Transcript ARS: Interactive Introduction

Valerie P Jackson, MD, FACR
Eugene C Klatte Professor and Chair
Department of Radiology and Imaging Sciences
Indiana University School of Medicine
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I have no financial interests to disclose
I am NOT an expert in Adult Learning
Principles
I have attended usual array of schools and
courses
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Understand the characteristics of good and bad
speakers
Understand Adult Learning Principles (ALP)
Introduce Case-Based Teaching (CBT)
Explain Audience Response Systems (ARS)
Realize advantages and disadvantages of ARS
this…….
to this?
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Unlike small children, adults
- have foundation of life experiences and
knowledge
- want to connect learning with knowledge
and experience base
Teachers should relate concepts and theories
to audience’s experiences
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Adults are
- autonomous and self-directed
- goal-oriented
- relevancy-oriented
- practical
Focus on aspects of lesson most useful to
them in work
Need respect
http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/adults-2.htm
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Free to direct themselves
Want to be actively involved in learning
Like to know how ‘class’ will help them
reach their goals
Teachers serve as facilitators
Teachers guide to knowledge rather than
provide facts
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Learners typically know their goals for class
Want organized curriculum
Teachers should show learners how they will
reach their goals
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Learners want to see reason to learn
Information applicable to work, life
Want to know how learning concept will
relate to familiar situations
Want to focus on what is important and
useful
Not necessarily interested to “just learn”
something
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Acknowledge the learners experience
Give opportunity to voice opinion and
knowledge in teaching setting
Don’t waste time on irrelevant stuff
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Case based teaching
Problem based learning
Both interactive
Focus on development of relevant skills
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Develop skills in analytical thinking and
reflective judgment
Reading and discussing complex, real-life
scenarios
Cases are stories with educational message
Can be done with large group
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Call on people to answer
Raising of hands/survey
Teams/split the room
Paper responses
Open microphone
Use ARS
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Keypads
Radio frequency receiver
Group response software
Laptop computer
LCD projector
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Question
Time to select
Recognizes input from participants
Displays data
? Improves learning environment
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Get to know the audience
0/0
51%
2. False
49%
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1. True
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1. Strongly Agree
2. Agree
3. Neutral
4. Disagree
5. Strongly Disagree
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Space ARS throughout talk to keep audience
engaged
First half of this lecture was boring
- you may not care about ALP
- too many words
- little/no interaction
Don’t save all ARS until the end
1. 0
2. 1-3
3. 4-6
4. 7-9
5. ≥ 10
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1-3
4-6
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7-9
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more
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Keep engaged
ARS
1. Yes
33%
(2) = XX.X
2. No
33%
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3. Doesn’t matter
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No
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2. No
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Interaction with audience ➔ more participation
Increases attendance
Faculty perceived more favorably
Able to get audience attitudes and opinions
Collins J. JACR 2008;5:993-1000
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Immediate feedback ➔ Improved teaching
and learning
Provides anonymous peer assessment
Collins J. JACR 2008;5:993-1000
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Portable/wireless system
Easy for participants to learn/use
Can track data anonymously
Flexible so ‘on the fly’ questions can be used
Facilitates CME for SAMS
Fun
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ARS and interactive lectures improve quiz
scores
 Family Medicine Residents
Immediate (%)
1 month (%)
ARS +
96
67
ARS -
61
48
Schackow, et al. Fam Med 2004;36(7):496-504
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ARS and interactive lectures improve quiz
scores
 Radiology Residents
Immediate (%)
3 months (%)
ARS +
76
58
ARS -
60
27
Rubio, et al. AJR:190, June 2008
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Interactive Teaching improves image
interpretation
 Fellow read 15 cases before training and 200 after
didactic lectures.
 Weekly interactive tutorials with experts
compared fellow’s interpretations to pathology
 Interactive training significantly improved
accuracy in tumor localization extension
Akin O, et al. Eur Radiol. 2010 Apr;20(4):995-1002
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Students report positive feedback for ARS
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Improved activity during lectures
Enhanced learning
Easier to ask questions during lectures
Majority enjoy ARS lectures more
Majority feel more engaged
Uhari, et al. BMC Medical Education 2003, 3:12
Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9
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Radiology instruction using ARS builds
 students’ confidence
 knowledge of self-mastery
 insights for future studying
Uhari, et al. BMC Medical Education 2003, 3:12
Nayak, et al. Acad Radiol. 2008 Mar;15(3):383-9
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Instant feedback
 Allows educator to direct lecture and discussion
 Gives trainees information about their knowledge
and performance
 Results in increased satisfaction for both lecturer
and trainee
Steinert & Snell. Med Teacher, Vol. 21, No. 1, 1999
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Autonomous, self-directed learners
 Want to be actively involved in learning
 Can be used to guide knowledge
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Foundation of experience
 Method to relate to life experience through CBT
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Relevancy-oriented/practical
 Practice what learned
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Desire respect
 Gives opportunity for audience to voice opinion and
demonstrate knowledge
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Motivation
 Allows connection of teacher and learner
 Provides avenue for challenging learner
 Provides mechanism for feedback
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Reinforcement
 Practice
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Retention
 Proven to have higher % retention
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Transference
 First step to applying knowledge learned
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Need to transport and set up
Expensive to use/buy/rent
Effectiveness depends on instructor
competence and equipment reliability
Questioning reduces time for lecture content
Time to prepare the lecture long
May be seen as a gimmick/game
Collins. J Am Coll Radiol 2008;5:993-1000
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Best to prepare questions in advance
(can do spontaneous additions)
Files from other software can be difficult to
import
System requires dedicated laptop unless
speaker comfortable with ARS software
Not easy to return to earlier question
Software has learning curve
IT support helpful/necessary?
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Fear of losing control
 Too much freedom for the audience
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Fear of not covering all the information
 Have to reduce facts to incorporate interactive
nature
 Too much information results in less retention
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Time constraints
Steinert & Snell. Med Teacher, Vol. 21, No. 1, 1999
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ARS-based lectures progress slower than
didactic formats
Amount of material covered less than in
didactic formats
ARS may not be designed ideally for
radiology in that MCQs may not be ideal way
to test in radiology
 However, studies show interactive learning helpful
 Need for creativity in CBT
Nicholson and Bassignani. Unpublished data (UVa)
ARS
1. Vanilla
2. Chocolate
3. Chocolate Cookie Dough
4. Mint Chocolate Chip
5. Other
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25%
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24%
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Tips to limit negatives and maximize positives
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Promote critical thinking through wording
Make topics/questions relevant to work
Prepare for questions that might arise
Keep simple, short, easy to read
 10-15 seconds time per question
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Vary question types
 MC, T/F, yes/no, Likert opinion
Collins. J Am Coll Radiol 2008;5:993-1000
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Number options 1 to 10
Incorporate time for questions/discussion of
options
 Average 5 minutes per question
 Range is broad (many factors)
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Insert question every 10 to 20 minutes
Provide instructions to audience prior to
beginning
Arrive early to review ARS and prevent IT
issues
Collins. J Am Coll Radiol 2008;5:993-1000
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Impromptu questions
More than one answer options
 Choose all that apply
 Rank order
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See ARS staff
Anonymous record keeping for follow up
Team play
 Involve audiences to pick teams
 Assign points for questions/answers
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Fastest responder
CME, SAM testing
Worst is Over………..