The Learning and Assessment Center : An Initiative from the Health Professions Colleges

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The Learning and Assessment Center An
Initiative from the Health Professions Colleges

• College of Human Medicine
• College of Nursing
• College of Osteopathic Medicine
• College of Veterinary
• Ruth B. Hoppe, MD, FACP, Director

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Purpose

• To develop a unique and state-of-the-art Center
  to assist health professionals associated with
  MSU in developing and demonstrating ABILITY to
  achieve effective, safe and satisfying care to
  patients and clients

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LAC Steering Committee

• CHM Rappley, Henry, Wagner
• COM Riegle, Scott, Kilbourn
• CON Vinson, Wehrwein
• CVM Krehbiel, Pazak, Bernardo
• CNS Doig

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Our Vision

• Support for competency-oriented modes of
  assessment and learning especially those
  involving
• Simulation Technologies
• Standardized Patients
• Computers

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From Focus on Knowledge to

• Focus on Performance

• KNOWS
• KNOWS HOW
• SHOWS HOW
• DOES Competently
• DOES Proficiently

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Why the LAC?

• Era of accountability
• Advent of competency-based curricula
• Concerns about medical error and patient safety
  shifting attention to performance and to systems
• Clinical environments degrading as educational
  sites too hit or miss
• Patients less willing/available
• Experimental animals less available
• Expectations of accrediting bodies
• Licensure examinations influencing curricula

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Era of Accountability

• The competency standards movement in Britain,
  Australia, New Zealand, and the United States is
  closely tied to political initiatives for global
  competitiveness and accountability (Chappell
  1996 Jackson 1994). The fundamental issue is
  whether and to what extent vocationalism should
  drive education.
• S. Kerka, 1998, Competency Based Education and
  Training Myths and Realities, Clearinghouse on Ad
  ult, Career,and Vocational Education  (ACVE)
  www.cete.org/acve/docgen.asp?tblmrID65

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WHY CBE?

• Society has the right to know that physicians
  who
• graduate from medical school and subsequent
• residency training programs are competent and can
• practice their profession in a compassionate and
• skillful manner. It is the responsibility of the
  medical
• school to demonstrate that such competence has
• been achieved and the responsibility of the
• accreditation agencies to certify that the
  educational
• programs in medical schools can do what they
• promise.
• Assessment is of fundamental importance because
  it is central to public accountability.
• Shumway,J.M, Harden, R.M. AMEE Guide No. 25
  The
• assessment of learning outcomes for the competent
  and reflective
• physician. Medical Teacher, 2003, 25, 569-584).

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WHY the LAC? cont

• Soon to be a mandate for health professions
  schools
• Opportunity beyond student programs for those who
  do it well and early continuous professional
  development and assessment
• MSU is certainly not alone, but could be unique
  multidisciplinary, outreach oriented

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Our educational focus has been

• KNOWS
• KNOWS HOW

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Traditional Educational Approaches

• Lecturing/
• Demonstrating
• Testing Command of
• Knowledge
• Experiencing Clinical Apprenticeships

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Clinical environments degrading as educational
sites

• Low rates of hospitalization for many problems
• High intensity of illness make patients less
  available
• Short stays make patients less available
• Ambulatory settings have become high volume due
  to reimbursement problems
• Patients less willing to participate as
  educational subjects
• Bottom Line too hit and miss

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Competency-Based Instruction

• Ability to assess competency at the end of stages
  of the program to allow promotion, graduation
• Ability to assess competency development as
  students learn

Learning
Assessment
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Criticisms of Competency Based Education

• Too reductionistic with behaviors measured
  yes/no with a checklist (monkey-like)
• Doesnt take into context into account
• More holistic views see competence not as
• trained behavior but thoughtful capabilities
  and a developmental process
• See Kerka

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Commitment to competency-based education ushers
in the need

• To articulate clearly the things needing to be
  assessed not easy!
• For help with assessment new tools
• The ability to simulate technology to the rescue

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Simulation Tools

• Synthetic models and mannequins
• Animal models
• Standardized patients
• Computer simulations
• Virtual reality
• Computer-driven synthetic models and mannequins

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MSUs Learning and Assessment Center

• www.lac.msu.edu

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MSUs Learning and Assessment Center
Opens Winter 2006 6th Floor Fee Hall
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Simulation Tools
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SimBaby by Laerdal
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Standardized Patients

• For teaching, practicing and assessing
• Communication skills
• Data gathering skills
• Problem solving and diagnostic assessment
• Patient management skills

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Computer Based Assessment

• Computer support of other assessment tools

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Virtual Reality
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Endoscopy Training
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Computer-Based Assessment cont.

• Computer support of assessment tools
• Reach distant learners
• Deliver assessment data to remote faculty
• Virtual Patients
• Link with other assessment centers

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Virtual Patients
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Developing the New Facility

• Vision and Business Plan - completed
• Preliminary Design and Estimate completed
• Design Phase completed April 05
• Final BOT Approval May 6, 2005
• Construction Phase May 05 Dec 05
• Begin operation January 2006

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Personnel

• Core personnel who vigorously serve each
  colleges faculty and curriculum
• 4-6 professionals
• Support staff
• Strong technology support unit
• Connection to other college/university units
• Collaboration within region

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Personnel

• Director R. Hoppe, MD 0.5
• Admin Ass B. Lee
  .75
• Sim Coordinator RN or PA TBD
• SP Coordinator TBN , R.N. 1.0
• Psychometrics D. Solomon, PhD .10
• Web SP Matt Koss
  .50
• GME MD D. Wagner MD .20
• GME DO TBN
  .20
• Computer Support Bernardo et al .65

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Challenges of CBE

• Requires College investment workshops,
  simulation tools, electronic portfolios
• Time challenge requires faculty to spend time to
  alter old products and methods
• Requires faculty to learn new concepts
  (assessment methods) and new skills (feedback)
  may threaten experts
• Is very hands on which challenges larger
  programs

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The Challenge of Forging College Links

• What goes in LAC and what stays/goes in colleges?
  Equipment, space, personnel, events,etc
• How motivate/engage faculty for needed case and
  simulation development work?
• How to forge links with other MSU resources
  computer-based learning and assessment, OMERAD,
  engineering interests, other?

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Other Challenges

• If you have a hammer, only nails will get
  assessed
• Efficient tests may drive out less efficient
  tests
• Other important abilities may not get assessed
  (or even taught)
• Fredrickson, N. The Real Test Bias, American
  Psychologist, 1984

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Research Needs

• Evaluation of existing tools
• New simulation tools
• Educational research scoring, security,
  receptiveness of users, skill transfer, cost
• Clinical research impact on specific clinical
  outcomes, safety records, impact on maintenance
  of competency

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Can the LAC Enhance Faculty Development? OSTEs?

• The appeal of direct, real-time observations
• The need for good observation
• The need for good feedback

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