Evaluation of an interactive, case-based review session in teaching medical microbiology

Posted 4/26/10

Medical schools across the globe are striving to use communication technology to appendage traditional face-to-face lecture practices. At University Hospital in Lausanne Switzerland, the Department of Internal Medicine has developed a pedagogical technique for teaching 3rd level students how to facilitate theoretical concepts with clinical situations. The faculty was interested in cultivating a clear connection between core concepts of biological changes of body fluids such as electrolyte and acid-based with disease manifestations. Previous investigation by the faculty at University Hospital noted students demonstrated a weakness in understanding basic academic Pathophysiology elements of connecting the physiological and biological changes which occur during the disease process.

In the past, the University Hospital faculty taught face-to-face Pathophysiology courses using lectures, summative exam (multiple choice questions) and interactive discussion (practicum). The ‘interactive discussion session’ is the module on which the faculty desired to improve. Listed below are the three phase processes cultivated to improve teaching techniques, strengthen core academic theories and develop understanding of pathophysiological effects of the disease fluids.

Part 1: Four patient’s clinical histories simulations were posted on the web fifteen days prior to the interactive discussion session. The histories exemplify common pathophysiological events and from the list of symptoms, the third year students would select the most suitable laboratory tests to be conducted. The results page would show only the correct tests required as predetermined by the faculty member. In addition, the students could correlate the correct responses to all the cases and print out the document for the interactive session.

Part 2: Two days before the session, the clinical case studies would be removed from the Internet by the course administrator. The data captured by the site trends provided statistical information about the number of students who studied each case and the breakdown on who asked for each laboratory tests. From this information the instructor would devise a lesson plan uniquely prepared for the students.

Part 3: Post class case discussion and documents will be available for students up to fifteen days after the interactive session to review or print out.

After a two year study, the results indicated the students who took advantage of the Web-based simulations that is was an effective content delivery system for the medical school. Other notable comments are listed below:

1. Students liked the Web-based format
2. Students tended to return numerous times to visit the site
3. Students liked to work independently
4. Students liked the anonymous feedback during the student-teacher interactive discussion session

After receive high ratings from faculty and students on the effectiveness of Web-based simulation learning activities, the Medical e-learning coordinator at the University Hospital, plans to extent pedagogical content delivery system into other curriculums.

Example of MSF (Doctors without borders) e-learning system.

American example of e-learning system:
Evaluation of an interactive, case-based review session in teaching medical microbiology

Podcasts: building Learning and Simulation Virtual Centers

Updated: 4/25/10

Medical student's supplementing traditional teaching methods

Entering into the lobby of Johns Hopkins Hospital Medical Campus, a visitor can see many people wearing headphones. Are they all listening to music or listening to the JHH’s Weekly Podcast discussing the top medical stories of the week? Who are these people: students or patients?

Since the early 2005, podcasts have been used to inform the masses about current trends and news events. Podcasts are audio or video files which can be placed on the Internet and downloaded to a computer or mobile devices like MP3 players and iPods. Initially Podcasts were in audio format but with the increase use of screened mobile devices, many people have been adding video components to enhance the audio presentation.


As discussed by Thomas Friedman, author of The World Is Flat, podcasts can be used to illustrate one of flattening forces in Globalization 3.0. One flattener, #9 in-forming, entails the idea of collective intelligence. Friedman defines in-forming as


“the ability to build and deploy our own personal supply chain…..
of information, knowledge and entertainment. In-forming is about
self-collaboration -becoming your own self-directed researcher, editor
and selector”[1]

Net Generation students habituated use the Internet for communication, entertainment and news events. Why not invest into content delivery systems, such as a Podcast, to augment learning styles? Well, many schools across the country, like Duke University, have been using Apple’s iPod for academic pursuits. Here are a few ideas on how mobile media devices can help students:

1. Convenience format for faculty and students to utilize for file storage
2. Provide independent access to digit content
3. Simple recording tools – classroom lectures, field notes, interviews
4. House Audio or electronic text books
5. Individualized custom learning system[1]

When you have a chance, listen to the Podcast created by Richard Lindstrom, Director, Academic Infrastructure Development at the Charles Drew University of Medicine and Science. He describes a major shift in teaching students in medical schools. Mr. Lindstrom concludes based on his knowledge of the informatics, ‘the human mind just cannot hold all the information out there’. [3] Educators need to change from the ‘apprentice model’ -retaining fundamental knowledge of teaching medical students to the ‘analytical model’ – learning how to build a repository of knowledge and how to use critical thinking to best synthesized the data into information.

These modes of information delivery can be developed into Decision Support Systems or clinical stimulation applications. Medical schools can have more control over the content presented to impressionable students but creating a custom Podcasts. As Mr. Lindstrom stated, by creating clinical simulation events, a student can analyze and critically asset the correct method of handling a procedure by viewing a podcast, not in ad hoc world of a clinic training environment.

So, if Podcasts can be useful for medical students by amalgamating the content delivery system with traditional educational methods to teach subjects areas, then can not the same type of delivery arrangement be used to inform patients about their healthcare? Lucky for the members of the JHH Health System the technology is already in place. Located on http://www.hopkinsmedicine.org/mediaii/podcasts.html, patients can access subject matter content ranging from how to treat the common cold to heart surgery. The podcast can be downloaded via iTunes for immediate viewing, delayed viewing or even repeated viewing.

Now, look again at the people using iPods. Can you tell if they are medical students or JHH patients?

[1] The World is Flat by Thomas Friedman, p. 153.
[2] Emerging Technology Center by Diane J. Skba presented in Nursing Education Perspectives
[3] Richard Lindstrom, Director, Academic Infrastructure Development at the Charles Drew University of Medicine, http://www.educause.edu/blog/gbayne/InterviewPodcastRichardLindstr/203581.

Podcast example viewings:

Med student Podcast: Pregnant Robot Trains Students

Hopkins Podcasts for the week of April 23, 2010.

Computerized learning systems for medical students? Are X-Box surgical simulation games the next step?

Back in the day.... as consumers we knew which hospitals were teaching hospitals and which ones were not. The stigma associated with being a patient of a student practicing to be a doctor, brought doubt into the minds of many. Even thought the students were supervised by the attending staff, I myself did not like being part of the learning cycle. Could there be another learning tool for students to use instead of human guinea pigs?
The infiltration of computers into daily tasks has blended people and processes together to provide information and infrastructure to our homes, education, corporate and leisure worlds. We are guided by computers from the minute we open our eyes to when we close our eyes. Computers are an integral part of our life no matter where we are located. Instead of reaching for a pencil, we reach for an electronic device.
Medical schools have revamped curriculums to allow computer integration with courses. The introduction of computerized training programs began as early as 2000. Around the same time, hospital trends revealed a decrease in the hospitalization intervals and an increase in medical student’s numbers. The combined result exemplifies the reduction of available instructional time and decline of on-hand hospitalized patients.
For instance, surgeons are required to take in-depth health histories of patients, which aids in diagnosing. A group called United Kingdom Medical Research Group created Simulated Patients (SP) modules on health history protocols for third year medical students. The module focused on two parts. First the program created a checklist layout on how to systemically take a health history and to make a diagnosis. Secondly, the program helped students learn how to effectively conduct a consultation. The program was developed into scenario based SP tutorials. Positive feedback from medical students indicated the SR program was well received. As a matter of fact, many of the students noted the SP tutorials encourage active discussions between themselves and instructors. In addition, since the SP is automated, students could repeat modules to gain confidence in the subject material.
Now back to the X-Box comment. Can med students train on computers to develop operating room techniques and practice what if scenarios? Student airline pilots practice many hours on simulated games to learn how to handle a large expense aircrafts. I know for sure that the Navy Seals are trained with simulated programs and play X-Box Navy Seals games off duty. So…I do not think it is a far stretch to image medical students practicing surgical procedures on SP applications. Who knows maybe Microsoft would develop a Surgical Duty game for the practicing students.