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The Impact of Instructional Design on Medical School Curriculum
1. The Impact of Instructional Design on
Medical School Curriculum
Max Anderson, MLIS, MS
@maxlibris
Instructional Designer
University of Illinois College of Medicine in Chicago - Office of Curricular Affairs
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2. Take-Aways
• What determined the need for an Instructional Designer at UI
College of Medicine - Chicago?
• Role of the Instructional Designer at UI COM - Chicago
• Evidence-based best practices are suggested to faculty
• Feedback loops
• Future plans for improvement
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3. Snapshot of UI College of Medicine - Chicago
• Largest medical school in the country (in terms of student
population)
• Change in campus structure
• Other campuses
• Curricular redesign looming
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4. “How Did We Ever Function Without
an Instructional Designer!?”
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IKR?
5. 5
Me
French —> Librarian —> Instructional Designer —> Instructional Technology
Or, how did I get from here to there,
or there to here?
6. 6
Challenges
• Teaching faculty who were never
trained to be educators
• Faculty who are ‘meh’ about new
teaching methods
• Slow moving bureaucracy
• Low or stagnant board scores
• Faculty evaluated poorly (and no
follow-up)
9. Analysis
• What types of learning
constraints exist?
• What are the delivery
options?
• What are the pedagogical
considerations?
• What is the timeline for
project completion?
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10. Design
• Documentation of the project’s
instructional, visual, and technical design
strategies
• Apply instructional strategies to
outline/create course content
• Create storyboards
• Design the user interface and user
experience
• Prototype creation
• Apply visual design
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13. Development
• Developers create and assemble
the content assets
• Programmers work to develop and
/ or integrate technologies
• Testers perform debugging
procedures
• Project is reviewed and revised
according to feedback from team
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14. Development
• Populate modules with content
(tables, videos, images, text, etc.)
• Blackboard tools: Blog, discussion
board, quizzes, group tools,
mashups, etc.)
• Integrated tools: Echo360,
Collaborate, Explain Everything,
Sharestream, etc.
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15. Implementation
• TAs and Instructors prepared to use new tools used in
course
• Learners prepared to use new tools, mode of delivery, and
pedagogical approach
• ID ensures that the learning materials (books, hands-on
equipment, tools, and software) are in place and course site
is functional
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16. Evaluation
• Formative evaluation
• Informing the design
• Present in each stage of ADDIE process
• Summative evaluation
• Informs instructional design improvements
• Conducted after course implementation is over
• Need data from systems and users
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Result of focus groups
Course directors have limited ‘power’
In ‘complex’ courses, CD don’t know
exactly where to make changes
Frustration with low student attendance at lecture
Time-management - feeling of being overwhelmed
Photo from http://www.publicdomainpictures.net/view-image.php?image=13829
18. UICOM - Chicago Course & Instructor Evaluations:
Continuous Quality Improvement
In AY 2015-2016
196 individual
instructor reports
16 course reports
3,855 pages of
documentation
16 meetings with
Course Directors and
Department Heads
9 meetings with
Deans, Department
Heads and Course
Directors
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Evaluation Cycle for One Fall Course
September
January
April
July
Faculty
Workshops
Faculty
Teaching
Observations
TBL
Observations
Course
Director ‘Pre-
‘Meeting
Deans,
Department
Head, Course
Director ‘Pre-
‘Meeting
Student Curricular
Board (SCB) Report
summarizing
ongoing feedbackInnovations on Deck
• Automate report
production via
Benware
• Contextualize data to
improve decision-
making
• Document instructor
response to feedback
• Rapid evaluations by
students
Fall
1. Each instructor is evaluated by
students as the course
progresses
• Instruction events
• Evaluation of instructors
2. Students evaluate the course
when it ends
• Evaluation of course
• Educational materials analysis (best
practices for presentations)
• Instructor & Course Evaluation (last
year & this year)
• Course Director receives reports to
distribute to instructors
• Course Director meets with
Curriculum Dean and Instructional
Designer; develops plan
• Course Director discusses plan with
Deans
• SCB: Course & Faculty reports
• Faculty workshops
• Course Director implements modified
course elements
Spring
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Best Practices Guidelines
Conceived of, and approved
by students, faculty, staff in
December 2013 and updated with
additional evidence-based content
in July 2015 & July 2016
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Problem(s) Solution(s)
Process
1. Student dissatisfaction with
LMS organization
2. Student dissatisfaction with
educational materials
3. Faculty resistance to facilitation
and design improvements
1. LMS organization cleaner and
consistent across courses
2. Educational materials more
student-centered and easy-to-
digest
3. Faculty more engaging and
interactive
1. Focus groups with students and faculty on reorganization
2. ID reviews educational materials and offers specific feedback to
instructors
3. ID meets with faculty, observes teaching and collaborates on
improvement
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Feedback Loops
• Course Reviews
• Summary by Course Director
• Graduation questionnaire
(AAMC)
• Student feedback
• Evaluation data
• Instructional Designer
feedback
• Board scores
Photo by https://www.flickr.com/photos/dbrekke/159390694 via Create Commons License
27. Faculty Development Learning Environment
• Best Practices in Learner-Centered Instruction
• Creating Effective Independent Learning Assignments
• Best Practices in Creating Powerful PowerPoint Presentations
• Setting the Stage: Meeting LCME Standard 6.3
• Hands on with Explain Everything
• Poll Everywhere
• Approaches to the Flipped Classroom: Achieve Student Engagement with Active Learning
Techniques
• http://www.medicine.uic.edu/education/faculty_learning___environment
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28. Educational Methods:
Ways of Delivering Content
• Readings
• Lecture
• Discussion
• Reflection
• Small group
• Team-based learning
• Standardized patients
• Clinical experiences
• Etc.
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32. Flipped Classroom & Active Learning
https://www.youtube.com/watch?v=wont2v_LZ1E
Active Learning Exercises
• Teamwork
• Debates
• Self-reflection
• Case Studies / Poll Everywhere
• Team-Based Learning
• Problem-Based Learning
McLaughlin, et al. (2014). The flipped classroom: A course redesign to foster learning and engagement in a health professions school. Academic Medicine (89),2. 236-242.
Flipped Classroom
• Instructors prerecord lectures and
post online for students to watch
• Class time is dedicated to student-
centered learning activities
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essons Learned Through This Process
• Objective view!
• First year, ID reviewed evaluations and then looked at materials
• Second year +, ID does analysis and then looks at evaluations
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Plans for the Future
• Use of Tableau for data visualization
• Shorter evaluations
• Evaluation sampling
Photo from https://www.flickr.com/photos/buckaroobay/3721809183 via Creative Commons License
36. Max Anderson, MLIS, MS
Instructional Designer & Apple Certified
Education Trainer
University of Illinois
College of Medicine at Chicago
Office of Curricular Affairs
max@uic.edu
312-996-5898
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Editor's Notes
The College of Medicine at University of Illinois at Chicago hired their first instructional designer (ID) in December 2013. An ongoing project since then for the ID has been to review educational materials for every lecture for the first two years of the four-year medical program, using evidence-based quality control and multimedia research principles as guides. Qualitative and quantitative data from student evaluations help to round out the feedback given to the teaching faculty. There has been some improvement in the creation or redesign of educational materials based on these reviews, which has been noted by students. Many faculty members have not implemented suggestions given by the ID, and the reasons are still unclear. There seem to be barriers for faculty to adopt innovative teaching methodologies and instructional technologies where appropriate. The ID is investigating why these barriers exist and how to help faculty to overcome them. As it is an ongoing project, this will serve as a preliminary set of findings.
One of the most popular instructional systems design framework is the ADDIE model. It appears to be linear but it does not have to be followed rigidly. There are also many variations on this model. Some layers are skipped because information is already available - for example, that you can only deliver a lecture or module in one format. This is not a theory per se! It can be used as a project template with any of the learning theories you use.
This is the “delivery’ of the most popular lecture of the year, on Toxins and Poisons.
Some things to keep in mind during the analysis phase:
The course needs to be relevant to the learner
Spend time with learners in their environment
Be a bridge between the creator and learners
Put the context in context
Measure the effectiveness of the learning activities
More of how the design prototype went - this example is from the Medical Genetics course.
In this example, I worked with the Medical Genetics instructor to learn how to use the Explain Everything app on his iPad in order to create videos that are specific to a salient point. These videos were no longer than 15 minutes.
The bullet points are “typical” tasks for this part of the model. In terms of developing and programming, I am really neither so fortunately Explain Everything makes this part much easier.
This is an example of a mashup of content in the Medical Anatomy and Embryology course. I also worked with course directors in Cell & Tissue Biology and even some of the clerkship directors to incorporate quizzing into their courses via Blackboard.
Talk about use of discussion boards.
There has been a lot of recent research on using multimedia design principles in teaching for understanding in medical classrooms. Richard Mayer is one author that I follow.
Effective Use of Educational Technology in Medical Education Colloquium on Educational Technology: Recommendations and Guidelines for Medical Educators
AAMC Institute for Improving Medical Education
March 2007
Because the overall technology topic is so broad, colloquium participants were charged to focus consideration on interactive instructional and assessment applications: namely, those that teach or assess understanding of biomedical concepts, patient diagnosis and management, and procedural skill training. Resources with little interactivity— such as those that only enable basic learner navigation of text and images—were considered less relevant to the colloquium’s scope. Likewise, the group did not discuss delivery systems such as teaching management systems (e.g., BlackBoard), pod-casting, computer-based testing, digitized lecture dissemination, and distance learning.
Notably, this report highlights the essential role of instructional design principles to promote the effective use of educational technology.
When I came on board in December 2013, the first task I was given was to go over all of the course-level and instructor-level evaluation material for the previous academic year. Because they have never had anyone in my role before, not a lot was done with this evaluation information. So, if an instructor got low marks year after year, they might still be allowed to teach - no one was minding the store. As I reviewed the evaluations, I watched parts of Echo360 lecture recordings for that instructor to see if I could figure out to what they students were referring in their quantitative comments.
Another big part of this analysis phase was to partner with someone in the Department of Medical Education. We interviewed each of the 15 course directors to find out very broadly, what was working in their courses, what was not, and how could they use UGME and me as ID? Feedback: they needed assistants or coordinators. Many of the instructors were managing multiple teaching faculty members, as well as managing the uploading of content into Blackboard and assessment data.
LCME Standard 6.3 is Self-Directed and Life-Long Learning
In a nutshell:
Identify, analyze, and synthesize information relevant to their learning needs
Assess the credibility of information sources
Share the information with their peers and supervisors
Receive feedback on their information-seeking skills
To me, including the medical librarian in these conversations is crucial.
Readings:
Pros: low-cost, little preparation time
Cons: Passive, self-motivation required
Lecture:
Pros: low-cost, accommodates large number of learners, structured presentation of complex topics
Cons: Passive, teacher centered, quality of lecture is highly dependent on speaker and A/V materials
Discussion:
Pros: Active learning, learners apply newly acquired knowledge, suitable for higher order cognitive levels
Cons: More faculty intensive, group and facilitator dependent
Reflection:
Pros: Promotes learning from experiences as well as self-awareness / mindfulness, can be built into discussion activities
Cons:
Small group:
Pros: Active learning, more multidisciplinary, encourages cooperation, teamwork & discussion
Cons: faculty facilitators (or experienced facilitators), time
TBL:
Pros: Active learning, higher cognitive levels, students take responsibility for learning, collaborative
Cons: Self-direction, need to orient students to process of teamwork and peer evaluation
Standardized Patients:
Pros:
While this is not an exhaustive list, I’m going to attempt to tie-in lecture capture / ad hoc capture to most of them…and how we used it to achieve improvement in student satisfaction in the classroom.
When I came back to UIC in late 2013 and started working for the college of medicine, one of the many first tasks I took on was to help find a way to make the Blackboard shells more consistent. Students have long complained that it was difficulty to find content they were looking for, in different courses. Some courses would have a syllabus tab and others would have a syllabus under some other tab. This drove not only the students crazy, but also any additional teaching faculty who might teach for more than one course.
While lectures are low-cost and can accommodate larger numbers of learners, it is also a very passive way to deliver information. The center of attention is on the teacher. The quality of the lecture also depends largely on the speaker and their a/v materials.
With the best practices in place, observations of teaching can be more specific and honed to each lecturer.
Evidence shows that engaging students in active learning enhances their learning outcomes and improves their motivation and attitudes.
McLaughlin, et al. (2014). The flipped classroom: A course redesign to foster learning and engagement in a health professions school. Academic Medicine (89),2. 236-242.
Talk about TBL and incorporating EBM into the ECM TBLs? Screenshots of TBL questions? Talk up work with LHS liaison in writing questions as well as rationale.