Do our medical schools need to adopt new education technology?

A recent article in Campus Technology by Trent Batson "Horns of the Dilemma for Faculty: Legacy Demands and Technology Expectations" discusses how universities have failed to change while educators have adopted all the web 2.0 technologies at home. Also there is this terrific presentation.

Purdue Tlt 09 Robbins

View more presentations from Sarah Robbins.

How does this apply to medical education? Is it important to adopt new technology for teaching our medical students? I love technology but I find myself thinking that the battle we need to fight is to make medical school education more student centered and not necessarily the immediate adoption of new technology.

Going from lectures to problem based learning is more important than changing the old chalkboards to electronic whiteboards! Getting our medical schools to move from grades to portfolios would be worthwhile cause to fight for but Portfolios can be done on paper. Students can use a paper textbook, they don't have to start medical school with a Kindle DX loaded with all their textbooks. Students can go to a "real" classroom as long as the "teacher" promotes active collaorative learning, they don't need the presentations loaded on their iPod or a virtual classroom.

Once we get our faculty to adopt a more collaborative and active learning approach, the adoption of the appropriate technology will follow. Technologies will be superseeded by newer ones, but the key principles of education should be more enduring. The current web 2.0 applications seem to be designed perfectly for collaborative learning and it would be great to integrate these into our curriculum delivery and assessments as we make adopt a more constructivist approach to medical education. But if I were to have one or the other, it would have to be the collaborative learning approach and not the technology! It does not have to be a dilema.

Collaborative learning in Medical Education - Where is the Patient?

For a while now I have been muddling over a few thoughts in my head. These were prompted by

1. Medicine's incredible success at treating acute problems and thus bringing chronic problems to the forefront e.g. patient survives a stroke but is left with bed sores, incontinence OR survives an acute heart attack and is left with congestive heart failure. A William Schwab put it at a recent grand rounds, "Success brings failure" and thus our success in treating acute problems has brought us an excess of chronic problems.
   
2. Increasing popularity of social media tools like Facebook, Twitter and Second Life. A recent study that I discussed earlier showing students were more likely to use Facebook for a course discussion than the University's learning management system.
   
3. Medical education moving from a traditional "talking to the boards" model to a small group collaborative problem solving model - can we use this momentum for including patients into the learning "group"? This thought was resurrected by a post I read by Anne Marie Cunningham.
   

It seems that learning how to treat an acute problem is something we can do well in our current model of education which has minimal involvement of the patient (in most schools). As our population ages, has more chronic problems, a model that does not involve the patient in the learning process is not going to succeed.

Thus we know what an obese patient with poorly controlled diabetes needs to do to bring his/her condition under control and maintain it there. Patient also often knows this. Still optimal outcome occurs only rarely and if it does, it is not sustained.

In managing chronic conditions, the patient has to learn to take control of his/her condition and the physician is only a part of the solution to make this happen. Our medical students learning is designed to occur either in classrooms or in hospitals - both of which are perfect for acute condition management. The exposure to outpatient chronic condition management where they can interact with the same few patients longitudinally does not occur in most schools.

The reasons for this are mostly logistic. Scheduling students to be in the clinic the same time as specific patients is a logistic nightmare. How about a model using social media?

Can we have students create limited, private accounts in a social media site like Facebook or create a specific site using Ning and invite consenting patients to be their "friends". We could have a list of patients with different conditions and abilities to use these social media tools. The sites would not be accessible except to invitees. The students would collaborate with a set of patients over their entire medical school experience. The patients would post/tweet about their symptoms, office visits, hospitalizations, test results and the students would learn/read up about these and explain these to the patients. In addition, they would work on skills like motivational interviewing, negotiated goal setting to help the patients take better control of their conditions.

This model will allow students to learn the role they have to play in management of chronic conditions and prepare them for the future!

3 Apps I love for capturing what's on the screen

For years I had taught people how to do screen captures with the Print Screen button and continued to be mildly surprised when people who get excited when they learned that there was actually a purpose for tha button on the keyboard! I still use that when I am not at my own computer.
Since I have to do some faculty development sessions, training medical educators on use of technology in education, I had to find some tools that were easier to use. So here is my very short list of 3 applications that I find very useful.

1. Jing - This is a great tool for capturing a portion of the screen and annotating it with arrows and text. While it does do screencasting, the free version has limits on time of a single movie and it puts its logo prominently at the end of the movie. It also allows to upload the captured image to its online repository. I do not use that much as I need to save and reuse the images for other purposes.

2. Wink - After a lot of trials and errors, I have settled on Wink for screencasting. It creates a flash movie from a window that you select on your screen. You select the number of frames/sec and it will capture these faithfully. It has a builtin annotation tool for adding callouts, textboxes etc. Also automatically adds pauses to the movie and you can add navigation buttons for the user so they can read the text and then proceed with the movie. You can delete unnecessary frames and thus keep the movie short and sweet. The only problem I had was deciding on the resolution. I used the Firefox window resizer add-on and captured at 800X600 so I could put the flash file in a frame or otherwise have room left on either side.

3. FRAPS - this is the only one of the 3 that I spent money on (35 dollars). I use Second Life for various educational purposes and FRAPS allows me to record the machinima in SL - both audio and video. It is very easy to use and has a hot key to start, stop the recording. The only thing to keep in mind is the incredibly HUGE file size. For one 20 minute recording it used up 10 GB of space on my HD. The solution is to use Virtual Dub to compress this to MPEG4 and the same file become close to 400 MB.

So that's it! Jing, Wink and FRAPS.