Integrating Technology into Medical Colleges

Integrating instructional technology into the 21st Century

Medical College

1- The changing role of the teacher

a. The one room school house generalist

b. The specialist teacher in the 20th and 21 century

c. The adjunct Medical Doctor instructor

Changing the Pedagogy of Medical College Faculty in Lectures

By Dr. Pelham Mead, retired Director of Faculty Development at NYiT, College

of Osteopathic Medicine, Old Westbury, L.I., N.Y.

The problem in most medical colleges is their over-dependence on the lecture method of

instruction to get across information to first, and second year, medical students. The pedagogy

of “lecture and leave,” is out of date, and ineffective. The pedagogy for faculty for the 21st

century is to engage the students in the process of analytical thinking so that it becomes natural

in the real- life profession of medicine.

There has been a growing trend since the late 1990’s to move from large lectures to small

groups at most Osteopathic, and Allopathic medical colleges across the United States. (Cite)

Lectures are convenient and require less space in terms of many classrooms vs. one large

lecture hall. Using lectures only allows a medical school to have a smaller faculty since it takes

more faculty members to facilitate many classrooms than it does to have one person lecturing to

a large body of students at one time. The pedagogy of the instructor has to change from

lecturing and depending 100% on Powerpoint to engaging students with case study scenarios,

motivating medical students to read and prepare the assignments in advance of the group

discussion class. As the class gets larger the distance of the instructor from the back of the class

increases. An effective instructor will move away from the podium and use a remote clicker for

Powerpoint and walk down the aisles to communicate with the students at the back and the

middle of the room. What an instructor can do with a class of 30 students, they can do with 200

or 300. The same rules apply. Engage the student in discussion. Wait for their answer. Allow

them to consult with a student on either side of where they are sitting as they do on the show

“Millionaire,” “Consult an Expert.”

Even the way a professor speaks to a medical student makes a difference. “Student Physician

Smith, can you tell me the solution is to this case and how you determined that solution?” By

using the term student Physician or student doctor the instructor has given the medical student

some power and pride. This style of teaching is the pedagogy of medical education for the 21st

century. It is used at Univ. of Texas Osteopathic School of Medicine, at NYCOM and many

other medical schools. Treating medical students with respect and giving them the

responsibility to solve case studies empowers them and gives them the motivation to perform

better.

Another method of student empowerment is to get the students to assess the classes, labs, and

lectures as well as the faculty teaching. At NYCOM we adapted an approach used by Mayo

Medical School in randomly assigning teams of students to each course and have them compile

a professionally written Executive report on the course in two pages. Likewise, one to two

pages summarized briefly regarding the faculty and their performance. The Executive report is

first made to the end of course round table with the Director of the course; thread coordinators,

and faculty who taught the course. The student assessment group of CFA (class/faculty

assessment) team selects a few representatives to give their recommendations regarding the

course to the faculty at the round table. After discussion, the recommendations that are

approved by the round table are then presented to the NYCOM Curriculum Committee for a

brief 5-minute presentation regarding just the course recommendations. The faculty

recommendations are kept confidential and are reported to the Associate Dean of Academic

affairs, which in turn follow up on the positive and negative reports on faculty by sharing the

information with the appropriate Department Chairperson.

At the NY College of Osteopathic Medicine, streaming video has been provided for almost a

decade. It first replaced television broadcasts, and was a unique tool in learning. Eventually by

2008, it became so good that is threatened to leave the lecture halls empty. The administration

struggled to find a solution to the attendance problem without removing streaming. Attendance

was mandatory and the administration was not about to change this policy.

In addition to computer streaming of lectures, the NY College of Osteopathic Medicine

provided all first ,and second year, medical students with notes on Moodle, outlined in advance.

The notes and Powerpoint presentations were printed out and put in all students’ mailboxes. On

the surface this seemed like a great sup portative idea to provide the students with all the study

aids possible to improve learning and test scores. In reality, however, students took the notes

into the lecture and yellow highlighted all the facts deemed necessary. Little real learning was

going on and as research has shown they only remembered 20-30% of the whole lecture after

they left the lecture hall.

Quizzes and test scores seemed to indicate a lack of comprehension on the student’s behalf.

Professors were teaching rote when they should have been teaching concepts through case

studies. One case study was presented each week and not covered in the lectures as a rule, even

thought it was supposed to be included.

The top down mandate from the College administration that lecture attendance be mandatory

did not work. Students were doing what ever they wanted to do without consequences. The

administration felt attendance should be mandatory because the students needed to interact with

the faculty. The interaction did not exist except for one or two professors. Many adjunct faculty

as well as full time faculty did not understand how to teach an interactive lecture and felt

comfortable rather than just repeating what the Powerpoint slide had on it.

Solution.

That lecture/discussion approach had become a big problem in terms of fluctuating attendance

by the fall of 2008. The problem of the student’s poor attendance, lack of professionalism,

punctuality, and student engagement was becoming a problem that needed a solution.

In the fall of 2008 change was needed. A strategy was developed to approach the

lecture/discussion aspect of the medical student education.

Strategy for Change

1. Get the full-time faculty and visiting lecturers to buy into establishing a new approach to

lectures.

2. Survey all faculty opinions as to what works in lectures and what doesn’t work.

3. Compare previous quiz and test scores from the previous three years with any change

pilot program to see if student test scores improve.

4. Survey student satisfaction before any pilot program is initiated and after a pilot is

introduced to the lecture program.

5. Interview and bring on-board the most outstanding interactive Professors on the staff and

encourage them to help change in the lecture program by modeling correct approaches to

lecturing. Video these presentations and make them available in streaming and podcast

format to all faculty.

6. Provide a new form of Faculty evaluation that only looks at the pedagogy of the professor

in utilizing an interactive lecture approach with collaborative student learning groups.

7. Attempt to recruit 3rd year and 4th year clinical students to come back to help part-time as

discussion group leaders after lectures for first and second year medical students.

8. In exchange for working as group discussion leaders the medical students would be given

a tuition rebate.

9. The Lecture schedule would be modified to allow for a 60-minute discussion group

session immediately following the lecture.

10. Some lectures would involve a lecture facilitator and Collaborative Learning Groups.

Note: the same groups as the discussion groups.

11. The new Interactive Lecture approach would not be implemented until the fall of 2009 to

phase in the change with the first year medical students only.

12. In the fall of 2010 the second cohort of first year medical students would get the

Interactive Lecture approach as well as the second year medical students who were

introduced to this approach the year before.

Faculties who know how to model an interactive lecture were chosen to be filmed for a podcast

for the other faculty to see. A faculty party was planned in which to gather opinions, and

comments from adjunct faculty and full-time faculty. The social aspect of the party drew a lot of

adjunct professors who were a great part of the problem. Comments were sought how to best

improve the lectures. These comments were recorded and then sent out after the party for all

faculty to review and make additional suggestions. From these suggestions some pilot studies

were planned having the best interactive pedagogical faculty on the staff taking the lead.

Students were evaluated before interactive lectures were used for the same professor and after

he or she utilized academic games, demonstrations, collaborative learning, walking down the

isle asking questions, and installation of 6 microphones for students to ask questions during a

lecture also.

The design of the lecture hall with 350 fixed seats bolted into the ground and swing out lecture

arm style was not conducive to collaborative learning groups. No change could be made

immediately as to the seating arrangement, but it was recommended to the Dean of the College

to have the chairs removed next year and replaced with round tables and free standing chairs

that would enable collaborative learning groups to sit around each table and have a discussion

on the lecture of the day.

The officers of the first year medical students and the second year medical students met with the

Director of Faculty Development to voice their opinions. Their suggestions were taken into

consideration. They were informed as to what planned changes would occur after the faculty

was surveyed for their opinions.

The next step was to phase out the streaming to get the students to come to the lectures or

change the mandated attendance policy. Since the Virtual Medical Center pulled groups of

students from lectures a backup such as streaming was necessary. This access could be limited

to those students who missed a lecture due to being pulled from the lecture to attend Virtual

Medical Center sessions. Podcasts could be a more practical approach rather than streaming

lectures. Podcasts can be edited down to represent a portion of the lecture but not the entire

lecture. Eventually NYCOM administration will need to address this problem and move

forward to new educational outcomes.

d. Adjunct technical instructors

2- The changing role of the student

a. The students of yesterday

b. The students of today 21st century

i. Surrounded by media, technology, laptops, ipods, cell phones

3- The generational conflict

a. Education is always a generation behind the trends

b. Textbooks vs, experience

4- The fear of technology and change

a. The fear of computers, ipods, iphones, ipads, new tools

b. The comfortable teacher

c. Being open to change

5- Technology tools in the 21st Century Classroom

a. Blackboard

b. Electronic Whiteboards

c. Manual and auto podcasting

d. Streaming

e. Student response systems

1. Clickers

2. remotes

f. Laptops in the classroom

1. Empowering the student

2. Using laptops as part of a lecture

3. The evils of laptops

g. Smart Classrooms

i. Trends past and present

ii. Keeping up with the trends

iii. Do they really work?

6- Solutions to large and small classrooms

a. Large lecture hall solutions

b. Small classroom solutions

c. Online courses

7- Engaging students in lectures

a. Getting out from behind the lectern

b. The “Phil Donahue” approach

c. Setting up collaborative groups

d. Projects within the lecture hall

e. Student participation

8- Embracing Technology tools

a. Student clicker response programs

b. Electronic Whiteboards for student interactive lectures

c. Wireless access in classrooms and lecture halls

d. PowerPoint that blows the students out of their chairs

e. Sound effects that can be heard clearly in all corners of a lecture hall

f. Blackboard as a backup support system

g. WEBsites or Blogs to keep up the narrative between teacher and students or

students and students.

h. Using group e-mail to alert your students as to reminders, homework due,

reading preparation

i. Provide a study guide for each reading or homework assignment with

questions to be answered

j. Give Quickie 1 minute quizzes using PowerPoint to keep students preparing,

to check attendance, instant feed back, assessment as to whether students are

keeping up with the assignments and lectures.

k. Another assessment technique. Give 10 slides and a one question quiz after

relating to the ten slides just given.

l. Have students come up to the Electronic Whiteboard and write answers

m. Have students give PowerPoint slide presentations on Project or Research

assignments.

n. Move around the classroom with a wireless microphone and ask students

questions on the fly. Bring in group discussion

o. Divide the class into collaborative learning groups and give each group the

same assignment in class to do or different assignments. Walk around the

room and join in listening to their research and discussion process. Encourage

the use of laptop computers in class to do these projects. Wireless printers

provide within 50 ft. range to print out project results.

p. Live demos using a document camera

q. Live microscope hooked up to a computer demonstrations

r. Introduce 3D graphics into presentations

s. Streaming or podcasting of lectures

t. Storing lectures on Blackboard

u. Using an iPad or iTouch hooked up to a digital HD large 60”+ TV for display

v. Create your own manual podcast clips in video and or audio or both. Store

online.

w. Use cloud to syn all your computers with the same files

x. Introduce music as a background to lectures; keep it soft and low unless you

want an upbeat response with a pop song.

y. Don’t ever post a Facebook page and communicate with students on a

personal basis. It may backfire on you.

z. Never post blogs expressing your political or personal views. Keep the blogs

focused on course content only.

aa. Don’t tweet personal comments to students

bb. Use Second Life if you are familiar with it and have taken time to buy

land.

cc. Educate your students in Second Life. Use it as an out of class instructional

tool.

dd. Use Second Life to drop in on worldwide conferences to learn what is

happening in other countries.

ee. Create online clinics as information centers for basic medical knowledge.

ff. Give a quiz using 3×5 cards with student name and the quiz answers on it.

gg. Try different approaches such as small skits using students as actors; debate

teams, dividing the class in half and have one side play checkers on an

electronic white board by answering course content questions created by the

students; Play Jeopardy

9- Technology drives Education and Education trains for Technology

10- Writing Syllabi for Faculty development

a. CMSV curriculum

College of Mount St. Vincent

Teacher Learner Center

TLC Course (45 hrs.) Syllabus-Year One- 2001

Developed by Dr. Pelham Mead

Tentative fall 2001- TLC Syllabus

I-Making Teaching even easier with the third arm of Education; Technology

• Computer Basics, CPU speed, Ram speed, Storage peripherals (zip disk, cd-rw, internet)

• Scanners, digital cameras, monitor projectors, DVD and DVD-rom.

II- File and Folder basics for Teachers (MAC or PC)

• Using My Computer and the old Explorer programs to read disks, hard drives and cdroms.

• Making folders, copying, cutting, deleting and pasting files and folders.

• Saveas vs save features

• Making backups on cd-rom-rw, zip disks and Internet.

III-e-mail and electronic communication for teachers

• Types of e-mail programs

• Using the e-mail at CMSV.

• Making an attachment.

• Requiring a receipt

• Sending free e-mail notes and greeting cards http://www.bluemountain.com

• Making a class group mailing list.

• Using the group mailing list in http://www.blackboard.com.

• IMing in AOL- INSTANT MESSENGING.

• Across the Internet IMing.

• Bulleting Boards

• Newsgroups

• Cookies and databases on the Internet

IV- The Internet and the Teacher/Professor of the 21st Century

• As the expression says, “time is money.” Everything about software today and computers

is about “speed.” Speed in Internet access time, speed in cup computer time, and speed

in RAM memory time, speed in printer page per minute time, speed in Internet download

time. This coupled with the framework of a one, two or three hour class makes

technology in the classroom not only possible but also desirable.

• Access time is everything on the Internet.

• Instant information access and printout. Printing out information rapidly is a great backup

for Professor lecture or discussions.

• Textbooks can be replaced by using “live” information off the Internet.

• CNBC, Yahoo, MSNBC, CBS, ABC, CNN are all on the Internet with instant news

information for courses using current news information. CNN offers a news download at

3:00 in the morning each day for Channel One viewers that might also be available for

anyone else with TV cable access.

• Consider a generation entertained by multi-media vs. traditional lecturing:

o TV Games- Station Playstation;

o DVD and Video children’s movies start from infancy as an entertainment medium.

The new babysitter is the video recorder and all the children’s videos. By Junior

High and High school students are mesmerized by TVs and video recorders and

multi-media is all that garners attention in College today.

o Research has shown the in lecturing only 30% is retained upon exit from the class

and the retention rate drops lower the next day. Slow learners cannot keep up with

notes with fast speaking lecturers.

o Lecturing is an easy method of communication for a Professor, not the student.

o Lecturing assumes all students are highly motivated

o Lecturing throws the material out there but does not want feedback.

o Lecturing does not meet the needs of students with special needs, language

barriers, learning disabilities, unclassified learning disabilities, slow students,

• We (Professors) become the facilitators rather than lecturers in the 21st Century in using

partnering learning, collaborative learning, cooperative learning, group projects

especially with laptops in the classroom or using a computer Lab as a classroom.

• It is never too late to change a “teaching style” or the pedagogy of teaching.

• Change is inevitable (chalk-less classrooms, smart classrooms, multi-media surround

sound theaters, cabled TV sets with videos and DVD, and multi-media computer carts

with printer and computer LAN accessed and LCD projector connection)

V -Teaching Students How to Access information on the Internet

Internet Drivers Test-

• Metaphor of an auto driving tests, including Parallel parking, U-turn, Getting the signals

right, speeding, etc.

• Get a digital copy of the form from Dr. Mead

VI- The battle of Microsoft Explorer Browser and Netscape.

• Search engines. Project in collecting the top 10 Search engines and documenting their

strengths and weaknesses.

• Portals-mega size sell everything, offer everything, shopping, search engines, bots, etc.

all in one

• Bots and specialty search engines

VII- How to research properly and quickly.

• Knowing when to change the search.

• Saving pictures from the internet: Right button, Save Picture as..

• Looking at source code on the internet

• Saving Text from the Internet: several approaches, Save the entire website in .html or

highlight the text, copy and paste into Word and Save.

• The new emphasis in Office 2000 and XP version suite programs emphasize hyperlinking

within a document to the Internet. XP Office 2000 will take that Internet access

even further.

VIII- Web Publishing in about an hour for Professors (MAC or PC)

• Why Web Publishing for Professors?

> To allow slower learners, students with learning disabilities and or language barriers such as

Hispanic students, Chinese and other foreign born to have another source to get class notes or

materials. Web Sites can be a great form of communication and course support for students.

• Using Microsoft Publisher 2000/XP (XP has been released, but is due for an update in the

fall of 2001) it is possible to create a Web Site using the Web Wizard in five minutes.

The harder part is putting in the content for students and the most difficult part in less

than an hour is to ftp (file transfer protocol) publishing to the Internet. Uploading a web

site folder to a host ISP on the Internet.

IX- Free HOST ISPs on the Internet:

Update this section

X- Hosting on the Blackboard.cmsv.edu system.

• Blackboard.cmsv.edu offers a Web Course design alternative to publishing a Web Page.

The difference is the Blackboard program is menu controlled and designed. Blackboard is

not the same as posting your own web page. It is a proprietary system that is already on

the Internet.

• Blackboard offers additional support for students who may or may not need it.

• Blackboard increases communication in new venues (e-mail, bulletin board discussion,

chat rooms, downloading additional readings and helpful files.

• Blackboard offers a display showcase for each Professor’s course for students to review

as a guest for possible future enrollment.

XI-Using an inexpensive commercial Host ISP.

• When using Frontpage (no longer produced by Microsoft), MS Publisher or

Dreamweaver, the extensions making publishing to the Internet difficult. Few free sites

can handle the .htm extension or the special components in dhtml found in Frontpage.

• When you want to remove any ads and the hassle of contacting a web site to ftp a file or

files a commercial site for only $7.95 a month is available.

• A small program called “Coffee Cup,” is a neat web site software program but it not free.

http://www.addr.com and many other low cost dependable host sites are available.

• Many other low cost sites are also available.

XII- Getting Started with MS Publisher

What works for Professors is a program that can develop a web site quickly and easily.

Publisher 2000/XP is perfect for that reason. It provides web templates, walks you through an

easy wizard program and creates 1-5 pages in just a few minutes.

XIII- Web Publishing in about an hour approach

1. Speed through the Publisher Web Wizard to establish 3-5 pages.

2. Edit the content

3. Link the navigation buttons

4. Saveas

5. Saveas Web site (default directory will be C:\publish

6. Use and easy ftp program or AOL built in ftp

7. Ftp each file or the entire folder to an ISP host.

8. For AOL ….http://members.aol.com/your screen name

XIV-Using the MS Publisher

Skills to learn:

• Adding or changing colors, adding sound, adding a form, choices of templates and

automatic navigation links.

• Editing the content first

• Activating the navigation links to each page and back to the main page. Save.

• Save as a WEB site in .html.

• Open the Web Publish Program and ftp the folder up to the Internet.

• Two page Web-converting from Professor’s Notes

• Five page Web-Converting from Professor’s Notes, Feedback form, URL link page and

course outline page.

• Adding features: Web Page Counter http://www.bravenet.com to keep track of the number of

visitors. Frames for Text.

• Shadow effects

• Graphics, clipart and pictures

XV-Hyper-linking pages, bookmark or anchoring, e-mail, outside links and other links.

• Highlight the word or phrase to link and click the Icon that shows the globe with a chain

link. The menu for linking will come up and you have the following choices:

o Link to another page

o Link to an external internet URL

o Link to an anchor or the same word further down the screen

o Link to an e-mail

o Link to a file to allow downloading

• When the link is established the word or phrase become underlined and change to blue or

some other color other than black.

XV1 Publishing to the Internet Easily with Blogs

Best free blogs

http://www.wordpress.com the basic Blog templates are free but WordPress will want you

to buy the expensive advanced templates which are not necessary. The basic template

allow you to copy and paste your text and pictures. They even provide small apps that

track your blogs activity.

http://www.blogger.com Has been around for a while and provides free templates for a

blog. You can create more than one blog if you wish.

XVII- MS Word for the Professor (MAC and PC)

Alternative instructional techniques using Word.

• A Professor who can type fast it is conceivable to actually type the notes while talking on

a computer and project the notes on the movie screen.

• Another useful technique is to print out the notes for the class using Word and hand them

out before the class to help students who are having learning difficulties, language

barriers or who are slow in note taking.

• A hyper-link to a web site right in the notes allows a Professor to divert off to an

information site on the Internet as part of the class instruction.

• Word basics that are helpful in note typing, letters, syllabus and curriculum materials.

• Use of Word Tables for definitions, words, menus, listings

• Graphics in Word, Inserting clipart and pictures.

• Word Art for headings and special effect such as the Marcella technique.

• Templates for Word

• Macros for Word.

• How to make a hyper-link in Word or e-mail link.

• When done with the document saveas a Web Site. This converts the Word document to

.html format so it can be uploaded to the Internet. If one page only the name of the

document must be renamed to index.html in order for the Internet browsers to be able to

read the .html document. An index file in a web site is the control and index to all other

pages or images in the web site.

XVIII- Powerpoint Beginner to Advanced

Jump Start Powerpoint

The Powerpoint Auto Wizard

Slide Sorter View

Change the background

Change the template

Edit the content

Add the whipped cream