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See, Do, then Teach - To See, Show-Do with Feedback, Teach with Feedback-Reflection- Scholarship

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Using Digital Repositories to Support Mastery Training and Deliberate Practice in Radiology Training and Medical Education Faculty Development

See also examples below:

http://www.ajnr.org/
(see Case Collections)

https://www.nejm.org/multimedia/images-in-clinical-medicine?query=main_nav_lg
(NEJM, see Images in Clinical Medicine)

http://casereports.bmj.com/collections/radiology2

http://www.radiologycases.com/index.php/radiologycases

https://radiopaedia.org/

Published in: Education
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See, Do, then Teach - To See, Show-Do with Feedback, Teach with Feedback-Reflection- Scholarship

  1. 1. See, Do, then Teach - To See, Show-Do with Feedback, Teach with Feedback-Reflection- Scholarship Goh Poh Sun MBBS(Melb), FRCR, FAMS, MHPE(Maastricht), FAMEE Associate Professor and Senior Consultant Department of Diagnostic Radiology, National University Hospital, National University Health System Associate Member, Center for Medical Education, National University of Singapore
  2. 2. Background & Objectives To demonstrate in radiology residency training, and health professions education faculty development, how a digital repository, within an open access online platform (Blogger), containing over 10,000 anonymised radiology cases, and 5,000 links to educational resources, can be used to 1) shorten postgraduate residency training, and support medical education faculty development; 2) make this process more efficient, using technology; 3) translate a core curriculum to a standardised set of learning experiences, centred around curated, peer reviewable, high quality teaching cases, learning paths and training plans; 4) support deliberate practice and accelerate mastery training; and 5) examine the role of the medical educator - as filter, curator, facilitator, guide, coach, and educational scholar.
  3. 3. "By reviewing research on medical performance and education, the author describes evidence for these representations and their development within the expert- performance framework. He uses the research to generate suggestions for improved training of medical students and professionals. Two strategies— designing learning environments with libraries of cases and creating opportunities for individualized teacher-guided training—should enable motivated individuals to acquire a full set of refined mental representations. Providing the right resources to support the expert- performance approach will allow such individuals to become self-regulated learners—that is, members of the medical community who have the tools to improve their own and their team members’ performances throughout their entire professional careers.’ from abstract of Ericsson KA. Acquisition and maintenance of medical expertise: a perspective from the expert-performance approach with deliberate practice. Acad Med. 2015 Nov;90(11):1471-86. doi:10.1097/ACM.0000000000000939. PubMed PMID: 26375267. https://www.ncbi.nlm.nih.gov/pubmed/26375267/?ncbi_mmode=std
  4. 4. "Understanding basic theory using a few illustrative examples. Mastering a topic by exposure to and experience with many examples Typical examples or real-life scenarios can be used to illustrate theory, and help students understand fundamental principles. Mastering a topic usually requires exposure to and experience with many examples, both typical and atypical, common to uncommon including subtle manifestations of a phenomenon. The traditional method of doing this is via a long apprenticeship, or many years of practice with feedback and experience. A digital collection of educational scenarios and cases can support and potentially shorten this educational and training process. Particularly if a systematic attempt is made to collect and curate a comprehensive collection of all possible educational scenarios and case-based examples, across the whole spectrum of professional practice. Online access to key elements, parts of and whole sections of these learning cases; used by students with guidance by instructors under a deliberate practice and mastery training framework, can potentially accelerate the educational process, and deepen learning." above from Goh, PS. A series of reflections on eLearning, traditional and blended learning. MedEdPublish. 2016 Oct; 5(3), Paper No:19. Epub 2016 Oct 14. http://dx.doi.org/10.15694/mep.2016.000105
  5. 5. Methods For example in Neuroradiology residency training - https://learningneuroradiology.blogspot.sg/2015/12/cerebral-infarcts-and-its-mimics.html and https://learningneuroradiology.blogspot.sg/2018/03/radiology-resident-tutorials-january.html and medical educator faculty development (eLearning) - https://telatcenmed.blogspot.sg/
  6. 6. "How could one use this material to dramatically reduce case review time? Reduce study time? Reduce residency duration? Use training time in other ways?" "How would you use this material to develop confidence and familiarity with less common conditions? Given that time is limited." "How do you stay sharp, not rusty, get better (sharper)." [Practice. With feedback. With reflection. With increasing difficulty. Systematically. Regularly. With material that is at hand. At your finger tips.] -Poh Sun (posted on 7 February 2018 @ 0358am)
  7. 7. This article investigates the relation between mind wandering and the spacing effect in inductive learning. Participants studied works of art by different artists grouped in blocks, where works by a particular artist were either presented all together successively (the massed condition), or interleaved with the works of other artists (the spaced condition). The works of 24 artists were shown, with 12, 15, or 18 works by each artist being provided as exemplars. Later, different works by the same artists were presented for a test of the artists' identity. During the course of studying these works, participants were probed for mind wandering. It was found that people mind wandered more when the exemplars were presented in a massed rather than in a spaced manner, especially as the task progressed. There was little mind wandering and little difference between massed and spaced conditions toward the beginning of study. People were better able to correctly attribute the new works to the appropriate artist (inductive learning) when (a) they were in the spaced condition and (b) they had not been mind wandering. This research suggests that inductive learning may be influenced by mind wandering and that the impairment in learning with massed practice (compared to spaced practice) may be attributable, at least in part, to attentional factors-people are "on task" less fully when the stimuli are massed rather than spaced. above abstract from Metcalfe J, Xu J. People mind wander more during massed than spaced inductive learning. J Exp Psychol Learn Mem Cogn. 2016 Jun;42(6):978-84. doi: 10.1037/xlm0000216. Epub 2015 Nov 30.
  8. 8. Inductive learning -- that is, learning a new concept or category by observing exemplars -- happens constantly, for example, when a baby learns a new word or a doctor classifies x-rays. What influence does the spacing of exemplars have on induction? Compared with massing, spacing enhances long-term recall, but we expected spacing to hamper induction by making the commonalities that define a concept or category less apparent. We asked participants to study multiple paintings by different artists, with a given artist's paintings presented consecutively (massed) or interleaved with other artists' paintings (spaced). We then tested induction by asking participants to indicate which studied artist (Experiments 1a and 1b) or whether any studied artist (Experiment 2) painted each of a series of new paintings. Surprisingly, induction profited from spacing, even though massing apparently created a sense of fluent learning: Participants rated massing as more effective than spacing, even after their own test performance had demonstrated the opposite. above abstract from Kornell N, Bjork RA. Learning concepts and categories: is spacing the "enemy of induction"? Psychol Sci. 2008 Jun;19(6):585-92. doi: 10.1111/j.1467- 9280.2008.02127.x.
  9. 9. When students encounter a set of concepts (or terms or principles) that are similar in some way, they often confuse one with another. For instance, they might mistake one word for another word with a similar spelling (e.g., allusion instead of illusion) or choose the wrong strategy for a mathematics problem because it resembles a different kind of problem. By one proposition explored in this review, these kinds of errors occur more frequently when all exposures to one of the concepts are grouped together. For instance, in most middle school science texts, the questions in each assignment are devoted to the same concept, and this blocking of exposures ensures that students need not learn to distinguish between two similar concepts. In an alternative approach described in this review, exposures to each concept are interleaved with exposures to other concepts, so that a question on one concept is followed by a question on a different concept. In a number of experiments that have compared interleaving and blocking, interleaving produced better scores on final tests of learning. The evidence is limited, though, and ecologically valid studies are needed. Still, a prudent reading of the data suggests that at least a portion of the exposures should be interleaved. above quote from https://link.springer.com/article/10.1007/s10648-012-9201-3 Rohrer, D. (2012). Interleaving helps students distinguish among similar concepts. Educational Psychology Review, 24, 355-367
  10. 10. "Technology enhanced learning or eLearning allows educators to expand access to educational content, promotes engagement with students and makes it easier for students to access educational material at a time, place and pace which suits them. The challenge for educators beginning their eLearning journey is to decide where to start, which includes the choice of an eLearning tool and platform. This article will share one educator's decision making process, and experience using blogs as a flexible and versatile integrated eLearning tool and platform. Apart from being a cost effective/free tool and platform, blogs offer the possibility of creating a hyperlinked indexed content repository, for both created and curated educational material; as well as a distribution and engagement tool and platform. Incorporating pedagogically sound activities and educational practices into a blog promote a structured templated teaching process, which can be reproduced. Moving from undergraduate to postgraduate training, educational blogs supported by a comprehensive online case-based repository offer the possibility of training beyond competency towards proficiency and expert level performance through a process of deliberate practice. By documenting educational content and the student engagement and learning process, as well as feedback and personal reflection of educational sessions, blogs can also form the basis for a teaching portfolio, and provide evidence and data of scholarly teaching and educational scholarship. Looking into the future, having a collection of readily accessible indexed hyperlinked teaching material offers the potential to do on the spot teaching with illustrative material called up onto smart surfaces, and displayed on holographic interfaces." Above abstract from Goh PS. Using a blog as an integrated eLearning tool and platform. Med Teach. 2016 Jun;38(6):628-9. [2015 Nov 11:1-2. Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/26558420
  11. 11. "In terms of evaluation of learners, assessment should be in-process, not at the conclusion of a course in the form of an exam or a test. Let’s say we develop semantically-defined learning materials and ways to automatically compare learner-produced artifacts (in discussions, texts, papers) to the knowledge structure of a field. Our knowledge profile could then reflect how we compare to the knowledge architecture of a domain — i.e. “you are 64% on your way to being a psychologist” or “you are 38% on your way to being a statistician.” above quote from George Siemens in interview below https://www.oreilly.com/ideas/education-data-analytics-learning
  12. 12. "Learning analytics (LA) can be combined with data from Assessment (both formative and summative), faculty and peer/student observations and feedback, to inform both (e)Teaching (for faculty), and (e)Learning (for students). LA can provide insight and visualisation of the learning journey undertaken by students and trainees, from attendance, through engagement, (active) interaction with the learning content and training process, as well as collaborative learning with fellow students and trainees, toward step-wise and progressive achievement of learning milestones, learning objectives and outcomes.” above first presented at 15th APMEC 2018 conference symposium below https://datainformedelearning.blogspot.sg/2017/11/using-data-analytics- to-inform.html and https://datainformedelearning.blogspot.sg/
  13. 13. Background & Objectives To demonstrate in radiology residency training, and health professions education faculty development, how a digital repository, within an open access online platform (Blogger), containing over 10,000 anonymised radiology cases, and 5,000 links to educational resources, can be used to 1) shorten postgraduate residency training, and support medical education faculty development; 2) make this process more efficient, using technology; 3) translate a core curriculum to a standardised set of learning experiences, centred around curated, peer reviewable, high quality teaching cases, learning paths and training plans; 4) support deliberate practice and accelerate mastery training; and 5) examine the role of the medical educator - as filter, curator, facilitator, guide, coach, and educational scholar.
  14. 14. Results The breadth and range of digital content, and training paths, together with a discussion of their value and impact will be demonstrated from a collection of training blogs -digital repositories on this link - https://goo.gl/rYMkH1
  15. 15. Conclusion Content and training paths from digital repositories, made available via blogs (as an integrated eLearning tool and platform) can support our efforts as clinician educators, and in health professions education faculty development.
  16. 16. References https://medicaleducationelearning.blogspot.com/2017/09/meded-peer-reviewed-publications.html Goh PS. Using a blog as an integrated eLearning tool and platform. Med Teach. 2016 Jun;38(6):628-9. doi:10.3109/0142159X.2015.1105947 Goh, P.S., Sandars, J. An innovative approach to digitally flip the classroom by using an online "graffiti wall" with a blog. Med Teach. 2016 Aug;38(8):858. Epub 2016 Jul 14. http://www.ncbi.nlm.nih.gov/pubmed/27414992 Goh, P.S. A series of reflections on eLearning, traditional and blended learning. MedEdPublish. 2016 Oct; 5(3), Paper No:19. Epub 2016 Oct 14. http://dx.doi.org/10.15694/mep.2016.000105 Goh, P.S., Sandars, J. Insights from the culinary arts for medical educators. MedEdPublish. 2017 Jan; 6(1), Paper No:10. Epub 2017 Jan 18. http://dx.doi.org/10.15694/mep.2017.000010 Goh, P.S. Learning Analytics in Medical Education. MedEdPublish. 2017 Apr; 6(2), Paper No:5. Epub 2017 Apr 4. https://doi.org/10.15694/mep.2017.000067 Goh, P.S. eLearning in Medical Education - Costs and Value Add. The Asia Pacific Scholar (TAPS). Published online: 2 May, TAPS 2018, 3(2), 58-60. DOI: https://doi.org/10.29060/TAPS.2018-3-2/PV1073

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