1. Clinical Microbiology & Infectious Diseases Clickers/ARS/CRS/EVS/PRS/Keypads Workshop for 13 th May 2012 A modest contribution from a newcomer to the game 1 Colin Block

2. Clinical Microbiology & Infectious Diseases Mini-quiz/survey How much time did you devote to preparing for this workshop? A.> 4 hours B.3-4 hours C.2-3 hours D.1-2 hours E.< 1 hour 2

3. 3 Almost 30 students felt free to admit they invested little or no time in preparing the workshop

4. My emphases Some basic issues Item types Clickers for the “basic science” segments of the curriculum Some examples 4

5. What is this stuff anyway? A very seductive idea A great way of actively involving the students A fashion wave? A respectable technique? Do clickers actually make a difference to anything? 5

6. Well? It depends… Some interesting literature – With mixed results Much ‘uninteresting’… – With mixed results 6

7. What do we (I) want from clicker questions? Active participation of students (“engagement”) Active discussion among the students “Deep” learning and better understanding Reveal misunderstandings and misconceptions Improved knowledge retention Attendance (?), grading, peer grading, etc 7

8. WHAT CAN WE LEARN FROM THE LITERATURE? 8

9. 9 A study in a Developmental Biology course Strong case for clicker use in a clearly defined and deliberate way Addresses faculty concerns frankly and clearly – Proposes solutions – Desscribes adaptation away from traditional methods

10. Electronic voting to encourage interactive lectures: a randomised trial Gynaecologists from Australia Less convinced about the advantages (but apparently not worse) Problematic design, but similar studies and findings do appear in the literature 10

11. Added value? An interesting angle Methodology not well matched to our limited use of the clickers (but the future is a big place) 11

12. There is much more The next slide offers a useful resource 12

13. A useful resource 13 http://cft.vanderbilt.edu/docs/classroom-response-system-clickers-bibliography/

14. 14 http://www.podnetwork.org/publications/teachingexcellence/09- 10/V21,%20N3%20Bruff.pdf

15. Bruff contd One best answer questions Student perspective questions Misconception questions Peer assessment questions Why clickers? – Anonymity in class > safety > honesty > participation in discussion – Individual responses can be tracked > accountability > grading etc 15 He also has a book: Teaching with Classroom Response Systems: Creating Active Learning Environments. Wiley 2009 ISBN: 978-0-470-28893-1

16. ONE BEST ANSWER 16

17. Which of the following descriptions most closely fits the term “formative assessment”? A.A quiz or test given to a class to enable students and their teachers to assess their progress in learning B.An evaluation of a course being developed to ensure its suitability for a group of students C.A student’s clinical evaluation of a child’s development D.A peer opinion of a teacher’s success in improving his teaching evaluations by the students E.An evaluation of a piece of reflective writing by a student to assess his perception of his progress 17

18. Which of the following descriptions most closely fits the term “formative assessment”? A.A quiz or test given to a class to enable students and their teachers to assess their progress in learning B.An evaluation of a course being developed to ensure its suitability for a group of students C.A student’s clinical evaluation of a child’s development D.A peer opinion of a teacher’s success in improving his teaching evaluations by the students E.An evaluation of a piece of reflective writing by a student to assess his perception of his progress This is quite a subtle question that can be used to generate discussion; the answers could be diagrammed as follows: LEAST CORRECT -C---D--------------B------E-----A- MOST CORRECT 18

19. STUDENT PERSPECTIVE QUESTIONS 19

20. We haven’t had a good opportunity yet to design such questions in medical microbiology Vaccine refusal will be one area for their use 20

21. REVEALING MISCONCEPTIONS 21

22. Case 3 – Severe pneumonia in a patient with systemic lupus erythematosus on chronic steroid therapy A middle-aged woman who has suffered for years with SLE and requires maintenance therapy with corticosteroids finally has an opportunity to take a holiday at a luxury Hotel in Eilat. She returns to her home in Jerusalem feeling relatively well and rested, but after a few days becomes febrile and short of breath and within a short time finds herself in hospital with a severe pneumonia. 22 Here is an example from one of our Case Workshops of a question deliberately chosen to expose a common misconception… The diagnosis reached in the Workshop is Legionnaire’s disease: Legionella pneumophila infection

23. Here is the relevant question… 14.What is the significance of the patient’s holiday in the clinical story? A.חשיפה לאנשים רבים B.רמה גבוהה של אבק נושא פטריות וחיידקי סביבה באוויר באילת C.חשיפה לאוויר ממוזג בבית מלון D.חשיפה למים חמים בבית מלון 23

24. Here is the relevant question… 14.What is the significance of the patient’s holiday in the clinical story? A.חשיפה לאנשים רבים B.רמה גבוהה של אבק נושא פטריות וחיידקי סביבה באוויר באילת C.חשיפה לאוויר ממוזג בבית מלון D.חשיפה למים חמים בבית מלון 24 This issue is then dealt with in the discussion and the source of the misconception explained

25. PEER ASSESSMENT 25

26. The plan is to use for grading peer lectures 12 short frontal lectures prepared and delivered by small groups Grading Competition? 26

27. CLICKERS IN “BASIC SCIENCES” Learning to play the game 27

28. Assessing the Integration of Audience Response System Technology in Teaching of Anatomical Sciences 28 (Genetics)

29. PROBLEM SOLVING (AND MAYBE SOME ‘CLINICAL’ REASONING?) Some examples 29

30. צביעת הגרםליחההרופא איבחן קלינית שלחולה הזה ( מס ' 1) קרוב לוודאי יש pneumococcal pneumonia. במעבדה בודקים את צביעת הגרם של הליחה, ומוצאים את התמונה הבאה. באיזו מידה תומכים הממצאים באבחנה ? A. מוכיחים את האבחנה B. בעד האבחנה במידה מסוימת C. לא משפיעים על האבחנה D. נוטים לשלילת האבחנה E. שוללים את האבחנה 30 X1000

31. צביעת הגרםליחההרופא איבחן קלינית שלחולה הזה ( מס ' 1) קרוב לוודאי יש pneumococcal pneumonia. במעבדה בודקים את צביעת הגרם של הליחה, ומוצאים את התמונה הבאה. באיזו מידה תומכים הממצאים באבחנה ? A. מוכיחים את האבחנה B. בעד האבחנה במידה מסוימת C. לא משפיעים על האבחנה D. נוטים לשלילת האבחנה E. שוללים את האבחנה 31 X1000

32. מדען ערך ניסוי במסגרת מחקר באלימות חיידק מסוים. הוא הזריק כמויות שונות של החיידק לקבוצות של 25 עכברים כל אחת (A-E). להלן התוצאות בתום הניסוי. באיזו קבוצה נקבע ה - ID50 ? 32 כמות החיידקיםעכברים חוליםעכברים מתים A 1,00010 B 10,00030 C 100,00082 D 1,000,000136 E 10,000,0001913

33. מדען ערך ניסוי במסגרת מחקר באלימות חיידק מסוים. הוא הזריק כמויות שונות של החיידק לקבוצות של 25 עכברים כל אחת (A-E). להלן התוצאות בתום הניסוי. באיזו קבוצה נקבע ה- ID50 ? 33 כמות החיידקיםעכברים חוליםעכברים מתים A 1,00010 B 10,00030 C 100,00082 D 1,000,000136 E 10,000,0001913 A very simple example that tests knowledge and a little calculation: -What is “ID”? -What does “50” mean?

34. A question that tests knowledge and reasoning/ application of knowledge, and encourages learning במקרה של necrotizing fasciitis של האמה מופיע הממצא שבתמונה. מהו הגורם למחלה ? A.Group A beta-hemolytic streptococcus B.Clostridium septicum C.Vibrio vulnificus D.Aeromonas hydrophila E.Streptococcus pyogenes F.Escherichia vulneris

35. This Q is of NO USE for exams במקרה של necrotizing fasciitis של האמה מופיע הממצא שבתמונה. מהו הגורם למחלה ? A.Group A beta-hemolytic streptococcus B.Clostridium septicum C.Vibrio vulnificus D.Aeromonas hydrophila E.Streptococcus pyogenes F.Escherichia vulneris

36. This Q is of NO USE for exams במקרה של necrotizing fasciitis של האמה מופיע הממצא שבתמונה. מהו הגורם למחלה ? A.Group A beta-hemolytic streptococcus B.Clostridium septicum C.Vibrio vulnificus D.Aeromonas hydrophila E.Streptococcus pyogenes F.Escherichia vulneris Knowledge: All the bugs > necrotizing fasciitis Group A strep & S. pyogenes are the same Reasoning and application: What’s the finding in the photo? How does it suggest a specific pathogen from the options? Which of the organisms produces a confluent erythematous rash that blanches with pressure? Learning: The discussion preceding the voting The discussion after the voting

37. Some bottom lines Join the revolution… Accept the inevitability of reducing content – Transfer some of the responsibility for knowledge acquisition to the students (assignments etc) Become knowledgeable in the use of the technique – Unnecessary to replicate others’ past mistakes – Range of useful applications, even if not every variation has yet been solidly proven to make better doctors 37