Web-Based Modules: Developing Effective Ones and Sustaining Them David Evans MD; Amanda Kost, MD; Jaime Grocock; Sharon Dobie MD, MCP – University of Washington http://depts.washington.edu/fammed/education/programs/upath Underserved Pathway: @UWSOM_UP

Objectives Learn how the Underserved Pathway (UP) at UW has grown with its online modules Relate our experience to emerging literature Share successes and pitfalls among participants Underserved Pathway: @UWSOM_UP

Purpose of the UP at UW To support medical students interested in working with the underserved. To provide an array of mentorship, academic and experiential activities. To prepare future providers to work with a variety of underserved populations. Underserved Pathway: @UWSOM_UP

The UW Underserved Pathway Students are required to complete 8 out of 15 modules with interactive elements. Required: “Who Are the Underserved?” In-Person sessions count as completion Underserved Pathway: @UWSOM_UP

UP Mentors and Students 2012-13 Underserved Pathway: @UWSOM_UP

The UW Underserved Pathway Students are required to complete 8 out of 15 modules with interactive elements. Required: “Who Are the Underserved?” In-Person sessions count as completion Underserved Pathway: @UWSOM_UP

UP Pathway Module History 2006-7 design year included focus groups 8 modules written and put online 2009-12 Focus groups lead to seven more modules all 15 updated or modified annually 2010 first course objectives developed first online evaluations 2012 Twitter added https://twitter.com/UWSOM_UP Underserved Pathway: @UWSOM_UP

Current Modules Who are the Underserved?* Persons with HIV Public Health Epidemiology* Introduction to Homelessness Advocacy* Chronic Poverty and Low Income* Health Care Teams and the Underserved Beyond the Medical Model: Exploring Disability Health Literacy* Victims of Intimate Partner Violence Medicare* Medicaid Introduction to Substance Abuse Race, Ethnicity, and Health Care* * Have been taught in person Rural Health Underserved Pathway: @UWSOM_UP

Learning Spiral Underserved Pathway: @UWSOM_UP

The Evidence: Andragogy over Pedagogy Adult learners like experiential learning They are facile with technology They want to learn what is useful Teachers need time and support to incorporate No method is all good or all bad The WWAMI reality Underserved Pathway: @UWSOM_UP

The Cal State Chico Tools “The Rubric” Six domains of the Rubric for Online Instruction: Learner Support and Resources Online Organization and Design Instructional Design and Delivery Assessment and Evaluation with Technology Innovative Teaching with Technology Faculty Use of Student Feedback Underserved Pathway: @UWSOM_UP

The Cal State Chico Tools “The Rubric” “Instructional Design and Delivery: Multi-modal Activities Baseline Course provides few visual, textual, kinesthetic and/or auditory activities to enhance student learning. Effective Course provides some visual, textual, kinesthetic and/or auditory activities to enhance student learning. Exemplary Course provides multiple visual, textual, kinesthetic and/or auditory activities to enhance student learning.” Underserved Pathway: @UWSOM_UP

Components for Online Learning Choosing a Platform Educational Objectives Content Design Evaluation Management Dissemination Underserved Pathway: @UWSOM_UP

Choosing a Platform Catalyst, Moodle, Canvas Our Experience: Underserved Pathway: @UWSOM_UP

Educational Objectives Three years in: develop a course; aha! We need objectives. Subsequent modules start with objectives. Underserved Pathway: @UWSOM_UP

Content Design Our Experience Interactive, evidence based, referenced Research Beta test: Try in-person Try different engagement strategies: reflections, quiz, cases to work through Underserved Pathway: @UWSOM_UP

Our Experience— Iterative or another cart leading a horse: Evaluation Our Experience— Iterative or another cart leading a horse: 2008-9 Focus groups 2008-10 Exit Interviews 2009-11 Survey Insert smart art 2010-13 Online evaluation with assignment Underserved Pathway: @UWSOM_UP

2008-10 Evaluations Focus groups/Exit Interviews “Excellent” “Some are relevant; some are not” “Introduced me to topics outside of my experience” “Make them more interesting” “Have more topics” Underserved Pathway: @UWSOM_UP

2010-2013 On Line Evaluations 198 responses 5 point Likert scale Contribute to knowledge? 72% 4-5 Effective in conveying material? 67% 4-5 Encourage future work with underserved? 63% 4-5 Underserved Pathway: @UWSOM_UP

Underserved Pathway: @UWSOM_UP QUESTION ASKED: What would you have liked this module to cover, and/or what additional topics would you like to see? Underserved Pathway: @UWSOM_UP

Module Themes from Interviews Flexibility “There was a large enough selection … could select the ones of interest to me.”  “I am really glad the program is flexible ... I did the modules as I had time to do them” Appreciation for in person modules  “In person modules were more fun and interesting.” Underserved Pathway: @UWSOM_UP

Module Themes from Interviews Fostering better understanding of the underserved “Modules …helped broaden my view… there are a lot of issues to know about and understand. I will probably use a lot of that.” “Even if an area I was not extremely interested in, it helped to understand different concepts.” Specific modules mentioned Medicare, Medicaid, Rural Health, Race and Ethnicity  Underserved Pathway: @UWSOM_UP

Ecological Model Brown AL and Cocking RR (2000) Brown, Ann L., and Rodney R. Cocking. How people learn. Ed. John D. Bransford. Washington, DC: National Academy Press, 2000. Underserved Pathway: @UWSOM_UP

Management Annual review Periodic complete overhaul Broken Links are Common New content driven by evidence, evaluations, student interest Underserved Pathway: @UWSOM_UP

Dissemination How to make the modules accessible How to not populate the discussions with outside posters Underserved Pathway: @UWSOM_UP

Dissemination Mirror site: https://courses.washington.edu/fmocw/ Kost A, Ruegg D, Dobie S. A recipe for health literacy. STFM Messenger, September, 2011. http://www.stfm.org/publications/EducationColumns_September2011.cfm. Keen M, Chi B, Lazzar R, Kost A, Chen F, Dobie S. Health Care of Underserved Populations: An Evidence-Based Approach. Family Medicine Digital Resource Library; 2011. http://www.fmdrl.org/3469 Underserved Pathway: @UWSOM_UP

Discussion Underserved Pathway: @UWSOM_UP

References Underserved Pathway: @UWSOM_UP Njenga JK, Fourie LCH. The myths about e-learning in higher education. BJ Ed Tech. 2010;41:199-212. Lee J. Design of blended training for transfer into the workplace. BJ Ed Tech. 2010;41:181-198. Bryce E, Choi P, Landstrom M, LoChang J. Using online delivery for workplace training in healthcare. J Distance Ed.2008;22:149-56. Lippert R. Maximizing the use of a web-based soils module: targeting diverse populations. J Instructional Media. 2006;33:81-86. California State U. Chico, Rubric for Online Instruction. http://www.csuchico.edu/roi/ Werth EP, Werth L, Effective training for millennial students. Adult Learning. 2011;22:12-19. Comas-Quinn A. Learning to teach online or learning to become an online teacher: an exploration of teachers’ experiences in a blended learning course. 2011; ReCALL, 23, 218-232 doi:10.1017/S058344011000152 Al Andrade, Harvard Project Zero, 1999 The Thinking Classroom is based on the collective research and ideas of the Cognitive Skills Group, Harvard Project Zero, 1999 (learning spiral) http://learnweb.harvard.edu/alps/thinking/design_learning_spiral.cfm • Brown AL, Cocking RR. How people learn. Ed. John D. Bransford. Washington, DC: National Academy Press, 2000 Underserved Pathway: @UWSOM_UP