Strategies for Online Teaching and Learning

Achieving success connecting academic and practicing clinicians through telemedicine

OBJECTIVE

Practicing clinicians, especially in rural areas, are often isolated from learning opportunities and interactions with subspecialty providers. Pediatric Physician Learning and Collaborative Education, an interactive, educational, telemedicine program, was developed to address this need. We evaluated the success of this program through surveys with practicing and academic physicians.

METHODS

Pediatric Physician Learning and Collaborative Education was assessed by using 2 evaluation forms collected from October 2007 to May 2008. One of the forms was completed by 197 attendees from the University of Arkansas for Medical Sciences and 172 attendees from remote sites. Another form was completed by 131 participants from Arkansas Children's Hospital, an academic, freestanding, children's hospital. Both evaluation forms asked participants to use a 5-point Likert scale to rank a number of criteria and included a section for participants to write comments and recommendations. Additional data were collected through an open-response e-mail survey of participants.

RESULTS

Ninety-five percent of the participants agreed that the presentations related to their professional needs, 98% agreed that the presentations increased their subject-matter knowledge, 81% evaluated the presentations as some of the best they had attended, and 93% agreed that the information would translate into professional practice, enhancing patient care. Health care personnel from the University of Arkansas for Medical Sciences evaluated the presentations significantly higher than did remote participants. Nursing staff members evaluated the presentations significantly higher than did medical staff members. Comments were generally positive and correlated with the Likert-scale data.

CONCLUSION

Participants reported being highly satisfied with Pediatric Physician Learning and Collaborative Education and considered it an effective way to address the continuing education needs of practitioners throughout Arkansas, especially in rural and underserved areas.

Videoconferencing surgical tutorials: bridging the gap

The expansion in medical student numbers has been associated with a move to increase the amount of time students spend in rural and remote locations. Providing an equivalent educational experience for students in surgical subspecialties in this setting is a logistical challenge. We sought to address this issue by providing synchronous tutorials in paediatric surgery using videoconferencing (VC) at two rural sites with the tutor located at a metropolitan paediatric clinical school. Between March 2005 and July 2006, 43 graduate students in the University of Sydney Medical Program were assigned to receive the paediatric component of the course at one of two sites within the School of Rural Health. During this 9-week rotation, students were involved in two or three surgical tutorials by videoconference. Students were then invited to complete a confidential, anonymous 20-point structured evaluation using a Likert scale. Valid responses were received from 40 students, a response rate of 93%. There were 21 females (52%), with 21 students based in Dubbo and 19 in Orange. Students agreed or strongly agreed that VC surgical tutorials were useful, the content well covered and student involvement encouraged (mean scores 4.7, 4.5 and 4.5; standard deviation 0.56, 0.72 and 0.72, respectively). Overall, the majority of students strongly agreed that participation in VC of surgical tutorials was valuable (mean 4.68, standard deviation 0.57). VC surgical tutorials were highly valued by graduate medical students as an educational method. Our data suggest that tutorials can be successfully provided at remote sites using VC.

Rotation as a course: lessons learned from developing a hybrid online/on-ground approach to general surgical resident education

PURPOSE

To improve the consistency and the quality of resident education on clinical rotations, 5 surgical rotations (thoracic, bariatrics, surgical oncology, pediatrics, and critical care) were restructured "as courses" with learning objectives, educational activities (online and on-ground), pretests, posttests, and oral examinations.

SETTING/PARTICIPANTS

University surgical training program in a large metropolitan area, which serves approximately 65 residents per year.

METHODS

The online course management system, WebCT/VISTA (Blackboard Inc., Washington, DC), was used to build 5 online course sites. To engage and garner support from faculty, several organizational change tactics and resources were employed, such as Grand Rounds presentations, a faculty retreat, consultation and support from professional staff, and the use of residents as reviewers and codevelopers. To support resident use of the online sites, a designated education coordinator provided individual and group orientation sessions and employed weekly tracking and reminder systems; completion of pretests and posttests was mandated.

RESULTS

Between 6 and 8 learning modules were created per rotation, with over 50 reading assignments (collectively) and 45 online presentations. Since July 2006, 53 residents have completed a total of 106 rotations on these services. Preliminary results from a longitudinal study suggest that the hybrid approach is well received and effective when fully executed, but that online course materials are used by residents only if they feel that the faculty members are truly engaged and actively promoting the site.

CONCLUSIONS

Changing the culture of learning on rotation to include learning objectives, assessment, and integrated online/on-ground activities takes significant leadership, resident input, professional staff support, faculty engagement, and time.

Distance Learning and Perioperative Nursing

Distance learning in nursing education is arriving with unprecedented speed, which has led to much uncertainty among educators. This article provides an overview of distance learning and its application to perioperative nursing. Lack of face-to-face interaction is of foremost concern in distance learning, and educators must develop new teaching strategies to address this problem. Models for assessing outcomes and effectiveness are important tools to use when implementing a distance learning program. Basic perioperative nursing concepts, skills, procedures, and recommended practices can be introduced effectively with online distance learning modalities and then reinforced through a clinical component.