Carol Kamin

A comparison of critical thinking in groups of third-year medical students in text, video, and virtual PBL case modalities.

Purpose To determine whether critical thinking in problem-based learning (PBL) group discourse differed according to case modality. Method The study was conducted in 2000 in the Department of Pediatrics at the University of Colorado School of Medicine in Denver. Third-year medical students on their pediatrics clerkship were divided into three groups: face-to-face with a text case, face-to-face with a digital video case, and virtual with a digital video case. Twenty-four groups were divided among the three case modalities. Using an existing coding scheme, each distinct codable unit of discourse was placed into one of 35 indicators reflective of five critical-thinking stages. For each groups discourse, a critical-thinking ratio was calculated for each of the stages. The Kruskal–Wallis test was used to compare the critical-thinking ratios for each stage across the three modalities. Residual conversation to indicate processes occurring within the group was also coded. Results A content analysis of the transcripts of 13 of the 24 group discussions occurred. The virtual groups had the highest critical-thinking ratio. Except for the problem-identification stage, the video groups had higher ratios that the text groups did. Conclusions This exploratory study examined how the mode of case presentation affected the critical thinking of groups using the PBL format. Students who learned in a virtual modality with a digital video case engaged in more critical thinking. The data suggest that the video enhanced critical thinking in both face-to-face and virtual PBL groups.

Measuring Critical Thinking in Problem-Based Learning Discourse

Background: Critical thinking (CT) is a composite of skills linked to problem-based learning (PBL). Purposes: This study has 3 purposes: (a) to determine if PBL discourse could be coded for CT, (b) to demonstrate reliable coding, and (c) to determine whether a CT ratio would provide a valid measure to compare 2 PBL groups. Methods: Using prior research, we refined the code for a content analysis of PBL transcripts. Raters coded 6 hr of transcripts and computed CT ratios for each of the 5 CT stages. Average interrater agreement was 85.5%. CT ratios appeared to differ between 2 PBL groups delivered in 2 modalities. Results: PBL discourse could be coded following a CT framework. Independent raters reliably applied the code, and the resulting CT ratios detected tenable differences. Conclusions: This approach could provide useful information about the effect of case modality.

Educational technology infrastructure and services in North American medical schools.

Purpose To describe the current educational technology infrastructure and services provided by North American allopathic medical schools that are members of the Association of American Medical Colleges (AAMC), to present information needed for institutional benchmarking. Method A Web-based survey instrument was developed and administered in the fall of 2004 by the authors, sent to representatives of 137 medical schools and completed by representatives of 88, a response rate of 64%. Schools were given scores for infrastructure and services provided. Data were analyzed with one-way analyses of variance, chi-square, and correlation coefficients. Results There was no difference in the number of infrastructure features or services offered based on region of the country, public versus private schools, or size of graduating class. Schools implemented 3.0 (SD = 1.5) of 6 infrastructure items and offered 11.6 (SD = 4.1) of 22 services. Over 90% of schools had wireless access (97%), used online course materials for undergraduate medical education (97%), course management system for graduate medical education (95%) and online teaching evaluations (90%). Use of services differed across the undergraduate, graduate, and continuing medical education continuum. Outside of e-portfolios for undergraduates, the least-offered services were for services to graduate and continuing medical education. Conclusions The results of this survey provide a benchmark for the level of services and infrastructure currently supporting educational technology by AAMC-member allopathic medical schools.

Evaluation of Electronic Discussion Groups as a Teaching/Learning Strategy in an Evidence-based Medicine Course: A Pilot Study

BACKGROUND As course directors, we wished to incorporate small group learning into our Evidence-based Medicine course for students to get feedback on the development of a well constructed, researchable clinical question. Scheduling of these groups was problematic. We sought to evaluate computer-mediated communication as an alternative to face-to-face small groups. METHODS Students were randomly assigned to either face-to-face small groups or asynchronous, electronic, small groups. Final examination scores were analyzed with an analysis of variance to determine if there were differences in student performance based on group type. Student survey items were analyzed using Fishers Exact test to determine if there were differences in student attitudes based on group type. RESULTS There were no significant differences found in overall student performance. Significant differences in student attitudes were found to exist with respect to: (1) participation in discussions, with face-to-face groups reporting greater participation; (2) putting more thought into comments, with electronic groups reporting more thought put into comments; and (3) difficulty relating to other students in the class, with electronic groups reporting more difficulty. DISCUSSION We found electronic discussion groups (computer-mediated communication) to be a viable teaching/learning strategy with no adverse effects on student performance or attitudes.

A case study of teaching presence in virtual problem-based learning groups

Interest in conducting problem-based learning (PBL) on-line has increased to meet student and physician schedules. Little research describes skills needed to facilitate PBL on-line. In this paper we studied teaching presence in asynchronous PBL groups. Two raters, with average inter-rater agreements of 0.80, used an existing code to measure teaching presence in 62 PBL case discussions facilitated by one instructor over five years. This instructor was selected because of consistently high teaching evaluations. Messages sent by the instructor in the on-line PBL discussion were coded into three categories: instructional design and organization, facilitating discourse and direct instruction. Instructional design indicators were most frequent averaging 22.5 (SD = 5.6)/discussion. Facilitating discourse and direct instruction were comparable, 19.5(SD = 7.4) and 19.5 (SD = 6.7), respectively. Messages and indicators of teacher presence rose across time with a decline during subsequent PBL cases with the same group.

Organizational Models of Educational Technology in U.S. and Canadian Medical Schools

Purpose To examine the organizational structure of educational technology units within U.S. and Canadian medical schools in order to (1) identify organization models that support educational technology, (2) describe key attributes of these models, and (3) discuss the strengths and challenges associated with these models. Method The authors distributed a survey to 88 schools that had previously provided information on their educational technology services and infrastructure. The authors developed the survey through a series of pilots and, then, from the data for each respondent school, created concept maps, which were used to identify organizational models. The authors conducted analyses to determine differences among models. The authors coded the comments about organizational models and identified themes. Results The authors received adequate data for analysis from 61 schools (69%). Four models for educational technology organizations emerged: (1) centralized units located in the school of medicine, (2) centralized units located at the health science center, (3) centralized units at the comprehensive university, and (4) no centralized unit (Dispersed Model). The majority (75%) of schools relied on some type of centralized organization. Whereas few organization attributes proved to be statistically significant, the centralized models have more resources devoted to educational technology and a closer alignment with the academic mission than the Dispersed Model. Conclusions Medical schools primarily use central models. The authors recommend that schools structuring their educational technology resources consider exploration of a central model because of its focused use of resources to improve teaching and learning.