Reflections on Assessment PatK

November 8, 2010 / Pat Karlovitz

Final Project

Here is a link to my final project.

http://physicianonlinelearningcourse.weebly.com/

October 31, 2010 / Pat Karlovitz

Reflection Week 6:Making a course more learner-centric

Reflections Week 6

The constructivism article was so helpful especially the Module. I want to keep the vocabulary and concepts at my finger tips.

Design the course to include these concepts:

Actively construct their own knowledge, self-awareness, student goals, student controlled learning, primary data, authenticity, real-world complexity, social negotiation, collaboration, previous knowledge constructions, beliefs and attitudes, problem-solving, higher-order thinking skills, allow errors and exploration, apprenticeship, collaborative, cooperative learning, scaffolding.

Succinct module

Koohang (2009): The design of learning activities included collaboration, cooperation, multiple perspectives, real world examples, scaffolding, self-reflection, multiple representations of ideas, and social negotiation.

The learning assessment elements consisted of instructor assessment, collaborative assessment,

and self-assessment. The instructor’s roles were coaching, guiding, mentoring, acknowledging,

providing feedback, and assessing student learning.

I would like to make some changes to the EMR course for Physicians. So here are my discussion note and survey to use in my final project.

I need to get more information (Zoomerang survey) from the physicians prior to class: their expectations for this class, their knowledge base, their specialties, and their concern about the technology, what they want and expect to learn, and what their current workflow is when using the non-electronic medical record. ? . I need to ask if they have any special needs or learning preferences. Do they want the choice of a live class? I would ask them how much time they could devote to this class and what kind of help and support would they expect. Currently they have the Help Desk for the technology piece but that’s it.

What are your preferred methods of learning new information?

What type of assistance, support, or information do you anticipate/need to successfully complete the online course?
How long have you been a physician (DO, APN, PA etc)?
How much and type of previous experience have you had using an EMR?
What are your personal goals for use of the EMR?
What EMR information and functionality will you need for your role?
How do you define effective use of the EMR?
What is a typical diagnosis/problem or planned procedure for your patients?
What pros and cons do you have regarding the use of an EMR?
What type of post class assistance will help you to more efficiently use the EMR in the care of your patient?

I need to work with leadership to provide more support and resources (cybercoaching) for them such as the choice of Email, chat area for cooperative learning and discussion, trainer access via pager or phone or appointment. I would like to create scaffolding support using outlines, checklists and the mind maps. I would like them to see the objectives and assessment criteria prior to class to see if they had any questions. I think it would be really great to have our simulated assessment gives feedback in a formative assessment that tell the user specific areas of weakness and what they can do about this: help as above, review pertinent demo and practice lessons and documents .

My Zoomerang Survey

http://www.zoomerang.com/Survey/WEB22BEBY64CL7

Pat Karlovitz

October 25, 2010 / Pat Karlovitz

Refections Week 5

Reflections week 5

This week we saw how Bloom taxonomy can be used to create assess higher levels of learning. The alignment of the suggested verbs with the level of learning is very helpful to creating objectives that are more authentic and performances based. I used the taxonomy to update the objectives I have been working on.

Remembering:

Able to open the correct patient encounter

Open the EMR
Log in
Select the correct patient
Open the correct Encounter
- Open the correct patient chart
- Select Patient Station
- Type the patient name Last,first
- Press enter
- Select the correct Admission encounter

Understating:

Able to demonstrate understanding of confidentiality issue by answering questions

Review the confidentiality lesson
Answer the confidentiality questions

Applying

Demonstrate the ability to enter accurate medication in the correct EMR.

Click on the Order Entry activity
Medications Activity
In the new order field type: Lopressor
Press Search
Select and Accept Lopressor 50mg
Open the order Summary Sentence
Select the Indications: MI
Check dose>Frequency: BID
Change Durations to First Dose Include Now
Review Start Times
Accept details
Sign orders

Analyzing

Update the patient EMR to include the patient’s current problem-based treatment plan.

Review lab, procedure and notes prior to selecting a note
Open Problem List activity
Type Problem: Heart Attack
Set Details as Medium Priority and Principal Problem
Add pertinent Lab results Troponin level
Add Heart Medication: Lopressor 50 MG
Accept.

Evaluating

Able to determine need for continued learning based on self evaluating of retention and efficiency of utilizing the EMR

Complete the simulated assessment
Evaluate your learning in the post class survey
Evaluate need for learning and practice and take the necessary steps
Determine amount of help and practice need
Call a trainer for one-on-one mentoring
Utilizes the Tip and Tricks information when using the EMR
Uses the EMR Practice environment to continue to learn
Review the Online course based of self assessment of learning

Creating

Create a progress note the demonstrate the treatment plan and patient progress based on the patient current health care record Completing the above activities,

Open Notes activity
Click on the Progress Note tab
Select New Note from toolbar
Type in dot phrases .probl
Press Enter
Complete variables
Accept Note

The reluctant professor used the following technology for his online course:

1) A simple website to serve as a gateway to the course, rather than a formal course management system, 2) blogs for team discussions, 3) podcasts (and optional RSS feeds), 4) GoogleDocs for collaborative work and the grade-sheet posting, and 5) an online webinar application for guest speakers.

I like the simplicity and ease of use for completing this course plus the cost savings over an expensive LMS.

Where I work we do not have audio access, and our server blocks Pod casts.

I think it would be unrealistic to require my students (very busy physicians) “to post to both team blogs a minimum of once a day.”

However, that much involvement would enhance learning if it could be accomplished. I think the use of multiple media and the instructor’s involvement in the new online process also enhanced the learning.

The plagiarism articles: Give credit and cite sources. Give your interpretation.

Explain that your students must retain the essential ideas of the original, but significantly change the style and grammatical structure to fit in the context of their argument. You may also want to send your students to” www.Plagarism.org

One way to prevent cheating is to assign pieces of the final project over a wider time frame.

Let your students know that

You will become familiar with their work
You can use a program to test for plagiarized text

Use Turnitin.com, which takes 24 hours to get results or Eve 2 that gives the results in fifteen minutes or less (instead of 24 hours). If the paper is saved as a text file and then scanned, Eve 2 will pinpoint which passages are plagiarized and even list the website (or websites) that the passages came from.: http://www.canexus.com/eve/index.shtml.

Making Education double Count by Laurel Felt

It is very apparent that objectives should address social and emotional learning.

Here are the ones I created for my students (Physicians)

October 18, 2010 / Pat Karlovitz

Reflections on Module 4 and the Midterm

Reflections on Module 4 and the Midterm

We used the Jigsaw procedure to create a toolbox of assessment tools for a course. We have chosen three tools and then each member of our group research the tools. Then we combined the research and created a summary of what we learned regarding the assessment tools.

The three tools were Zoomerang, Groove and Live Journal.

I chose Zoomerang because I have access to it at work. We use it mainly as a post class evaluation and assessment of learning based on the objectives of the course. We use other assessment tools that are more data driven: Qarbon and Flash simulated EMR Assessments posted on the LMS.

The post class Zoomerang eval is the only place where we get feedback on the course content for the users view point. We recently cut back on the number of questions so we do not get as much information.

But I am going to work improving the post class evaluations s based on the following:

Were the needs of a diverse audience met such as ESL, ethnicity, computer literacy, specialty workflows, socioeconomic ( access and technology issues) different learning styles
Was Simulated Competency assessment of the course a good performance assessment of what they need to know to do their work
Was it an authentic assessment of the course objectives
Was the online course seamless in meeting the course objectives and goal
Were you able to get help and answers to you question in a timely manner
Does the course objective meet the standards for using an EMR

Performance assessment versus standard tests

When we first started teaching clinicians on the use of the EMR, we had to decide on a way to test users. We chose to not only use a question and answer format but also require students to complete an EMR based on tasks related to our course objectives. It has worked really well since we teach it in the course, they practice it and then complete a true authentic performance assessment.

Unfortunately, our clinical population is very diverse so we are not yet able to creates small relevant chunks of course material and only teach and test to what they need for their role. But I think this should change. We need smaller chucks of information and smaller chunks of assessment. They would benefit from group work during the workflow based practices exercises.

Users need more help for online questions. No one is assigned to this role.

We should provide for these users of our online course that cannot type, do not see well and have fear of using the technology involved all of which affect their learning.

I would like to increase the use of available technology to give more feedback to our users during their online assessment as well as generate areas of weakness for post class mentoring. I think using a mind map would also be good feedback about where they are and where they are headed in the course. We do provide post online class trainers as needed but I think some users would benefit from a live course review and a more blended approach when not able comfortable after taking the online course. They need choices.

Excel for beginners

How perfect for me: the clear steps were great and I like that is created a graph. I will be using this!

Objectives

I am still having a little trouble with some pieces of the assignment this week. My tools objectives were for any course, my EMR course objectives are in my mind map. I will need to think about this. My EMR course in not a “traditional school” course: it is a corporate technology course. Maybe I should change my objectives.

October 13, 2010 / Pat Karlovitz

Complete and Accurate EMR

Goal: Complete and accurate EMR

October 12, 2010 / Pat Karlovitz

Reflections week 3

Reflections week 3

What technology could be used for train clinicians to use the EMR in a hospital setting that has limited access to servers, blogs and audio among other technology.

Start by creating engaging content based on good instructional design delivered by the fowling technologies. Also make sure the users are comfortable with these technologies and they work seamlessly.

Using Bonk’ s article numbers as a reference,

#2 Consider assistive technologies for users with disabilities: unable to read smaller print, type or hear.

#4 Provide asynchronous discussion forums for users who like to share best practice with other users of the EMR system. Provide a question and answer area for the users to ask the experts. (Links to Jaws or Dragon) . Will also provide the opportunity to discuss course content and other articles and information posted regarding the use of the EMR. (http://www.webcrossing.com/Home/ , http://www.novell.com/promo/sitescape.html , http://www.caucuscare.com/ and http://www.ubbcentral.com/ )

#5 We have anew course management system http://www.cornerstoneondemand.com/lms-learning-management That will allow users to access our elearning and provide additional feature and feedback to user and staff. Also I would like to try http://moodle.org/ again and compare it to http://sakaiproject.org/ for continuing learning with new staff and student nurses. We loose contact with these people after class. We could optimize their use of the system post class.

#6 I would love to create (or find) a Digital Library on e-learning and instructional design to allow my fellow trainer a place to go when they have time or need to find pertinent articles on E-learning, I think our whole team needs to continue to learn about ID as it pertain to ILT or e-learning and an easily searchable just-in-time library is just the answer. I had trouble find the website for www.libraryshare.com

#8 The use of portfolios can provide online displays of one’s learning or work in one or more areas. Good sites to review to see what is possible for a personal training site. Can be accessed and edited as you find newer and better material. Links are automatically be updated by their users so the info would be more current than a document

Alverno College: http://ddp.alverno.edu
IUPUI’s Institutional ePortfolio: www.iport.iupui.edu
Minnesota efolio project: www.efoliomn.com)Digital http://www.merlot.org/merlot/index.htm.
www.trainingshare.com/resources/links.htm for products to use to display your work.

#12 Instructor Portals online Web sites wherein lecturers, professors, and support staff can share and find information that might help them teach better or connect one’s class to other classes around the globe. Good sites for a TTT class and also to support continuing learning and resource sites for our trainers. Trainers ask where they can go to find information or complete a course or certificate .

Free instructor resources sites

#15 and 23 I think when we have changes in our system or optimization or train “Meaningful Use”, we should consider video conferencing to all sites. We could create a weekly, biweekly or monthly schedule to keep users abreast of changes as well as allow them to ask questions and share best use.

#17 Create online quizzes and Exams for less formal learning or less critical changes and upgrade checks.We could post the quizzes in our LMS and the managers can check compliance and completion scores. We could recommend follow up documents or training if unsuccessful. Stand alone products include Questionmark, Test.com, and Principia Product . Results can also be linked to digital portfolios and online gradebook tools.

#18 Online survey and polling can be used before and after a class to get assessment and opinion result for additional training or changes to the curriculum. For efficiencies, use survey reminders, survey scheduling, and the sharing of results.

Products include InfoPoll, WebSurveyor, Zoomerang, KeySurvey, SurveyKey, SurveyPro, and SurveyShare

#2.2.2 Online Mentoring for providing a site to ask questions from the experts and also share information.

questions sent to experts and responses received via email, synchronous chats with experts at set times(need extra resources or use our current staff)
expert evaluations on meaningful use and best practice and optimization
support expert feedback and mentoring

Epic system already provides some of the expertise and communication with other users. https://userweb.epic.com/all/uweblogin/login.aspx?ReturnUrl=%2f

Example of a site is:

http://tappedin.org/tappedin/

K-12 teachers, librarians, administrators, and professional development staff, as well as university faculty, students, and researchers gather here to learn, collaborate, share, and support one another.

http://inkido.indiana.edu/mikeb/portfolio/teachered_ilf.html

Web based, professional development system designed to support a community of in-service and pre-service mathematics and science teachers sharing, improving, and creating inquiry based pedagogical practices.

Use “Jigsaw” to help all trainers learn changes and upgrades

Jigsaw was originally developed by Elliot Aronson (1978).it is a cooperative learning lesson design. Each trainer on the team will research and test a part of the change to the EMR system. Each trainer is then responsible for teaching their section to the other trainers on the team. When all the pieces are put together, the trainers should have the whole picture – hence the name, Jigsaw. This is what we already do but it is nice to have a name for it and a reason for doing it. I think also that each trainer should create assessment pieces covering their content. Then all trainers need complete the entire assessment to see if they have learned the new material.

October 3, 2010 / Pat Karlovitz

Assessments and Learning, module 2 reflections

Reflections: Module 2

Student Centered learning and assessment

I think the student-centered learning related to assessment is an ideal to strive for. I can see challenges.

It requires student to be active, self directed and responsible for their learning. Non-traditional learners may not be comfortable with this as they are use to a more receptive role: they are less computer literate, and have more time constraints with families and jobs, It is harder for me since I do not type fast enough to express myself. I also cannot spend any free work time on this since all blogs are blocked on our work server as are many other sites.

But when basing instructional design on student –centered assessments, these issue could be addressed early through discussion and reflection. They would be able to connect ( and be engaged)with other students who have addressed similar issue and found solutions, strengthening the Social and Cognitive presence indicators and learning online.

I really resonated with the vocabulary and terms this week: Authentic, social constructivist, engaging, participatory, value, collective and distributive intelligence. They help me to focus on the instructional design goals.

Making meaning and transfer of meaning. Grant Wiggins and Jay McTighe

How this information can be transferred to my adult EMR classes for clinicians in a hospital setting

The intent of training use of the EMR is not that that leaner knows only what is discussed and practiced in 1-2 day class but that they also learn the skills necessary to address other situations that require documentation and use of the EMR, that they understand the meaning of accurate and timely documentation and that that can transfer that meaning to other events and patients plus changes that occur at any upgrade to the system.

We need to create different instructional design to our classes : different sequence and a more meaningful sequence. Start with early and continued engagement in relevant real life situation and content; promoting understating and rigor at the same time.

Following Wiggins an McTighue’s “ A More Meaning Sequence”

(Inpatient Epic Physician class 2 days)

Begin with Hook Problem: How can you utilize the EMR to make an informed treatment plan, locate pertinent information, write notes, update the record and create orders?
Introduce essential questions: Where to locate the most recent information? Where and how can you write a note? How can I enter orders for admission transfer and discharge utilizing the order history already in the EMR? How (and why) can I add to body of knowledge for other providers in the healthcare record of this patient ?
Preview the culminating performance task: An up-to-date comprehensive record of the patient’s current condition, treatment plan and care.
Provide direct instruction: The navigation in the EMR to locate information , the functionality to write a comprehensive note. Where and how to update the patient’s history and problems. The functionality for entering an accurate order.
Provide opportunities for further discussion: What are the users typical workflow, What other information do they need or want to know. How can the user optimize their use of the EMR? What additional help or information is provided post class in the clinical setting? What other documents will help in the use of the system post class? Where can they get help if they have a problem in the EMR?
Provide an application task: As a practice exercise in a training patient’s EMR: Locate information on the patient’s recent lab work, past medical history and medication history to write a note on the treatment plan, update the problem list and create orders.
Lead a whole-class discussion: Discuss the exercises in depth, what issues do you have with using an EMR, what concerns do you have post class, what additional help will you need to be successful in using the EMR?
Provide a small group application: Group similar specialties together: What is your workflow and how will you use the EMR for that workflow?
Revisit the original hook problem: How can you utilize the EMR to make an informed treatment plan, locate pertinent information, write notes, update the record and create orders? Do you want to review and practice anything to achieve this performance task
Assign the final performance task: Ask the user to go into the EMR (practice patient in the training environment) and locate specific information, update the EMR (History and problems and notes) and add order
Give student an opportunity to reflect the essential questions: Post performance task talk about what was helpful and what was not useful for them, what additional information or help is still needed.

My EMR course design needs to include more time for review, discussion and individual and group performance tasks, and less didactic instruction. Build the course with more time for individual help, exercises and practice that would encourage more active participation. And most importantly, “provide a safety net for all types of learners”; those that are having trouble need continuing assessment of their needs and provisions for their learning via individual coaching.

In the article by Hunley and Schaller “The Key to Creating Spaces That promote Learning”, I feel strongly about these statements:

Stimulate positive emotional responses interest and enjoyment and encourage feeling of autonomy and competence with challenging task. Add learning contexts tat incorporate high-quality opportunities for independent and social activities likely to hold the attention for adult learners. Assessment has a relationship between space and pedagogy, programming and content.

To me this mean that assessment should include not only the leaner-centered content (engagement, relevance, rigor and enjoyment built into the ID), but meeting the emotional needs such as an appropriate conducive learning space: a learning environment that includes trust, respect, social, individual needs assessed before, during and after the learning event,

“Adult learning processes are ideally self regulated, planned, spiral, and reflective behavior change.” The challenge is to provide a learning experience that allows them to do that in a limited time frame, place, time and content. Since doctors are very busy, they need to leave class transformed: see the need, relevance and value of utilizing the EMR to it’s maximum efficiency in providing a viable, accurate patient record and treatment plan.