PRIMAFAMED and NextGenU: a global co-democratization of … · 2014-07-07 · ACSM Guidelines for...

23/06/2014

Erica Frank, MD, MPH

Founder and President, NextGenU.org

Professor and Canada Research Chair, University of British Columbia

PRIMAFAMED and NextGenU:a global co-democratization of family medicine residency and primary care training?

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Kampala Declaration

• WHO identified a need for 12.9 million more trained health workers by 2035

• WHO also said that this will require greater use of training innovation, especially information and communication technologies

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Traditional (6) Novel (11)

- Credit - Competency-based- Human interactions - Best resources- 360 assessment - Coordinated curriculum- Higher-level education - Tested efficacy- Customizability - Multiple languages - Warm prestige - Advertisement-freeMOOCs (6) - Asynchronous- Free - Active educational partnerships- Limitless scalability - Teacher/learner respectful- Low risk - Open research policy- Low barriers - Financial efficiency- Low carbon emissions- Computerized interactions

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Founding Collaborators and Funders American College of Preventive Medicine

Annenberg Physician Training Program

Centers for Disease Control and Prevention

Grand Challenges Canada

NATO – Science for Peace

University of British Columbia

World Bank

World Health Organization

World Medical Association

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Family and Preventive Medicine Residencies

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Match existing competencies and resources

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Organize in modules

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For Example…. Our 3 Course, 3 Country Pilot Design

1) Emergency Medicine (EM) for all senior U.S. medical students at the University of Missouri (UM) and the Uniformed Services University of the Health Sciences (USUHS) (with national and local control groups)

2) Environmental Health (EH) with master’s of public health students at Canada’s Simon Fraser University (with local historical controls)

3) Physical Activity Counseling (PAC) with volunteer Colombian PA students (with local contemporary controls), all using the NextGenU.org platform, with mentored and peer interaction

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Characteristics/differences between 3 NextGenU pilo t courses and traditional courses and students, 2011-2013

Course Title Course Co-Sponsors

Course Competencies

/ Main Resource Sources

Pilot Site Description

Comparative Educational

Activities

Comparison Test Populations and

Knowledge Outcomes

Differences in Knowledge:

NextGenUsers v. Traditional Students

Emergency Medicine (EM) Clerkship for Senior Medical Students

Emory University Center for Injury Control, International Federation of EM, Society for Academic EM (SAEM)

Clerkship Directors in EM

Uniformed Services University of the Health Sciences (USUHS, senior U.S. medical students, required training at 11 sites nationally)

Paper copy of Emergency Medicine: Critical Concepts for Clinical Practice vs. NextGenU readings

SAEM national senior medical student exam (2011 version) scores for 2012-2013 USUHS NextGenUsers (n=167) vs. 2011-2012 USUHS controls (n=163)

NextGenUsers= 80.3% (+/-6.4 SD)

Traditional Controls= 80.9%

p=0.4Emergency Medicine (EM) Clerkship for Senior Medical Students

Emory University Center for Injury Control, the International Federation of EM, Society for Academic EM (SAEM)

Clerkship Directors in EM

University of Missouri (UM, senior U.S. medical students, required course, distributed state-wide)

Emergency Medicine Manualvs. NextGenU readings

SAEM national senior medical student exam (2012 version) scores for 2012-2013 UM NextGenUsers (n=35) vs. national controls (n =415)

NextGenUsers= 71.2% (+/-5.7 SD)

Traditional Controls= 71.4%

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Course Title Course Co-Sponsors Course Competencies / Main Resource

Sources

Pilot Site Description

Comparative Educational

Activities

Comparison Test Populations and

Knowledge Outcomes

Differences in Knowl/Satisfaction:

NextGenUsers v. Traditional Students

Physical Activity Counselling (PAC)

Universidad Pedagógica Nacional, U.S. CDC, Exercise is Medicine (an AMA and American College of Sports Medicine initiative), Fundacion Santa Fe Bogota

ACSM Guidelines for Exercise Testing & Prescription,ACSM Certified Personal Trainer Certification, Canadian Society for Exercise Physiology ,NSPAPPH Competency Areas

Universidad Pedagógica Nacional (UPN, Colombian PA students, not required, taught locally)

Usual course vs. usual course plus NextGenU readings and activities

Improvements in knowledge scores of 2011-2012 NextGenUser PA students (n=11) vs. 2011-2012 PA students not adding (n=26) the NextGenU course

NextGenUsers= 23.9% increase

Traditional Controls= 9.3% increase

p=0.07

Environmental and Occupational Health (EH)

Simon Fraser University (SFU), International Society of Doctors for the Environment, Physicians for Social Responsibility

Association of Schools of Public Health

Simon Fraser University (SFU, Canadian MPH students, required, and taught locally)

In-class lectures and assorted readings vs. NextGenU readings and in-class learning and application activities (flipped classroom design)

2012-2013 NextGenU SFU students (n=9) vs. those taking the course in prior years (n=130)

NextGenUsers= 88.8%Trad’l= 86.4%, p=0.72

“Overall I would rate this course as excellent”, 4.7/5 for NextGenUsers vs. 3.7 (2012), 4.3 (2011), 4.1 (2010), and 3.9 (2009) for traditionally-trained students

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72 Languages Available

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- Credit - Competency-based- Human interactions - Best resources- 360 assessment - Coordinated curriculum- Higher-level education - Tested efficacy- Customizability - Multiple languages- Warm prestige - Advertisement-freeMOOCs (6) - Asynchronous- Free - Active educational partnerships- Limitless scalability - Teacher/learner respectful- Low risk - Open research policy- Low barriers - Financial efficiency- Low carbon emissions- Computerized interactions

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Interactive Activities Feedback Opportunities

Peer MCQs / cases Feedback form for each resource

Mentored activities Peer feedback for posted assignments

Discussion forums Guided & free text feedback in forums

Instantly translated chat rooms Course evaluations

Word Games: Crossword, Cryptex, NextGenU.org version of “hangman”

Live technical support

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Course/Self-Evaluation and Assessment

• Learning objects

• Peer activities

• Mentored activities

• Multiple choice quizzes and final examination

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Assessment Security

• Students can be video-recorded sitting the examination

• Computers’ cut and paste functions can be frozen

• Sites accessed during exam-taking can be tracked

• (Customized) examinations can be printed and administered locally under direct supervision

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Research Metrics

• Name

• Email

• Prior degrees

• Current training

• Location

• Institution

• Job title

• NextGenU metrics

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Fullname # of Attempts Marks Percentage Last attempted onStudent1 1 59/75 78.7%April 26, 2012, 6:17 amStudent2 1 75/75 100%April 26, 2012, 6:35 amStudent3 1 72/75 96%April 26, 2012, 6:44 amStudent4 1 68/75 90.7%April 26, 2012, 7:25 amStudent5 1 72/75 96%April 26, 2012, 7:34 amStudent6 1 71/75 94.7%April 26, 2012, 7:39 amStudent7 1 69/75 92%April 26, 2012, 7:34 amStudent8 1 68/75 90.7%April 26, 2012, 7:42 amStudent9 1 66/75 88%April 26, 2012, 8:11 amStudent10 1 74/75 98.7%April 26, 2012, 8:07 amStudent11 1 69/75 92%May 4, 2012, 11:49 am

Cumulative 763/825 92.48%

Final Exam Sampling

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Quiz: Competency 6.1. Understand the approach to the approachto abdominal pain 10

66.66% 1

100.00% 9

Quiz: Competency 6.2. Understand the approach to altered mental status 10

66.66% 5

100.00% 5

Quiz: Competency 6.3. Understand the approach to cardiac arrest 10

66.66% 2

100.00% 8

Quiz: Competency 6.4. Understand the approach to chest pain 10

100.00% 10

Quiz: Competency 6.5. Understand the approach to gastrointestinal bleeding 10

66.66% 2

100.00% 8

Quiz: Competency 6.6. Understand the approach to headache 10

66.66% 1

100.00% 9

Quiz: Competency 6.7. Understand the approach to poisoning 10

33.33% 1

66.66% 3100.00% 6

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“I’ve gotten to know how to handle people with these struggles. Because in the beginning I could not. Because I looked - I used to look - at these people like people who are just failures, people who don’t really really want to work in life. But then I got to change that perspective of mine, so I can say that that’s a skill that I’ve acquired, in that now I know how to approach them. I don’t go with them with a stereotypical mind that these people are just failures in the community. “

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- Credit - Competency-based- Human interactions - Best resources- 360 assessment - Coordinated curriculum- Higher-level education - Tested efficacy- Customizability - Multiple languages - Warm prestige - Advertisement-freeMOOCs (6) - Asynchronous- Free - Active educational partnerships- Limitless scalability - Teacher/learner respectful- Low risk - Open research policy- Low barriers - Financial efficiency- Low carbon emissions- Computerized interactions ?s – EFrank@NextGenU.org

PRIMAFAMED and NextGenU: a global co-democratization of … · 2014-07-07 · ACSM Guidelines for...

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