Elisa is a sustainable design student studying in Cologne and has been active in the DID-ACT Project since May 2021! Even though it is her first experience in medical education, Elisa easily managed to help various members of our team by creating storyboards, videos, audio recordings and animations based on summaries given to her in the curriculum development process. She works on a piece approximately every month, and has worked on over 12 pieces in total, each of which can take her days to create. Needless to say, Elisas’ contribution to the project has been essential. A big thank you to Elisa for her contribution to the DID-ACTProject and to @Daniel Donath from EDU-A Degree Smarter for the blog post!
It is hard to believe our clinical reasoning project is already ⅔ complete. Being the final year of the project, we look back at our learning units, pilots, and evaluations with appreciation for how they bring us into the project’s next phase.
The DID-ACT project team is currently full speed toward our next round of project deliverables. Building from last year’s pilots implementations, we are taking our curriculums into their refinement stages. We will be working on the train-the-trainer (TTT) course’s refinements (D3.3), which we aim to have ready by May. Alongside this, we are finalising the student curriculum (D 4.1), which we will have ready by the end of March.
Upcoming Student Clinical Reasoning Curriculum
Happening simultaneously is the evaluation and analysis of learner activities for the student curriculum (D5.3). Our results, retrieved from the pilot implementations of the student curriculum, are being sorted and reported on under the leadership of Dr A. Kononowicz (Jagiellonian University). We look forward to these results as they will be implemented as refinements for the student course, which is planned to start in April 2022.
Curriculum Integration Guideline
Apart from the curriculum, the curriculum integration guideline is being prepared. This document will serve as a guide for various institutions aiming to integrate the curriculum into their own institutions. While it is currently being drafted as part of WP7, led by EDU and supported by Instruct, it will need to be refined after the curriculum is completed. This will go hand in hand with the sustainability model, which is due at the end of the project.
Dissemination of the results of the project and research done by partners surrounding the project will also continue; results will be shown at medical education conferences, including the AMEE. Time speeds forward as we are working to bring this project to life and help support educators and students develop their clinical reasoning skills. Here’s to the DID-ACT project starting off 2022!
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:
Hege I, Tolks D, Adler M, Härtl A. Blended learning: ten tips on how to implement it into a curriculum in healthcare education. GMS J Med Educ. 2020;37(5):Doc45. (Article)
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)