Anju Relan

Increasing the pool of educational leaders for UCLA.

The dual goals of the faculty Fellowship in Medical Education (MEF) program at the David Geffen School of Medicine at UCLA, established in 1992, are to prepare excellent teachers to serve as clerkship chairs, course chairs, or residency program directors while strengthening their dossiers for promotion based on a scholarly approach to curriculum development, implementation, and evaluation. Fellows are nominated from their departments and must demonstrate a strong interest in assuming educational leadership in their respective specialties. A total of eight fellows are accommodated each year based on interviews with the MEF faculty. The two-year program consists of two seminars and two projects focused on four objectives: to critique teaching and testing practices in medical education in light of current theories of learning; to develop and implement curricula that reflect these theories; to improve personal teaching skills through reflection and feedback; and to design and conduct an educational research or program evaluation study. An analysis of the curricula vitae of faculty members who have completed the fellowship suggest that this program continues to provide educational leaders for the school as originally intended. Of the 71 medical school faculty members who completed the MEF between 1993 and 2004 and have remained at the university, 43 (61%) have assumed new leadership roles in medical education. The evaluation data strongly suggest that the MEF has had a major role since its inception in creating a pool of faculty members with the confidence to manage the tasks of educational planning and implementation.

Demystifying "learning" in clinical rotations: do immersive patient encounters predict achievement on the clinical performance examination (CPX)?

Background Although the Liaison Committee on Medical Education required U.S. medical schools to quantify students’ clinical encounters, optimum patient exposure needed to predict performance has been elusive. This study explored the relationship between comprehensive patient encounters logged on personal digital assistants (PDAs) during three medicine clerkships, to performance on a clinical performance examination (CPX). Method PDA log data for 166 medical students were used to identify educationally “rich” patient encounters, where students were assigned full responsibility for patient care. Results Univariate regression analyses predicting the effect of immersive patient encounters on CPX case scores did not show statistical significance. Conclusions Amount of patient exposure defined by the richness of student–patient interaction did not reflect on the CPX performance for six selected cases. Further research should examine qualitatively different learning experiences occurring with patient encounters and a higher volume of exposure to predict outcomes.

Morbidity and mortality as a televideoconference: a randomized prospective evaluation of learning and perceptions.

BACKGROUND Central morbidity and mortality conferences ensure uniform content and more participants but consume work hours in commuting for programs with multiple teaching hospitals. Internet-based televideoconferencing (TVC) technology has the potential to eliminate commuting and expand participation and retain quality of instruction. STUDY DESIGN A prospective, randomized pilot study compared a control (home, n = 43) group in a live morbidity and mortality conference with an experimental (remote, n = 35) group exposed to TVC. After the conference, 78 participants (11 faculty, 38 residents, and 29 medical students) completed a survey assessing learning (6 questions) and conference effectiveness and appeal (7 questions). RESULTS Comparison of pooled scores on the 6 test items showed no difference by home versus remote group (4.9 versus 4.4; p = 0.47) or among faculty, residents, and students (4.5 versus 4.7 versus 4.7; p = 0.89), indicating that learning was not compromised by TVC. Overall perceptions of TVC were similar for home and remote sites (25.5 versus 23.4; p = 0.13); TVC was perceived as slightly less effective as attending a conference in person, but preferable to commuting. Perceptions of TVC grew proportionately more favorable as commuting distances increased. Students had a more positive perception of TVC than did residents, and faculty had the least positive perception (p = 0.048). Participants were comfortable giving a presentation via TVC, but less comfortable asking questions or participating in a discussion. CONCLUSIONS This is the first study using televideoconferencing for morbidity and mortality. TVC did not hinder overall learning and was preferable to commuting between facilities. TVC can help maximize educational efficiency and opportunities in programs with multiple training sites.

Production of a Multisource, Real-Time, Interactive Lesson in Anatomy and Surgery: Corn Demonstration

During Internet2s 2002 Fall Member Meeting in Los Angeles, the California Orthopaedic Research Network (CORN) demonstrated a unique distributed learning environment that sought to enrich medical student understanding of hand anatomy and surgery. Live, streaming video of an orthopedic surgical procedure at UCLA Medical Center was combined with related stereoscopic “virtual hand” images from Stanford, to teach participants at a third location. Medical students, anatomists, and surgeons at these remote but connected sites valued the simultaneous real-time interactions among the different venues. A number of technical issues were resolved during this exercise. This article describes the process of arranging such a demonstration and summarizes the lessons learned from our experience so that this innovative pedagogical approach can be successfully adopted on a broader scale.

Implementation of a flipped classroom approach to promote active learning in the third-year surgery clerkship

BACKGROUND Constructivist student-centered instructional models such as the flipped classroom (FC) have been shown to improve learning. METHODS A FC approach was implemented for the surgery clerkship. Data was collected in phase 1 to evaluate student learning and attitudes. Based on these results, questions for the phase 2 open-ended survey were developed to improve understanding of learner attitudes, and ascertain how well the FC aligns with constructivist principles. RESULTS There was no significant difference in shelf exam performance between the control and intervention groups. A majority of students agreed that they preferred the FC over lectures, and that their learning improved. Open-ended survey analysis demonstrated that the FC fostered self-directed, active learning, and that the in-class sessions facilitated application of concepts and deeper learning. Areas identified for improvement included better alignment with learning preferences through greater variety of pre-class learning options, improvement of podcast technical quality, and utilization of smaller in-class discussion groups. CONCLUSIONS Students had a positive perception of the FC. The FC supports self-directed and more active and deeper in-class learning.