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T. Bradley Tanner, MD - Branched Path Learning and Gamification for Student Training in Health and Medicine

Bradley Tanner, President, Clinical Tools Inc. This presentation was given at the 2016 Serious Play Conference, hosted by the UNC Kenan-Flagler Business School. The talk highlights how educators in the health sciences and health professions can successfully create and deploy branched-path learning and gamification elements. Attendees will gain practical advice on how create educational experiences that enhance interest and relevance and that target successful attainment of clinical skills.

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T. Bradley Tanner, MD - Branched Path Learning and Gamification for Student Training in Health and Medicine

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  1. SERIOUS PLAY CONFERENCE 2016 | UNC, Chapel Hill, NC BRANCHED PATH LEARNING AND GAMIFICATION for Student Training in Health and Medicine T. Bradley Tanner, MD (Clinical Tools, Inc. - http://docs.clinicaltools.com/conference/2016-SeriousPlay/SeriousPlayTalk-Tanner-2016-07-26-01bt.pdf Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) http://clinicaltools.com) The talk http://tinyurl.com/hdanfod 1 / 54

  2. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS SUMMARY The talk highlights how educators in the health sciences and health professions can successfully create and deploy branched- path learning and gamification elements. Attendees will gain practical advice on how create educational experiences that enhance interest and relevance and that target successful attainment of clinical skills Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 2 / 54

  3. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Objectives: The attendee will be able to:  Apply knowledge of branched-path learning to the process of creating an educational experience for students in health science, medical, and health professions.  Identify elements of gamification that will enhance learner interest and participation and that match the needs of future clinical care.  Calculate the challenge of creating an educational experience using branched-path learning and gamification so educators can determine its appropriate use in their organization 3 / 54

  4. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Disclosure: About Me and Clinical Tools President of Clinical Tools Inc., Tanner: Board Certified in Psychiatry and in Obesity Medicine. Past stops at UVA, Pgh Company: located in Chapel Hill, NC specializing in software and curriculum development CTI is a small R&D company 4 / 54

  5. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS WHO ARE YOU Health Care Provider Health Care related employment Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 5 / 54

  6. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS WHO ARE YOU Health Care Provider Health Care related employment Care about Health Care Provision? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 6 / 54

  7. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS The Need Vision and Goal  Need: Do providers have all the skills they need?  Can current education can fill in all those gaps?  Vision: Together, branched-path learning and gamification can create scalable and easily alterable training for today’s and future health and medical students  Goal: Outline how we can best use the potential of gamification to enhance the provision of health care 7 / 54

  8. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS WHY GAMES Why is this talk not a game? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 8 / 54

  9. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS WHY GAMES Why is this talk not a game? Money?. $100K/40 minutes, Time? 3 months Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 9 / 54

  10. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS WHY GAMES Why is this talk not a game? Scalability: We need a huge audience to justify that expense. A marketplace to buy sell this lecture (think android store/iphone store Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 10 / 54

  11. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS OK. Let’s throw in some Gamification  I'll go too fast.  Too slow;  Go backwords.  Skip slides.  Put some confusing slides with pictures that make no sense. Create some hard to read slides with errors so we introduce the "what is he trying to do?" game  11 / 54

  12. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS THE ANATOMY COLORING BOOK Games don't work? Games have to be in sync? Perhaps what (or how) we are teaching is wrong? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 12 / 54

  13. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS How to implement: Cognitive  Meeting a Greater Purpose Meaning. Professionalism.  Challenge;  Competence: Task Accomplishment.  ACGME Competencies: Personal Development. 13 / 54

  14. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Cognitive: Challenge  Games are hard.  Anxiety is good ... when it isn't.  Branched Paths. 14 / 54

  15. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Cognitive: Challenge → Branched Path  What are they?  Development.  Models. 3x3 model, 3x3x3, What about software driven experience? AI?  Use: Do people do more than one – 50/50? Use is asymmetric. Clearly "wrong" paths are rarely chosen - but is it worth it?  Preference: Do users want points for successful choices - No Feedback is enough (except perhaps "patient health" points. Timed - yes, adds realism. "hints" rarely - want this to be real 15 / 54

  16. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS How to implement: Emotional  Enabling Creativity and supporting Autonomy  Social Connections - Health professional students want a system that rewards cooperation, improvement, and group success  Failure NOT! - In medicine "Losing" often means mortality or morbidity.  Unpredictability and Variation 16 / 54

  17. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS WHAT IS THE NEED? “Clinical skills' training is arguably the weakest point in medical schools' curriculum. We need to bring back into the medical curriculum and clinical practice the art of observation, listening, clinical reasoning, and focused and targeted clinical examination of the patient.” (Shelley BP. Wither clinical skills and humanism? . Arch Med Health Sci 2014;2:1-3) Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 17 / 54

  18. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Case-Based Branched Learning New medical education Problem: standards require clinical skills training, but lectures aren’t interactive and simulations are expensive Branched-learning scenarios Solution: where students experience Real-world environments Outcomes of their decisions 18 / 54

  19. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Simulated 3D Patient Interaction Medical Education Training Case In Development Case Rendered In Tablet App Case-based branched learning 19 / 54

  20. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS SIMULATES A REAL WORLD PATIENT ENCOUNTER Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 20 / 54

  21. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Full Patient Encounter Presented History Physical Exam Screening Brief Interventions Referral and Treatment Follow-Up 21 / 54

  22. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS CREATED VIA BRANCHED LEARNING TOOL Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 22 / 54

  23. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Uses Online Case-Building Tool  Cases written online in Twine framework  Visual layout of case available as you go 23 / 54

  24. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS CASE FILES TRANSLATED TO AN INTERACTIVE APP App Will be Available Free of Charge Initially! Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 24 / 54

  25. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Inviting Visual Interface On App  Students see rendering of patient on app  Visual interface makes real-world connections 25 / 54

  26. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS REALISTIC DIALOGUE ENHANCES COMMUNICATION SKILLS Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 26 / 54

  27. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Simulated Patient Conversations Models ideal conversation approaches Emphasizes patient-centered treatment 27 / 54

  28. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS USER CHOICES CREATE INDIVIDUALIZED EXPERIENCE Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 28 / 54

  29. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Multilevel Choice Pathways  User choices lead to decision-outcomes  Individualized experiences based on pathways 29 / 54

  30. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS INTERACTIVITY: CHOICES FEEDBACK Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 30 / 54

  31. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Outcome Of Choices Explained  Chapters end with summary of student choices  Both ideal and non-ideal choices summarized 31 / 54

  32. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS HOW CAN I LEARN MORE? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 32 / 54

  33. CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS Branched Simulated Patient Interaction Medical Education Training Clinical Tools has over 20 years experience in medical student and continuing medical education training. Fill out our survey on ClinicalTools.com to keep up to date on our development! Currently free of charge! ClinicalTools.com feedback@clinicaltools.com 33 / 54

  34. CE: CASE BUILDING ENGINE LET US INTRODUCE YOU TO ANOTHER APPROACH TO CASE SIMULATION…. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 34 / 54

  35. CE: CASE BUILDING ENGINE Clinical Encounter Case Building Engine Build cases for a simulation app! Developed by 35 / 54

  36. CE: CASE BUILDING ENGINE WHAT IS THE CASE BUILDING ENGINE? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 36 / 54

  37. CE: CASE BUILDING ENGINE Case Building Engine What Does It Do? Internal page from clinical simulation app:  A tool to create cases for clinical encounter simulation  Uses an online form  Renders in a clinical simulation app  App helps develop medical skills  Currently free of charge! 37 / 54

  38. CE: CASE BUILDING ENGINE WHAT ARE THE INTENDED GOALS? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 38 / 54

  39. CE: CASE BUILDING ENGINE Case Building Engine Goals 1)Create cases using Case Building Engine 2)Share completed cases with others 3)Learn by creating, reviewing, interacting with cases “Knowing is not enough; we must apply. Willing is not enough; we must do.” — Goethe 39 / 54

  40. CE: CASE BUILDING ENGINE HOW DOES THE CASE BUILDING ENGINE WORK? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 40 / 54

  41. CE: CASE BUILDING ENGINE Users Create Cases for App Using an Online Form Case App For Skills Training Online Webform 41 / 54

  42. CE: CASE BUILDING ENGINE Form Prompts You For Information History Evaluation Diagnosis Brief Interventions Referral and Treatment Follow-Up 42 / 54

  43. CE: CASE BUILDING ENGINE HOW IS THE CASE RENDERED? Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 43 / 54

  44. CE: CASE BUILDING ENGINE In An Interactive App: Clinical Encounter Developed by 44 / 54

  45. CE: CASE BUILDING ENGINE Multiple Completed Cases to Choose From 45 / 54

  46. CE: CASE BUILDING ENGINE Rendered in a Simulated EHR* *EHR = Electronic Health Record 46 / 54

  47. CE: CASE BUILDING ENGINE Timer Increases Challenge of Game 47 / 54

  48. CE: CASE BUILDING ENGINE INTERACTIVITY: CHOICES/FEEDBACK Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 48 / 54

  49. CE: CASE BUILDING ENGINE Get Feedback Make Clinical  Choices  49 / 54

  50. CE: CASE BUILDING ENGINE INTEGRATION INTO MEDICAL EDUCATION Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 50 / 54

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