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LKCSoM Clinical and Experimental Sciences Building Fly-Through

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LKCSoM Clinical and Experimental Sciences Building Fly-Through

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The Lee Kong Chian School of Medicine (LKCMedicine) intends to pioneer new programmes and pedagogies, starting with the latest model and the best practices in medical education. The LKCMedicine's educational model with its focus on inter-disciplinary learning, will draw on synergies from the fields of medicine, science, engineering, technology, humanities and business management.

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Re " The Drawn-Out Degree " (Education Life section, Aug. 3):

Before we conclude that medical school is "drawn out," it is important to consider why medical schools have not shortened training time.

First, as long as residencies place a premium on the United States Medical Licensing Exam Step 1 ("the boards") performance, medical schools will be reluctant to undertake radical changes to reduce certain science requirements that may be of little future use to physicians.

Because competitive residencies also value research productivity, it is not uncommon for students to use their fourth year or take an additional year to conduct research.

While medical graduates are older, medical school admissions select for "life experience," meaning that the most desirable medical students are often not directly from college, instead having traveled, volunteered or worked.

To shorten medical training effectively, the entirety of medical training, from premedical education to residency, should be critically examined. After all, while the fourth year of medical school seems easy to eliminate, the additional time for career selection, maturation, skill and professional development is undoubtedly more valuable to a future physician than a fourth year of college.

VINEET ARORA
JEANNE FARNAN
Chicago, Aug. 5, 2014
The writers are associate professors of medicine at the University of Chicago Pritzker School of Medicine. To the Editor:
Don't shorten medical education; revamp it. Most medical students have taken some mix of undergraduate courses in cell biology, physiology, biochemistry and statistics, only to retake them in medical school.

Furthermore, there is inadequate time in the third year of medical school to master the requisite information, while students in the second half of the fourth year frequently resemble high school seniors in that they ease up while awaiting news of residency placement.

Consider tossing the first two years of medical school into a six-year continuum ending in a master's degree in medical science.

Combine the third and fourth year of medical school with the internship into a three-year clinical continuum during which these young medical students accept increasing responsibilities and have sufficient time to become real physicians with more generalized skills before specialty training begins.

These changes will ultimately produce better doctors.

DAVID BRONHEIM
New York, Aug. 3, 2014

The writer is an associate professor of anesthesiology at Mount Sinai School of Medicine.
To the Editor:
As a board-certified cardiologist and a graduate of the Albany Medical College's accelerated seven-year medical program, I applaud your article.

There is a huge shortage of primary care physicians in this country, which has severely affected our country's quality of health care. This is because two-thirds of medical school graduates have more than $150,000 in student debt.

Today, medical students are forced to choose higher earning specialties like orthopedic surgery and anesthesiology over primary care to pay the cost of their expenses.

Shortening the medical school education will decrease the average debt significantly and encourage more students to enter primary care. This will help improve our health care system significantly.

SHEILA GUPTA NADIMINTI
Livingston, N.J., Aug. 3, 2014
To the Editor:
Re " Second-Chance Med School " (Education Life, Aug. 3):

I was fortunate to go to a "second-chance med school" 35 years ago, in Guadalajara, Mexico. Culturally, it was hard, but oh, what an opportunity.

I'm fully bilingual in Spanish, and saw diseases I would have never seen stateside with such frequency: amebic dysentery, acute bacterial endocarditis and more.

As a result of such experience and hard work, I did a fellowship at a major cancer research hospital, wrote a textbook and a patient-friendly user's manual for cancer survivors, see patients in primary care and work for one of the most respected accreditation agencies in the United States.

Bravo to those who take the challenge, and rest assured that the educational advantages can be found if you look for them.

STEWART B. FLEISHMAN
Palm Springs, Calif., Aug. 3, 2014
To the Editor:
There are some fine doctors who graduate from Caribbean medical schools. But a much greater percentage - estimated to be more than half of the enrollees - accumulate enormous debt yet are unable to obtain residencies and thus a career as doctors.

According to a 2010 study by the Government Accountability Office, from 1998 to 2008 American students borrowed $1.5 billion in federally guaranteed student loans to study at for-profit foreign medical schools.

Should we really be spending taxpayer money when more than half of the students will never practice medicine? We need to support physician training, but in ways that will obtain a better return on investment.

JO WIEDERHORN
President and Chief Exec., Associated
Medical Schools of New York
New York, Aug. 4, 2014

A version of this article appears in print on , on Page A16 of the New York edition with the headline: Rethinking the Education of a Doctor. Order Reprints | Today's Paper | Subscribe

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Opinion | Rethinking the Education of a Doctor

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Re " The Drawn-Out Degree " (Education Life section, Aug. 3): Before we conclude that medical school is "drawn out," it is important to consider why medical schools have not shortened training time.

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Should medical education be shorter?

The answer is yes, at least according to administrators at many of America's leading medical schools. The idea may conjure up images of clueless residents Googling symptoms on their smartphones at the patient's bedside, but advocates insist that time spent in school can be trimmed without shortchanging education or compromising quality of care. And they say there are compelling reasons to speed up the process: to reduce the crushing debt many face by eliminating a year's tuition and allowing doctors to start careers, and earn money, earlier.

The traditional four-year medical curriculum - two years of academic study and two years on the wards - is based on recommendations made in 1910 in a study called the Flexner Report and, many educators say, it's time to rethink the program.

A recent, unpublished survey of 120 medical schools, conducted by the New York University School of Medicine, found that 30 percent were considering or already planning to start three-year programs, according to Dr. Steven B. Abramson, the senior vice president and vice dean for education, faculty and academic affairs. N.Y.U. enrolled its first three-year medical students a year ago. A handful of other pioneers include the medical schools at Mercer University in Savannah, Ga.; Texas Tech in Lubbock; the University of California, Davis; and Lake Erie College of Osteopathic Medicine.

The American Medical Association is among those urging changes in the way doctors are taught. Last year, it awarded $11 million to medical schools to spur innovative approaches. One emphasis is competency-based programs, in which students' pace is determined by how well they perform a task, not by the number of years spent in school. Such programs in other fields have shortened the education process by about 20 percent, said Dr. Susan E. Skochelak, the association's group vice president for medical education.

More than a dozen medical schools already have programs to move students more quickly from the classroom to the clinic, but by shortening premedical studies rather than medical school. Among them are Albany Medical College, Northeast Ohio Medical University and the medical schools at Boston University, Drexel, George Washington, Howard, Jefferson, Meharry and Northwestern. Gifted high school seniors or early college students are guaranteed admission to medical school if they perform well during freshman year of college. Combined bachelors/M.D. programs have been around for half a century, but these students complete both degrees in six or seven years instead of the usual eight.

"I absolutely think it's doable," said Dr. Charles G. Prober, senior associate dean for medical education at Stanford School of Medicine, which is considering such a program. Well-designed programs to accelerate doctors' training "don't send them out prematurely, but send them out with adequate tools, recognizing that they will grow," said Dr. Prober, who writes and speaks extensively on medical education reform. "Real learning begins when you are actually beginning to take care of patients, doing what you were trained to do."

While research is scant, a few studies show promising results. Comparisons of graduates of three-year programs at the University of Calgary and McMaster University to graduates of four-year Canadian medical schools found "equivalent performance." And a small study at Marshall University in the 1990s, which for almost a decade incorporated fourth-year requirements with the first year of residency in family practice, declared it a success for "carefully selected candidates."

Indeed, educators make clear that not all students can handle the accelerated curriculum. Dr. Prober notes that with the explosion of medical information, students more than ever must learn to work smart, figuring out what they need to memorize and how to find out the rest. Part of the education process today is learning to collaborate and tap the expertise of others.

That point - that there is too much to learn - is often cited to explain the failure of fast-track efforts in the 1970s amid student and faculty burnout and what some worried was inadequate preparation. An essay published on Sept. 19 in The New England Journal of Medicine called it "unwise" to eliminate the fourth year of medical school. The authors, Dr. Stanley Goldfarb and Dr. Gail Morrison, professors and administrators at the University of Pennsylvania's medical school, argued that students needed more experience taking care of patients, not less, and would miss out on opportunities like the chance to work in other countries and to delve more deeply into topics like medical ethics, patient safety and health policy.

One counterargument is that training simply drags on too long. Residencies and fellowships after medical school have lengthened over the years, taking up productive working years.

An article co-authored by Dr. Abramson, also in the Sept. 19 issue of The New England Journal of Medicine, reported that the average age of newly minted doctors had increased. Since 1975, the percentage of doctors younger than 35 had declined from 28 percent to 15 percent.

The article also noted that in 2011, 64 percent of medical students owed $100,000 or more. The enormous costs have insidious effects: Indebtedness drives students to pick lucrative specialties that will help pay off loans sooner, like orthopedics and dermatology, instead of fields like internal medicine and geriatrics, where physicians are greatly needed. Cutting time off medical school saves $30,000 to $50,000 a year.

The N.Y.U. School of Medicine enrolled 16 students (out of a class of 150) in its first three-year M.D. program last summer. The curriculum is identical to that of the rest of the class, except that the fourth year is missing. And the three-year applicants must know what type of physician they wish to become. Unlike students in traditional programs, who study, rotate through various specialties and then decide on one, three-year students must pick a specialty up front, are assigned mentors in that field and given opportunities to go on rounds, observe in the operating room and participate in research.

"If you want to be a certain kind of physician, you need to find out what it's like," Dr. Abramson said. Traditionally, students spend much of their fourth year applying for residencies and visiting programs all over the country, sometimes spending $20,000 just on travel for interviews.

"There's an abrupt break, no continuum," between medical school and residency, Dr. Abramson said. "There shouldn't be abrupt breaks."

Three-year students, on the other hand, will be guaranteed residencies at N.Y.U. "They'll be secure, and they won't have to worry about matching and interviewing." He added: "Our approach is about being able to pursue personalized pathways."

Right now, 15 percent of traditional N.Y.U. medical students actually take a fifth year, often to get a master's in public health or business. (Dr. Prober, too, said that, typically, Stanford medical students stay on for nearly five years to take advantage of scholarly opportunities.) At N.Y.U., 10 percent coming in prefer a three-year program.

Devon Ryan, 24, plans to become an orthopedic surgeon. The program appealed to him, he said, because of "the opportunity to accelerate your career, given how long it is with med school plus residency and fellowship," but also because of the chance to get to know people in the orthopedics department and become involved in patient care and research.

Amy Ou, 22, entered the program with plans to be a gastroenterologist, and welcomed the chance to bypass a year, which she estimated would save her and her family $70,000.

"One of the things I strongly believe in is that education is not the same for everybody," Ms. Ou said. "For me, it's not to regurgitate facts, but to learn to solve problems. I value being efficient with my time, so it makes sense for me to do it in three years."

Denise Grady is a reporter for The Times covering medical issues.

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Should medical education be shorter? The answer is yes, at least according to administrators at many of America's leading medical schools. The idea may conjure up images of clueless residents Googling symptoms on their smartphones at the patient's bedside, but advocates insist that time spent in school can be trimmed without shortchanging education or compromising quality of care.

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You know that bag of chips sitting on your kitchen counter? It's "listening" to all the sounds in your room, and if the right visual filming equipment looks at it, other people can can hear inside your room, too.

Yes, they can hear the sounds simply by looking at the bag, even through a sound-proof glass door, no sound recording needed whatsoever.

"That's the results of the astounding visual microphone," project done by researchers at MIT, reports by Sarah Lewin for IEE Spectrum's blog.

It works like this: All sound creates vibrations. Those vibrations move your eardrum and that's why you can hear.

Sound vibration can also microscopically move other objects in the room. The researchers used a high-speed camera to film such objects and wrote an algorithm to translate the tiny movements captured on film back into the sounds that created them.

Some objections captured visual sounds better than other. For instance a bag of chips, great; a potted plant, mediocre; a soda can, bad.

The researchers were able to re-create the sounds, even when filming an object through a sound-proof glass door.

Here's one example. A man recited "Mary Had A Little Lamb" in a room with a bag of chips. It sounded like this (video below takes about 10 seconds):

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Researchers Can Now Listen To Voices In A Room By Videotaping A Bag Of Chips

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You know that bag of chips sitting on your kitchen counter? It's "listening" to all the sounds in your room, and if the right visual filming equipment looks at it, other people can can hear inside your room, too.

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Presentations on making killer presentations

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Presentations on making killer presentations

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Weekend Reading: Presentations on Making Killer Presentations

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Presentation tips are always -- and naturally -- a hot topic with the SlideShare community. What's best advice for making a killer deck? There's plenty of advice, on everything from design to structure and delivery. More recently, three presentation pros shared their top tips for creating an outstan

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TED Talk Takeaways: 8 ways to hook your audience

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TED Talk Takeaways: 8 ways to hook your audience

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TED Talk Takeaways: 8 Ways to Hook Your Audience

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"You will live 7.5 minutes longer than you would have otherwise, just because you watched this talk." This was the claim that video game designer Jane McGonigal presented to the crowd during her June 2012 TED talk.

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eModule (CDTL and CELC)

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IBM's five predictions in five years looks at innovations from the doctors surgery to the classroom, and paints a picture of a smarter society with data at the centre.

You can't really lose with five-year predictions; if five years elapse and they still haven't come true, you need only apologise for being too far ahead of your time - assuming anyone remembers you made them in the first place.

With its 5 in 5 predictions, IBM has for eight years made an annual exercise of casting its imagination forward half a decade. This year, its crystal ball sees learning in all our futures, as intelligent cities, schools and healthcare figure out how to give us what we need without being asked.

It's all down to a new era of cognitive systems in which machines 'will learn, reason and engage with us in a more natural and personalised way', driven by cloud computing, big data analytics and learning technologies.

Here's how they see it unfolding:
The classroom will 'learn' you
The cloud-based classroom of the future will learn about each individual student over the course of their education, suggests IBM, helping them to master the skills that match their goals. 'Imagine a system that knows you are a visual learner with a maths phobia. Not only will the classroom create a lesson plan to help you master algebra, it will pre-empt difficulties in calculus and maybe even tailor coursework to a particular career. It's the end of the era of one-size-fits-all education and the beginning of personalised, experiential learning.'
Buying local will beat online
Online retail may now be worth a trillion dollars worldwide, but that's not the last word. 'In five years, bricks and mortar stores will have fought back to become better than etailers can ever hope to be, merging the tactility and immediacy of physical retail with the richness and personalization of online,' they suggest. It's all about augmented reality, wearable computing and location-based technologies, which will break the abilities of the internet out into the real world, making the physical experience superior to a pure online one.
Doctors will routinely use your DNA to keep you well
Medicine reinvented by data scientists doesn't necessarily always pass muster with actual doctors, but IBM nonetheless has a data-driven solution for pesky ill health. 'Today, full DNA testing to help make treatment decisions is still rare. But cognitive systems and cloud computing may make this form of treatment mainstream. It could be done faster, more affordably and much more frequently. In addition to DNA testing for cancers, we may even see DNA-specific personalized treatment options for conditions such as stroke and heart disease.' By crunching DNA data and huge repositories of medical records, IBM suggests, there'll be a diagnosis and a treatment plan in minutes.
A digital guardian will protect you online
The innovation here is a contextual security system that observes everything you do online, blocks out the nasties and handles all your passwords for you. This is one for the identity-theft brigade, but it also relates to the everyday irritation of passwords, which IBM suggests could be a thing of the past within five years. Technologically, that's perfectly achievable, but do we want to surrender the personal data that will make it possible?
The city will help you live in it
You know the deal with this one. More than half of us live in cities, so why shouldn't cities harness smart technology to make our lives better? 'Picture a city that knows not only when it's raining or when trains run, but also knows its citizens. With residents freely providing information, device data and social sentiment, cities will interpret billions of events in real time,' says IBM.

Needless to say, such predictions say at least as much about IBM and the services it provides as they do about the actual future that awaits us all. Indeed, its picks all have their roots in very current talking points, such as security, localisation and personalisation.

Here's a run-down of IBM's past forecasts, going back five years. Some of them, you'll notice, are still doing the rounds:
2008 2009 2010 2011 2012

Touch: You will be able to touch through your phone

Sight: A pixel will be worth a thousand words

Hearing: Computers will hear what matters

Taste: Digital taste buds will help you eat smarter

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IBM's five predictions in five years looks at innovations from the doctors surgery to the classroom, and paints a picture of a smarter society with data at the centre. You can't really lose with five-year predictions; if five years elapse and they still haven't come true, you need only apologise for being too far ahead of your time - assuming anyone remembers you made them in the first place.

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Personalized Learning: 5 Future Technology Predictions from IBM

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In five years, classrooms will learn about you, and personalize coursework accordingly. It's the end of the era of one-size-fits-all education, and the beginning of personalized learning. Every year IBM makes predictions about 5 technology innovations that stand to change the way we live within the next 5 years.

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Cognitive Education and Interactions - IBM

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Watson Care Manager - Overview - United States

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Enable your care teams with the ability to individualize patient care needs and recommend action on the optimal combination of treatment, services and benefits.

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Microsoft Enterprise: Disruptive innovation in technology solutions

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Get insight from Microsoft, the leader in disruptive innovation. See how industry and government-specific services and cloud solutions deliver digital transformation.

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NUS Medical Undergraduate Curriculum Radionalisation CNS Systems Based Workgroup

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NUS Medical Undergraduate Curriculum Radionalisation CNS Systems Based Workgroup

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Long dismissed as a waste of time, doodling is getting new respect.

Recent research in neuroscience, psychology and design shows that doodling can help people stay focused, grasp new concepts and retain information. A blank page also can serve as an extended playing field for the brain, allowing people to revise and improve on creative thoughts and ideas.

Doodles are spontaneous marks that can take many forms, from abstract patterns or designs to images of objects, landscapes, people or faces. Some people doodle by retracing words or letters, but doodling doesn't include note-taking.

"It's a thinking tool," says Sunni Brown, an Austin, Texas, author of a new book, "The Doodle Revolution." It can affect how we process information and solve problems, she says.

Doodling in meetings and lectures helps ease tension for Samantha Wilson, a high-school teacher and graduate student from Southborough, Mass. Drawing squiggly patterns that are "very vegetal, scrolling and organic," with shaded blocks and spirals in red and blue pen on paper, also allays boredom, she says.

"It looks like I'm spacing out when I'm doodling, but I'm actually making my thoughts come together, solidifying my own ideas," Ms. Wilson says. Doodling recently helped her come up with a theme for a paper in a graduate-school course she is taking, she says.

Scientists in the past thought doodles provided a window into the doodler's psyche, but the idea isn't supported by research, says a 2011 study in The Lancet, a medical journal.

Some researchers suspect doodling may help the brain remain active by engaging its "default networks"-regions that maintain a baseline of activity in the cerebral cortex when outside stimuli are absent, the Lancet study says. People who were encouraged to doodle while listening to a list of people's names being read were able to remember 29% more of the information on a surprise quiz later, according to a 2009 study in Applied Cognitive Psychology.

Jesse Prinz draws people's heads to help himself pay attention during lectures and speeches at conferences he attends. The head usually has "something happening to it-an animal on top of it or something coming out of it," says Dr. Prinz, a distinguished professor of philosophy at the City University of New York Graduate Center.

When Dr. Prinz returns to the doodle later, "I can reconstruct a lot of what I heard" in the lecture. He compares it to a post card: A traveler may forget specifics about a trip, but "if you look at that post card, a lot of things that aren't depicted in it come back to you," he says.

Ms. Brown, the author, says doodling provides an alternate route to learning for some people. Her professional work includes training company managers to translate ideas and concepts into sketches and drawings in order to spark ideas and improve communication.

Michiko Maruyama, a medical-school student, says she writes down key words during class lectures and later draws "daily doodles" that bring together what she learned. Ms. Maruyama, who attends the University of British Columbia in Vancouver, says she fills gaps in her understanding while she draws images of gastric secretions, hernias and other subjects of study.

"It's not until I doodle that I think about how everything comes together. I find out what I know and what I don't know," she says. When she stopped doodling for a week, her grades went down.

The appearance of a doodle can stimulate ideas for improvement, according to a 2014 study by Gabriela Goldschmidt, a professor emeritus of architecture at the Technion-Israel Institute of Technology in Haifa and a researcher on learning techniques of design. A doodle can spark a "dialog between the mind and the hand holding a pencil and the eyes that perceive the marks on paper," the study says.

The study discussed an architecture student who became stalled in his efforts to design a new kindergarten and started a habitual doodle he found pleasurable-writing his signature over and over.

The student soon began to see between the letters of the doodle the outline of a layout for the kindergarten's three activity spaces. He drew progressively larger versions that eventually became an architectural sketch, the study says.

A doodle also can express emotions too complex for words. Ten doodlers in a four-week study were equipped by researchers to share their sketches on social media, using digital pens and Bluetooth-equipped phones.

Many of the participants' doodles expressed complex emotions they wouldn't have shared via written posts or texts, according to the study, presented in 2011 at a Stockholm conference on human-computer interaction.

One 37-year-old teacher, the father of a newborn baby, drew a frazzled-looking brain to convey a feeling of being overwhelmed. A 27-year-old graduate student drew a towering obelisk looming over a childlike figure, to convey the pressure she felt over a deadline for a paper, according to the study, which was led by Lisa Cowan, who earned a Ph.D. in computer science at University of California San Diego and now works as a software developer in Mammoth Lakes, Calif.

The opportunity to doodle "changed the way people expressed their feelings," says Nadir Weibel, a research assistant professor in computer science at UCSD and a co-author of the study. "Their pictures communicated more than just a text or a regular photo. They were more personal, more intimate."

Doodling doesn't work for all tasks. People who were asked to view and remember a collection of images struggled at the task if they were asked to doodle at the same time, according to a 2012 study published by the University of British Columbia. The likely reason: Doodlers' visual-processing ability was split between two visual tasks, says the study's author, Elaine Chan, a former psychology student at the university who is now a researcher at a Vancouver children's hospital.

Put another way, when doodling and another task use the same cognitive pathways, "you have a traffic jam," says Ms. Brown.

Write to Sue Shellenbarger at sue.shellenbarger@wsj.com

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The Power of the Doodle: Improve Your Focus and Memory

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Long dismissed as a waste of time, doodling is getting new respect. Recent research in neuroscience, psychology and design shows that doodling can help people stay focused, grasp new concepts and retain information. A blank page also can serve as an extended playing field for the brain, allowing people to revise and improve on creative thoughts and ideas.

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The tactical implementation action plan requirements (Version1.0):

1. a faculty wide communication / and engagement strategy; including key points, action steps, and plans for faculty and IT support and additional training as required

2. a phased implementation timeline with parallel tracts - faster for early adopter faculty / and early adopter departments; and slower for traditionalists

3. a clear set of milestones, as well as platform (likely digital) for keeping all participants up to date, as well as providing an overview of progress, and lagging areas, which can double up as a framework for an interactive eCurriculum augmented with digital educational content, both didactic "lectures", and interactive eCases

Implementation tools:

A. start with existing didactic teaching content - handouts (text with simple graphics), lecture slides, recommended reading, curated videos - index, and progressively hyperlink

B. a simple interface / website / online landing page where all the digital content is laid out visually for sampling, selection and use (the "buffet table", and later "grocery aisle")

C. a longitudinal set of eCases, or "virtual patients" as an integrative educational tool

D. a continuing editorial, and peer review mechanism, coupled with teaching evaluation/TPM/P and T process
E. involving NUS/NUHS legal team (PDPA, intellectual property consultations)

F. coupling usage analytics (eg. Google Analytics) to educational content (working with Computer Centre/IT team/IT training; and rolling out to NUS department admin/IT support staff)

G. external "big data" consultants (eg. Microsoft; or IBM eLearning team, Janet Ang, country GM, Singapore, IBM) to measure and customise education / digital learning (both online/mobile and face to face via interactive digital interfaces)

http://www-07.ibm.com/sg/media/biographies/sg_executive.html
http://www-01.ibm.com/software/analytics/training-and-certification/enterprise_offerings.html

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Making biopsies less invasive and more informative

Researchers from the NUS Institute for Health Innovation & Technology (iHealthTech) developed the novel STAMP technology that could sensitively and accurately detect and classify cancer cells, as well as determine...

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Making biopsies less invasive and more informative Researchers from the NUS Institute for Health Innovation & Technology (iHealthTech) developed the novel STAMP technology that could sensitively and accurately detect and classify cancer cells, as well as determine...

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School of Health Professions Education, Maastricht University

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School of Health Professions Education, Maastricht University

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SHE is the Maastricht School of Health Professions Education led by professor Cees van der Vleuten, a graduate school with a wide variety in education, training and research in medical education.

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Using a digital knowledge repository to personalise learning in medical education - a follow up report (to TeL 2013)

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Using a digital knowledge repository to personalise learning in medical education - a follow up report (to TeL 2013)

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Using a digital knowledge repository to personalise learning in medical education - a follow up report (to TeL 2013)

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TLHE 2014 final draft submission for peer review and consideration for paper presentation. Conference website -http://www.cdtl.nus.edu.sg/tlhe/ (accepted as pa...

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November, 2012 Idea proposed to CMB and participants at eLearning workshop

January, 2013 Continuing discussions on sidelines of 10th APMEC with DIO and Associate DIO

February, 2013 Lunchtime discussion with VCMB(Education)

Idea pitched to O and G department during invited presentation on topic of eLearning at departmental morning CME session

May, 2013 Afternoon discussion with Vice Dean(Education), YLL SOM

May and June, 2013 Preparation followed by First meeting with Pioneering First Group of Department Champions from

EMD - Lau Thian Phey
O and G - Tan Eng Kien
Psych Med - Cyrus Ho
Eye - Clement Tan
ENT - Raymond Ngo

with

NUHS Education Admin Team

Ang Hwee Khoon
Chen Qiongyu
Goh Poh Sun (project lead)
Kevin Yap
NUHS CIO Ng Chun Kiam joined group in July

July, 2013 Extended abstract on project submitted and accepted for presentation at NUS TEL 2013, October 7, 2013

http://cdtl.nus.edu.sg/tel2013/

June and July, 2013 Half-day combined Undergraduate and Postgraduate EIT Retreat followed by Half-day EIT Corporate Planning Retreat

August, 2013

IT group discussions following EIT retreats

Rapid prototyping: Google Ventures

The product design sprint: 5 day recipe for startups

Innovation with Purpose

Dinner discussion with educational researcher from Maastricht University visiting Singapore

APMEC short communication / paper presentation at AMEE 2013 Conference, Prague on the 2 year experience of the Diagnostic Radiology Department using 2000 case online repository to support postgraduate training

Slide-deck for AMEE 2013 Presentation - An online case repository facilitates radiology residency education and evaluation of education theory

Reflections on (e)Learning

http://www.ameelive.org/ (closing plenary session by Geoff Norman - review of this strongly recommended, for AMEE 2013 participants see email from AMEE dated Aug 30, 2013 for login and password; see also presentation by Cees van der Vleuten - slides can be downloaded on link below)

http://www.fdg.unimaas.nl/educ/cees/amee/

http://mededworld.org/reflections/reflection-items/September-2013/Harden's-Blog-61-New-thoughts-and-ideas.aspx

Reflections on the use of AMEE Live Online (Ron Harden)

Dong Chaoyan from MEU will work with Poh Sun on educational scholarship areas related to the Radiology Department online case repository. In addition to attending workshops related to this area, I have scheduled meetings with educational researchers from Maastricht and Canada.

http://thetravellingspud.blogspot.sg/2013/08/luch-at-amee-2013-conference-prague.html

NUH CEO leading medical education team attending AMEE 2013

Discussion with Director - Designate, Nursing Administration, NUHS at AMEE 2013

September, 2013

Discussions with HOD Radiation Oncology, Pathology and EMD

Afternoon meeting with Vice Dean Education

CurriculumMapping@NUHS

http://learning-layers.eu/project-overview/

Discussions with Chair, UMC; Director, National University Cancer Institute; and HOD Anaesthesia

Presentation at business meeting, UMC, Sep 27, 2013 (1pm)

http://www.slideshare.net/dnrgohps/learningnuhs-umc-business-meeting-slidedeck-sep-27-2013

Discussion with Chair, University Orthopaedics, Hand & Reconstructive Microsurgery Cluster

Follow up discussion with Group CIO, NUHS

Food for thought: public access to publicly funded materials, what could be

October, 2013

Building an online repository of teaching resources to facilitate consistent and good quality teaching of postgraduates and undergraduates in medicine - a preliminary report (slidedeck for presentation at NUS CDTL TEL 2013 symposium, Oct 7, 2013)

http://cdtl.nus.edu.sg/tel2013/

http://www.cdtl.nus.edu.sg/tel2013/docs/programme.pdf

http://www.slideshare.net/JohnShank/shank-dl-melearningacrl2011

http://www.slideshare.net/mkeppell/digital-literacies-knowledge-skills-and-attitudes-for-a-digital-age-ruth-wong-mem

http://www.slideshare.net/mkeppell/keynote-personalised-learning

http://www.slideshare.net/meganpoore/lecture-7-integrating-icts-into-your-teaching

EIT meeting, Oct 16, 2013 (1330hrs to 1530hrs), T07-01

Follow up meeting with UMC group (Respiratory Medicine, Endocrinology, Nurse Education): Kay Choong SEE; Tong Wei YEW; Margaret LEE; Gek Noi Doreen HENG
Thursday 17 October 2013, 0730hrs @ T08-05

Presentation at UG curriculum mapping group, Oct 21, 2013 (1430hrs)

CurriculumMapping@NUHS

http://news.nus.edu.sg/highlights/6956-it-plays-key-role-in-higher-education-of-the-future

November, 2013

Implementing a digital mindset (example for a cultural institution/museum)

Why University Leadership is Interested in Massive Open Online Courses (MOOCs) - 7th November 2013 (9.30 am - 10.45am - Central Library Theatrette 2).

http://news.nus.edu.sg/highlights/6870-state-of-the-university-address-2013-mount-kailash-and-the-paths-beyond

http://news.nus.edu.sg/highlights/6869-reinventing-nus-education-and-campus-spaces

http://news.nus.edu.sg/highlights/6956-it-plays-key-role-in-higher-education-of-the-future

http://news.nus.edu.sg/highlights/7020-nus-president-appointed-to-new-global-learning-council

http://news.nus.edu.sg/highlights/7064-creating-an-academic-medical-centre-of-impact

Discussion with NUHS Cardiology Senior Residency Program director.

Creation of repository of learning enablers (LEs), NUS CIT

January, 2014

Technology enhanced learning symposium @ 11th APMEC, Saturday, Nov 18, 2014; 1415hrs to 1545hrs

Goh Poh Sun
Marcus Henning
Sanjay Khanna
Junji Otaki
Kenneth Pinto
Gominda Ponnamperuma

http://telroundtable2014.blogspot.sg/

Tablets @ NUS

February, 2014

Learning@NUHS implementation meeting on:
Date: Wednesday, 12 February
Time: 1 - 2 pm
Venue: T07-06

Cyrus Ho - Psych Med
Tan Eng Kien - O and G
Melvin Chua - Medicine
Victor Ong - EMD
Clement Tan - Ophthalmology
Raymond Ngo - ENT

with
Goh Poh Sun
Ang Hwee Khoon
Chen Qiongyu

http://www.nuhs.edu.sg/nuhsresidency/residency-homepage/learning-at-nuhs.html (internet demo site)

Learning@NUHS (intranet only site with expanded content)

Web Tracking (Google Analytics)

https://developers.google.com/analytics/devguides/collection/analyticsjs/pages

Event Tracking

http://searchenginewatch.com/article/2214166/How-to-Measure-File-Downloads-Using-Events-Virtual-Pageviews-in-Google-Analytics

http://www.timeforcake.com/blog/post/tracking-downloads-in-google-analytics/

Blog Traffic - Making Sense of Blog Traffic Statistics

http://weblogs.about.com/od/addonsandplugins/tp/BlogStatTrackers.htm

http://blogs.adobe.com/digitalmarketing/analytics/custom-link-tracking-capturing-user-actions/

EIT (Learning@NUS site analytics) meeting - Feb 24, 2014; Monday, 10am / T11-07

From Computer Centre, NUS

1. Ms Chew-Goh Swee Wah - Senior Associate Director
2. Ms Phua Chui Ying - Senior Systems Analyst

Other confirmed attendees are:
1. Goh Poh Sun
2. Lau Tang Ching
3. Qiongyu
4. Ada
5. Jin Nan
6. Hwee Khoon
7. Derek Aw - IT Manager, AIO

Working NUS YLL SOM Sharepoint + Google Analytics Site with content uploaded + hyperlinked (index) + educators and students using material + weekly usage reports

Learning analytics (SlideShare presentation)

http://www.slideshare.net/erik.duval/learning-analytics-22435294

http://www.slideshare.net/erik.duval/learning-analytics-tracking-learning

with Apr 27, 2014 version of table below

Consultative meeting with Linda Hoon and NUHS legal team, 0800hrs to 0900hrs, Friday, March 28, 2014.

http://en.wikipedia.org/wiki/Digital_scholarship

For the Sake of Inquiry and Knowledge - The Inevitability of Open Access (NEJM, 2013)

https://www.mededportal.org/

Follow-up for 1st implementation meeting including Rhematology (Lau Tang Ching), Radiology and Pathology + Departmental IT Support Staff (1 hour)

May, 2014

NUS Prime presentation: Technology enhanced learning - three case studies, May 5, 2014

Evaluating teaching - quantity and quality (methods and examples)

Use of hyperlinked radiology case repositories in medical education

Use of hyperlinked clinical case repositories in medical education

Educational IT - three ideas, one vision

July, 2014

Meeting Vice Dean (Education), YLL SOM, July 29, 2014

August, 2014

Strategic Retreat (Education), YLL SOM, Aug 1, 2014

http://padlet.com/dnrgohps/iLearnatYLLSOM

Follow up meeting of working group - to review progress, and re-look at efforts to improve institutional platform, and use of Google analytics to monitor and review utilisation and indices of educational quality of the digital teaching material

Evaluating teaching - quantity and quality (methods and examples) + comparison with traditional research metrics

September, 2014

TEL symposium @ AMEE 2014, September 1, 2014

YLLSOM Edutech Team - focus on eLecture production, faculty development; "Community Collaborative Learning", let's learn together, anywhere, everywhere, all the time.

Caroline Nayad Zamora
Tan Yan Ling
Suriya Nor Hanifah Bte Aman
Justin Lim Win Shern
Ada Chia Ghee Chuan
Goh Poh Sun
Terry Pan
Prof Hooi Shing Chuan

November, 2014

Undergraduate medical education - 3 eLectures completed, including three versions (basic, intermediate and advanced).

Year 2 Imaging of Respiratory Disorders lecture resource website

Padlet wall showing photos of medical students interacting with eLecture, iBook and website material during the scheduled lecture time, as well as some photos of the eLecture video production process

Survey of student eContent preference questions

Screenshot of early response to survey

Screenshot of free text response to survey 1

Screenshot of free text response to survey 2

Presentation (website) to YLLSoM Anatomy department educators on December 1st, 2014

Postgraduate medical education (8 ongoing, 2 startup, 1 to have first meeting by end November, 1 in January 2015)

Eye - team with dedicated fellow, prospective presentation acquisition, peer review and indexing and sharing process (clinical radiology pathology round team, including HOD), prospectively collected all presentations from OPR round in 2014; plans for eBook moving forward.

EMD - working with postgraduate teaching director on pedagogy for formative assessment of educational modules developed by EMD for postgraduate CT brain teaching for EMD residents. Neurology has reviewed this for its own resident use. Has existing series of educational videos on intranet for residents.

O and G - team with dedicated department executive collecting all presentations prospectively, for peer review and indexing (meetings with HOD and department educators, department presentations X 2); have collected first month of all departmental presentations (28 presentations), had first review meeting after this; will continue this process and meet again in January 2015.

Medicine - dermatology team (discussion with division head and educators), neurology (discussion and presentation at combined rounds, neurology using radiology material on website)

Paediatrics - paediatric haematology/oncology (had short discussion with division head, will be meeting education team January 2015)

Pharmacy - met education team including deputy director (head) end November

ENT - to follow up

Psych Med - to follow up

Orthopaedics/Spine - ongoing

Pathology - ongoing

Radiology - ongoing

December, 2014

TLHE 2014, International Conference, Dec 9 to 11, 2014

Evaluating Teaching: Quantity and Quality (Methods and Examples)

(e)Learning, Digital Repositories, and Digital Scholarship (Slideshare document)

(e)Scholarship: Traditional vs Digital Scholarship (MedEdWorld reflection)

October 2015

Met and briefed new NUHS Group General Counsel on project

http://app.sgdi.gov.sg/listing_expand.asp?agency_id=0000017095

End 2015

Future plans

NUS eLearning week

? 2nd implementation meeting (open invitation all departments)

Clinician Educators (NUHS), NUS Undergraduate Teachers + Departmental IT Support Staff (1 hour)

Aim for 30 to 50 staff members.

? 3rd implementation meeting (open invitation)

Education grand round presentation

# data[].attributes.attachment_link.description
Welcome to the multidisciplinary Case Based Learning knowledge repository Learning@NUHS. This is a 3 year pilot project using a rapid prototyping development process. This will give institutional visibility of ongoing educational IT efforts at departmental and individual level; to encourage and facilitate sharing of educational resources.

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Charles Prober

Dramatic changes are needed in medical student education, including a substantial reduction in the number of traditional lectures, according to a perspective piece published May 3 in the New England Journal of Medicine by two Stanford University professors.

Medical education has changed little in the past 100 years despite dramatic changes in the world of medicine, the explosion in biomedical information and the ever-growing complexity of the health-care system. The traditional lecture format persists even as class attendance is plummeting and as many complain that the current system is failing to produce compassionate, well-trained physicians.

"Students are being taught roughly the same way they were taught when the Wright brothers were tinkering at Kitty Hawk," write co-authors Charles Prober, MD, senior associate dean for medical education at the Stanford School of Medicine, and Chip Heath, PhD, professor of organizational behavior at the Stanford Graduate School of Business. (Heath and his brother, Dan, also authored a bestselling book, Made to Stick: Why Some Ideas Survive and Others Die.) In contemplating medical education reform, Prober reached out to Heath because a critical goal of any educational effort is to optimize the retention of lessons - to increase their "stickiness."

In their perspective, titled "Lecture halls without lectures," Prober and Heath propose a new approach to teaching to make better use of the fixed amount of educational time available to train doctors.

"That's the vision that we want to chase: education that wrings more value out of the unyielding asset of time," the authors write. "Why would anyone waste precious class time on a lecture?"

Prober also has been working closely with Salman "Sal" Khan, the Silicon Valley-based online learning pioneer whose nonprofit effort, Khan Academy, is widely credited, in the words of Bill Gates, for having "turned the classroom - and the world of education - on its head." Prober and Heath's perspective piece proposes a Khan Academy-styled "flipped-classroom" model of teaching. Lecture content is packaged in 10- to 15-minute videos that are watched by the students at their own pace and as often as necessary to learn the material. Class time is then freed up for more interactive education, with greater emphasis on patients' clinical stories as a way to increase the relevance of the necessary scientific and medical knowledge.

"Teachers would be able to actually teach, rather than merely make speeches," the authors write.

The core biochemistry class at Stanford medical school was redesigned this year to follow this model. The instructors replaced the lecture-based format with short online videos made available to students. "Class time was used for interactive discussions of clinical vignettes that highlighted the biochemical bases of various diseases," the article said. "Student reviews of the course improved substantially from the previous year, and class attendance increased from 30 to 80 percent, even though class attendance was optional."

Prober said early experimentation with this model has been extremely positive.

"It's my strong belief that this is an effective model for delivering factual material," Prober said. "It could facilitate students' education by allowing them to learn the core content in a user-friendly way. Students struggling with the information can watch the mini-videos over and over again. Low-stakes quizzes ensure the students have grasped the knowledge."

Students then come together in the "flipped classroom" where they can use the facts they've learned in "engaged, active learning," Prober explained. The in-class lessons would use alternatives to lectures to more successfully engage students, fuel their curiosity and increase information retention. "Patients' stories are what makes the acquisition of medical knowledge compelling," the authors write. "They serve as the scaffolding on which facts and concepts can be organized and reinforced. ...Yet conversations with medical students about the first-year medical curriculum reveal that about half of lectures proceed without even the briefest patient example.

"A single case could serve as the lead-in to multiple medical school topics that otherwise might seem dry and routine," the authors write. "It's a method used often in pop culture to draw in viewers in such television shows as 'House' and 'ER.'"

The authors imagine instead a new world of medical education, one where students are engaged and fueled by a curiosity that makes learning stick.

They write: "Imagine a first-year medical student who learns critical biochemistry pathways by watching short videos as many times as necessary in the comfort of his or her personal learning space. Knowledge acquisition is verified by repeated low-stakes quizzes. Then, in class, the student participates in a discussion that includes a child with a metabolic disease, his or her parents, the treating clinician, and the biochemistry professor. The relevant biochemistry - so dry on the page of a textbook - comes to life.

"The lesson sticks."

# data[].attributes.attachment_link.title
Professors propose 'lecture-less' medical school classes

# data[].attributes.attachment_link.description
Charles Prober Dramatic changes are needed in medical student education, including a substantial reduction in the number of traditional lectures, according to a perspective piece published May 3 in the New England Journal of Medicine by two Stanford University professors.

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Online learning reinventing medical school courses

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Online learning reinventing medical school courses

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Brian Tobin

Professor Neil Gesundheit works with student Morgan Theis to prepare an online segment for a class.

Andrew Patterson, MD, associate professor of anesthesia, is convinced that the only way forward in medical education is what he calls a revolutionary path. No more of the old way - professors lecture, students listen.

Instead, the time for online learning for medical students has arrived, said Patterson, and a core group of Stanford medical professors, education technology specialists and collaborators from the Khan Academy who are working toward that future.

Charles Prober, MD, the senior associate dean for medical education at the School of Medicine, is onboard. Prober, who oversees the school's new educational technologies, leapt to national visibility in May with the publication of an article in the New England Journal of Medicine titled "Lecture halls without lectures: A proposal for medical education." Co-written with Chip Heath, PhD, a professor of organizational behavior at the Stanford Graduate School of Business, the article stated flatly, "It's time to change the way we educate doctors."

Prober is one of the driving forces behind the Stanford Medicine Interactive Learning Initiatives, otherwise known as SMILI. The idea is to combine the Internet with something very old - the Socratic method - and ensure that the knowledge being taken in by medical students actually means something to them.

Prober believes that meaning derives from interaction, and that flipping classrooms - using videos to impart basic knowledge and reserving class time for more engaging activities - is the first step.

"The videos are not the endgame; they're a way of creating a product that's useful for students," he said. "We're packaging knowledge, but that's not the real learning part. Pushing facts at people isn't learning. The learning is the embedding of the facts to create rich, interactive sessions."

That's where SMILI comes in. The idea is to provide what Prober calls a "seamless concierge service for faculty" to help them overcome their skepticism and then produce class materials online with the aid of the school's education technology staff.

"Faculty reaction has been variable," he said. "Some have been very enthusiastic; they say it's the natural thing, the way of the future, and they're out there creating courses in the image of this idea. But others - and it's not a matter of age or field - think it's a bad idea. They say, 'We don't know if the new methods will be effective.' They say, 'Show me the data.'"

Charles Prober

It is too early for reliable data, but several medical classes and programs nonetheless are moving forward this year. Portions of classes in cardiovascular physiology and endocrinology are being made more interactive by going online.

The endocrinology and women's health tutorial, part of the Human Health and Disease course, brings together people from pathology, endocrinology, gerontology, and obstetrics and gynecology. Before going to class, students will watch videotaped lectures. The clear advantage, Patterson said, is that students who don't follow a particular point can pause and replay the video, or pause and consult another source.

"That's what an on-site culture can't do," he said. "Unprepared students zone out or don't even come to class." But now, using the online pilots, when they come to class they will meet with patients (live or on video), debate with their peers and do immersive group exercises, putting into practice what they've learned beforehand.

Part of Prober's vision is that video instruction could be shared by the country's leading medical schools - they all teach essentially the same material to first- and second-year students. Representatives of those schools are discussing shared curriculum, he said, and they are all reconsidering how they deliver knowledge.

Griff Harsh, MD, a professor of neurosurgery and associate dean of postgraduate medical education, said at a recent SMILI meeting that as many as nine online pilots will be produced this year for practitioners enrolled in continuing medical education. They include units on critical care ultrasound, clinical trials, antibiotics, sepsis, dermatitis and cardiac crisis management.

The benefits of online learning also could extend far beyond the School of Medicine; the videos for Patterson's course on cardiovascular physiology will be watched by students in Rwanda, a project made possible thanks to Patterson's longtime collaboration with medical professionals in that battered country who have, nearly miraculously, established a medical school.

The videos for the cardiovascular physiology unit will be made by the professors with the assistance of Khan Academy, a nonprofit organization that since 2006 has been producing free videos about a variety of academic (and medical) topics. Khan Academy is involved with Stanford in other areas as well - for example, problem sets on Stanford's open-source course-hosting platform, Class2Go, use the Khan exercise framework - but it has been particularly active with the School of Medicine.

"I'm very attracted to what they're doing, very impressed by Sal Khan," Prober said, referring to the organization's founder. "Their mission really resonates, the mission to educate anyone, everywhere, at no cost. When we create medical education, I want to share it as broadly as possible, at no profit. If it helps raise the level of education, that's great. That's our mission."

Rishi Desai, MD, a pediatric infectious disease physician and a medical fellow at the Khan Academy, is working with the medical faculty to generate content in short videos. "It's been an honor to work with medical students and faculty here to help them make medical education more interactive and fun," Desai said after the first of what will be a series of open houses to attract potential faculty converts and hold discussions about the mechanics and virtues of online education.

One of the people at that meeting. Don Regula, MD, a professor of pathology involved in the online endocrinology pilot, said he remains skeptical, though he's teaching online. He insisted that class time would have to be used wisely to ensure that the knowledge sticks.

But the professors themselves say that an estimated 70 percent of medical students do not attend lectures. Clearly, the traditional approach is not working. Prober, Patterson, Regula and a growing number of medical professors are convinced that online learning is a large part of the solution.

# data[].attributes.attachment_link.title
Online learning initiative reinventing medical school courses

# data[].attributes.attachment_link.description
Brian Tobin Professor Neil Gesundheit works with student Morgan Theis to prepare an online segment for a class. Andrew Patterson, MD, associate professor of anesthesia, is convinced that the only way forward in medical education is what he calls a revolutionary path. No more of the old way - professors lecture, students listen.

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Interactive Learning - Stanford Medicine Interactive Learning Initiatives

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Choosing an appropriate and effective instructional approach for your interactive session will lay the foundation for the rest of the process, and will make your materials and activities easier to develop and more likely to positively impact student learning.

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Pilots at Stanford - Stanford Medicine Interactive Learning Initiatives

# data[].attributes.attachment_link.description
The School of Medicine is exploring a range of interactive learning strategies with the aim of developing best-practice support for faculty who want to evolve their courses. Our efforts are building on the results of early pilots that have demonstrated benefits in a number of courses.

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Interactive Learning @ Stanford School of Medicine

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Interactive Learning @ Stanford School of Medicine

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Interactive Learning - Stanford Medicine Interactive Learning Initiatives

# data[].attributes.attachment_link.description
The exploration of interactive learning is part of a larger effort at the school to align our curriculum with the changing healthcare environment and the new ways in which students learn. Led by Charles Prober, Senior Associate Dean for Medical Education, this reform effort includes four working groups, which are reviewing different elements of our medical education program.