Old Dog, Old Trick, New Toy

1. <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><AllResponses /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>255,255,0</gridFillColor><gridOpacity>50%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Red</insertObjectUsingColor><showResults>Yes</showResults><teamColors>Use PowerPoint Color Scheme</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>All Slides</showControlBar><defaultCorrectPointValue>0</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName></Settings> <?xml version="1.0"?><SlideMaster><tagSlideID>d584be44923a4f9494af927af812c15d</tagSlideID><slideID></slideID></SlideMaster> <?xml version="1.0"?><AllAnswers /> Valerie P Jackson, MD, FACR Eugene C Klatte Professor and Chair Department of Radiology and Imaging Sciences Indiana University School of Medicine Old Dog, Old Trick, New Toy

3. Disclosures • I have no financial interests to disclose • I am NOT an expert in Adult Learning Principles • I have attended usual array of schools and courses

4. Objectives • Understand the characteristics of good and bad speakers • Understand Adult Learning Principles (ALP) • Introduce Case-Based Teaching (CBT) • Explain Audience Response Systems (ARS) • Realize advantages and disadvantages of ARS

5. Your Own Experiences in Education

6. When Did Education Go from this……. to this?

7. When did Didactic Lectures Take Over?

8. Adult Learning Principles • Unlike small children, adults- have foundation of life experiences and knowledge- want to connect learning with knowledge and experience base • Teachers should relate concepts and theories to audience’s experiences

9. Adult Learning Principles • Adults are- autonomous and self-directed- goal-oriented- relevancy-oriented- practical • Focus on aspects of lesson most useful to them in work • Need respect http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/adults-2.htm

10. Autonomous, Self-directed • Free to direct themselves • Want to be actively involved in learning • Like to know how ‘class’ will help them reach their goals • Teachers serve as facilitators • Teachers guide to knowledge rather than provide facts

11. Goal-oriented • Learners typically know their goals for class • Want organized curriculum • Teachers should show learners how they will reach their goals

12. Relevancy-oriented, Practical • Learners want to see reason to learn • Information applicable to work, life • Want to know how learning concept will relate to familiar situations • Want to focus on what is important and useful • Not necessarily interested to “just learn” something

13. Desire Respect • Acknowledge the learners experience • Give opportunity to voice opinion and knowledge in teaching setting • Don’t waste time on irrelevant stuff

14. Education Methods for Adults • Case based teaching • Problem based learning • Both interactive • Focus on development of relevant skills

15. Search: CBT

16. Case-Based Teaching (CBT) • Develop skills in analytical thinking and reflective judgment • Reading and discussing complex, real-life scenarios • Cases are stories with educational message • Can be done with large group

17. Interactive Methods • Call on people to answer • Raising of hands/survey • Teams/split the room • Paper responses • Open microphone • Use ARS

18. Search: ARS

19. ARS Components • Keypads • Radio frequency receiver • Group response software • Laptop computer • LCD projector

20. How it Works • Question • Time to select • Recognizes input from participants • Displays data • ? Improves learning environment

23. Introduction to ARS • Get to know the audience

24. 10 0/0 I plan to use ARS in my next presentation/lecture. • True • False Cross-Tab Label

25. 10 0/0 I am nervous about my next presentation/lecture. • Strongly Agree • Agree • Neutral • Disagree • Strongly Disagree Cross-Tab Label

26. Introduction to ARS • Space ARS throughout talk to keep audience engaged • First half of this lecture was boring- you may not care about ALP- too many words- little/no interaction • Don’t save all ARS until the end

27. 10 0/0 How many times have you been to RSNA? • 0 • 1-3 • 4-6 • 7-9 • ≥ 10 Cross-Tab Label

28. Keep engaged More ARS Examples ARS

29. (1) = XX.X (2) = XX.X (3) = XX.X 10 0/0 Do you prefer lectures that are ‘case-based’? • Yes • No • Doesn’t matter Cross-Tab Label

30. 10 0/0 Have you utilized ARS in a lecture before? • Yes • No Cross-Tab Label

31. Benefits of ARS • Interaction with audience ➔ more participation • Increases attendance • Faculty perceived more favorably • Able to get audience attitudes and opinions Collins J. JACR 2008;5:993-1000

32. Benefits of ARS • Immediate feedback ➔ Improved teaching and learning • Provides anonymous peer assessment Collins J. JACR 2008;5:993-1000

33. Benefits of ARS • Portable/wireless system • Easy for participants to learn/use • Can track data anonymously • Flexible so ‘on the fly’ questions can be used • Facilitates CME for SAMS • Fun

34. Data supporting ARS/Interactive Methods • ARS and interactive lectures improve quiz scores • Family Medicine Residents Schackow, et al. Fam Med 2004;36(7):496-504

35. Data supporting ARS/Interactive Methods • ARS and interactive lectures improve quiz scores • Radiology Residents Rubio, et al. AJR:190, June 2008

36. Data supporting ARS/Interactive Methods • Interactive Teaching improves image interpretation • Fellow read 15 cases before training and 200 after didactic lectures. • Weekly interactive tutorials with experts compared fellow’s interpretations to pathology • Interactive training significantly improved accuracy in tumor localization extension Akin O, et al. Eur Radiol. 2010 Apr;20(4):995-1002

37. Data supporting ARS/Interactive Methods • Students report positive feedback for ARS • Improved activity during lectures • Enhanced learning • Easier to ask questions during lectures • Majority enjoy ARS lectures more • Majority feel more engaged Uhari, et al. BMC Medical Education 2003, 3:12 Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9

38. Data supporting ARS/Interactive Methods • Radiology instruction using ARS builds • students’ confidence • knowledge of self-mastery • insights for future studying Uhari, et al. BMC Medical Education 2003, 3:12 Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9

39. Data supporting ARS/Interactive Methods • Instant feedback • Allows educator to direct lecture and discussion • Gives trainees information about their knowledge and performance • Results in increased satisfaction for both lecturer and trainee Steinert & Snell. Med Teacher, Vol. 21, No. 1, 1999

40. Again, why ARS? • Autonomous, self-directed learners • Want to be actively involved in learning • Can be used to guide knowledge • Foundation of experience • Method to relate to life experience through CBT • Relevancy-oriented/practical • Practice what learned • Desire respect • Gives opportunity for audience to voice opinion and demonstrate knowledge

41. Again, why ARS? • Motivation • Allows connection of teacher and learner • Provides avenue for challenging learner • Provides mechanism for feedback • Reinforcement • Practice • Retention • Proven to have higher % retention • Transference • First step to applying knowledge learned

42. Limitations of ARS • Need to transport and set up • Expensive to use/buy/rent • Effectiveness depends on instructor competence and equipment reliability • Questioning reduces time for lecture content • Time to prepare the lecture long • May be seen as a gimmick/game Collins. J Am Coll Radiol 2008;5:993-1000

43. Limitations of ARS • Best to prepare questions in advance (can do spontaneous additions) • Files from other software can be difficult to import • System requires dedicated laptop unless speaker comfortable with ARS software • Not easy to return to earlier question • Software has learning curve • IT support helpful/necessary?

44. Cons of using ARS • Fear of losing control • Too much freedom for the audience • Fear of not covering all the information • Have to reduce facts to incorporate interactive nature • Too much information results in less retention • Time constraints Steinert & Snell. Med Teacher, Vol. 21, No. 1, 1999

45. Cons of using ARS • ARS-based lectures progress slower than didactic formats • Amount of material covered less than in didactic formats • ARS may not be designed ideally for radiology in that MCQs may not be ideal way to test in radiology • However, studies show interactive learning helpful • Need for creativity in CBT Nicholson and Bassignani. Unpublished data (UVa)

46. Another example ARS

47. 10 0/0 What is your favorite ice cream flavor? • Vanilla • Chocolate • Chocolate Cookie Dough • Mint Chocolate Chip • Other Cross-Tab Label

48. Tips to limit negatives and maximize positives Make the most of ARS

49. Tips for ARS • Promote critical thinking through wording • Make topics/questions relevant to work • Prepare for questions that might arise • Keep simple, short, easy to read • 10-15 seconds time per question • Vary question types • MC, T/F, yes/no, Likert opinion Collins. J Am Coll Radiol 2008;5:993-1000

50. Tips for ARS • Number options 1 to 10 • Incorporate time for questions/discussion of options • Average 5 minutes per question • Range is broad (many factors) • Insert question every 10 to 20 minutes • Provide instructions to audience prior to beginning • Arrive early to review ARS and prevent IT issues Collins. J Am Coll Radiol 2008;5:993-1000