Building an online repository of teaching resources to facilitate consistent and good quality teaching of postgraduates and
undergraduates in medicine – a preliminary report
Dr Goh Poh Sun MB,BS(Melb), FRCR, FAMS, MHPE(Maastricht) Associate Professor and Senior Consultant
Department of DiagnosFc Radiology NaFonal University Hospital
NaFonal University Health System Singapore
Conclusions
• An online case repository of teaching resources supports undergraduate and postgraduate teaching and learning in radiology.
• A new iniFaFve to build an insFtuFon wide case repository has the potenFal to have a wider significant impact in medical educaFon.
The following are the feedback from reviewers with regard to the extended abstract (ID: 063): • Abstract needs to focus why this is different from other online medical repositories which might be FREE. • What next for this repository? What are the unique features of this repository other than the contents? • It would be good if some findings on the use of the repository be shared – e.g. how the repository has impacted students’ learning.
Why this iniFaFve is different?
ThemaFc Experience Stroke and Mimics
Use of repository, impact on learning
Over 40,000 Page Views Over 2 Years
Residents Report That SystemaFc Review/Deliberate PracFce With Theme based Cases Significantly Increases Their Confidence in both EMD, and day to day Neuroradiology ReporFng This is Supported by Actual Day to Day Clinical Performance Assessment by Supervising Radiologists (paper in dra` revision)
What next?
CaseBasedLearning@NUHS Learning@NUHS
CurriculumMapping@NUHS
Mastery Training in Radiology – Use in the Diagnosis and Management of Acute Ischaemic Stroke on CT Scan
Dr Goh Poh Sun MBBS(Melb), FRCR, FAMS, MHPE(Maastricht)
Department of DiagnosFc Radiology NaFonal University Hospital
NaFonal University Health System Singapore
Pre-‐Test (2 parts – diagnosis and management) 1. Acute / Hyperacute Infarct on CT (range of cases), admit/thrombolyse 2. Look-‐alikes of acute CVA eg. Tumour, EncephaliFs, admit/treat 3. Subacute/Chronic Infarct, consider outpaFent follow up
Learning, followed by Deliberate PracFce + Feedback
Fail Pass
Post-‐Test (2 parts – diagnosis and management) 1. Acute / Hyperacute Infarct on CT (range of cases), admit/thrombolyse 2. Look-‐alikes of acute CVA eg. Tumour, EncephaliFs, admit/treat 3. Subacute/Chronic Infarct, consider outpaFent follow up
Standard sefng by panel of radiologists, and neurologists using online repository
References
• hgp://meded.ucsf.edu/radme/medical-‐educaFon-‐expert-‐william-‐mcgaghie-‐address-‐ucsf-‐simulaFon-‐based-‐medical-‐educaFon
• hgp://www.royalcollege.ca/portal/page/portal/rc/common/documents/events/icre/2012proceedings/competency_based_residency_educaFon/mastery_learning_of_clinical_skills.pdf
2013 AssociaFon for Medical EducaFon in Europe Annual Conference, Prague PS Goh. An online case repository facilitates radiology residency training and evaluaFon of educaFon theory, can potenFally shorten duraFon of training, and aid mastery training -‐ a follow up report
2012 AssociaFon for Medical EducaFon in Europe Annual Conference, Lyon PS Goh. An online repository facilitates radiology residency training and evaluaFon of educaFon theory
2011 AssociaFon for Medical EducaFon in Europe Annual Conference, Vienna PS Goh, G Sundar, C Tan, ME Nga, TP Thamboo, S Amrith. CreaFon and Use of An Online MulFspecialty Case Repository and Its MulFple Uses for Specialist Training.
2009 AssociaFon for Medical EducaFon in Europe Annual Conference, Malaga PS Goh, J Tam. Deliberate distributed pracFce with paired and mixed examples is an efficient and effecFve method to learn key abnormaliFes on the CXR
2010 7th Asia Pacific Medical EducaFon Conference, Singapore PS Goh, J Tam. Applying deliberate pracFce to chest radiology teaching – further work with undergraduates and experience with postgraduates
8th Asia Pacific Medical EducaFon Conference, Singapore PS Goh. Deliberate PracFce Using Paired and Mixed Examples of Imaging AbnormaliFes on the CXR is more effecFve and efficient for postgraduate training compared with tradiFonal methods
6th Asia Pacific Medical EducaFon Conference, Singapore PS Goh, J Tam. ApplicaFon of EducaFonal Theory Regarding Teaching for Skill Transference for Chest Radiograph InterpretaFon in Undergraduate EducaFon and Training
2008 AssociaFon for Medical EducaFon in Europe Annual Conference, Prague PS Goh EvaluaFon of a Radiology eLearning program – key factors contribuFng to success
EducaFonal Sefng – Radiology Department, Postgraduate Training 30 Consultants – 30 Residents in Training
Current Digital / Online Teaching and Learning Case-‐Based Cases
Online Digital Repository and Examples of Its MulFple Uses
ThemaFc Experience Stroke and Mimics
Short Theme Based InstrucFonal Video PresenFng Unknown Cases or Cases with AnnotaFons and Answers
Visual ThemaFc Index – Stroke and Mimics à So you teach, have designed an Evidence Based/Literature Supported Curriculum and ProgrammaFc Assessment Strategy … Now show me what you actually teach “with”, and what you assess “on” … Range … Breadth and Depth
Text based Hyperlinked Case Index
For rare condiFons Hyperlinking to other Online Repositories
www.ajnr.org
www.eurorad.org
Not just confined To Radiology Examples
www.nejm.org
Imagine the teaching and learning possibiliFes with 1000s of cases in eBook format on (internet enabled) tablets /
smartphones
Imagine if the cases can be selected, grouped and reordered to fit any learning or teaching purpose
IllustraFon examples from “Apple” and “Samsung” Company websites
More examples of scholarship potenFal – ThemaFc eBook Chapters
Conclusions
• An online case repository of teaching resources supports undergraduate and postgraduate teaching and learning in radiology.
• A new iniFaFve to build an insFtuFon wide case repository has the potenFal to have a wider significant impact in medical educaFon.
Advantages of online case repositories
• For Tutors – Online repository facilitates access – Unannotated case images give greatest flexibility for repurposing and different educaFonal usage
– URL linkage for each case allows easy incorporaFon of case material on websites, blogs etc. (this addresses the issue of copyright à use a hyperlink, similar to a citaFon in tradiFonal academic publicaFon)
• For Residents – Online case repositories can be an efficient method for reviewing many cases
– Facilitates personalized, customized self-‐directed or guided learning
Problems Using RLO Approach
• Formalizing System and Procedures for Regular SystemaFc CollecFon of RLOs
• Quality control and peer review • Metadata, tagging, labeling and finding resources, and ensuring paFent confidenFality/anonymity
• Lack of awareness in academic culture – uFlizaFon and sharing
• Reluctance to make unpublished teaching material publicly available
• Lack of reward systems and recogniFon – Koppi, Bogle & Bogle, 2005
Take Advantage of Regular Clinical AcFviFes as Source of RLOs
• Day to day work à SystemaFc Case collecFon (annotated in PACS, or use of mobile phone camera and online repositories)
• Weekly clinical case audits (5%) à Good examples of normal and discrepancies used for teaching and self directed learning
• Weekly clinical-‐radiology-‐pathology rounds à case material reused for residency self directed learning or assessment
Thank you