Over two decades of blended and online physics courses at Michigan State University

In Fall 1992, our first physics course offered online homework. Over two decades later, we have seven physics courses online, spanning the whole range of introductory course offerings, with a total of over 1600 students in 2014. We found that several of the the purely online courses had better learning success than traditional lecture courses, as measured by exam scores. Particularly successful were online materials with embedded assessment. This result can be interpreted in different ways, but may serve as an indicator that during in-class lectures, we are oftentimes not taking advantage of the fact that we have the students on-site.

Blended Learning in der Musiklehrerbildung. Erfahrungen und Perspektiven am Beispiel eines Praxisprojekts

In der Lehrerbildung zu Beginn des 21. Jahrhunderts wird einem hohen Bezug zum Berufsfeld Schule, phasenübergreifender Zusammenarbeit und lebenslangem Lernen zunehmend Bedeutung geschenkt. Mehr und mehr kommt in Veröffentlichungen und auf den Internetseiten von Lehrerbildungszentren deutscher Universitäten ein umfassendes Verständnis von Lehrerbildung zum Ausdruck, das alle Phasen der Aus- und Fortbildung von Lehrkräften einschließt: Studium, Vorbereitungsdienst („Referendariat“) und Fortbildungen für Lehrkräfte im Schuldienst. Wenn Lehrerbildung in diesem Sinne gestaltet und nicht reduziert wird auf eine Phase der Ausbildung, die der Tätigkeit im Schuldienst vorangeht, wenn neben den Qualifizierungsmaßnahmen in Studium und Vorbereitungsdienst auch Fortbildungsangebote für bereits im Beruf stehende Lehrkräfte als Selbstverständlichkeit im Rahmen eines lebenslangen Lernprozesses aufgefasst werden, eröffnet die Implementierung digitaler Medien besondere Chancen – etwa im Hinblick auf kooperatives Lernen sowie auf die Arbeit mit und den Zugriff auf Unterrichtsmaterialien. Am Beispiel eines interdisziplinär angelegten Projekts, dessen Ausgangspunkt und Zentrum das Fach Musik bildet und in dem phasenverbindendes und lebenslanges Lernen einen hohen Stellenwert einnehmen, thematisiert dieser Beitrag Möglichkeiten, Perspektiven und Herausforderungen von Blended Learning in der Lehrerbildung. Es handelt sich um einen Einblick in die Verknüpfung von Präsenz- und Online-Anteilen des Projekts und in erste Ergebnisse aus der Projektevaluation. Vorgestellt werden Teilergebnisse aus einer explorativen Studie zur Bedeutung von Kooperationen und phasenübergreifender Vernetzung, im Rahmen derer unter anderem die Akzeptanz und die Relevanz des E-Learning-Angebots thematisiert wird.

Rahmenwerk für zielgruppenorientiertes Blended E-Learning im MINT-Bereich im Kontext des Lebenslangen Lernens

Das heutige Leben der Menschen ist vom Internet durchdrungen, kaum etwas ist nicht „vernetzt“ oder „elektronisch verfügbar“. Die Welt befindet sich im Wandel, die „Informationsgesellschaft“ konsumiert in Echtzeit Informationen auf mobilen Endgeräten, unabhängig von Zeit und Ort. Dies gilt teilweise auch für den Aus- und Weiterbildungssektor: Unter „E-Learning“ versteht man die elektronische Unterstützung des Lernens. Gelernt wird „online“; Inhalte sind digital verfügbar. Zudem hat sich die Lebenssituation der sogenannten „Digital Natives“, der jungen Individuen in der Informationsgesellschaft, verändert. Sie fordern zeitlich und räumlich flexible Ausbildungssysteme, erwarten von Bildungsinstitutionen umfassende digitale Verfügbarkeit von Informationen und möchten ihr Leben nicht mehr Lehr- und Zeitplänen unterordnen – das Lernen soll zum eigenen Leben passen, lebensbegleitend stattfinden. Neue „Lernszenarien“, z.B. für alleinerziehende Teilzeitstudierende oder Berufstätige, sollen problemlos möglich werden. Dies soll ein von der europäischen Union erarbeitetes Paradigma leisten, das unter dem Terminus „Lebenslanges Lernen“ zusammengefasst ist. Sowohl E-Learning, als auch Lebenslanges Lernen gewinnen an Bedeutung, denn die (deutsche) Wirtschaft thematisiert den „Fachkräftemangel“. Die Nachfrage nach speziell ausgebildeten Ingenieuren im MINT-Bereich soll schnellstmöglich befriedigt, die „Mitarbeiterlücke“ geschlossen werden, um so weiterhin das Wachstum und den Wohlstand zu sichern. Spezielle E-Learning-Lösungen für den MINT-Bereich haben das Potential, eine schnelle sowie flexible Aus- und Weiterbildung für Ingenieure zu bieten, in der Fachwissen bezogen auf konkrete Anforderungen der Industrie vermittelt wird. Momentan gibt es solche Systeme allerdings noch nicht. Wie sehen die Anforderungen im MINT-Bereich an eine solche E-Learning-Anwendung aus? Sie muss neben neuen Technologien vor allem den funktionalen Anforderungen des MINTBereichs, den verschiedenen Zielgruppen (wie z.B. Bildungsinstitutionen, Lerner oder „Digital Natives“, Industrie) und dem Paradigma des Lebenslangen Lernens gerecht werden, d.h. technische und konzeptuelle Anforderungen zusammenführen. Vor diesem Hintergrund legt die vorliegende Arbeit ein Rahmenwerk für die Erstellung einer solchen Lösung vor. Die praktischen Ergebnisse beruhen auf dem Blended E-Learning-System des Projekts „Technische Informatik Online“ (VHN-TIO).

An innovative blended learning approach using virtual patients as preparation for skills laboratory training: perceptions of students and tutors

BACKGROUND Currently only a few reports exist on how to prepare medical students for skills laboratory training. We investigated how students and tutors perceive a blended learning approach using virtual patients (VPs) as preparation for skills training. METHODS Fifth-year medical students (N=617) were invited to voluntarily participate in a paediatric skills laboratory with four specially designed VPs as preparation. The cases focused on procedures in the laboratory using interactive questions, static and interactive images, and video clips. All students were asked to assess the VP design. After participating in the skills laboratory 310 of the 617 students were additionally asked to assess the blended learning approach through established questionnaires. Tutors' perceptions (N=9) were assessed by semi-structured interviews. RESULTS From the 617 students 1,459 VP design questionnaires were returned (59.1%). Of the 310 students 213 chose to participate in the skills laboratory; 179 blended learning questionnaires were returned (84.0%). Students provided high overall acceptance ratings of the VP design and blended learning approach. By using VPs as preparation, skills laboratory time was felt to be used more effectively. Tutors perceived students as being well prepared for the skills laboratory with efficient uses of time. CONCLUSION The overall acceptance of the blended learning approach was high among students and tutors. VPs proved to be a convenient cognitive preparation tool for skills training.

Blended Learning: Integrating an e-Learning Component for Competency Validation

Introduction: Emergency care providers are required to demonstrate competency in the management of life-threatening situation. The care provider’s ability to manage an emergency situation depends upon his/her knowledge and skills in basic CPR; and the use of emergency equipment and supplies. The education department at our healthcare facility is responsible for CPR/Emergency Management competency validation of over 2500 employees annually. Historically each employee was scheduled to attend 4 hours of class every year to review the content, complete the post-test and demonstrate skills. It was resource-intensive, time consuming, stressful and often difficult to schedule the 24/7 employees for the sessions. [See PDF for complete abstract]

A Time-Motion Study of Registered Nurses’ Workflow in Intensive Care Unit Remote Monitoring

Utilizing advanced information technology, Intensive Care Unit (ICU) remote monitoring allows highly trained specialists to oversee a large number of patients at multiple sites on a continuous basis. In the current research, we conducted a time-motion study of registered nurses’ work in an ICU remote monitoring facility. Data were collected on seven nurses through 40 hours of observation. The results showed that nurses’ essential tasks were centered on three themes: monitoring patients, maintaining patients’ health records, and managing technology use. In monitoring patients, nurses spent 52% of the time assimilating information embedded in a clinical information system and 15% on monitoring live vitals. System-generated alerts frequently interrupted nurses in their task performance and redirected them to manage suddenly appearing events. These findings provide insight into nurses’ workflow in a new, technology-driven critical care setting and have important implications for system design, work engineering, and personnel selection and training.

Interruptions in Workflow for RNs in a Level One Trauma Center

An understanding of interruptions in healthcare is important for the design, implementation, and evaluation of health information systems and for the management of clinical workflow and medical errors. The purpose of this study is to identify and classify the types of interruptions experienced by Emergency Department(ED) nurses working in a Level One Trauma Center. This was an observational field study of Registered Nurses (RNs) employed in a Level One Trauma Center using the shadowing method. Results of the study indicate that nurses were both recipients and initiators of interruptions. Telephones, pagers, and face-to-face conversations were the most common sources of interruptions. Unlike other industries, the healthcare community has not systematically studied interruptions in clinical settings to determine and weigh the necessity of the interruption against their sometimes negative results such as medical errors, decreased efficiency, and increased costs. Our study presented here is an initial step to understand the nature, causes, and effects of interruptions, thereby improving both the quality of healthcare and patient safety. We developed an ethnographic data collection technique and a data coding method for the capturing and analysis of interruptions. The interruption data we collected are systematic, comprehensive, and close to exhaustive. They confirmed the findings from earlier studies by other researchers that interruptions are frequent events in critical care and other healthcare settings. We are currently using these data to analyze the workflow dynamics of ED clinicians, to identify the bottlenecks of information flow, and to develop interventions to improve the efficiency of emergency care through the management of interruptions.

Computerized provider order entry adoption: implications for clinical workflow.

OBJECTIVE: To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems. METHODS: We analyzed qualitative data from field observations and formal interviews gathered over a three-year period at five hospitals in three organizations. Five multidisciplinary researchers worked together to identify themes related to the impacts of CPOE systems on clinical workflow. RESULTS: CPOE systems can affect clinical work by 1) introducing or exposing human/computer interaction problems, 2) altering the pace, sequencing, and dynamics of clinical activities, 3) providing only partial support for the work activities of all types of clinical personnel, 4) reducing clinical situation awareness, and 5) poorly reflecting organizational policy and procedure. CONCLUSIONS: As CPOE systems evolve, those involved must take care to mitigate the many unintended adverse effects these systems have on clinical workflow. Workflow issues resulting from CPOE can be mitigated by iteratively altering both clinical workflow and the CPOE system until a satisfactory fit is achieved.

Interruptions in workflow for RNs in a Level One Trauma Center.

An understanding of interruptions in healthcare is important for the design, implementation, and evaluation of health information systems and for the management of clinical workflow and medical errors. The purpose of this study is to identify and classify the types of interruptions experienced by ED nurses working in a Level One Trauma Center. This was an observational field study of Registered Nurses employed in a Level One Trauma Center using the shadowing method. Results of the study indicate that nurses were both recipients and initiators of interruptions. Telephone, pagers, and face-to-face conversations were the most common sources of interruptions. Unlike other industries, the outcomes caused by interruptions resulting in medical errors, decreased efficiency and increased cost have not been systematically studied in healthcare. Our study presented here is an initial step to understand the nature, causes, and effects of interruptions, and to develop interventions to manage interruptions to improve healthcare quality and patient safety. We developed an ethnographic data collection technique and a data coding method for the capturing and analysis of interruptions. The interruption data we collected are systematic, comprehensive, and close to exhaustive. They confirmed the findings from early studies by other researchers that interruptions are frequent events in critical care and other healthcare settings. We are currently using these data to analyze the workflow dynamics of ED clinicians, identify the bottlenecks of information flow, and develop interventions to improve the efficiency of emergency care through the management of interruptions.

Optimal Workflow and Process-Based Performance Measures for Endovascular Therapy in Acute Ischemic Stroke: Analysis of the Solitaire FR Thrombectomy for Acute Revascularization Study.

BACKGROUND AND PURPOSE We report on workflow and process-based performance measures and their effect on clinical outcome in Solitaire FR Thrombectomy for Acute Revascularization (STAR), a multicenter, prospective, single-arm study of Solitaire FR thrombectomy in large vessel anterior circulation stroke patients. METHODS Two hundred two patients were enrolled across 14 centers in Europe, Canada, and Australia. The following time intervals were measured: stroke onset to hospital arrival, hospital arrival to baseline imaging, baseline imaging to groin puncture, groin puncture to first stent deployment, and first stent deployment to reperfusion. Effects of time of day, general anesthesia use, and multimodal imaging on workflow were evaluated. Patient characteristics and workflow processes associated with prolonged interval times and good clinical outcome (90-day modified Rankin score, 0-2) were analyzed. RESULTS Median times were onset of stroke to hospital arrival, 123 minutes (interquartile range, 163 minutes); hospital arrival to thrombolysis in cerebral infarction (TICI) 2b/3 or final digital subtraction angiography, 133 minutes (interquartile range, 99 minutes); and baseline imaging to groin puncture, 86 minutes (interquartile range, 24 minutes). Time from baseline imaging to puncture was prolonged in patients receiving intravenous tissue-type plasminogen activator (32-minute mean delay) and when magnetic resonance-based imaging at baseline was used (18-minute mean delay). Extracranial carotid disease delayed puncture to first stent deployment time on average by 25 minutes. For each 1-hour increase in stroke onset to final digital subtraction angiography (or TICI 2b/3) time, odds of good clinical outcome decreased by 38%. CONCLUSIONS Interval times in the STAR study reflect current intra-arterial therapy for patients with acute ischemic stroke. Improving workflow metrics can further improve clinical outcome. CLINICAL TRIAL REGISTRATION: URL http://www.clinicaltrials.gov. Unique identifier: NCT01327989.