1. Web-Based Modules: Developing Effective Ones and Sustaining Them
David Evans MD; Amanda Kost, MD; Jaime Grocock; Sharon Dobie MD, MCP – University of Washington
Underserved

2. 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

3. 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

4. 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

5. UP Mentors and Students 2012-13
Underserved

6. 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

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

8. 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

9. Learning Spiral
Underserved

10. 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

11. 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

12. 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

13. Components for Online Learning
Choosing a Platform
Educational Objectives
Content Design
Evaluation
Management
Dissemination
Underserved

14. Choosing a Platform Catalyst, Moodle, Canvas Our Experience:
Underserved

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

16. 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

17. Our Experience— Iterative or another cart leading a horse:
Evaluation
Our Experience— Iterative or another cart leading a horse:
2008-9
Focus groups
Exit Interviews
Survey
Insert smart art
Online evaluation with assignment
Underserved

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. Management Annual review Periodic complete overhaul
Broken Links are Common
New content driven by
evidence,
evaluations,
student interest
Underserved

25. Dissemination How to make the modules accessible
How to not populate the discussions with outside posters
Underserved

26. Dissemination Mirror site: https://courses.washington.edu/fmocw/
Kost A, Ruegg D, Dobie S. A recipe for health literacy. STFM Messenger, September, 2011.
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.
Underserved

27. Discussion
Underserved

28. References Underserved Pathway: @UWSOM_UP
Njenga JK, Fourie LCH. The myths about e-learning in higher education. BJ Ed Tech. 2010;41:
Lee J. Design of blended training for transfer into the workplace. BJ Ed Tech. 2010;41:
Bryce E, Choi P, Landstrom M, LoChang J. Using online delivery for workplace training in healthcare. J Distance Ed.2008;22:
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.
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, doi: /S
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)
• Brown AL, Cocking RR. How people learn. Ed. John D. Bransford. Washington, DC: National Academy Press, 2000
Underserved