A Next Generation Training System
The MedEDge Approach
The learning installation explores a new frontier in medical education: the merging of digital and physical space to create self-directed, immersive, interactive and collaborative learning experiences that meet the next generation of learners where they live. We seek design inspiration far outside of traditional medical education, and then apply design thinking to current teaching tools so we can build learning spaces for the next generation of clinicians.
Merging Digital & Physical Space to Transform the Learning Experience
For our installation design, we took elements of the arts, graphic design and the museum style audio tour, and combined them with more familiar forms of medical education to create a theme-based, narrative driven medium that integrates and enhances, our current teaching styles. All the installations are built on a set of core principles, and incorporate best practices in education: using an interleaved, adult learning model to promote the rapid translation of essential knowledge and complex skills into patient care.
This is a step by step introduction and guide to the learning installation.
Why it Matters
The current generation of physicians live in a healthcare environment of increasing complexity; disruptive and accelerating change. They have radically different learning styles, and they consume media and information differently than their predecessors.
To meet these challenges, educators must be skilled at integrating new learning styles with traditionally siloed teaching tools to meet multiple learning objectives. Success in transforming medical education will be measured by how well we meet learners where they live, while addressing the challenges of our current healthcare system. To achieve this, the time has come build the “learning delivery systems” for our next generation of learners.
What it Is
Learning installations are designed to be completely self-directed and immersive experiences and are built around a series of uniquely interactive posters that are the backbone and the bridge between the digital and physical space. Each poster is created with meticulous focus on the power of infographic design and the language of visual arts to transmit knowledge. Related multimedia content is then embedded within the posters to create the interactive design. It is these interactive posters that are used to fill and define the physical space, and they become the backbone of a larger learning experience. Their size and artistic style draws the learner in, and also provides structure and flow within the installation.
Our goal was to replicate the look and feel of the audio tour format successfully employed in museums for the purposes of medical education using a low cost “off the shelf” technology that could be easily recreated by others. To do this we used the simple QR code. QR code scanners are now fully integrated into the cameras of all mobile devices, and makes them a ubiquitous, low cost, and simple technology that can be leveraged for medical education.
Using their own mobile devices, these interactive posters allow learners to travel back and forth between the digital and physical space in a way not yet attempted in medical education. Familiar social media platforms such as Soundcloud, Twitter and YouTube are used within the posters in creative new ways: giving educators the ability to share original content to wider audience and leverage content curated from across the FOAMed world.
While QR codes have gained popularity, to date we know of no other use of the QR code to create such a fully integrated and immersive multimedia experience in education.
Beyond the Digital space
Our interactive posters are the jumping off point for a more immersive experience in the physical space: providing an opportunity for hands on activities, simulations, and deliberate practice.
For example a poster on mechanical ventilation in one of our installations is included in a station with a ventilator allowing learners to get comfortable with “knobology” and practice changing vent settings. Next to it, an interactive poster on the use of PEEP employs a simple model that gives a visceral demonstration to learners of the effects of PEEP on lung recruitment.
By continuing this process of merging digital and physical space, the installations now become a self-directed “training lab” and overcomes one of the key limitations of digital learning: the lack of a physical space to develop the hand-eye co-ordination and problem solving-skills required to successfully perform complex procedures.
Expert faculty placed in key locations within an installation space adds another layer of value to the installations. Because the installation is essentially an immersive “flipped classroom,” learners can direct their own learning. This also frees faculty from having to teach in a one size fits all format: coaching rather than teaching, and tailoring their feedback to the individual. Instead of talking or lecturing at groups of passive learners, faculty are able to ask “show me your technique” or “what would you like to work on.” This higher level learning benefits both learners and educators.
Simulation Challenges & Gamification
Learners are also given the opportunity to test what they’ve learned within an installation with a challenge. This is typically a high fidelity simulation, but other creative challenges such as escape the rooms have been developed. This “higher order” component of the installation allows learners to solidify their new knowledge and skills by actively deploying them in a more realistic and team-based environment. Debriefs by faculty identify areas of improvement which allows them to customize a path back through the installation for even more focused learning. This iterative learning cycle between the digital and physical space be can be repeated as many times as needed to develop mastery.
Beyond the use of digital content to provide asynchronous learning, supplement lectures, conferences, and journal clubs, the boundary between digital and physical space remains largely unexplored. We wanted to see if that boundary could be erased.
Learning installations occupy both the digital and physical space, and together they transform it into an immersive, interactive, and self-directed learning experience.
A key feature of the installation design is its pop-up style for rapid deployment and re-use. Once developed, an installation can be left in place for as long as required, and recreated as many times as needed in much the same way a museum exhibit is deployed. This provides a valuable education resource that can be used in an endless variety of teaching settings. Rather than a preset lecture or conference time. Imagine instead an installation placed in a student lounge, spare office, teaching space or other site for easy access for several weeks allowing learners to revisit and explore at their own pace. In this version, coaching and simulations can be scheduled asynchronously.
Learning installations are collaborative. The backbone of the system, the interactive posters, allow for co-operation with multiple departments programs interested teaching using this new platform.
Currently the format is used to teach at a large two day airway course in our institution which provides emergency airway training to over 50 emergency medicine residents, pediatric emergency fellows, pulmonary critical care fellows. At an annual national advanced care providers conference and in our medical college’s transition to residency training curriculum. We are working with the critical care department at Columbia Presbyterian to design installations for their faculty, and with the our Anatomy department for their upcoming national education conference (American Association of Clinical Anatomists.
We are lucky enough to be located in New York City; surrounded by creative arts centers. Part of our design inspiration for the learning installations comes from seek partnerships that bring fresh perspectives to how we teach in medical education. We are currently working with the Maker Lab at Cornell Tech, and with the Design for Social Interaction program at the School of Visual Arts to improve and develop the learning installations concept. Future partnerships with the Cooper Hewitt Museum Design Interaction Lab, and The Storytelling Lab at Columbia are future partnerships that are in development.
The Value of Stories
By placing interactive posters in a series they also have the potential to become theme-based and narrative driven. Procedure training is often disconnected from clinical context and patient experience. Learning installations can embed a procedure into a larger narrative: one where learners gain insight into the human factors that contribute to failure, or associate it with a cognitive tool can help them perform the procedure more effectively in moments of stress. We can also personalize the learning experience; embedding audio or video content of personal patient and physician stories. Learning installations therefore offer opportunities for nuance and layered context to procedures that are often disconnected from clinical context.
Learning That Empowers
Installations are a truly self-directed and adult learning platform. Learners get to decide how long they want to spend within an installation. They can move freely throughout the space, visit a station as many times as they like, and decide what is important to them. They can practice at their own pace without time constraints or faculty “looking over their shoulder.” Only working with a faculty coach when they feel ready. This is in stark contrast to traditional conference formats with scheduled lectures or small groups that allow little room for learning customized to the individual. Our goal is to empower the adult learner by making learning that inspires them to explore and learn.
An Efficient Learning Style
Learning installations erase many of the logistic and time constraints of current conference or teaching formats. Installations can be open for a few hours, a day, a week, a month, and because they are self-directed we have found the number of learners that can travel though an installation is much larger than what is possible in many other teaching formats. The logistics for rotating small groups can be rate limiting, and large conference style lectures are a return to a passive style. Learning Installations are able to retain a free, open and interactive format while allowing for large numbers of participants to explore without the need for complicated schedules.
Incubators for Innovation & Faculty Development
The learning installations have proven themselves to be incubators for innovation and a place to develop the skills of current and future medical educators. We have worked with students, residents, fellows, faculty, biomedical engineers, artists, graphic designers, and even musicians and actors, to create new teaching tools, demonstration models, and low cost, high fidelity medical training devices, as well as tested new clinical tools for quality improvement purposes within the learning installations. Their format allows for creativity and offers a place for the development of ideas. This wonderful feature of the learning installation is by design, and is part of the engine of iterative change and improvement we believe is essential for all current models of medical education development.
Incredible Participant Feedback
The early feedback on this new learning style is enthusiastic and well received by participants. Our survey data and feedback suggests that learners take quickly and easily to this style of learning and often describe it as one of the most engaging learning they have ever participated in during their medical training. Feedback from faculty that participate as educators is also very positive. We think this is due to the enthusiasm of the learners at stations as well as the fact that learning installations free educators to be active and engaged mentors and coaches rather than lecturers or speakers.
The learning installation is a robust, next generation, learning delivery system that provides an interactive, immersive and self-directed experience. Designed for how current learners consume information, it extends the boundaries of traditional medical education in ways we are just beginning to explore. As a teaching style it is cost effective, uses ubiquitous and low cost technology, and integrates familiar teaching tools that make its replication within reach of most educators at academic centers.
Be Part of the Leading Edge of Medical Education
We are looking for partners interested in innovative medical education design. If you are interested in having us bring learning installations to your institution, or want to develop one yourself, or have ideas for other medical education innovations that you would like to showcase, please contact us.