Inter-institutional ForumMoving Forward with

Teaching and Learning during a CrisisVishna Nadarajah

Pro Vice Chancellor Education and Institutional Development

IMU , Malaysia 20th March 2020

Curriculum content,

delivery and

assessment;

Faculty/Students

Outcomes of the

curricula

Faculty Departments

Corporate

functions

Academic Support

departments

Outcomes based approach versus a silos approach

Identifying areas for

continued services

based on curriculum

and academic

programme NEEDS

Continuation of

Teaching Learning

based on learning

outcomes

(fit for purpose)

Aligning to Curricula

NEEDS Academic

Support : EL, ASD, IT Continuous

evaluation and

adapting to

NEEDS

Implementation of

Basic and Enhance

Delivery for Remote

Learning; Faculty and

Student Buy In

Outcomes based approach to Crisis Management and BCP

Adjustments to the Way We Work : A reflection

Delivery Model

Student/

Faculty Readiness

Timetable/ Cyberspace

Resource Allocation

Resource Allocation and Approval

What can we do to make it work?

Increase Storage, Security , Helpdesk, Remote access

to resources, Upscale Server, Version Difference

Helpdesk for Students, Manage upgrading on

accessibility –reduce turn around, Guide on

uploading e-resources, Remote access

Remote access, Comprehensive Grouping List, Laptops,

Helpdesk (for staff), Onsite versus offsite timetable

Familiarised with e-learning platform, Self directed learning skills needed for digital skills, Move from face-to-face facilitator to e-facilitator, independent learning

Identify priority area

Communicate to ASD/e-learn/students (stakeholders)

Rules and regulation associated to teaching and learning

Staff contact and assignment of roles

IT

eLearning

ASD

Faculty

School

Ensu

ring co

nn

ectivity o

ffsite, Participate in

o

nlin

e se

ssion

s, Givin

g feed

back co

nstru

ctivelyS

tud

en

ts

Keep it simple, yet strategic

Make effective use of existing learning technologies

Start somewhere & focus on realistic implementation

Source: http://modernworkplacelearning.com/magazine/modern-professional-learners-toolkit-for-2018/

‘Beyond’ implementation:

Product

Buy, build, commission, partner?

Scholarship

Generate capacity to research and disseminate outcomes:Assessment authenticity? Is learning taking place? Have we truly transformed to achieve sustainable assessment?

People

Up skill existing +/- hire; value innovation and creativity

.

Processes

Data; governance, security, transfer, reporting, inter-

operability and tech assessment failure

Continuous Resource

Investment and

Development

Summary

• Unified Approach

• Applications based on educational principles

• Evaluate as you apply

• Share your work in a scholarly manner

Examples of IMU related publications useful for online or Technology Enhanced Learning

• Hui Meng Er, Vishna Devi Nadarajah, Yu Sui Chen, Snigdha Misra, Joachim Perera, Sneha Ravindranath & Yee YeeHla (2019) Twelve tips for institutional approach to outcome-based education in health professions programmes, Medical Teacher, DOI: 10.1080/0142159X.2019.1659942

• Lessons Learnt from the Development and Implementation of an Online Assessment System for Medical Science Programmes. Er, H.M., Nadarajah, V.D., Hays, R.B. et al. Med.Sci.Educ. (2019). https://doi.org/10.1007/s40670-019-00802-5

• Kang, Y.B and Nadarajah, V.D. MedEdPublish (March 2019). Building a database for curriculum mapping and analytics. https://doi.org/10.15694/mep.2019.000038.1

• Evaluation of Computer-based Simulation Learning on Knowledge, Learning Approaches and Motivation among Pharmacy Students. Mai, Chun-Wai & Lee, E-Lyn & Wong, Pei-Se & Er, Hui-Meng. . Indian Journal of Pharmaceutical Education and Research. 2019, 53. 595-602. 10.5530/ijper.53.4.120.

• Study on impact of open and closed book formative examinations on pharmacy students performance, perception and learning approach. Ramamurthy S, Er HM, Pook PCK, Nadarajah VD*. Currents in Pharmacy Teaching and Learning , 8 (3), 364-374, 2015

• Evaluation on Students Perception on Live Online Virtual e-Problem Based Learning (LOVE-PBL) by using Google Hangouts. Hazwanie Hashim, David Chong, Hui Meng Er, Pran Kishore Deb, Pei Se Wong, Mun Sun Lee, Mari Kannan Maharajan, Hasnain Zafar Baloch, E Lyn Lee. Education in Medicine Journal 2017, DOI 10.5959/eimj.v9i4.545

Forum 1- Online Teaching & Learning

• A/P Nilesh Kumar Mitra (IMU)Facilitating PBL using Microsoft Teams

• Dr. Effat Binti Omar (UiTM)UiTM Experience in Utilising Pre -clinical MOOCs

• HMP Singh (Perdana)Online Clinical Teaching

• Prof Ian Wilson (IMU)On Line Clinical Teaching- Experience from Australia Institution

Question & Answer

Facilitating PBL using Microsoft Teams

Associate Prof Dr Nilesh Kumar Mitra

MBBS, MS (Anatomy), MEd

Associate Dean, Technology Enhanced Learning

International Medical University

Facilitating PBL using Microsoft Teams

CREATING WhatsApp Group and

Connectivity Essential –send links

Wi-Fi and Network Connectivity at different

Geographic area X Coaching –how to use

functionalities (phasic upload

of triggers)

When to

switch off

-A/P Dr Nilesh

Facilitating PBL using Microsoft Teams What are the

BARRIERS in

COMMUNICATION?

Facilitator unable to see all

9 students

Students should be

trained to switch off

camera when they do not

speak

Facilitator should identify

the students who are silent

(Concurrent interaction)

Non-verbal cues- difficult

to perceive

Some students FREEZE as visible

in camera (with time adjusts)

Network Latency

Display of Exaggeration (attention)

Problem SolutionLACK of COLLABORATION Let the students Control

Let them initiate Group Channel

Each PBL (1 & 2) –separate students lead and operate

channel

Team Work??? Facilitator Should be ACTIVE (not passive)– Let a pair of

students together construct a video on some learning issue

and upload in Stream

Distance in Communication ??? Communication channel with the students via WhatsApp

between 1 & 2

Enquiry about availability of resources

If necessary, those with limited connectivity—facilitate by

uploading links or resources

“Do not assume –students are prepared to take PBL online”

“Do not assume—students understand the expectations” –Parallel communication

“Do not assume—students will communicate you or friends when there is a distress”

It took me 40 mins to chat in WhatsApp to find out a student who could not connect (shy to express)

UiTM Experience in Utilising Pre -clinical MOOCs

Dr. Effat Binti Omar (UiTM)

Medicine UITM experience in MOOC

13 active MOOCs MOOC in

FOM

40 in progress

• Complement F2F• Flip classroom

MicrobiologyEthics

PaediatricO&G

2000 users

• Planning

• Management

• Enhance

Quality of

Teaching &

Learning

• Increase

digital

teaching &

learning

Online Clinical Teaching

HMP Singh (Perdana)

On Line Clinical Teaching- Experience from Australia Institution

Prof Ian Wilson (IMU)

Clinical SkillsOn Line

Prof Ian Wilson

Director, IMU Centre for Education (ICE)

Background

• In Australia• Rural GP trainees are able to train with remote supervision

• Remote from their supervisor

• Teaching by videoconference

• These are nearly always between two people

• Senior medical students can also work in remote areas• Supervision is generally by nurse

• Teaching is by a remote supervisor in tutorial format with 4-5 students in one venue

• Early clinical students in remote areas have local supervisors with teaching from the central university using zoom and widely distributed students

Options for Clinical Skills Teaching

• Demonstrations live, on-line or through youtube or similar• Interview techniques

• Teacher interviews a patient and then discusses process

• Demonstration of physical signs• Neurological

• Orthopaedic

• Hands & feet

• Dermatological

• There is an extensive collection of demonstrations of physical signs and good and bad consultations

Options for Clinical Skills Teaching

• Student interviews patient• Records on mobile phone and submits to teacher

• Teacher conducts a video-stimulated recall session with student

• Generally in private, but can be in front of group of students

• Telehealth• The advent of telehealth in Australia has led to teaching students how to

organize and run patient interviews by video and teleconference

• Student interviews patient (usually an SP) by videoconference (or telephone) and debriefs with teacher who observes the interaction

General comments

• Physical examination• Generally it is possible to assess process but not whether the patient’s

findings have been discovered• Heart sounds

• Abdominal palpation

• Obstetric and gynaecological examination

• It is possible to see the discovery of findings where the findings are visible externally• Orthopaedic

• Skin

• Neulrological

References

• Srinivasa K, Chen Y, Henning M The role of online videos in teaching procedural skills to post-graduate medical learners: A systematic narrative review. Medical Teacher 2020 Publ online 15 March.

• McCutcheon K, Lohan M, Traynor M, Martin D. A systematic review evaluating the impact of online or blended learning vs. face‐to‐face learning of clinical skills in undergraduate nurse education. Journal of Advanced Nursing. 2015; 71(2): 255-270

• Buch V, Treschow F, Svendsen J, Worm B. Video- or text-based e-learning when teaching clinical procedures? A randomized controlled trial. Adv Med Educ & Pract. 2014; 5: 257–262.

Forum 2- Assessment & Resource management

• Prof Er Hui Meng (IMU)Online Assessment and Open Book Assessment

• A/P Dr Chen Yu Sui (IMU)Resource and Academic Management

• Dr Lakshmi Selvaretnam (Monash )Resource repository for Online/Remote learning

Question & Answer

Online Assessment and Open Book Assessment

Prof Er Hui Meng (IMU)

Be clear about the ‘why and what’ for Online Assessment • Intention?

• Replace/Augment existing practice

• Transform and innovate design, delivery and impact

• Scope?• Assess (cognition, skills, behaviours, all)?

• Give feedback and support learning

• Understand and evaluate assessment

Some assessment options for online/remote learning• Open book assessment

• Students are allowed to use textbooks, online resources, or other reference materials while taking the test

• Can be used to test higher order thinking skills like problem solving and reasoning.

• Stimulate students to use deeper learning strategies.

• Faculty training on setting questions to test higher order thinking skills is crucial – to ensure that answers are not directly available from textbooks or other reference materials

Findings of study:

• No significant difference in deep learning approach of students

• Performance of students was significantly better in open book examination.

• Student perception of open book examinations: lower anxiety levels, less requirement of memorization, and more focussed on problem solving skills

• Online assessment

• Students take test online within a specified time and duration

• Formats can be multiple choice questions, short answer questions, essay or other written formats

• Online assessment taken remotely – Issues:• Student authentication

• Acceptability by professional bodies

Resource and Academic Management

A/P Dr Chen Yu Sui (IMU)

Faculty- Curriculum- Student

Academic

Identifying the appropriate content/delivery for Online learning

Preparation of materials

Delivery of Online learning

Resources

Evaluation of Online learning

Commercial productE-learning dept (technical assistance)Institutional education center (training)

Staff training

Student training

Technical staff for system maintenance and update

Online learning platform e.g. Moodle,Blackboard

Quality cycle

Example of resource management for online education:

Similar to conventional including quality management and team building

Resource repository for Online/Remote learning

Dr Lakshmi Selvaretnam

Assoc. Professor of Anatomy, Jeffrey Cheah School of MedicineMonash University Malaysia

WHY THE NEED FOR A RESOURCE REPOSITORY?

#FLATTEN THE CURVE

Current COVID-19 situation in Malaysia / globally is enforcing temporary closure of HEIs and no FTF teaching

Are we ready as HP educators to make that switch to online T&L and assessment?

Barriers to remote & online learning: Learners

Teachers (e.g. training of trainers)

Curriculum (e.g. content development , integration in T&L/A)

HEI/ School (e.g. quality assurance))

Others –social inequity/ digital divide

BARRIERS TO E-LEARNING

Learners

Teachers

Curriculum

HEI/ School

Others -digital divide/ inequity

Embi (2011/ MOHE Malaysia); Assareh & Bidokht (2011)

PROPOSED REPOSITORY BASED ON MILLER’S FRAMEWORK

Witheridge et al (2019); Norcini (2003); [Fig courtesy of Prof. Yong Rafidah]

WAY FORWARD

Come help us develop a Resource Repository for all Healthcare Professionals (integrated T&L/A)

MAEMHS will help coordinate and compile; host on website (?)

Do send us info/links, your ideas/ share your experiences

BUT please include pedagogy basis for any e-learning practice

We want to be evidence-based, as far as possible

Thank you for your support!

Forum 3- Forum 3: Challenges in conducting Online Teaching and

Learning & Lesson Learnt

• Dr Nurman Yaman (UKM)Challenges and opportunities on moving to online platform : faculty perspective

• Prof Yang Faridah (UM)Challenges and Opportunities to Teaching Online: In multi distributed academic

healthcare setting

Question & Answer

Challenges and opportunities on moving to online platform : faculty perspective

Dr Nurman Yaman (UKM)

CHALLENGES• E-Learning Infrastructure

• Cost• Penetration• Speed

• Lecturers’ preparedness• ICT competency• Online apps• Training • Interest in online T/L

• Faculty Administrators• Technical support• Cost

• Curriculum• Pre-clinical• Clinical• Soft skills• Sustainability• Assessment • Transferability to real-world

• Students• Affordability• Accessibility of ICT

• Wifi / internet• Penetration• Speed

OPPORTUNITIES• Learn anytime anywhere

• Development of e-learning platform and support

• Provision of e-learning infrastructure

• E-Learning tools

• Partnership, networking and collaboration with other departments, faculties and universities

• Diversity in own learning and assessment experiences

• Ability to engage and support isolated learners

• Flexibility and sense of belonging among students

• New standard in e-learning development

REFERENCES• Castillo, Nathan M.; Lee, Jinsol; Zahra, Fatima T.; and Wagner,

Daniel A., 2015. MOOCs for Development: Trends, Challenges, and Opportunities. Journal Articles (Literacy.org). 6

• Chitanana, L., Makaza, D. & Madzima, K. 2008. The current state of e-learning at universities in Zimbabwe: Opportunities and challenges. International Journal of Education and Development using ICT, 4(2), 5-15

• Jenna Gillett-Swan, 2017. The Challenges of Online Learning Supporting and Engaging the Isolated Learner , Journal of Learning Design, 10(1), 20-30

Challenges and Opportunities to Teaching Online: In multi distributed academic

healthcare setting

Prof Yang Faridah (UM)

Challenges and Opportunities to Teaching Online:

In Multi distributed academic healthcare settingYang Faridah Abdul Aziz & Jamuna S Vadivelu

Faculty of Medicine

University of Malaya

National Postgraduate Curriculum Project ONE curriculum for ALL: A unified and structured

curriculum for training of Malaysian specialists

Systematic Training for

Trainers(3 Levels)

PG Medical Digital Education Development: Challenges

• Delivery of standardized training:• Different specialties – Medical-based vs Surgical-based• Multiple healthcare training sites – clustering of hospitals• Trainers – Universities (IPTA & IPTS), Ministry of Health, Private:

• Training the trainers (initial training and continuous development)

• Technology enabled:• IT infrastructure to remote sites• Placement and scheduling: Massive!

• National registration portal• Re-invent the wheel? (e.g. MedHub)

• T&L activities: E-guide (stages, syllabus, ELAs, competence, performance levels, attitudes/values/professionalism); E-logbook; Long Distance Training (Project ECHO)

• On-line assessment & monitoring – buy in from trainers to use e-learning/ digital platform for workplace-based assessment and monitoring

• Cost – RMK12

PG Medical Digital Education Development: Opportunities

• Collaborative growth – online platform as enablers• New open learning pathway • Trainees can be trained in their respective hospitals (or in

cluster hospitals)• Open access• Expansion (downwards and upwards):

• extent from housemanship to sub-specialty training

• Innovations• Increase quantity and quality of specialists – improve

patient safety and quality of care

THANKYOU

Inter-Institutional Discussion

• How does your institution decide what to take online?

• What are the aspect of teaching and learning that has be taken online?

• What assessment can be or has been conducted online?

• What aspects of teaching and learning and assessment that cannot be done online? Why?

• What are the challenges of implementing online learning and assessment?

• What are the advantages of having online learning and assessment?

Some of the questions raised during the forum:

• Are the MOOCS made available to others outside UITM?- Yes. Generally they are made available but currently it is park under UiTM MOOCs Platform.

• How do we overcome the challenges in ensuring that collaborative learning takes place in an e-PBL?- Synchronous mode collaboration can be facilitated asking them to discuss together and come with answer.Students use a mixture of modalities to work collaboratively online for groupwork-in our experience- WhatsApp groups/ FB chat/ emails/

• How do students perform the examination using OSCT online?

• Can MMC/MQA accept virtual/online MBBS Professional Exams? Or even progression from year to year ?- MQA will actually accept if MMC accepts. Something everyone needs to work on. Collaborative effort by universities and Academy of Medicine, by providing more evidence

• Shouldn't we have FDA in order to create questions for an Open book assessment? Faculty training on preparing questions to test higher order thinking is crucial. In the study that was carried out, the faculty involved in setting the questions told us that it was indeed more challenging to set those questions as they had to make sure that students couldn't get the answers directly from the books and other resources since it was open book.

Some of the questions raised during the forum:

• in the current situation - then how do we deal with progression exams? Standardized curriculum, Standardized competencies, NLE, Online assessment- : I am not sure for high stake examination online platform assessment will be acceptable, online assessment can be a complimentary

• In Trudy Roberts’s plenary at Ottawa 2020 she talked about the years of frustration developing teaching modules for students who never engaged with them. More recently they have developed MyPAL at Leeds University which was developed WITH students. Is this feasible here? https://mypalinfo.leeds.ac.uk/

• what are some of the incentives in place in Monash for educators using e-learning? Currently no major incentives as such at Monash. However, senior management from DVC (educ) , our campus PVC and Monash Education Academy is really promoting this. Agree totally that we need far more recognition and incentives for all work towards online education development & delivery

• What happens now re online teaching? Is this banned only by teachers? What about students running peer groups online at present? Nothing formal but all the on-line teaching and learning are open to students

• Any suggestion on how to manage students with low resources?

Data support allowances directly with service providers perhaps (depends on students context and socio demographic background)

• How are we managing student mental health?

• Anthony Cummins (Perdana): we have a Mentor/ Mentee programme plus a dedicated team of counsellors at Perdana. It all hinges on faculty being aware of students’ behaviour change etc and alerting mentors/ counsellors.

• Sue Chen (IMU)- The mentor and mentee system could help to assure the studentsThe mentors themselves should be proactive and equipped with the latest update of University news. Anudeep - I think WhatsApp or better the Microsoft teams can be used to have face 2 face communication

• Rohini Karunakaran -mentor mentee programme will help enhance the students perception and behaviour- Microsoft Teams and Zoom

• Yang Faridah : UM have mentor/ mentee, counselling services as well as walk-in at psychiatry clinic at UMMC. During covid 19, clear SOP for students and staff feeling unwell. And since students now have left campus, we gave a few names for them to contact should they face problems

• Lakshmi S : The tone of emails and messages from Dean/senior management to students is VERY important. If we are reassuring students are more likely to be less anxious - regarding flexibility with online classes/more time for SDL / internet issues/ tuition fee adjustments etc. if we come down hard/inflexible or waffly, students are more anxious for sur

Platform for Online teaching• let the students decide on what platform they want to use.

• Focus on a few user friendly applications.

• Choose items that can go online

• Modality-• screencast, podcast or vodcast-

• needs very little tech knowledge. • added quiz as a formative tool. • A forum is also available for the students to communicate regarding the topic.• Screeencast + Quiz + Forum = effective online TLA I

• YouTube • convenient , free, and student are familiar with YouTube. • Questions can be posted at comments under each YouTube. • Upload small chunks of your learning material . about 4-5 min, on your own YouTube channel. the link can be

shared to students via WhatsApp link. • Social Media- Facebook, Instagram, Twitter• MedHub-quite comprehensive. Everything in there. To re-invent the wheel would take longer

time then.

Summary Points

• Ganesh : As educators who are training doctors we all face difficulties with real time training as patients are short in number. Some of us do not have our own hospitals. BUT our end users still expect houseman to be trained and adept with real patients. Plus the fact that many of our adjuncts are not always engaged in teaching as a priority because of many reasons

• Online materials for learning should be a norm throughout. An ongoing process.

• what we have to realize is that learning doesn’t necessarily require f2f, and we can learning anywhere, anytime, and anyhow.

• We have to be a very fast learner

• we should know our own limitation and innovate teaching/learning

• Train academics and staff- Online learning require effort from different team.

• Accessibility can be a real issue for students and lecturers

• Start small and build up , start collaboration between institutions

• Guidelines on online learning.

• On-line learning is a solution to multi-sited teaching location

• Support multilocation open system for postgraduates. • Continuity from undergraduate to postgraduate curriculum and online T&L

systems v important to maintain• Online learning streamlines contents of training modules.

Special Thanks:IMU Multiprofessional Team: Hasnain, Siti, Elaine and Raja

All the wonderful speakers and engaging participants

We announce the next session soon

Will updated on MAEMHS chat

Improved version with increased capacity

21 march 2020

VDN