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Valerie P Jackson, MD, FACREugene C Klatte Professor and ChairDepartment of Radiology and Imaging SciencesIndiana University School of Medicine
I have no financial interests to disclose
I am NOT an expert in Adult Learning Principles
I have attended usual array of schools and courses
Understand the characteristics of good and bad speakers
Understand Adult Learning Principles (ALP)
Introduce Case-Based Teaching (CBT)Explain Audience Response Systems
(ARS)Realize advantages and disadvantages of
ARS
this……. to this?
Unlike small children, adults- have foundation of life experiences and knowledge- want to connect learning with knowledge and experience base
Teachers should relate concepts and theories to audience’s experiences
Adults are- autonomous and self-directed- goal-oriented- relevancy-oriented- practical
Focus on aspects of lesson most useful to them in work
Need respect
http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/adults-2.htm
Free to direct themselvesWant to be actively involved in
learning Like to know how ‘class’ will help
them reach their goalsTeachers serve as facilitatorsTeachers guide to knowledge rather
than provide facts
Learners typically know their goals for class
Want organized curriculumTeachers should show learners how
they will reach their goals
Learners want to see reason to learn Information applicable to work, lifeWant to know how learning concept
will relate to familiar situationsWant to focus on what is important
and usefulNot necessarily interested to “just
learn” something
Acknowledge the learners experience
Give opportunity to voice opinion and knowledge in teaching setting
Don’t waste time on irrelevant stuff
Case based teachingProblem based learningBoth interactiveFocus on development of relevant
skills
Develop skills in analytical thinking and reflective judgment
Reading and discussing complex, real-life scenarios
Cases are stories with educational message
Can be done with large group
Call on people to answerRaising of hands/surveyTeams/split the roomPaper responsesOpen microphoneUse ARS
Keypads Radio frequency receiverGroup response softwareLaptop computerLCD projector
QuestionTime to selectRecognizes input from participantsDisplays data? Improves learning environment
Get to know the audience
Cro
ss-T
ab L
abel1. True
2. False
51%
49%
0/010
Cross-Tab Label0/0
1. Strongly Agree2. Agree3. Neutral4. Disagree5. Strongly Disagree
20% 20% 20% 20% 20%
1 2 3 4 5
10
Space ARS throughout talk to keep audience engaged
First half of this lecture was boring- you may not care about ALP- too many words- little/no interaction
Don’t save all ARS until the end
Cross-Tab Label0/0
1. 02. 1-33. 4-64. 7-95. ≥ 10
20% 20% 20% 20% 20%
Zero 1-3 4-6 7-9 10 ormore
10
Keep engaged
ARS
Cro
ss-T
ab L
abel
1.Yes
2.No
3.Doesn’t matter
33%
33%
33%
0/0
(1) = XX.X
(2) = XX.X
(3) = XX.X
10
10Cross-Tab Label0/0
1. Yes2. No
51% 49%
Yes No
Interaction with audience ➔ more participation
Increases attendanceFaculty perceived more favorablyAble to get audience attitudes and
opinions
Collins J. JACR 2008;5:993-1000
Immediate feedback ➔ Improved teaching and learning
Provides anonymous peer assessment
Collins J. JACR 2008;5:993-1000
Portable/wireless systemEasy for participants to learn/useCan track data anonymouslyFlexible so ‘on the fly’ questions can
be usedFacilitates CME for SAMSFun
ARS and interactive lectures improve quiz scores Family Medicine Residents
Schackow, et al. Fam Med 2004;36(7):496-504
Immediate (%)
1 month (%)
ARS + 96 67
ARS - 61 48
ARS and interactive lectures improve quiz scores Radiology Residents
Rubio, et al. AJR:190, June 2008
Immediate (%)
3 months (%)
ARS + 76 58
ARS - 60 27
Interactive Teaching improves image interpretation Fellow read 15 cases before training and
200 after didactic lectures. Weekly interactive tutorials with experts
compared fellow’s interpretations to pathology
Interactive training significantly improved accuracy in tumor localization extension
Akin O, et al. Eur Radiol. 2010 Apr;20(4):995-1002
Students report positive feedback for ARS Improved activity during lectures Enhanced learning Easier to ask questions during lectures Majority enjoy ARS lectures more Majority feel more engaged
Uhari, et al. BMC Medical Education 2003, 3:12Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9
Radiology instruction using ARS builds
students’ confidence knowledge of self-mastery insights for future studying
Uhari, et al. BMC Medical Education 2003, 3:12Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9
Instant feedback Allows educator to direct lecture and
discussion Gives trainees information about their
knowledge and performance Results in increased satisfaction for both
lecturer and trainee
Steinert & Snell. Med Teacher, Vol. 21, No. 1, 1999
Autonomous, self-directed learners Want to be actively involved in learning Can be used to guide knowledge
Foundation of experience Method to relate to life experience through CBT
Relevancy-oriented/practical Practice what learned
Desire respect Gives opportunity for audience to voice opinion
and demonstrate knowledge
Motivation Allows connection of teacher and learner Provides avenue for challenging learner Provides mechanism for feedback
Reinforcement Practice
Retention Proven to have higher % retention
Transference First step to applying knowledge learned
Need to transport and set upExpensive to use/buy/rentEffectiveness depends on instructor
competence and equipment reliability
Questioning reduces time for lecture content
Time to prepare the lecture longMay be seen as a gimmick/game
Collins. J Am Coll Radiol 2008;5:993-1000
Best to prepare questions in advance (can do spontaneous additions)
Files from other software can be difficult to import
System requires dedicated laptop unless speaker comfortable with ARS software
Not easy to return to earlier question Software has learning curve IT support helpful/necessary?
Fear of losing control Too much freedom for the audience
Fear of not covering all the information Have to reduce facts to incorporate
interactive nature Too much information results in less
retentionTime constraints
Steinert & Snell. Med Teacher, Vol. 21, No. 1, 1999
ARS-based lectures progress slower than didactic formats
Amount of material covered less than in didactic formats
ARS may not be designed ideally for radiology in that MCQs may not be ideal way to test in radiology However, studies show interactive learning
helpful Need for creativity in CBT
Nicholson and Bassignani. Unpublished data (UVa)
ARS
Cross-Tab Label
0/0
1. Vanilla2. Chocolate3. Chocolate Cookie Dough
4. Mint Chocolate Chip5. Other
25% 25% 25% 24%
1 2 3 4
10
Tips to limit negatives and maximize positives
Promote critical thinking through wording
Make topics/questions relevant to work Prepare for questions that might arise Keep simple, short, easy to read
10-15 seconds time per question Vary question types
MC, T/F, yes/no, Likert opinion
Collins. J Am Coll Radiol 2008;5:993-1000
Number options 1 to 10 Incorporate time for
questions/discussion of options Average 5 minutes per question Range is broad (many factors)
Insert question every 10 to 20 minutes Provide instructions to audience prior
to beginning Arrive early to review ARS and prevent
IT issues
Collins. J Am Coll Radiol 2008;5:993-1000
Impromptu questions More than one answer options
Choose all that apply Rank order
Anonymous record keeping for follow up Team play
Involve audiences to pick teams Assign points for questions/answers
Fastest responder CME, SAM testing
See ARS staff
The Worst is Over………..