#203 How to Create an Online Curriculum for Medical Education

April 2, 2020 | By Matthew Watto, MD

A Step-by-Step guide for medical educators with Drs. Kat Zechar and Amreet Sidhu 

Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running. You should also check out this guide to building your online curriculum at https://www.brosencephalon.com/onlinecurriculum.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com 

Credits

Written and Produced by: Paul Williams MD, FACP

Cover art and Show notes by: Matthew Watto MD, FACP

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   

Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Guest: Kat Zechar MD and Amreet Sidhu MD

Join The Curbsiders! 

Medical students, we need your help with production of the show! You’ll learn all aspects of podcasting, get to network with national thought leaders and join an amazing global team of Curbsiders. We are especially in need of folks with experience creating video content, developing websites and using social media tools. Application deadline is Friday April 10, 2020. Send an email to thecurbsiders@gmail.com and include the following:

[  ] A half page on why you’d make a great Curbsider

[  ] A copy of your CV

[  ] Your social media handles on Instagram, Twitter, etc. 

[  ] Samples of prior work (e.g. videos, websites, etc.)

Time Stamps

• 00:00 Announcement: We’re looking for pre-med and medical Student members. Send applications to thecurbsiders@gmail.com by deadline April 10, 2020.
• 01:22 Intro, disclaimer and guest bios
• 03:38 Guest one-liners, Picks of the week*: Gumption (book) by Nick Offerman; Man Search for Meaning (book) by Viktor Frankl; Death Stranding (videogame); Alita: Battle Angel (film)
• 09:30 Why you might need an online meded curriculum
• 16:33 Overview of Amreet and Kat’s online curriculum
• 21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment
• 36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org)
• 46:35 Time commitment
• 50:55 Take home points and Outro

Goals for an online curriculum

• Supplement your traditional curriculum (e.g. monthly board review quizzes)
• Widen program-sponsored educational materials over multiple modalities
• Website creates a central repository for program info/tools
• Facilitate resident engagement and combat dwindling in-person didactic attendance
• Track learner engagement through web traffic tools, video viewing trackers

Hilarious research: “Number needed to Eat” Pizza at Noon conference (link at bottom) – US$46 cost for each extra resident that attended https://onlinelibrary.wiley.com/doi/abs/10.1111/medu.13080

Dr. Zechar’s and Sidhu’s website

The website that they built was divided into three major sections:

1. Core internal medicine educational material (videos, text, links)
2. Self-assessment tools (multiple choice quizzes, flashcards)
3. Interactive learning tools (Clinical Scenarios, Zebra Cases)

All residents were provided with a de-personalised log-in to the website, which allowed program leadership to track engagement and performance on self-assessment tools. 

To see an example of the tools they built, check out https://intentionalmeded.org/interactive-tools/

Tools for an Online Curriculum

The TOTAL COST FOR EVERYTHING: $140 for tech/hardware, $750/year. Below is a breakdown of what they used, with relevant costs. 

Website

Purchase a domain

They used www.namecheap.com to obtain a domain for 7$ per year. GoDaddy.com is another popular site for domain name purchase.

Choose a web hosting service

They created their website using WordPress www.wordpress.com and paid for the ability to host media ~$300/year. Media hosting services (like those provided by WordPress) are necessary to obtain server space that allows files like videos or podcasts to be uploaded to your site and be stored on remote servers without crashing your site or slowing it down.

Amreet and Kat recommend WordPress (instead of out of the box website software like SquareSpace or Wix) because it allows them to easily monitor traffic and offers a wide range of plug-ins that can be used for generating self-assessment tools, flash cards, interactive cases, or embedding video from another site. 

Self Assessment tools

Doctors Sidhu and Zechar recommend using the ABIM Internal Medicine blueprint to develop content (more at Exam Blueprints | About ABIM Exams | About ABIM | ABIM.org)

1. For vignette-style, multiple choice questions use the ‘WordPress Pro Quiz’ plugin.
2. For self-retrieval, short-answer flashcards use www.qwizcards.com and their associated WordPress plugin.
3. For interactive cases, use Twine, a free, open-source, interactive story creator (www.twinery.org).
4. Use the WordPress plugin ‘CM Video Lesson Manager’ to consolidate videos and track learner viewing data (FREE).

Other software tools

1. Zoom: Videoconferencing was added at $180/year, which allows for up to 100 participants, which was needed for a 50 person residency plus student learners. This also gave them CLOUD Recording and Storage, which made remote access and sharing much easier. Note: Larger programs may need an add-on for more participants.  
2. They use www.vimeo.com to host videos and for $240/year. The subscription keep videos private and allows for sped-up playback.

Hardware

Amreet and Kat purchased a digital camera with HD video capability, mic and headphones, tripod and two SD cards allowed recording in rooms that did not have a laptop and slide projector. Total cost was: $75, $25 and $15 respectively.

HD Video Camera $64

Microphone (multi-directional) $20

Barriers to an Online Curriculum 

Note: We did not have time to discuss all barriers in detail on-air, but have included the full list for the show notes. 

• Faculty concerns re: engagement with live didactics
• IT blocking sites/programs (only learning after we built them)
• Media transfer (file transfer from people recording didactics to website admin)
• Determining who gets what level of access
• Keeping things inside or outside of a password – relates to intellectual property, patient information (HIPAA concerns)
• What hosts allowed what media (html files were a surprising issue)
• Convincing GME to allocate in the budget “but you have a website” – hospital based website updates can be VERY slow
• People check into the online conference, but not participate in discussion –the online equivalent of sitting in the back of the lecture hall and scrolling Instagram 

Unintended benefits to an online curriculum

• Passwords/ID helps track users and allows for de-identified information to be distributed
• PGY year specific usernames (that are depersonalized) to report monthly scores, allows residents to gauge their relative function compared to peers
• Quickly respond to resident needs e.g. create Rapid Response interactive scenarios based on early PGY2 residents struggling in that role.
• Monthly board quizzes and tracking engagement helped at CCC. If a learner was behind on medical knowledge it was possible to see if they were taking the advice to “read more”, or and adhering to the recommended review plan.

How an online curriculum might improve learning

1. Scientific American article by John Dunlosky et al from 2013. “Some study techniques accelerate learning, whereas others are just a waste of time—but which ones are which? An unprecedented review maps out the best pathways to follow” https://www.scientificamerican.com/article/what-works-what-doesn-t/ 
2. Review of how to learn in medical school that discusses the utility of the testing effect, active recall, and spaced repetition https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031794/.

Links*

1. Gumption (book) by Nick Offerman
2. Man Search for Meaning (book) by Viktor Frankl, 
3. Death Stranding (videogame), 
4. Alita: Battle Angel (film)
5. Dr. Sidhu’s guide to building an online curriculum can be found here https://www.brosencephalon.com/onlinecurriculum

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will learn the basic tools needed to develop their own online curriculum and educational model.

Learning objectives

After listening to this episode listeners will…

1. Outline the benefits of creating an online curriculum.
2. Identify the necessary tools to create an online curriculum.
3. Recognize the potential benefits and pitfalls of asynchronous education.
4. Discuss the learning theory that supports asynchronous learning.
5. Explain how an existing curriculum can be quickly modified to adapt to evolving learner needs.

Disclosures

Drs. Sidhu and Zechar report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Sidhu A, Zechar K, Williams PN, Watto MF. “#203 How to Create an Online Curriculum for Medical Education”. The Curbsiders Internal Medicine Podcast. http://thecurbsiders.com/episode-list. April 2, 2020.