Home » Posts tagged 'harvard'
Tag Archives: harvard
Inclusion/Case Study : John, an engineering Postgrad PhD student with Cerebral Palsy.
Inclusion/Multimedia Demo: Xerte.
Inclusion/Workshop: Creative Problem Solving: YouTube
Loads of ideas in VanGundy’s book: VanGundy, A.B. (1988) Techniques of Structured Problem Solving, 2nd ed, Van Norstrand Reinhold. Techniques 4.01, 4.06, 4.57
Innovation/Paper: Spaced-Ed, now QStream. A platform initially designed to support junior doctors as they revised for formal knowledge assessments. Paper (Paper available in OU Library)
Innovation/demo: QStream 90 day trial.
Innovation/Workshop: Creative Problem Solving:
This is crucial stuff. It has stopped me in my tracks. You can see how far I have or have not got with the reading – an article in the Scientific American and a lengthy paper published while at Princeton have already hi-jacked my mind. Then we get this.
Here is the problem with some interactive learning and before that video based learning – indeed any kind fo learning. It does not pay to make it easy. If you spoon feed your learners will they engage? Will it stick? Will anything much at all go on in the head to generate a memory?
Oblinging the learner to make an effort is just the start – it is no good their repeating the same exercise as they will quite naturally learn how to do it, randomization of a lengthy set of difficult multiple choice questions might be a start – randomized introduction of a variety of metpahors, examples and tasks would be better. Getting them away from a desktop screen, mixing up applied, placement learning with on the job learning is vital too. Variety, human interaction, challenges and sometimes the unexpected must surely be vital?
The test of course, isn’t just a test of the learner, but a test of the systems as a method of knowledge sharing or task efficiency – does it work? Do leaners coming out at the end still know and apply their stuff the next day, week or month?
I might have interviewed Dr Price Kerfoot of Spaced-Ed for H807, ‘Innovations in E-learning’ a year ago.
We used Skype. Clear barely broken sound. Sharp video in colour. It worked.
It was a fascinating discussion.
I should have asked to record and done so.
Next time. I’m sure the conversation has only just begun.
Though armed with a set of questions used in TMA02 of H807 non were necessary. I’d prepared them to follow a narrative flow, and that is what we did.
We have something in common, we were both at Balliol College, Oxford.
I was there as an undergraduate 1984, he was there five years later as a Rhodes Scholar taking a BA in Medicine. Dr B P Kerfoot is now an Associate Professor of Harvard Medical School. He is also a passionate educator and e-learning entrepreneur. I suspect we will continue to hear a great deal about him – he has a passion for education, reminding me of the late Randy Pausch, even the Robin Williams character from Dead Poets Society; there is an unstoppable, engaging warmth backed by a profound intellect.
Price had finished his surgical training when he went into education, an odd elective he admits, but one that through circumstances and surely an innate interest has proved fruitful.
What is the problem?
I didn’t need to make this prompt. You strive to fix something when you see it isn’t working. Learning outcomes from first year medical students were poor. Why, in US terms, spend $1000 dollars on a course only to find a year later that the traditional methods of acquisition and retention of knowledge has failed.
No problem, no fix.
Price looked to web-based teaching to create learning modules. Two concepts were devised, the spacing of questions proved successful. This is from one of a dozen papers authored by Kerfoot and his team; each one, naturally, a worthy, academic, professional appraisal.
Two reports are cited as we talk, one on the effect on the hippocampus of rats, another on phosphate levels in fruit flies. As an OU student these reports are readily available.
There is physiological evidence that ‘spaced learning works’.
a) you want something that works,
b) you want something that will justify the investment.
We give it away, academics in the US are commercially savvy.
Its as if in the UK academics (individuals and institutions) are like bachelors and spinsters, whereas in North America they are eager to marry.
More importantly the research has shown that the Spaced-ed approach improves patient outcomes the goal it was found that cancer screening of patients improved by 40% for the year spaced-education was introduced.
In 2006 the methodology was submitted by Harvard for a patent application. Entrepreneurs and venture capital companies were also approached.
It’s a shame the Spaced-Ed blog hasn’t been maintained, though you’ll get some further insights here.
What began as continual education in medicine has expanded. If you go to the Spaced-Ed website there are all kinds of courses you can take, typically 20-30 questions of the multi-choice type fed to your laptop, SmartPhone or iPad. Writing these multiple choice questions is an effort and requires skill to get right,, indeed I can admit to wanting to create what I thought would be a simple set of questions relating to teaching swimming … but the correct construction of the questions, let alone the creation of appropriate images has held me back. It isn’t as easy to get this right as it looks. You don’t want to feed your audience lame questions, nor do you want to overstretchthem. There is also some negative feelings about Multi-choice, perhaps we have all had negative experiences at school … I personally remember what we described as ‘multi-guess’ that was so often used in Chemistry classes. Though clearly effective, not enough people have been persuaded to pay for these sets of questions, even a dollar or so.
The challenge, has been to move on from asynchronous to synchronous, real time learning, including video and other rich media. The new platform promoted as Qform is an Facebook App and Twitter-like in its approach. People elect to follow a Qstream which goes out to everyone. You join in collectively, rather than alone, which creates a sense of participation and competition. If I understand this correctly, as I’m yet to give it a go, you pose a response to an open question that others read. You then vote on the various responses given. As Price, engaging as Robin Williams in Dead Poets Society enthused about the platform I thought about Skype and Elluminate, even forum threads. Indeed, I wonder if we could all organise to be online and go to one of these threaded conversations to turn an asynchronous environment into a synchronous one. Harvard is also the home of Rotisserie, which rotates a threaded conversation between online learners to ensure that everyone has a turn… and of course Facebook.
Gameification is the key. You respond in a way that other s like and you get points for it and your name appears on a leader board.
Rich content and a range of responses is what’s new. And its live And its competitive
And so Qstream delivers synchronicity and a sense of community Price also talked about how to make it possible for answers to questions to become searchable in Google – I guess with the inclusion of the right metadata. I didn’t need to say it to find I’m told the more controversial responses would generate the most responses. Now it’s starting to sound like the format of the Oxford Union Debating Society – I guess Price went along there at some stage too. By listening to two sides battle it out you form your own opinion.
One final statistic – 85% of those studying urology in North America (that’s the US and Canada) are using Dr B Price Kerfoot’s 23 question Spaced-ed multi-choice Q&A.
The competitors are Quora, Stackoverflow and FormSpring or some such … I’ll go take a look.
J Gen Intern Med 23(7):973–8
© Society of General Internal Medicine 2008
SpacedEd is a platform designed to allow learners and teachers to harness the educational benefits of spaced education.
Spaced education is a novel method of online education developed and rigorously investigated by Dr. B. Price Kerfoot (Associate Professor, Harvard Medical School).
It is based upon two core psychology research findings:the spacing effect and the testing effect.
In more than 10 randomized trials completed to date, spaced education has been found to:
- Improve knowledge acquisition
- Increase long-term knowledge retention (out to 2 years)
- Change behavior
- Boost learners’ abilities to accurately self-assess their knowledge.
In addition, spaced education is extremely well-accepted by learners.
The spacing effect refers to the psychology research finding that information which is presented and repeated over spaced intervals is learned and retained more effectively, in comparison to traditional bolus (‘binge-and-purge’) methods of education.
- The testing effect refers to the research finding that the long-term retention of information is significantly improved by testing learners on this information.
- Testing is not merely a means to measure a learner’s level of knowledge, but rather causes knowledge to be stored more effectively in long-term memory.
- The spaced education methodology is content-neutral and thus can be utilized to learn most anything.
- Potential applications range from teaching chemistry concepts to high school students to reinforcing Arabic language skills among health workers in the Middle East.
- It can also be used to reinforce educational material which was initially presented in the classroom.
- The full multi-media capabilities of the Internet can be harnessed to create a rich and effective learning experience.
Fig. 1. Spaced education randomised trial. Kerfoot (2008)
‘The psychological conclusion demands a distribution of repetitions such that some of them should be produced at a later time, separated from the first repetition by a pause’. (Vygotsky, 1926:Location 2686)
So wrote the educational psychologist Lev Vygostsky over 80 years ago. Putting this into practice using email (and now Smart Phone apps and eventually Facebook), the team at Spaced-Ed have created a learning system that works.
SPACED EDUCATION – DR B PRICE KERFOOT
Interactive Spaced-Education to Teach the Physical Examination: A randomized Controlled Trial
Several studies have documented that physical examination knowledge and skills are limited among medical trainees.
The objective of the study is to investigate the efficacy and acceptability of a novel online educational methodology termed ‘interactive spaced education’ (ISE) as a method to teach the physical examination.
Randomized control trial.
170 second year medical students.
- Spaced-education items (questions and explanations)
- Validated by two experts
- Piloted and 36 items selected for inclusion
- 6 spaced-education e-mails each week for a 6 week cycle.
- Students submitted answers to the questions online and received immediate feedback
- An online end-of program survey was administered.
RESULTS: Successful 85% participants recommended the ISE programme for students the following year.
CONCLUSIONS: ISE can generate significant improvements in knowledge of the physical examination and is very well-accepted by students.
While many studies have documented the dearth of physical examination knowledge and skills among trainees, ISE has the potential to remediate these deficiencies across the spectrum of medical education’. (p977)
Students do the training, but may still have poor recall a year later. Spacing works.
The spacing effect is the psychological finding that educational encounters that are spaced and repeated over time (spaced distribution) result in more efficient learning and improved learning retention, compared to massed distribution of the educational encounters (bolus education). (P973)
As Vygotsky expressed it 80 years previously:
‘It should also be emphasized that every person has his own customary rate of response, and that any change in this rate, either speeding it up or slowing it down, weakens the force of recall’. (Vygotsky, 1926:Location 2686)
And so here students can tailor the timing of questions they are fed – spacing them out or bunching them as they see fit and circumstances change. Go try it, there are courses you can do on topics that a far less demanding that second year physical examinations. Try world history in maps, for example, or getting the most out of your iPhone.
A distinct neurophysiologic basis for the spacing effect has been identified
‘Spaced education’ refers to online educational programs that are structured to take advantage of the pedagogical benefits of the ‘spacing effect’.
Interactive spaced-education (ISE) combines the pedagogical merits of both the ‘spacing effect’ and the ‘testing effect. (974)
Each spaced-education item consists of an evaluative component (a multiple choice question based on a clinical scenario) and an educational component (the answer and explanation)
Based on item difficulty, point-biserial correlation, and Kuder–Richardson 20 score, 36 of the questions were selected for inclusion in the ISE program.
- Students receive spaced-education e-mails at designated time intervals which contain a clinical scenario and question (evaluative component).
- Upon clicking on a hyperlink in this e-mail, a web-page opens which displays pertinent images and allows the student to submit an answer to the question.
- Upon downloading this answer to a central server, students are then immediately presented with a webpage displaying the correct answer to the question and an explanation of the curricular learning point (the educational component).
- By having the provider submit a response before receiving the correct answer and an explanation, this process requires greater interactivity, which educational theory argues may improve learning outcomes.
- The submitted answers of students were recorded using the MyCourses™ web-based education platform
The survey was constructed and administered online using the SurveyMonkey web-based platform.
Future developments and assimilation of spaced-education alongside traditional medial school teaching methods
For example, as ISE utilizes traditional web-pages for the submission of answers and for the presentation of learning points, it should be possible to use all of the functionalities of web-pages within the ISE program to meet the training needs of care providers. For example, physician trainees learning how to auscultate the heart can be presented with ISE items which contain an audio recording of an unknown heart sound, and then, trainees can be asked to identify the murmur.
Micro-learning is favoured over more substantial time being given to this. I can imagine many applications.
This finding is in stark contrast to the strong resistance we encountered when conducting a recent trial of web-based teaching modules among 693 medical residents and students. In this trial focusing on systems based practice competency education, trainees were expected to spend 20 minutes per week over 9 weeks completing web-based teaching modules (interactive web-pages and online narrated slide presentations). (p977)
This high acceptability also likely reflects the ease of use of the spaced-education delivery system, the immediate relevance of the content, and the importance that students attribute to learning the physical examination. (p977)
Some items to cover if you are thinking of being a professional and thorough as the team at Harvard and Spaced-Ed:
- · Conflict of Interest:
- · Funding/Support:
- · Financial Disclosures:
- · Author Contributions:
- · Conception and design:
- · Acquisition of data:
- · Analysis and interpretation of data:
- · Drafting of the manuscript:
- · Critical revision of the manuscript for important intellectual content:
- · Statistical analysis:
- · Obtaining funding:
- · Ethical Approval to Perform the Study:
- · Corresponding Author:
And a finaly word from Lev Vygotsky.
‘Rhythm plays a decisive role in the learning process, unifying some of the material, conferring on it a sequential symmetry, and, finally, organizing the various elements into a unified whole’. (Vygotsky, 1926)
Kerfoot . B. P (2006) SPACED EDUCATION. Interactive Spaced-Education to Teach the Physical Examination: A randomized Controlled Trial.
Kerfoot. B. P (2008) Interactive Spaced-Education to Teach the Physical Examination: A Randomized Controlled Trial. Armstrong,E.G., O’Sullivan,P.M., JOURNAL OF GENERAL INTERNAL MEDICINE Volume 23, Number 7 Harvard Medical International.
Vygotsky, L (1926) Educational Psychology
- Here’s how to improve retention in e-learning – scaffolding, mentors, interaction and community (mymindbursts.com)
- 10 Ways Augmented Reality Could Change Learning Experience (classroom-aid.com)
- Lev Vygotsky: Pioneer of Psychology (learnpsychology.wordpress.com)
- Does Online Ed Spell Doom for Traditional Universities? (blogs.the-american-interest.com)
Dr Price Kerfoot is an alumni of Balliol College and he was featured in the College Magazine.
This Balliol and Harvard trained doctor had considered ways to improve the way in which medical students learn. A great deal must be learnt rote, you have to know your anatomy (to start with). This means dissecting a cadaver, making the information stick, then testing yourself relentlessly so that exams can be passed.
Here is a professional educator using e-technology to solve a problem.
As an innovation in e-learning nothing compares. It may not use second life or 3D animation, but is addresses a learning problem and offers an effective solution – good-bye factoids on Rolodex cards, hello 21st century email and text alerts probing you to answer multi-choice questions correctly. If you get it wrong, you receive the right answer and an explanation. This question will be resent in due course and sent repeatedly until it is self-evident that you now know the correct answer.
I’m signed up for Core Anatomy.
I haven’t a clue but using Google and go into research mode. It is staggering the wealth of visual materials to support learning, beautifully rendered images of the human body, podcasts from doctors, definitions of the terminology with audio so you learn how to pronounce these things. I still get the first couple of questions wrong, but never mind. I understand what the right answer is, I am building a corpus of knowledge that will in time enable me to answer 100 questions rather than only 25.
Give it a go.
Better still, build your own Space Ed programme. The platform is free to use and you are free to offer the results of your endeavour for free … or for a fee.
TESTING NEW INSTRUCTIONAL METHODS
Interactive Spaced-Education to Teach the Physical Examination:
A Randomized Controlled Trial
B. Price Kerfoot, MD EdM1,2,3, Elizabeth G. Armstrong, PhD2,3, and Patricia N. O’Sullivan, MD3,4