Lifelong Learning and Information Technology

Class 1 1

Lifelong Learning and Lifelong Learning and Information Technology Information Technology Lifelong Learning and Lifelong Learning and

Information Technology Information Technology

Nancy Clark, M.Ed.Nancy Clark, M.Ed.Dir. Medical Informatics Ed.Dir. Medical Informatics Ed.

FSU College of MedicineFSU College of Medicine

Nancy Clark, M.Ed.Nancy Clark, M.Ed.Dir. Medical Informatics Ed.Dir. Medical Informatics Ed.

FSU College of MedicineFSU College of Medicine

All resources from today’s workshop can be found at:www.med.fsu.edu/informatics/LLL.asp

FSU CFSU COLLEGE OF OLLEGE OF MMEDICINEEDICINEFSU CFSU COLLEGE OF OLLEGE OF MMEDICINEEDICINEClass 1Class 1 22

Objectives

Students will Establish a method of ongoing self-

assessment of learning needs which includes constantly and accurately assessing the state of his or her knowledge and experience base

Identify and utilize his or her best learning style

Developing a written plan for addressing learning needs that is realistic

Recognize types of references and sources of information for lifelong learning

Identify good information habits to remain current


Office of Medical Education



COM Objectives

Seehttp://www.med.fsu.edu/education/COMcompetency.asp

Under Life Long Learning

Class 1 6

What is Medical Informatics?What is Medical Informatics?What is Medical Informatics?What is Medical Informatics?

What does it have to do with What does it have to do with Lifelong Learning?Lifelong Learning?

What does it have to do with What does it have to do with Lifelong Learning?Lifelong Learning?


Health (Medical) Informatics

Medical Informatics is the branch of science concerned with the use of computers and communication technology to acquire, store, analyze, communicate, and display medical information and knowledge to facilitate understanding and improve the accuracy, timeliness, and reliability of decision-making. Warner, Sorenson and Bouhaddou, Knowledge Engineering in Health Informatics, 1997


Knowledge

Quote over the entrance to Quote over the entrance to Dodd Hall, FSUDodd Hall, FSU


Textbooks don’t smell as their contents rot, Textbooks don’t smell as their contents rot, so readers will need to develop alternative so readers will need to develop alternative crap detectors to avoid poisoning their crap detectors to avoid poisoning their minds and robbing their patients of current minds and robbing their patients of current best care.best care.

David SackettDavid Sackett


Goals of Informatics Curriculum

Create independent, lifelong learnersWho keep up to dateExcellent problem solversWho integrate evidence into clinical

decision makingWho practice information masteryValue instant access to latest informationWho are comfortable with new technology


Longitudinal Theme of Integrated Informatics Curriculum

Information management and computer skills to support– Lifelong Learning– Education– Research – Communications– Patient Care


Year 1 Curriculum

Computer basic skills Presentation SkillsEffective use of Information

Resources for – Education (small group)– Lifelong learning– Patient care

Using a PDA


Year 2 Curriculum

Evidence Based Medicine Information Resources for Decision

Support, Patient EducationResearch

– Statistical/epidemiological concepts– Writing a research paper– Using Medline and other databases


Year 3

Information Management in patient care– Documentation of clinical encounters

(Electronic medical/health records)– Accessing patient information– Other practice data management issues

Evidence Based Medicine


Computer Skills

Survey ResultMavis Bacon Typing Tutor is

available

Class 1 16

Learning Styles and ApproachesLearning Styles and ApproachesLearning Styles and ApproachesLearning Styles and Approaches

How are these a predictor of your How are these a predictor of your success in medical school and success in medical school and

long term as a physician?long term as a physician?

How are these a predictor of your How are these a predictor of your success in medical school and success in medical school and

long term as a physician?long term as a physician?


Learning Styles and Approaches

Learning Styles Inventories– http://www.med.fsu.edu/informatics/ – Lifelong Learning– Additional files on intranet:

What are some learner characteristics?

What are your characteristics?


Physicians Reactions to LS

Think non-judgmentallyAppreciate differencesPatient Care and educationPractice management &

administrationMedical Education

Thompson, H. & Bing-you, R. (1998) Physicians’ reactions to learning style and personality type inventories. Medical Teacher


Goals of Understanding LS

Short Term– Self aware– Succeed in med

school– Form cohesive,

productive study groups

– Adapt to new learning situations

– Maintain Sanity

Long Term– Life long learning– Select right

specialty – Work well with

healthcare team– Teach students– Educate patients– Clinical

competence


Development -- Piaget

ToddlerToddler AdultAdult


Adult Learning Theory

Learning Theory– http://

tip.psychology.org/index.html

Learning takes place – in context of patient care– when questions are answered– the issues are applicable to work– when it doesn’t take too much

time


Inventory of Learning Styles

VisualVisual VerbalVerbal

SensingSensing IntuitiveIntuitive

ActiveActive ReflectiveReflective

SequentialSequential GlobalGlobal

Felder-Silverman Model

DecisionDecision

PerceptionPerception

Sensory Sensory ReceptionReception

OrganizationOrganization

Strong Moderate Weak


Decision Models-- Kolb

ImpulsiveImpulsive ReflectiveReflective

Active Active ParticipantParticipant

Reflective Reflective ObserverObserver

DecisionDecision


Active vs Reflective

Tend to retain and understand information best by doing something with it—discussing, applying or explaining it to others.

"Let's try it out and see how it works"

Like to work in group Sitting through lectures

hard Usually Extroverts

Prefer to think about it quietly first

"Let's think it through first" is reflective learner's response.

Reflective learners prefer studying alone

Are quiet in group learning situations

Usually Introverts


The majority of undergraduate students are Active

83% of college student leaders were active

65% of Phi Beta Kappas were reflective Around 62% med students are ActiveMajority of university professors are

Reflective

Active vs Reflective


Personality Types -- Jung Meyers-Briggs

TThinkinghinking FFeelingeelingJudgmentJudgment

SSensingensing IINNtuitivetuitivePerceptionPerception

EExtrovertxtrovert IIntrovertntrovertOrientationOrientation

JJudgingudging PPerceivingerceiving

Do: What is your Myers Briggs Type?



Sensing vs Intuitive

like learning facts like solving problems by well-established

methods (logical)dislike complications and surprises want step-by-step instructions (linear)patient with details (detailed) Like memorizing facts and doing hands-

on (procedures) workmore practical and careful than intuitorsdon't like courses with no apparent

connection to real world (concrete)



prefer discovering possibilities and relationships like innovation and dislike repetition may be better at grasping new concepts often more comfortable than sensors with

abstractions (abstract) tend to work faster and to be more innovative

than sensors don't like "plug-and-chug" courses that involve

memorization and routine calculations



The majority of undergraduates are Sensing

56% -72% college freshmen Sensing 83% of national merit scholarship finalists

were Intuitive92% of Rhodes Scholars were Intuitive 75% of first year medical students are

Sensing*


Organization-- Wertheimer Gestalt Theory

GlobalGlobalSequentialSequentialOrganizationOrganization

Step 1Step 2Step 3Step 4…


Sequential vs Global

gain understanding in linear steps, with each step following logically from the previous one

follow logical stepwise paths in finding solutions

Majority of M1s are sequential

Detailed

learn in large jumps, absorbing material almost randomly without seeing connections, and then suddenly "getting it."

to solve complex problems quickly or in novel ways, but have difficulty explaining how they did it.

Want to see Big picture first. Do not like details.


Sensory Reception Preferences

AuditoryAuditory VisualVisual

KinestheticKinesthetic

Do: Visual, Auditory, Kinesthetic Styles Inventory


Visual vs Verbal

Visual learners remember best what they see--pictures, diagrams, flow charts, time lines, films, and demonstrations

70%+ students are visual

Verbal learners get more out of words--written and spoken explanations

30%- are verbal



Tablet PC as Visual Learning Aide

Case Solver for Windows Journal

On Informatics Intranet site under Teaching Files > TabletPC


Left BrainLeft Brain Right BrainRight Brain

Hemispheric DominanceHerrmann

Do: Hemispheric Dominance Test (Left brain/right brain)


Intelligences -- Gardner

VerbalLogical MathematicalBodily/KinestheticVisual/SpacialMusicalInterpersonalIntrapersonalNaturalist LOWLOW

HIGHHIGH


Special Needs

PhysicalMentalEmotionalSocio/economicLogisticalGenderEthnic/Cultural


Approach to Learning

More predictive of success in medical school than learning styles

Three approaches to learning– Surface– Deep– Strategic

Newble, DI & Entwistle, NJ. (1986) Learning styles and approaches: implications for medical education. Medical Education. (20);162-171.


Surface Approach

Predominate Motivation– Passing the course– Fear of failure

Intention– Fulfill course

requirements by reproduction

– Gorge and regurgitate

Learning Process– Rote Learning: focus on

tasks and pieces of information in isolation

– Uses routine procedures and repetition to memorize facts and ideas

Outcome– Superficial level of

understanding– Substantial knowledge

of factual information


Deep Approach

Outcomes– Deep level of

understanding– Integrated principles

with facts– Uses evidence to

develop arguments– Excellent problem

solving skills – Success in medical

school– Excellent physician

with honed lifelong learning skills

Predominate Motivation– Interest in subject

matter– Career relevance

Intention– Reach personal

understanding Learning Process

– Relates evidence to ideas; details to big picture

– Building frameworks to add new information


Strategic Approach

Outcome– Variable level of

understanding– Shallow, course specific

knowledge– Depth of learning

dependent on assessment strategies of courses and course requirements

Predominate Motivation– Making high grades– Competing with others

Intention– To be successful by

any means

Learning Process– Whatever it takes to

make good grades


Transfer of Learner Control

Time

High

Low Co

ntr

ol

of

Lea

rnin

g

Faculty

Student

Class 1 45

Lifelong Learning and Lifelong Learning and Addressing Learning NeedsAddressing Learning NeedsLifelong Learning and Lifelong Learning and Addressing Learning NeedsAddressing Learning Needs


Life Long Learning

Half-life medical information = 5 years– Volume doubles

Average physician practices 30 years> 25,000 clinical trial articles published in

2005 (663,524 total new medical journal articles [MEDLINE citations] in 2005)

200 new prescription drugs per yearMedical errors increasing


Lifelong Learning

Old method: read a few journal articles per week

Reality: Primary care docs would need over 17 hrs/day just to review reasonable pertinent material

Even in one narrow specialty would need 6+ hrs/wk

Practicing docs (all specialties) average 1-1.5 hrs/wk


Learning Needs

How do we recognize a learning need?

What steps do you take to fill the gap?

What resources do you use to gain knowledge?


Adult Learning Theory

Learning takes place – in context of patient care– when questions are answered– the issues are applicable to practice– when it doesn’t take too much time

Apply this to medical practice…


Addressing Needs

Passively (ineffective or biased)– Go to conference– Read this weeks journal– What the drug rep wants to tell you…

Actively (very effective)– Look it up when question occurs

Use reliable, current resourcesApply what you learn immediately


Information at the Point of Care

A physician seeing patients in an office setting will generate 15 questions per day– 33% related to treatment– 25% to diagnosis– 15% to pharmacotherapeutics

70% unansweredBarrie AR, Ward AM. Questioning behaviour in general practice: a pragmatic study. BMJ. 1997 Dec 6;315(7121):1512-5.


Sources of Information

Traditional– Colleagues – Textbooks– PDR– Journals– CME– Pharmaceutical

Reps

Web BasedComputer BasedPDA Based


Good Information Habits

Using multiple information sources for problem solving

Know where to go to get question answered

Maintaining a healthy skepticism about the quality and validity of all information

Making decisions based on evidence, when such is available, rather than opinion


Compare References and Sources

Answering Family Physicians’ Clinical Questions Using

Electronic Medical DatabasesBrian S. Alper, MD; James J. Stevermer, MD, MSPH;

David S. White, MD; and Bernard G. Ewigman, MD, MSPH Columbia, Missouri

http://www.jfponline.com/content/2001/11/jfp_1101_09600.asp


Compare References and Sources

Answering Family Physicians’ Clinical Questions Using

Electronic Medical DatabasesBrian S. Alper, MD; James J. Stevermer, MD, MSPH;

David S. White, MD; and Bernard G. Ewigman, MD, MSPH Columbia, Missouri

http://www.jfponline.com/content/2001/11/jfp_1101_09600.asp

Bottom line – there is no one resource that will answer all

your clinical questions

Learn to use many


Assignment

Create a thought paper on your learning styles and needs which outlines an individual plan for remaining current.

Limit 3 pages E-mail to me before July 19 classFormat- see handoutCopy and paste your official picture from

the web page to your title page


Informatics Intranet Site

Go to Intranet from main web pageClick on SitesClick on Academic AffairsClick on Informatics


Next Time

Finding Reliable Medical InformationBring your laptopsUpload your assignment from this

week before coming to next session

Documents

Lifelong Learning and Information Technology