Delivering education and training via mobile learning

MBBS(Mal),AM(Mal),FRCS(Ed),FRCS(Glasg),FICS(USA),MBA(USA), Dip Hand Surgery(Eur), Dip MedEd(Dundee), MIDT(OUM),FHEA(UK),FFST(Ed), FAcadMEd(UK).

Senior Consultant Hand Surgeonwww.handsurgeryedu.com

Dr Vaikunthan Rajaratnam

Credentials

• > 30 years clinical practice and teaching• Qualifications in medical education(FAcadMEd)• Director of On line Courses, Perdana University, Malaysia• Experience in instructional design and technology(MIDT)• Publications and research in surgical education• Senior Clinical Examiner – Birmingham/ Singapore• External Examiner Ortho and Hand Surgery Exit exams –

Indonesia/Malaysia/Singapore• Examiner /Faculty Royal College of Surgeons Edinburgh• Quality Assurance Panel of Visitor in PG ME&T, UK• Core Faculty Member Orthopaedic Surgery – ACGME-I• Core Faculty Member Hand Surgery Residency, Singapore• Advisor to Special Committee for redesign of hand surgery exit

exam Singapore• Fellow HEA UK• Reviewer for Educational Research Grants HEA

IndiaSri LankaBangladeshCambodiaIndonesia

Maslow's hierarchy of needs

ALTRUISM IN MEDICINE – a survey of medical professionals’ thoughts and attitudes

: 74% of respondents had used their medical expertise and experience in altruistic behaviour outside of their normal working role, with nearly 1 in 5 of respondents spending over 6 month doing so.

57% was completed in their home country, and 43% abroad.

83% were willing to commit a period of time each year towards organised altruistic work

Altruism in Medicine An analysis of perception , definition and practice of altruism among medical professionals in Singapore

. 79% of the respondents said they had used medical training in an altruistic manner outside their work , 32% at home and 36% at home as well as abroad .

94% said they are willing to commit to a fixed period in a year towards altruistic activity

Makings of an equitable, just and accessible system of sustainable global health for the needy

Glocal

Education

Management

annually account for $740 million (in U.S. dollars) and rank first in the order of most expensive injury types, before knee and lower limb fractures ($562 million), hip fractures ($532 million), and skull-brain injury ($355 million). Productivity costs contributed more to the total costs of hand and wrist injuries (56%) than did direct health-care costs. Within the overall group of hand and wrist injuries, hand and finger fractures are the most expensive group ($278 million), largely due to high productivity costs in the age group of twenty to sixty-four years ($192 million).

Why hand surgery

De Putter, C. E., Selles, R. W., Polinder, S., Panneman, M. J. M., Hovius, S. E. R., & Van Beeck, E. F. (2012). Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study. The Journal of bone and joint surgery. American volume, 94(9)

Glocal

Education, Education and Education

1. Quality care/optimum outcomes - education 2. The current UG curriculum inadequate3. Currently PG hand programs - exclusive 4. Need

• flexibility, • student centred • on-demand learning that is • universally accessible, • affordable and • locally relevant.

1. designed for practising doctors 2. universally accessible3. e-learning platform4. modular in nature5. catering to working doctors educational

needs

The Solution

An on-line modular programme Three levels of qualifications:

PG Certificate, Diploma and Master’s degree,

MOODLE LMSInternational faculty - 8 Deployed on line (handsurgeryedu.com).Perdana University Malaysia

• Future of learning changing• Everyone can learn. • Communities of practice can build programs. • Ubiquitous learning changing the landscape • Massively open online course - the model • Alter the relationship of all stake holders • Viability of this educational model.

Management

Intangible Tangible

People

Organisational

Relationships

Real Estate

Equipment

CollaborationCommunicationCoordinationEducationPassionCompassionConcentrationEffort

International CollaborationLocal SurgeonsSystemsStructureStrategyValues

Brain

Education and Training

Education has a much broader aim to develop an individual

training has a narrow aim to increase knowledge and skill in specific areas.

Pressing problems of education

accessquality and Cost

Daniel, J. (2002). Technology is the Answer: What was the Question? 

UNESCO Assistant Director for Education

way forward for online education

involves the participation of both instructional designers/learning technologists and discipline-based academics

Larreamendy-Joerns, J. and Leinhardt, G. (2006). Going the Distance with Online Education.

Review of Educational Research, 76/4, 567-605.

THE LEARNING PROCESS

PEOPLE LEARN IN DIFFERENT WAYS

THE BRAIN PLAYS A ROLE

BASED ON ASSOCIATIONS

OCCURS IN CULTURAL AND SOCIAL CONTEXTS

PEOPLE THINK ABOUT THEIR OWN LEARNING, AND THEIR FEELINGS MATTER

Teaching

PROCESS OF ORGANIZING THE ENVIRONMENT

ORGANIZING KNOWLEDGE, INFORMATION, AND ACTIVITIES

PROCESS OF ORGANIZING PEOPLE

Cognitivist Theories:

Assimilation Theory (Ausubel)

Attribution Theory (Weiner)

Cognitive Load Theory (Sweller)

Cognitive Theory of Multimedia Learning (Mayer)

Component Display Theory

Elaboration Theory (Reigeluth)

Gestalt Psychology (Tolman)

Mental Models (Johnson-Laird)

Schema Theory

Stage Theory of Cognitive Development (Piaget)

Behaviorist Theories

Classical Conditioning (Pavlov)

GOMS Model (Card, Moran, and Newell)

Operant Conditioning (Skinner)

Social Learning Theory (Bandura)

Constructivism

Cognitive Apprenticeship (Collins et al.)

Communities of Practice (Lave and Wenger)

Discovery Learning (Bruner)

Social Development Theory (Vygtosky)

Problem-Based Learning (PBL)

Situated Learning (Lave)

Humanism

ARCS Model of Motivational Design (Keller)

Emotional Intelligence (Goleman)

Experiential Learning (Kolb)

Maslow’s Hierarchy of Needs (Maslow)

Self-Determination Theory (Deci and Ryan)

Design-Based

ADDIE Model of Instructional Design

ARCS Model of Motivational Design (Keller)

Elaboration Theory (Reigeluth)

Open Education Resources

U.S. Secretary of Education Arne Duncan at the U.S. Agency for International Development (USAID) Global Education SummitAugust 6, 2013

…potential to transform education

“At the same time, the fast-evolving field of education technology—from cloud computing to personal learning devices to Open Education Resources like the Khan Academy, which my two young children enjoy—has huge potential to transform education”

http://www.ed.gov/news/speeches/education-only-solution

..opportunities..

“Open Education Resources and other communication tools can help improve and expand teacher training and professional development—a huge opportunity in countries grappling with large teacher shortages and under-educated teachers”

http://www.ed.gov/news/speeches/education-only-solution

Rapid Prototyping

E learning

Using Instructional Design in post graduate surgical skill training

Vaikunthan Rajaratnam1, 2, Tong Pei-Yein1

1Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore2Yong Loo Lin School of Medicine, National University of Singapore, Singapore

psychomotor specialty predictable, reliable and

cost effective surgical skills development

high quality simulations model to acquire skills

Current theory and trends

Behaviorism

Cognitivism

Constructivism

Design-Based

Humanism

On line & E Learning

MOOC - Free courses Open access

Models – MITX www.edx.org

SOLE-Self Organizing Learning Environments

Remove barriers to learning

Identified real world problems

Demonstrated skill gaps in hand surgery

Used the theories of instructional design (ID) and learning

Analyse the instructional needs of learners and skill gap

Generated solutions using the principles of ID.

Individual needs of the learners

Entry behaviour and characteristics,

Stated objectives of the instructions.

Developed instructional activities and materials

Effective and efficient transfer of information and skills

Immediate and relevant feedback and

Valid and reliable

An Instructional Design model (ADDIE)

The curriculum The Delphi method was used to map the curriculum

grounded on community orientated and outcome based, incorporating , surgical experts and tertiary hand referral center

data .The pedagogy

catered to projected learner demographics utilising the work based learning framework ensuring flexibility,focusing on process-driven curriculum, self-directed andexperiential learning.

Formative assessment onlyautomated e -assessments,learning logs and reflective practice assignments

Methodology

perform a professional task with sufficient independence. Defining and developing Entrustable Professional Activities (EPAs) in hand surgery.

4 skill acquisition workshop were conceptualized and developed :-1. Injured Hand Assessment; 2. Flexor Tendon Workshop; 3. Hand Fracture Fixation; 4. Micro-neural repair workshop

Community needs and ensuring fit for purpose outcomes

EPAs are entrusted when a supervisor is confident the trainee can demonstrate the knowledge, skills and attitude required of the task, knows when to ask for additional help and can be trusted to seek assistance in a timely manner.

Instructional Event Internal Mental Process

1. Gain attention Stimuli activates receptors

2. Inform learners of objectives Creates level of expectation for learning

3. Stimulate recall of prior learning Retrieval and activation of short-term memory

4. Present the content Selective perception of content

5. Provide “learning guidance” Semantic encoding for storage long-term memory

6. Elicit performance (practice) Responds to questions to enhance encoding and verification

7. Provide feedback Reinforce and assessment of correct performance

8. Assess performance Retrieval and reinforcement of content as final evaluation

9. Enhance retention and transfer to the job Retrieval and generalization of learned skill to new situation

Gagnes 9 events of instruction

Twice yearly (except for micro-neural repair wokshop - annually).

Assessed for usefulness with immediate feedback following the course.

These were analysed and showed there was high satisfaction and learning of skills.

Results

vaikunthan@gmail.com

www.handsurgeryedu.com

http://www.facebook.com/handsurgeryedu

https://twitter.com/handsurgeryedu

http://www.linkedin.com/groups/Hand-Surgery-International-3804094