Thesis: “Educators will (should) stop insisting on the inequality of outcomes”

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In the following series of videos, Dr. Bill Cope of the College of Education at the University of Illinois, calls for educators to move away from student assessments that attempt to put students along a bell-shaped curve of educational achievement, seeking rather to move all students towards similar proficiency (mastery).

Parts 3 and 4 describe in detail the social learning platform that we have employed with veterinary students to analyze their ability to write a case analysis, perform peer reviews of each others work, and even self-reflect on their own engagement in improvement of their work. In other words, rather than evaluate only a single timepoint of the “final product,” the student’s progress and participation in identifying communication or content issues with other students’ work and seeks to lead to a more uniform high quality outcome for all students following review and revision of a first draft.
As a participating instructor and collaborator of Dr. Cope, I should add that our goal was to improve all students’ ability to reflect and think critically about what they know and don’t know, and to teach them about the practical aspects of evidence-based medicine. To be honest, our experience with first year veterinary students was similar to that described by academics attempting to teaching evidence-based medicine at 22 North American veterinary schools described in the J. Vet Med Education paper on which I commented in the previous blog post. That is, perhaps because it is limited to 5-10% of the students’ instructional time (and yes, participation grade), the critical clinical thinking (problem-solving) exercises do stick out “like a sore thumb” within the largely content and fact-driven curriculum as delivered mostly in lectures. As Dr. Cope points out, the final versions of the student case analyses reflect impressive depth of thought, research and writing for first year veterinary students. Nonetheless, a fundamental question remains for us…if we don’t alter curricular expectations throughout the 4 year experience, can we expect students to take the lesson of team-based peer review and quality assurance from the first year of vet school through into their careers as a problem-solving veterinarian?

With that preamble, I encourage you to at least review the first and last of these short videos to gain an impression of what Dr. Cope is encouraging all educators to consider…that is mastery-based education powered by the affordances of new computational learning platforms.

5.1: Mastery Learning Perspective

5.2: The Not So New School

5.3 Learning Analytics in Scholar – specific example of use of Scholar learning analytics platform to follow veterinary student progress through a case analysis writing project with peer review.

5.4: Visualizing Learning

5.5: Summary: New Learning: Because We Can We Should

Is there a lesson for vet medicine?: “Educating in a Neurodiverse World”

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If you haven’t taken the opportunity before, I encourage you to take a look at the learning platform developed by TED-Ed, as well as to listen to a very insightful presentation by Brian Kinghorn accompanied by review and thought questions, and links allowing the learner to “Dig Deeper” into the subject.  I’ve even added a veterinary medicine-centric open-ended thought question under the “Discuss” section at the end of those by the author of this lesson. I’d be interested in your thoughts posted via that lesson or as comments to this blog post on the following:

How should veterinary medicine consider the neurodiversity amongst its students when designing and refining curricula? In your comments, go beyond the issue of students needing testing accomodations, and consider what Brian Kinghorn notes as the full spectrum of neurodiversity, in particular, how this range of students best learns, and whether progression rates and pathways through a currriculum might be customized. Finally, how might considerations of neurodiversity inform how we should be directing students towards different areas of veterinary medicine?

http://ed.ted.com/on/91TyaCBM

Teaching Evidence-Based Veterinary Medicine

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Shurtz et al. recently published “Teaching Evidence-based Veterinary Medicine in the U.S. and Canada” in the Journal of Veterinary Medical Education.

http://dx.doi.org/10.3138/jvme.1215-199R

The authors reported on their survey of faculty and librarians of 22 out of 35 of the North American veterinary colleges. An average of 4 representatives of each institution responded to questions about where and how they taught evidence-based veterinary medicine (EBVM) in their curricula. They reported that the most common skill taught was literature searching (61%), followed by applying evidence to patient care (48%), critically appraising the literature (40%), formulating a clinical question (38%), and assessment of success of clinical application of evidence (19%). Most of the skills were taught in didactic clinical courses, with the exception of critical appraisal, which was generally taught in basic science courses.

The top 3 information resources they taught and/or students used were PubMed/MEDLINE (96%), CAB Abstracts (42%), and Veterinary Information Network (41%). Surprisingly, librarians were engaged in the instruction only 41% of the time.

The article also asked instructors about the challenges they faced in implementing EBVM instruction. Key problems mentioned were:
1. Students were resistant to use the literature to answer clinical questions.
2. Students often felt that the answers should be provided to them by instructors, not obtained following a search.
3. Faculty and students saw that faculty didn’t often overtly practice EBVM, “relying on their own clinical experiences and expert opinion rather than research-based information.”
4. Students often searched Google and VIN steering toward findings not necessarily focused upon research results.
5. Faculty were resistant to assigning students literature searches on clinical rotations.
6. Faculty just didn’t see that there was enough time for EBVM in the curriculum as it competed with primary content instruction.

Perhaps one quote provided by a survey respondent summarizes the real challenge:
‘‘The veterinary curriculum is overfull. . . . Having too much material to commit to memory leaves little time for students to focus on the critical role of research in advancing clinical practice.’’

So, it appears that most veterinary medical curricula still hold “content as king.” Shouldn’t we be looking for ways to put process such as critical thinking and evaluation of current evidence a bit higher on priority list? Content and knowledge evolve…the practice we might give our students during their training on application of information WILL transfer 5-10 years into the future. Much of the content we assiduously lecture to them about, will NOT.

The above image is based on the EBM Page Generator (2006) from Dartmouth College and Yale University and the Coursera MOOC “Understanding Clinical Research: Behind the Statistics“ (2016)