Instructional Designers in Medical Education

I’m happy to show the world the first look at an article I wrote with colleagues at the University of Nebraska Medical Center.

Looking Beyond the Physician Educator: The Evolving Roles of Instructional Designers in Medical Education

This is the culmination of a study based on a cross-sectional survey sent to various online environments such as the DR-ED listserv. The goal was to reach people in medical education who also have a hand in instructional design. One major limitation is that we did not leave the survey open long enough to gain an even larger sample. Read the article and let me know what you think in the comments!

Playing around with H5P

I’ve been starting to play around with the cool tool of the year, H5P. If you are unfamiliar with it, think of it this way: you can create interactive educational content in a browser, that can also be viewed in a browser – no installation of additional programs required.

At the University of Illinois College of Medicine, our faculty members have created hundreds of hours of video podcasts, yet we haven’t had a good way of embedding true interactive elements in these videos. It is possible to add quizzes, etc. in video / screencast content that is created using products like Captivate or Camtasia, but in order for students to interact with it, Flash is required. Most of our students use Apple devices and as we know, Flash does not work on iPhones or iPads. So, I was pretty jazzed about this product. I heard about it on an AAMC GIR Educational Technology Workgroup monthly call recently and has been used by some of my colleagues including Anand Khurma (OSU) and Randy Graff (UF). More to come as I flesh out this tutorial on evidence-based medicine.

Here is a ‘work in progress’:

[h5p id="1"]

Getting Past the Uncomfortable

Today I gave a presentation for the faculty & fellows in the Division of Pulmonary, Critical Care, Sleep and Allergy in the Department of Medicine. I met with Dr. Christie Brillante a month or so ago because she had heard about some of the presentations I have given here in the college of medicine. I was slightly apprehensive to do this one, because she wanted me to talk about facilitation skills for people who do ‘micro-consults’ which could also be considered bedside consultations, ‘mini-consults’ which are slightly longer, and their regularly scheduled noon conferences.


I was nervous because I have never been on rounds before so I did not really feel like I am an appropriate person to speak to it, and I made sure Dr. Brillante knew this. So, I went in, and delivered my presentation. It was a bit difficult as usual getting some of the attendees to speak up, but I persevered. What I can talk about is multimedia design. I shared some of our best practices in the college in regards to PowerPoint slide deck design like choice of color, font, amount of content, and taking into consideration some cognitive issues. In particular, I talked about some of Richard Mayer’s 12 Principles of Multimedia Learning. By the way, this document came from the University of Hartford, Faculty Center for Learning development. I focused on these three:

  • Coherence Principle – People learn better when extraneous words, pictures and sounds are excluded rather than included.
  • Signaling Principle – People learn better when cues that highlight the organization of the essential material are added.
  • Spatial contiguity Principle – People learn better when corresponding words and pictures are presented near rather than far from each other on the page or screen.

There is a ‘Last Page’ in Academic Medicine journal coming out soon and it was right on target with this topic. It’s called “‘We’re Not Too Busy’: Teaching with Time Constraints on Rounds” by Flint Y. Wang, MD, and Jennifer R. Kogan, MD at Perleman School of Medicine at the University of Pennsylvania. I have seen an advance copy of this one and it’s definitely worth looking at when the journal issue comes out.

Here is my presentation via SlideShare. Let me know what you think. I feel like the presentation went well. One of the attendees offered to bring me on consults and I jumped at the chance. It will give me some insight into an area of content facilitation that I am lacking expertise.

Instructional Designers are Architects of Learning

This was a comment to an article I read this morning called The Quest for Great Instructional Designers. Another commenter on this article made some strong points that I identify with:

The biggest problem, from personal experience as an instructional designer myself, is many institutions don’t have a clear definition, or simply don’t understand, of what instructional design (ID) is and what an instructional designer does. At the end of the day, instructional design is about taking everything we know about teaching/learning (systematically) and creating environments conducive to learning. ID postings that are seeking individuals to do high-end multimedia production, creating instructional media for faculty, and/or creating online courses for faculty is not instructional design. In cases like this, institutions are really asking for multimedia developers and course developers. Familiarity with contemporary learning management systems, in my mind, will always be an expectation for an instructional design position at least in higher education. With regards to knowing specific software applications, most ID graduate programs don’t offer much in terms of software skills. More focus tends to be on instructional design theory/practices, research, and andragogy. The software is one of those things that most instructional designers are left to learn on their own. By the way my MA and Ph.D. are in Instructional Technology/Design. Thanks for sharing your perspective.

The bold above is mine. Most job postings I see regarding instructional designer or technologist openings want someone who can do it all. So, great, you find a person who matches ALL of your requirements. They can do faculty development, understand how to use learning management systems, can program in multiple languages, have excellent video / audio / multimedia skills. First, is that what your organization needs, and second, you hire this one person who can do ‘it all,’ and a year later they leave. Back to square one. There is no I in TEAM!! You need a team of people to be ‘architects of learning.’

Keep an eye out for a research article hopefully later this year, which addresses this very issue. Dr. Linda Love, Dr. Faye Haggar and I did a survey on instructional designers in medical education and the results we got back address what is in this article and the comments. We are in the middle of writing up the results and hope to have it published within the next 6 months.

What is your perspective on what makes a great instructional designer?

Gamification in Medical Education

At the University of Illinois College of Medicine (UICOM), we have been exploring ways to liven up our educational sessions. With the advent of a new curriculum that has significantly fewer didactic sessions, and increased preparatory work by students leaves some holes to fill for face-to-face activities. One such example of gamification that we have employed recently is Kahoot!

Here is an example of Dr. Mahesh Patel using Kahoot! to encourage more interaction, and it proved to be a success.

We only use it sparingly, which I believe is why it is successful. Dr. Patel and I have worked together to figure out the best way to introduce it and when – the most success we have had with it is at the end of a busy week during a core case session. The students (and us!) are wiped out and it helps end the week on a fun note. We already use Poll Everywhere (probably too much), so this is a nice break from the ordinary.

Frontpiece image of an article by Bohyun Kim for an article she wrote called Learning with Games in Medicine and Healthcare and the Potential Role of Libraries
Kim, B. (2015). Understanding gamification. Library Technology Reports, 51(2).



There is a growing number of scholarly articles in the medical education literature about gamification, and I predict that will just increase. A wonderful colleague of mine, Bohyun Kim, has published extensively on this topic, from the perspective of the librarian educator.




Here are some peer-reviewed citations to check out:

Hicks, G. L. (2015). Gamification: Fuelish or foolish? Journal of Thoracic and Cardiovascular Surgery, 150(5), 1059-1060.

Kim, B. (2015). Understanding gamification. Library Technology Reports, 51(2).*

McCoy, L., Lewis, J. H., & Dalton, D. (2016). Gamification and multimedia for medical education: A landscape review. Journal of the American Osteopathic Association, 116(1), 22-34. doi: 10.7556/jaoa.2016.003

McDougall, A. (2018). When I say ….. gamification. Medical Education, 52, 469-470.

*she wrote pieces for the entire report


Academic Conferences – Fun or Folly?

I went to the Information Technology in Academic Medicine conference last week in Austin, TX. I met many people who are a part of the Instructional Design Community – so nice to put faces to names. To be honest, I think I expected the conference to be very IT focused and outside of my interest level. I was pleased to be surprised – it was a fantastic conference. The ID Community was referred to by many people numerous times during the conference – so I am proud of what has been accomplished so far.

If you did not go to the conference last week, this will give you an idea of what was presented.

I want to put in a plug for the fall AAMC meeting in Austin, TX. Registration just opened. The conference is November 2-6, 2018: Registration is here.

Some of the sessions that I think pertain to the ID community:

Saturday, November 3

  • Evidence-Guided Self-Learning: How to Determine What You Need to Learn/Know/Do
  • Unhealthy Politics: The Battle Over EBM (I do a bit of work in this area, but not sure how prevalent it is with IDs)
  • Towards Competency-Based Time-Variable Education in Medical Education
  • When Robots Take Over Teaching? How VR and AI May Transform Medical Education

Sunday, November 4

  • Navigating the Medical Education Continuum: Strategies to Increase American Indian Engagement
  • Highlights in Medical Education: Faculty Development, Promotion and Tenure
  • Development of Expertise: The Role of Learning Science in Medical Education
  • The Use of Longitudinal Education Data for Learner Assessments and Program Evaluations
  • GIR Education Technology Knowledge-Sharing Session

Monday, November 5

  • Capturing Educational Data to Advance Medical Education
  • Highlights in Medical Education: Innovations in Teaching Clinical Reasoning
  • The Next Generation of Medical School Curriculum: Exploring Curricular Innovation and Change
  • An Inside Tour of Visionary Education Spaces

Tuesday, November 6

  • Highlights in Medical Education: Faculty Development Strategies
  • Highlights in Medical Education: Innovations in Medical Student Curriculum
  • Practical Strategies to Achieve Cognitive Integration of Clinical Skills and Basic Science Science

Theoretical Frameworks In My Brain

As I’m working on a mini-proposal for a class on mixed methods research this semester, I’m trying to be sure I am choosing the ‘right’ theoretical framework for my proposed study. I don’t want to go too much into my proposal idea (partially because I’m a little paranoid that someone else will do it before I get to it!!)

When I was on campus recently, I met with my advisor, Dr. Cindy York. As I was telling her a bit about my ideas, she thought I might want to look at the Intention to Integrate Model. When I scoured the literature (as only a good librarian can), I couldn’t really find a lot on a theory with that name. What kept on coming up though were two other theories: Planned Behavior (TPB) and Reasoned Action (TRA).

Planned Behavior was a theory that Dr. Icek Ajzen created.  The three considerations that drive human nature:

  1. Behavioral beliefs
  2. Normative beliefs
  3. Control beliefs

According to the theory, these three considerations lead to the intention of performing a behavior. It is primarily used in health outcomes studies, such as, what is the likelihood of a person with HIV to take their prescribed medications regularly. I want to use it to determine intention to perform a behavior. As Dr. Ajzen writes on his site, Planned Behavior includes behavioral control as a mechanism whereas Reasoned Action assumes behavioral control and focuses a bit more on reasoning in making decisions. I do have to investigate both of these further, but I would like to figure out if I need to incorporate Bandura’s theory of Self-Efficacy in the mix.

Going back to Intention to Integrate – it’s actually the Integrate Model (IM). It becomes so minor in the literature that I don’t know if it can stand on its own or not. Fortunately a copy of one of his books came in the mail today so I can spend the weekend reading it to get a better handle on it.

Why am I feeling anxious about this!?

iPads for All!

I came to UIC College of Medicine in late 2013 and had just left a short stint at Rush University as the Director of the McCormick Educational Technology Center (METC). In that role, I had worked on a large project to get iPads to incoming medical students. As with any large project, there are a lot of lessons learned. When the college at UIC started talking about this as well, I was able to bring a lot of ‘what not to do’ issues.

The biggest issue: We neglected to give any faculty members an iPad so while we were directing the students how to use it, the faculty really had no idea how to use these tools – so that was a minor failure.

We had numerous meetings here at the college about potentially doing a similar project, but after numerous meetings with Apple, it never got off the ground.


I was able to convince the administration that purchasing iPads for faculty is a great idea – we did a pilot with a few faculty members and it was successful. For the anatomy faculty, we purchased iPad Pro’s with Apple Pencil. The reason for this, is there are some fantastic apps for anatomy that use the 3-D functionality on the iPad pretty well. An example is Complete Anatomy. You can “draw” spurs on bones and the harder you press, the larger the spur. Pretty cool. I just don’t want them for real.

Next steps – work with administration to get more iPads for other faculty so they can use for teaching. We have Apple TV’s in most of our lecture / active learning sessions, and I’ve been working with the faculty to step away from the lectern – and roam around the room displaying their content via the monitors in the room. When the faculty do it, they end up loving it.

This gets into a bigger topic for another time – technology adoption, and barriers to adoption!

Different Methods of Recording a Narrated PowerPoint

Here at the University of Illinois College of Medicine, our faculty have been busy making what we are calling “micro-lectures,” or short, salient videos to help describe concepts to our students. I did not want to give our faculty too many options with which to make these videos, so we narrowed it down to the following:

  • OfficeMix
    • Only available for PC at the moment; it creates an additional tab in PowerPoint and is easy to use.
  • Explain Everything
    • Works on tablets (Android and iOS) and is also fairly easy to use. Just read on their site it also works with Windows!
  • Echo Personal Capture
    • This is a tool we have access to here at UIC. We use Echo360 to record our lectures, and there is a standalone tool that faculty can use to record themselves or their screen. For the PC, there is an additional program that can create a tab in PowerPoint, like OfficeMix.
  • Camtasia
    • I recommend this product over others because as a more ‘souped up’ program, our faculty find it easier to use than Adobe Captivate.

What tools would you recommend and why?

All Work and No Play Makes Max a Dull Boy

On Monday, October 2, 2017, I was out in DeKalb, IL at Northern Illinois University to attend the last face-to-face doctoral class with the group of people with whom I started this PhD journey. We have additional coursework, but this is the last time we will all be together.
Photo of PhD GroupFrom left to right in this photo: Ade, Catherine (front), Danielle, Karen, Rabab, Flora, (me in the back), Dr. Psu, Brigitte (who joined us this term after taking a year off), Kristin, Ahmad, and Rakez. In a strange twist of the universe, Kristin and I were in the same class during our masters in library science program at FSU many (many) years ago. Cool how the universe brings people back to you. I’m learning a lot from these people!

At the same time, I’m a teaching assistant for an undergraduate class at NIU. This is my second term doing this – and so far it’s run quite a bit smoother than the last term. Perhaps part of it is experience – I know a bit more what to expect from these students, like what questions and issues they run into during the semester.

Not to keep myself overly bored, I’m also working full-time in my “day job” as an instructional designer at the University of Illinois College of Medicine – Chicago Campus. We are going through a pretty significant curriculum change, so it’s been a very stressful year as we have been preparing for it, and now implementing it.

Let’s see what I can do to take care of myself during this period, so I keep myself sane and healthy!