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Teaching struggling students : lessons learned from both sides of the classroom
\"This text tackles the phenomenon of limited learning on campuses by approaching it from the point of view of the author, an educator who writes about the experience of being, simultaneously, a college student and a college professor. The author lays out her experience as a student struggling in an introductory linguistics class, framing her struggles as sites ripe for autoethnographic interrogation. Throughout the book, the author melds her personal narratives with the extant research on college student learning, college readiness, and the interconnectedness of affect, intellect, and socio-cultural contexts\"-- Provided by publisher.
Book
A Context-Aware Mobile Learning System for Supporting Cognitive Apprenticeships in Nursing Skills Training
The aim of nursing education is to foster in students the competence of applying integrated knowledge with clinical skills to the application domains. In the traditional approach, in-class knowledge learning and clinical skills training are usually conducted separately, such that the students might not be able to integrate the knowledge and the skills in performing standard nursing procedures. Therefore, it is important to develop an integrated curriculum for teaching standard operating procedures in physical assessment courses. In this study, a context-aware mobile learning system is developed for nursing training courses. During the learning activities, each student is equipped with a mobile device; moreover, sensing devices are used to detect whether the student has conducted the operations on the correct location of the dummy patient's body for assessing the physical status of the specified disease. The learning system not only guides individual students to perform each operation of the physical assessment procedure on dummy patients, but also provides instant feedback and supplementary materials to them if the operations or the operating sequence is incorrect. The experimental results show that the students' learning outcomes are notably improved by utilizing the mobile learning system for nursing training.
Journal Article
The synergistic role of virtual coaching with simulation‐based mastery learning for upper endoscopy
Introduction Our simulation‐based mastery learning (SBML) curriculum, delivered in person, has been shown to successfully train novices in structured esophagogastroduodenoscopy (EGD). SBML with virtual coaching (VC) has the potential to improve the effectiveness and efficiency of endoscopy training and expand access to trainees from around the world. We share our observations conducting an EGD training course using SBML with VC. Methods We conducted a 1‐week virtual SBML course for novice trainees across seven academic centers in the USA and Asia. The cognitive component was delivered using an online learning platform. For technical skills, a virtual coach supervised hands‐on training and local coaches provided assistance when needed. At the end of training, an independent rater assessed simulation‐based performance using a validated assessment tool. We assessed the clinical performance of 30 EGDs using the ASGE Assessment of Competency in Endoscopy tool. We compared the trainees’ scores to our cohort trained using in‐person SBML training using non‐inferiority t‐tests. Results We enrolled 21 novice trainees (mean age: 30.8 ± 3.6 years; female: 52%). For tip deflection, the trainees reached the minimum passing standard after 31 ± 29 runs and mastery after 52 ± 37 runs. For structured EGD, the average score for the overall exam was 4.6 ± 0.6, similar to the in‐person cohort (4.7 ± 0.5, p = 0.49). The knowledge‐based assessment was also comparable (virtual coaching: 81.9 ± 0.1; direct coaching: 78.3 ± 0.1; p = 0.385). Over time, our novice trainees reached clinical competence at a similar rate to our historical in‐person control. Conclusions VC appears feasible and effective for training novice gastroenterology trainees. VC allowed us to scale our SBML course, expand access to experts, and administer SBML simultaneously across different sites at the highest standards.
Journal Article
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial
Background
Diagnostic uncertainty occurs frequently in emergency medical care, with more than one-third of patients leaving the emergency department (ED) without a clear diagnosis. Despite this frequency, ED providers are not adequately trained on how to discuss diagnostic uncertainty with these patients, who often leave the ED confused and concerned. To address this training need, we developed the Uncertainty Communication Education Module (UCEM) to teach physicians how to discuss diagnostic uncertainty. The purpose of the study is to evaluate the effectiveness of the UCEM in improving physician communications.
Methods
The trial is a multicenter, two-arm randomized controlled trial designed to teach communication skills using simulation-based mastery learning (SBML). Resident emergency physicians from two training programs will be randomly assigned to immediate or delayed receipt of the two-part UCEM intervention after completing a baseline standardized patient encounter. The two UCEM components are: 1) a web-based interactive module, and 2) a smart-phone-based game. Both formats teach and reinforce communication skills for patient cases involving diagnostic uncertainty. Following baseline testing, participants in the immediate intervention arm will complete a remote deliberate practice session via a video platform and subsequently return for a second study visit to assess if they have achieved mastery. Participants in the delayed intervention arm will receive access to UCEM and remote deliberate practice after the second study visit. The primary outcome of interest is the proportion of residents in the immediate intervention arm who achieve mastery at the second study visit.
Discussion
Patients’ understanding of the care they received has implications for care quality, safety, and patient satisfaction, especially when they are discharged without a definitive diagnosis. Developing a patient-centered diagnostic uncertainty communication strategy will improve safety of acute care discharges. Although use of SBML is a resource intensive educational approach, this trial has been deliberately designed to have a low-resource, scalable intervention that would allow for widespread dissemination and uptake.
Trial registration
The trial was registered at clinicaltrials.gov (
NCT04021771
). Registration date: July 16, 2019.
Journal Article
An enhanced approach to simulation-based mastery learning: optimising the educational impact of a novel, National Postgraduate Medical Boot Camp
Background
Simulation-based mastery learning (SBML) is an effective, evidence-based methodology for procedural skill acquisition, but its application may be limited by its resource intensive nature. To address this issue, an enhanced SBML programme has been developed by the addition of both pre-learning and peer learning components. These components allowed the enhanced programme to be scaled up and delivered to 106 postgraduate doctors participating in a national educational teaching programme.
Methods
The pre-learning component consisted of an online reading pack and videos. The peer learning component consisted of peer-assisted deliberate practice and peer observation of assessment and feedback within the SBML session. Anonymised pre- and post-course questionnaires were completed by learners who participated in the enhanced programme. A mixture of quantitative and qualitative data was obtained.
Results
Questionnaires were distributed to and completed by 50 learners. Both sections of the pre-learning component were highly rated on the basis of a seven-point Likert scale. The peer learning component was also favourably received following a Likert scale rating. Peer observation of the performance and assessment process was rated similarly by first and second learners.
The thematic analysis of the reasons for which peer-assisted deliberate practice was considered useful showed that familiarisation with equipment, the rehearsal of the procedure itself, the exchange of experiences and sharing of useful tips were important. The thematic analysis of the reasons why peer observation during ‘performance, assessment and feedback’ was useful highlighted that an ability to compare a peer’s performance to their own and learning from observing a peer’s mistakes were particularly helpful.
Conclusion
The SBML programme described has been enhanced by the addition of pre-learning and peer learning components which are educationally valued and allow its application on a national scale.
Journal Article
Development of a 3D printed simulator for closed reduction of distal radius fractures
BackgroundThe use of simulators in medical education is critical for developing procedural competence prior to treating patients. Current training of emergency physicians to perform distal radius fracture reduction is inconsistent and inadequate.ApproachWe developed a 3D printed distal radius fracture simulation training model that is easy to assemble and relatively inexpensive. We present step-by-step instructions to reproduce the model.EvaluationThe model was found to have high fidelity for training by both instructors and participants in a simulation-based mastery learning course.ReflectionWe successfully designed a low cost, easy to reproduce, high fidelity model for use in a simulation-based mastery learning course to teach distal radius fracture reduction.
Journal Article
Transformational Teaching: Theoretical Underpinnings, Basic Principles, and Core Methods
Approaches to classroom instruction have evolved considerably over the past 50 years. This progress has been spurred by the development of several learning principles and methods of instruction, including active learning, student-centered learning, collaborative learning, experiential learning, and problem-based learning. In the present paper, we suggest that these seemingly different strategies share important underlying characteristics and can be viewed as complimentary components of a broader approach to classroom instruction called transformational teaching. Transformational teaching involves creating dynamic relationships between teachers, students, and a shared body of knowledge to promote student learning and personal growth. From this perspective, instructors are intellectual coaches who create teams of students who collaborate with each other and with their teacher to master bodies of information. Teachers assume the traditional role of facilitating students' acquisition of key course concepts, but do so while enhancing students' personal development and attitudes toward learning. They accomplish these goals by establishing a shared vision for a course, providing modeling and mastery experiences, challenging and encouraging students, personalizing attention and feedback, creating experiential lessons that transcend the boundaries of the classroom, and promoting ample opportunities for preflection and reflection. We propose that these methods are synergistically related and, when used together, maximize students' potential for intellectual and personal growth.
Journal Article
The Effectiveness of Direct Instruction Curricula: A Meta-Analysis of a Half Century of Research
Quantitative mixed models were used to examine literature published from 1966 through 2016 on the effectiveness of Direct Instruction. Analyses were based on 328 studies involving 413 study designs and almost 4,000 effects. Results are reported for the total set and subareas regarding reading, math, language, spelling, and multiple or other academic subjects; ability measures; affective outcomes; teacher and parent views; and single-subject designs. All of the estimated effects were positive and all were statistically significant except results from metaregressions involving affective outcomes. Characteristics of the publications, methodology, and sample were not systematically related to effect estimates. Effects showed little decline during maintenance, and effects for academic subjects were greater when students had more exposure to the programs. Estimated effects were educationally significant, moderate to large when using the traditional psychological benchmarks, and similar in magnitude to effect sizes that reflect performance gaps between more and less advantaged students.
Journal Article
Are badges useful in education?: it depends upon the type of badge and expertise of learner
Educational Badges are touted as an alternative assessment that can increase learner motivation. We considered two distinct models for educational badges; merit badges and videogame achievements. To begin unpacking the relationship between badges and motivation, we conducted a study using badges within an intelligent-tutor system for teaching applied mathematics to middle-school students. Our findings indicate that badge earning could be driven by learner motivations and that systems with badges could have a positive effect on critical learner motivations. However, badge acquisition patterns were different across learners with different levels of prior knowledge. Different badge types also affected different learners motivation. Additionally, we believe that our findings are compatible with the research finding that extrinsic motivators have a negative influence on learning. The implication for educational badge designers is that they must consider the ability and motivations of learners when choosing what badges to include in their curricula. We believe our findings exist as one piece of the large research base needed to understand educational badges.
Journal Article
The research we have is not the research we need
The special issue “A Synthesis of Systematic Review Research on Emerging Learning Environments and Technologies” edited by Drs. Florence Martin, Vanessa Dennen, and Curtis Bonk has assembled a noteworthy collection of systematic review articles, each focusing on a different aspect of emerging learning technologies. In this conclusion, we focus on these evidence-based reviews and their practical implications for practitioners as well as future researchers. While recognizing the merits of these reviews, we conclude our analysis by encouraging readers to consider conducting educational design research to address serious problems related to teaching, learning, and performance, collaborating more closely with teachers, administrators, and other practitioners in tackling these problems, and always striving to make a difference in the lives of learners around the world.
Journal Article