All 5 entries tagged Education

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May 03, 2010

Twitter for Medical Student Lectures?

Writing about web page

I had a great time at the International Conference on Virtual Patients in London last week. One of the real positives to come out of the web2.0 discussions was how to hear how students can get engaged with elearning technologies. I personally took one idea as being a really helpful one.Twitter in action

The concept of using twitter and the use of hash-tags (like #lecture) to allow students to post up comments on a running board during the process of a teaching session sounded to me really attractive.

I wonder if anyone else is using a similar technique to help teach, and what their experiences have been. It can be a little daunting teaching groups of 150+, and I guess things could get out of hand, but it sounds like quite an engaging thing to get the students to do. I think Ill roll it out the next time I get to teach a few medical students.

There were quite a few other comments from people attending the conference, I hope to put some of them in a more formal form here.

There is also a great clip on YouTube which really summed up the buzz or the vibe that I'd like to create trying to deliver these new things, from a chap from the University of Arizona. It was interesting to hear the opinions of some of his previous peers on his teaching style, he certainly gets my vote for the high quality production and the messages you get from the video.

February 03, 2010

Web Based Learning in Rheumatology, where are we now, and where do we need to be?

We all know about the potential of the web, but how should it be best put to use? Here are some of my musings frommy own thoughts on web based learning and rheumatology as it stands today.internal rotation of the shoulder


When considering web based learning (WBL), extensive research has been conducted to compare e-learning against more traditional teaching methods. Up until recent years, the majority of educational research studies into WBL were non inferiority studies, or comparisons of additional e-learning resources ‘added into’ standard curricula (Cook, 2005, 2008). The largest meta-analysis of WBL learning in healthcare conducted to date has concluded that it is not if, but how we deliver web based learning that is the most critical question facing educators (Cook, 2008). It was confirmed by Wong (2003) that delivery of web based teaching is not simply a case of ‘putting your course on the web’. Robust evidence does not exist on exactly how the delivery of this material influences learning. Few studies attempt to directly compare two different approaches, with almost no data on an ‘interactive video’ based approach compared to a standard online presentation of material.

WBL in Rheumatology
Education in musculoskeletal medicine provides some evidence for some forms of WBL when added to traditional methods (Wilson, 2006); however I have identified no trials that compare different online strategies to teach a clinical skill. Various e-learning techniques have been tried, but they are often not web based. The Arthritis Research Campaign (ARC) have produced a more traditional CD ROM based e-learning package has been evaluated, and been shown to improve OSCE scores post intervention and improve self reported confidence (Vivekananda-Schmidt, 2005), however WBL has not been studied extensively studied by the ARC, or other research groups.

How is WBL Delivered
Web based learning (WBL) is commonly delivered in the form of a Virtual Learning Environment (VLE). A VLE can be thought of as a navigational menu driven system by which a student directs his or her educational pathway through a series of resources or activities. Any accessory materials such as pre/ post teaching evaluation can be delivered, with the results often being automatically collated by the VLE. This structure allows the delivery of educational material to trainees, in a reproducible, secure way. Each VLE can be accessed by students and teachers, with different priorities and user privileges available to users depending on a pre determined level of access.

Online material can be presented I a number of formats inside a VLE, namely via traditional text and pictures with associated connections between topics (hyperlinks), or via more detailed methods incorporating video and audio based aids to assist in their development. There is evidence to support that the more sophisticated the technology or advanced the delivery method, there is an increased associated cost. Furthermore this has been shown as one factor to dissuade medical schools in the United States to sharing online e-learning material, or producing open access medical resources (Huang, 2007).

In summary there is a large amount that is still to be studied relating to web based learning in  Rheumatology. Where do we go from here?

Selected References and Further Reading, if you're interested...

Badcock LJ, Raj N, Gadsby K, Deighton CM. Meeting the needs of increasing numbers of medical students--a best practise approach. Rheumatology  2006;45(7):799-803.

Cook DA, Levinson AJ, Garside MD et al. Internet-Based Learning in the Health Professions, A Meta-analysis. JAMA. 2008;300(10):1181-1196.

Cook DA. The research we still are not doing: an agenda for the study of computer-based learning. Acad Med 2005;80:541-8.

Cook DA. Where are we with Web-based learning in medical education? Med Teach. 2006;28(7):594-8.

Downing SM. Reliability: on the reproducibility of assessment data. Med Educ. 2004;38(9):1006-12.   

Huang G, Reynolds R, Candler C. Virtual Patient Simulation at U.S. and Canadian Medical Schools. Acad Med. 2007;82:446-451

Kay LJ, Deighton CM, Walker DJ, Hay EM. Undergraduate rheumatology teaching in the UK: a survey of current practice and changes since 1990. Arthritis Research Campaign Undergraduate Working Party of the ARC Education Sub-committee. Rheumatology. 2000;39(7):800-3

Norman G Eva KW. Quantitative Research methods in medical education. AMSE. Edinburgh 2008.

Vivekananda-Schmidt P, Lewis M, Hassell AB.Cluster randomized controlled trial of the impact of a computer-assisted learning package on the learning of musculoskeletal examination skills by undergraduate medical students. Arthritis Rheum. 2005 15;53(5):764-71.

Wilson AS, Goodall JE, Ambrosini G, Carruthers DM, Chan H, Ong SG, Gordon C, Young SP. Development of an interactive learning tool for teaching rheumatology- a simulated clinical case studies program. Rheumatology (Oxford). 2006 Sep;45(9):1158-61.

Wong G, Greenhalgh T, Russell J, Boynton P, Toon P. Putting your course on the Web: lessons from a case study and systematic literature review. Med Educ. 2003;37(11):1020-3.

July 07, 2009

Virtual Patients

Writing about web page

I've been enjoying working with a number of different software packages for virtual patients over the past few

Labrynth is one of a number of educational developments to improve education based on simulated clincal cases

weeks including Labyrinth, vpSim and a number of offerings from a number of organisations.

What I can say is the beauty and speed of whats been evolving really does put these developments into really new areas of research.

The real point is that its not clear exactly how to educate undergraduates, doctors or patients using these forms of software, but  research is now being dedicated towards this area including a European Body eViP, which held the first International Conference dedicated to Virtual patients earlier last month (June 09) in in Krakow.

Numerous e-learning developments are blogged daily by practitioners interested in the Web2.0, and virtual patients really offers the opportunity to practising physicians and educationalists to work together, each generating significant content.

Im looking forward to developing some elearning content here at Warwick for undergraduates. But how is this actually done? A diagram below (created using vpSim from the University of Pittsburgh) will help to explain things. Depending on which system is in use, a series of interconnecting pathways with options for questions/ interventions and branches along with multimedia gives students the opportunity to work their way through different clinical cases.

An example of the pathway followed when creating a vritual patient case

Each of the nodes contains detailed clinical information as well as patient resources.


Obviously there are a number of concerns that go along with generating such content. material published on the world wide web can be copied and is difficult to withdraw once consent for publication has been given. Fortunately detailed consent forms and information given to patients whose clinical images may be used in such cases helps minimise the impact of such problems.


hopefully the open access nature of the Web 2.0 revolution, the creative commons licence and other initiatives will bring virtual patients to an international audience and overall improve the quality of patient care. Important research questions remain to be asked about how these tools can be used to teach doctors, nurses, physiotherapists and other allied health care workers.

For more information on eViP, watch a video, from them, embedded below.

February 06, 2009

Enjoying the commentry on Twitter

Writing about web page /mmannion/entry/twitter_is_not/

Writing about an entry you don't have permission to view

I'm enjoying the commentry on Twitter, getting more topical by the day it seems!

January 28, 2009

Virtual Learning Environments and Research: Presenting at the BSR

I'm please to say Ill be presenting an oral presentation at the British Society of Rheumatology Annual meeting in April 2009 regarding my work with virtual learning environments and their application to every day medical education and research.

Ill be publishing the presentation here on the blog here and also at my other blog site.

In the piece in question Ill be discussing the implementation of video based educational techniques and their comparison with text based delivery.

I have some experience of working with VLE's at a number of sites primarily from a research basis at and another site relating to exam revision.

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