Improving Online education

[iuhsms4]

Welcome to "Improving Online Education" thread. The purpose of this thread is to dicuss new and innovative ways to improve the delivery of online medical education, consider integration of "traditional" medical education into an online program's curriculum, and compiling/discussing ideas that could specifically assist IUHS in becoming a more reputable and respected medical education program. Please refrain from posting accusations and otherwise negative comments about IUHS. There are plenty of other threads where you can voice your opinions. We've heard them loud and clear. But, they are getting to be redundant and cumbersome. However, in this thread, let's try to get past that and stay focussed on it's title: "Improving Online Education". Again, welcome.

Thank you,

IUHSMS4

[Genossa maximillian]

To prof and anatomy guy and any other parties interested in delevoping a realistic, unbiased constructive thread on this subject. I want to quote the excellent contribution that prof and anatomy guy made last week. below are their postings from last week.

Originally Posted by anatomy_guy
As a medical faculty member involved in using educational technology or the internet in education, I have to point out that there are some pitfalls and good uses of the internet in basic sciences for the first 2 years. Ron Harden at the Centre for Medical Education, University of Dundee in Scotland is trying to put together IVIMEDS, which is an internet version of medical education. He has already established a curriculum, which is not difficult given the standardization of medical education in the UK and elsewhere. Technically, the knowledge required can be acquired whether by lecture, problem based learning or group study or systems or regional based learning or independent self learning. However, in anatomy and pathology, one needs to see the human cadaver or the expanse of tumours and disease to gain an understanding of the extent of disease or the relationship of anatomical structures so one can build a 3D picture of the human body. It is really a matter of scale and relationships of anatomical structures before one truly understands anatomy. Pathology is not just what is found in Robbins et al but also the experiences and folklore you learn from academic and clinical pathologists. Seeing the pathological specimen very often helps you understand what the extent of disease can be and why it appears as it does in clinical presentation. I have taught medical, dental, nursing and occupational therapy students anatomy and physiology and the one aspect that they have remarked about upon seeing the anatomical specimens and some of the pathology is that they had a realistic scale and understanding about what the anatomical structures or pathology actually was and how they are related 3D. Also, lacking through the internet version of basic sciences medical education is how to do history, physical examination, diagnosis and prognosis or the various aspects of a medical interview. What philosophy of medicine is being taught? If it is patient centered, you need to see it in action and unfortunately, the internet does not and can not really convey this aspect very well. Having an independent study method where one links with a physician would be good but you actually need to link with many physicians so students can take the good aspects of these physicians and dispose of the bad habits they see in them. If you train with only one physician, you only see one way of doing the medical interview or HPE and thus you do not develop your own methods. Let me side track, I was a soccer referee who reached the national or professional levels for a few years. I learned my craft from working with many excellent, top notch or top level referees and assistant referees. I used some of the things, such as player management or awarding a penalty kick without being hassled or questioned, I saw from these referees because they worked for me but I had to discard some of the other techniques because they did not work for my personality or myself in general. The same is true in medical communications. You will be given a method for delivering bad news such as a cancer diagnosis or a diagnosis of terminal disease to patients, however, you will need to develop your own method that works with a variety of patients for yourself. If you are uncomfortable with handling this situation, patients will pick up on this and be uncomfortable as well and then the situation can totally breakdown with no resolution. This is not a good outcome for anyone. Some physicians in training develop a thick skin like "House" on TV and think this is good--personally I think "House's" manner stinks as he is a self absorbed a--hole and gives physicians a bad reputation. Others try having a caring attitude such as "****" on ER. But TV aside, you, the individual physician in training, need to develop your own style. The internet is not a place to do this nor is having a single mentor a good approach either. This is why stand alone institutional medical schools associated with a particular area are important because it is the variety and not the singleness of one's approach that adds to the educational experience. IUHS program really needs to be more in line with IVIMEDS and use many mentors and be properly monitored and administered. This takes time, effort and money, but in the long run can contribute greatly to the future of medical education if done right!!

Originally Posted by prof
This is such an interesting topic, as we as American educators are now dealing significantly with how to get the basic and clinical didactic material to the students via technology. The latest I heard last week was that we should now be considering "podcasting", so that our material can be seen by the students and residents anywhere they are on "ipods". With the increase in Allied Health students, especially the physical therapy doctors to be (yes they get doctorates now too), and the rapid increase in nursing students (big nursing shortage in country), lecture rooms are at an all time premium. Nobody wants to build new lecture rooms, because they all want to build new laboratory space for researchers, and specialized outpatient/daysurgery clinics. Tight budgets are not replacing the retiring basic science professors, unless the new hires are fully funded researchers (that don't want to teach). Thus technology will be hitting us much faster than many of us thought. And of course as the lectures are becoming webbased, now all the involved professors want intellectual rights to any use of them. Some American schools are working hard to put out excellent approved web based series so that they can market them to other schools. You can see how fast this is moving in CME training. The basic science professors see this as a way to be entrepreneurial and bring dollars into their departments, so they can have less teaching duties and get more NIH research grants which has become the golden goose for all US medical schools now. State budget constraints and the high expense of training medical students at state institutions without much tuition reimbursement will create many novel education models in the next few years. The impending doctor shortage will likely force some states to start new medical schools, increase class size, or bring back the 3 year MD.

Originally Posted by anatomy_guy
Better terminology for online degree when a degree may not be truly online is the use of instructional technology or e-learning for portions that are on line. I have dealt with this aspect on numerous occasions. I was even involved in setting up e-learning for a new medical school. E-learning is not a bad educational tool if done appropriately and with student interaction at the maximum level! E-learning encourages maximum student interaction whether intended or not. Those that do not avail themselves of the e-learning opportunities will miss out tremendously and loose out on exams or other summative assessment. E-learning requires a certain number and level of participants to be successful.

[iuhsms4]

IUHs currently used the KMx system for it's online component. Has anybody heard any pros and/or cons of this software? How could it be improved?

[Genossa maximillian]

IUHs currently used the KMx system for it's online component. Has anybody heard any pros and/or cons of this software? How could it be improved?

I am becomming familiar with it now, as soon as I am done researching it I will give you my opinion. I am familiar with IVIMEDS and Sydney

[iuhsms4]

Where can I get info on IVIMEDS? It sounds like a good software.

[Genossa maximillian]

Where can I get info on IVIMEDS? It sounds like a good software.

IVIMEDS.ORG As a matter of fact UHSA Antigua is a member of it as well as many other reputable international and US schools.

[iuhsms4]

I am not surprised that this thread did not get as much attention as my "assumptions" thread! The ghost writers on this forum have proven once again that their focus is to try and demean a school that they had a bad experience at. Genossa is probably one of the few people on this Valumed forum that has responded responsibly and objectively. I applaud your insight, Genossa. It's a shame that there aren't more like you on this forum. I suspect that there will not be too many more replies to how online medical education could improve. That's too bad.

[Genossa maximillian]

...people just love confrontation, that's why Jerry Springler got so popular.





I am not surprised that this thread did not get as much attention as my "assumptions" thread! The ghost writers on this forum have proven once again that their focus is to try and demean a school that they had a bad experience at. Genossa is probably one of the few people on this Valumed forum that has responded responsibly and objectively. I applaud your insight, Genossa. It's a shame that there aren't more like you on this forum. I suspect that there will not be too many more replies to how online medical education could improve. That's too bad.

[anatomy_guy]

I am not surprised that this thread did not get as much attention as my "assumptions" thread! The ghost writers on this forum have proven once again that their focus is to try and demean a school that they had a bad experience at. Genossa is probably one of the few people on this Valumed forum that has responded responsibly and objectively. I applaud your insight, Genossa. It's a shame that there aren't more like you on this forum. I suspect that there will not be too many more replies to how online medical education could improve. That's too bad.

In reality, improving online education requires that you get an institution or group of institutions to be recognized as providing appropriate education that is then translated into an online educational system. The problem is that many states do not recognize online education as an acceptable form of education for medical licensure. How do you get around this issue? I suggest you don't get around this issue but take it on "head first".

Probably, the best approach would be to maintain that all students must complete the first semester of the basic sciences of the medical education program on campus. Only in this manner can you be assured that students have a framework with which to learn the rest of the material required in basic medical sciences. Also, you can provide students with a baseline knowledge in gross human anatomy and an understanding of pathology . It is necessary for students to get a feel or insight into the extent of the various organs within the human body and also to have a kinesthetic experience when looking at the human body. The extent of scale is very important! Secondly, all exams must be administered by a testing agency such as Sylvan Prometric so that there is no avenue for impropriety and or the fudging of exam scores. Test integrity is the hallmark of any institution or testing agency. Thirdly, the last basic sciences or fifth semester must be taken on campus so students can obtain clinical skills such as HPE and professional development before entering the clinical years. This last basic sciences or fifth semester could actually be a half semester with the other half semester spent doing a Kaplan Review or other commercial review program for USMLE Part 1 at their home area. The time limit for taking USMLE Part 1 should be no more than 3 months past the time the fifth semester is completed. In this way, you have 3 semesters that are being completed via distance or online education but because the exams are administered by a testing agency, you have ensured the integrity of the exams!!

There will still be some states that will require physical attendance at a campus to be licensed. To handle this situation, it might necessary to find a state that be more lenient in its view of what is required to be a physician. Also, it behoove such an online program to join with some major universities to write, use and demonstrate how medical school curricula can be used as online education. I also suggest that final exams at the end of each semester be conducted on the campus. It would also help to document each student's progress by the use of e-portfolios and their use of managed and virtual learning environments. States love documentation to show that students are actively involved in their learning. The more documentation you have and the more you can indicate student success at the various levels of USMLE Steps from attending the online programs, the more solid is your case both legally and academically. Also, one wants to indicate student success by demonstrating how many students or what percentage of students have passed their boards for specialty or general practice. This is an important measure because the boards indicate not only did the students get an academic degree of MD but that this student has passed their apprenticeship and can function as a fully independent physician.

It has been awhile but I am watching the Olympics from a Canadian point of view and I am busy teaching at a local University.
Cheers, A_G:)

[anatomy_guy]

...people just love confrontation, that's why Jerry Springler got so popular.
Sorry, I've been busy teaching and I just got tired of the ..... on the other thread. I am glad it was shut down. I do suggest that we look at the thread that Neil put together on the State Licensing Forum and see how some of his research has turned out and also what is the feeling of states towards online education. I bet that there will be an eventual breakthrough. The question is where and when?
Cheers, A_G

[IMG X-Files]

Many medical schools are now implementing blackboard into their online learning component.

Main reason: it is a cheap and effective way to communicate knowledge.
I predict that more and more medical schools will integrate online courses into their traditional program.

Here are several examples:
http://www.georgetown.edu/dmlfacs/bb_request.html
http://www.med.uth.tmc.edu/edprog/Bb/
http://www.und.edu/blackboard/
http://som.uthscsa.edu/admissions/MD_PhD.asp

However, with every major transition there are skeptics that hold to the traditional programs, for few good reasons...The traditional program work !...It will take years before online learning will proove itself as an equal....Nevertheless, integrating online to traditional learning might be a great way to learn medicine, as this is a student centred approach !

Best wishes,

[Genossa maximillian]

Can we compare how this program http://www.physicianassistant.wisc.edu/prostudents.htm

compares to IUHS?

At least it looks similar to the one IUHS was using during the old Dr. N administration.

Please lets stay on topic.

[anatomy_guy]

Can we compare how this program http://www.physicianassistant.wisc.edu/prostudents.htm

compares to IUHS?

At least it looks similar to the one IUHS was using during the old Dr. N administration.

Please lets stay on topic. Hi Max et al This is the type of program I would advocate. It works because it forces students to come onto campus during their introductory phase and prepares them for the distance learning component. Also, it is very difficult to teach the spatial and 3D relationships required in anatomy. Most everything else can be taught at a distance because it is considered to be 2D. Also, I like the idea that students get the introduction to being a PA and their medical interviewing skills as well as H&P work on site. This allows for some standardization and evalution of medical interviewing and H&P skills before entering into a preceptorship and on the job training. If program could be properly expanded to medical school I do not see why it cannot happen and be approved by the LCME and CACMS. Also, if Wisconsin PAs in this program are approved and licensed by both Wisconsin and Minnesota, why can't they be approved nationwide. The same could then be extended to medical school! Again there is a standard that is maintained and the skill level of the graduates is not called into question. Cheers, A_G

[Genossa maximillian]

..." If program could be properly expanded to medical school I do not see why it cannot happen and be approved by the LCME and CACMS. Also, if Wisconsin PAs in this program are approved and licensed by both Wisconsin and Minnesota, why can't they be approved nationwide. The same could then be extended to medical school! Again there is a standard that is maintained and the skill level of the graduates is not called into question."

Now we need opinions from any of our IUHS friends or UHSA and see how it compares to what their schools are doing.



Hi Max et al This is the type of program I would advocate. It works because it forces students to come onto campus during their introductory phase and prepares them for the distance learning component. Also, it is very difficult to teach the spatial and 3D relationships required in anatomy. Most everything else can be taught at a distance because it is considered to be 2D. Also, I like the idea that students get the introduction to being a PA and their medical interviewing skills as well as H&P work on site. This allows for some standardization and evalution of medical interviewing and H&P skills before entering into a preceptorship and on the job training. If program could be properly expanded to medical school I do not see why it cannot happen and be approved by the LCME and CACMS. Also, if Wisconsin PAs in this program are approved and licensed by both Wisconsin and Minnesota, why can't they be approved nationwide. The same could then be extended to medical school! Again there is a standard that is maintained and the skill level of the graduates is not called into question. Cheers, A_G

[anatomy_guy]

..." If program could be properly expanded to medical school I do not see why it cannot happen and be approved by the LCME and CACMS. Also, if Wisconsin PAs in this program are approved and licensed by both Wisconsin and Minnesota, why can't they be approved nationwide. The same could then be extended to medical school! Again there is a standard that is maintained and the skill level of the graduates is not called into question."

Now we need opinions from any of our IUHS friends or UHSA and see how it compares to what their schools are doing.

I taught Gross Anatomy 1 at UHSA for a month. I found out that students traveled to Antigua for a month and took two or three courses intensively for that month. I taught from 8 am until 12 noon, 6 days per week. So the one day off was Sunday. I prepared my course ahead of time and had a manual, exam prep material and exams written and ran off before I arrived. I charged each student USD 20 to recover my costs. I was glad I did as I needed some cash to eat on the island. I also brought some cans and other processed food items until I was paid at the end of the first week. The first month students usually took Gross Anatomy 1 (Upper Limb, thorax, and Head and Neck) for 96 hours of class and lab time. Embryology was after lunch from 1-3 pm and Medical Terminology was 3-4:30 or 5 pm. Other classes were Biochemistry for 4 hours in the morning or maybe Microbiology for 4 hours every morning and I know General Pathology was 4 hours every afternoon. I also had to design anatomy problems (usually 10 problems) for a take home work assignment that would be graded by the next person teaching anatomy. It was an interesting experience but I would only do it again if I were retired and could pick up extra cash to add to my retirement pay or I had some time off and wanted to have a "busman's holiday". You are paid in cash and the income is tax-free. UHSA also pays your expenses, the flight down and back and hotel stay if necessary, and provides a place to stay. In a way you do get your lecture hours in for a course as students have to attend usually 3 times per year. However, the courses are broken in smaller mini-courses. The other aspect is you usually do not get physical examination and medical interviewing as this is considered to be something you pick up in your job when you are back home working as a nurse, chiropracter, or nurse practitioner or physician's assistant. In reality, I would think it takes at least a good 2 years before you are done with the basic sciences portion and most people usually take 2 1/2 to 3 years. I did tend to make my material a little easier than it would be for the US or Canadian schools as I felt that students may not be able cover it rigorously in such a short period of time. However, I can say that most the students were very driven to succeed and would make good physicians given the proper academic support services.
Cheers, A_G