In this study, the authors assessed the educational impact of weekly Fast Facts and Concepts (FFAC) e-mails on residents’ knowledge of palliative care topics, self-reported preparedness in palliative care skills, and satisfaction with palliative care education.
The more papers I read, like learning a foreign language, the thinner the blur between mystery and comprehension in terms of judging a paper and its contents. My goal is to be able to conduct such research and write such papers. I understandably feel that a first degree in medicine and a second masters degree in education is required at this level. At best I might be able to take on psychology or neuroscience. My preference and hope would be to become part of a team of experts.
Purpose: Educational interventions such as electives, didactics, and Web-based teaching have been shown to improve residents’ knowledge, attitudes, and skills. However, integrating curricular innovations into residency training is difficult due to limited time, faculty, and cost.
What – A clear problem:
Integrating palliative care into residency training can be limited by the number of trained faculty, financial constraints, and the difficulty of adding educational content with limited resident duty hours. (Claxton et al. p. 475 2011)
Who – Participants
Beginning internal medicine interns
Why – Time- and cost-efficient strategies for creating knowledge transfer are increasingly important. Academic detailing, an educational practice based on behavioral theory, uses concise materials to highlight and repeat essential messages. Soumerai (1990)
How – We designed this study to assess the educational impact of weekly e-mailed FFAC on
internal medicine interns in three domains: knowledge of palliative care topics, satisfaction with palliative care education, and self-reported preparedness in palliative care skills.
This randomized, controlled study of an educational intervention included components of informed consent, pretest, intervention, and posttest.
Fast Facts and Concepts
FFAC are 1-page, practical, peer-reviewed, evidence-based summaries of key palliative care topics first developed by Eric Warm, M.D., at the University of Cincinnati Internal Medicine Residency Program in 2000.6
One e-mail containing two FFAC was delivered weekly for 32 weeks to interns in the intervention group.
All participants completed a pretest that assessed knowledge of palliative care topics, self-rated preparedness to perform palliative care skills, and satisfaction with palliative care education.
Method: Internal medicine interns at the University of Pittsburgh and Medical College of Wisconsin were randomized to control and intervention groups in July 2009. Pretests and post-tests assessed medical knowledge through 24 multiple choice questions, preparedness on 14 skills via a 4-point Likert scale and satisfaction based on ranking of education quality.
The intervention group received 32 weekly e-mails.
No e-mails were sent to the control group.
Respondents completed a post-test 1 to 8 weeks after the
All study participants were informed of the content and the online availability of FFAC during recruitment. At the conclusion of the study, both control and intervention groups were given a booklet that contained all the e-mailed FFAC.
Descriptive statistics and t tests were used to compare the demographic data between the control and intervention groups. Medical knowledge, preparedness, and satisfaction were compared pretest and post-test within groups by Wilcoxon tests and between groups via Mann-Whitney U tests. The data did not meet assumptions for multivariate analysis due to the small sample size. Only univariate analysis was performed.
Although traditional academic detailing techniques include educational outreach visits and distribution of printed graphic materials, e-learning techniques such as e-mail delivery of educational content, listservs and Web-based tutorials can also be considered rooted in this behavioral theory given their focus on repeated, concise content.
Pain assessment and management, breaking bad news, communicating about care goals, and providing appropriate medical care for a dying patient are necessary skills for surgery, family medicine, pediatric, obstetrics and gynaecology, physical medicine and rehabilitation, emergency medicine, neurology, radiation oncology, anesthesiologist, and psychiatry residents.
Studies that focus on e-mail education interventions have shown that weekly e-mails change the behavior of e-mail recipients, improve learner retention of educational content and that retention improvements increase with the duration over which e-mails were received. (Kerfoot et al. 2007 ) (Matzie et al. 2009)
Results: The study group included 82 interns with a pretest response rate of 100% and post-test response rate of 70%. The intervention group showed greater improvement in knowledge than the control (18% increase compared to 8% in the control group, p = 0.005).
Preparedness in symptom management skills (converting between opioids, differentiating types of pain, treating nausea) improved in the intervention group more than the control group ( p = 0.04, 0.01, and 0.02, respectively).
There were no differences in preparedness in communication skills or satisfaction between the control and intervention groups.
Conclusions: E-mailed FFAC are an educational intervention that increases intern medical knowledge and self-reported preparedness in symptom management skills but not preparedness in communication skills or satisfaction with palliative care education.
Claxton, R, Marks, S, Buranosky, R, Rosielle, D, & Arnold, R 2011, ‘The Educational Impact of Weekly E-Mailed Fast Facts and Concepts’, Journal Of Palliative Medicine, 14, 4, pp. 475-481, Academic Search Complete, EBSCOhost, viewed 25 February 2013.
Matzie KA, Price Kerfoot B, Hafler JP, Breen EM: (2009) Spaced education improved the feedback that surgical residents given to medical students: A randomized trial. Am J Surg 2009;197:252–257.
Price Kerfoot B, DeWolf WC, Masser BA, Church PA, Federman DD: (2007) Spaced educational improves the retention of clinical knowledge by medical students: A randomized controlled trial. Med Educ 2007;41:23–31.
Soumerai SB, Avorn J: (1990) Principles of educational outreach (‘academic detailing’) to improve clinical decision making. JAMA 1990;263:549–556.
- Palliative care: knowing when not to act (oup.com)
Exploring students’ understanding of how blogs and blogging can support distance learning in Higher Education
Fig.1. Why Blog?
If anything has been written on blogging I want to read it. On 27th September 1999 I posted to my first blog – it was on blogging and new media. We’re now in the phase of transition that took the printed book after the Gutenberg Press some 400 years. The clunky blog of 1999 barely compares the variety and scope of what we still call a blog today.
This rightly questions when and where blogging should be an endeavour to use with students.
Exploring students’ understanding of how blogs and blogging can support distance learning in Higher Education (2007) Kerawalla, Minocha, Conole, Kirkup, Schencks and Sclater.
Based on this research blogging is very clearly NOT of interest to the majority of students, NOR is it likely to be of value to them for collaborative learning. There may be value in blogging for your own sake – aggregating content in one place.
(Research on using blogging with students of Public Relations gives a far more favourable response … I would suspect that this would apply to courses on journalism and creative writing i.e. use the medium that is appropriate for those on specific courses).
This is a study of OU students.
A more promising, and appropriate study I am looking at concerns PR students who a) need to develop their writing skills b) need to understand what blogging is all about.
The greatest value I have got from this self-inflicted exercise is to deconstruct the research that was undertaken should I wish to undertake research of this ilk myself. Can I fault the research?
What do you think?
|Problem||Does blogging support student in their learning or not?
Are educators perceptions of the positive uses of blogging for learning borne out by the perceptions of and uses of blogging by students?
|Questions||QQ Designed to ascertain their level of experience of blogs and to gather their opinions about how blogs (and other tools) could support their learning.
The research questions we sought to answer were as follows:
1) What degree of blogging experience do students have?
|Setting||Online students at the OU
Survey of 795 student and course designers
|Authors||‘Enthusiastic’ OU IETT Academics|
|Previous research||O’Reilly 2005, Sade 2007, Weller 2007 – literature search, previous research …|
|Methods||Qualitative – explorative/iterative rather than set
All questions required students to select their response by clicking on a radio button, (e.g. ‘yes’ or ‘no’, or Likert scales such as ‘not at all’, ‘slightly’, ‘in-between/no opinion’, fairly’, or ‘very much’). (Kerawalla et al. p. 6. 2007) + an open question for expanded thoughts.
Interviews with course designers – Interview questions were designed to address the following areas: the rationale for introducing blogs, whether blog content would be assessed, whether blogging was compulsory, uptake levels and whether there were any plans to evaluate the success of blogging activities.
– extract, collate and compare.
Analysis – The survey generated both quantitative and qualitative data.
i.e. Not everything they’re cracked up to be.
Krause (2004) reports haphazard contributions to blogs by his students, minimal communication between them, and found that posts demonstrated poor quality reflection upon the course materials.
Williams and Jacobs (2004) introduced blogs to MBA students and although he reports overall success, he encountered problems with poor compliance as, for example 33% of the students thought they had nothing valuable to say in their blog.
Homik and Melis (2006) report only minimal compliance to meet assessment requirements and that students stopped blogging at the end of their course. Other issues include:
It appears that the ideals of educators can be difficult to implement in practice. (Kerawalla et al. p. 5. 2007)
|Paradigms||A cultural psychological approach to our research that proposes that learning is a social activity that is situated and mediated by tools that fundamentally shape the nature of that activity (e.g. Cole, 1996, Wertsch, 1991 and Vygotsky, 1979).|
|Limitations||Expectations about sharing, enthusiasm for the genre …definition of blog (see e-portfolio and wiki), journalism …. hard to define (Boyd, 2006).
They mean different things to different people. Uses to collate resources (portfolio) (Huann, John and Yuen, 2005) , share materials and opinions .. (Williams and Jacobs, 2004).
|Implications||Guidelines, informs design|
- 53.3% of students had read a blog
- only 8% of students had their own blog
- 17.3% had commented on other people’s blogs
- 23% of students thought that the commenting feature on blogs is ‘slightly’ or ‘not at all’ useful,
- 42% had ‘no opinion’
- 35% thought that commenting is ‘fairly’ or ‘very’ useful.
- only 18% said that they thought blogs would be ‘fairly’ or ‘very’ useful.
- of those who blog only 205 of these thought blogs would be ‘fairly’ or ‘very’ useful.
Students were asked ‘how much would you like to use a blog provided by the OU as part of your studies?’
35% ‘not at all’
13% said ‘slightly’
34% had ‘no opinion’,
12% said ‘fairly’
6% responded ‘very much’
Students were asked ‘how much would you like to use a blog provided by the OU for personal use?’.
52.6% said ‘not at all’
8.7% said ‘slightly’
28.3% had ‘no opinion’
8% said ‘fairly’
2.7% responded ‘very much’.
Examination of the observed and expected frequencies for this data suggests that in both cases, there is a relationship between not seeing a role for blogs and not wanting greater use of conferencing.
Supporting findings that when given a choice between classroom based learning or e-learning those who have a choice are equally satisfied by what they get.
All of the positive responses refer to the students’ own (potential) study blog. (Kerawalla et al. p. 7 2007) Others use their blog as a repository. Few saw the benefits of linking or using a blog to for reflection and developing ideas.
Responses to the question ‘would you like a blog provided by the OU to support your studies?’ reveal that there is a profound lack of enthusiasm (from 82% of the sample) for blogging as part of courses.
Later this year, we plan to explore PhD blogs. This variety and combination of methods will enable us to gather different perspectives and to triangulate our findings. (Kerawalla et al. p. 7 2007)
Cole, M. (1996) Cultural Psychology. Camb. Mass: The Belnap Press of Harvard University Press.
Kerawalla, Lucinda; Minocha, Shailey; Conole, Grainne; Kirkup, Gill; Schencks, Mat and Sclater, Niall (2007). Exploring students’ understanding of how blogs and blogging can support distance learning in Higher Education. In: ALT-C 2007: Beyond Control: Association of Learning Technologies Conference, 4-6 September 2007, Nottingham, UK.
Vygotsky, (1979) Mind in society: The development of higher psychological processes. M. Cole M, V. John-Steiner, S. Scribner and E. Souberman (eds and trans). Cambridge, MA: Harvard University Press.
Wertsch, J (1991) A sociocultural approach to socially shared cognition. In L.Resnick, J. Levine and S. Teasley (eds), Perspectives on Socially Shared Cognition, Washington: American Psychological Association.
- Let the journey begin… (chelseachavira.wordpress.com)
- One More Look @ Introversion: Digital Literacy and the Quiet Child (solve4why.wordpress.com)
- 8 Reasons Should Blog About Your Postgraduate Life (postgrad.com)
- Getting More Out of Student Blogging | Sue Waters Blog (suewaters.com)
- To Blog or Not To Blog? (careersandplacements.wordpress.com)
- What Inspires me to Blog? (prefs.zemanta.com)
- What Are the Dos and Don’ts of Blogging? (bizsugar.com)
- What Kind of Blogger Are You? 7 Different Blogger Types Explained. (zemanta.com)
- I hate blogs (stumblegrumble.wordpress.com)
I just watched Daphne Koller’s TED lecture on the necessity and value of students marking their own work. (for the fifth time!)
Whilst there will always be one or two who cheat or those who are plagiarists, the results from ‘Big Data’ on open learning courses indicate that it can be a highly effective way forward on many counts.
- it permits grading where you have 1,000 or 10,000 students that would otherwise be very expensive, cumbersome and time consuming
- as a student you learn from the assessment process – of your work and that of others
- student assessment of other’s work is close to that of tutors though it tends to be a little more harsh
- student assessment of their own work is even closer to the grade their tutor would have given with exceptions at opposite ends of the scale – poor students give themselves too high a grade and top students mark themselves down.
- it works
- it’s necessary if learning reach is to be vastly extended
- isn’t human nature a wonderful thing?! It makes me smile. There’s an expression, is it Cockney? Where one person says to another ‘what are you like?’
‘What are we like?’ indeed!
Philip M. Sadler & Eddie Good (2006): The Impact of Self- and Peer-Grading on Student Learning, Educational Assessment, 11:1, 1-31
- Online university giant gets bigger (bbc.co.uk)
- To be told when you are right or wrong is essential to student learning (mymindbursts.com)
- Massive online education: Daphne Koller at TEDGlobal 2012 (ted.com)
- Who would you invite to an e-learning dinner party? (mymindbursts.com)
- TED Talk: What we’re learning from online education (ezrasf.com)
- Technology brings classroom experience to distance learners (guardian.co.uk)
- What we’re learning from online education by Daphne Koller (bluesyemre.com)