, Second Edition. New York: Macmillan Reference, USA.) New York: Macmillan Reference, USA.)

Redefining ExpertiseRedefining Expertise

Staged model (“end-state”)Staged model (“end-state”) Dreyfus & Dreyfus, 5 Steps from Novice to Dreyfus & Dreyfus, 5 Steps from Novice to

Expert & Schmidt, Norman & Boshuizen Expert & Schmidt, Norman & Boshuizen “illness to instance scripts”“illness to instance scripts”

Process model (“cognitive reinvestment”)Process model (“cognitive reinvestment”) Bereiter & Scardamalia, progressive problem Bereiter & Scardamalia, progressive problem

solving at increasing levels of complexitysolving at increasing levels of complexity

(Bereiter, C. & Scardamalia, M. (1993).(Bereiter, C. & Scardamalia, M. (1993). Surpassing Ourselves: An Inquiry Surpassing Ourselves: An Inquiryinto the Nature and Implications of Expertise. into the Nature and Implications of Expertise. Peru, Il: Open Court, USA)Peru, Il: Open Court, USA)

IPE Expert KB/KT Database

Multimedia& Virtual Patient

Unfolding Clinical Case Unfolding Clinical Case ScenariosScenarios

Standardized PatientsStandardized Patients Real PatientsReal Patients Future: Expert DemosFuture: Expert Demos Future: Participant VideoFuture: Participant Video

Building-on Diverse Ideas

INTU & A Better Theory

Optimizing & Improving Ideas

Providing Authoritative Resources

Creating High Level Summaries

Linking & Multi-Referencing

Reflecting

Integrating Learning & Knowledge Building

Supporting Evidence-based KB

Using Visuals for Deep Understanding

Working with Real Ideas, Real Problems

KF Database = Knowledge Objects Repository

Advance beyond knowledge tellingAdvance beyond knowledge telling

2002: student database2002: student database Shallow KB = knowledge sharing & Shallow KB = knowledge sharing &

idea exchangeidea exchange

2003: expert database aiming for2003: expert database aiming for Deep KB = knowledge transformation Deep KB = knowledge transformation

& innovation& innovation

Knowledge Building ChallengeKnowledge Building Challenge

MethodsMethods

Design Experiment MethodologyDesign Experiment Methodology (Brown, (Brown, 1992; Collins, 1992; The Design-Based Research Collective, 2002)1992; Collins, 1992; The Design-Based Research Collective, 2002)

Ethical approval of research protocolEthical approval of research protocol Self-selected volunteers (enthusiasts)Self-selected volunteers (enthusiasts) n=16n=16

AnalysesAnalyses

Attitudes & Opinions SurveyAttitudes & Opinions Survey ATK KB Measures ATK KB Measures KB Qualitative IndicatorsKB Qualitative Indicators Pain Conceptions/MisconceptionsPain Conceptions/Misconceptions Pre- & Post-test on Pain BeliefsPre- & Post-test on Pain Beliefs Reflective Feedback Survey (4 months Reflective Feedback Survey (4 months

later)later)

Experts Attitudes & Experts Attitudes & Opinions KT Survey Opinions KT Survey

RESULTSRESULTSResponse rate = 12/14 (86%)Response rate = 12/14 (86%)

DemographicsDemographics The program or faculty I am currently The program or faculty I am currently

registered/associated with is: registered/associated with is: Nursing=7, Nursing=7, Medicine=1, Pharmacy=2, Social Work=1, Medicine=1, Pharmacy=2, Social Work=1, Physical Therapy=1,Physical Therapy=1, Occupational Occupational Therapy=0, Dentistry=0Therapy=0, Dentistry=0

I am: Female=11 I am: Female=11 Male=1 Male=1

My age group is: My age group is: 30-39=5   30-39=5   40-49=7 40-49=7 

Did you find this Did you find this interprofessionalinterprofessional continuing continuing education experience useful?education experience useful?Yes=11/12Yes=11/12

Was there purposeful Was there purposeful discoursediscourse online between online between participants?participants?Yes=11/12Yes=11/12

Did you acquire Did you acquire new knowledgenew knowledge??Yes=11/12    Yes=11/12       

Do you think as a result of Do you think as a result of this course you will change this course you will change your approach to your approach to interprofessional practiceinterprofessional practice??

Yes=7/12    Yes=7/12    

Example:Example: ““I have been fortunate to work with some I have been fortunate to work with some great teams but this did help in allowing me great teams but this did help in allowing me to see each individuals focus and not to see each individuals focus and not expecting any one individual to carry all the expecting any one individual to carry all the knowledge.”knowledge.”

•

Do you think as a result of Do you think as a result of this course you will change this course you will change your approach to your approach to pain pain assessment & assessment & managementmanagement??

Yes=9/12 Yes=9/12        

Example:Example: ““I thoroughly enjoyed reading the comments made by I thoroughly enjoyed reading the comments made by the other participants, and realize how narrow the other participants, and realize how narrow focused I am and how much of a broader perspective focused I am and how much of a broader perspective the other members bring to the table. They truly the other members bring to the table. They truly have expertise that I never fully appreciated. I have have expertise that I never fully appreciated. I have learned that management of pain encompasses much learned that management of pain encompasses much more than merely drug therapy - but should focus on more than merely drug therapy - but should focus on the whole person. We need to look at emotional, the whole person. We need to look at emotional, financial, personal and other supports.”financial, personal and other supports.”

Would you like to see Would you like to see more E-Learningmore E-Learning CE/KTP courses made available? CE/KTP courses made available? Yes=11/12Yes=11/12

Based on my experience of E-learning, I Based on my experience of E-learning, I would recommend it to a colleague. would recommend it to a colleague. 10/12 strongly agree/agree10/12 strongly agree/agree

Overall I would rate my E-learning Overall I would rate my E-learning experience as: 83.3% excellent/very experience as: 83.3% excellent/very good/goodgood/good

KB KB Idea DiversityIdea Diversity

““Socio-cognitive dynamics:Socio-cognitive dynamics: Ideas diversity is Ideas diversity is essential to development of knowledge... To essential to development of knowledge... To understand an idea is to understand the understand an idea is to understand the ideas that surround it, including those that ideas that surround it, including those that stand in contrast to it. Idea diversity creates stand in contrast to it. Idea diversity creates a rich environment of ideas to evolve into a rich environment of ideas to evolve into new and more refined forms.” new and more refined forms.”

Technological supports:Technological supports: link & reference link & reference

KBKBCommunity Knowledge, Community Knowledge, Collective ResponsibilityCollective Responsibility

““Socio-cognitive dynamics:Socio-cognitive dynamics: Contributions to Contributions to shared, top-level goals…are prized…as much shared, top-level goals…are prized…as much as individual achievements. Team members as individual achievements. Team members produce ideas of value to others and share produce ideas of value to others and share responsibility for the overall advancement responsibility for the overall advancement of knowledge in the community.”of knowledge in the community.”

Technological supports:Technological supports: build-on, link, build-on, link, summarizingsummarizing

Future DirectionsFuture Directions

KB/KF progressive iterative design KB/KF progressive iterative design experiment, addressing the experiment, addressing the continuum of health professional continuum of health professional education from undergraduate to education from undergraduate to knowledge translation in practice, to knowledge translation in practice, to advance pain education & advance pain education & interprofessional outcomes.interprofessional outcomes.

AcknowledgementsAcknowledgements

Research Support:Research Support: Numerous UofT Faculty & Dept. in-kind contributions;Numerous UofT Faculty & Dept. in-kind contributions; UofT Academic Priorities Fund, Council of Health UofT Academic Priorities Fund, Council of Health

Sciences and Social Work Deans, Interprofessional Sciences and Social Work Deans, Interprofessional Education Implementation Committee, Dr. C. Whiteside, Education Implementation Committee, Dr. C. Whiteside, Chair, Associate Dean, Faculty of Medicine; Chair, Associate Dean, Faculty of Medicine;

University of Toronto Centre for the Study of Pain, Dr. University of Toronto Centre for the Study of Pain, Dr. M. Salter, Director; andM. Salter, Director; and

Institute for Knowledge Innovation and Technology, Dr. Institute for Knowledge Innovation and Technology, Dr. M. Scardamalia, Director, OISE/UTM. Scardamalia, Director, OISE/UT

Collaborators (research, case writing & Collaborators (research, case writing & facilitation):facilitation):

Dr. J. Watt-Watson (Nursing), Dr. P. Dr. J. Watt-Watson (Nursing), Dr. P. Pennefather (Pharmacy), Prof. J. Hunter (PT), Pennefather (Pharmacy), Prof. J. Hunter (PT), Dr. M. Scardamalia (IKIT) and Dr. A. Gordon Dr. M. Scardamalia (IKIT) and Dr. A. Gordon (Mt. Sinai Hospital) (Mt. Sinai Hospital)