Kia Ora ... well, I must say that it doesnt look nearly as nice without the formatting....Adam is there a place we can drop these documents or shall we just email them to each other?
L
Course Development Document
E-Learning & Clinical Education (ClinEd 711)
department:
Psychological Medicine
course:
Psychiat 768 Clinical skills in child, adolescent and family mental health
course coordinator:
Leah Andrews
project sponsor:
date:
20/05/07
doc version:
4
[To complete this document, use the MS Word version; left click in the grey boxes and type.]
Scoping Questionnaire
Project Title:
Clinical formulation and the development of management plans in child & adolescent mental health
Client:
Project Goal:
Clinical work in child and adolescent mental health requires more than simple recognition of diagnostic categories. Developing structured plans in collaboration with children, young people and whanau is at the core of good mental health practice, yet service-user and service audit data suggests that it is often poorly done. The project aims to extend practising clinicians’ skills in the area of clinical formulation and the development of management plans in child and adolescent mental health.
Development Team:
Project Objectives:
Structure of Learning Objectives and Content for Course/Module:
Unit/Module/Topic
Learning objectives
(consistent with Needs Analysis Document)
Learning hours
Who is responsible for content?
Formulation and Management Plans in Child & Adol Mental Health
1. 1 Demonstrates understanding of structure and process of formulation
1
LA
1.2. Demonstrates understanding and process of structured management plans
1
LA
1.3. Demonstrates evidence-based approach to management plans
1
LA
2.1 Demonstrates understanding of formulation structures used by Maori
1
LA
What is the intended audience, and any characteristics that are relevant to your learning design and its implementation?
20-25 learners who are currently clinicians working in child and adolescent mental health. They generally have access to computers with fast connections through their workplaces but may be underconfident in the use of technology.
All clinicians have current experience and some basic knowledge of diagnosis and psychopathology. Many students have worked in adult mental health and take this course to extend their knowledge of child and adolescent mental health. However, they are a mixed group and some students have little mental health background.
If this is an existing course/module, how has it been delivered in the past?
Current delivery is by a lecture on formulation, some small group teaching (held during four two-day blocks over two semesters) in which learners pair together to practise formulation and management plans, reading and using set texts and by writing a case study which forms a large part of the summative assdessment.
In 1-2 paragraphs, what is your intended teaching/learning strategy for the course/module in an e-learning environment?
The project aims to extend practising clinicians’ skills in the area of clinical formulation and the development of management plans in child and adolescent mental health.
It aims to use students’ knowledge, background and current clinical work to develop and extend their knowledge of these areas, while exposing them to a range of models.
Your strategy should be:
consistent with your Project Goal and Project Rationale from your Needs Analysis Document;
enacted by, and consistently evident throughout, your learning design in this document.
Learning Design (note the colour-coding in relation to the e-learning framework)
Detail the proposed e-learning tasks, resources, supports, technologies and assessment for your project that will enable your students to achieve the learning objectives you have specified earlier in this document.
Use Herrington et al’s (2001) ‘Quality Guidelines for Online Courses’* to guide your design decisions; these guidelines will be used for both peer and instructor assessment of the quality of your learning design.
Module/Topic and
Learning task
Student role/activities (what will students do?)
Technologies
(how will you enable access,
communication,
collaboration?)
Resources (what materials or information will students draw on to complete the task?)
Teacher role (how will you support the students as they undertake the task?)
Assessment/Feedback (how will you assess and/or provide feedback on the students’ work?)
Built into course
Contributed during course
Understanding structure and process of formulation processes in child & adolescent mental health
Students working in twos or threes: post introductions, (self generated descriptions of learners and services they work in,) statement re their current models of formulation, asked to comment briefly on one other model & post to group for assessment
Use learning object to develop a formulation in pairs, critique each others & post
Use formulation structure for two different clinical cases: submit to peer for critique and development: post to instructor and whole class
Cecil management system
On-line discussion forum (Cecil)
Possible use of WIki if not document development/sharing not available in Cecil.
Powerpoint files of suggested structures
Relevant linked article regarding models of formulation (McConville, 2006)
Whare Tapawha available from
http://www.maorihealth.govt.nz/moh
“Anonymised” clinical cases from workplaces
http://shscal.swan.ac.uk/eward/sshots.html
NB I think we can do a better on eof these in my department, on reflection.
Introduction and self- description Create files based on commonly used structures
“Pair” students & outline their tasks
Reminders
Structure discussion on formulation models
Development of resource of multiple examples of formulations contributed by students
Teacher proposed questions on formulation to start
Teacher provides structure for comments and feedback from students on others’ formulations
Development of structure for assessment
Student self-assess by marking guide
Feedback on two formulations from peer pair/trio depending on numbers
Completion of two structured formulations posted by student 10%
Assessment structure to be developed, circulated to students
Discussion in response to questions: participation assessed by a structure
Developing structured management plans using evidence-based treatments
Students work in pairs to share & critique at least 2 anonymous management plans and post 1 online, using evidence-based approaches
Cecil management system
On-line discussion forum (Cecil)
Possible use of WIki if not document development/sharing not available in Cecil.
Powerpoint files of suggested structures
“Anonymised” clinical cases from workplaces
http://shscal.swan.ac.uk/eward/sshots.html
Relevant linked article regarding models of management plans
Course texts (electronic) regarding treatments
As above
As above
-
Same process for management plans as above for formulatio
5%
Understanding structured formulation and management plans used by Maori
Discussion about formulation and management plans as used in Kaupapa Maori services
Cecil
Online discussion
Powerpoint files
Recorded lecture
As above
As above with special emphasis on student-student engagement
One of the cases or management plans to use a Taha Maori structure
Assessment structure for this 5%
Does your learning design depart from Herrington et al’s (2001) ‘Quality Guidelines for Online Courses’. If so, how, and why?
1. Pedagogies:
Authentic tasks, opportunities for collaboration, relatively learner-centred and meaningful assessments.
But: not sure if environments/tasks will be engaging enough or how to improve on this.
2. Resources:
Accessibility may be an issue, currency is ok, richness of perspective ok I think, and the materials will demonstrate social, cultural and gender inclusivity since students will be provide many of the examples.
3. Delivery strategies:
Reliability and band-width - who knows??
I still have some work to do on clarifying goals and directions and learning plans. Communication will be encouraged between learners and all materials should be accessible as long as students have access to on-line. I don’t think I want to know about corporate style!! Perhaps it just means having the University logo on everything?I
Are there any technical or other constraints on the development?
Yes, I think some of the more complex electronic organisation is beyond me.
Current Budget Available:
$0
When will the project begin?
?
When will the project end?
What are the project deliverables & milestones, and who is responsible?
Deliverables
Responsibility
Milestones
Signed off by Project Sponsor:
Name: Date:
* Herrington, A., Herrington, J., Oliver, R., Stoney, S. & Willis, J. (2001). Quality guidelines for online courses: The development of an instrument to audit online units. In G. Kennedy, M. Keppell, C. McNaught & T. Petrovic (Eds.) Meeting at the crossroads: Proceedings of ASCILITE 2001, (pp 263-270). Melbourne: The University of Melbourne. Available from: http://elrond.scam.ecu.edu.au/oliver/2001/qowg.pdf.
McConville, B., Delgado, S. (2006). How to Plan and Tailor Treatment: An Overview of Diagnosis and Treatment Planning (p ) In W. Klykylo & J. Kay (Eds.), Clinical Child Psychiatry (pp. 91-108). Baltimore: John Wiley & Sons, Ltd
Sunday, May 20, 2007
Tuesday, May 15, 2007
Discussion for Learning Objects Module 7
This is the learning object I have chosen:http://shscal.swan.ac.uk/eward/sshots.html
Learning Objects
1. Which repositories did you visit, and what process/strategy did you use to locate an appropriate learning object? What tips would you offer to somebody else undertaking their own search?
Learning Object Repositories
I visited the following repositories and websites which stated that they gathered learning materials and searched by “Mental Health” and Psychiatry” and “Paediatrics/Pediatrics.”
CAREO (Campus Alberta Repository of Educational Objects)
Intute (Intute)
MedEdPORTAL (Association of American Medical Colleges) Here I found a suitable-sounding resource (simulated teenage patient with depression and obesity) and emailed the contact but have not heard back.
JISC (Joint Information Systems Committee (JISC))
The following search strategies were used:Via Google:
Child psychiatry learning objects/child psychiatry online teaching/Psychiatry learning objects/teaching/ Mental Health learning objects/Mental Health learning online.
Since this didn’t produce much, I also looked at:Paediatrics learning objects/online teaching and Interview learning objects/online teaching
Via Medline & ERIC
Psychiatry AND online, teaching AND online, learning AND online
Much information from these sources is about learning/training eg (Kobak, Opler, & Engelhardt, 2007)rather than examples of resources.
Like Robyn I would suggest specific searches, going to the places where learning objects are collected and being sure to specify “free” if this is required. I think that searching for learning objects in my field is extremely time-consuming and not very satisfactory. Many resources sound good but don’t deliver formed Learning Objects, eg Massey University’s PBL site (Massey University) and others seem great for psychiatry but require substantial fees.
2. What learning objective(s) will the learning object help your students achieve? How?
AND
4. How will you integrate the learning object into your course design? Can it be used exactly as is, or does it (or your course) require changes? Are changes permissible/realistic?
Chosen Learning ObjectSearches for learning objects supporting the learning aims did not reveal anything entirely suitable, but there was one which was close and could be adapted.(I am declaring war on the verb “repurpose.” This word is culturally insulting to me: as the daughter of an English teacher! I just can’t use a noun as a verb!!)
This is as follows:http://shscal.swan.ac.uk/eward/sshots.html
This learning object is an unfolding scenario of a 17 year old with psychotic symptoms (it says 19 on the website but 17 on the screenshots) and I think that it could be adapted to use with local content and a structure for case formulation and planning for management.
(We have a number of digital interviews with actors which we currently use in our courses for helping students learn about diagnosis: they are at present on DVD and CD but could be uploaded to Cecil (I think – I have not used Cecil for this) for students to view by segment.)
Learning Objectives
The learning aims which this would support:
Understanding structure and process of formulation processes in child & adolescent mental health
Developing structured management plans using evidence-based treatments
Students would use this learning object to practise their skills at formulation by observing a standardised interview and making a formulation and management plan. They would share these and critique each others’ work.
3. What are the terms and conditions for accessing and re-using the learning object in your course? If you did not locate an appropriate learning object, what were the access/re-use terms and conditions for one of the repositories you visited that you found notable?
There are no listed terms or conditions, There is a contact email. It is not entirely clear whether this is a resource which will be shared, although it is listed in a site which says it exists for that purpose.
From viewing other sites it seems that it depends on the purpose of the site: commercial sites clearly have very strict limits on altering learning objects, whereas the repositories allow alteration as long as the original source is acknowledged. For some sites you have to contact a specific person: one wonders how viable this is long-term as people change jobs or take leave, and as noted I haven’t had a response to a request to view a learning object.
5. What knowledge, experience and attitudes of your particular student group do you anticipate might help or hinder the integration of your learning object? How can you best harness or overcome these factors?
My learners are likely to need IT access, support and practise, (McKimm, Jollie, & Cantillon, 2003)possibly with some of the learning objects I have found which address readiness for e-learning.
They are also likely to require the usual strategies for successful e-learning, including student-student contact or teacher-student contact.
They are experienced clinicians therefore engaging them in tasks they see as meaningful is likely to result in authentic learning.
References
CAREO Campus Alberta Repository of Educational Objects. from http://careo.netera.ca Intute. from http://www.intute.ac.uk/Association of American Medical Colleges. MedEdPORTAL
from http://services.aamc.org/jsp/mededportal
Campus Alberta Repository of Educational Objects, C.
Joint Information Systems Committee (JISC). from http://www.jisc-collections.ac.uk/
Kobak, K. A., Opler, M. G. A., & Engelhardt, N. (2007). PANSS rater training using Internet and videoconference: Results from a pilot study: Schizophrenia Research. Vol 92(1-3) May 2007, 63-67. Elsevier Science.
Massey University. Tools for Delivering Scenario-Based E-Learning both Locally and Across the Internet, from http://pbl.massey.ac.nz/pbl-interactive.htm
McKimm, J., Jollie, C., & Cantillon, P. (2003). ABC of learning and teaching: Web based learning
10.1136/bmj.326.7394.870. BMJ, 326(7394), 870-873.
Learning Objects
1. Which repositories did you visit, and what process/strategy did you use to locate an appropriate learning object? What tips would you offer to somebody else undertaking their own search?
Learning Object Repositories
I visited the following repositories and websites which stated that they gathered learning materials and searched by “Mental Health” and Psychiatry” and “Paediatrics/Pediatrics.”
CAREO (Campus Alberta Repository of Educational Objects)
Intute (Intute)
MedEdPORTAL (Association of American Medical Colleges) Here I found a suitable-sounding resource (simulated teenage patient with depression and obesity) and emailed the contact but have not heard back.
JISC (Joint Information Systems Committee (JISC))
The following search strategies were used:Via Google:
Child psychiatry learning objects/child psychiatry online teaching/Psychiatry learning objects/teaching/ Mental Health learning objects/Mental Health learning online.
Since this didn’t produce much, I also looked at:Paediatrics learning objects/online teaching and Interview learning objects/online teaching
Via Medline & ERIC
Psychiatry AND online, teaching AND online, learning AND online
Much information from these sources is about learning/training eg (Kobak, Opler, & Engelhardt, 2007)rather than examples of resources.
Like Robyn I would suggest specific searches, going to the places where learning objects are collected and being sure to specify “free” if this is required. I think that searching for learning objects in my field is extremely time-consuming and not very satisfactory. Many resources sound good but don’t deliver formed Learning Objects, eg Massey University’s PBL site (Massey University) and others seem great for psychiatry but require substantial fees.
2. What learning objective(s) will the learning object help your students achieve? How?
AND
4. How will you integrate the learning object into your course design? Can it be used exactly as is, or does it (or your course) require changes? Are changes permissible/realistic?
Chosen Learning ObjectSearches for learning objects supporting the learning aims did not reveal anything entirely suitable, but there was one which was close and could be adapted.(I am declaring war on the verb “repurpose.” This word is culturally insulting to me: as the daughter of an English teacher! I just can’t use a noun as a verb!!)
This is as follows:http://shscal.swan.ac.uk/eward/sshots.html
This learning object is an unfolding scenario of a 17 year old with psychotic symptoms (it says 19 on the website but 17 on the screenshots) and I think that it could be adapted to use with local content and a structure for case formulation and planning for management.
(We have a number of digital interviews with actors which we currently use in our courses for helping students learn about diagnosis: they are at present on DVD and CD but could be uploaded to Cecil (I think – I have not used Cecil for this) for students to view by segment.)
Learning Objectives
The learning aims which this would support:
Understanding structure and process of formulation processes in child & adolescent mental health
Developing structured management plans using evidence-based treatments
Students would use this learning object to practise their skills at formulation by observing a standardised interview and making a formulation and management plan. They would share these and critique each others’ work.
3. What are the terms and conditions for accessing and re-using the learning object in your course? If you did not locate an appropriate learning object, what were the access/re-use terms and conditions for one of the repositories you visited that you found notable?
There are no listed terms or conditions, There is a contact email. It is not entirely clear whether this is a resource which will be shared, although it is listed in a site which says it exists for that purpose.
From viewing other sites it seems that it depends on the purpose of the site: commercial sites clearly have very strict limits on altering learning objects, whereas the repositories allow alteration as long as the original source is acknowledged. For some sites you have to contact a specific person: one wonders how viable this is long-term as people change jobs or take leave, and as noted I haven’t had a response to a request to view a learning object.
5. What knowledge, experience and attitudes of your particular student group do you anticipate might help or hinder the integration of your learning object? How can you best harness or overcome these factors?
My learners are likely to need IT access, support and practise, (McKimm, Jollie, & Cantillon, 2003)possibly with some of the learning objects I have found which address readiness for e-learning.
They are also likely to require the usual strategies for successful e-learning, including student-student contact or teacher-student contact.
They are experienced clinicians therefore engaging them in tasks they see as meaningful is likely to result in authentic learning.
References
CAREO Campus Alberta Repository of Educational Objects. from http://careo.netera.ca Intute. from http://www.intute.ac.uk/Association of American Medical Colleges. MedEdPORTAL
from http://services.aamc.org/jsp/mededportal
Campus Alberta Repository of Educational Objects, C.
Joint Information Systems Committee (JISC). from http://www.jisc-collections.ac.uk/
Kobak, K. A., Opler, M. G. A., & Engelhardt, N. (2007). PANSS rater training using Internet and videoconference: Results from a pilot study: Schizophrenia Research. Vol 92(1-3) May 2007, 63-67. Elsevier Science.
Massey University. Tools for Delivering Scenario-Based E-Learning both Locally and Across the Internet, from http://pbl.massey.ac.nz/pbl-interactive.htm
McKimm, J., Jollie, C., & Cantillon, P. (2003). ABC of learning and teaching: Web based learning
10.1136/bmj.326.7394.870. BMJ, 326(7394), 870-873.
Friday, May 11, 2007
Discussion for Module 6
Discussion for Module 6 Assessment
Assessment for Formulations/Management plans in mental health
Feedback on two formulations from peer pair/trio depending on numbers
Completion of two structured formulations posted by student
Assessment structure to be developed, circulated to students
Discussion in response to questions: participation assessed by a structure
Same process for management plans
1. The form of assessment I have chosen for each learning activity is consistent with its learning objectives, and is integrated into the learning activity.
The form of the assessment that I have decided on (Producing formulations as for clinical work) will exactly mirror the task in an everyday setting: it is therefore authentic and consistent with the learning objectives that I have specified. I am interested to see that Race (Race, 2003)concentrates on authenticity in terms of plagiarism rather than a broader view: how well does this task assess what the students want and need to know?
The discussion assessment will follow a structure yet to be decided, although I have seen that some of the sites dedicated to sharing resources have standard rubrics which may be adapted according to the circumstances(Anon).This should increase the validity of the assessment as well as the transparency. I also hope that, as Race suggests(Race, 2003) the quantity will be at a level which allows meaningful and prompt feedback rather than a flurry of writing.
In addition, there will be some accumulation of assessment into a whole (a process which we are going through in this course) although I am not really very clear about how to do this for this particular section.
This year the students are completing a portfolio which will become a resource for their learning as well as something which can be assessed bit-by-bit and I can probably use this for the electronic delivery: ie a structure for their formulations, which can be completed by the students for their particular patients, thereby providing examples. I notice that electronic portfolios are increasingly used in clinical education(Dornan T, Lee C, & Stopford A, 2001), (Duque G, Finkelstein A, Roberts A, Tabatai D, & Winer L, 2006) in the move away from traditional health professional apprenticeship/transmission models. I think forming a whole document contributes very much to the reality/authenticity of the learning.
2. Students will have opportunities to undertake self-assessment and peer critique as well as receiving instructor feedback
As the tasks include peer critique this part is covered. How to pair people up? In classes people sit with friends and colleagues so they don’t always get exposed to a range of views/experiences, and I have learned to be a bit bossy about arranging groups for small group discussions. But we feel more comfortable with people who are known to us! I guess if the class is small learner-learner contact occurs and maybe people don’t feel so exposed in online anyway.
I am not sure how to ensure that the assessment process includes self-assessment: formal strategies seem too mechanistic eg checklist (have I covered X? Y?Z?) or methods such as unfolding linked statements. Perhaps I am taking self-assessment too formally: self assessment also includes noting what others do and comparing one’s own work with others’.
3. The strategy underlying the assessment approaches I have chosen reflects the view of teaching and learning evidenced by my Teaching Perspectives Inventory results, but also reflects new insights I have gained into assessment and e-learning.
There are elements of the range of teaching perspectives in these strategies: transmission in the provision of structures and the organisation of the materials, nurturing in hassling people nicely to get on with their tasks, but also a strong developmental approach. I have noticed that I have been far more active in interacting with students via Cecil than I have previously based on some of the principles about student-teacher interaction and the need for feedback and contact.
References
Anon. Applying Assessment Strategies in Psychology. Critique of Assessment Strategies Applied to Goals and Outcomes.
. Retrieved 11/05/07, from http://www.apa.org/ed/critique_goals.html
Dornan T, Lee C, & Stopford A. (2001). SkillsBase: a web based electronic learning portfolio for clinical skills. Academic Medicine, 76, 542–543.
Duque G, Finkelstein A, Roberts A, Tabatai D, & Winer L. (2006). Learning while evaluating: the use of an electronic evaluation portfolio in a geriatric medicine clerkship, BMC Medical Education (Vol. 6).
Race, P. (2003). Why fix Assessment? [Electronic Version]. . Retrieved 02/05/07, from http://www.scu.edu.au/services/tl/why_fix_assess.pdf
Tuesday, May 8, 2007
Reflections on Module 6 Assessment in course development doc
Reflections on Course Development: Assessment Module 6
Assessment clearly has a vital role in driving e-learning course design, but I think it is also quite problematic. Although van der Vleuten and Schuwirth (2005) are often quoted as saying assessment drives learning in fact assessment may simply drive learning for assessment, (MacLachlan 2006) This makes the issue of ensuring that assessment is authentic as defined by Wiggins in 1999 about teacher education even more vital. He says that all assessment should be about completing tasks that learners are actually training to do, and never about parts of tasks.
If assessment is checking that learners “know” subject matter that is only loosely relevant to their context, then knowledge without context may be what we get.
Positives and Negatives
Two issues that I think are problematic in e-learning (and why it can never fully replace F2F learning for clinical education) are the areas of interactions with others and attitudes. How does skill with electronic methods of communication correlate with abilities to interact with staff and patients? I don’t know, and haven’t found much which helps me know.
While there are some methods of assessment which attempt to assess complex clinical reasoning, eg (Sibert, Darmoni et al. 2005)it is clear that complex human-to-human activities can be difficult to assess online. This is not to say that they cannot be assessed: for example the fact that there are many on-line therapists offering support to people with mental health problems and developing guidelines to decide whether patients can benefit from these methods (eg http://www.ismho.org) suggests that feasibility of at least some aspects of assessment.
This is an are which is far from resolved, however and I like Robyn’s analogy of the Emperor’s new clothes: so much written, so little well-validated.
I am involved in psychiatry exams which attempt to assess clinical skills with patients, and know first hand how difficult it can be. Even in a face-to-face setting. There is a bit of literature:a review of peer assessment models showed that there was lots of promise but little validation (that sounds familiar!!) (Evans, Elwyn et al. 2004). I guess the answer still lies in regarding on-line learning as a part but not as the whole: drawing out the things that can be assessed online and not attempting to do the things that can’t. I would once have said that clinical reasoning could not be taught on-line but now I can see that it can, so perhaps we will find ways which allow us to extend what we can do.
References
Evans, R., G. Elwyn, et al. (2004). "Review of instruments for peer assessment of physicians." BMJ 328(7450): 1240-.
Sibert, L., S. Darmoni, et al. (2005). "Online clinical reasoning assessment with the Script Concordance test: a feasibility study." BMC Medical Informatics and Decision Making 5(1): 18.
Wiggins, Grant (1990). The case for authentic assessment. Practical Assessment, Research & Evaluation, 2(2). Retrieved May 7, 2007 from http://PAREonline.net/getvn.asp?v=2&n=2
Assessment clearly has a vital role in driving e-learning course design, but I think it is also quite problematic. Although van der Vleuten and Schuwirth (2005) are often quoted as saying assessment drives learning in fact assessment may simply drive learning for assessment, (MacLachlan 2006) This makes the issue of ensuring that assessment is authentic as defined by Wiggins in 1999 about teacher education even more vital. He says that all assessment should be about completing tasks that learners are actually training to do, and never about parts of tasks.
If assessment is checking that learners “know” subject matter that is only loosely relevant to their context, then knowledge without context may be what we get.
Positives and Negatives
Two issues that I think are problematic in e-learning (and why it can never fully replace F2F learning for clinical education) are the areas of interactions with others and attitudes. How does skill with electronic methods of communication correlate with abilities to interact with staff and patients? I don’t know, and haven’t found much which helps me know.
While there are some methods of assessment which attempt to assess complex clinical reasoning, eg (Sibert, Darmoni et al. 2005)it is clear that complex human-to-human activities can be difficult to assess online. This is not to say that they cannot be assessed: for example the fact that there are many on-line therapists offering support to people with mental health problems and developing guidelines to decide whether patients can benefit from these methods (eg http://www.ismho.org) suggests that feasibility of at least some aspects of assessment.
This is an are which is far from resolved, however and I like Robyn’s analogy of the Emperor’s new clothes: so much written, so little well-validated.
I am involved in psychiatry exams which attempt to assess clinical skills with patients, and know first hand how difficult it can be. Even in a face-to-face setting. There is a bit of literature:a review of peer assessment models showed that there was lots of promise but little validation (that sounds familiar!!) (Evans, Elwyn et al. 2004). I guess the answer still lies in regarding on-line learning as a part but not as the whole: drawing out the things that can be assessed online and not attempting to do the things that can’t. I would once have said that clinical reasoning could not be taught on-line but now I can see that it can, so perhaps we will find ways which allow us to extend what we can do.
References
Evans, R., G. Elwyn, et al. (2004). "Review of instruments for peer assessment of physicians." BMJ 328(7450): 1240-.
Sibert, L., S. Darmoni, et al. (2005). "Online clinical reasoning assessment with the Script Concordance test: a feasibility study." BMC Medical Informatics and Decision Making 5(1): 18.
Wiggins, Grant (1990). The case for authentic assessment. Practical Assessment, Research & Evaluation, 2(2). Retrieved May 7, 2007 from http://PAREonline.net/getvn.asp?v=2&n=2
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