Old Dog, Old Trick, New Toy

Valerie P Jackson, MD, FACREugene C Klatte Professor and ChairDepartment of Radiology and Imaging SciencesIndiana University School of Medicine

NumericNoExplosionAnswer NowUse PowerPoint Color SchemeHorizontalCheckmarkNo10TicToc.wavBoxNoAnswered255,255,050%Keypad #Response Devices# of Responses50NoOval# of Votes ReceivedRedYesUse PowerPoint Color SchemeNoneVoting pads only15All Slides00187,224,22751,51,1530,153,153153,204,0128,128,1280,0,00,102,204204,204,255255,0,0255,255,0187,224,22751,51,1530,153,153153,204,0128,128,1280,0,00,102,204204,204,255255,0,0255,255,0YesYesYesYesExpandedTrueYellowd584be44923a4f9494af927af812c15d

I have no financial interests to discloseI am NOT an expert in Adult Learning PrinciplesI have attended usual array of schools and courses

Understand the characteristics of good and bad speakersUnderstand 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 baseTeachers should relate concepts and theories to audiences experiences

Adults are - autonomous and self-directed - goal-oriented - relevancy-oriented - practicalFocus on aspects of lesson most useful to them in workNeed respecthttp://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 classWant organized curriculumTeachers should show learners how they will reach their goals

Learners want to see reason to learnInformation 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 experienceGive opportunity to voice opinion and knowledge in teaching settingDont 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 messageCan 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

Cross-Tab Label True False

Cross-Tab Label Strongly Agree Agree Neutral Disagree Strongly Disagree

Space ARS throughout talk to keep audience engagedFirst half of this lecture was boring - you may not care about ALP - too many words - little/no interactionDont save all ARS until the end

Cross-Tab Label 0 1-3 4-6 7-9 10

Keep engagedARS

Cross-Tab LabelYesNoDoesnt matter

Cross-Tab Label Yes No

Interaction with audience more participationIncreases attendanceFaculty perceived more favorablyAble to get audience attitudes and opinionsCollins J. JACR 2008;5:993-1000

Immediate feedback Improved teaching and learningProvides anonymous peer assessmentCollins 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 scoresFamily Medicine Residents

Schackow, et al. Fam Med 2004;36(7):496-504

Immediate (%)1 month (%)ARS +9667ARS -6148

ARS and interactive lectures improve quiz scoresRadiology Residents

Rubio, et al. AJR:190, June 2008

Immediate (%)3 months (%)ARS +7658ARS -6027

Interactive Teaching improves image interpretationFellow read 15 cases before training and 200 after didactic lectures. Weekly interactive tutorials with experts compared fellows interpretations to pathologyInteractive 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 ARSImproved activity during lecturesEnhanced learningEasier to ask questions during lecturesMajority enjoy ARS lectures moreMajority feel more engagedUhari, et al. BMC Medical Education 2003, 3:12Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9

Radiology instruction using ARS builds students confidenceknowledge of self-masteryinsights for future studyingUhari, et al. BMC Medical Education 2003, 3:12Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9

Instant feedbackAllows educator to direct lecture and discussionGives trainees information about their knowledge and performanceResults in increased satisfaction for both lecturer and traineeSteinert & Snell. Med Teacher, Vol. 21, No. 1, 1999

Autonomous, self-directed learnersWant to be actively involved in learningCan be used to guide knowledgeFoundation of experienceMethod to relate to life experience through CBTRelevancy-oriented/practicalPractice what learnedDesire respectGives opportunity for audience to voice opinion and demonstrate knowledge

MotivationAllows connection of teacher and learnerProvides avenue for challenging learnerProvides mechanism for feedbackReinforcementPracticeRetentionProven to have higher % retentionTransferenceFirst step to applying knowledge learned

Need to transport and set upExpensive to use/buy/rentEffectiveness depends on instructor competence and equipment reliabilityQuestioning reduces time for lecture contentTime to prepare the lecture longMay be seen as a gimmick/gameCollins. 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 importSystem requires dedicated laptop unless speaker comfortable with ARS softwareNot easy to return to earlier questionSoftware has learning curveIT support helpful/necessary?

Fear of losing controlToo much freedom for the audienceFear of not covering all the informationHave to reduce facts to incorporate interactive natureToo much information results in less retentionTime constraintsSteinert & Snell. Med Teacher, Vol. 21, No. 1, 1999

ARS-based lectures progress slower than didactic formatsAmount of material covered less than in didactic formatsARS may not be designed ideally for radiology in that MCQs may not be ideal way to test in radiologyHowever, studies show interactive learning helpfulNeed for creativity in CBTNicholson and Bassignani. Unpublished data (UVa)

ARS

Cross-Tab Label Vanilla Chocolate Chocolate Cookie Dough Mint Chocolate Chip Other

Tips to limit negatives and maximize positives

Promote critical thinking through wordingMake topics/questions relevant to workPrepare for questions that might ariseKeep simple, short, easy to read10-15 seconds time per questionVary question typesMC, T/F, yes/no, Likert opinionCollins. J Am Coll Radiol 2008;5:993-1000

Number options 1 to 10Incorporate time for questions/discussion of optionsAverage 5 minutes per questionRange is broad (many factors)Insert question every 10 to 20 minutesProvide instructions to audience prior to beginningArrive early to review ARS and prevent IT issuesCollins. J Am Coll Radiol 2008;5:993-1000

Impromptu questionsMore than one answer optionsChoose all that applyRank orderAnonymous record keeping for follow upTeam playInvolve audiences to pick teamsAssign points for questions/answersFastest responderCME, SAM testingSee ARS staff

The Worst is Over..

*http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/adults-2.htmThe presentation opens up with the speaker demonstrating how a learner teaches themselves a new concept . In this example the learner is researching case based teaching and ARS on the next slide. The speaker then describes Problem-Based Learning.******Place holder again; next slide is interactive question for audience on second screen***Perception of change from pre-survey to post-survey comparing tradition with ARS lectures**Wake up audience again Just before the summary/climax of talk*Could do pie graph or horizontal bars ???**