Attendance and Performance: Then Now Perspectives from the U.S. - - PowerPoint PPT Presentation

6/8/2020 1

Attendance and Performance: Perspectives from the U.S. Medical Education System

Christine A. Kauffman, M.D. Associate Professor of Pediatrics University of Central Florida College of Medicine

Why Attendance and Performance?

Then… …Now

The U.S. Medical Education System

• After Bachelor’s Degree
• Graduate degrees: ~10%
• Average student age: 24 yo
• 4-year program
• 2 preclinical (basic sciences)
• Shortening in many programs
• 2 clinical
• USMLE

The Informal Curriculum

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Adv Physiol Educ42: 593–598, 2018 Adv Physiol Educ43: 512–518, 2019

Where We Were When COVID Started

July August September October November December January February March April May June

M1 Orientation Cellular Function and Medical Genetics (8 weeks) Structure and Function (16 weeks) Psychosocial Issues in Healthcare (13 weeks) Health and Disease (10 weeks) Hematology/Oncology (4 weeks) Practice of Medicine including Community of Practice I Focused Inquiry and Research Experience I M2 Orientation Focused Inquiry and Research Experience II USMLE STEP 1 M3 Orientation Int./Fam. Medicine Neurology OB/GYN Pediatrics Psychiatry Surgery Practice of Medicine including Community of Practice II Cardiovascular and Pulmonary Systems (7 weeks) Endocrine and Reproductive Systems (6 weeks) Gastrointestinal and Renal Systems (6 weeks) Skin and Musculoskeletal Systems (3 weeks) Brain and Behavior (7 weeks)

Preliminary Data From the Lockdown

60.00 65.00 70.00 75.00 80.00 85.00 90.00 95.00 100.00 20 40 60 80 100

Performance (%) Attendance (%)

Attendance v Performance

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Medicine is About People

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… with the undeniable upsurge

• f scientific research, we

cannot continue to rely on the mere fact that we have learned how to teach what is

• known. We must learn to teach

the best attitude to what is not yet known. Charles Scott Sherrington (1857-1952)

pixabay.com

D

• I

n e e d t

• k

n

• w

t h i s ?

The six words that finally made me

• 1. Smells Like Teen Spirit - Nirvana
• 2. Imagine - John Lennon
• 3. One - U2
• 4. Billie Jean - Michael Jackson
• 5. Bohemian Rhapsody - Queen
• 6. Hey Jude - The Beatles
• 7. Like A Rolling Stone - Bob Dylan
• 8. I Can't Get No Satisfaction - Rolling Stones
• 9. God Save The Queen - Sex Pistols

10.Sweet Child O'Mine - Guns N' Roses 11.London Calling - The Clash 12.Waterloo Sunset - The Kinks 13.Hotel California - The Eagles 14.Your Song - Elton John 15.Stairway To Heaven - Led Zeppelin 16.The Twist - Chubby Checker 17.Live Forever - Oasis 18.I Will Always Love You - Whitney Houston 19.Life On Mars? - David Bowie 20.Heartbreak Hotel - Elvis Presley

• DR. MICK GRIERSON, UNIVERSITY OF LONDON

The most iconic songs of all time list redbubble.com

• 1. How many can you sing along to?
• 2. How many can you sing off by heart?

familiarity understanding Dualism - Received Knowledge

(knowledge as objective facts)*

Commitment In Relativism – Constructed Knowledge

(knowledge as creative, critically-informed intersection of facts, experience, method)*

* Belenky et al, Harper Collins 1986

So … can we help our students develop constructed knowledge as well as other required graduate attributes?

Graduate attributes in HE: Routledge

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Directmedia Publishing

But not like this…

The teacher – learner conundrum

• Cheating
• Alienation
• Resistance
• Corner-cutting
• Fixation on

credentials

• To get the

most learning

• ut of the

students as possible

SUCCESS not LEARNING becomes the goal …

“Industrialised model of a pre-determined, teacher-centric curriculum measured by time in seat and high stakes testing”

Susan Blum

US THEM W e n e e d t

• s
• l

v e

The teacher – learner conundrum

US THEM

Are we ‘parents’ or the ‘hired-help’?

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Meaning Feeling Relevance

Freedom to Learn Rogers 1969 e.g. the learning of nonsense syllables: baz, ent, nep, arl, lud e.g. learning that a radiator can be very hot

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Students need to change their expectations and we need to change how we teach

ACTIVE LEARNING WORKS

“In the STEMM classroom, should we ask or should we tell?”

Freeman et al (2014) PNAS 111 8410-8415

• more effective learning
• better retention of information
• better performance in assessments

Healey (2005) The research-teaching nexus

Future-proofing curriculum design and delivery to account for change

Emphasis on research content Emphasis on research processes and problems Teacher focused: students as audience Students as participants

bus gif by eropa 580

“This is a really important article – the impression I get is that it’s almost unethical to be lecturing if you have this

• data. It’s good to see such a cohesive picture emerge from their meta-analysis – an abundance of proof that

lecturing is outmoded, outdated, and inefficient.” Eric Mazur, Harvard University

news.sciencemag.org

So what’s stopping us?

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Newton’s First Law an object will remain at rest or in uniform motion in a straight line unless acted upon by an external force “We often miss opportunity because it's dressed in overalls and looks like work”

― Thomas A. Edison

megatek.com

Willie Nelson

Nobody said it was gonna be easy It's only as hard as it seems But lately it's harder than usual Am I dreaming impossible dreams?

It reminded me of the bit in house at Pooh corner when a nervous piglet asks what would happen if a tree fell down when he was beneath it. “Supposing it didn’t” Pooh replies

nicepng.com

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What and How Do Students Learn Without Classroom Attendance: Lessons from Lockdown 3

• Dr. Harry Witchel

Discipline Lead in Physiology Brighton and Sussex Medical School

2

Introduction

• There is no classroom attendance now !
• What does the pedagogical literature say?
• Advances in Physiology Education
• PNAS, USA (sometimes)

3

What happens in learning

• Rehearsal of retrieval
• Effortful
• Repetition
• Repeated reading inefficient
• The idea of effortless

learning is only partially true

• Salience
• Meaning

Helmholtz

4

What is valuable about what happens in the classroom

• Adaptive teaching & learning
• Rapid teacher-to-student feedback
• Recognising students' confusion and need for clarification
• Adapting to students' weaknesses
• Socratic Q&A
• Skills learning
• Manual skills
• Communication skills
• Social learning
• Joining a community of practise
• Peer-to-peer learning
• Additional social motivation for engagement
• "Liveness"
• Gestures
• Body language

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Conclusion: What do we do about teaching during covid?

• Depends on the student
• Self-efficacy
• Academic reserve
• Bright and motivated students
• Curate
• Answer questions
• Teaching skills will require adaptive feedback
• Medium students
• Add motivation
• Include activities
• Break the tedium of screen time

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Resources for Educators

• LifeSciTRC
• Teaching Resource Community
• Lt (ADI Instruments)
• Petzold, A. M. (2020). Letter to

the Editor: Resources and recommendations for a quick transition to online instruction in physiology. Advances in Physiology Education, 44(2), 217-219.

• Gannon K. Four Lessons From

Moving a Face-to-Face Course Online (Online). The Chronicle of Higher Education. https://www.chronicle.com/ article/4-Lessons-From-Moving- a/245926

Physiology 2021

Birmingham, UK Education Workshop 12 July - 14 July 2021

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