Module A – Inquiry E-folio

Interview with Dr C – excerpts and analysis

The following are excerpts from my interview with Dr S. She is a maternal fetal medicine specialist and an associate professor at the University of Alberta. She has been teaching for 14 years. On the left, you will find the interview excerpts and on the right will be my reflections based on the responses.

How have you integrated technology into your teaching activities? I am interested in trying to keep update with technology and have been trying to be enthusiastic adopter. However, I do feel that I am sort of a luddite. I mostly use PowerPoint or film. I have also tried blended learning, but this is difficult for didactic sessions because it requires students to allocate extra time for them to prepare for blended learning environment to be successful. I have recently started exploring use of whiteboard technology and do YouTube videos to incorporate that type of technology to teaching but it is still in the fetal stage of development.	Examining Dr C’s response, it highlights that the use of technology in medical education, at least at the undergraduate level is quite limited. A lot of it is still passive learning, where the students just listen to the instructor, though technology has allowed a variety in the medium that this information is delivered. Blended learning, in principle, does incorporate some active learning, but she has identified some challenges with it. It makes me wonder if we need to expand our minds a little bit and stop confining ourselves to the traditional “lecture theatre”.
What has been the impact on both yourself as well as your learners, of integrating technology into teaching activities? I feel that there hasn’t been much of an impact. This is because the technology that I have been using has been around for a long time. I have made some of my PowerPoint lectures into Vodcast format and the feedback has been mixed. I have tried to make it interactive by having worksheets that they can fill in as they follow along and again the feedback has been mixed. I feel that it is learner dependent on whether they prefer that format versus a person physically there talking to them the whole lecture. And that’s the only feedback I have gotten on the technologies I have used.	It seems to me that Dr C is a little frustrated at the current situation. But the lack of positive feedback could be attributed to the fact that besides the medium, the way knowledge is acquired is not any different. The information is still delivered in a linear fashion, from teacher to student. This is a very knowledge-centred method of teaching and learning
What kind of challenges have you encountered while integrating technology into your teaching, and how did you or do you plan to overcome these challenges? My main challenge is time. I’m a very busy clinician and the patient practice sometimes makes it difficult to coordinate time to learn some of the new technologies. I think the other barrier is the geographic separation of our department from the main teaching site in our city.	Dr C identified two challenges for her in regards to integrating tech into her teaching, which were time and geographical separation from the main teaching site. One solution would be for some of the faculty development on tech and learning to be offered via online modules or with the use of other elearning modalities that are independent of time and location. There is definitely room for improvement in this regard.
Can you elaborate on how you think technology could actually enhance learning? I think there’s a lot of information to cover in a short amount of time. If you could have them review some of the concepts, and you can have a mixed bag of how you provide that content, I think if they could do that ahead of time, you aren’t starting from zero when introducing or doing a topic. I think that’s one way that technology can enhance learning. Things like vodcasts can enhance learning, as people learn in different ways. Some people are auditory learners some people are visual learners, so for those individuals who are auditory learners being able to hear someone explaining the concepts and doing it at their own pace does enhance their learning	Dr C concentrates on delivering information using different media to accommodate student learning differences. But in my opinion it is still very knowledge-centred as opposed to learner-centred, with minimal use of active learning strategies. Can this really lead to deeper level of understanding? I think in these cases, we are underutilizing technology.
When you decide to integrate technology, what are your main goals? My main goals are to make it interesting and to make it in a format that maybe the learners more used to learning from. So I think sometimes just learning material without any extra visuals or examples or other types of technology can make it maybe not so exciting to learn. And maybe easier concepts to be embedded if could anchor them with a particular symbol or particular examples.	Again, Dr C uses technology to represent information in different formats, but this use of technology is still very knowledge-centred.

I had a few more questions I asked but due to word count limitations, I will stop at the above. The interview highlighted to me that use of technology in large medical school classes is limited in terms of active learning and constructivist strategies. I would like to further explore how technology could be used more effectively in the large class setting, to promote a greater degree of active learning. Similar to many of my peers in this class, time commitment to learn new technologies is highlighted during my interview. Another area to explore would be faculty development in these areas and how it could be improved to help educators with e-tech integration and use.

Video cases

So this week’s task was to view some videos and analyze them in the context of technology use in the classroom.

The first video I watched was case 1. This involved a STEM curriculum teacher demonstrating the use of technology in his classroom. The students learned about making crystals, the properties that were required for this task, as well as thermodynamics. Then they moved on to the project, which was to create a chamber that would facilitate crystal growth. Students were required to learn how to use the arduino platform to regulate temperature, incorporating some computer science and engineering into their project. In one project, they learned a vast number of skills and gained knowledge, both foundational and application. I was extremely impressed with the capability of these students, and realized my own biases towards students of this age group. Perhaps I have been so far removed from secondary students, I underestimated their development and potential.

The next video I watched was case 7. It was the only video that demonstrated use of technology in the post secondary environment. As a faculty member at a university, I thought this would be most applicable to myself. The video was about the use of clicker technology during class, and how it could be used to make the lecture more engaging and interactive. Personally I have used clickers in my lectures as well. One issue that came up while viewing this video was that the quality of the interaction and discussion is dependent on the question that is posed by the lecturer. This dictates whether or not misconceptions would be uncovered or how much discussion will be generated. Therefore, it can be variable based on what the lecturer believes to be important questions to ask. This, as we have seen from our own assumptions and biases, can be problematic as misconceptions that we may not have anticipated or perceived by continue to go unnoticed or addressed. Another issue that I have experienced personally was the level of participation. Once the novelty of the technology wore off, I noted that the level of participation dropped off. Many students “forgot” to bring their iclicker to class, and despite having over 100 students, only 24 were participating at my last iclicker lecture. This may not be representative of the class and thus certain misconceptions may again go uncovered.

Finally, I watched case 6 as this was in the area of life sciences, which is also applicable to me and my area of practice. In this video, the teacher got students to create animations, powerpoint presentations and podcasts/videos about certain topics that they were learning about. What stood out to me about this video was that the technology used had nothing to do with the topic being studied. So my question was does the use of technology in this manner actually lead to a deeper understanding of the material? The teacher in this video stated that the students were more engaged in the activity, but does this actually equate to deeper meaning and ability to apply this learned material? Are they only engaged in the technology component of the activity? Certainly it promotes collaboration and can uncover some misconceptions but because these projects can be time consuming, it is important to be able to answer this question.

My thoughts on Heather’s challenges and misconceptions

Heather’s challenges
It was really interesting to see Heather before and after formal instruction. Heather is really confident about her theories regarding the seasons, earth’s rotation and the phases of the moon. Then she is confronted with contradicting information, which challenged her own conceptions. Surprisingly, she modified some theories (such as the rotation of the earth around the sun) but held on to other theories (such as her definition of direct and indirect light). Heather’s own theories must have been derived from her prior experience, readings or teaching which she incorporated into her knowledge base. As Driver et al. points out in Children’s Ideas In Science, these ideas and interpretations are personal and sone ideas remain stable (like the direct and indirect light idea), such that formal instruction did not modify her ideas.

Seafood allergy and iodine
A commonly held misconception in medicine is the link between seafood and/or shellfish allergy and iodine. I encounter this quite often as I am a surgeon and we use povidone-iodine as a topical antiseptic that is applied to the skin or other tissues before surgery. I’m not sure where it comes from but many physicians and nurses believe that seafood and/or shellfish allergy is a contraindication to the use of iodine. It seems to be a commonly held belief that is perpetuated in both disciplines. And no matter how much evidence to the contrary is presented, the operating room management refuses to recognize the safety of its use in this population of patients. This misunderstanding likely stems from the fact that seafood and shellfish contain high levels of iodine. But many other foods also contain iodine. In addition, the allergen causing anaphylaxis or other severe allergy with seafood/shellfish is NOT iodine. In fact, we learn in our medical education that iodine is a essential mineral needed for proper thyroid function. Just as in Heather’s example, I can present my colleagues with evidence to the contrary yet their ideas remain stable. I often wonder if these stable ideas are more difficult to change in adults that have completed their education (aside from the mandatory continuing education that is required of our professions). According to Posner et al, who refers to the change in stable ideas as accommodation, there are certain conditions that must be met before accommodation will occur:
1) there must be dissatisfaction with existing conceptions
2) a new conception must be intelligible
3) a new conception must appear initially plausible
4) a new concept should suggest the possibility of a fruitful research program

Given the above, I think the greatest barrier is dissatisfaction with existing conceptions. It seems that there isn’t enough motivation to change their existing conceptions, because there is minimal dissatisfaction with what they believe. One way to address this using digital technology is to use something like simulation to visually show the difference between using povidone-iodine as a skin preparation versus the alternative that is currently used in patients that have shellfish/seafood allergies. Or a visual presentation on molecular mechanism of seafood/shellfish allergy to demonstrate that their ideas are in direct contradiction to scientific findings. Just having a conversation without hands-on activities to engage them may not be effective.

While looking into misconceptions in medical education, I came across a really interesting article that looked at novice biology teachers, and their misconceptions (Yip, 1998). According to this article misconceptions in science after formal instruction can be categorized into three groups:
1) informal ideas formed from everyday experiences which children bring with them to the classroom
2) incomplete or improper views developed by students during classroom instruction
3) erroneous concepts propagated by teachers as well as textbooks.

Yip states that for many complex and abstract phenomena, such as mechanisms of circulation and other medical topics, children are less likely to develop their own explanations/ideas because they would be unlikely to come in direct contact with these topics in daily life. Thus, these misconceptions are derived from the latter two categories. In Yip’s study of 26 secondary biology teachers (all university graduates with majors in biological science), he identified many basic biological concepts that were misunderstood by them. Some of these misconceptions were a result of oversimplification of concepts and erroneous information propagated in some text books, as well as misuse or imprecise use of terminology. Perhaps this is another area that should be explored when looking into the origins of students’ misconceptions.

* Driver, R., Guesne, E., & Tiberghien, A. (1985). Children’s ideas and the learning of science. Children’s ideas in science, 1-9. Available online: search the title using any engine. https://staff.fnwi.uva.nl/e.joling/vakdidactiek/documenten/driver.pdf
* Posner, G. J., Strike, K. A., Hewson, P. W. and Gertzog, W. A. (1982). Accommodation of a scientific conception: Toward a theory of conceptual change. Sci. Ed., 66: 211–227
* Yip, D. (1998). Identification of misconceptions in novice biology teachers and remedial strategies for improving biology learning. International Journal of Science Education. 20:4. 461-411. http://dx.doi.org/10.1080/0950069980200406

Unpacking assumptions

When I initially reflected on these questions, I didn’t think there was much from my own experience that constituted “good” use of technology in the (medical) science classroom. Most of the technology used in our classroom (which is actually a lecture theatre) is powerpoint, LMS, vodcasts etc. Though this has increased accessibility to lecture material and allows students to learn in different environments and at their convenience, it’s still a didactic process and doesn’t fit with constructivist learning theories. But, medical education goes beyond the lecture theatre. Students and instructors are now using social media, high and low fidelity simulators, apps and games, as well as google docs to create collaborative pieces of work. When I consider these technologies, I feel that it is an effective tool in medical education. When I think about “good” use of digital technology, I always refer back to Chickering’s 7 principles. I can’t remember them all but some of these principles include student collaboration, active learning, and interactions between faculty and students. Social media, simulators, apps/games, as well as google docs all promote at least one of these seven principles.

When considering medical education, especially at the pre clerkship level the greatest challenge that I perceive is the large class sizes. At my institution, one class has approximately 160 students. To promote the use of chickering’s 7 principles in the context of digital technologies, it may require more small group work and facilitation of sessions by multiple faculty (as opposed to one lecturer). This model also presents a challenge as finding multiple faculty members is difficult considering that many teaching faculty in medicine are either part time or full time clinicians.