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Revolutionizing Education in Medicine: AACEM 2017
- 1. Revolutionizing Education using Alternative Approaches Michelle Lin, MD UCSF Professor of EM, Academy Endowed Chair for EM Education Founder, Academic Life in Emergency Medicine @ M_Lin
- 2. Revolutionizing Education using Alternative Approaches aliem.link/aacem2017 Michelle Lin, MD UCSF Professor of EM, Academy Endowed Chair for EM Education Founder, Academic Life in Emergency Medicine @ M_Lin
- 3. Medical education is at a critical fork in the road It could be outsourced beyond the walls of academia.
- 9. Learner 2.0 Educator Institution Accreditation Body
- 10. Learner 2.0 Educator Institution Patient Knowledge doubles every 12 hrs
- 11. Learner 2.0 Educator Institution Patient Knowledge doubles every 12 hrs
- 12. Learner 2.0 Educator Institution Patient Knowledge doubles every 12 hrs
- 17. Learner Educator 2.0 Institution Accreditation Body
- 19. Learner Educator 2.0 Institution ≠ Education Information Delivery X 15 min Classroom Accreditation Body
- 20. Learner Educator 2.0 Institution Patient ≠ Education Information Delivery X 15 min Flipped classroomClassroom
- 21. Learner Educator Institution 1.0 and 2.0 Accreditation Body
- 22. Learner Educator Institution 1.0 and 2.0 Accreditation Body
- 23. Learner Educator Institution 1.0 and 2.0 Accreditation Body
- 24. Learner Educator Institution 1.0 and 2.0 Patient
- 25. Learner Educator Institution Accreditation Body 1.0 & 2.0
- 26. Learner Educator Institution Poor measures of learner competency Strict, traditional criteria for “education” initiatives Accreditation Body 1.0 & 2.0 Program-centric rather than learner-centric
- 27. Learner 2.0 Educator 2.0 Institution 2.0 Accreditation Body 2.0
- 28. Learner 2.0 Educator 2.0 Institution 2.0 Accreditation Body 2.0
- 29. Clinician- educator Educator- scholar Digital innovator- educator 3 groups of people in education in 2009
- 30. Clinician- educator Educator- scholar Digital innovator- educator Academic value 3 groups of people in education in 2009
- 31. Clinician- educator Educator- scholar Digital innovator- educator Academic value 3 groups of people in education in 2009
- 32. Clinician- educator Educator- scholar Digital innovator- educator Academic value Who our LEARNERS were listening to in 2009
- 33. But then what happened? Clinician- educator Educator- scholar Digital innovator- educator Academic value Who our LEARNERS were listening to in 2009
- 34. Emergence of social media in emergency medicine 2002-2013 Cadogan M, et al. Emerg Med J. 2014 Oct;31(e1):e76-7. Websites Blogs Podcasts
- 35. Digital innovator- educator Academic value Clinician- educator Educator- scholar Where are we in 2017?
- 36. Digital innovator- educator Educator- scholar Academic value Clinician- educator Where are we in 2017?
- 37. Digital innovator- educator Academic value Clinician- educator Educator- scholar Where are we in 2017?
- 38. Academic value Clinician- educator Educator- scholar Digital innovator- educator Where are we in 2017?
- 39. Digital innovator- educator Academic value Clinician- educator Educator- scholar Where are we in 2017?
- 40. Digital innovator- educator Academic value Clinician- educator Educator- scholar Where are we in 2017?
- 41. Digital innovator- educator Academic value Clinician- educator Educator- scholar Where are we in 2017? Rise of social entrepreneurs in medical education
- 42. Examples of Innovation: Creative solutions to address pain points
- 43. 1. Social media platforms are the modern version of textbooks for information delivery. Scalable Archived Push-pullable Open access Mobile responsive Easy means to update
- 46. 4. Approved Instructional Resources (AIR) Series National initiative to identify quality EM blog and podcast content for resident education by crowdsourcing experts
- 47. 5. Chief Resident Incubator Year-long virtual community of practice for EM chief residents for their professional development
- 48. Year-long virtual community of practice for EM chief residents for their professional development 5. Chief Resident Incubator
- 49. Future of Medical Education: How do we support innovators and sustain innovation within academia?
- 50. My vision for 2020
- 51. Learner 3.0 Educator 3.0 Institution 3.0 Accreditation Body 3.0
- 52. Learner 3.0 Improve digital info management, identify trustworthy info Institution 3.0 Educator 3.0 Accreditation Body 3.0
- 53. Educator 3.0 Improve digital literacy and competency. Go to where the learners are. Institution 3.0 Accreditation Body 3.0 Learner 3.0 Improve digital info management, identify trustworthy info
- 54. Educator 3.0 Improve digital literacy and competency. Go to where the learners are. Patient 2.0Institution 3.0 Learner 3.0 Improve digital info management, identify trustworthy info
- 55. Educator 3.0 Improve digital literacy and competency. Go to where the learners are. Institution 3.0 Expand promotions criteria. Avoid stifling innovations by claiming intellectual property. Patient 2.0 Learner 3.0 Improve digital info management, identify trustworthy info
- 56. Educator 3.0 Improve digital literacy and competency. Go to where the learners are. Accreditation Body 3.0 Eliminate time-based metrics; expand definition of education Learner 3.0 Improve digital info management, identify trustworthy info Institution 3.0 Expand promotions criteria. Avoid stifling innovations by claiming intellectual property.
- 57. Digital innovator-educator (social entrepreneur) Academic value Clinician- educator Educator- scholar My vision for 2020
- 58. Academic value Clinician- educator Educator- scholar My vision for 2020 Digital innovator-educator (social entrepreneur)
- 59. Academic value Clinician- educator Educator- scholar My vision for 2020 Digital innovator-educator (social entrepreneur)
- 60. Academic value Digital innovator- educator Clinician- educator Educator- scholar My vision for 2020
- 61. Academic value Digital innovator- educator Clinician- educator Educator- scholar My vision for 2020
- 62. Academic value Digital innovator- educator Clinician- educator Educator- scholar My vision for 2020
- 63. Medical education is at a critical fork in the road It could be outsourced beyond the walls of academia.
- 64. What is your vision for the future of education? Where should we target our innovation efforts? aliem.link/aacem2017
- 65. We cannot solve our problems with the same thinking we used when we created them. - Albert Einstein Listen to your residents and junior faculty. They are the thought-leaders in ALiEM.
- 66. Revolutionizing Education using Alternative Approaches Michelle Lin, MD UCSF Professor of EM, Academy Endowed Chair for EM Education Founder, Academic Life in Emergency Medicine @ M_Lin
Editor's Notes
- What are your sentinel events in your academic career that totally reshaped its trajectory and path? It was 2009 and I’ve been deliberating all week with myself – Should I or shouldn’t I? Am I crazy? Why is no one else doing this? Should I hit the PUBLISH button on my very first post on a so-called free blog platform on Google. You mean that I can publish my thoughts and teachings onto the open web and learners can read for free in an open classroom or open textbook sort of way? I then closed my eyes and then just did. Click, PUBLISH. What then followed has been the amazing, and often accidental, journey to advance education through non-traditional means. In the next 30-40 minutes, I hope to share some of my behind-the-scenes experiences, pitfalls behind how medical education, specifically in residency education can come to be.
- So to kick off this talk, I thought I’d go a little meta and teach about innovation using an innovation. I created a google document page that will allow us all to type in questions, comments, and reflections. If you are wifi, go ahead and type in the link shown. This “backchannel” approach to education is allows the audience members to connect with each other and provide real-time feedback. Let’s go even one step further. At the mid-point of this talk, I’m going to toggle over to this sheet and try to answer some or all your questions. This approach allows you to engage with your audience, to clarify any miscommunications, and identify what finer points your audience is interested in.
- If we keep on the path that we current are on, I suspect that a majority of education will be outsourced beyond the walls of academia, excluding patient bedside teaching. It feels crazy to say it out loud, but I’ve learned over the years is that one must always challenge assumptions to improve and evolve. Just because it wasn’t possible 100 years ago doesn’t mean that it’s not possible no. But still, the mission of medical education being outsourced? Will educators be recruited and drawn away from academic faculty positions? I’m starting to see hints of this happening.
- Let’s first look at our downstream stakeholder in all this – the learner. Think back to when you were a resident. For me I diligently read Tintinelli’s and Rosen’s. I attended the 5-hour weekly conference which were comprised of 1-hour podium lectures. It’s the same read, listen, learn approach that we all had during college and medical school. And I was totally happy with that. It’s what I’ve always known. Sit, listen, digest, repeat. Over 100 years ago in the days of Flexner when medical education systems were being built and accredited, this makes plenty of sense to at least get some minimum standard of educational exposure for everyone. But does it make sense now??
- Let’s first look at our downstream stakeholder in all this – the learner. Think back to when you were a resident. For me I diligently read Tintinelli’s and Rosen’s. I attended the 5-hour weekly conference which were comprised of 1-hour podium lectures. It’s the same read, listen, learn approach that we all had during college and medical school. And I was totally happy with that. It’s what I’ve always known. Sit, listen, digest, repeat. Over 100 years ago in the days of Flexner when medical education systems were being built and accredited, this makes plenty of sense to at least get some minimum standard of educational exposure for everyone. But does it make sense now??
- Let’s first look at our downstream stakeholder in all this – the learner. Think back to when you were a resident. For me I diligently read Tintinelli’s and Rosen’s. I attended the 5-hour weekly conference which were comprised of 1-hour podium lectures. It’s the same read, listen, learn approach that we all had during college and medical school. And I was totally happy with that. It’s what I’ve always known. Sit, listen, digest, repeat. Over 100 years ago in the days of Flexner when medical education systems were being built and accredited, this makes plenty of sense to at least get some minimum standard of educational exposure for everyone. But does it make sense now??
- But today’s learner, or the Learner 2.0, is different from Learner 1.0. They now have to contend with a continued exponential growth of information and digital technologies that will be unfathomable to manage on one’s own. There are now easily accessible blogs, podcasts, videocasts, and testing apps to name a few, in addition to textbooks and journal articles to balance into one’s day. Today’s learners will need to be digitally adept at not only filtering this information to guide their foundational learning, but to set their own personal approach that works for them in pursuit of being a lifelong learner. Buckminster Fuller
- But today’s learner, or the Learner 2.0, is different from Learner 1.0. They now have to contend with a continued exponential growth of information and digital technologies that will be unfathomable to manage on one’s own. There are now easily accessible blogs, podcasts, videocasts, and testing apps to name a few, in addition to textbooks and journal articles to balance into one’s day. Today’s learners will need to be digitally adept at not only filtering this information to guide their foundational learning, but to set their own personal approach that works for them in pursuit of being a lifelong learner. Buckminster Fuller
- But today’s learner, or the Learner 2.0, is different from Learner 1.0. They now have to contend with a continued exponential growth of information and digital technologies that will be unfathomable to manage on one’s own. There are now easily accessible blogs, podcasts, videocasts, and testing apps to name a few, in addition to textbooks and journal articles to balance into one’s day. Today’s learners will need to be digitally adept at not only filtering this information to guide their foundational learning, but to set their own personal approach that works for them in pursuit of being a lifelong learner. Buckminster Fuller
- But today’s learner, or the Learner 2.0, is different from Learner 1.0. They now have to contend with a continued exponential growth of information and digital technologies that will be unfathomable to manage on one’s own. There are now easily accessible blogs, podcasts, videocasts, and testing apps to name a few, in addition to textbooks and journal articles to balance into one’s day. Today’s learners will need to be digitally adept at not only filtering this information to guide their foundational learning, but to set their own personal approach that works for them in pursuit of being a lifelong learner. Buckminster Fuller
- What about from the lens of the educator? Remember when you were in your first year of being a faculty member? You gave your lectures to medical students, residents, and faculty in likely a very podium-style approach. We (or at least I) was abusing all of Powerpoints many dizzying transitional features. But information delivery does not equate to learning. Let me repeat – just because you dropped knowledge bombs all throughout your talk does not necessarily mean that anyone will remember it. In fact, it’s been proven in that lecture-based talks result in poor learning retention rate of 10-25% after 3 days.
- What about from the lens of the educator? Remember when you were in your first year of being a faculty member? You gave your lectures to medical students, residents, and faculty in likely a very podium-style approach. We (or at least I) was abusing all of Powerpoints many dizzying transitional features. But information delivery does not equate to learning. Let me repeat – just because you dropped knowledge bombs all throughout your talk does not necessarily mean that anyone will remember it. In fact, it’s been proven in that lecture-based talks result in poor learning retention rate of 10-25% after 3 days.
- What about from the lens of the educator? Remember when you were in your first year of being a faculty member? You gave your lectures to medical students, residents, and faculty in likely a very podium-style approach. We (or at least I) was abusing all of Powerpoints many dizzying transitional features. But information delivery does not equate to learning. Let me repeat – just because you dropped knowledge bombs all throughout your talk does not necessarily mean that anyone will remember it. In fact, it’s been proven in that lecture-based talks result in poor learning retention rate of 10-25% after 3 days.
- What about from the lens of the educator? Remember when you were in your first year of being a faculty member? You gave your lectures to medical students, residents, and faculty in likely a very podium-style approach. We (or at least I) was abusing all of Powerpoints many dizzying transitional features. But information delivery does not equate to learning. Let me repeat – just because you dropped knowledge bombs all throughout your talk does not necessarily mean that anyone will remember it. In fact, it’s been proven in that lecture-based talks result in poor learning retention rate of 10-25% after 3 days.
- But today’s educator 2.0 – whether it be generational or because of all the digital technologies and open access information that we grew up with, this approach no longer meets their needs. I think it’s crazy that we still subscribe to much of the same processes as 100 years ago. Because let’s say that you are the primary investigator for a study drug that is cures cancer. You’ve done retrospective analysis, case-controls, and tackled a randomized controlled DB study on it. All results show that it works! The scientific community concurs with your conclusions. But for some odd reason, hardly anyone uses it. Yes, it is more expensive, but it definitely works better than the current standard care therapy. Same thing with education. We have proven adult learner theories and educational frameworks that demonstrate better learning and learning retention, but we are all still beholden to the podium-based didactic across the spectrum of medical education UME, GME, CME. It is more resource intensive in the short-term, but aren’t the learners worth it? And yes, I realize the irony of this in that I’m giving a talk, but I’m splitting this talk such that in the second half, I’d like to have an unscripted dialogue with you about next steps and how I can help you innovate in that direction.
- But today’s educator 2.0 – whether it be generational or because of all the digital technologies and open access information that we grew up with, this approach no longer meets their needs. I think it’s crazy that we still subscribe to much of the same processes as 100 years ago. Because let’s say that you are the primary investigator for a study drug that is cures cancer. You’ve done retrospective analysis, case-controls, and tackled a randomized controlled DB study on it. All results show that it works! The scientific community concurs with your conclusions. But for some odd reason, hardly anyone uses it. Yes, it is more expensive, but it definitely works better than the current standard care therapy. Same thing with education. We have proven adult learner theories and educational frameworks that demonstrate better learning and learning retention, but we are all still beholden to the podium-based didactic across the spectrum of medical education UME, GME, CME. It is more resource intensive in the short-term, but aren’t the learners worth it? And yes, I realize the irony of this in that I’m giving a talk, but I’m splitting this talk such that in the second half, I’d like to have an unscripted dialogue with you about next steps and how I can help you innovate in that direction.
- But today’s educator 2.0 – whether it be generational or because of all the digital technologies and open access information that we grew up with, this approach no longer meets their needs. I think it’s crazy that we still subscribe to much of the same processes as 100 years ago. Because let’s say that you are the primary investigator for a study drug that is cures cancer. You’ve done retrospective analysis, case-controls, and tackled a randomized controlled DB study on it. All results show that it works! The scientific community concurs with your conclusions. But for some odd reason, hardly anyone uses it. Yes, it is more expensive, but it definitely works better than the current standard care therapy. Same thing with education. We have proven adult learner theories and educational frameworks that demonstrate better learning and learning retention, but we are all still beholden to the podium-based didactic across the spectrum of medical education UME, GME, CME. It is more resource intensive in the short-term, but aren’t the learners worth it? And yes, I realize the irony of this in that I’m giving a talk, but I’m splitting this talk such that in the second half, I’d like to have an unscripted dialogue with you about next steps and how I can help you innovate in that direction.
- But today’s educator 2.0 – whether it be generational or because of all the digital technologies and open access information that we grew up with, this approach no longer meets their needs. I think it’s crazy that we still subscribe to much of the same processes as 100 years ago. Because let’s say that you are the primary investigator for a study drug that is cures cancer. You’ve done retrospective analysis, case-controls, and tackled a randomized controlled DB study on it. All results show that it works! The scientific community concurs with your conclusions. But for some odd reason, hardly anyone uses it. Yes, it is more expensive, but it definitely works better than the current standard care therapy. Same thing with education. We have proven adult learner theories and educational frameworks that demonstrate better learning and learning retention, but we are all still beholden to the podium-based didactic across the spectrum of medical education UME, GME, CME. It is more resource intensive in the short-term, but aren’t the learners worth it? And yes, I realize the irony of this in that I’m giving a talk, but I’m splitting this talk such that in the second half, I’d like to have an unscripted dialogue with you about next steps and how I can help you innovate in that direction.
- Social entrepreneurs
- Social entrepreneurs
- Social entrepreneurs
- Social entrepreneurs
- Social entrepreneurs
- Social entrepreneurs
- Within academia Outside walls of academia Virtual innovation lab at ALiEM with 40 core team members where we peer and near-peer mentor and support each other Open transparent, flat heirarchical structure where all voices are heard and titles are meaningless. We value quality No significant money yet but I am able to pay them all a small honoraria through a composite of multiple small revenu streams In academia - Will need to fix many things (EDUCAUSE)
- If we keep on the path that we current are on, I suspect that a majority of education will be outsourced beyond the walls of academia, excluding patient bedside teaching. It feels crazy to say it out loud, but I’ve learned over the years is that one must always challenge assumptions to improve and evolve. Just because it wasn’t possible 100 years ago doesn’t mean that it’s not possible no. But still, the mission of medical education being outsourced? Will educators be recruited and drawn away from academic faculty positions? I’m starting to see hints of this happening.
- I would champion that you should take stock and listen to your residents and junior faculty. They grew up nderstanding the complexities and digital technologies around them. In fact, they are the drivers and thought leaders in our organization at ALiEM. They are my secret weapon in… Revolutionizing Health Professions Education.
- What are your sentinel events in your academic career that totally reshaped its trajectory and path? It was 2009 and I’ve been deliberating all week with myself – Should I or shouldn’t I? Am I crazy? Why is no one else doing this? Should I hit the PUBLISH button on my very first post on a so-called free blog platform on Google. You mean that I can publish my thoughts and teachings onto the open web and learners can read for free in an open classroom or open textbook sort of way? I then closed my eyes and then just did. Click, PUBLISH. What then followed has been the amazing, and often accidental, journey to advance education through non-traditional means. In the next 30-40 minutes, I hope to share some of my behind-the-scenes experiences, pitfalls behind how medical education, specifically in residency education can come to be.