The View from North America


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  • Good morning. I’ve been invited here today to talk about the status of educational technology in chiropractic education in north america.
  • Where are we at with educational technology in the US and throughout North America? I don’t think anyone really knows for sure to what extent or degree we are using technology in our teaching.
  • Obviously before I could present the view from North America I needed to do some investigating. I reviewed the literature as well as conference proceedings from the 2008 WFC and 2009 ACC-RAC. I took a better look at what we are doing at my own institution. We have developed a survey to distribute to the North American chiropractic institutions and are currently waiting for responses. EBSCO, PubMed, Science Direct
  • Searched the Journal of chiropractic education with “technology”
  • Searches of data bases such as EBSCO and PubMed didn’t find much more other than this article published in Spine regarding the use of an instrumented mannequin to learn spinal manipulation. BACKGROUND CONTEXT: Spinal manipulation is a widely accepted therapeutic approach in the treatment of back pain. In standard training programs, feedback on student performances is provided by an instructor based on teaching and clinical experience. Systematic study of the type of augmented feedback provided and skill learning is lacking in the literature. PURPOSE: The goal of this investigation is to compare the performance of two groups of chiropractic students, one receiving traditional training from experienced instructors, and the other, augmented feedback on specific biomechanical aspects of spinal manipulation therapy using an instrumented manikin. STUDY DESIGN: Randomized controlled study. PATIENT SAMPLE: Thirty-one fourth-year students from the Department of Chiropractic of Université du Québec à Trois-Rivières participated in this study. OUTCOME MEASURES: Kinetic parameters (force-time curves) of spinal manipulation were evaluated. METHODS: Spinal manipulation parameters were measured before and after a 5-week training period in which one group received standard chiropractic training while a second group received augmented feedback about specific biomechanical parameters of spinal manipulation. For both groups, practice scheduling and time duration were similar and consisted of a weekly practice session of 90 minutes for five consecutive weeks. Both groups had to practice thoracic spine manipulation throughout the training period. RESULTS: Both groups showed a decrease in peak force applied, with a diminution in the number of trials where a downward incisural point was present in preload force. Participants in the feedback training group significantly reduced their peak force variability and significantly increased their preload force. No significant difference was observed for time to peak force. CONCLUSIONS: The results of this study highlight the merits of practicing with an instrumented manikin or other instrumented training aids. Such a device can provide specific feedback on specific parameters of the task during learning; it can also serve as a tool to assess the progress of students and eliminate the risks relating to repetitive spinal manipulative therapy practice on student colleagues.
  • I attended this conference and the presentations from North America tended towards the theoretical rather than discussing what was currently used in chiropractic education. I got the impression that we know we need to go in this direction and are starting to implement more technology in teaching and learning but we aren’t very far yet. I think perhaps that institutions in other countries are more advanced in their use of technology. But, I have no direct research to back this up. More on that later! Review new web-based and other teaching technologies, their use in chiropractic education, and the challenges and opportunities these technologies present
  • Considered any technology being used from records keeping to security. This is quite a comprehensive list as you will see on the following slide.
  • This survey was very comprehensive and considered any technology being used from records keeping to security.
  • Overall 79% use a CMS evenly split between open source such as Moodle and proprietary such as Blackboard
  • Based simply on the WFC presentations, the North American chiropractic colleges were using the technologies noted here… However, this is certainly a limited representation.
  • I also attended ACC-RAC this year. Only 4 workshops, posters, or presentations out of ~140 at the 2009 ACC-RAC conference addressed educational technology related topics. If technology is being used extensively in chiropractic education, it is not being presented or reported in the literature.
  • I sometimes get the impression that we consider this information top secret. That we might somehow lose a competitive edge should we share what we are doing.
  • So far I’ve given you a lot of “don’t know’s”. What kind of view is that? I can tell you specifically what we do at our North American institution- Northwestern Health Sciences University.
  • We are one of the 79% of the institutions using a CMS- Moodle in our case. We presented our first content on Moodle in the Summer of 2006- 3 years ago now. All courses are now on Moodle with varying degrees of content.
  • All faculty are required to at least post their syllabus on Moodle.
  • Syllabus and one quiz
  • Assessment information, Lab notes, and instructions, weekly schedule Weekly schedule outlined with links to assessments and power point presentations
  • Links to sites, sample test questions, rubrics, test info, power points, assignment uploading and more. In many courses Moodle is used extensively as a repository and means of delivering information . Some quizzes and assignments may be administered onlin but I think it is important to point out at this point that the examples shown so far are not online courses.
  • We do have online courses. Last summer I taught our first hybrid online course Methods 3: Cervical and Thoracic Manual Therapies. The course was presented in a hybrid, asynchronous format. While both lecture and lab material were presented online, the laboratory sessions continued to be taught in the traditional format while the online material replaced the bulk of the actual classroom lectures. Exams are proctored, not online. I think that it is interesting to note that in the survey of technology use by chiropractic colleges that I referred to earlier, Only 7% of the administrators thought that technique could be taught effectively online. And here that is where our institution started.
  • We also initiated an online nutrition master’s curriculum this summer and are currently teaching two courses online. In this beta phase the students are attending lectures on campus in the diplomate program and completing additional content online for the master’s component. In the future, all content will be delivered online with two required session on campus over the course of the program.
  • The EIP course is a course designed to teach our students about evidence informed practice (our term for evidence based medicine). It is offered in a hybrid format with online modules and class time. It is given in all three programs, though slightly different for each program - and I believe the credits are not the same for the massage therapy students. The course and the EIP training for faculty, and eventually field docs, was created through the funding that we received from NCCAM. We have one of the R-25 grants that partners CAM institutions with research universities to improve the research skills of CAM students and clinicians.
  • A number of technologies are used in the development of the content presented via the course management system. Including those shown on this slide.
  • Used for presentation of significant core content for the nutrition master’s program and extensively in the continuing education department Used by 5+ faculty to regularly capture lectures Horns, Eggebrecht, Manne, DeVries, Elkington, Oyelowo, Erickson and departments like Clinical Ed., Research, Institutional Effectiveness and HR frequently use Mediasite. Periodically by others to cover absences, tape special guests,
  • During the summer of 2008 converted our campus clinics from plain film radiography to digital technology. Students now view their own films on computers, using viewing software. This summer we will be converting to a digital radiology labwith30 computers and two LCD or plasma screens. Radiology labs will be taught using digital images stored in folders - testing will be done using the computers rather than with plain films.
  • Camtasia is used to narrate power point presentations that are then posted on Moodle. They may be used to replace a portion of the lecture content and serve as the foundation for the online Methods 3 course. Faculty use is slowly growing- it can be technologically challenging to learn the software. Video-based screen capturing software program. It is analogous to using a video camera to record your screen. However, unlike using a video camera, the software is installed on your computer, so your screen captures are directly recorded to a digital video format with higher quality audio. Camtasia can also be customized to capture the entire screen, a specific window, or user-defined region. Screen capture videos can be recorded with or without voice narration and can even implement the proverbial talking head. This slide shows the view the user will see as they narrate a power point.
  • SoftChalk is a desktop software application that allows you to create professional looking web based lessons. lets you create and style professional looking web-based lessons quickly and easily. It integrates with Moodle but apparently doesn’t allow for secure testing or quizzing as there is no way to limit how many times the student can access the activities. Active learning is promoted with the use of various activities and quizzes. Students can view a lesson using any standard web browser. SoftChalk is compatible with most course management systems and can be integrated into the grade book. Computer savvy faculty will find Softchalk relatively easy to master.
  • SnagIt is a software that I highly recommend for anyone creating online content. Everyone who experiences likes! Inexpensive software that allows you to capture anything on your screen- edit, share, organize.
  • Great for teaching but more work to set up and carry your computer around. Also didn’t have enough training.
  • I believe we will be hearing more about student response systems or clickers later today. Many of our faculty like to teach with clickers and more will likely be using this technology when we require students to purchase their own clicker and bring them to each class.
  • Me, tom, kashif, bill (neti pot)EENT course, spicer, moe Newborn reflexes 3 massage
  • While these are not currently utilized, several may very well be in the near future
  • I mentioned when I started that I was giving you a lot of “don’t know’s”. We hope to address this by the survey we are currently working on. This survey is different in the WFC survey in that it more specifically addresses educational technology use.
  • I do have concerns regarding the view of educational technology as presented solely by chief academic officers. As I was putting together this talk, I realized just how difficult it is to get a true picture or view. Individual faculty usage of technology is highly variable. The view might be a “circle” but as you can see by this image, this circles could be very different.
  • To address this potential skewing, we intend to survey our own faculty on educational technology usage and then expand this to other institutions to hopefully get a better picture of exactly were we are at in chiropractic education.
  • We need to continue this dialogue to see what we can accomplish in chiropractic education.
  •   LACC posted basic science instructional material and test material on the college intranet.
  • The Southern California University of Health Sciences developed an Interactive Atlas of Histology
  • Sherman college used digital technology for virtual instruction in x-ray anatomy and positioning
  • LACC created an online self guided tutorial in diagnostic imaging and looked at its effects on student learning and faculty work load.
  • The View from North America

    1. 1. Glori Hinck, RD, MS, DC Assistant Professor, Methods Department Northwestern Health Sciences University Bloomington, MN USA
    2. 4. <ul><li>Literature </li></ul><ul><ul><li>Journal of Chiropractic Education </li></ul></ul><ul><ul><li>Database searches </li></ul></ul><ul><li>2008 WFC </li></ul><ul><li>2009 ACC-RAC </li></ul><ul><li>NWHSU overview </li></ul><ul><li>Survey of North American institutions </li></ul><ul><ul><li>In development </li></ul></ul>
    3. 5. <ul><li>Number of articles related to educational technology in North American chiropractic institutions published since 1999…. </li></ul><ul><li>6 </li></ul>
    4. 9. <ul><li>4 colleges </li></ul><ul><ul><li>Los Angeles College of Chiropractic (2) </li></ul></ul><ul><ul><li>Sherman College of Chiropractic (1) </li></ul></ul><ul><ul><li>New York Chiropractic College (1) </li></ul></ul><ul><ul><li>Southern California College of Chiropractic (2) </li></ul></ul>
    5. 11. <ul><li>Chiropractic Education in an Era of Digital Natives and Digital Immigrants: How to Make the Successful Transition to 21 st Century Technology </li></ul>
    6. 12. <ul><li>Survey sent to all WFC-ACC colleges to determine exactly where we stand with technology </li></ul><ul><ul><li>NOT limited to educational technology </li></ul></ul><ul><ul><li>NOT limited to North American institutions </li></ul></ul><ul><li>Joe Ferguson, MS, DC, CCSP </li></ul><ul><li>Dean- Life Chiropractic College- West </li></ul>
    7. 13. <ul><li>• Comprehensive campus management systems </li></ul><ul><li>• Course management software </li></ul><ul><li>• Areas in which online classes were offered </li></ul><ul><li>• Online content as part of hybrid classes/blended learning </li></ul><ul><li>• Electronic medical records </li></ul><ul><li>• Imaging systems and applications </li></ul><ul><li>• Computerized balance training and rehab </li></ul><ul><li>• Patient education </li></ul><ul><li>• Office suites and publishing applications </li></ul><ul><li>• Email and emergency notification systems </li></ul><ul><li>• Social networking sites and software </li></ul><ul><li>• Video capture </li></ul><ul><li>• Library and research software </li></ul><ul><li>• Assessment software </li></ul><ul><li>• Collaborative writing software </li></ul><ul><li>• Computer or web-based faculty development </li></ul><ul><li>• Web design and updates </li></ul>
    8. 14. <ul><li>79% use course management system </li></ul>
    9. 15. <ul><li>North American Chiropractic Institutions </li></ul><ul><ul><li>Course management systems </li></ul></ul><ul><ul><li>Clickers </li></ul></ul><ul><ul><li>Adobe Connect </li></ul></ul><ul><ul><li>Web-based lectures </li></ul></ul><ul><ul><li>Hybrid online course </li></ul></ul><ul><ul><li>Educational software to support online learning </li></ul></ul><ul><ul><li>Virtual microscopy </li></ul></ul><ul><ul><li>Online case studies </li></ul></ul>
    10. 16. <ul><li>Web 2.0 Technology for Information Transfer </li></ul><ul><li>From Students that “Click” to Classrooms that “Click”: Engaging All Generations of Learners </li></ul><ul><li>The Implementation of Virtual Instruction in Relation to X-Ray Positioning and Imaging in Chiropractic Education </li></ul><ul><li>Comparison of Hybrid Online Format and Traditional Classroom Format in a Chiropractic Methods Course </li></ul>
    11. 18. Northwestern Health Sciences University (NWHSU)
    12. 26. <ul><li>Chiropractic </li></ul><ul><ul><li>Methods 3: Cervical and Thoracic Manipulative Therapy </li></ul></ul><ul><ul><li>Principles & Philosophy 3 </li></ul></ul><ul><li>Chiropractic, Oriental Medicine, Massage </li></ul><ul><ul><li>Evidence Informed Practice </li></ul></ul><ul><ul><ul><li>National Center for Complementary and Alternative Medicine grant funded </li></ul></ul></ul><ul><li>Nutrition Master’s curriculum/diplomate </li></ul>
    13. 27. Unofficial Survey of NWHSU Faculty…
    14. 32.
    15. 36. <ul><li>Wikis </li></ul><ul><li>Blogs </li></ul><ul><li>Q/A forum </li></ul><ul><li>Online office hours </li></ul><ul><li>Online case studies </li></ul><ul><li>Demonstration videos of patients/conditions/adjustments/procedures </li></ul><ul><li>DVD recordings of student adjustments/histories/exams </li></ul><ul><li>Skype </li></ul>
    16. 37. <ul><li>Twitter </li></ul><ul><li>Facebook, My Space </li></ul><ul><li>E portfolio </li></ul><ul><li>Interactive whiteboard </li></ul><ul><li>Second Life* </li></ul><ul><li>Podcast/Vodcast* </li></ul><ul><li>*Soon! </li></ul>
    17. 38. <ul><li>In process </li></ul>
    18. 39. <ul><li>Institutional surveys may not give true picture </li></ul><ul><li>Individual faculty usage of technology highly variable </li></ul>
    19. 40. <ul><li>Faculty survey at NWHSU </li></ul><ul><li>Expand to faculty at all chiropractic institutions </li></ul>