Lifelong Learning and Information Technology

1. Lifelong Learning and Information Technology Nancy Clark, M.Ed. Dir. Medical Informatics Ed. FSU College of Medicine All resources from today’s workshop can be found at: www.med.fsu.edu/informatics/LLL.asp

2. Objectives Students will • Establish a method of ongoing self-assessment of learning needs which includes constantly and accurately assessing the state of his or her knowledge and experience base • Identify and utilize his or her best learning style • Developing a written plan for addressing learning needs that is realistic • Recognize types of references and sources of information for lifelong learning • Identify good information habits to remain current

3. Office of Medical Education

5. COM Objectives • Seehttp://www.med.fsu.edu/education/COMcompetency.asp • Under Life Long Learning

6. What is Medical Informatics? What does it have to do with Lifelong Learning?

7. Health (Medical) Informatics • Medical Informatics is the branch of science concerned with the use of computers and communication technology to acquire, store, analyze, communicate, and display medical information and knowledge to facilitate understanding and improve the accuracy, timeliness, and reliability of decision-making. Warner, Sorenson and Bouhaddou, Knowledge Engineering in Health Informatics, 1997

8. Quote over the entrance to Dodd Hall, FSU Knowledge

9. Textbooks don’t smell as their contents rot, so readers will need to develop alternative crap detectors to avoid poisoning their minds and robbing their patients of current best care. David Sackett

10. Goals of Informatics Curriculum Create independent, lifelong learners • Who keep up to date • Excellent problem solvers • Who integrate evidence into clinical decision making • Who practice information mastery • Value instant access to latest information • Who are comfortable with new technology

11. Longitudinal Theme of Integrated Informatics Curriculum • Information management and computer skills to support • Lifelong Learning • Education • Research • Communications • Patient Care

12. Year 1 Curriculum • Computer basic skills • Presentation Skills • Effective use of Information Resources for • Education (small group) • Lifelong learning • Patient care • Using a PDA

13. Year 2 Curriculum • Evidence Based Medicine • Information Resources for Decision Support, Patient Education • Research • Statistical/epidemiological concepts • Writing a research paper • Using Medline and other databases

14. Year 3 • Information Management in patient care • Documentation of clinical encounters (Electronic medical/health records) • Accessing patient information • Other practice data management issues • Evidence Based Medicine

15. Computer Skills • Survey Result • Mavis Bacon Typing Tutor is available

16. Learning Styles and Approaches How are these a predictor of your success in medical school and long term as a physician?

17. Learning Styles and Approaches • Learning Styles Inventories • http://www.med.fsu.edu/informatics/ • Lifelong Learning • Additional files on intranet: • What are some learner characteristics? • What are your characteristics?

18. Physicians Reactions to LS • Think non-judgmentally • Appreciate differences • Patient Care and education • Practice management & administration • Medical Education Thompson, H. & Bing-you, R. (1998) Physicians’ reactions to learning style and personality type inventories. Medical Teacher

19. Short Term Self aware Succeed in med school Form cohesive, productive study groups Adapt to new learning situations Maintain Sanity Long Term Life long learning Select right specialty Work well with healthcare team Teach students Educate patients Clinical competence Goals of Understanding LS

20. Development -- Piaget Toddler Adult

21. Adult Learning Theory • Learning Theory • http://tip.psychology.org/index.html • Learning takes place • in context of patient care • when questions are answered • the issues are applicable to work • when it doesn’t take too much time

22. Inventory of Learning Styles Felder-Silverman Model Decision Active Reflective Perception Sensing Intuitive Sensory Reception Visual Verbal Organization Sequential Global Strong Moderate Weak

23. Decision Models-- Kolb Impulsive Reflective Decision Active Participant Reflective Observer

24. Tend to retain and understand information best by doing something with it—discussing, applying or explaining it to others. "Let's try it out and see how it works" Like to work in group Sitting through lectures hard Usually Extroverts Prefer to think about it quietly first "Let's think it through first" is reflective learner's response. Reflective learners prefer studying alone Are quiet in group learning situations Usually Introverts Active vs Reflective

25. Active vs Reflective • The majority of undergraduate students are Active • 83% of college student leaders were active • 65% of Phi Beta Kappas were reflective • Around 62% med students are Active • Majority of university professors are Reflective

26. Personality Types -- Jung Meyers-Briggs Orientation Extrovert Introvert Perception Sensing INtuitive Judgment Thinking Feeling Judging Perceiving Do:What is your Myers Briggs Type?

28. Sensing vs Intuitive • like learning facts • like solving problems by well-established methods (logical) • dislike complications and surprises • want step-by-step instructions (linear) • patient with details (detailed) • Like memorizing facts and doing hands-on (procedures) work • more practical and careful than intuitors • don't like courses with no apparent connection to real world (concrete)

29. Sensing vs Intuitive • prefer discovering possibilities and relationships • like innovation and dislike repetition • may be better at grasping new concepts • often more comfortable than sensors with abstractions (abstract) • tend to work faster and to be more innovative than sensors • don't like "plug-and-chug" courses that involve memorization and routine calculations

30. Sensing vs Intuitive • The majority of undergraduates are Sensing • 56% -72% college freshmen Sensing • 83% of national merit scholarship finalists were Intuitive • 92% of Rhodes Scholars were Intuitive • 75% of first year medical students are Sensing*

31. Organization-- Wertheimer Gestalt Theory Step 1 Step 2 Step 3 Step 4 … Big Picture Organization Global Sequential

32. gain understanding in linear steps, with each step following logically from the previous one follow logical stepwise paths in finding solutions Majority of M1s are sequential Detailed learn in large jumps, absorbing material almost randomly without seeing connections, and then suddenly "getting it." to solve complex problems quickly or in novel ways, but have difficulty explaining how they did it. Want to see Big picture first. Do not like details. Sequential vs Global

33. Sensory Reception Preferences Auditory Visual Kinesthetic Do:Visual, Auditory, Kinesthetic Styles Inventory

34. Visual learners remember best what they see--pictures, diagrams, flow charts, time lines, films, and demonstrations 70%+ students are visual Verbal learners get more out of words--written and spoken explanations 30%- are verbal Visual vs Verbal

36. Tablet PC as Visual Learning Aide • Case Solver for Windows Journal • On Informatics Intranet site under Teaching Files > TabletPC

37. Hemispheric DominanceHerrmann Left Brain Right Brain Do:Hemispheric Dominance Test (Left brain/right brain)

38. Intelligences -- Gardner • Verbal • Logical Mathematical • Bodily/Kinesthetic • Visual/Spacial • Musical • Interpersonal • Intrapersonal • Naturalist HIGH LOW

39. Special Needs • Physical • Mental • Emotional • Socio/economic • Logistical • Gender • Ethnic/Cultural

40. Approach to Learning • More predictive of success in medical school than learning styles • Three approaches to learning • Surface • Deep • Strategic Newble, DI & Entwistle, NJ. (1986) Learning styles and approaches: implications for medical education. Medical Education. (20);162-171.

41. Predominate Motivation Passing the course Fear of failure Intention Fulfill course requirements by reproduction Gorge and regurgitate Learning Process Rote Learning: focus on tasks and pieces of information in isolation Uses routine procedures and repetition to memorize facts and ideas Outcome Superficial level of understanding Substantial knowledge of factual information Surface Approach

42. Outcomes Deep level of understanding Integrated principles with facts Uses evidence to develop arguments Excellent problem solving skills Success in medical school Excellent physician with honed lifelong learning skills Predominate Motivation Interest in subject matter Career relevance Intention Reach personal understanding Learning Process Relates evidence to ideas; details to big picture Building frameworks to add new information Deep Approach

43. Outcome Variable level of understanding Shallow, course specific knowledge Depth of learning dependent on assessment strategies of courses and course requirements Predominate Motivation Making high grades Competing with others Intention To be successful by any means Learning Process Whatever it takes to make good grades Strategic Approach

44. Transfer of Learner Control High Student Control of Learning Low Faculty Time

45. Lifelong Learning and Addressing Learning Needs

46. Life Long Learning • Half-life medical information = 5 years • Volume doubles • Average physician practices 30 years • > 25,000 clinical trial articles published in 2005 (663,524 total new medical journal articles [MEDLINE citations] in 2005) • 200 new prescription drugs per year • Medical errors increasing

47. Lifelong Learning • Old method: read a few journal articles per week • Reality: Primary care docs would need over 17 hrs/day just to review reasonablepertinent material • Even in one narrow specialty would need 6+ hrs/wk • Practicing docs (all specialties) average 1-1.5 hrs/wk

48. Learning Needs • How do we recognize a learning need? • What steps do you take to fill the gap? • What resources do you use to gain knowledge?

49. Adult Learning Theory • Learning takes place • in context of patient care • when questions are answered • the issues are applicable to practice • when it doesn’t take too much time • Apply this to medical practice…

50. Addressing Needs • Passively (ineffective or biased) • Go to conference • Read this weeks journal • What the drug rep wants to tell you… • Actively (very effective) • Look it up when question occurs • Use reliable, current resources • Apply what you learn immediately