Wednesday, December 23, 2009
Wednesday, December 9, 2009
- It was mandatory - and it was being done for the wrong reasons - for compliance rather than education.
- No attempt was made to understand what I already knew about these topics
- Too much information was presented in a short space of time
- It was very passive - all lectures with little discussion
- Facts -"A unique bit of information that identifies an object, person, place etc". e.g. Prilosec is a brand name for omeprazole which is a proton pump inhibitor
- Concept - "A category of items or ideas that share some common features" e.g. Symptoms or presentations of Gastroesophageal refulx disease
- Procedure - "A series of steps that show how to make or do something" e.g. how to do an esophagogastroduodenoscopy (EGD)
- Process - "A description of how something works or operates" e.g. how is acid or H+ produced in the stomach
- Principle - "Rules, algorithms or guidelines" e.g. How to manage GERD, When to do EGD in GERD etc.
- Information that one should be aware of but don't really need to be able to recite - and is not needed urgently- e.g. the mechanism of acid production in the gastric mucosa
- Information that one should either know or be able to find very quickly- name of a PPI and its dose
- Information that one would like to validate or learn from others - reading about it alone might not be sufficient - how to do an EGD
- Information that one is not aware of and have to make efforts to determine if it exists and to acquire - relative effectiveness of one PPI over another in treating GERD symptoms, or benefits of adding a H2 receptor blocker to a PPI in managing persistent GERD symptoms
Thursday, November 26, 2009
- Non judgmental
- Based on observed interactions
- Include what was done well, what could be done better.
Tuesday, November 17, 2009
- Going down from head to toe
- Patient comfort and convenience
As I was wondering how to present this information, I came across Bubbl.us a cool mindmapping tool. So I created the following schema of the Logical Flow of a Physical Exam using Bubbl.us
If you want to check it out on Bubbl.us, here is the read only link
Monday, November 16, 2009
Sunday, November 1, 2009
I find these Social Media sites to be terrific in several ways
- Learn a lot from Tweets by other people with similar interests whom I follow on Twitter
- Helps me keep up with updates in medicine, technology, education and combinations of these
- Stay current with friends and family efficiently and effectively - Friended Dad on FB so he can see my daughters soccer videos and dance performances.
- Learn about interests and hobbies of "friends" on FB - developed even more respect for them and got something new to talk about when we meet next
- Twitter helps me find and exchange ideas with an amazing group of people on the planet - something that I cherish more and more
- Learn techniques of communication - mutual respect, prompt feedback, sharing with attribution that I can bring back to live meetings
But why not?
One of the key parameters used in promotion is "recognition by your peers". So if your peers who work at other academic medical centers follow you on Twitter, it should help right?
When you post a blog and get comments from several followers, is this not a transparent peer review process?
If you do meta-analyses and you poll the twitterverse for unpublished studies, your systematic review will have less of the publication bias right?
As far as other "work" goes, I am on the social media committee for my institution and that blurs the distinction even more. Experience with social media has helped me suggest/develop solutions like
- Using Yammer and biomedexperts within the institution to help people find mentors and coaches - creating groups for each major competency or area of interest
- Creating a FB page for a non-profit physician organization to improve communication between members
- Using Google groups for our medical students to share information and resources
- Using Zotero for our medical students to collect evidence from their online assessment system and cite it when writing their ePortfolios
- Creating a Chronic Disease curriculum with students and selected patients communicating in private groups in FB/Ning
- Using Second Life to help students practice and learn history taking and communication skills in a non-threatening environment
- Pre-teen daughter picked up blogging as a way of journaling her thoughts and experiences. She has now gone on to help several of her classmates set up their own blogs.
- She learned with me how to edit and stitch together her soccer videos using windows movie maker and post on YouTube and share with her friends (private limited URL) - She had to select the "good" parts and eliminate the videos of "mistakes". This helped her to review her soccer skills and identify areas for improvement. (Sneaky heh? Hope she does not find this post!)
- Wife and daughter get invited to dance at various social events (e.g. weddings). Helped them create coaching dance videos and share with attendees before the event on YouTube. The people who saw the videos felt comfortable joining them for a group dance at the end of their performance!
- Found that wife and I tend to post news items of each others accomplishments on FB. Recognized that we value and respect each other more than we might have let on before! It seems to mean even more than telling each other - great job on that seminar or dance!
Still I think we still need to find a balance in our work, personal and families and computers and the Internet can be a challenge in this struggle. Used creatively social media might actually help solve the problem.
Before you jump headfirst into this, one suggestion - if you can, use 2 computers:
- Computer 1 (AKA work computer) - turn off e-mail, FB and Tweet alerts. On that computer, make sure you don't visit any social media site. Use this for collecting and analysing your research data, writing your articles, completing your patient visit notes and other electronic health record tasks, etc.
- Computer 2 (AKA SM computer) - keep several tabs open on your Social Media related sites. Google reader, Tweetdeck etc. also get used on this computer. Make sure to keep it on mute so you cannot hear alerts.
Does this work? Well seeing that I started doing this only recently and this is my first Blog in over a month, it seems it does.
So which computer did I use to write this blog? The work computer of course!
Tuesday, September 15, 2009
Last year a simple fist bump by President Obama got politicized. But this year it has come back with a new purpose. With the swine flu pandemic threatening to get worse with students returning to school and college and the seasonal influenza season just a few weeks away, hand washing has become the mantra for flu prevention.
But what if you don't have your hand sanitizer ready. Every time you shake hands you worry about contributing to the spread of the virus. For physicians it is a specially relevant issue. You walk into an exam room and shake hands with your patient. Everything you touch thereafter has a chance to get contaminated - the keyboard, the mouse, the table surface, the stethoscope etc. Even though you sanitize your hands religiously between patients, you probably don't sanitize them right after each handshake.
Enter the fist bump. Walk into the exam room and do a fist bump with the patient. Not only does it prevent your palms from getting contaminated but it gives you a great opportunity to start talking about the flu. We know that patients put a high value on their physician's opinion. A fist bump to start the office visit will give you a great chance to mention the importance of hand washing and educate the patients about how to prevent the spread of the virus.
I tried this today with all my patients and it worked!
Friday, June 12, 2009
Our burden of chronic disease is huge and growing. In a lot of cases the patients' lifestyles contributed to the chronic disease. We are spending huge chunks of health care dollars to treat these patients and keep looking at ways to cut this spending to decrease health care costs - the totally useless "length of stay" parameter comes to mind.
What we need to do is invest in the future so we can change lifestyles before they lead to chronic diseases. Also, we need to provide early treatments of chronic conditions like hypertension before we get into renal failure, heart failure and strokes. This will let us have a healthier productive tax-paying population that will help balance the budget.
The article points out how frequent contact between physician and patients may help in changing lifestyles and improve compliance with medications. With the advent of social networking tools we don't need to physically bring the patient into the office for this purpose. We can repurpose/create secure social networking tools for this.
- Physicians are inundated with work... a lot of it due to bureaucracy - filling out forms, documenting for purpose of billing, multiple pharmacy call backs due to multiple/illogical formularies
- There is no model for reimbursement for physician-patient contact outside of the office. And the payment is for the complexity of the office visit. Thus if you call and talk to the patient 15 times in a year and get him to take his meds, exercise and lose weight, you would be paid zilch! But if you see him twice a year, give him more medications as his diabetes and blood pressure go up and he gains weight, and then see him in the hospital when he get a heart attack you gets tons of money.
- Due to point # 2 the health care system is too top heavy with more specialists than generalists. Hospitals have invested huge amounts of money into high tech and not much into prevention.
Saturday, May 9, 2009
How does this apply to medical education? Is it important to adopt new technology for teaching our medical students? I love technology but I find myself thinking that the battle we need to fight is to make medical school education more student centered and not necessarily the immediate adoption of new technology.
Going from lectures to problem based learning is more important than changing the old chalkboards to electronic whiteboards! Getting our medical schools to move from grades to portfolios would be worthwhile cause to fight for but Portfolios can be done on paper. Students can use a paper textbook, they don't have to start medical school with a Kindle DX loaded with all their textbooks. Students can go to a "real" classroom as long as the "teacher" promotes active collaorative learning, they don't need the presentations loaded on their iPod or a virtual classroom.
Once we get our faculty to adopt a more collaborative and active learning approach, the adoption of the appropriate technology will follow. Technologies will be superseeded by newer ones, but the key principles of education should be more enduring. The current web 2.0 applications seem to be designed perfectly for collaborative learning and it would be great to integrate these into our curriculum delivery and assessments as we make adopt a more constructivist approach to medical education. But if I were to have one or the other, it would have to be the collaborative learning approach and not the technology! It does not have to be a dilema.
Thursday, April 30, 2009
- Medicine's incredible success at treating acute problems and thus bringing chronic problems to the forefront e.g. patient survives a stroke but is left with bed sores, incontinence OR survives an acute heart attack and is left with congestive heart failure. A William Schwab put it at a recent grand rounds, "Success brings failure" and thus our success in treating acute problems has brought us an excess of chronic problems.
- Increasing popularity of social media tools like Facebook, Twitter and Second Life. A recent study that I discussed earlier showing students were more likely to use Facebook for a course discussion than the University's learning management system.
- Medical education moving from a traditional "talking to the boards" model to a small group collaborative problem solving model - can we use this momentum for including patients into the learning "group"? This thought was resurrected by a post I read by Anne Marie Cunningham.
Thus we know what an obese patient with poorly controlled diabetes needs to do to bring his/her condition under control and maintain it there. Patient also often knows this. Still optimal outcome occurs only rarely and if it does, it is not sustained.
In managing chronic conditions, the patient has to learn to take control of his/her condition and the physician is only a part of the solution to make this happen. Our medical students learning is designed to occur either in classrooms or in hospitals - both of which are perfect for acute condition management. The exposure to outpatient chronic condition management where they can interact with the same few patients longitudinally does not occur in most schools.
The reasons for this are mostly logistic. Scheduling students to be in the clinic the same time as specific patients is a logistic nightmare. How about a model using social media?
Can we have students create limited, private accounts in a social media site like Facebook or create a specific site using Ning and invite consenting patients to be their "friends". We could have a list of patients with different conditions and abilities to use these social media tools. The sites would not be accessible except to invitees. The students would collaborate with a set of patients over their entire medical school experience. The patients would post/tweet about their symptoms, office visits, hospitalizations, test results and the students would learn/read up about these and explain these to the patients. In addition, they would work on skills like motivational interviewing, negotiated goal setting to help the patients take better control of their conditions.
This model will allow students to learn the role they have to play in management of chronic conditions and prepare them for the future!
Wednesday, April 29, 2009
Since I have to do some faculty development sessions, training medical educators on use of technology in education, I had to find some tools that were easier to use. So here is my very short list of 3 applications that I find very useful.
1. Jing - This is a great tool for capturing a portion of the screen and annotating it with arrows and text. While it does do screencasting, the free version has limits on time of a single movie and it puts its logo prominently at the end of the movie. It also allows to upload the captured image to its online repository. I do not use that much as I need to save and reuse the images for other purposes.
2. Wink - After a lot of trials and errors, I have settled on Wink for screencasting. It creates a flash movie from a window that you select on your screen. You select the number of frames/sec and it will capture these faithfully. It has a builtin annotation tool for adding callouts, textboxes etc. Also automatically adds pauses to the movie and you can add navigation buttons for the user so they can read the text and then proceed with the movie. You can delete unnecessary frames and thus keep the movie short and sweet. The only problem I had was deciding on the resolution. I used the Firefox window resizer add-on and captured at 800X600 so I could put the flash file in a frame or otherwise have room left on either side.
3. FRAPS - this is the only one of the 3 that I spent money on (35 dollars). I use Second Life for various educational purposes and FRAPS allows me to record the machinima in SL - both audio and video. It is very easy to use and has a hot key to start, stop the recording. The only thing to keep in mind is the incredibly HUGE file size. For one 20 minute recording it used up 10 GB of space on my HD. The solution is to use Virtual Dub to compress this to MPEG4 and the same file become close to 400 MB.
So that's it! Jing, Wink and FRAPS.
Thursday, April 23, 2009
So how does this work?
A medical student interviews a patient - both are in Second Life sitting face to face in an exam room. They "talk" to each other using headsets with microphones. They use lip-synching so when they talk, their lips move. They also use speech gestures so when they talk their hands and arms move around like most people in real life. The patient also has a number of pre-programmed gestures - crying, laughing, frowning, wringing ones hands, etc.
So why is this a good idea? Can't they just meet in some place in real life and do this? Can't they just talk over the phone?
They can meet in real life but that can be inconvenient. With S/L the 2 people can be poles apart! In addition, with S/L they are anonymous - the patient can be controlled by a physician without the student being aware of who it is. Also it can be less intimidating for a student than being face to face.
Does S/L add anything over and above a phone encounter? I sure hope so. There is good data that being in a MUVE affects spatial behavior. In addition the Social Identity model of Deindividuation Effects (SIDE) has shown that anonymity can have profound effects on group interactions. Does it make the encounter appear more real? We are interviewing the students to find out.
There are other advantages:
- The encounter can be captured digitally using software like FRAPS.
- The encounter can be viewed by anyone later - student or faculty. The faculty member can provide feedback to the student. Would be great to use VoiceThread for this.
- There are few geographic barriers. This could be offered as a service run by retired clinicians to train medical and nursing students in patient interviewing skills - a little bit like outsourcing your OSCE's.
As I was viewing the macinima of the first 2 patient interviews, I could recognize several teaching moments. What if we give this recording to a clinician educator not involved with the study, have them record their comments as annotations on the video (like VoiceThread) and then share with the student or even with other students?
The possibilities are numerous. I cannot post the machinima without student consent. Will write more about this once we get some feedback!
Wednesday, April 15, 2009
Say you were trying to teach the lyrics of a song "I dreamed a dream" or you wanted to teach a group of kids (all adults) not to judge a book by its cover, you could show this video (which half the world seems to have seen already).
See the first 5 minutes and then if you disagree post a comment.
I rest my case. Go Susan Boyle. (My heart keeps telling my cynical side that this was not staged by the marketing gurus at "Britain has got talent").
If after watching the video, you want the lyrics, here they are:
Lyrics | Fantine - I Dreamed a Dream lyrics
Saturday, April 11, 2009
The main finding in this exploratory study was that while only about 40% of students used the Facebook discussion board, they used it in richer ways (posting photos of molecule structures, links etc) and for a longer period. The discussion group on WebCT was not used much and quickly petered out.
We don't know from the available data whether students who used Facebook were already using it socially? The authors were also not able to survey the students regarding the reasons why they used or did not use a specific tool. Thus we are left to wonder...
One guess is that if you are already using Facebook, clicking over to your Organic Chemistry Group to check something out or put in a comment would be quick and easy. Problem is getting the other 60% of students to also use this tool. Would love to know if it was their learning style, attitude towards technology, use of other social networking sites, or some other reason that prevented them from joining this discussion board. Is it even important to get them to join? What if only 10% of students had joined? What is the critical mass for something like this to be meaningful? The activity required instructor time to moderate the group. If a number of students were using another site like MySpace, would it be possible to moderate 2 groups? What about 3?
What if WebCT had a facebook widget or the other way around so both the WebCT and Facebook users could participate without having to log in some where else?
Thursday, April 9, 2009
Practical model for using the Information Processing Theory to stay current with (medical) literature
While I don't know how well validated this theory is, it does describe an interesting flow of information from the sensory register to short term memory to long term memory.
The wikipedia describes it thus
Sensory register: the mental processing unit that receives information from the environment and stores it fleetingly.
Short-term memory: the mental processing unit in which information may be stored temporarily; the work space of the mind, where a decision must be made to discard information or to transfer it to permanent storage, in long-term memory.
Long-term memory: the encyclopedic mental processing unit in which information may be stored permanently and from which it may be later retrieved.
The way I understand it, Constructivism works great for understanding how we can facilitate learning of new concepts e.g. medical students learning anatomy in their first year. Active learning, Problem based small group discussions, etc.
When we think about how to help a practicing physician keep up with medical updates in his or her specialty, it is a different setting. The person already knows the subject, is busy and probably does not have much time for collaborative learning in small groups. The constructs have already been formed during medical school, residency and subsequent experiences. It seems self directed learning using the principles of the Information Processing Theory would very helpful to help the physician refine these constructs on a longitudinal basis. Let me show you a model of how this would work.
- Google Reader This is a free web application and all it requires is a free Google account.
- Zotero I have referred to Zotero in a previous post. It is a free bibliography and citation tool that works as an add on to Firefox.
Overview of Google Reader
Google Reader Detail:
Retrieval from Zotero:
Steps in the Model:
- Set up RSS subscriptions to your specialty medical journals in Google Reader
- This allows abstracts of articles flow into your Reader automatically and allows you to view these in one place
- This is equivalent to the sensory register mentioned above. When you browse through the RSS feeds, you "receive the information from the environment and store it fleetingly"
- As you scan through the abstracts, you can in Google Reader mark the ones that seem significant and relevant with a star. The Google Reader automatically tracks the ones you have browsed and removes them from the "home screen".
- You have thus gone through the process of determining whether the abstracts are to be discarded or to be processed for storage in long term memory. This is similar to the short term memory proposed in the Information Processing Theory.
- When you have more time and inclination, you return to the Google Reader using Firefox that has the Zotero plug-in installed.
- You click on the hyperlink to the abstract and from there to the full text article if you have access. You read the abstract and determine that it is worth "storing". Zotero allows you to take a "Snapshot" of the article and annotate it with notes, keywords and highlights. The bibiliography information of the article along with the annotated snapshot and notes and keywords are all stored in your Zotero library
- Zotero allows each reference item to be included in several collections. Thus as an Internist, I have collections for all subspecialties of medicine - e.g. Cardiology, Pulmonary etc.
- This process of analysing the article, annotating it and adding keywords, notes and sorting into collections is similiar to encoding that is described in Constructivism and helps move the information into a more permanent long-term storage.
- The entire Zotero library is searchable and allows for easy retreival of previously processed information. As information is recalled and applied more often, it is more likely to become true knowledge.
Sunday, April 5, 2009
GOAL: Get the cat to chase and catch the red ball of wool. Have to get the mouse pointer exactly over the red ball. I forgot to de-link the mouse pointer from the cat so you have to click on the red stop sign to stop the script. Hey you live and you learn right?
Learn more about this project
After you spend more than a few minutes working on Scratch, you can create something like this:
Learn more about this project
1. Free programming tool with a terrific user interface from http://scratch.mit.edu
2. Requires JAVA
3. Free hosting service on Scratch servers
4. You can download and examine the code for all uploaded projects
5. Code is "written" by stacking blocks on each other!
6. Once uploaded to Scratch servers, you can embed the "game" into your blog or web page like I just did.
So how can you use this?
1. Teach logic
2. Teach the concepts of programming
3. Create educational games - that teach medical concepts e.g. A red blood cell moves through the circulation and you have to click on the appropriate valve in appropriate sequence to get it through from the vena cava to the Right Atrium to Right ventricle to Lungs to Left Atrium to Left Ventricle to Aorta. Or you could allow them to click on a valve to create a state of Stenosis or regurgitation and show what happens.
4. You could embed this into a LMS or Assessment tool or even PowerPoint to help make for more active learning!
Sunday, March 29, 2009
One of the fundamental principles of education is for the learner to learn at their own pace and learn what they are interested in. Maria Montessori advocated the same approach. Setting specific times to learn specific topic based on an arbitrary schedule is contrary to this principle.
Now we have the WWW, great search tools, terrific information resources and ubiquitous broadband access. Still finding good information from reliable sources and separating the wheat from the chaff has been a difficult task. We may just be getting closer to solving this problem. YouTube EDU just went live last week:
From YouTube Blog (3/26/09)
"Do You EDU? Educational Hub Launches: Using YouTube as a vehicle to democratise learning is one of the coolest, unintended outcomes of the site's existence. YouTube EDU is a volunteer project sparked by a group of employees who wanted to find a better way to collect and highlight all the great educational content being uploaded to YouTube by colleges and universities. We'll feature some of these videos on the home page on Friday and elaborate further in a separate post on that day."
As I look at the growing number of sites promoting democratisation of education, I can't help but think that we live in great times! Here is my short list of sites that almost uniformly provide terrific educational value. While the amount of medical information on these sites leaves much to be desired, it is just a matter of time.
As a complete TV-Computer integration gets closer, we can easily see this content on our TV screens/monitors. In addition you could dump this into your mobile device like iPod or Zune. Now I will not cringe when I next hear the rant "there is nothing good on television!". When someone has "spare time" and is looking for something mentally stimulating, it may not be hard to find!
Another question is whether these online "universities" can replace classrooms and professors.
We are all familiar with the recent paper on Podcasts replacing Professors by McKinney, Dyck and Luber in Computers and Education. The study abstract:
"iTunes University, a website with downloadable educational podcasts, can provide students the opportunity to obtain professors’ lectures when students are unable to attend class. To determine the effectiveness of audio lectures in higher education, undergraduate general psychology students participated in one of two conditions. In the lecture condition, participants listened to a 25-min lecture given in person by a professor using PowerPoint slides. Copies of the slides were given to aid note-taking. In the podcast condition, participants received a podcast of the same lecture along with the PowerPoint handouts. Participants in both conditions were instructed to keep a running log of study time and activities used in preparing for an exam. One week from the initial session students returned to take an exam on lecture content. Results indicated that students in the podcast condition who took notes while listening to the podcast scored significantly higher than the lecture condition. The impact of mobile learning on classroom performance is discussed."The study showed that when students listened to the podcast of a "lecture" more than once and took notes (thus transforming or encoding the information) they did better than their classroom colleagues.
I would love to know a couple more things:
1. What was the level of interactivity in the live class? Did students or the professor ask questions? Was there any discussion? Was this captured in the podcast?
2. How big was the class size?
3. Did the professor use an audience response system to gauge student needs, assess comprehension of the material or customize the lecture?
4. Why choose 25 min as the lecture length?
5. What was the complexity of the content compared to the average student's understanding of it?
6. Why choose a week as a recall period?
Education in general is moving away for passive lectures to large groups - because most educators would believe that active learning in small groups which allow for some transformation of the knowledge into non-textual formats works best. Maybe we need to look at this by doing a study that compares one such "ideal" class with a passive podcasts with ability to listen multiple times and take notes.
The other issue is whether we are trying to impart knowledge or educating our learners about how to acquire knowledge.
What one would love to see is a pedagogic model that incorporates podcasts into interactive small group learning. There have been studies where this has been tested and shown to work.
Well sounds like thats enough food for thought for now!
Friday, March 27, 2009
- Image and video with/without audio capture
- Integrated upload to server
- Annotation tools - arrows, text, rectangles
- Cool interface
I tried it out and while it works as stated I found several issues
- The video saves only as swf files (for free version)
- The end of the video has a Jing splash page which means you would not use this for any professional use. (the Pro version does not have this)
- It does not allow one to select a particluar application window - just has cross hairs to select an area.
So if you want to capture static images from your screen, it works fine but there are several other similar tools to choose from. I found this review by Matthew Ellison which includes reviews of 2 free utilities ScreenHunter 5 Free and TNT ScreenCapture 2.1. Of course One Note does a great job of grabbing the screen shots and then letting you annotate them. The good old method of [Print Screen] and then pasting into your favorite image editing application works too.
Having made these screencasts I wanted to put them into a PowerPoint presentation. This was easier said than done. You cannot just insert the swf file created by Jing into PowerPoint. You have to go through some steps which are not difficult. These are outlined here by Geetesh Bajaj. The key step there is to get the Shockwave Flash ActiveX control. Surprisingly neither Microsoft nor Adobe provide this control! But you can get it by just searching in Google.
Summary of steps (PowerPoint 2003):(added 3/28/09)
- Save/copy the flash movie to the same folder as your PowerPoint file
- Go to the slide where you want the movie to show
- View >> Toolbars >> Control toolbar
- On Control Toolbox >> click on More Controls >> Scroll down to
Shockwave Flash Object
- If you don't have this option, Google for Shockwave Flash Object ActiveX
control and install it.
- Drag the cross-hairs on your slide and size and position the object
- Right click on the window and choose Properties
- In the table that pops up do the following:
a) Opposite Movie type in
the name of your swf file (since it is in the same folder you don't need to type
the entire path)
b) Change Embed to True
- Now run the slide show and you should be able to see the movie!
The next big challenge is to navigate the slide show with the flash movie playing. The normal keyboard arrow key shortcuts do not work to go to next or previous slide while the Flash movie is playing. The best option is to create some action buttons for next and previous slides on the master slide. Make these quite small and size the flash control so that these buttons are not hidden. Then you can navigate the slide show and if you get your timing down you can jump to the next slide just before the Jing Splash page shows up at the end of the movie. If you are going to create the show as a tutorial for someone else to navigate, might be best to set up timings. You can do this by Slide show>> Slide transition >> Advance slide automatically after XX seconds (depending on length of movie).
Saturday, March 21, 2009
Zotero is among the many excellent applications developed by the Center. The appear to have some very creative minds and an excellent team of designers, user interface experts and programmers along with some strong funding.
Zotero is in some ways like other reference managers:
- Allows one to build up a library of references along with specific information like Author names, dates, journal name, pages etc...
- Has a Word (and Open Office) plug in to insert citations into articles you write and to create a bibliography of the citations you use at the end of the article.
- Has multiple styles for citations and bibliographies that you can use based on which journal you are sending your manuscript to.
- It is free
- It is an extension of a browser - this feature means Zotero understands that most databases of information are now online and people use a browser to search these databases. Even if you do want to add an article from a print journal into your library, you could still go to the appropriate database where this journal is indexed and find that article.
- Adding the article's appropriate information to your library is often seamless. A large number of these online databases (e.g. PubMed) are now Zotero ready. What this means is that when the browser opens a web page with information re' say a journal article, Zotero "senses" this and a small icon appears to the right of the URL box. Clicking on this icon adds all the metadata about that article into the appropriate fields in the Zotero Library.
- Zotero allows you to tag the article with keywords and also to add it to various "Collections". It also has a powerful search tool to search for through your references.
- Zotero allows you to get a "snapshot" of the webpage and annotate your copy of this snapshot (much like highlighting or commenting in a PDF file).
- Zotero also allows you to add your notes to the reference.
I have one specific problem when using Zotero for a specific purpose. I am working with a couple of medical students to use Zotero for their ePortfolios. We have a home-grown ePortfolio system where all medical students get narrative formative and summative feedback through out their 5 years. These assessments are competency based (similar to ACGME competencies) and organized into areas of improvement and areas of strength. These are all done online and when submitted, they appear in the students' ePortfolio workspaces. The students write essays (ePortfolios) regarding their meeting various standards in each competency citing the evidence from the assessments.
We use EndNote or RefWorks to allow students to download all their references (assessment information), write their essays, cite the references, and then upload it all into a review area. The citations work as hyperlinks so when reviewer reading the essay wants to look at one of the cited references s/he has to just click on the citation to open a new window where the assessment form is displayed.
The problem I am facing with Zotero is that we cannot figure out how to make the citations in the text of the essay or in the bibliography clickable without going to each one and editing them. Since some of the students have as many as a 100 references in their bibliography this is not a viable solution.
It is very surprising that though Zotero is built on the philosophy of getting the references from online databases, it seems to have neglected that the manuscripts written by people using Zotero would be reviewed online where it would be critical for these citations to be hyperlinks!
I am relatively new to Zotero and am quite possibly missing something. I have scoured the Zotero forums, Googled the web and found nothing so far. Maybe the CSL does not at present allow this to occur? Would it be possible to add a "Web style" to Zotero's growing list of styles? If someone can do that, it will be the most appreciated!
Saturday, March 14, 2009
For the smart board one needs the following:
- A bluetooth enabled computer (Win)
- A Wiimote (Wii Remote) - need to set up bluetooth connection with computer
- An infrared LED pen - could test with just a infrared remote of a discarded appliance?
- His software (Free download from his site)
- A projector or any LCD display connected to the computer.
I spent a good 2 hours this morning trying to get this to work. I have a Fujitsu Lifebook tablet PC with a built-in bluetooth adapter. It has Win XP. Its had a Toshiba Bluetooth stack that did not recognize the Wii Remote. So I found a newer version and installed that. Heart stopping moment when it uninstalled the older stack and the installation of the new stack stopped half way. Luckily after a couple of reboots, the new stack was installed and working.
Next the details of the bluetooth connection. I found several tutorials on this and the key things to remember are
- Use the 1 and 2 buttons on the Wii Remote simultaneously to put it in Discovery mode. If you want you can use the red button under the battery cover. The 4 blue LEDs at the bottom of the Wii Remote need to be flashing - this means it is in Discovery mode.
- Run the bluetooth manager on the PC and it should recognize the Wii Remote. Keep repeatedly pressing the 1 + 2 buttons to keep the LEDs flashing. When asked for a Passkey - choose the radiobutton that says "Do not use passkey". If you do not have that option, you need a newer Toshiba Bluetooth stack.
I got this far and then I tried to run another script in GlovePIE (it comes with several) and it stopped detecting the Wii Remote! Also Mr. Lee's software said no Wii Remote detected under HID device list! The Bluetooth manager still showed the Wii Remote as connected to the PC. Did not have time to troubleshoot this further. Needless to say this is not a easy install. People might want to wait for a more seamless solution - a bundled BT adapter + driver/stack + a script to use it as a mouse + some LED pens! I will wait for a while before I will have the time and energy to try this again.
Sunday, March 8, 2009
Friday, March 6, 2009
The question is whether the real use of SL in education is the structures and buildings of these universities or is it the ability to interact with others in a unique way? The ability to cloak oneself behind one's avatar lends a special characteristic to SL interactions.
Physicians are well aware of how some patients are able to ask questions more frankly via e-mail rather than face to face (See article by Daniel Sands http://www.mahealthdata.org/data/library/guidefiles/1999_PatientCtrdEmailGdlns-Sands.pdf). Does SL allow a similar disinhibition and thus a more free and frank discussion? Are students more likely to admit that they don't know something and ask more questions? Is the interaction in SL likely to be healthier?
At least with the present technology and bandwidth it is difficult to provide simulations with enough richness and detail in SL. On the other hand the ability to voice chat and convey some emotions maybe sufficient to use SL as a medium for collaborative learning specially when participants are not all at one site.
Wednesday, March 4, 2009
Chris Taylor in her recent post cited a recent study re' use of technology in education. The comments highlight some of the potential problems of such studies - the concern being how the teaching method or style may be confused with the actual technology used by the educator. One needs to keep this in mind when appraising literature on this topic.
Sunday, March 1, 2009
How can we train medical students to take a good history in a safe environment before they start working with real patients?
One method we often use is "standardized patients" who are trained to act like patients with particular medical problems. These encounters can be video taped for later review. This is generally an excellent method for training medical students but has some drawbacks:
- Scheduling problems
- Shortage of well-trained standardized patients.
- Informed consent for use of video
We are working on a project to test the feasibility of using SL for training students on history taking and presented a poster on this at a recent education retreat at Case Western Reserve University School of Medicine. At present we are working on creating the appropriate settings and emotions and gestures for a test case (Special thanks to Sue Shick for these images). Should have some results in the next 12 months.
CNN just ran a story on the Imperial College of London efforts in SL
Friday, February 27, 2009
Most educators would agree with the constructivism theory. Thus we have in our minds a model to explain what we have experienced and every time we have a new experience, we modify the model.
Educators believe in "active learning" where the process of acquiring and assimilating the information is an active process that helps with the process of modifying the model.
The phrase "PowerPoint presentation" conjures up images of a dark room with a speaker hidden behind a podium droning away at a large audience that is nodding off. The exact opposite of what we would want education to be. Still PowerPoint is one of the most popular tools of teachers and lecturers.
But it is quite possible to use PowerPoint to make fun and interactive presentations. Some examples are:
- Audience Response systems
- Using a tablet PC to annotate the slides during the presentation
- Imaginative use of Action buttons and hyperlinks to customize the presentation to the learning needs of the audience
- Making invisible hot spots on images
- Use of templates like the Jeopardy Templates.
Friday, February 20, 2009
One way to solve this problem is to get all workshop participants to review a computer and Web skills checklist prior to the actual session. In addition we can provide links to some good tutorials if they need to brush up on specific skills.
I have put together a skills checklist and links to some tutorials that cover basic Windows skills here.