The Portal for Postgraduates in Medicine
Dr Steve Walsh - May 2010 (4th Annual Conference on the Scholarship of Teaching and Learning)
To address problems identified with the postgraduate curriculum in Medicine, a portal was created. The portal integrates knowledge resources from medical journals and academic presentations with concept maps. This is combined with teaching on metacognition and peer review of the concept maps thus providing a constructivist learning environment.
Context and Problems Identified
Mastery of Medicine requires a thorough understanding of clinical and physiological topics. Postgraduates in Medicine rotate through different sub-specialties during their four year course. Each sub-specialty runs their own academic programme which involves registrars generating much of the academic content. They expend enormous effort on their presentations (mostly using PowerPoint) which are generally delivered to small audiences. Many constraints prevent colleagues from attending and benefiting from these academic presentations.
Registrars are required to pass the College of Medicine examinations but many fail the physiology section. Three major gaps in our postgraduate program were identified:
- Inadequate emphasis on physiology
- Widely differing end of block evaluation methods
- Poor presentation skills
The Medicine Department created a portal on the University network which is open to the Internet. It has two aims: to promote deep learning and facilitate access to current knowledge.
Accessing Current Knowledge
Access to the latest medical information is provided on the website by an RSS (Really Simple Syndication)feed reader which automatically checks the table of contents of more than thirty relevant medical journals. Users can search through the abstracts of all journals. They can subscribe to the journals that interest them and get notified of updates via email.
What Improves Learning?
There are three major factors contributing to enhanced learning:
- Metacognition - This refers to how students are able to set goals, choose appropriate learning strategies and monitor progress. Marzano1 suggests that up to 26% improvement in performance can be gained by improving students’ metacognition.
- Formative assessment - using formative assessment has a positive outcome on learning. Black and Williams2 suggest that using better formative assessment can produce an improvement of around 30%, which is larger than for other educational interventions.
- The choice of assessment method - The method of assessment is important as students are motivated to master what the assessment measures.
Figure 1 - Concept map of the Postgraduate Portal
Our solution consists of two computer servers: a Microsoft Internet Information Server and an IHMC Concept Map Server3. Both servers are integrated into a single portal using DotNetNuke4. The portal is available on the university intranet and global Internet (http://sumed.sun.ac.za).
The portal provides:
- Secure role-based login (some features of the website are not available to unregistered users)
- Various navigation features (e.g. site map, index, tag cloud and breadcrumb navigation). These are mostly organised on the organ system structure that commonly forms the basis of many medical resources.
- Doctors were taught how to add audio to their PowerPoint slideshows. These are converted to videos, indexed and placed on the portal for users to access whenever required. Most presentations deal with literature reviews and advice on best current medical practice.
- At the beginning of each block, the new postgraduates attend a workshop where they learn how to construct concept maps (using the free CmapTools program5) and are taught relevant aspects of metacognition. The webmaster creates relevant links between the concept maps and the presentations.
Concept maps are graphical representations of a knowledge domain. They consist of concepts contained within nodes. The nodes are connected by linking phrases to form propositions. Concept maps are based on the most widely accepted theory of learning, namely Ausubel’s assimilation theory. “Concept Maps differ from other types of mapping systems, such as Knowledge Maps, Conceptual Graphs, and Mind Maps because of their grounding in Ausubel’s learning theory of learning, their semantic and syntactical (structural) organization, the nature of concepts that comprise the nodes in a concept map, and the unconstrained nature of linking phrases.”6
Promote Deep or Meaningful Learning
“Meaningful learning occurs when the learner interprets, relates, and incorporates new information with existing knowledge and applies the new information to solve novel problems.”7 This involves building multiple knowledge models. In medicine, meaningful learning implies that acquired knowledge can be integrated with future medical practice to enable patient management. Numerous studies attest that using concept mapping promotes meaningful learning.
There are numerous ways to score concept maps by allocating different weighting factors to the various components.8, 9 One can also score the similarity of the student’s concept map with one generated by experts. However, this introduces some subjectivity. As I am interested in changes to the concept maps over time, I use an objective method that allocates a predefined score to each element.
Table 1 - Objective scoring criteria
||1 per proposition
|Links (In and Out) from Concepts
||1 per link
||5 per level
||10 per link
||10 points or zero
||1 per resource link
Scores obtained from concept maps have been found to correlate poorly with scores from conventional short answer or multiple choice questions. The latter mostly promote and measure rote learning while concept map scores measure a different dimension of knowledge namely deep or meaningful learning.10
Peer Review Provides Formative Assessment
Each student creates two concept maps per month and presents these to peers for critique and discussion. They are required to construct a total of at least six concept maps over three months. Changes and additions suggested by their peers are made to their concept maps before they are submitted for publication on the portal.
The Research Project
The case study includes postgraduates in General Medicine during 2010. There are four groups of about eight students every three months. At the beginning they are taught how to use CmapTools for creating concept maps. Each month the students are required to present their concept maps for formative assessment by their peers. After peer review, students make the relevant improvements to their concept maps and submit these for objective summative assessment as well as publication on the concept map server. A Revised Approach to Study Inventory (RASI)11 is completed by each student at the beginning and end of the three month block. This will provide insight as to whether the intervention changes their approach to learning. At the end of the block: a group interview is conducted, recorded, transcribed and thematically analysed; and an online questionnaire answered (using a Likert scale).
Constructivist Learning Environment
The portal provides our postgraduates with the three Cs of a constructivist learning environment: a meaningful and authentic Context for learning; the tools, support, time and space for personal knowledge Construction; and support for Collaboration and group reflection and production.12, 13
A literature review shows that concept map servers have previously been integrated with:
- A learning management system14, and
- A case based reasoning syste15
The Medicine Department’s Postgraduate Portal is unique in that it integrates a concept map server with access to the latest literature and PowerPoint slides containing audio to create a knowledge resource within a constructivist learning environment.
1. Marzano RJ. A theory-based meta-analysis of research on instruction. Mid-continent Regional Educational Laboratory. Aurora, Colorado. 1998
2. Black P, William D. Assessment and classroom learning. Assessment in Education: Principles, Policy & Practice 5(1):7-75,March 1998
3. Institute for Machine and Human Cognition. http://cmap.ihmc.us, visited on 2010/04/20
4. DotNetNuke Content Management Platform. http://www.dotnetnuke.com, visited on 2010/04/20
5. CmapTools. http://cmap.ihmc.us/download/, visited on 2010/04/20
6. Cañas AJ, Coffey JW, Carnot MJ, et.al. A Summary of literature pertaining to the use of concept mapping techniques and technologies for education and performance support. Prepared for the Chief of Naval Education and Training. Pensacola FL 32500. July 2003
7. González HL, Palencia AP, Umaña LA, et al. Mediated learning experience and concept maps - a pedagogical tool for achieving meaningful learning in medical physiology students. Advan Physiol Educ 32:312-316, 2008
8. West DC, Park JK, Pomeroy R, Sandoval J. Concept mapping assessment in medical education: a comparison of two scoring systems. Medical Education 2002;36:820–826
9. Taricani EM, Clariana RB. A technique for automatically scoring open-ended concept maps. Association for Educational Communications and Technology 2006; 53(1):65-82
10. West DC, Pomeroy R, Jeanny K, et al. Critical thinking in graduate medical education: a role For concept mapping assessment? JAMA. 2000;284(9):1105-1110
11. Mattick K, Dennis I, Blight J. Approaches to learning and studying in medical students: validation of a revised inventory and its relation to student characteristics and performance. Medical Education 2004; 38: 535–543
12. Jonassen, D. Towards a constructivist design model. Educational Technology1995; 34(4), 34-37
13. Lefoe, G. Creating constructivist learning environments on the web: the challenge in higher education. Australian Society for Computers in Learning in Tertiary Education, 1998
14. Laanpere M, Matsak E, Kippar J. Integrating a concept mapping tool into a virtual learning environment: pedagogical and technological challenges. Concept Maps: Theory, Methodology, Technology. Proc of the Second Int Conference on Concept Mapping. San José, Costa Rica, 2006
15. Cañas AJ, Leake DB, Wilson DC. Managing, mapping, and manipulating conceptual knowledge. Exploring the synergies of knowledge management & case-based reasoning. Menlo Park CA, AAAI Press.