I didn’t become a physician to do data entry

I opened Ms. Tucker’s chart. There were twenty-one tabs vertically on the left-hand corner of the screen and eighteen tabs horizontally on the top of the screen. I quickly glanced through the cluttered twenty-one vertical tabs; I clicked on the one I am looking for — “transfer medication reconciliation” in the 19th slot. A new grid showing sixteen held orders opened. I selected each of them separately and clicked on “continue.” Select and continue. Sixteen times two: thirty-two clicks.

Source: Mallidi, J. (2018). I didn’t become a physician to do data entry.

Another call for clinicians to be more involved in the design, development, deployment and evaluation of clinician-facing software. There’s evidence that poor software design leads to unreliable data capture, placing patients at risk, as well as being at least partly responsible for physician burnout. Unless you’re a clinician working in the complex (chaotic?) environment of a health system, you’re probably not going to design a user interface that:

  • Is intuitive to use
  • Enables accurate (valid and reliable) data capture
  • Is secure but ALSO user-friendly
  • Degrades gracefully (is tolerant to faults)

See also:

Constructing a blog post for the PHT402 Ethics course

This is a post for participants in the #pht402 Professional Ethics online course being run by the University of the Western Cape and Physiopedia. Many of our participants have little or no blogging experience, so this post is intended to provide some suggestions and resources that may be useful when learning how to write your own posts. You should explore the additional content provided here through hyperlinks, as they are aimed at helping you to develop your blogging skills.

The point of this course is that you work with the ideas of other people to inform your own thinking about a topic. So, for the benefit of everyone taking the course you need to read other peoples work and you want them to read yours. A reader will often decide in the first few seconds if they’re going to read your post, which gives you very little time to make a good first impression. One way to encourage them to continue is to begin with a bit of introductory text (like I’ve done above), or to ask a challenging question, or to come up with a controversial or interesting title for your post. I’m not saying that this post is perfect but in it I’ve tried to show some examples of the different elements that can help make your writing both contextually and visually interesting, and which will encourage others to engage with you.

First of all, you should be aware that blogging can help you to develop certain skills, which could have value in your professional life, above and beyond what you may learn in this course. Being aware of these skills and actively trying to develop them will show returns in your professional career in the future. Here are some good reasons to consider blogging:

Incorporating other elements into your post will help to create interest for the reader. Embedded videos and images are great to break up long passages of text, as well as to provide contextually rich multimedia content that supports your writing. Since one of the major aims of this course is to think about the concept of empathy, I’ve embedded one of my favourite TED Talks below in order to demonstrate what an embedded video looks like.

You should also use links in your posts, for two main reasons; they direct the reader to additional resources and they can be used to support claims that you make. If you write something that’s just your opinion it won’t carry much weight. But, if you add a link to another source that says the same thing that you do, it strengthens the argument you’re trying to make. In this way, linking is a form of in-text citation. Note that simply adding another source doesn’t automatically strengthen your argument, especially if that source isn’t credible. When your thinking around a topic has been influenced by someone else’s work, you should acknowledge them by linking to their post. You can do this by copying the URL of their post (note that this is different to the URL of their blog) and then using it when you create a link in your own post. Describing how your own thinking has been informed by others is a powerful form of reflection that is strongly encouraged during this course.

Michael Rowe - Google+_002
My Google+ profile, showing the card UI design.

When it comes to design (look and feel), I like to have a clear, uncluttered interface, lots of white space, neutral colours and a crisp font. For these reasons, I love Google’s updated user interface guidelines across it’s various platforms, and especially the “card” interface. My point is that you should choose a template for your blog that reflects a little bit about who you are and what you like. Does simplicity say something about you? Or, lots of bright, vibrant colours? What about serif or sans-serif fonts?

When it comes to personalising your blog using your own photos not only adds an element of personal style, but also avoids issues with licensing the content of others. The images above are screenshots that I’ve taken myself, of my own online spaces. The picture below is one that I took myself and can therefore use in any way that I want. Adding a personal touch to your blog is great but when you’re using content that you haven’t created yourself it’s important that you’re familiar with licensing. The search function at Creative Commons is a great resource for finding openly licensed content.

Just an example of an embedded picture with a caption that explains the context of the image.
Just an example of an embedded picture with a caption that explains the context of the image.

And that’s it! The first of what will hopefully be a short series of posts as part of this course, aimed at helping participants develop a set of skills that can be used beyond the boundaries of this short course on Professional Ethics. If you have any suggestions of other tips and tricks to enhance your posts, I’d love to hear about them in the comments.

“Design” and “Evolution” in curriculum development

tumblr_lj8a50nUXv1qi0qqro1_500Awesome quote from Linus Torvalds (creator of the Linux kernel) on the difference between evolution and design.

Don’t ever make the mistake [of thinking] that you can design something better than what you get from ruthless massively parallel trial-and-error with a feedback cycle. That’s giving your intelligence much too much credit.

For implementing the module that I ended up evaluating for my PhD project, we approached the initial phase with design that was heavily based on the literature, learning theories and teaching frameworks because we needed a solid foundation. However, once the module was up and running, we switched to evolving it over time with rapid iteration based on feedback from both students and facilitators. This process of evolving the module based on regular feedback identified problems that we couldn’t have predicted in advance and created solutions that we couldn’t have developed through design alone.

Design principles for clinical reasoning

graphic_design smallerClinical reasoning is hard to do, and even harder to facilitate in novice practitioners who lack the experience and patterns of thinking that enable them to establish conceptual relationships that are often non-trivial. Experienced clinicians have developed, over many years and many patients, a set of thinking patterns that influence the clinical decisions they make, and which they are often unaware of. The development of tacit knowledge and its application in the clinical context is largely done unconsciously, which is why experienced clinicians often feel like they “just know” what to do.

Developing clinical reasoning is included as part of clinical education, yet it is usually implicit. Students are expected to “do” clinical reasoning, yet we find it difficult to explain just what we mean by that. How do you model a way of thinking?

One of the starting points is to ask what we mean when we talk about clinical education. Traditionally, clinical education describes the teaching and learning experiences that happen in a clinical context, maybe a hospital, outpatient or clinic setting. However, if we redefine “clinical education” to mean activities that stimulate the patterns of thinking needed to think and behave in the real world, then “clinical education” is something that can happen anywhere, at any time.

My PhD was about exploring the possibilities for change that are made available through the integration of technology into clinical education. The main outcome of the project was the development of a set of draft design principles that emerged through a series of research projects that included students, clinicians and clinical educators. These principles can be used to design online and physical learning spaces that create opportunities for students to develop critical thinking as part of clinical reasoning. Each top-level principle is associated with a number of “facets” that further describe the application of the principles.

Here are the draft design principles (note that the supporting evidence and additional discussion are not included here):

1. Facilitate interaction through enhanced communication

  • Interaction can be between people and content
  • Communication is iterative and aims to improve understanding through structured dialogue that is conducted over time
  • Digital content is not inert, and can transform interactions by responding and changing over time
  • Content is a framework around which a process of interaction can take place – it is a means to an end, not an end in itself
  • When content is distributed over networks, the “learning environment” becomes all possible spaces where learning can happen
  • Interaction is possible in a range of contexts, and not exclusively during scheduled times

2. Require articulation

  • Articulation gives form and substance to abstract ideas, thereby exposing understanding
  • Articulation is about committing to a statement based on personal experience, that is supported by evidence
  • Articulation is public, making students accountable for what they believe
  • Articulation allows students’ thinking to be challenged or reinforced
  • Incomplete understanding is not a point of failure, but a normal part of moving towards understanding

3. Build relationships

  • Knowledge can be developed through the interaction between people, content and objects, through networks
  • Relationships can be built around collaborative activity where the responsibility for learning is shared
  • Facilitators are part of the process, and students are partners in teaching and learning
  • Facilitators are not gatekeepers – they are locksmiths
  • Create a safe space where “not knowing” is as important as “knowing”
  • Teaching and learning is a dynamic, symbiotic relationship between people
  • Building relationships takes into account both personal and professional development
  • Building relationships means balancing out power so that students also have a say in when and how learning happens

4. Embrace complexity

  • Develop learning spaces that are more, not less, complex
  • Change variables within the learning space, to replicate the dynamic context of the real world
  • Create problems that have poorly defined boundaries and which defy simple solutions

5. Encourage creativity

  • Students must identify gaps in their own understanding, and engage in a process of knowledge creation to fill those gaps
  • These products of learning are created through an iterative activity that includes interaction through discussion and feedback
  • Learning materials created should be shared with others throughout the process, to enable interaction around both process and product
  • Processes of content development should be structured according to the ability of the students

6. Stimulate reflection

  • Learning activities should have reflection built in
  • Completing the reflection should have a real consequence for the student
  • Reflection should be modelled for students
  • Reflections should be shared with others
  • Feedback on reflections should be provided as soon after the experience as possible
  • Students need to determine the value of reflection for themselves, it cannot be told to them

7. Acknowledge emotion

  • Create a safe, non­judgemental space for students to share their personal experiences and thoughts, as well as their emotional responses to those experiences
  • Facilitators should validate students’ emotional responses
  • These shared experiences can inform valuable teaching moments
  • Facilitators are encouraged to share personal values and their own emotional responses to clinical encounters, normalising and scaffolding the process
  • Sensitive topics should be covered in face­to­face sessions
  • Facilitators’ emotional responses to teaching and learning should be acknowledged, as well their emotional responses to the clinical context

8. Flexibility

  • The learning environment should be flexible enough to adapt to the changing needs of students, but structured enough to scaffold their progress
  • The components of the curriculum (i.e. the teaching strategies, assessment tasks and content) should be flexible and should change when necessary
  • Facilitators should be flexible, changing schedules and approaches to better serve students’ learning

9. Immersion

  • Tasks and activities should be “cognitively real”, enabling students to immerse themselves to the extent that they think and behave as they would be expected to in the real world
  • Tasks and activities should use the “tools” of the profession to expose students to the culture of the profession
  • Technology should be transparent, adding to, and not distracting from the immersive experience

We have implemented these draft design principles as part of a blended module that made significant use of technology to fundamentally change teaching and learning practices in our physiotherapy department. We’re currently seeing very positive changes in students’ learning behaviours, and clinical reasoning while on placements, although the real benefits of this approach will only really emerge in the next year or so. I will continue to update these principles as I continue my research.

Note: The thesis is still under examination, and these design principles are still very much in draft. They have not been tested in any context other than in our department and will be undergoing refinement as I continue doing postdoctoral work in this area.

Twitter Weekly Updates for 2011-08-01

  • Cities Are Immortal; Companies Die http://bit.ly/pEWOmx. Masie briefly mentioned this Kelly article (I think)  in his great presentation at #cityafrica # (link updated after the fact)
  • Historic medical manuscripts go online http://ow.ly/1v9v0b #
  • Omniscient Mobile Computing: What if Your Apps Knew Everything About Where You Are? http://ow.ly/1v9tkE. Reminded of Masie at #cityafrica #
  • Is RT a form of legitimate peripheral participation? Attended #tedxstellenbosch yesterday & did a lot of RT, wondering “did I padticipate”? #
  • @Sharoncolback not sure if it’s so simple, see @jeffjarvis who is very public re. personal stuff & who inspires many in similar situations #
  • Am I addicted to the internet? Maybe, but so what? http://ow.ly/1v8Cd0 #
  • Before iPhone war, Samsung sells 5M GS2′s in 85 days http://ow.ly/1v8BPZ. Got my samsung galaxy S2 last week and loving it so far #
  • Are there some things that shouldn’t be tweeted about? http://ow.ly/1v8BDT #
  • Feds Will Pay Doctors For Using Medical Records iPad App http://ow.ly/1v8AYl #
  • Electronic medical records get a boost from iPad, federal funding http://ow.ly/1v8AH5 #
  • The current impact agenda could consider the impact of inspirational teaching, not just research http://ow.ly/1v8An8 #
  • Mendeley 1.0 is here! http://ow.ly/1v8y0T #
  • Learning spaces haven’t changed much since structured education emerged centuries ago. #cityafrica providing inspiration for change #
  • @wesleylynch venue is packed, hard to find 5 seats next to each other, realm team always inviting 🙂 #
  • @wesleylynch re-designing cities to be integrated spaces for working, learning and living #
  • @wesleylynch not sitting with #realm team, but chatted a bit #
  • @hotdogcop “quality teaching” isn’t going to happen without policy change that affect salaries and other factors related to job satisfaction #
  • @hotdogcop interest groups aren’t confined to academia though…some academics seek radical change, institutional structure makes it hard #
  • @hotdogcop “academic” doesn’t have to mean “top-down” or “policy maker” #
  • @hotdogcop agreed, but we train the people who will be called on to implement change #
  • @hotdogcop Mokena has some great ideas re. the city & education. would be interesting have him talk to our academics #
  • RT @TEDxStellenbsch: The future city already exists <- no, the technology exists, it’ll take a few years to implement #cityafrica #
  • Mokena Makena the best speaker so far at #tedxstellenbosch #CityAfrica #
  • Classrooms are not inspiring #cityafrica #
  • How could learning spaces change if city / community / nature were more fully integrated? #cityafrica #
  • How would the world look if cities were planned to integrate nature? #cityafrica #
  • Cities and nature don’t have to be mutually exclusive #cityafrica #
  • @vivboz hi vivienne, I’m not sure what writing group you mean? #
  • If the world can’t see or hear you, are u relevant? Do gangs and violence allow young people to be feared, if not seen & heard? #cityafrica #
  • How do our living and working spaces change the way we think and what does that mean for how we live? #cityafrica #
  • At #tedxstellenbosch trying to better understand the relationship between city and community #cityafrica #
  • Using social media: practical and ethical guidance for doctors and medical students – The British Medical Association http://bit.ly/nHBIyj #
  • Sites for the QR-enabled Tourist http://bit.ly/qcMuan #

Twitter Weekly Updates for 2011-05-30

Posted to Diigo 03/28/2010

    • If you can master these fundamental concepts, your graphical treatments — from PowerPoint slides to Microsoft Word documents to company brochures — will greatly improve
    • Seven basic graphic design principlesUnity
    • Unity may be the single most important concept. All elements on a page (or slide, poster, etc.) must look like they belong together
    • However, it is important to break up the unity once in a while (or on parts of a page). You need unity so that the message you want to communicate comes out clearly and strong. But you also need variety in the design to add interest and life and to grab attention
    • Gestalt
    • The whole is more — sometimes much more — than the sum of the design elements
    • Gestalt helps us to perceive the overall clear message of the design
    • Space
    • Often, the more space you don’t use on a page, the clearer your message becomes
    • empty space also implies importance, elegance, professionalism
    • Empty space is beautiful
    • Color
    • The conscious use of color to create hierarchy, dominance, and balance in a design can be very effective
    • Consistency is easier to achieve if the designer (i.e., you) limits the use of color choices to just a few
    • Make your color choices at the beginning of the design process rather than at the end. Leaving color choice to the end will likely end up leading to a superficial application of color. Color, like good design in general, is not cosmetic or veneer. Color choice is fundamental
    • Color (say, red on a white page with black body text) can be used to highlight elements on a page which are most important. Color can also provide direction
    • Dominance
    • If one item in a design is clearly dominant, this helps the viewer “get” the point of the design. Every good design has a strong and clear focal point and having a clear contrast among elements (with one being clearly dominant) helps. If all items in a design are of equal weight, with nothing being clearly dominant, it is difficult for the viewer to know were to begin
    • Hierarchy
    • What is most important, less important, and the least important parts of the design can be clearly expressed by having a clear hierarchy
    • In general, according to White, having more than three levels of hierarchy in a single design leads to confusion for the reader
    • Balance
    • If a design is out of balance, the individual elements of the design will dominate the overall design. A well-balanced design has a clear, single, unified message
    • sticky, compelling, and memorable messages and ideas share six common attributes: Simplicity, Unexpectedness, Concreteness, Credibility, Emotions, and Stories. Ask yourself how your presentations rate for these elements
    • good presenting is like good writing, you’ve got to pare it down and dump the superfluous and the non-essential. But since we are so close to the material it is hard for us to see what works and what does not, or what is repetitive, etc. This is why you cannot only rehearse alone
    • Turn off the computer, grab some paper and a pencil, and find someplace quiet. Think of the audience. What is it they need? What is it you want to say that they need to hear. Identify what’s important and what is not. You can’t say everything in a twenty-minute talk
    • The problem with most presentations is that people try to include too much. You can go deep or you can go wide, but you can’t really do both
    • By the way, if you ask the audience to bear with you as you try to make the computer work, you might as well stick a fork in it because you are done
    • criteria for looking at the effectiveness of instructional innovations
    • 1. Develop and test activities through multiple classroom iterations. Try it more than once! See if the same outcome occurs. See if some minor alternations make it even more effective.

      2. Collect evidence from multiple sources, such as students and outside observers. Yes, your opinion as to whether and how well something worked counts, but verify what you think happened by collecting information from students. They don’t always experience things the way we think they do. Ask a colleague or a professional from the teaching center to come to class and observe and report what results they’re seeing.

      3. Collect evidence using multiple methods. Most of us don’t evaluate what students know by only using multiple-choice methods. So our instructional alternations ought to be assessed with multiple methods—qualitative, quantitative, descriptive, and so on.

      4. Tie evidence to learning objectives. Why did you try the new activity? Is it an attempt to better reach one of your learning objectives for the course? Usually changes are, which makes it natural to judge their effectiveness by looking at evidence documenting how well they accomplish the learning objective.

Giving good presentations

I gave my first conference presentation in June, 2008 and thought that it was terribly boring. I presented the results of my Masters thesis and since I’m quite new to the whole “being an academic” thing, I did it the same way that everyone else was doing it. In other words, I fired up OpenOffice and began adding bullet points. I knew that I wasn’t happy with it, and I knew that there must be a better way of presenting my work, but didn’t really know how.

Since then I’ve learned a little more about giving effective presentations (although I’m not, by any stretch of the imagination, a good presenter), and with each subsequent one I’ve given I’ve gained the confidence to try something different. I’ll always try something to break the tedium of merely summarising my results into bullet points, and along the way I’ve learned a few useful thing. Here are some sources of inspiration for me.

Finally, I try to remember that my goal in giving a presentation should be to entertain, not just to inform. On a related topic, read this post by Seth Godin on why most academic conferences are…typical.