My name is Joshua Harding I'm currently a second year medical student at Warwick Medical School some years ago i wrote a 4 part article series with a colleague about how iPads will revolutionise medical education. Off the back of these articles i have been asked to come and speak to you today about my relationship with information.First of all I am not an expert in the field in which you work and i do not admit to be one and so i do not aim to educate, but rather try and illuminate and perhaps insight some provocation and debateI will leave it to you, to discuss the semantics of the points i raise and i hope you find them interesting
I started my higher education at Newcastle University, where I studied physiology. As a student my primary source of information were, printed lectures and notes.We would then go Home or to the library to study and consult our essential core textbooks, and recommended research papers, where inevitably we would write some more notes.This is probably representative of the majority of your educations and it is essentially analogue. I kept all my notes and textbooks from my degree, and….. THIS PHOTOshows the sum total of my education from Newcastle University, It's a good thing I can remember absolutely everything I was ever taught…. as finding any of it now, would be a real challenge.
Medical school is an entirely different experience when it comes to consuming information. I'm more than 2 years into my course and I have easily covered the same amount, if not more content than I did in my 3 years at Newcastle. It was apparent from day one at med school that I needed to consult a lot of information, quickly and efficiently. Our course texts had all the answers, but is it practical to physically carry all the course texts I would need on a day to day basis?No!But we will try anyway!
So did I find a solution?Yes – Digital consumptionI bought the first iPad and quickly realised it was the solution to my problems, I recognised its potential to revolutionise how students access information and I adopted it early. Three years on and I am now a completely paperless student.
So my primary source of information for medical school is nowHold up iPadThisEverything I need to study medicine is in my handI now view my lectures like thisMy notebooks like this, or thisMy notes look like thisAnd my textbooks look like this
Using this device I am able to search across all of my content and resourcesSeamlessly switch between note taking and resources……. In essence I am able to utilise all of the information I need in a fraction of the time it would take to route through my hand written notes from Newcastle.I feel that this is completely essential for a student of the future and we will come to expect it. Especially when you consider the current and future generations of students who are growing up in an on demand society, where everything is available when you want it, where you want it,how you want it.So this was a peak into my history and present, as a student. And as you can see, the role of information in my life is quite domain specific and my experiences and view points therefore will be based on this. So please bear that in mind
In the past three years, advances in tablets have captured the imagination of educators around the world. The tablet computer is not a new idea, but it is an idea that until the iPad was release, had failed. The iPad has gone on to carve a niche into education, as a portable and always connected device. Equipped with Wifi, 3G, High res screen and a battery that will last all day long. It is a powerful personalised education tool that I feel will be adopted as a norm by students within next 18 months.As this happens students will at minimum expect access to their most used resources as well as new, exciting and enhanced education resources.So I suppose the question most pertinent to yourselves would be are you ready to meet the inevitable demand? So what are the benefits of using a tablet and why would students adopt them?Research has shown,We Remember 20% of what we read….iPads allow for a personalised education experience. We all have different learning styles which focus on different aspects of learning. Most of us have a visual preference, others an auditory. Some like to read or write in order to learn, and some have a strong kinaesthetic preference. However you learn, the iPad is flexible to your needs and can be setup in such a way as to best reflect your learning style.So the adoption of a device that allows you to do all of those things is a no brainer! And students do want to use tablets and digital content. I am yet to find a student who has observed how I use an iPad and not want to buy one afterwards, I always ask the question so why haven’t you bought one? The usual response I get is, well I have always wanted to buy one, but until now I haven’t been sure how I could actually use it.This brings up a key point – Awareness and I will touch on it later
I felt that giving you a direct insight into a normal day in my life as a student would be the best way to display my common workflows, how, when and where I access information. My current clinical rotation is Orthopaedics & Anaesthetics and an average day for me would involve:Meeting with my consultant in the morning for a ward roundI know the topic I am covering and so before my consultant arrives I am able to que up any relevant notes I have made, apps or textbooks that might be of use.I'm now ready to tackle any potential situations where I may need to access information quickly. The ward round begins and I take a history from one of the patients, my anaesthetist assesses the patients airway and asks me some questions on the subject.My consultant leaves and asks me to perform a clinical examination on the patient to assess their risk for the operation. I open up my notes on clinical examination and quickly refresh my memory. I perform my examination, thank the patient and leave, I’m then able to immediately check what I just did against what I should have done, essentially giving myself instant feedback on my performance.
After the ward round we will head down to day surgeryAnd more often than not I will see my anaesthetist using a drug that I have never seen before.So I’m able to open up the BNF app and look it upAllowing me to learn about the drug in a fraction of the time it would take for me to go and get the paper copy that you will find on every wardI can then ask my consultant about the drug and get subsequent reinforcementOn this particular day the next surgery was a radical neck dissection, I'm asked to scrub in and assist, I jump at the opportunity but immediately realise it has been a long time since I did any head and neck anatomy.I open up one of my anatomy apps and quickly look over the anatomy in the area we will be working. Putting the knowledge to the forefront of my mind and allowing for easy anchor points in which I can hang new learning and reinforce the content I looked at just minutes previously. I can honestly tell you that this quick recap of info is invaluable, I have been in situations where I have been unable to do this and unsurprisingly I cannot remember nearly as much as if I'm able to refresh my knowledge immediately before a learning experience.
Once a week we have academic teaching in a lecture theatre.I arrive, sit down load the lecture from my university intranet and export them into my note taking app. I'm now able to annotate the lecture notes and record the speaker, so I won't miss anything from the session.During the lecture I can consult textbooks, resource apps, old notes that might tie in and the internet if required. The end result is a near complete set of notes at the end of the lecture which can be used to revise from. Most of my colleagues will then go home or to the library and consult their textbooks on the subject, filling in the gaps in their notes and produce a revision page. I'm able to spend my time re-enforcing and learning that content.
Inkling is the only format I am aware of that offers interactive ebooks in the UK. These newer forms of ebook may also be known as Smart books or multi-touch books.I strongly believe that they are the foundation in which the future of textbooks should be built upon.I hope that the majority of you will have used an interactive textbook at some point or at least know about them. They always wow my colleagues when I show them what I read from.but If I’m honest I have been using them for quite a while now and they have already become old hat.
Although I do believe we are witnessing the death of the paper textbook.I still don’t think that publishers have even scratched the surface regarding utilising the full potential that tablets have to offer with regards to their textbooks.I still think that even though having the ability to carry your entire library of books + their interactive nature with you at all timesWhich is reason enough to justify buying and using a tablet. Publishers need to add a little bit more of a USP to their products to push students into definitively going paperless.
And I think that this USP should be learning analytics.Interactive textbooks should be the base modelSmart textbooks would be irresistibleWhy? Simple they will get you a better gradeSo at this point some terminology in case you are getting lost. Interactive textbooks are books with multimedia content. Smart textbooks are interactive textbooks with the added benefit of adaptation based on learning analytics.What do I want my textbook to do?Well I want it to study me whilst I study itI want it to tell me how I am doingI want it to congratulate me on my strengthsRemind me about the weaknesses I know I haveEnlighten me about the weaknesses I don’t know I haveAnd adapt the content of the book to suit what I need to learn.It would feasibly be able to do this by collecting data on how long I have been reading each chapter, which chapters I am missing out, what content I haven’t covered before. What questions I am getting correct and which I am getting incorrect.It would nice for instance if it could remind me I need to re-cover some content. For instance I know that to maximise retention of something I have just learnt I will need to re-read the content roughly 2 days later, then 7 days then a month. If my book could track these specific learning objectives and let me know when it is likely I am about to forget something, if you stuck to what the book said, it would drastically increase your retention of knowledge.It might seem ambitious but I think that for students to fully adopt digital media over print there needs to be an added USP and this is it.Until this happens I can see students adopting a half and half approach to using tablets and digital consumption.
This diagram represents an average workflow for me. It includes eBooks, Reference Apps and Lectures in the form of ppt's, audio and visual media.This all feeds into my note taking app where I can add content and make my handwritten notes, these notes can then be opened and switched between easily using goodreader a pdf library. Unfortunately I don’t have time to go over all of the apps I use in depth, but I will see if it is possible to upload an extended ppt that will contain this information.The key thing here though is how all this information syncs to the cloud and then to all of my devices
This connectivity really is the fulcrum of being a digital student. At the heart of this connectivity is cloud storage. For those of you unfamiliar with cloud computing, this refers to the provision of resources on demand via a network. Using an app like dropbox, it allows you to connect to the ‘cloud’, where you can upload, download and sync your files across all of your devices.It has so many benefits I couldn’t list them all, it is also a very powerful tool for sharing information with colleagues.
So lets talk about some of the barriers to being a digital student.The way I look at it is, the challenge for me as a student is to learn the information, the challenge for yourselves is to improve the pathway by which this information is delivered to me. So I touched on awareness at the beginning of my presentation, and eluded that it was a reason that students have not yet fully adopted digital consumption of information via tablets. Two key points arose from thediscussion I mentioned earlierAwareness of what you can actually achieve using a tabletCostsThe bottom line regarding awareness was that my colleagues are not aware of the workflows made possible by using a tablet and digital consumption.This is even apparent amongst the students who own tablets.I feel Improvements in digital literacy would help librarians to engage more with their student populations and provide them with advice and improve awareness.Student advisors would be a potential idea where they could advise on workflows that can be used by the student populationPublishers could also help here by offering free (offline) ebooks with paper copies sold in shopsCostsUpfront costs will not change, and there is no way around it, it will make a hole in your pocket.And I suppose loaning from libraries could always be an optionPublishers though really hold the keys to one of the biggest problems I currently face with costs, and that is
I have to rely solely on private consumption of information, IF I wish to remain paperless, and not settle for lesser resources.Meaning I have to pay for it all myself. This is not right, in theory my university fee’s should be paying for the resources I find most useful, and these are increasingly digital.The sink hole currently for digital students is not the upfront costs or the costs of the essential apps you will use on a day to day basis. But the purchasing of textbooks, and subscription based apps, I can get free access to all the popular texts in paper form from my librarySo why not digital?Well perhaps it is that the Institutes either do not have the ability to offer the digital content for free (for example Inkling’s textbooks are probably not available to institutes) OR they cannot afford to the subscription costsOther frustrations I commonly face arefragmentation.I have to buy ebooks from multiple sources and then use multiple platforms to access the contentthe quality of these platforms can vary tremendouslyNot to mention the mere act of having to use numerous different apps to read different publishers books is a real painThe quality of the electronic book can also vary too. ePubs are horrible as textbooks and a PDF is much preferable (as long as it is without DRM protection) This is so that I can edit it and annotate it using third party apps.
So what would my ideal workflow look like?Well the only real problems with my workflows are textbooks and their costs.Interactive textbooks need to be adopted as a standardThe whole ebook market seems fragmented and something needs to be done about it:Preferably we will be looking at a future of interactive textbooks, but even so, PDFs and dare I say it ePubs need to be available from One store, and able to be viewed on one platform of your choosing.I think eventually this will happen, whether it is by amicable negotiation or capitalist monopoly, it doesn’t matter to me.I feel that Publishers also need to start thinking about applying learning analytics to their interactive textbooksWhilst reducing the costs or finding a better payment plan that will allow students to rent high quality digital content from their university libraries.With this in mind institutes and libraries need to start thinking about subscription models in a wider sense, not just to their journals but also to apps and other digital content.From my limited perspective, much of what is wrong with the system comes down to the fact that publishers and libraries have to plan well in advance and make changes slowly over time based on evidence, Students on the other hand are able to change direction quickly and easily. The problem exist because the market has changed so radically in the past few years that students have been able to adopt the new technologies well before the industry and libraries were able to make changes to support these students. So unless this disparity is tackled students will continue to receive sub par products and support. And pay through the nose if they want access to the best digital content.
The Student-Information Relationship By Joshua Harding
Agenda• Setting the scene• Tablet computing• Consulting information• Workflows• Barriers & Challanges• An ideal future• Q&A• Conclusion
• Ourmonths I texts had all In 18 core had covered the same amount of content! theoverload! • Information answers • I needed to be able to accessMBChB - Medicine • Lots of Info • Quickly • Efficiently No! But we will try anyway!
So did I find a solution? Yes Digital ConsumptionI am a paperless student
MBChB - Medicine• Search across all my content & resources • Seamlessly switch between note taking, resource apps & textbooks • ↑ Efficacy • ↓ Time taken • ↓ Stress, ↑ Satisfaction • On demand society
Tablet Computing• Not a one as aWhy usenew idea student?• Powerful personalised education tool We remember Ultimately we remember 90% of what we20% ofmonths – If not sooner!• 18 what we read read, see, hear, say and do30% of what we hear• Expectations will40% of what we see rise!50% of what we say60% of what we do• Adoption of a device that allows this = no brainer!• Personalised education experience Flexible• Desire is present• Question - “So why haven’t you bought one?”• Answer – “I’ve always wanted to buy one, but I’ve never been sure how I could actually use it.”
Consulting Information• Notes & Resources at my finger tips• Notability (Note taking app) – Take a history from the patient• Answer questions with confidence• Refresh memory• Perform with confidence• Instant feedback
Pocket Body (Anatomy App) Consulting Information • British National Formulary (BNF) – Resource App Instant learning & subsequent reinforcement • Recap anatomy • Forefront of mind • Anchor points • Improved learning • ↑ retention
Consulting Information• Notability (Note taking app) – Annotate lecture notes – Record lecture• Inkling• GoodReader (Notes)• Resource Apps• Internet
Inkling• Interactive, Smart, Multi-touch – books• The future of the textbook – Intuitive navigation – Interactive, movies, animations, music, podcasts, slideshows, interactive images, 3D models – Search through the entire book – Highlight text, make notes & share them• Purchase per chapter – Free content updates
Maximising digital potential• Interactive textbooks as a base model• Smart textbooks would be irresistible!• Why? Simple You will get a better grade• What do I want my textbook to do? – Whilst I study it, it studies me – Inform me of my progress – Adapt the content of the book to me – Be a personal study buddy – A true personal learning environment – Compare me to my peers
Dropbox• The fulcrum of a digital student• Upload, Sync & Download all your content – Offline viewing – Never lose your content• Organises your files• Sharing
Barriers to being a digital student1. Awareness – Solutions • Librarians – Digital literacy, Student advisors • Publishers – Free (offline) ebooks with paper copies2. Costs – Solutions • Upfront costs wont change – Loaning from libraries? • Publishers Institutional and Private consumption
Challenges• Key dichotomy – Private consumption – Institutional consumption• I get free access to all the popular texts in paper form from my library• So why not digital?• Fragmentation, Reduced Variety & Variable Quality
My ideal workflow• Interactive textbooks as a standard – Export content from (in PDF format) to my notes• Interactive textbooks – One universal store to buy them (privately) – One universal platform to view them on – Easy to loan from my library (free)• Apply learning analytics• Institutional subscriptions to Apps
Conclusion• Digital consumption is the future• Paperless students will become more common• Publishers need to adapt or go the way of the dinosaur – Or Universities will start using iBooks author and do it for you!• Libraries & Institutions need to re-organise their funds to incorporate Apps & more digital content