• Atypical use of audience response system provides students the opportunity to formatively assess faculty teaching and improve learning outcomes

      Hopper, Mari K.; Carroll, Megan; Wright, Serena
      Use of audience response systems (“clickers”) offer faculty the ability to formatively assess student learning. Unfortunately, this technology is very rarely - if ever - used to provide students the opportunity to formatively assess faculty teaching. Over the past two years, Indiana University School of Medicine completely reformed its curriculum. Reform efforts led to a variety of innovative and experimental teaching and learning methods. One new method involved a series of nine classroom sessions that were based on clinical cases and engaged a panel of experts (physiologist, pathologists, pharmacologists, and physicians). Panel presentations were interactive, and delivered course content via livestream to all 360 second year medical students enrolled at nine different campus sites. In order to assess the effectiveness of this entirely new approach, a series of four questions were delivered via an audience response system to all students at the end of each three hour session. Students responded to the following questions:  1) To what degree has this session required you to utilize higher order skills?; 2) on a scale of 1-10 rate your overall level of engagement; 3) estimate the percentage of time you remained focused; and 4) please share what went well and suggestions you have for improvement. Response to questions following the first session indicated that only 10% of students viewed the session as requiring very high levels of engagement, 55% of students reported high to very high levels of engagement, and 55% felt they remained focused for 70% or more of the class period. Students provided many informative responses to open ended questions. Based on student input, faculty made revisions prior to delivery of the next class session (next day) including addition of more challenging and interactive questions, narrative to slides, and summation of cases.  Each day changes were made based on student input. By the ninth (final) session, over 30% of students indicated the session required very high levels of higher order skills, 80% reported high to very high levels of engagement, and 75% felt they were able to remain focused over 70% of the session. At all levels of education, student feedback is essential as faculty seek to design applicable and intellectually challenging learning exercises that students find useful and enjoyable. In this study, innovative use of an audience response system allowed faculty to gather student feedback that resulted in improvement in student engagement, focus, and utilization of higher order skills.
    • Designing Active Learning Exercises that Utilize Multiple Learning Strategies

      Anderson, Maria; Lipp, Sarah; Hopper, Mari K.
      Governing bodies for higher education have encouraged curricular reform supporting more active and integrative learning. In response, Indiana University School of Medicine "renewed" its curriculum and asked that all courses commit at least 50% of student contact time to active learning strategies (non lecture). One particularly effective new learning exercise was a collaborative small group activity designed to reinforce key concepts in renal processing of ions and nutrients, and at the same time utilize multiple learning strategies. Evidence based learning strategies incorporated included: small group collaboration, peer teaching, retrieval practice using "clickers," and elaboration through discussion (Mayer 1980, Slavin 1980, Van Boxtel and Veerman 2000, Webb 1991). A convenience sample 23 students was assembled and completed a five question anonymous survey providing feedback. Survey responses indicated perceived usefulness of the exercise with average Likert scores of 3.7 on a maximum 4.0 scale. Response to open ended questions were also very positive. Customized National Board of Medical Examiner (NBME) exam scores further substantiated student perceptions. Student completing this exercise averaged 79% correct responses on questions mapped to this exercise compared to 76% correct responses for students nationwide. This nephron mapping exercise provides a model for designing exercises that promote use of Bloom's higher order skills and engage students in methods proven to enhance learning. Although this exercise included physiology content specific to the kidney, others could use this exercise as a model for developing interactive exercises for diverse learners (high school through post-graduate) in any discipline.
    • Engagement and Higher Order Skill Proficiency of First and Second Year Medical Students A Comparison Between IUSMs Legacy and Reformed Curricula

      Francis, Brandon; Hopper, Mari K.
      In order to better prepare students for clinical practice in today’s environment, the Association of American Medical Colleges (AAMC), American Medical Association (AMA), and Accelerating Change in Medical Education Consortium (Cooke, 2010) have all called for reform in medical education. In response to these calls, the Indiana University School of Medicine (IUSM) transitioned from its legacy curriculum (LC) to a newly reformed curriculum (RC) in the 2016-2017 academic year. The LC focused primarily on didactic methods to deliver necessary material, while RC incorporated active learning into at least 50% of student contact hours. This study set-out to determine if students enrolled in Indiana University’s RC demonstrated higher levels of engagement and proficiency in use of Bloom’s higher order skills (HOS) than students in LC; furthermore, the authors conducted analysis of student development in engagement and HOS from first year (MS1) to second year (MS2), focusing on MS1 students initially in the lowest HOS quartile. Following IRB approval, study participants’ engagement and HOS were annually assessed during MS1 and MS2 for the Class of 2019 (LC) and the Class of 2020 (RC). Engagement was determined using a validated Survey of Student Engagement (SSE) (Ahlfeldt, 2005). HOS proficiency was assessed using the Collegiate Learning Assessment (CLA+), professionally developed and validated by the Council for Aid to Education (https://cae.org/flagship-assessments-cla-cwra/cla/). Preliminary statistical analysis indicated that RC students increased engagement significantly from MS1 (39.0±7.0) to MS2 (40.8±5.3) and demonstrated significantly higher engagement than LC MS2 students (36.3±5.3); however, there were no differences in HOS proficiency when comparing RC to LC, or MS1 to MS2. Additionally, RC MS1 students in the lowest HOS quartile (1688.8±53.1) demonstrated significantly increased HOS when re-tested during MS2 (1809.5±86.8). This phenomenon was not seen in LC students. Implementation of RC resulted in higher levels of student engagement than LC and, despite literature suggesting that more engaged learners will become more proficient in HOS (Bonwell & Eison, 1991), there were no differences in HOS group means between RC and LC. 
    • Incorporating a brief mental health curriculum into a course for college freshmen can increase student awareness and early intervention for mental health problems

      Hopper, Mari K.; Rieford, Kathy
      Student retention through graduation is negatively impacted by impaired mental health (Pedrelli, et al. 2015). According to an annual report by the Center for Collegiate Mental health (CCMH), more than 150,000 college students sought treatment for mental health concerns in 2016, which was a 50% increase over 2015 (CCMH, 2016). The purpose of this presentation is to suggest a potential model to engage students in conversations related to mental health. By empowering peer educators to address and open conversations about mental health concerns in a preemptive way, students will benefit. A mental health curriculum was developed to be piloted in a course required for all college freshmen. Objectives were to direct students to (a) self-assess mental health status, (b) recognize mental illness and suicide threat behaviors, and (c) identify and acquire mental health care.  Student learning to meet the objectives occurred through media presentation, providing students with relevant resources, faculty presentation and guided discussions among small student groups. Campus and community resources were provided, and a team member from the USI Counseling Center participated in a majority of class sessions. Students were assigned to small peer groups to work together for the purpose of generating short videos that demonstrated strategies to deal with relevant hypothetical cases based on real life experiences.  Class discussions encouraged student reflections of the cases and alternate perspectives were encouraged among the class. The short curriculum has been incorporated into UNIV101 courses for four semesters, which has involved more than 250 students. Pre/post surveys consisting of seven questions on a four-point Likert scale showed significant differences from pre to post on every question in every cohort (p<0.001). This provided evidence that student knowledge and perceptions were positively impacted by the brief mental health curriculum, indicating that it was highly successful in meeting stated objectives. Mental health impairment often interferes with a student’s school performance, and many factors prevent students from seeking help, including stigma that surrounds mental illness, lack of adequate resources and student knowledge about those available resources. This project addressed all those issues.  References: Center for Collegiate Mental health. (2016). Department of educational psychology, counseling, and special education, Penn State University. http://ccmh.psu.edu/publications/ Pedrelli, P., Nyer, M. , Yeung, A., Zulauf, C., &  Wilens, T. (2015). College Students: Mental Health Problems and Treatment Considerations. Academic Psychiatry, 39(5): 503–511.  doi:  10.1007/s40596-014-0205-9
    • Training improves student performance and perceptions in small group learning

      Hopper, Mari K.; Gidley, Patrick; Mann, Daniel; Weinzapfel, Jacob
      Fifty percent of course contact time in the “renewed” curriculum at Indiana University School of Medicine (IUSM) was dedicated to non-didactic, small-group learning. End of course evaluations indicated that students did not understand or value the approach, perhaps due to lack of training in this methodology. Our aim was to determine if engaging students in training designed to enhance small group dynamics and explain outcomes of this approach would result in improved small group performance and enhanced perceptions. Following IRB approval, small-group case-based sessions were audiotaped on two occasions prior to training (Pre), and two additional sessions following training (Post). Recordings were evaluated and scored by trained evaluators using a rubric including the following categories: Participation, Shared Roles, Focus on Learning Objectives, Approach, Independent Thinking and Interpersonal Interaction. Scores for each category were averaged across the three evaluators both Pre and Post. Additionally, to assess student perceptions, a 15-question survey was administered at three time periods: 1) before any small group sessions or training; 2) after recording two small group sessions and directly prior to training; and 3) following training and after recording two additional sessions. Survey questions included topics such as personal preparation, interpersonal interactions, prior undergraduate experience, and perceptions of small group as an effective learning strategy. Question responses were based on a Likert scale of one through seven. Although work is ongoing, preliminary data analysis using paired T-tests indicate that participation scores increased following training, with members participating more equally and encouraging input from each other more frequently. There was little change in rubric scores for other criteria including ability to share roles and addressing learning objectives. Survey responses reveal that students enjoy small group sessions more, contribute more equally, and have fewer tangential discussions in comparison to the pre-training survey responses. These data suggest that students participating in small group learning sessions benefit from training in this approach, and such training will enhance student perceptions regarding effectiveness of this learning strategy.