AT&T Fellows Final Report: Mark Frank

AT&T Fellows Final Reports

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Name	Mark S. Frank, M.D.
Title	Professor
Department	Diagnostic Radiology
Campus	School of Medicine / IU Medical Center
Project Title	Application of a new education technology to create a web-centric core curriculum in diagnostic radiology for fourth-year medical students at Indiana University School of Medicine
Project Goal	Use an innovative software system to create a dynamic a
Type of Technology Used in the Project	Software framework called EDACTIC. (See http://edactic.com)

Executive Summary of Results

The project has been successful in providing an innovative and well-liked online curriculum for senior medical students. The underlying education technology subsequently has grown in both capabilities and breadth of application, and is used nationally by medical centers and medical societies.

Need for the Project

Education in medicine has come under tremendous pressures. Healthcare providers, including those in teaching hospitals, face expectations of ever-greater clinical productivity, and consequently have less time for in-person interaction with their learners. This project (a fully functional proof-of-concept) was intended to show how new education technology can help physicians as educators, and teaching hospitals as educational institutions, to become more efficient in terms of their educational productivity and the subsequent impact of their efforts.

Use of Technology

We used a digital-content management and online education framework called EDACTIC to show how educators, with the appropriate technology at hand, can quickly and inexpensively teach what they want to teach online in the style they want to teach it,simulating real-life scenarios and interactions, reaching as many of their constituency as possible, thus providing a rich and enduring on-demand message for their learners wherever and whenever they are.

Instructional Design Plan

It might come as no surprise when exasperated educators in healthcare ask:

“Without having to actually be there, how can I lead a resident, medical student, or nursing student through a case-based clinical scenario, incrementally revealing information, providing not only text but also rich media such as sequences of images or digital videos? How can I challenge and engage the learner by interspersing within my content, at will, any number of dynamic, situation-specific, question-and-answer episodes with immediate feedback, placing my pupil in a learning environment that simulates in-person interaction with me? How can I make my curriculum dynamically adapt and alter itself in response to a learner's performance? How can I do this quickly and self-sufficiently, and then make revisions with point-and-click whenever it suits me and also instantly have those revisions be manifest in my learners’ material? How can I conveniently create, manage, and assemble 30 or 50 such case-based exercises into a curriculum and then expand, contract, or otherwise revise this curriculum whenever I want?How can I assess my learners’ competency and determine how well each one is doing?”

Thus was born EDACTIC, and it was designed with this teaching approach in mind.

Potential to Impact Student Learning

The approach we use enables educators to embody not only their knowledge, but also their teaching style, within their electronic content when delivered over the Internet. Each educational entity, whether a “case”, “tutorial”, “chapter”, or “test” (whatever the author chooses to create) can be customized and choreographed to meet the specific learning objectives of that component of course work. Dynamic interactive questions with immediate feedback can be interspersed at will throughout such material to test and guide learners, and an audit trail of performance and learning is automatically maintained. Objective competency testing is a built-in capability of the framework, and we use this for key components of our residency curriculum. On a broader scale, a learning audience can be virtually any size, yet each learner experiences bi-directional interaction that simulates being in the presence of the teacher.

Among reasons why this approach has become a cornerstone for competency testing within our residency program are: 1) Resident is tested at distinguishing normal vs abnormal in addition to being tested on truly abnormal findings, 2) Coursework provides a realistic and engaging learning environment that simulates point-of care, 3) System provides real-time perspectives of self-vs-peers and self-vs-historical-self in order to offer improved objectivity when compared to anecdotal and sporadic evaluation of learning often characteristic of residency training, and 4) The education framework facilitates mass-production and delivery of highly customized coursework without requiring additional software programming and related costs

We now have online several curricula for medical students and residents. This includes a "What to order When" curriculum, an "Introduction to Radiology" curriculum, an objective self-assessment curriculum for residents preparing to take call, and about 18 (so important to our residents) board-review curricula spanning the subspecialties within radiology

EDACTIC can be used for education in all aspects of medicine, as well as for non-medical applications. Its capability to enable use of customized teaching approaches, provide performance tracking, and to embody different interactive styles can be applied to learning in virtually any domain. We have licensed the technology to other medical centers, commercial dot-coms, and national medical societies.

Assessment Plan

For medical student education, at end of rotation, we used subjective assessment, asking students to rank from 1-5 (5 highest) their online curricula as part of their evaluation of the overall rotation in radiology. The medical student curricula consistently ranked 4.5 of possible 5 in medical student evaluations, with recurring free-text comments describing it as the best part of their experience on the rotation.

Plan for Colleague Development

Since the inception of our involvement with the Ameritech Fellow's Program, we have mentored several junior faculty and residents (including 2 residents who helped create the medical student curricula) on their way to becoming physician educators. The EDACTIC framework is also used nationally. For example, during the first two weeks of June, 2006, the American College of Radiology (measuring with WebTrends software) recorded an average of 5100 visiters per day to its peer-reviewed EDACTIC-powered education site (http://CaseInPoint.acr.org) with an average of 45,000 page views per day. As of June 2006, over 200 radiologist educators from 56 USA teaching institutions who contribute to this online learning resource have enjoyed the fulfillment of reaching a daily constituency of 5000+ and providing to them a fun, engaging, and high-quality online learning experience made possible by EDACTIC.

Final Comments on Project Results

We are indebted to the Ameritech / SBC (now ATT) Fellow's program. Their support of our initiative with online learning for Medical Students has resulted in a very well-liked online curriculum and it motivated us to expand the uses of EDACTIC for both our local community of physician educators as well as on a national basis.

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