The

1
The Future of Didactics
Kathryn Andolsek MD, MPH Duke University
Hospital Graduate Medical Education
2
Imagine the best didactic experience you ever
had?
3
Goal

• Anticipate expectations for didactics
• Develop creative, feasible, cost- effective
  options

4
Didactics

• Definition
• Impact on Learning
• What ACGME really
  requires
• Possible options
• New content
• Competency

5
Didactics Defined
(ACGME 9/29/2010 glossary)

• Didactic A kind of systematic instruction by
  means of planned learning experiences such as
  conferences or grand rounds
• GME period of didactic and clinical education in
  a specialty.

6
Evidence Based
Educational approach

• Limited evidence of impact of Traditional
  lectures
• On- line learning as good
• Refocus from strategy to outcome

7
Adult Learning Theory(with thanks to Malcolm
Knowles)

• Active Learning
• Problem/case based
• ? interaction associated better achievement
  retention of information
• Best ways of learning
• Doing
• Teaching others
• Just in time learning
• Virtual and or simulation environments
• Capacity of learner to access and integrate
  multiple sources of information (this generation
  may be the best at multi-tasking)

8
Bligh, 2000
9
Institutional Requirements
10
CPR (new)

• PD mustoversee and ensure the quality of
  didactic clinical education in all sites
  II.A.4.a (IM)
• curriculum must contain the following
  educational components regularly scheduled
  didactic sessions IV.A.3..
• learning objectives must be accomplished
  through appropriate blend of supervised patient
  care responsibilities, clinical teaching and
  didactic educational events VI.A.4.a)

11
IM- Didactics

• Regularly Scheduled Didactic sessions IV.A.3
• Must include a didactic program. based upon core
  knowledge content IV.A.3.a.
• May include lectures, web-based content, pod
  casts IV.A.3.a.1
• Program must afford each resident an opportunity
  to review all of the core curriculum topics
  IV.A.3.a.1
• Residents must have opportunity to participate in
• morning report,
• grand rounds,
• journal club, and
• M and M (or quality improvement)
• all of which must involve faculty
  IV.A.3.a.2
• Program must provide opportunities for residents
  to interact with other residents and faculty in
  educational session at a frequency sufficient for
  peer-peer and peer-faculty interaction
  VI.A.3.a.3
• Didactic and clinical education must have
  priority in the allotment of residents time and
  energy VI.A.3

12
Surgery - didactic sessions

• The education of surgeons. encompasses both
  didactic instruction in the basic and clinical
  sciences procedural skills and operative
  techniques Int.A.
• Regularly Scheduled Didactic sessions IV.A.3
• Increases in resident complement documentation
  of adequate clinical material and complex
  operative cases and quality didactic education
  III.B.2.b)
• Regularly scheduled didactic sessions IV.A.3
• Didactic and clinical education must have
  priority in the allotment of residents time and
  energy VI.A.3

13
Didactics

• opportunity to review
• opportunity to participate in
• morning report,
• grand rounds,
• journal club, and
• M and M (or quality improvement)
• all of which must involve faculty
• opportunities for residents to interact with
  other residents and faculty
• Core content of anything specified by RRC

14
Generation Y (1982-1998)
15
Capturing Lectures

• Audacity
• Camtasia
• Lectopia
• Panopta
• And more.

16
(No Transcript)
17
Duke iTunesUwww.itunes.duke.edu
18
Duke itunesU

• Login for Classes
• Net ID protected
• Invitation only

• Public Material

19
GME iTunesU
20
(No Transcript)
21
(No Transcript)
22
Wiki

• Website allowing numerous people access for edits
• Restriction options for viewing, editing, etc.
• Examples
• Meeting agenda and minutes
• Program Information managed by residents (ex.
  Pathology)
• Project Committee Organization
• Group work
• Lecture series (ex. Health Policy)

23
Health Policy Lecture Series Example

• Links from Wiki
• Roster
• Lecture Schedule
• Presenter Bio
• Presenter Photo
• Readings
• iTunesU
• Evaluation
• Post-test

24
(No Transcript)
25
New Content

• Professionalism
• Personal Responsibility
• Patient Safety
• Transitions of Care
• Alertness Management/Fatigue Mitigation
• Supervision
• Teamwork

26
Other On-line Resources

• LIFE Curriculum
• www.LIFEcurriculum.com
• Trigger Scenarios
• MedEdPortal
• www.aamc.org/mededportal
• AMA Electronic Ethics Journal
  (virtual mentor)
• http//virtualmentor.ama-assn.org/

27
Didactics

• Definition
• Impact on Learning
• What ACGME really
  requires
• Possible options
• New content
• Competency

28
FAQs, Possible pertinence to Didactics

• Duty hours are defined as all clinical and
  academic activities related to the program i.e.,
  patient care (both inpatient and outpatient),
  administrative duties relative to patient care,
  the provision for transfer of patient care, time
  spent in-house during call activities, and
  scheduled activities, such as conferences. Duty
  hours do not include reading and preparation time
  spent away from the duty site. VI.G.1. Max Hours
  work per week
• Duty hours do not include reading, studying, and
  academic preparation time, such as time spent
  away from the patient care unit preparing for
  presentations or journal club .
• Any tasks related to performance of duties, even
  if performed at home, count toward the 80 hours.
• Residents who have satisfactorily completed the
  transition of care may, at their discretion,
  attend an educational conference that occurs
  during the four hours VI.G.4.b) Max Duty Period
  Length
• The goal of the added hours at the end of the
  on-call period is to promote didactic learning
  and continuity of care
• If attendance (at a conference) is strongly
  encouraged, the hours should be included because
  duty hours apply to all required hours in the
  program, and it is difficult to distinguish
  between strongly encouraged and required.
  Another way to look at it is that such a journal
  club, if held weekly, would add two hours to the
  residents weekly time. A program in which two
  added hours result in a problem with compliance
  with the duty hour standards likely has a duty
  hour problem Duty Hours limits and Research and
  Other Non-Patient Care Activities

29
References

• Andolsek KM, Murphy G, Pinheiro S, Petrusa E,
  Tuck T, Weinerth J. Efficacy and Efficiency of
  Webcast Orientations Versus Live Resident
  Orientations Results of a 2-Year Survey. Journal
  of Graduate Medical Education March 2010 2(1)
  136-140.
• Casebeer L Andolsek K Abdolrasulnia M Green J
  Weissman N Pryor E Zheng S Terndrup T Evaluation
  of an online bioterroism continuing medical
  education course. J Contin Ed Health Profes
  200626(2)137-44
• Cook DA Garside S Levinson AJ Dupras DM Montori
  VM What do we mean by web-based learning? A
  systematic review of the variability of
  interventions. Med Educ 2010 Aug,44(8)765-75
• Cook DA Levinson AJ Garside S Dupras DM Erwin PJ
  Montori VM Instructional design variations in
  internet-based learning for health professions
  education a systematic review and meta-analysis
  Acad Med 2010 May,85(5)909-22
• Cook DA Levinson AJ Garside S Time and learning
  efficiency in Internet-based learning a
  systematic review and meta-analysis Adv Health
  Sci Educ Theor Pract 2010 Dec, 15(5)755-70 Epub
  2010 May 13
• Cook DA Levinson AJ Garside S Dupras DM Erwin PJ
  Montori VM Internet-based learning in the health
  professions a meta-analysis JAMA 2008 Sept 10,
  200(101181-96
• Cook DA Gelula MH Dupras DM Schwartz A
  Instructional methods and cognitive and learning
  styles in web based learning repot of two
  randomized trials Med Educ 2007 Sep
  4(9)897-905

30
References

• Cook DA Web-based learning pros, cons and
  controversies. Clin Med 2007 Jan-Feb, 7(1)37-42
• Cook DA Where are we with Web-based learning in
  Medical education? Med Teach 2006 Nov,
  28(7)594-8
• Cook DA Learning and Cognitive styles in web
  based learning theory, evidence and application.
  Acad Med 2005 Mar 80(3)286-78
• Darling-Hammond L, Youngs P. Defining highly
  qualified teachers What does scientifically-based
  research actually tell us? Educ Res
  20023113-25.
• David TH Wagner GS Gleim G Andolsek KM Arheden H
  Austin R Courtney-Eighmy Gradison M Leist JC
  Maynard C Noga EM Ostbye T Eisenstein EL Probloem
  based learning of research Skills J
  Electrocardiol 2006Jan 39(1)120-8
• Griner PF, Danoff D. Sustaining change in medical
  education. JAMA, 2000283(18)2429-2431
• Hatem CJ, Lown BA, Newman LR. The academic health
  center coming of age Helping faculty become
  better teachers and agents of educational change.
  Acad Med. 200681941-944.

31
References

• Nagler A Andolsek K Dossary K Schlueter J
  Schulman K Med Teach 201032(12)e559-65
• McLean M. Rewarding teching excellence. Can we
  measure teaching excellence? Who should be the
  judge? Med Teac 2001236-11.
• McKimm J Jollie C Cantillon P ABC of learning and
  teaching. web based learning. BMJ
  2003326(7394)870-873
• Morzinski JA, Fisher JC. A nationwide study of
  the influence of faculty development programme in
  teaching skills. Med Educ. 200741592-600.
• Ruiz JG Mintzer MJ Leipzig RM The impact of
  e-learning in medical education. Acad Med 2006
  81(3)207-212
• Sandars J Morison C What is the Net Generation?
  The challenge for future medical Education. Med
  Teach 200729(2)85-88
• Steinert Y, Mann K, Centeno a, et al. A
  systematic review of faculty development
  initiatives designed to improve teaching
  effectiveness in medical education. Med Teach
  200628497-526.
• Swanwick T. See one, do one, then what? Faculty
  development in postgraduate medical education.
  Postgrad Med J 200884339-343.
• Young L, Orlandi A, Galichet B, Heussler H.
  Effective teaching and learning on the wards
  easier said than done? Med Educ
  200943(8)808-816.