School of Medicine Technology Enhanced Learning University of Leeds

Innovation in Placement AssessmentThe Leeds Experience

Gareth Frith

Technology Enhanced Learning Manager, School of Medicineg.s.frith@leeds.ac.ukDecember 2014

Innovation in mobile learning for Medical undergraduates

Leeds Institute of Medical EducationUniversity of Leeds

ALPS - CETL

A Centre of Excellence for Teaching and Learning

2005 to 2011 funded by HEFCE

5 Universities in West Yorkshire and 16 Healthcare professions

Skill and competencies for Healthcare in Practice

Mobile Devices for recording competencies

Our History with Mobile learning

www.alps-cetl.ac.uk

Undergraduate Medicine in Leeds - MBChBFive or six year course260 students per yearNew Curriculum launched in 2010 Students are learning in hospitals, clinics and the communityWork based practice crucial to successNew clinical placements:• Year 1 & 2 – Primary & Secondary Care• Year 3 – Elderly Medicine & Special Senses (2012)• Year 4 – Acute & Critical Care; Cancer & long term care• Year 5 – Assistantships and transitions to practice

Mobile Learning supports learning and assessment

Why Mobile MBChB?

Where are our students coming from (educationally, technologically, culturally)?

What might they look like (and be doing as doctors in 2015-2020?)

What are doctors using mobile for at present?

• Apps• iPads• Hard wired

Why Mobile Learning?

Helping Students become better doctors

Support of MBChB Students in practice

Near patient experience

Access to medical information

Assessments undertaken with practice professionals

Reflection, evidence and assessment outcomes recorded and sent to an e-portfolio

Mobile Learning DeliveryCurriculum review 2007-2010 provided golden opportunity

Key to success was that MBChB mobile activities were embedded

• Integrated across different strands of the programme

• Central platform• Replace rather than ‘bolt on’• Teaching, learning & assessment

Students at the heart of road testing and innovating

Mobile Learning Delivery

Provide access to published medical content from practice

Provide a number of assessments that can be completed as self assessment or with practice professional

Provide a method of recording assessment outcomes and publishing them through the e-portfolio for CPD and Lifelong Learning

Solution

Each Year 4 and Year 5 medical student is loaned an iPhone 5 which they can use as their device (260 each year)

Medical Content such as the Oxford Handbooks (standard Medical texts) and the BNF (prescribing manual).

Applications for assessment of students

O2 3G Network with unlimited broadband and voice and txt

Dr Companion

BNFOxford Handbook titlesDelivered by Medhand

Other apps

RRAPIDOSCE ToolkitInstant ECGMedscape

Medical Content

Apps for Assessment and Learning

Reflection Tools

Reflection and recording of evidence through progress file.

Publishing to e-portfolio (private and public)

either Assessment for Learning (formative) or Assessment for Progression (summative)

Delivered by MyKnowledgeMap

Feedback

Assessment Tools

Based on the ALPS assessment suite of inter-professional assessments

Others which prepare for postgraduate medicine such as:

miniCEX - mini Clinical examination

Work Place Based Assessment

10,655

Number of items of formative feedback recorded by students from clinical and healthcare professionals in academic year 2013 / 2014

10,655276 year 5 students completed 3514 MiniCEX assessments

269 Year 4 students completed 7141 Workplace Based Assessments

Assessment Tools

Learning Suite application (lecturers can build their own assessment questions)

The e-portfolio - The progress file

Space for reflection

Space for recording evidence

Space for publishing assessment outcomes

preparing for Life Long Learning

developing skills for CPD

key tool for Mobile learning

Mapping to Tomorrows Doctors

Some Outcomes

Students Views

GP Clinical TeacherMiniCEX

“I think we always did give feedback, but actually this just formalises it and makes you do it really, and makes the student really ask for specific feedback, so I think that’s really good, and it makes it timely because you are doing it you know at the end of, shortly after seeing the patient (GP clinical teacher)

F2 doctor - non Leeds Graduate“And I also think from a foundation point of view for the future portfolio, well the portfolio I do at the moment, the more exposure you get earlier on as a student, it makes it easier for you to understand what an e-portfolio is, and makes your own portfolio better. Because when I started my foundation year we hadn’t done any electronic evidence, it was quite an adjustment to make.” (F2 Doctor – non-Leeds graduate)

E-Portfolio

“And I also think from a foundation point of view for the future portfolio, well the portfolio I do at the moment, the more exposure you get earlier on as a student, it makes it easier for you to understand what an e-portfolio is, and makes your own portfolio better.  Because when I started my foundation year we hadn’t done any electronic evidence, it was quite an adjustment to make.” (F2 Doctor – non-Leeds graduate)

F2 Doctor - Graduated 2011“And I also think from a foundation point of view for the future portfolio, well the portfolio I do at the moment, the more exposure you get earlier on as a student, it makes it easier for you to understand what an e-portfolio is, and makes your own portfolio better. Because when I started my foundation year we hadn’t done any electronic evidence, it was quite an adjustment to make.” (F2 Doctor – non-Leeds graduate)

Mobile Learning

“It’s definitely changed the way that I use my mobile now and use technology now to learn, to have like ongoing learning whilst working, and I think sort of that the resources are endless which is what I quite like, and there are still things that are out there which I know would help me in my career that I haven’t found yet or downloaded yet, so it’s quite good to know that I have this sort of endless resource out there to use.”

What did the students think?On Dr Companion:

It’s like learning to drive, you wonder how you coped before you could drive. I mean I’ve been onto placement and I remember specifically a day when I forgot my phone, and I felt like I was without an arm, not because I couldn’t text but because I didn’t have my Dr Companion app or something that I could just pick up. You forget how reliant actually you do become on them.

Year 5 student

ROTATION 1 ROTATION 2

Total number and average No. of WBA completed per student on mobile devices within rotation 2012 / 2013

The average number of WBAs recorded in the progress file between rotation datesColours show student cohort (i.e. Group A – E)

1 2 3 4 5

N Av N Av N Av N Av N Av

ACC 286 5.4 284 5.3 282 5.4 288 5.3 264 4.8

CCC 297 5.5 295 5.7 286 5.3 257 4.7 287 5.3

GOSH 224 4.1 288 5.4 290 5.4 294 5.7 296 5.5

Paeds 327 6.1 293 5.4 285 5.3 279 5.2 303 5.6

Psych 281 5.2 293 5.4 254 4.7 291 5.4 279 5.2

Success - Programme View

Programme

• Enhancing our assessment for learning + profiling• Encouraging open book / ‘look up, practice and record’• Which clinical staff are assessing – and what is feedback

like?

Students & Unexpected developments

• Value of near patient encounters and feedback/supervision• Breaking down barriers with others• Remote usage - revision and preparation

Success - Clinical viewEnhancing clinical practice learning (cf. postgrad)

• More engaged students • ‘Upping the stakes’ of a clinical encounter• Value of seeing positive feedback loops

Opportunistic

• Students increasing self select – ‘Can I do’• Better use of everyday material

Resources

• We use them as much as the students!

Clinical Skills ebook

Mobile Learninganytime, anywhere, anyplace

Questions?