Clinical Microbiology & Infectious Diseases

Clickers/ARS/CRS/EVS/PRS/Keypads

Workshop for 13th May 2012

A modest contribution from a newcomer to the game

1Colin Block

Clinical Microbiology & Infectious Diseases

Mini-quiz/survey

• How much time did you devote to preparing for this workshop?

A. > 4 hoursB. 3-4 hoursC. 2-3 hoursD. 1-2 hoursE. < 1 hour

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Almost 30 students felt free to admit they invested little or no time in preparing the workshop

My emphases

• Some basic issues

• Item types

• Clickers for the “basic science” segments of the curriculum

• Some examples

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What is this stuff anyway?

• A very seductive idea• A great way of actively involving the students

• A fashion wave?• A respectable technique?

• Do clickers actually make a difference to anything?

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Well?

• It depends…• Some interesting literature

– With mixed results• Much ‘uninteresting’…

– With mixed results

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What do we (I) want from clicker questions?

• Active participation of students (“engagement”)• Active discussion among the students• “Deep” learning and better understanding• Reveal misunderstandings and misconceptions• Improved knowledge retention• Attendance (?), grading, peer grading, etc

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WHAT CAN WE LEARN FROM THE LITERATURE?

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• A study in a Developmental Biology course• Strong case for clicker use in a clearly defined and

deliberate way• Addresses faculty concerns frankly and clearly

– Proposes solutions– Desscribes adaptation away from traditional methods

Electronic voting to encourage interactive lectures: a randomised trial

• Gynaecologists from Australia• Less convinced about the advantages (but

apparently not worse)• Problematic design, but similar studies and

findings do appear in the literature

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Added value?

• An interesting angle• Methodology not well matched to our limited

use of the clickers (but the future is a big place)

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• There is much more

• The next slide offers a useful resource

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A useful resource

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http://cft.vanderbilt.edu/docs/classroom-response-system-clickers-bibliography/

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http://www.podnetwork.org/publications/teachingexcellence/09-10/V21,%20N3%20Bruff.pdf

Bruff contd

• One best answer questions• Student perspective questions• Misconception questions• Peer assessment questions• Why clickers?

– Anonymity in class > safety > honesty > participation in discussion

– Individual responses can be tracked > accountability > grading etc

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He also has a book: Teaching with Classroom Response Systems: Creating Active Learning Environments. Wiley 2009 ISBN: 978-0-470-28893-1

ONE BEST ANSWER

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Which of the following descriptions most closely fits the term “formative assessment”?A. A quiz or test given to a class to enable students and their

teachers to assess their progress in learningB. An evaluation of a course being developed to ensure its

suitability for a group of studentsC. A student’s clinical evaluation of a child’s developmentD. A peer opinion of a teacher’s success in improving his

teaching evaluations by the studentsE. An evaluation of a piece of reflective writing by a student to

assess his perception of his progress

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Which of the following descriptions most closely fits the term “formative assessment”?A. A quiz or test given to a class to enable students and their

teachers to assess their progress in learningB. An evaluation of a course being developed to ensure its

suitability for a group of studentsC. A student’s clinical evaluation of a child’s developmentD. A peer opinion of a teacher’s success in improving his

teaching evaluations by the studentsE. An evaluation of a piece of reflective writing by a student to

assess his perception of his progress

This is quite a subtle question that can be used to generate discussion; the answers could be diagrammed as follows:

LEAST CORRECT -C---D--------------B------E-----A- MOST CORRECT18

STUDENT PERSPECTIVE QUESTIONS

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• We haven’t had a good opportunity yet to design such questions in medical microbiology

• Vaccine refusal will be one area for their use

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REVEALING MISCONCEPTIONS

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Case 3 – Severe pneumonia in a patient with systemic lupus erythematosus on chronic steroid therapy

• A middle-aged woman who has suffered for years with SLE and requires maintenance therapy with corticosteroids finally has an opportunity to take a holiday at a luxury Hotel in Eilat. She returns to her home in Jerusalem feeling relatively well and rested, but after a few days becomes febrile and short of breath and within a short time finds herself in hospital with a severe pneumonia.

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Here is an example from one of our Case Workshops of a question deliberately chosen to expose a common misconception…

The diagnosis reached in the Workshop is Legionnaire’s disease:Legionella pneumophila infection

Here is the relevant question…

14.What is the significance of the patient’s holiday in the clinical story?

.A רבים לאנשים חשיפה

.B באוויר סביבה וחיידקי פטריות נושא אבק של גבוהה רמהבאילת

.C מלון בבית ממוזג לאוויר חשיפה

.D מלון בבית חמים למים חשיפה

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Here is the relevant question…

14.What is the significance of the patient’s holiday in the clinical story?

.A רבים לאנשים חשיפה

.B באוויר סביבה וחיידקי פטריות נושא אבק של גבוהה רמהבאילת

.C מלון בבית ממוזג לאוויר חשיפה

.D מלון בבית חמים למים חשיפה

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This issue is then dealt with in the discussion and the source of the misconception explained

PEER ASSESSMENT

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• The plan is to use for grading peer lectures

• 12 short frontal lectures prepared and delivered by small groups

• Grading

• Competition?

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CLICKERS IN “BASIC SCIENCES”Learning to play the game

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Assessing the Integration of Audience Response System Technology in Teaching of Anatomical

Sciences

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(Genetics)

PROBLEM SOLVING (AND MAYBE SOME ‘CLINICAL’ REASONING?)

Some examples

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) קרוב 1הרופא איבחן קלינית שלחולה הזה (מס' •. במעבדה pneumococcal pneumoniaלוודאי יש

, ומוצאים את ליחה של הצביעת הגרםבודקים את התמונה הבאה.

באיזו מידה תומכים הממצאים באבחנה?

.Aמוכיחים את האבחנה

.Bבעד האבחנה במידה מסוימת

.Cלא משפיעים על האבחנה

.Dנוטים לשלילת האבחנה

.Eשוללים את האבחנה

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X1000

) קרוב 1הרופא איבחן קלינית שלחולה הזה (מס' •. במעבדה pneumococcal pneumoniaלוודאי יש

, ומוצאים את ליחה של הצביעת הגרםבודקים את התמונה הבאה.

באיזו מידה תומכים הממצאים באבחנה?

.Aמוכיחים את האבחנה

.Bבעד האבחנה במידה מסוימת

.Cלא משפיעים על האבחנה

.Dנוטים לשלילת האבחנה

.Eשוללים את האבחנה

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X1000

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מדען ערך ניסוי במסגרת מחקר באלימות חיידק מסוים. הוא הזריק כמויות שונות של החיידק

). להלן A-E עכברים כל אחת (25לקבוצות של התוצאות בתום הניסוי.

כמות ?ID50באיזו קבוצה נקבע ה-•החיידקים

עכברים חולים

עכברים מתים

A 1,000 1 0

B 10,000 3 0

C 100,000 8 2

D 1,000,000 13 6

E 10,000,000 19 13

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מדען ערך ניסוי במסגרת מחקר באלימות חיידק מסוים. הוא הזריק כמויות שונות של החיידק

). להלן A-E עכברים כל אחת (25לקבוצות של התוצאות בתום הניסוי.

כמות ?ID50באיזו קבוצה נקבע ה-•החיידקים

עכברים חולים

עכברים מתים

A 1,000 1 0

B 10,000 3 0

C 100,000 8 2

D 1,000,000 13 6

E 10,000,000 19 13

A very simple example that tests knowledge and a little calculation:- What is “ID”?- What does “50” mean?

A question that tests knowledge and reasoning/ application of knowledge, and encourages learning

של האמה מופיע necrotizing fasciitisבמקרה של הממצא שבתמונה. מהו הגורם למחלה?

.AGroup A beta-hemolytic streptococcus

.BClostridium septicum

.CVibrio vulnificus

.DAeromonas hydrophila.EStreptococcus pyogenes.FEscherichia vulneris

This Q is of NO USE for exams

של האמה מופיע necrotizing fasciitisבמקרה של הממצא שבתמונה. מהו הגורם למחלה?

.AGroup A beta-hemolytic streptococcus

.BClostridium septicum

.CVibrio vulnificus

.DAeromonas hydrophila.EStreptococcus pyogenes.FEscherichia vulneris

This Q is of NO USE for exams

של האמה מופיע necrotizing fasciitisבמקרה של הממצא שבתמונה. מהו הגורם למחלה?

.AGroup A beta-hemolytic streptococcus

.BClostridium septicum

.CVibrio vulnificus

.DAeromonas hydrophila.EStreptococcus pyogenes.FEscherichia vulneris

Knowledge: • All the bugs > necrotizing fasciitis• Group A strep & S. pyogenes are the

sameReasoning and application: • What’s the finding in the photo?• How does it suggest a specific

pathogen from the options?• Which of the organisms produces a

confluent erythematous rash that blanches with pressure?

Learning:• The discussion preceding the voting• The discussion after the voting

Some bottom lines• Join the revolution…• Accept the inevitability of reducing

content– Transfer some of the responsibility for

knowledge acquisition to the students (assignments etc)

• Become knowledgeable in the use of the technique– Unnecessary to replicate others’ past

mistakes– Range of useful applications, even if not

every variation has yet been solidly proven to make better doctors

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