Klas Karlgren

A glass box approach to adaptive hypermedia

Utilising adaptive interface techniques in the design of systems introduces certain risks. An adaptive interface is not static, but will actively adapt to the perceived needs of the user. Unless carefully designed, these changes may lead to an unpredictable, obscure and uncontrollable interface. Therefore the design of adaptive interfaces must ensure that users can inspect the adaptivity mechanisms, and control their results. One way to do this is to rely on the users understanding of the application and the domain, and relate the adaptivity mechanisms to domain-specific concepts. We present an example of an adaptive hypertext help system POP, which is being built according to these principles, and discuss the design considerations and empirical findings that lead to this design.

MED NORD–A tool for measuring medical students’ well-being and study orientations

Background: The relationship between medical students’ well-being, motivation, and their conceptions of learning and knowledge has not been previously explored. Aims: This study aimed to validate a research instrument intending to measure medical students’ (n = 280) (1) experiences of stress, anxiety and disinterest, (2) motivational (thinking) strategies, (3) conceptions of learning and knowledge (epistemologies), and (4) approaches to learning. Methods: We developed an instrument, MED NORD, which is a composition of scales measuring different theoretical constructs that previously have shown good predictive value, validity and reliability. A principal component analysis with Varimax-rotation was performed in order to see how the scales related to each other. Results: The internal consistency reliability was found to be satisfactory or good for each scale. The results showed five factors: Dysfunctional Orientation, Collaborative Knowledge Building Orientation, Cookbook Orientation, Social Orientation, and Individual Abilities Orientation. These study orientations were related to how medical students perceived their learning environment. Conclusions: The new tool showed consistency and validity and was judged appropriate for future use in measuring medical students’ well-being and study orientations.

Fostering superficial learning

Different views of learning and what it means to follow rules are discussed. The activities, the language and context of expertise and knowledge have traditionally often been neglected and underestimated as something ancillary to the real knowledge which lies ‘beyond’ such surface manifestations. The primacy of ‘superficial’ aspects are argued for. It is further argued that these should be more emphasis and fully appreciated. The goal of fostering ‘superficial’ learning is suggested, i.e. an emphasis on practical activities, the use of the language of the domain to be learned and getting familiar with the new culture. A case study is presented and discussed in terms of this theoretical viewpoint.

Introducing and adapting a novel method for investigating learning experiences in clinical learning environments

The Contextual Activity Sampling System (CASS) is a novel methodology designed for collecting data of on-going learning experiences through frequent sampling by using mobile phones. This paper describes how it for the first time has been introduced to clinical learning environments. The purposes of this study were to cross-culturally adapt the CASS tool and questionnaire for use in clinical learning environments, investigate whether the methodology is suitable for collecting data and how it is experienced by students. A study was carried out with 51 students who reported about their activities and experiences five times a day during a 2-week course on an interprofessional training ward. Interviews were conducted after the course. The study showed that CASS provided a range of detailed and interesting qualitative and quantitative data, which we would not have been able to collect using traditional methods such as post-course questionnaires or interviews. Moreover, the participants reported that CASS worked well, was easy to use, helped them structure their days and reflect on their learning activities. This methodology proved to be a fruitful way of collecting information about experiences, which could be useful for not only researchers but also students, teachers and course designers.

Promoting reflection by using contextual activity sampling : a study on students' interprofessional learning

Abstract Students’ engagement and reflection on learning activities are important during interprofessional clinical practice. The contextual activity sampling system (CASS) is a methodology designed for collecting data on experiences of ongoing activities by frequent distribution of questionnaires via mobile phones. The aim of this study was to investigate if the use of the CASS methodology affected students’ experiences of their learning activities, readiness for interprofessional learning, academic emotions and experiences of interprofessional team collaboration. Student teams, consisting of 33 students in total from four different healthcare programs, were randomized into an intervention group that used CASS or into a control group that did not use CASS. Both quantitative (questionnaires) and qualitative (interviews) data were collected. The results showed that students in the intervention group rated teamwork and collaboration significantly higher after than before the course, which was not the case in the control group. On the other hand, the control group reported experiencing more stress than the intervention group. The qualitative data showed that CASS seemed to support reflection and also have a positive impact on students’ experiences of ongoing learning activities and interprofessional collaboration. In conclusion, the CASS methodology provides support for students in their understanding of interprofessional teamwork.

A pilot for a computer-based simulation system for risk estimation and treatment of mentally disordered offenders

Risk/need analysis and treatment of mentally disordered offenders (MDOs) take place in constrained clinical settings, but violence has to be considered in a context where both social and cultural factors are of significance. One way to improve treatment and risk/need analysis of MDOs could be to develop simulation systems where users interact with video-based scenarios. The objective of this study was to develop and pilot test a simulation system to be used as a tool to study MDOs and possibly also to play a part in their rehabilitation. Collaboration between simulation and forensic psychiatry experts and a professional film team was set up. A simulation system called ‘Reactions on Display’ (RoD) was developed and a pilot study with eight patients and 13 staff members was carried out. Results from the study showed that RoDs interface and design were well received by patients and staff. Participants indicated that they found the video sequences realistic and the system enjoyable to use. The pilot study of RoD was positive, but further research should study possible clinical outcomes of the system. However, we believe that RoD could provide an advance in treatment and risk/need analysis of MDOs.

The challenges of military medical education and training for physicians and nurses in the Nordic countries - an interview study

BackgroundDevelopment and use of e-learning has not taken place to the same extent in military medicine in the Nordic countries. The aim was to explore the similarities and differences in education and training in military medicine for health professionals in the Nordic countries, and more specifically to identify the specific challenges regarding education and training of military medicine, and how e-learning is used at present and the opportunities for the future.MethodsKey educators within military medicine in the Nordic countries, as approved by the respective Surgeons General, were interviewed and the interviews were analyzed using content analysis.ResultsThe data showed that all Nordic countries cooperate in the field of military medical training to some extent. The models of recruitment and employment of health professionals differed as well as the degree of political support. These differences affected the ability for health professionals to gain actual experience from the military environment. To improve the quality of medical education and training, attempts were made to recruit physicians. The recruitment of physicians was considered a challenge which had resulted in disruptions of courses, training programs and maintenance of accreditation. The Nordic countries were described as having commonalities in the military medical systems and common needs for international collaboration within training, but differing in the range of education and training. Gaps were identified in methods for transferring outcomes from education into practice, as well as regarding evaluation and feedback of outcomes to military medicine. The educational tradition was described as oriented towards practical skills training without requirements on pedagogical education of educators. The results confirmed previous studies showing that e-learning was underutilized. Contextual understanding and experience of healthcare were seen as crucial factors for successful e-learning development.ConclusionsExtended Nordic cooperation on military medical education and training are needed because of the limited volumes of advanced trauma cases. A key issue to the success of e-learning and blended learning is combining educational competence with contextual understanding into a strategy, of how to use digital educational methods.

Trialogical Design Principles as Inspiration for Designing Knowledge Practices for Medical Simulation Training

This chapter discusses introduction of the trialogical approach to simulation training courses for medical teams involved in neonatal resuscitation. We analysed and developed knowledge practices in a tradition-laden educational context, which has not viewed itself as promoting learners’ ‘knowledge-practices’ or ‘knowledge creation’. The overarching educational objective was to support medical teams in improving their coordination, leadership, teamwork, and communication in order to contribute to patient safety.

Theories of meaning and different perspectives on information systems

Even though automated information systems have been used in work life for almost three decades, the academic discipline of information systems development is still in a ‘pre-paradigmatic phase’. There is no central corpus of a well understood and accepted theory of how these artifacts should be understood and designed. What we see is a set of scattered methods and theories, with influences from a wide variety of other disciplines, such as logic, linguistics, philosophy, cognitive psychology, organizational theory, ethnography, etc. There is a practical need for creating an overview and a deeper understanding of how different theories and methods are related to each other, what their relative strengths and weaknesses are and when they are applicable.

The potential of providing blended learning in education and training for advanced civilian and military trauma care

INTRODUCTION In the field of advanced care of the complex trauma patient, there is an emerging need for focused education and training. However, several hospitals do not support further education and training in this field, and the challenge of releasing time for physicians and nurses is well-known. Educational strategies using blended learning, which combines traditional classroom methods with modern computer-assisted methods and media, have not yet been widely used. This study analysed the educational challenges and areas for improvement, according to senior physicians and nurses, and investigated the potential use of blended learning. METHOD The setting was an international course, Definitive Surgical Trauma Care (DSTC) - Military Version, part of a programme which prepares health professionals for work during extreme conditions. The sample consisted of senior physicians and nurses, participating in the course in September 2015. A survey was completed, interviews were performed and a post-course survey was conducted 18 months later in March 2017. RESULTS The most difficult aspect of learning how to manage the complex trauma patient, was the lack of real practice. Even though the respondents were knowledgeable in advanced trauma, they lacked personal experience in managing complex trauma cases. Cases presented during the course represented significantly greater complexity of injury compared to those usually seen in hospitals and during military deployment. The following educational challenges were identified from the study: (1) Lack of experience and knowledge of advanced trauma care. (2) Lack of the use of blended learning as support for education and training. (3) Limited time available for preparation and reflection in the education and training process. (4) Lack of support for such education and training from home hospitals. (5) The unfulfilled requirement for multidisciplinary team-training in the military medical environment. CONCLUSION Educational strategies and methods, such as blended learning can support education and training, and the learning process by unlimited practice in reasoning and decision making in virtual patients. It can also provide flexibility and mobility for senior health professionals and their home hospitals, and contribute to an improved military pre-deployment training with less time strain on the civilian home hospitals.