DID-ACT at AMEE 2020

The Association for Medical Education in Europe (AMEE) is one of the biggest organisations focused on excellence and research in health professions education. It has been organising annual conferences for scholars engaged in this topic for close to 50 years.  The interest in these meetings is rising and has reached the level of around 4000 participants last year. The DID-ACT consortium decided to disseminate its outcomes at AMEE by submitting an abstract informing about the results of the project’s needs analysis.

This year’s conference was originally planned to be held in Glasgow, United Kingdom, however, changes had to be made due to the ongoing COVID-19 pandemic; AMEE’s traditionally face-to-face format was adapted to be a virtual conference that  rose to the challenge and exceeded expectations. Rather than following suit to mainstream reliance on primarily traditional audio-video teleconferencing tools, AMEE took on the challenge to host the conference in a virtual world. The virtual venue encompassed a group of interconnected locations with different purposes. A palm tree grown lobby with information booths led to several lecture theatres, exhibition halls, networking areas and poster rooms. The participants, prior to joining the conference, designed their own avatar and then navigated it through the locations meeting on the way avatars of other participants. The meetings enabled interactions either by typing in a chat window or an audio conversation. Participation in the events held in parallel conference communications could be interactive as well, enabling the audience to applaud, raise hands, and talk to the next-sited neighbour.

The DID-ACT submission was accepted for AMEE 2020 as a virtual poster. This presentation format involves constructing a digital “stack” of multimedia resources which could be presented either in a smartphone app or in a web browser. The content is organised in nested sections depicted as rectangular tiles, each containing resources as text entries, images, web links. Each conference presenter was encouraged to incorporate in the poster a short video showing a voice-over PowerPoint presentation giving an overview of the most important content. In addition it was required to prepare a one page digital print-out of the poster including a QR-code for easy access by smartphones from the real world. The DID-ACT poster was prepared by Andrzej Kononowicz, Małgorzata Sudacka, Felicitas L. Wagner,  Samuel Edelbring, Inga Hege and Sören Huwendiek on behalf of the consortium. In the image below we present the poster print-out. The content is available via this link https://api.ltb.io/show/BWPMF.

The virtual conference was held from 7th until 9th September. Several DID-ACT members participated in the conference events and networked with fellow researchers. In particular there were several conference presentations around the topic of clinical reasoning. By the end of conference the participants form DID-ACT project decided to gather virtually in one of the exhibition hall for a virtual group selfie:

Standing from the left are: Desiree Wiegleb Edstöm, Živa Ledinek, Małgorzata Sudacka, Maria Elvén, Andrzej Kononowicz and Inga Hege

The conference contributions presented at the virtual AMEE conference will be available at least throughout the next year and by that enable playback of the presentations and sustainable project dissemination. Participation in the conference was a memorable event, impressive by its innovation and showing how far virtualisation of education and research can nowadays go. Despite the many benefits of the virtual conference, and thankful it was possible to be held in these troubled pandemic times, we hope we will be able to meet up at the face-to-face conference next year at AMEE 2021 in real world Glasgow to present the community more news around the DID-ACT project.

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How to teach synchronously in a virtual setting

  • You need a reliable camera, microphone, and virtual platform and be familiar with its features, such as whiteboard, chat, polling, breakout rooms, etc.
  • At the beginning establish communication rules, e.g. whether participants should raise their (virtual) hand, use the chat, and/or just speak. Also, we recommend asking participants to turn on their camera
  • For small group work break out rooms work very well, just be clear about the tasks the groups should work on prior to dividing them into the groups.
  • For collaboration the use of integrated virtual whiteboards or other platforms such as Padlet are very useful. Just make sure prior to the session that you have everything setup and the links at hand, e.g. to post them in the chat.
  • Allow a bit more time for starting the session and the group works as there might be participants who are not familiar with the platform or technical problems might occur.

How to motivate unprepared participants

  • Make clear that the asynchronous assignments are a core part of the course and that its content will not be repeated. Even if it is difficult, stick to that when starting the synchronous teaching session.
  • If you expect unprepared participants, you can start the session with a student-centered group exercise mixing prepared and unprepared students to increase peer-pressure and make them realize that being unprepared does not feel good.  
  • Use the introductory or closing quizzes / tests so that participants can self- assess whether they have the required knowledge and you as a facilitator can see the level of knowledge and preparation of your participants.

Further recommended reading:

How to involve participants with different levels of experience

  • To account for such different levels, we recommend making use of the asynchronous preparatory phases which also include introductory quizzes in which participants can self-assess their prior knowledge and you as a facilitator can assess the differences within your group. Participants with less prior experience can also be guided to additional preparatory resources.
  • Encourage participants to work in pairs or small groups when preparing so that they can help and learn from each other. You could even facilitate this by dividing them into groups with different levels of experience.
  • Similarly, during the synchronous phases, we recommend forming groups with participants different levels of experience and emphasize the peer support aspects of such group activities.
  • We also recommend starting with rather smaller groups and allow more time than stated in the course outlines, if you expect a heterogenous level of experience. This way you can better manage this challenge.
  • Encourage your participants to ask questions, emphasizing that nobody knows everything and that it is important for learning to ask questions.  
  • Especially in the train-the-trainer course you might have to deal with over-confident participants, who especially in an interprofessional setting can dominate the group. This is a complex cultural challenge, but you could try to establish (and follow) communication rules at the beginning of a session.  

How to address potential overlaps or redundancies

  • Identify what is already included and what is missing in your curriculum related to clinical reasoning outcomes and compare it to the DID-ACT blueprint. Prioritize learning outcomes that are not yet covered but regarded as important.
  • Identify activities, resources, or teaching sessions with similar learning outcomes that might be in need for change anyway because of low evaluation results, teachers or students struggle with it. These could be suitable for adding or replacing parts with DID-ACT activities.
  • Ask teachers and students about overlaps and gaps they see in their teaching / learning of clinical reasoning and where they struggle. This could also be done by a reflection round after related teaching activities in the curriculum
  • Although ideally a longitudinal integration is aimed at, we recommend to starting small with a pilot implementation to gain experience and develop a show case.

How to teach in an interprofessional setting

  • Allow for enough time prior to the teaching for the organization and motivation / encouragement of stakeholders and participants
  • Allow for enough time and guidance during the course so that the participants from the different professions can get to know each other and their professions and discuss their different perspectives. This might mean that you need to calculate some extra time in addition to the suggested duration of the learning unit.
  • There may be a different understanding of clinical reasoning in the different health professions, so we recommend making participants aware of this. You could for example use and adapt activities from the learning units on the health profession roles to facilitate this.
  • Courses in an interprofessional setting should not come too early in the curriculum (not before professions have formed their own professional identity - however, this also depends on the aim of the course). 
  • Make sure you have enough participants from different professions. If possible, the facilitator could divide the participants in smaller groups with an equal distribution of professions. 
  • Similarly, you need an equal distribution of facilitators / facilitators from different professions.
  • Develop customized learning materials considering the different professions. If needed you can adapt the material and activities provided in the DID-ACT curriculum.

Further recommended reading:

van Diggele, C., Roberts, C., Burgess, A. et al. Interprofessional education: tips for design and implementation. BMC Med Educ 20, 455 (2020). (Link)

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