1. The “Emergency Curriculum:” Using Technology-on-the-Fly to Teach in (Snow-)Apocalypse Rachel Franklin, M.D. Elizabeth Ekpo, MS4 University of Oklahoma Source: NASA Moderate Resolution Imaging Spectroradiometer. Accessed at http://www.nasa.gov/topics/earth/features/snowstorm_feb2011.html on 1/28/2012http://www.nasa.gov/topics/earth/features/snowstorm_feb2011.html

2. Background 4 week required rotation – MS3 140 students/year Clinical experience (16 days supervised patient care) Standardized curriculum (1 + 3 half days direct teaching/remediation) –fmCASES – based quizzes and feedback session –Longitudinal PBL session –Progress Note Assignment and Review Final exams (2 half days) –fmCASES written exam (22 cases, 100 questions) –Objective Clinical Skills Examination (OSCE) Lifestyle change counseling Musculoskeletal complaint We’ve never done web based teaching

3. Curricular Schedule Week One Monday (full day) AM:  General Orientation  Musculoskeletal Evaluation: Shoulder, Neck/Back, Knee  Dr. Franklin’s orientation PM:  Dr. Crawford Welcome  Dermatology Review  PBL Longitudinal Case “Bob”: Hypertension, Diabetes, Preventive Care, Screening Guidelines Wednesday PM  fmCASES Quiz and Discussion  PBL “Bob” Presentations Week Two Wednesday PM  fmCASES Quiz and Discussion  Longitudinal Case “Bob”: Hyperlipidemia Week 3 Wednesday PM  fmCASES Quiz and Discussion  Longitudinal Case “Bob”: Chest Pain, Elevated Blood Pressure, Elevated Blood Sugar  EKG Analysis and Cardiovascular Risk Assessment  Clinical Note Writing/Differential Diagnosis Week 4 Wednesday PM  fmCASES Quiz and Discussion  Longitudinal Case “Bob”: Elevated Blood Pressure, Elevated Creatinine  Clinical Note Writing/Differential Diagnosis

4. fmCASES: Linear Progress Week One: Preventive Care and Musculoskeletal Pain Week Three: Assessing Undifferentiated Complaints Case 1 Case 2 Case 4 Case 10 Case 11 Case 3 Case 19 Case 20 Case 21 Case 23 Case 24 Case 26 Week Two: Chronic Disease and Complications Week Four: Reproductive Health and Dermatologic Lesions Case 6 Case 7 Case 8 Case 9 Case 13 Case 18 Case 14 Case 16 Case 17 Case 27

5. Final Grade Determination fmCASES Exam: 40% Preceptor evaluation: 30% OSCE: 10% Weekly quizzes: 8% Progress Note: 5% fmCASES completion: 5% PBL session: 2%

6. Curricular Week One: Monday, January 31, 2011 Source: http://i292.photobucket.com/albums/mm13/joeobima/widespread-snow-13111-453x340.jpg Accessed 1/28/2012http://i292.photobucket.com/albums/mm13/joeobima/widespread-snow-13111-453x340.jpg

7. Really…? January 28-29, 2011: highs in mid-70s January 30-31: highs in 30s-40s Emergency? Hype? Or meme magnet? Sources: http://quizilla.teennick.com/user/yukixkyoxsohma/journal/1798166/snowpocalypse-2011/ andhttp://quizilla.teennick.com/user/yukixkyoxsohma/journal/1798166/snowpocalypse-2011/ http://bloggingfoodforthought.blogspot.com/2011/02/weather-permitting.htmlhttp://bloggingfoodforthought.blogspot.com/2011/02/weather-permitting.html Accessed 1/28/2012

8. Source: http://meandmarisa.files.wordpress.com/2011/02/snow-graph.jpg Accessed 1/28/2012http://meandmarisa.files.wordpress.com/2011/02/snow-graph.jpg

9. Yes, really… Monday 1/31/11 Sought consensus with students Gathered phone numbers Brought materials home Linked laptop to VPN server Began search for curricular delivery systems Tuesday 2/1/11 OUHSC preemptively closes campus (first time) Snow starts - afternoon Delivery systems identified –SurveyMonkey –Freebinar (now AnyMeeting) Begin curricular tool transfer –Lecture slides to AnyMeeting –Quizzes/feedback to SurveyMonkey

10. Wednesday, 2/2/11 Source: National Weather Service Forecast Office, Norman, OK. Accessed at http://www.srh.noaa.gov/oun/?n=events-20110131 1/28/2012 http://www.srh.noaa.gov/oun/?n=events-20110131

11. And, the next week… Source: National Weather Service Forecast Office, Norman, OK. Accessed at http://www.srh.noaa.gov/oun/?n=events-20110208, 1/28/2012http://www.srh.noaa.gov/oun/?n=events-20110208

12. The Intervention Email invitation to students –Webinar access –Instructions for sessions “Virtual class” –Students log into webinar site –Greet in chat mode, send all to survey site to complete quiz –Following quiz, call conference number for class –Dermatology lecture –Quiz feedback –PBL session/Socratic questioning

13. Quiz - 10 questions followed by faculty feedback

14. DEMONSTRATION

15. Results: Final Grades

16. Grade Distribution

17. Grades: Raw Scores

18. Student Satisfaction (Control vs. Intervention)

19. Satisfaction with Intervention

20. Narrative Feedback Positive: –“It worked out pretty well, and seemed to be a good way to manage situations like this.” –“I thought it went great.” –“Everything went smoothly.” –“I am still learning effectively without having to drive back to campus in the bad weather.” –“…the teacher facilitated well…one person was called at a time so we were all able to hear.” –“It was easy, convenient, and actually worked.”

21. Narrative Feedback Constructive: –“It didn’t work well on a Mac.” –“I was using my cell phone minutes…built in audio would have been preferred.” –“Video (ie Skype) sessions might be nice as well.” –“I would recommend no more than 10 students…overlap on the conference call and…text chat might take away from the learning.”

22. SWOT Analysis Business 101 –Strengths –Weaknesses –Opportunities –Threats Purpose: –Goal setting –Strategic planning Applicable to what we do as teachers, too! –Campus politics –Curricular review

23. Strengths Ensured student safety Maintained curricular structure Prevented compression Innovation was exciting Measurements maintained –Quizzes –Feedback Dialogue maintained (compared to “correspondence course”)

24. Weaknesses Speed Group dynamic Cost – cell phone minutes Not compatible with all devices

25. Opportunities New model for OUHSC –Future crises –Class of 2016 Internal web conferencing Policies for emergency curricular delivery VPN policy –Prevent opening fmCASES during quiz –Prevent wireless printing of quizzes

26. Threats Technologic failure –Compatibility –Power –Lack of access Cheating –Lock down Survey site –Timed testing –Professionalism

27. Discussion?