MOOCs in Health Professions
Education:
Hype or Hope?
Catherine R Lucey MD
Professor of Medicine
Vice Dean for Education
UCSF School of Medicine
Medbiquitous
5/19/14
1
Conclusions
In all change initiatives (including MOOCS), Hype is a
necessary precursor to Hope: it creates interest and
momentum that sustains innovation.
In all disruptive innovations, disagreement and
disillusionment is necessary to drive iteration and the
identification of the best strategy.
Enlightenment comes from experimentation in the midst of
disillusionment and leads to the Plateau of Productivity
Health professions educators are in the perfect position to
serve as change leaders for the adoption of technology
enhanced learning.
2
Learning is a social endeavor
Teachers
Engage Inform Challenge Coach Motivate Inspire
Learners
Engage Inquire Inform Challenge Share
3
Inspire
3
Faculty have always embraced new
technologies to help
4
4
And students have always been one step ahead in
their adoption of tools
5
5
The Spectrum of On Line Content Delivery
High
Tec
h
Khan
Academy
MOOCS
Minerva
University based
distance learning
Low
Tec
h
Asynchronous
Semi-synchronous
Synchronous
6
MOOCS: A High Quality Disruption
• Recruited Elite Institutions
• Platform allowed for up to
100,000 users
• Semisynchronous
• Course constructed of short
videos with quizzes
• Scale allows Crowd Sourced
TA role
• Computer or Peer Reviewed
Assignments
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The Push Back
8
Questions We at UCSF Asked
1. Feasibility: Can computer assisted instruction teach
Clinical Problem Solving?
2. Interest: Who would want to learn about a topic that
would not lead to credit towards a degree?
9
9
Module 1: How experts understand diseases and how to
read like an expert to form disease based illness scripts.
Module 2: How experts analyze their patient' problems:
processing and the patient illness script.
Module 3: Using disease and patient illness scripts to
prioritize differential diagnostic possibilities into tiers of
probability
Module 4: Understanding how diagnostic tests can be
appropriately used to improve diagnostic accuracy.
Module 5: Diagnostic Mistakes: how they happen, how you
can avoid them and how to find them once they occur.
Module 6: How our clinical problem solving strategies can be
used to write good test questions, perform well on tests, and
teach others to do well too.
10
Adapted Blended Learning Principles to
Facilitate Design of the Course
Establish a Teaching Relationship
purpose driven reason for the course
eye contact with the viewer
encouragement
Design with Explicit Cognitive Strategies
skills, not content alone
short videos, immediate quizzes with answers
cliff hangers to keep people coming back
prioritize graphics over text
begin and end the week with summaries
Support the development of Learning Communities
short answer homework with peer review
chat rooms and office hours
11
Garrison, D. R., & Vaughan, N. (2008) Blended Learning in Higher Education:
Framework, Principles, and Guidelines. San Francisco: Jossey-Bass
29000
Dabblers
4000
Experimenters
1500
Completers
12
40%
30%
20%
10%
0%
Current Education
Would you
recommend?
Yes
No
✔
✔
✔
✔
13
13
Student and Resident Testimonials
“..this course taught me more about
how to study than the three years
I’ve been spending in medical
school.”
“…It has shaped the way I study and I
can’t wait to bring many of the lessons
forward with me to clerkship next year.”
“I took your course and thought it was
fantastic. I was inspired to give my R3 talk
on the subject…”
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Faculty and Practitioner Testimonials
“…was a transformative learning experience.
As an educator in a clinical skills course, I
thought this would be excellent for our
students. Is there a way to make it available?”
“I am working as a physician in Poland. The
course changed my way of thinking in all
day clinical practice. I am convinced patients
and students will profit tremendously.”
“ I am a pulmonologist/internist working in the
UK. The feedback I have been getting is as I
expected—”it has completely changed the
way I look at clinical problems.”
15
15
Five challenges
that Computer
Assisted
Instruction
can
help us meet
16
16
1. Create flexible educational paths
Students can use web based instructional tools to
take a different approach to their learning.
17
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2. Facilitate authentic workplace learning experiences
• Students can be freed up to
engage in workplace learning
experiences at different sites or
during prime class time.
• Face to face activities can occur
via computer or at the workplace.
18
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3. Enable inter-professional and international education
• Mitigates the academic
schedule problem
• Study groups can
expand to include
– Employed professionals
– Professionals from different
institutions or countries
19
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4. Rapidly disseminate new advances to broad
audiences
• Emerging topics taught to this generation of students can
be disseminated to current generation of practicing
professionals, thus shortening the time from discovery to
implementation in practice.
• Relationships with our graduates: Learners for Life
20
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5. Demonstrate the quality & impact of
excellent teachers beyond their institution.
• Promotion/Tenure requires dissemination, peer
review and national/international impact.
• Educators whose work requires them to be at
their home institution may be challenged to meet
this requirement.
• Disseminating actual teaching may allow for
broad based peer review
• Peer review of actual teaching will be enhanced
and the field will continue to improve.
21
21
Five Challenges that
Computer Assisted
Instruction Alone
Won’t Help Us Meet**
**AT THIS TIME
22
22
1. Truly Individualized Learning
• Flexible learning paths
are not individualized
paths.
• True individualization
requires faculty and
learner interaction
23
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2. Foster Innovation and Inquiry
Inquiry requires give and take exchange between
learners and mentors.
24
24
3. Facilitate Professional Identity Formation
• Professional identity formation requires personal
interactions between role models and learners, in
authentic practice environments, with critical reflection.
25
25
4. Decrease educational expense
• Excellent computer assisted
instruction is expensive.
• Faculty time
• Instructional design time
• Production infrastructure
• Teaching Assistant support
• Possible economies of scale???
26
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5. Increase Efficiency of Learning
• Time on task remains critical to success.
• Failure to incorporate time for CAI in blended learning
environments is a common error.
• Student motivation is also critical
27
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Health Professions Educators as the
Explorers of the Slope of Enlightenment
Strong Incentives
Expert Learners
Faculty Resiliency
Culture of continuous
improvement and
change
28
It is 2030.
What will the plateau of productivity look like?
29
“Online education is not
an enemy of residential education
but an inspiring and liberating ally.”
Susan Hockfield, PhD President, MIT
30
Conclusions
In all change initiatives (including MOOCS), Hype is a
necessary precursor to Hope: it creates interest and
momentum that sustains innovation.
In all disruptive innovations, disagreement and
disillusionment is necessary to drive iteration and the
identification of the best strategy.
Enlightenment comes from experimentation in the midst of
disillusionment and leads to the Plateau of Productivity
Health professions educators are in the perfect position to
serve as change leaders for the adoption of technology
enhanced learning.
31