Twelve tips for conducting educational design research in medical education

Abstract

Despite a steady growth in educational innovations and studies investigating the acceptance and effectiveness of these innovations, medical education has not realized sufficient improvement in practice and outcomes from these investments. In light of this lack of impact, there has been a growing call for studies that more effectively bridge the gap between research and practice. This paper introduces Educational Design Research (EDR) as a promising approach to address this challenge. Twelve tips are provided to inspire and guide medical educators to conduct EDR to achieve the dual goals of tackling a significant educational problem in a specific context while at the same time advancing the theoretical knowledge that may be used to improve practice elsewhere.     

The reCAPTCHA of medical education

This article focuses on what Luis von Ahn called the “twofer,” that is, a single solution that elegantly addresses two problems on a large scale. We describe two of von Ahn’s creations: reCAPTCHA, which validates a human web presence while also digitizing hard-to-read words, and Duolingo, which teaches new languages while translating the web. We then consider how this approach can be applied to medical education. Embedding Wikipedia-editing into educational settings is one such solution that could both improve the quality of health information available to the public while enhancing the learning of future health professionals.     

The Bologna Process and medical education

The Bologna Process designates the ongoing activities whereby the Ministers responsible for Higher Education in Europe attempt to change and harmonize fundamental aspects of all higher education in the many countries involved. This grand scheme is gaining momentum. The number of participating countries is increasing, more aspects of higher education are included and the number of activities and projects is growing. Medical education has so far been neglected in the process and awareness of the development at medical schools has been limited. The purpose of this paper is to introduce the Bologna Process, its background, objectives and main activities and to draw attention to some of the challenges medical education will probably have to face in the near future such as a structure based on two main cycles, undergraduate and graduate, a system of easily readable and comparable degrees and European cooperation in quality assurance including a system of accreditation, certification or comparable procedures. The position of medical education towards the Bologna Process is essential.     

Simulation in medical education

Studies in cognitive psychology inform us that the recall of information and its application are best when it is taught and rehearsed in environments similar to workplace. The healthcare professions are heavily task- and performance-based where non-technical skills, decision making and clinical reasoning are important alongside integrity, empathy and compassion. Most of these attributes are difficult to teach and assess in the traditional classrooms. Enhanced patient safety on one hand has to be the ultimate outcome of any medical curriculum while on the other hand, it itself can be potentially compromised in an apprenticeship-based model of medical education. A range of simulation techniques are very well placed to be used alongside clinical placements. These can be employed to enhance learning of healthcare professionals in safe environments, without compromising the patient safety, while maintaining a high degree of realism. This article builds an argument for the use of simulation techniques to enhance patient safety and points the readers to the AMEE Guide No. 50 on simulation, which is written as a practical manual on building a simulation programme in healthcare education.     

The foundations of measurement and assessment in medical education

As a medical educator, you may be directly or indirectly involved in the quality of assessments. Measurement has a substantial role in developing the quality of assessment questions and student learning. The information provided by psychometric data can improve pedagogical issues in medical education. Through measurement we are able to assess the learning experiences of students. Standard setting plays an important role in assessing the performance quality of students as doctors in the future. Presentation of performance data for standard setters may contribute towards developing a credible and defensible pass mark. Validity and reliability of test scores are the most important factors for developing quality assessment questions. Analysis of the answers to individual questions provides useful feedback for assessment leads to improve the quality of each question, and hence make students’ marks fair in terms of diversity and ethnicity. Item Characteristic Curves (ICC) can send signals to assessment leads to improve the quality of individual questions.     

Instructional design quality in medical Massive Open Online Courses for integration into campus education

Abstract

Purpose: Medical Massive Open Online Courses (MOOCs) are of interest for campus education. With growing interest in integrating medical MOOCs, their quality must be ensured. This however, has not been studied. We investigated if medical MOOCs meet the instructional design principles: problem-centeredness, activation, demonstration, application, integration, collective knowledge, collaboration, differentiation, authentic resources, feedback, and goal-setting.

Methods: An overview of medical MOOCs and inclusion criteria were developed. Out of 410 MOOCs, 33 were selected. A data collection tool was compiled and calibrated. Investigators enrolled in selected MOOCs and coded presence of instructional design principles after examination of all course pages.

Results: Application, authentic resources, problem-centeredness, and goal-setting were found to be present in many of the courses. Activation, collective knowledge, differentiation, and demonstration were present in less than half of the courses. Finally, integration, collaboration, and expert feedback were present in less than 15% of the courses.

Conclusions: Medical MOOCs meet these principles in varying degree. Certain principles might be scarcely present due to a problematic fit with the MOOC concept or a need for further development in online settings. Assessment of instructional design quality is desired before integrating so that MOOC quality can be considered in relation to the quality of existing campus education.     

e-Learning in medical education Guide 32 Part 2: Technology, management and design

With e-learning now part of the medical education mainstream, both educational and practical technical and informatics skills have become an essential part of the medical teacher's portfolio. The Guide is intended to help teachers develop their skills in working in the new online educational environments, and to ensure that they appreciate the wider changes and developments that accompany this 'information revolution'. The Guide is divided into two parts, of which this is the second. The first part introduced the basic concepts of e-learning, e-teaching, and e-assessment, the day-to-day issues of e-learning, looking both at theoretical concepts and practical implementation issues. This second part covers topics such as practical knowledge of the forms of technology used in e-learning, the behaviours of teachers and learners in online environments and the design of e-learning content and activities. It also deals with broader concepts of the politics and psychology of e-learning, as well as many of its ethical, legal and economical dimensions, and it ends with a review of emerging forms and directions in e-learning in medical education.     

The anatomy and physiology of conflict in medical education: a doorway to diagnosing the health of medical education systems

This qualitative study uses data from students, teachers and administrators to deepen our understanding of conflict in medical education, its nature and its consequences. It especially looks at systemic issues which may foster or hinder the health of an educational system or of any organization. Its intention is to provide better understanding of the medical education system so that this knowledge can be used to enhance the health of future medical education systems. It is preliminary to a study that would focus on ways of improving the healthiness of future systems. The findings underline the importance of moral education in the training of our future physicians (McWhinney, 1986). The importance of example by faculty and staff and moral development of the physician flows from the authors' data and their interpretation of its meaning. Also, it further underlines the importance of faculty and medical educators modeling both caring and exemplary moral behavior within our educational institutions. Bandura (1986) developed the notion of modeling and showed that, 'even at a preconscious level, we learn moral behaviors through observing and imitating authority figures and/or significant others' (Crysdale, 2006). This is especially important because caring, or compassionate presence, is so essential to healing.     

The use of the opinion leader in continuing medical education

This paper describes a process evaluation of an opinion leader (OL) project for a geriatric medical education program in dementia. Structured interviews with OLs were conducted to understand their experience as formal OLs from their initial training to the project's completion. Thirteen of 15 physicians involved in an OL project were interviewed. The adoption of a formal educational OL role was not an easy transition for most identified OLs. Some physicians struggled with the role and would have preferred more specific guidance. For this subject some content expertise was felt to be essential. Strong project leadership and some measures of success are important to sustain the OL commitment to a project. More attention needs to be devoted to the appropriate selection and training of OLs for educational projects to ensure that they have the relevant clinical expertise and skills to be effective and feel comfortable adopting a formal OL role.