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T. Bradley Tanner, MD - Branched Path Learning and Gamification for Student Training in Health and Medicine

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Bradley Tanner, President, Clinical Tools Inc.

This presentation was given at the 2016 Serious Play Conference, hosted by the UNC Kenan-Flagler Business School.

The talk highlights how educators in the health sciences and health professions can successfully create and deploy branched-path learning and gamification elements. Attendees will gain practical advice on how create educational experiences that enhance interest and relevance and that target successful attainment of clinical skills.

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T. Bradley Tanner, MD - Branched Path Learning and Gamification for Student Training in Health and Medicine

  1. 1. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 1 / 54 BRANCHED PATH LEARNING AND GAMIFICATION for Student Training in Health and Medicine T. Bradley Tanner, MD (Clinical Tools, Inc. - http://clinicaltools.com) SERIOUS PLAY CONFERENCE 2016 | UNC, Chapel Hill, NC http://docs.clinicaltools.com/conference/2016-SeriousPlay/SeriousPlayTalk-Tanner-2016-07-26-01bt.pdf
  2. 2. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 2 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S SUMMARY The talk highlights how educators in the health sciences and health professions can successfully create and deploy branched- path learning and gamification elements. Attendees will gain practical advice on how create educational experiences that enhance interest and relevance and that target successful attainment of clinical skills
  3. 3. 3 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Objectives: The attendee will be able to:  Apply knowledge of branched-path learning to the process of creating an educational experience for students in health science, medical, and health professions.  Identify elements of gamification that will enhance learner interest and participation and that match the needs of future clinical care.  Calculate the challenge of creating an educational experience using branched-path learning and gamification so educators can determine its appropriate use in their organization
  4. 4. 4 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Disclosure: About Me and Clinical Tools Tanner: President of Clinical Tools Inc., Board Certified in Psychiatry and in Obesity Medicine. Past stops at UVA, Pgh Company: CTI is a small R&D company located in Chapel Hill, NC specializing in software and curriculum development
  5. 5. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 5 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S WHO ARE YOU Health Care Provider Health Care related employment
  6. 6. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 6 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S WHO ARE YOU Health Care Provider Health Care related employment Care about Health Care Provision?
  7. 7. 7 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S The Need Vision and Goal  Need: Do providers have all the skills they need?  Can current education can fill in all those gaps?  Vision: Together, branched-path learning and gamification can create scalable and easily alterable training for today’s and future health and medical students  Goal: Outline how we can best use the potential of gamification to enhance the provision of health care
  8. 8. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 8 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S WHY GAMES Why is this talk not a game?
  9. 9. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 9 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S WHY GAMES Why is this talk not a game? Money?. $100K/40 minutes, Time? 3 months
  10. 10. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 10 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S WHY GAMES Why is this talk not a game? Scalability: We need a huge audience to justify that expense. A marketplace to buy sell this lecture (think android store/iphone store
  11. 11. 11 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S OK. Let’s throw in some Gamification  I'll go too fast.  Too slow;  Go backwords.  Skip slides.  Put some confusing slides with pictures that make no sense.  Create some hard to read slides with errors so we introduce the "what is he trying to do?" game
  12. 12. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 12 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S THE ANATOMY COLORING BOOK Games don't work? Games have to be in sync? Perhaps what (or how) we are teaching is wrong?
  13. 13. 13 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S How to implement: Cognitive  Meeting a Greater Purpose Meaning. Professionalism.  Challenge;  Competence: Task Accomplishment.  ACGME Competencies: Personal Development.
  14. 14. 14 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Cognitive: Challenge  Games are hard.  Anxiety is good ... when it isn't.  Branched Paths.
  15. 15. 15 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Cognitive: Challenge → Branched Path  What are they?  Development.  Models. 3x3 model, 3x3x3, What about software driven experience? AI?  Use: Do people do more than one – 50/50? Use is asymmetric. Clearly "wrong" paths are rarely chosen - but is it worth it?  Preference: Do users want points for successful choices - No Feedback is enough (except perhaps "patient health" points. Timed - yes, adds realism. "hints" rarely - want this to be real
  16. 16. 16 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S How to implement: Emotional  Enabling Creativity and supporting Autonomy  Social Connections - Health professional students want a system that rewards cooperation, improvement, and group success  Failure NOT! - In medicine "Losing" often means mortality or morbidity.  Unpredictability and Variation
  17. 17. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 17 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S WHAT IS THE NEED? “Clinical skills' training is arguably the weakest point in medical schools' curriculum. We need to bring back into the medical curriculum and clinical practice the art of observation, listening, clinical reasoning, and focused and targeted clinical examination of the patient.” (Shelley BP. Wither clinical skills and humanism? . Arch Med Health Sci 2014;2:1-3)
  18. 18. 18 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Case-Based Branched Learning Problem: New medical education standards require clinical skills training, but lectures aren’t interactive and simulations are expensive Solution: Branched-learning scenarios where students experience Real-world environments Outcomes of their decisions
  19. 19. 19 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Simulated 3D Patient Interaction Medical Education Training Case-based branched learning Case In Development Case Rendered In Tablet App
  20. 20. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 20 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S SIMULATES A REAL WORLD PATIENT ENCOUNTER
  21. 21. 21 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Full Patient Encounter Presented History Physical Exam Screening Brief Interventions Referral and Treatment Follow-Up
  22. 22. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 22 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S CREATED VIA BRANCHED LEARNING TOOL
  23. 23. 23 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Uses Online Case-Building Tool  Cases written online in Twine framework  Visual layout of case available as you go
  24. 24. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 24 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S CASE FILES TRANSLATED TO AN INTERACTIVE APP App Will be Available Free of Charge Initially!
  25. 25. 25 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Inviting Visual Interface On App  Students see rendering of patient on app  Visual interface makes real-world connections
  26. 26. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 26 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S REALISTIC DIALOGUE ENHANCES COMMUNICATION SKILLS
  27. 27. 27 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Simulated Patient Conversations Models ideal conversation approaches Emphasizes patient-centered treatment
  28. 28. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 28 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S USER CHOICES CREATE INDIVIDUALIZED EXPERIENCE
  29. 29. 29 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Multilevel Choice Pathways  User choices lead to decision-outcomes  Individualized experiences based on pathways
  30. 30. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 30 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S INTERACTIVITY: CHOICES FEEDBACK
  31. 31. 31 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Outcome Of Choices Explained  Chapters end with summary of student choices  Both ideal and non-ideal choices summarized
  32. 32. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 32 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S HOW CAN I LEARN MORE?
  33. 33. 33 / 54 C A S E - B A S E D B R A N C H E D L E A R N I N G F O R M E D I C A L S T U D E N T S Branched Simulated Patient Interaction Medical Education Training Clinical Tools has over 20 years experience in medical student and continuing medical education training. Fill out our survey on ClinicalTools.com to keep up to date on our development! Currently free of charge! ClinicalTools.com feedback@clinicaltools.com
  34. 34. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 34 / 54 C E : C A S E B U I L D I N G E N G I N E LET US INTRODUCE YOU TO ANOTHER APPROACH TO CASE SIMULATION….
  35. 35. 35 / 54 C E : C A S E B U I L D I N G E N G I N E Clinical Encounter Case Building Engine Build cases for a simulation app! Developed by
  36. 36. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 36 / 54 C E : C A S E B U I L D I N G E N G I N E WHAT IS THE CASE BUILDING ENGINE?
  37. 37. 37 / 54 C E : C A S E B U I L D I N G E N G I N E Case Building Engine What Does It Do?  A tool to create cases for clinical encounter simulation  Uses an online form  Renders in a clinical simulation app  App helps develop medical skills  Currently free of charge! Internal page from clinical simulation app:
  38. 38. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 38 / 54 C E : C A S E B U I L D I N G E N G I N E WHAT ARE THE INTENDED GOALS?
  39. 39. 39 / 54 C E : C A S E B U I L D I N G E N G I N E Case Building Engine Goals 1)Create cases using Case Building Engine 2)Share completed cases with others 3)Learn by creating, reviewing, interacting with cases “Knowing is not enough; we must apply. Willing is not enough; we must do.” — Goethe
  40. 40. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 40 / 54 C E : C A S E B U I L D I N G E N G I N E HOW DOES THE CASE BUILDING ENGINE WORK?
  41. 41. 41 / 54 C E : C A S E B U I L D I N G E N G I N E Users Create Cases for App Using an Online Form Online Webform Case App For Skills Training
  42. 42. 42 / 54 C E : C A S E B U I L D I N G E N G I N E Form Prompts You For Information  History  Evaluation  Diagnosis  Brief Interventions  Referral and Treatment  Follow-Up
  43. 43. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 43 / 54 C E : C A S E B U I L D I N G E N G I N E HOW IS THE CASE RENDERED?
  44. 44. 44 / 54 C E : C A S E B U I L D I N G E N G I N E In An Interactive App: Clinical Encounter Developed by
  45. 45. 45 / 54 C E : C A S E B U I L D I N G E N G I N E Multiple Completed Cases to Choose From
  46. 46. 46 / 54 C E : C A S E B U I L D I N G E N G I N E Rendered in a Simulated EHR* *EHR = Electronic Health Record
  47. 47. 47 / 54 C E : C A S E B U I L D I N G E N G I N E Timer Increases Challenge of Game
  48. 48. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 48 / 54 C E : C A S E B U I L D I N G E N G I N E INTERACTIVITY: CHOICES/FEEDBACK
  49. 49. 49 / 54 C E : C A S E B U I L D I N G E N G I N E  Make Clinical  Choices   Get  Feedback
  50. 50. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 50 / 54 C E : C A S E B U I L D I N G E N G I N E INTEGRATION INTO MEDICAL EDUCATION
  51. 51. 51 / 54 C E : C A S E B U I L D I N G E N G I N E Case Building Engine in the Classroom We envision scenarios like this one: Students use the Case Building Engine to create cases about any of today’s most common medical problems. They work in pairs and come up with cases. Then they share their cases with each other.
  52. 52. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 52 / 54 C E : C A S E B U I L D I N G E N G I N E HOW CAN I LEARN MORE?
  53. 53. 53 / 54 C E : C A S E B U I L D I N G E N G I N E Clinical Encounter: Case Building Engine Clinical Tools has over 20 years experience in medical student and continuing medical education training Fill out our survey on ClinicalTools.com to keep up to date on our development!
  54. 54. Funded by the NIH & NIAAA grants #1R43AA020456-01A1 and #2R44AA020456-02 ©Clinical Tools, Inc. (ClinicalTools.com) 54 / 54 CASE-BASED BRANCHED LEARNING FOR MEDICAL STUDENTS WITH 3D IMAGES T. Bradley Tanner, MD (Clinical Tools, Inc.) Serious Play Conference 2016 UNC, Chapel Hill, NC Clinical Encounter: Alcohol (Branched Learning) Clinical Encounter: Case Building Engine More information available on ClinicalTools.com THANK YOU!

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