1. Medicine, Nursing and Health Sciences Using technology to maintain course quality: Delivering a city course in the countryRural Curriculum Innovation Conference, Dec 2012 Dr. Hung The Nguyen Clinical education and Professional Development Unit, School of Primary Health Care email@example.com hung
2. Acknowledgements**Course designAssociate Professor Lyn ClearihanDr. George ZahariasDr. Hung The Nguyen**TutorsDr. Nizar FarjouDr. Mohammad R.Al-MagablehDr. Nadida Kachkouche**Course administrationMs. Caroline Menara
3. Background International Medical Graduates make up a significant workforce in the rural Australia • Australian health system is increasingly reliant on IMGs (HWA Health Workforce 2025, 2012) • 25% of the medical workforce are IMGs (AMWAC, 2005) • 23% work in regional areas and 13% in rural and remote areas (Hawthorne et al, 2003) • Permanent resident OTDs fill the gap in vocational training programs (AMWAC, 2005) • 43% of Victorian GPRs were PR OTDs (RWAV, 2004) • 36% of the GP workforce in rural Victoria were IMGs (RWAV, 2010)
4. Background IMGs require adequate educational, supervisory and other socio- cultural supports for themselves and their family (Lost in the Labyrinth report, 2012): • Introductory support (clinical and professional orientation, cultural awareness training; social and cultural orientation for their families) • Ongoing support (education and professional development, examination preparation, mentoring and peer support programs) IMGs can travel great distances to access educational activities they need
5. Monash University IMG Clinical Bridging Course Based in Notting Hill 8 days Tutorials, lectures Workshops – demonstrations, role play, simulated patients Clinical exam practice
6. 3D Intensive Clinical Bridging CourseBased in Mildura3 daysTutorialsWorkshops – demonstrations, role plays and simulated patientsClinical exam practicesPre-course and at home in-course activities activities Google sites
7. Learning concepts and tools Challenges: • How to maximise classroom efficacy? = in-class tools AND out-of class study • How to structure out-of-class study? = content AND delivery • How to maximise peer-peer instruction? = building team spirit AND safe learning environment The "flipped" classroom • Information transfer takes place in advance. • students study before rather than during or after class. • the classroom becomes a place for active learning, questions, and discussion. • facilitators spend their time addressing students difficulties rather than lecturing.
8. Learning concepts and tools Content • Developed by the Unit • Available on the web Delivery of content - Google Sites • Available: web-based • Accessible: easy to sign up and sign in, staff/students can collaborate • Affordable: free • Appropriate/Acceptable: ?
9. Learning concepts and tools Educational instructions • Before the course: • readings (clinical guidelines, cultural competency concepts and principles, clinical interview tips and strategies, study plan and learning objectives), • videos (demonstration physical examinations); • case studies (history, physical examination, management strategies) • In-course: • minute paper; safe learning environment; peer-peer feedback • role play, simulated patients and immediate feedback • Between sessions: • revision of reading; • preparation for the next day
10. Google Sites Structured out-of-class learning activities • readings (clinical guidelines, cultural competency concepts and principles, clinical interview tips and strategies, study plan and learning objectives), • videos (demonstration physical examinations); • case studies (history, physical examination, management strategies)
11. Minute paper To investigate how well students understand important concepts presented during a class period, and to improve instruction in the succeeding class by modifications in delivery/presentation. • Real time feedback • During or at the end of a session • Anonymous What we were interested in: • Learning environment • Delivery • Relevance • Learning achievements
12. Safe Learning Environment SLE = engaging, inclusive, challenging, supportive AND culturally safe • foster peer to peer feedback • increase group interactions • “Giving it a go” • honest and meaningful feedback
13. Our first class... n = 21 all in working in general practice or hospital most from rural victoria, NSW/ACT and SA =12 Melbourne (4) interstate - WA (4), Qld (1) IMGs working in general practice, have AMC part 1, studying for AMC part 2 or FRACGP/FACRRM
14. Did the minute paper help? D2 D1
15. Did the minute paper help? D2 D1
16. Did the minute paper help? D2 D1
17. Did the minute paper help? The questions: • learning environment • relevance • delivery - scored 4-5/5 in all areas, with improvements on D2 learning achievements • D1 - physical examination skills, communication skills, history taking skills, interpreting x-rays • D2 - mock exam cases, physical examination skills - practical skills > knowledge - practice cases > case studies Changes to the sessions: • D3 “expert” individual feedback in front of peers, before peer-peer discussions
18. Was Google Sites acceptable?
19. Was Google Sites acceptable?
20. Was Google Sites acceptable?
21. Was Google Sites acceptable?
22. Was Google Sites acceptable?
23. Was Google Sites acceptable?• very useful, focused, gives us option to read what you need and not everything in a typical section• what about joining IMG remotely for a few online bridging course and study program; maybe more videos made by examiner as he is a good teacher• I would be happy to pay a yearly fee for the site
24. Acceptability of the “flipped class” Evaluation: - What was the best? • delivery - interactive, hands on, OSCEs are a good way to learn • feedback - personal, individual, immediate • environment - friendly, non-judgemental • content - comprehensive, perfect and precise - What could be better? • more time, more cases • obstetrics, gynaecology, paediatrics
25. Acceptability of the “flipped class”
26. Acceptability of the “flipped class”
27. Conclusion A successful approach (flipped class, google sites) • To manage available time for the application of knowledge, skills and attitudes • To allow learning in a place, at a time and at a pace students most benefit • To maximise instruction and feedback time with expert facilitator Does this suggest changes to the main course? • A different cohort • Teacher resistance Other tools? • Resource development (videos, virtual patients) • Online tools egNB