Engaging Health Professionals and Trainees in Online Learning

1. EngagingHealth Professionals and Trainees in Online Learning Graham McMahon MD MMSc gmcmahon@partners.org

2. The World of Medicine is Changing Fast Hard to anticipate how this generation of learners will be practicing?

3. Our learners have changed: Some Characteristics of Millenials have never known a life without computers and the Internet generally began using computers between the ages of 5 and 8; almost all used computers by age 16 are more accustomed to using keyboards rather than pens or pencils generally prefer to read information from computer screens or mobile devices rather than from printed texts have more friends in social networking sites than in person have spent more time playing games than reading books

4. More standardization? Create new standards Raise standards

5. Standardization  Conformity

6. vs.

7. Engage the heart • Goal that is meaningful (task vs. knowledge orientation) • Engage the mind • Interesting achievable task • Personalized feedback over time • Engage with others • Nurture collaboration

8. Information is Ubiquitous and Easily Accessible

9. Challenges

10. The Challenge Millenials don’t need information; they need Prioritization Context Understanding Feedback The Challenge: Engage Learners Variety Style Interactivity

11. Unique Issues The technological forces that have affected this generation necessitate digital multitasking and interaction in online communities Individuals raised with computers deal with information differently compared to previous cohorts: “They develop hypertext minds, they leap around.” Efficiency is very important

12. Issues for Learning learn better through discovery and experiential learning rather than by being told want an immediate response have the ability to shift their attention rapidly from one task to another and may choose not to pay attention to things that don’t interest them — attentional deployment believe multitasking is a way of life and are comfortable when engaged in multiple activities simultaneously respond to visual cues and stimuli

13. The Decline of Experts Millenials are interactors – creating and consuming information Old Model: Reputation Experience Access New model: Crowd Someone with experience Anyone with an opinion

15. What are gamers getting good at? • Urgent optimism • Ability to engage immediately with a problem where there is a reasonable hope of success • “always worth trying, and trying now” • Tight social fabric • Takes a lot of trust to play a game with someone • Blissful productivity • Happier working hard gaming than relaxing

16. Emotion and Learning • Students retain what they learn when the learning is associated with strong positive emotion. • Dulay & Burt, 1977; Krashen, 1982 • Stress, boredom, confusion, low motivation, and anxiety individually, and more profoundly in combination, interfere with learning • Christianson, 1992

17. Attributes of Engaging Games Clear and consistent rules Clear goal Clear rationale Mission connected to and dependent on your ability Plenty of support Lots of positive feedback Shared experience

18. Educational technologies are advantageous in providing: • safe, controlled environments that eliminate risk to patients • enhanced, realistic visualization • authentic contexts for learning and assessment • documentation of learner behavior and outcomes • instruction tailored to individual or group needs • learner control of the educational experience • repetition and deliberate practice • uncoupling of instruction from place and time • standardization of instruction and assessment • perpetual resources and new economies of scale

19. Creating Engagement • Individualize the offering • Relevant and important • Build on prior learning • Personalized comparative feedback • Develop and maintain a longitudinal relationship • Curriculum for personal growth • Make it rewarding • Goal oriented • Fun • Positive • Engage the social instinct • Collaborative models

21. Learning is facilitated when the learner • is engaged in solving a real-world problem. • is engaged at the problem or task level, not just the operation or action level. • solves a progression of problems. • is guided to an explicit comparison of problems

23. Learning is facilitated when the learner • is directed to recall, relate, describe, or apply knowledge from relevant past experience that can be used as a foundation for the new knowledge. • is provided relevant experience that can be used as a foundation for the new knowledge.

24. Learning is facilitated when • the learner is shown rather than told. • the demonstration is consistent with the learning goal. • the learner is shown multiple representations. • the learner is directed to explicitly compare alternative representations. • the media play a relevant instructional role.

25. Learning is facilitated when • the learner is required to use his or her new knowledge to solve problems. • the problem solving activity is consistent with the learning goal. • the learner is show how to detect and correct errors. • the learner is guided in his or her problem solving by appropriate coaching that is gradually withdrawn.

26. Learning is facilitated when the learner • can demonstrate his or her new knowledge or skill. • can reflect-on, discuss, and defend his or her new knowledge. • can create, invent, and explore new and personal ways to use his or her new knowledge

27. Rationale: Learning Theory Learning can be optimized if the material Activates prior knowledge Is engaging relevant Integrative interactive Facilitates elaboration Page 28

28. Online Simulations

29. Rationale Learning is greatest when The materials meet the learner’s needs Relevant Sufficient detail The learning process is active Problem solving Making choices Feedback is provided

30. Simulation to Enhance the Learning Experience • 20 cases across many specialties • Flash environment • Recreate the physician-patient encounter • History • Physical Exam • Relevant clinical decisions • Real patient cases, actual data & media • Reinforce learning and retention • Make decisions and receive feedback • “Learn more” links Page 31

35. Questions with Feedback Page 36

36. Article Learn More Page 37

37. More Questions with Feedback Page 38

38. Learning Element Page 39

39. Learning Element Page 40

42. Learning Element Page 43

45. Total IMCs Initiated and % Completed 550,175 initiations Page 46

46. Rating of Interactive Cases

47. Amount of Information N=10,329 Page 48

48. How they will be used?

49. Recommend to Whom?

50. How Often?