Web Knowledge Forum WebCT Online Forms PAIN WEEK 2002 WEBSITE PORTAL My.library & PPT Repository UofT PAIN WEEK DESIGN EXPERIMENT: Interprofessional Knowledge Building for Knowledge Translation Undergrad CE/KTP Students Experts Prof. Leila Lax

Iterative Design Experiment Iterative Design Experiment Pain Week 2002 (KF2 & WebCT) Interprofessional student E-Learning model Interprofessional student E-Learning model Pain Week 2003 (Blackboard & KF4) Scaled-up (70 to 560 students) & fully integrated Scaled-up (70 to 560 students) & fully integrated Development of KB/KF model for Continuing Education/Knowledge Translation (experts) Development of KB/KF model for Continuing Education/Knowledge Translation (experts)

Pain Week KB Goals To engage learners in discourse about the most cutting edge knowledge of pain mechanisms, assessment & management. To engage learners in discourse about the most cutting edge knowledge of pain mechanisms, assessment & management. To create opportunities to connect discourses within and between communities opening new possibilities for barrier-crossing in interprofessional education & collaborative KB. To create opportunities to connect discourses within and between communities opening new possibilities for barrier-crossing in interprofessional education & collaborative KB.

Knowledge Building Theoretical Framework “Learning is an internal, unobservable process that results in changes of belief, attitude or skill. Knowledge building by contrast, results in the creation or modification of public knowledge...The goal is to advance the frontiers of knowledge (as they are currently perceived).” “Learning is an internal, unobservable process that results in changes of belief, attitude or skill. Knowledge building by contrast, results in the creation or modification of public knowledge...The goal is to advance the frontiers of knowledge (as they are currently perceived).” (Scardamalia, M. & Bereiter, C. (2002). Knowledge Building. In Encyclopedia of Education, Second Edition. New York: Macmillan Reference, USA.)

Redefining Expertise Staged model (“end-state”) Staged model (“end-state”) Dreyfus & Dreyfus, 5 Steps from Novice to Expert & Schmidt, Norman & Boshuizen “illness to instance scripts” Dreyfus & Dreyfus, 5 Steps from Novice to Expert & Schmidt, Norman & Boshuizen “illness to instance scripts” Process model (“cognitive reinvestment”) Process model (“cognitive reinvestment”) Bereiter & Scardamalia, progressive problem solving at increasing levels of complexity Bereiter & Scardamalia, progressive problem solving at increasing levels of complexity (Bereiter, C. & Scardamalia, M. (1993). Surpassing Ourselves: An Inquiry into the Nature and Implications of Expertise. Peru, Il: Open Court, USA)

IPE Expert KB/KT Database

Multimedia & Virtual Patient

Unfolding Clinical Case Scenarios Standardized Patients Real Patients Future: Expert Demos Future: Participant Video

Building-on Diverse Ideas

INTU & A Better Theory

Optimizing & Improving Ideas

Providing Authoritative Resources

Creating High Level Summaries

Linking & Multi-Referencing

Reflecting

Integrating Learning & Knowledge Building

Supporting Evidence-based KB

Using Visuals for Deep Understanding

Working with Real Ideas, Real Problems

KF Database = Knowledge Objects Repository

Advance beyond knowledge telling 2002: student database Shallow KB = knowledge sharing & idea exchange Shallow KB = knowledge sharing & idea exchange 2003: expert database aiming for Deep KB = knowledge transformation & innovation Deep KB = knowledge transformation & innovation Knowledge Building Challenge

Methods Design Experiment Methodology (Brown, 1992; Collins, 1992; The Design-Based Research Collective, 2002) Design Experiment Methodology (Brown, 1992; Collins, 1992; The Design-Based Research Collective, 2002) Ethical approval of research protocol Ethical approval of research protocol Self-selected volunteers (enthusiasts) Self-selected volunteers (enthusiasts) n=16 n=16

Analyses Attitudes & Opinions Survey Attitudes & Opinions Survey ATK KB Measures ATK KB Measures KB Qualitative Indicators KB Qualitative Indicators Pain Conceptions/Misconceptions Pain Conceptions/Misconceptions Pre- & Post-test on Pain Beliefs Pre- & Post-test on Pain Beliefs Reflective Feedback Survey (4 months later) Reflective Feedback Survey (4 months later)

Experts Attitudes & Opinions KT Survey RESULTS Response rate = 12/14 (86%) Demographics The program or faculty I am currently registered/associated with is: Nursing=7, Medicine=1, Pharmacy=2, Social Work=1, Physical Therapy=1, Occupational Therapy=0, Dentistry=0 The program or faculty I am currently registered/associated with is: Nursing=7, Medicine=1, Pharmacy=2, Social Work=1, Physical Therapy=1, Occupational Therapy=0, Dentistry=0 I am: Female=11 Male=1 I am: Female=11 Male=1 My age group is: 30-39= =7 My age group is: 30-39= =7

Did you find this interprofessional continuing education experience useful? Did you find this interprofessional continuing education experience useful?Yes=11/12 Was there purposeful discourse online between participants? Was there purposeful discourse online between participants?Yes=11/12 Did you acquire new knowledge? Did you acquire new knowledge? Yes=11/12 Yes=11/12

Do you think as a result of this course you will change your approach to interprofessional practice? Yes=7/12 Do you think as a result of this course you will change your approach to interprofessional practice? Yes=7/12 Example: Example: “I have been fortunate to work with some great teams but this did help in allowing me to see each individuals focus and not expecting any one individual to carry all the knowledge.”

Do you think as a result of this course you will change your approach to pain assessment & management? Yes=9/12 Do you think as a result of this course you will change your approach to pain assessment & management? Yes=9/12 Example: Example: “I thoroughly enjoyed reading the comments made by the other participants, and realize how narrow focused I am and how much of a broader perspective the other members bring to the table. They truly have expertise that I never fully appreciated. I have learned that management of pain encompasses much more than merely drug therapy - but should focus on the whole person. We need to look at emotional, financial, personal and other supports.”

Would you like to see more E-Learning CE/KTP courses made available? Would you like to see more E-Learning CE/KTP courses made available? Yes=11/12 Yes=11/12 Based on my experience of E-learning, I would recommend it to a colleague. Based on my experience of E-learning, I would recommend it to a colleague. 10/12 strongly agree/agree Overall I would rate my E-learning experience as: 83.3% excellent/very good/good Overall I would rate my E-learning experience as: 83.3% excellent/very good/good

KB Idea Diversity “Socio-cognitive dynamics: Ideas diversity is essential to development of knowledge... To understand an idea is to understand the ideas that surround it, including those that stand in contrast to it. Idea diversity creates a rich environment of ideas to evolve into new and more refined forms. ” “Socio-cognitive dynamics: Ideas diversity is essential to development of knowledge... To understand an idea is to understand the ideas that surround it, including those that stand in contrast to it. Idea diversity creates a rich environment of ideas to evolve into new and more refined forms. ” Technological supports: link & reference Technological supports: link & reference

KB Community Knowledge, Collective Responsibility KB Community Knowledge, Collective Responsibility “ Socio-cognitive dynamics: Contributions to shared, top-level goals … are prized … as much as individual achievements. Team members produce ideas of value to others and share responsibility for the overall advancement of knowledge in the community. ” “ Socio-cognitive dynamics: Contributions to shared, top-level goals … are prized … as much as individual achievements. Team members produce ideas of value to others and share responsibility for the overall advancement of knowledge in the community. ” Technological supports: build-on, link, summarizing Technological supports: build-on, link, summarizing

Future Directions KB/KF progressive iterative design experiment, addressing the continuum of health professional education from undergraduate to knowledge translation in practice, to advance pain education & interprofessional outcomes. KB/KF progressive iterative design experiment, addressing the continuum of health professional education from undergraduate to knowledge translation in practice, to advance pain education & interprofessional outcomes.

Acknowledgements Acknowledgements Research Support: Numerous UofT Faculty & Dept. in-kind contributions; Numerous UofT Faculty & Dept. in-kind contributions; UofT Academic Priorities Fund, Council of Health Sciences and Social Work Deans, Interprofessional Education Implementation Committee, Dr. C. Whiteside, Chair, Associate Dean, Faculty of Medicine; UofT Academic Priorities Fund, Council of Health Sciences and Social Work Deans, Interprofessional Education Implementation Committee, Dr. C. Whiteside, Chair, Associate Dean, Faculty of Medicine; University of Toronto Centre for the Study of Pain, Dr. M. Salter, Director; and University of Toronto Centre for the Study of Pain, Dr. M. Salter, Director; and Institute for Knowledge Innovation and Technology, Dr. M. Scardamalia, Director, OISE/UT Institute for Knowledge Innovation and Technology, Dr. M. Scardamalia, Director, OISE/UT

Collaborators (research, case writing & facilitation): Dr. J. Watt-Watson (Nursing), Dr. P. Pennefather (Pharmacy), Prof. J. Hunter (PT), Dr. M. Scardamalia (IKIT) and Dr. A. Gordon (Mt. Sinai Hospital)