1. Jacob Prunuske, MD, MSPH STFM Predoc 2009
Asynchronous web-based orientation for a required rotation: creating time to teach complex concepts
Jacob Prunuske, MD, MSPH
STFM Predoc 2009

2. Objectives Educational potential Effectiveness: live vs web
Approved by the University of Wisconsin Educational Research IRB

3. UW 4th Year Preceptorship
Required
171 students in ‘08-’09
6 weeks
45 sites, 31 Communities
Community Health Focus
Rotation Structure
Clinical
Modules

4. Rationale for change Orient & drive Didactics & geography
Peer learning
Complex topics

5. Live vs WBL
Multiple studies showing equivalency in knowledge assessment following WBL or live lecture
Wofford, Spickard et al. 2001
Williams, Aubin et al. 2001
Chumley-Jones, Dobbie et al. 2002
Solomon, Ferenchick et al. 2004
Jenkins, Goel et al. 2008

6. Web Based Learning Advantages Convenience Revisit* Travel
Standardization
Disadvantages
Questions
Group interaction
Discussion
Course Changes
* 70% of students revisited previous online courses to review lecture presentations, notes or quizzes. (Masters and Gibbs 2007)

7. Ho = No difference live vs web

8. Orientation
Orientation Video
Course management software

9. 150 Evaluations Month 2007-2008 Paper 2008-2009 Electronic July 3
August 11
September 25
November 16 21
January 19 12
February
March 22
Total 78 72

10. Results Average difference = 0.33 * * * * * * * * * * Question
* P < 0.05

11. Time of Year Month 2007-2008 Paper 2008-2009 Electronic July 3 August11
September 25
November 16 21
January 19 12
February
March 22
Total 78 72

12. Nov 07 vs Nov 08 No difference in 7 out of 13 questions… * * * * * *
* P < 0.05

13. Time of Year Month 2007-2008 Paper 2008-2009 Electronic July 3 August11
September 25
November 16 21
January 19 12
February
March 22
Total 78 72

14. Jan 08 vs Jan 09 No difference in any of the questions… Question
P > 0.05 for all questions

15. Learner Comments
Live: 21 of 78
Web: 54 of 72

16. Live = 21 comments 7 critical of length 3 critical of content
7 positive review of speaker/content

17. Web = 54 Comments 4 critical of length 2 critical of content
3 tech problems
24 appreciate electronic format
11 positive review speakers/content

18. Few Tech Problems
“Downloading the videos was INCREDIBLY slow.”
“I have a mac laptop and was able to access all 3 videos, however none of the 3 played to completion”

19. Not a barrier
Students had some technical difficulties using the modules, but agreed or strongly agreed that modules could serve as adequate replacement for live lectures
Solomon, Ferenchick et al. 2004

20. Positive Comments

21. “The orientation was probably the best one I have had before a clerkship.  I really liked that we could watch the video on our own time and go back to things that were maybe not clear the first time through.”

22. “Overall, this was an excellent orientation to the 6 week rotation
“Overall, this was an excellent orientation to the 6 week rotation.  The first lecture provided all of the basic information needed for the clerkship, and did so succinctly and while providing useful information regarding meaningful participation/goals for the rotation.”

23. “It was really awesome how you allowed us to watch videos & go thru orientation on our own.  This is a tremendous help in the interview season as well as for travelling between sites.  If we would have had to come back to Madison for doing the same thing that we were able to do online, it would not have been a good use of our time.  Thank you.”

24. Limitations Perception vs Reality
Students preferred live 1/3 point on 5-pt scale
Did not measure actual knowledge acquisition
Students attending the live lecture rated their knowledge & skills higher than students who used computers, despite no measurable difference
Williams, Aubin et al. 2001

25. Limitations Did not adjust for student demographics
Knowledge performance live = on-line & unrelated to
Age
level of computer skill
attitudes toward computer tasks
beliefs in role of computers in medical education
time between intervention & post-test
Spickard, Alrajeh et al. 2002

26. Hurdles
“Probably my own fault, but it was not clear to me that I was to have this orientation before the start of the preceptorship and it would have been helpful if I had. Perhaps another reminder or two? I know, I should have been more on top of it.”
- Adult Learner

27. Benefits Efficiency: Lecturers free to do other tasks
60 min live vs 25 min on-line
12 ½ min if watch 2x speed
Lecturers free to do other tasks
Addition of workshop
Students participating in on-line lecture
spent significantly less time at the task
Spickard, Alrajeh et al. 2002

28. Plans Month 2007-2008 Paper 2008-2009 Electronic July 3 August 11
September 25
November 16 21
January 19 12
February ?
March 22
Total 78 72

29. Plans
Evaluate workshop
Use evaluation data to improve video

30. Conclusions Live & web orientations comparable
More learner comments online
Learner preference for web delivery
Benefits of efficiency & flexibility outweigh 1/3 point difference
Minimal tech problems
Faculty time: Workshop vs orientation

31. Discussion

32. Thanks! 40