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Visit our web page http://umanitoba.ca/faculties/medicine/education/ed_dev/ for full details on all Medical Education Events. 1

In This Issue:

Department Head’s Message

by Andy MacDiarmid

1

Editorial Welcome

Changes to Med Ed

1

2

Featured Topic: The Flipped Classroom by Anita Ens

3

Research Highlights by Stephanie Arm-strong

5

Temporal Bone - Printed and Haptic Models

by Bertram Unger

6

FAQ 7

Featured Colleague 8

Conference Reports 9

MED ED NEWS Winter 2014 Volume 4 No. 1

Faculty of Medicine

Welcome to the revamped newsletter of the Department of Medical Education. I

thank Wil Fleisher and Cindy Lewkiw who edited the newsletter in recent years for their good work and for trusting it to the Med Ed team who will be taking turns with editorship.

We in the Department feel lucky to be part of this time of excitement and growth in medical education. Inside you will read details of recent arrivals and departures and about new and old educational initiatives. With new people come new perspectives and energy and I hope you will join us at one of our rounds or workshops in the near future to see these for yourself. As always we are keen to hear from you about how we may serve the faculty better.

Department Head’s Message by Andy MacDiarmid

Welcome to our new issue of Med Ed News. The Department of Medical Education has un-

dergone somewhat of a transformation in recent months, and more changes are in store with a

different look and content of the newsletter in upcoming issues. As a department, we look

forward to the possibilities as we navigate new waters and hope to learn much in our adven-

tures ahead.

In terms of newsletter content, we would like this to be a medium through which we offer

information on the latest in medical education research, trends, and conversations as well as

teaching tips and information about our department. The purpose of the newsletter is to in-

form, inspire, educate, and support medical educators on all things medical education, includ-

ing those relating specifically to our department. To that end, if you have ideas, please share

them with us.

Editorial Welcome by Anita Ens


Continued from Page 1

This issue offers a glimpse of some of

the ways in which medical education is

growing at the University of Manitoba.

In our department, we are working to

build a community of educators; devel-

oping curriculum and supporting others’

efforts to do so; identifying teaching and

learning opportunities and methods; and

offering faculty development that’s rele-

vant and timely.

This issue features the Flipped Class-

room as a pedagogical approach. The

newsletter also includes regular columns

such as conference highlights, staff

changes, and research reports. Enjoy!

Anita Ens, Issue Editor

In the last year, Med Ed has experienced a number of staffing changes. In upcoming newsletters, Med Ed team members will be featured. In this issue, our featured member is Cindy Lewkiw. Charlotte Rhodes, research and evaluation, has moved on to other pursuits. Thank you, Charlotte, for your work on many interesting projects with the department and all the best in your future endeavours. Dr. Cheryl Kristjanson retired in January. She retains a part time position with the Faculty of Pharmacy. Enjoy those golf greens in your spare time! Stephanie Giberson-Kirby is our director of Faculty Development. She holds a Masters of Continuing Education and has experience in both K-12 and profes-sional education. Her focus with Medical Education is on teaching in the clini-cal setting and rural faculty development. Sandra Schönwetter and Anita Ens have joined the team as Educational Spe-cialists. Sandra holds her Bachelor of Education and has teaching and curriculum de-velopment experience in K-12 and community colleges. As Educational Spe-cialist, her focus is on instructional development, online learning, and innova-tion in the classroom. Anita holds her PhD in Education and has taught both in private adult educa-tion and public post-secondary settings. At present, her focus is on postgradu-ate medical education, in particular with Family Medicine, supporting the development and implementation of the postgraduate Triple-C curriculum and competency-based education. We also welcome Stephanie Armstrong who will contribute her skills as Re-search Associate. Her background includes a BSc in Microbiology, BA Honors, and MA in Anthropology. Her current research focuses on the continuing edu-cation of physicians in practice, including maintenance of competence, inter-national medical graduate retention and integration, assessment of unper-ceived knowledge gaps, and interprofessional education. Read more about her work in the research updates section on page 5.

Another significant change has been the physical move of Med Ed from S204 Medical Services Building to 260 Brodie Centre, formerly the Dean’s Office.

Editorial Welcome Changes

Staffing

Space


You may have heard the term Flipped Class-

room rolling off colleagues’ tongues or featured in an article you skimmed in a professional jour-nal. If you’re like me, you’ll think flipped means upside down or reversed. And, although there are many understandings, the essential meaning of the term is exactly that: The “traditional” classroom is flipped.

Stemming from the preliminary work of Khan and associates (1), some versions of flipped classroom include team based learning (TBL), problem-based learning (PBL), case studies with discussion, blended learning (combination of online and face-to-face), or student led, interac-tive classes such as debates, role plays, or simu-lations (2). Commonly shared among these ap-proaches is active student participation.

The idea of a flipped classroom is not novel. What is novel is its introduction to what has been traditionally exclusively lecture-based teaching in academic sessions in medical educa-tion.

Considering a range of learning and teaching approaches to change the way we educate the next generations of physicians and health care professionals has ongoing relevance. What makes it so critical today is the combination of rapidly growing technologies, proliferation of information available and management systems, and a changing access to knowledge among pa-tients. And support for flipped classrooms seems to be growing in the medical field (2, 3, 4).

The doctor or health care professional is no longer seen as the repository of information that must be handed to the student. Although still role model and expert, the medical teacher’s

Featured Topic: The Flipped Classroom by Anita Ens

role is to facilitate learning, supporting the student as much as needed to move towards competence. Content that can be learned by students inde-pendently can be offered online. The expectation is that learning in the classroom engages students in processes that require complex or “higher order” thinking skills. Much of the learning happens in the interactions among learners, between learner and teacher, and through a balance of experiential activi-ties and reflection.

Here at University of Manitoba’s Faculty of Medi-cine, the flipped classroom is being tried in a number of contexts. Change often requires support. The fol-lowing resources (p.4) offer some issues to consider when implementing a flipped classroom approach. The potential for learning is promising.

See References on page 4.


References

1. Prober CG, & Khan S. Medical education reimagined: a call to action. Acad Med. 2013 Oct;88(10):1407-10.

2. McLaughlin JE, Roth MT, Glatt DM, Ghar-kholonarehe N, Davidson CA, Griffin LM, et al. Acad Med. 2014 Feb;89(2): 1-8.

3. Green DE & McNeeley MF. Is radiology education ready for a flipped classroom? Ra-dioGraph 2013. 33:533-534 Published online www.rsna.org

4. Pierce R & Fox J. Instructional design and assessment: vodcasts and active-learning exercises in a “flipped classroom” model of a renal pharmacotherapy module. Am J of Pharm Educ. 2012: 76(10). Article 196.

The Flipped Classroom (cont’d from page 4)

by Anita Ens

The Flipped Classroom: Further Reading

Mehta NB, Hull AH, Young JB, Stoller J K. Just im-agine: new paradigms for medical education. Acad Med. 2013 Oct;88(10):1418-23. Varpio L, Bell R, Hollingworth G, Jalali A, Haidet P, Levine R, et al. Is transferring an educational in-novation actually a process of transformation? Adv in Health Sci Educ. 2012. 17:357-367.

The authors pose the question “Is what we did TBL?” in examining the larger issue of the fidel-ity of implementing educational innovations in local contexts. DaRosa D. AM rounds blog [Internet]. Sklar DP, ed. 2013. What’s missing from the flipped class-room model? Available from: http://tinyurl.com/ls5y55b

DaRosa advocates for adoption of the flipped classroom but cautions eager adopters to create related faculty development for educators unfamiliar with non-didactic approaches and to adjust the curriculum for learner progression.

AM Rounds is the official blog of the AAMC journal Academic Medicine. Other guest writers also contribute on the blog to a series on the flipped classroom.

Critz CC & Knight D. Using the flipped classroom in graduate nursing education. Nurs Educr. 2013. 38(5): 210-213. Available from PubMed with Full Text

http://www-ncbi-nlm-nih-gov.proxy2.lib.umanitoba.ca/pubmed/23969367

http://www.rsna.org

http://www-ncbi-nlm-nih-gov.proxy2.lib.umanitoba.ca/pubmed/23969368


New Series October 10, 2013 marked our first Dean’s Grand Rounds Medical Education Research Day. Qualitative and quan-titative research in medical education was represented by the whole spectrum of professions in the poster ses-sion. After a welcome from Andrew MacDiarmid, our department head, speakers Bruce Martin, Ming-Ka Chan, and Bertram Unger presented on the topic of UG-ME, PGME & Beyond! Dieter Schönwetter facilitated an informative workshop on Tell-Tale Signs of Effective Teaching and Learning: Using Your Classroom as a Re-search Laboratory. Overall, the day was an excellent means of acknowledging recent scholarship in teaching and learning in medical education! New Team As we move forward in our new home in 260 Brodie, there has been a move towards increasing collaboration between the Research and Evaluation positions within Medical Education, Continuing Professional Develop-ment, Physician Assessment, and the International Med-ical Graduate training programs. We hope that this new team will be an important resource for the department and that the collaboration leads to exciting new pro-jects. Projects Stephanie Armstrong is working on a number of pro-jects including one on the implementation of CanMEDS-enabled CPD planning tools. She has also assumed Char-lotte Rhodes’ role on a number of Med Ed research pro

jects, including the longitudinal evaluation of the UGME renewed curriculum, an evaluation of resi-dent teaching skills, and a program on preparing residents for lifelong learning. Bertram Unger is active in multiple projects as well, including design work in the Laboratory for Surgical Modeling, Simulation and Robotics, vali-dation projects, and other projects. Design

Temporal Bone Modeling for Surgical Training 3D Anatomy Viewer Microsoft Kinect based stereoscopic anatomy

viewer iOS platform mobile 3D anatomy curriculum

development tool

Validation Mechanical and vibratory properties of rapid-

prototyped bone Simulated haptic and rapid-prototyped tem-

poral bone validation against isomorphic cadaveric samples

The effect of stereoscopy during haptic train-ing for temporal bone surgery (BSc Med Project)

Validation of LapSim and Vimedix simulator metrics

Other

Optic disc assessment with ultrasound for measurement of increased intracranial pressure

Formative and summative metrics from force, torque and hand motion during laparos-copy and intubation

Research Highlights by Stephanie Armstrong


We have just completed a moderately large vali-

dation trial of our temporal bone printed and hap-tic models. The printed models are created using a 3D printer and generated from segmented CT scans. The rapid prototype model looks and feels like real bone inside and out, and can be drilled with a surgical drill. The haptic models are com-puter models that can be felt with the aid of a computer-controlled robotic arm which acts as a surrogate surgical drill. Subjects watch a virtual drill and bone on a computer screen and then per-form a surgical procedure. As the virtual bone is contacted on screen, the robot arm simulates the contact forces which allows the user to feel the procedure. Our study asked ten residents to drill 10 different cadaveric temporal bone specimens followed by matched rapid prototyped and haptic models. The

models were isomorphic (identical in morphology) to the cadaveric bones, having been based on mi-croCTs done prior to the experiment. Subjects were then asked to assess the models with respect to the cadaveric bone drilling experience, using a questionnaire. The questionnaire was divided into sections on the overall look and feel of the models,

Featured Research: Temporal Bone - Printed and Haptic Models by Bertram Unger

their usefulness for specific types of procedures and anat-omy, and their overall usefulness in surgical skills training. Final results showed that the rapid prototyped models were significantly better than the haptic models in nearly all categories. Haptic models retain some advantages in the area of automated metrics, complex graphic visualiza-tions using colour and transparency, and the ability to simply reverse procedural steps after an error is made.

This work is currently being prepared for publication and has been partially presented as a poster at the Royal Col-lege Simulation Summit 2013 in Vancouver. It is support-ed by grants from the HSCF, MMSF and University of Man-itoba.

As the virtual bone is contacted on screen, the robot arm simulates the contact forces which allows the user to feel the procedure.

Dr. Bertram Unger and Dr. Jordan Hochman pose with

some robotic and practice equipment.

Boris Minkevich, originally published in the Winnipeg

Free Press, April 30, 2012 Used with permission.


What is the difference between Continuing Professional Development and Medical Education?

Answer by Joanne Hamilton

There are two different aspects to this question: an organizational and a conceptual aspect.

From an organizational perspective, Continuing Professional Development (CPD) refers to both the division and a subunit within the division. Medical Education (Med Ed) is also a subunit within the Division of CPD. The two subu-nits (CPD and Med Ed) have different but related functions.

CPD offers programs for physicians, surgeons, dentists and allied health professionals for maintenance of their cer-tification and to keep them current in their given field. Previously known as CME (Continuing Medical Education), CPD changed its name to reflect the broader audience its members engage. Med Ed delivers programs that help the Faculty of Medicine achieve its academic mission in the areas of educational development and faculty develop-ment.

From a conceptual perspective, Med Ed offers programs focused on improving teaching and curriculum and help-ing the Faculty of Medicine achieve educational priorities (such as accreditation, curriculum renewal, social ac-countability). The CPD unit focusses its activities on improving the health of Manitobans through helping to ensure that health professionals practice in a current evidence-based manner (through activities such as the Rural CPD series, the Bannatyne Campus program, accreditation of events etc.). Workshops using evidence-based medicine may focus on a new medical procedure or recent research on a given medical intervention. See the related chart Division of Continuing Professional Development.

FAQ

Division of Continuing Professional Development

Unit Continuing Professional Development Medical Education

Population Served

Physicians, surgeons, dentists and allied health professionals

Health professionals & educators involved in teaching and curriculum development

Programs Bannatyne campus program, community based program, small group/Main-pro-C workshops, Neil John Maclean Health Sciences Library CPD Pearls series, plus many other co-developed events

Faculty development workshops & Lunch Learn series, med ed research, and communi-cation skills courses

Focus Maintenance of certification, maintenance of pro-ficiency, quality and performance improvement in practice, knowledge and skills

Teaching and curriculum and related devel-opment, assessment, research

Credit All programs meet the accreditation criteria of The College of Family Physicians of Canada (Mainpro). Select events are accredited by the Royal College of Physicians and Surgeons of Canada

Some learning opportunities are eligible for credit from the College of Family Physicians of Canada (Mainpro) and the Royal College of Physicians and Surgeons of Canada


Cindy has been with Med Ed since 2009 where she

is the program administrator. Her role includes ad-ministering day-to-day business operations, taking care of financial, HR, purchasing, payroll, webpage maintenance and supervisory activities. She also works with Continuing Professional Development as a program administrator. Prior to her current posi-tion, Cindy worked at the University of Winnipeg as the Administrative Coordinator of Academic Space and Course Scheduling for the Faculties of Arts, Sci-ence, and Education. The following conversation is excerpted from a short interview with Cindy. What is one enjoyable aspect of your job? One, there are so many! The people always are the most enjoyable part of it. I enjoy interacting with people. I love the gym here. There’s a wonderful gym with great fitness classes, which is a big part of my life. What is one thing you’ve learned while working here? I’ve learned so many things. The difference between CPD and Medical Education was the first thing I had to learn! (Laughs). CPD offers the programs which physicians and other health professionals can take for credits to maintain their professional certifica-tion. Medical Education offers programs in faculty development, i.e. teaching physicians and other health professionals to teach, to be instructors and

Featured Colleague: Cindy Lewkiw

professors. What are some changes that have occurred while you’ve been this position? What hasn’t changed? Our former location, S204, was renovated shortly after I arrived in 2009 and then again 2 years ago. Then we moved this past Au-gust from the Medical Services Building to 260 Bro-die in order to be with the other educational pro-grams. The organization of the Faculty of Medicine also changed a couple of years ago. Medical Educa-tion, CPD, the IMG Program, CPD Assessment and the CLSF all amalgamated to become the Division of Continuing Professional Development. What might someone be surprised to learn about you? I’m pretty much an open book. (Laughs). I love sports—skiing, golf, baseball, cycling, running, roller-blading, skating; I like physical activity. I have run 3 half marathons in the Manitoba Marathon. I played a lot of organized sports when I was younger, mainly basketball, volleyball and baseball. I played mixed slow pitch for about 20 years but finally gave it up because I was the oldest person on the team. What are you currently reading? I am currently reading two books. One is called Lon-gevity Now, by David Wolfe. I like books about health and wellness. And the other one is a Ken Follett: World Without End. It’s the follow-up to Pillars of the Earth – I think three generations after. What inspires or motivates you? It depends on what I’m doing. If I’m working, it’s usu-ally something I’m really interested in—solving a problem. I like to have a project that has a start and an end, and to be involved in getting from the start to finish. I like a project that takes a few months where you can really get into the heart of it.


Members of MedEd attended a number of engag-ing conferences in the past year. The following abbreviated reports represent selected highlights. Canadian Conference in Medical Education Quebec City, Quebec, April 20-23, 2013 CCME is the conference of choice for medical edu-cators in Canada. At this conference we partici-pate in meetings with our colleagues in the area of faculty development and share ideas and re-sources. This meeting also includes a ‘preconference’ event focussing on the promotion of clinician educators in medical schools across Canada, and meetings of a number of interest groups (arts and humanities, narrative medicine, informatics) where we share teaching practices and curriculum ideas. Workshops we attended focussed on a number of educational topics, in-cluding teaching clinical reasoning, using simula-tion, and technology in education.

Manitoba Association for Distributed Learning and Training (MADLaT) Winnipeg, May 2-3, 2013 This local conference provides educators with leading edge information on technology in the classroom. Sessions we attended included “IPads in the classroom” where an overview of apps for education was presented and models for incorpo-rating them in learning were discussed and “Developing Effective Online Communication to Promote Critical Thinking” which focussed on lev-eraging online discussions as a tool to foster rea-soning. Association for Medical Education in Europe (AMEE) Prague, Czech, August 28-30, 2013 As the pre-eminent Medical Education conference globally, AMEE provides an opportunity to see ‘what the rest of the world is doing.’ Competency based education, social accountability, lifelong learning, and technology in education were im-portant sessions in the program that we attended. As well, the Department presented five research projects and networked with colleagues from across the globe. 2nd Annual Conference on Faculty Development in Health Professions August 23-25, 2013 Prague, Czech Republic Scheduled just before the AMEE conference, the biennial International Conference in the Health Professions is the only conference focused on health professions faculty development. The con-ference provided opportunities both to learn about innovative approaches to faculty develop-ment (including workshops using post cards as a metaphor and the teaching of clinical reasoning) and to make connections with international col-leagues. We also had the opportunity to present two research projects at this conference.

Conference Reports

Family Medicine Forum participants. CFPC/

CMFC Photostream, flickrhttp://

www.flickr.com/photos/cfpc/


Family Medicine Forum: College of Family Physicians of Canada Vancouver, BC November 6-9, 2013 Conference organizers and facilitators exceled at identifying challenges and celebrating success related to Family Medicine and there were many opportunities for meaningful connection with colleagues. With a strong educational stream in the conference, a particular focus of interest was the Hot Med Ed Literature Topics which included remediation, how residents seek answers in clinical settings, choosing platforms for online professional development, understanding non participation of clinical teachers in faculty development activities and more. At the conference, a lively discussion-based workshop occurred on the topic of ‘Scholarship Reframed’ which in-cluded encouraging scholarship in already busy family practices, reframing scholarship activity and affecting cultur-al change. Scholarly success can be defined in multiple ways by moving away from almost exclusive focus on re-search for publication. For example, small projects that focus on local problems and expertise have immediate rel-evance. Building on these, larger teams and research across sites and universities can evolve. To support scholarly growth, physicians can be taught how to write meta analyses or case studies.

The Department of Medical Education Phone: 204-272-3102 260 Brodie Centre 727 McDermot Avenue Fax: 204-480-1372 Winnipeg, MB R3E 3P5

[email protected]

Conference Reports (cont’d from page 9)

Issue Editor: Anita Ens Contributors: Andy MacDiarmid, Anita Ens, Joanne Hamilton, Stephanie Armstrong, Bertram Unger Photography: Stock, Anita Ens, Boris Minkevich, CFPC: FMF Design & Copy Editing: Cindy Lewkiw Proofreading: Karen DePape

mailto:[email protected]

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