Juanita Fernando - Learning the game: a creative approach to mHealth informatics in medical education
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A creative approach to mHealth informatics in medical education
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Juanita Fernando - Learning the game: a creative approach to mHealth informatics in medical education
- 1. Medicine, Nursing and Health Sciences Learning the game A creative approach to mHealth informatics in medical education Ms Jennifer Lindley & Dr Juanita Fernando HINZ Conference, 20th October 2015
- 2. Part 1 The program and its theoretical underpinning June 2015PACTS MEERG 2
- 3. What was the problem? Placements Lack of eHealth teaching (mHealth) Anecdotal evidence of impacts Dispersed student clinical and education experiences Crowded curriculum Hidden curriculum - “too hard” “no expert” interpreted by students = “not important” October 2015HINZ Conference, Christchurch, NZ 3
- 4. What was the problem 2 The majority of Australian medical schools have no explicit mHealth curriculum. October 2015HINZ Conference, Christchurch, NZ 4 Medical registration Medical education WIL placements Professional requirement Research pervasive mHealth practice
- 5. Curriculum aims – Computer games & applications for health & wellbeing To improve effective digital learning and teaching on mHealth in pre-vocational primary health care courses in Australia to equip graduates with the skills for professional digital practice. Our specific goals were to: October 2015HINZ Conference, Christchurch, NZ. 5 Design an mHealth elective pre work integrated training - practice placement (champions) Pilot an elective for first year undergraduate medical learners. Utilize self-reflective methods as quality improvement process
- 6. Learning Theory to maximise impact: 1 Billet & Pavlova (2005) October 2015HINZ Conference, Christchurch, NZ 6 Beginner Learner “agental” • Authentic & experiential learning • Community of knowing • Building on prior knowledge and experience • Design learner driven Beginner Learner’s situational perception is limited • Instances/Cases • Subjective • Field-Force analysis development Beginner Learner discretionary judgement • Independent critical users • Continually negotiated • Astute, confident decisions on use for clinical context
- 7. Learning Theory to maximise impact: 2 Adult Learning Theory Learner brings experience Builds on existing knowledge (social and academic) The learner is self directed Options for choice in how the learning is applied Deeper learning with problem-centred learning Self direction through instances/cases October 2015HINZ Conference, Christchurch, NZ 7
- 8. Intervention (15 – teams of 3) Titles • Introduction • Eval tools • Games • Phone apps • Social networks • 3D applications Focus • Web site tours • Practice cases • Usability • Guest presentations • Force-field matrices Type • Technical skills quiz • Discussion, lrge and sml group • Force-field analysis own tool • Problem solving and own practice • Assessment presentations October 2015HINZ Conference, Christchurch, NZ 8
- 9. Student Presentations 1 Gaming and Addiction 2 3D Anatomy Apps 3 Medical Smartphone Apps 4 The Usability of Online Brain-Training Apps 5 Investigating and Critiquing the Relationship Between Electronic Games and the Onset of Dementia October 2015HINZ Conference, Christchurch, NZ 9
- 10. Part 2 Results and discussion of our learning June 2015PACTS MEERG 10
- 11. Results Enrol • ½ indicated active interest in mHealth practice • Remainder said it was the only interesting option left them Tech quiz • Many novice users of mHealth for practice or education so teams incl tech savvy learner • Few owned or had access to devices –borrow • Students mislead by program title • More explicit explanation of content, assistance with access to technology, basic use skills • “On-the-run” audit and modification Apps • Student choice • App choices limited to free, open source apps • No useful free apps • Could connect to Internet from classroom Team reports f/n • Force-field matrix analysis & critique: fitness of purpose • Ongoing self-managed team evaluative instruments developed outside of class and around first clinical placement • Educator required: ways to show presentation files in various formats Experts • Student engagement palpable June 2015PACTS MEERG 11
- 12. Results of self-reflection for quality improvement education October 2015HINZ Conference, Christchurch, NZ 12 … After each teaching session ... • Assistance with access to digital technology and the development of basic skills in its use by health prof. • Funds required for app purchases • Contextual training to students outside elective sessions as required. • Force-field analysis embedded • Independent learner workshops to analyze and evaluate the mHealth apps • Additional training outside elective
- 13. Discussion of key results No formal evaluation- study limitation! No existing evidence in the literature for comparison Unique elective “Agental”, active participation in development Continuous learner evaluation Flexibility to modify “on-the-run” Ongoing collaborations October 2015HINZ Conference, Christchurch, NZ 13
- 14. Lessons learned 1. Formal evaluation process- pre and post session and elective diaries?(Feedback loop) 2. Expertise and champions 3. Clearly transparent title 4. Ability to be flexible and rapidly adjust program 5. Explicit content 6. Adequate resourcing – devices & apps 7. Technical expertise on the ground October 2015HINZ Conference, Christchurch, NZ 14
- 15. Final comments Possible to include eHealth in crowded curriculum Demonstrated mHealth potential to students at a point where ready Student practice and placement skill set expanded Collaborations with champions HI research projects Scope of universities to properly resource HI curriculum ? 15 students so findings indicative of need for further research October 2015HINZ Conference, Christchurch, NZ 15
- 16. Our thanks October 2015HINZ Conference, Christchurch, NZ 16 Dr Chris Bain Dr Kaihan Yao Mr Mick Foy ACHI Members and Fellows (MACHI & FACHI)
Editor's Notes
- The first part of this presentation sketches out the program and its theoretical underpinning. The second part discusses program delivery results and our learning for your consideration.
- in fact it is an increasing important aspect of practice expertise.
- So we developed an explicit strategy to by piloting the introduction of a single semester elective option around medical student’s first placements to address a significant pedagogical WIL placement deficiency.
- Developed our elective through discussions with students, consulting with Australasian College of Health Informatics email list and faculty and e-Learning division support. ensuring learner fitness to practice. Students need to be able to make appropriate, astute and confident mHealth judgements during educational placements from first year as well as for medical registration purposes – a flipped learning model?
- We relied on work by Billet and Pavlova to expand students “agentic” action to shift program design and authentic learning outcomes from the classroom to real life practice. The program evolved from session to session driven by students’ critical judgements about mHealth in real life. Force-field analysis training sessions supported students instrument developemnt for the evaluation of mHealth applications. Force-Field matrices analyze the reasons for and against the phenomenon in question, communicating and unpacking the reasons behind the individual’s or group’s decision. [13] To encourage the development of real life expertise and critical faculties, the students needed to build and critique evaluative tools of their own make to analyse a single mHealth instance or category of applications.
- Billet and Pavlova’s work was supported by adult learning theory to maximise program learning outcome impacts. Read slide.
- Elective sessions and titles are summarised in the slide. Read slide. Note: Two sessions per title were planned and content was designed to provide medical students with an introduction to the breadth of key practice realities of mHealth informatics tools for education and everyday practice. Note: 15 students were organised into teams of 3 for small group work.
- This slide illustrates the titles of their final presentations for summative assessment. These were appraised by independent champion-assessors made up of senior academic staff and external health informatics experts. The students scored extremely well and we were quietly very proud of their achievements and quality of work.
- NOTES: . Following some discussion, each group then selected one type of mHealth application to evaluate. App choices were limited to free, open source applications using tablets or smartphones that could be connected to the university system and the Internet from the classroom. expert speakers on topics such as the application of telehealth and telemedicine (public health) to actual patient care. In reality the force-field matrix analysis of each group evaluation instrument development was ongoing throughout the elective after classes. This ensured that the students appraised and refreshed their instruments to maintain fitness for purpose for the duration of the elective. Each group then used their team instrument during self-managed workshops to analyze and evaluate the mHealth apps of their choice for smart phone and tablet devices. Assessment tasks centred on student participation and active engagement in more than eighty percent of set activities to pass the elective. Every second week the students reported on their team evaluation tools during the elective using their own devices relating to the mHealth elective learning objectives. We frequently needed to work on ways to show presentation files in various formats and using different platforms. This presentation work stimulated useful and critical discussions. The student groups took turns to present and lead class analyses of their work. The groups proposed and defended hypotheses about the mHealth apps they had analysed. The presentations demonstrated these students’ improved capacity and performance over the period of the elective.
- Notes- Skills deficits included jargon busting
- NOTES: Lessons limited to insights from feedback gained from pilot with 15 students. 1. A formal program evaluation by students would have better informed this discussion but was not possible for organisational reasons. 2. Inclusion of champions for successful design & delivery of the elective. Experts included academics with technical & educational knowledge, HI & IT professionals as well as business experts: ensuring suitably constructed LOs that reflected practice reality & identified appropriate content for the sessions. 3.1 - Students expected that the elective would encompass playing computer games rather than being a serious exploration of games and apps for healthcare despite publishing the entire syllabus on the e-learning system, 3.2 - gender bias in enrolments with a greater representation of male students in the class. The incongruity between students’ expectations & program design suggests the construction of clear and transparent titles is necessary and may also assist in redressing gender bias. 4. 1 - Clearly identifiable mismatch between our literature-based, expert & anecdotal perceptions of the knowledge & skill levels of students & their actual expertise. Our assumptions regarding the ‘techno-savvy’ of students were ill-founded so mHealth informatics skills assessment & follow-up training sessions needed. The requirement is borne out by similar experiences overseas [14]. 5 - The ability to be flexible and rapidly adjust the program during delivery was critical to securing student engagement. Became apparent that it was necessary to provide an explicit context for the students, outlining current efforts in mHealth and telehealth from both global and domestic perspectives. 5.1 - Jargon busting - these elements are better to be included at the beginning of the program design process. 6.1 -The assumption that students would have access to personal smartphones and tablets was misguided. A set of iPad tablets, borrowed from another department in the university and loaned to learners, resolved this concern. 6.2 - Funding was not sufficient to allow learner purchases of many relevant serious games and apps. Ultimately students were provided with a small sum of money to allow the purchase of apps. The program was subsidised from the research funds of the academic delivering the program. 7. Range of devices and platforms used by the students. Successful teaching required an academic with both technical & educational HI & mHealth expertise. Technical expertise included strong knowledge of platforms and systems as well as the capability to link a range of platforms into the university IT system and the Internet
- We believe this case supports notions of integrating mHealth informatics components into the medical curriculum, seemingly a logical response to new practice horizons for health. It provides a space for students to reflect upon their own learning about mHealth in a practice context. Experience in design and delivery of this elective has informed content for knowledge management, which is a core component of the current undergraduate medicine curriculum at our institution. Further robust academic exploration of this domain is clearly warranted.