Tag: healthcare

TinCan projects underway at UMHS

Posted on July 9, 2013December 18, 2016 by ellen

I work for the University of Michigan Health System, on the Learning Management Team. We run the enterprise LMS, create online learning activities for use across UMHS, and offer innovative solutions and training for educators embedded throughout the system.

Back in 2008, I attended a SCORM 2.0 requirements gathering workshop hosted by LETSI in Pensacola. My participation was driven by the hope we could improve SCORM and maybe move it toward some of the capabilities that we particularly wanted:

Make the LMS disappear from the user’s view where it wasn’t absolutely needed, yet track everything that needs to be tracked.
Open up the data inside the LMS to any application that needed to consume it using standards, so this wouldn’t be a custom project for every application.
Track and use demographic, role and other types of non-SCORM data for consumption by adaptive learning applications.
Eliminate technical limitations of SCORM, including cross-domain issues, the requirement for an open SCORM session to be present before communication could occur, and allow third party participation in tracking for use cases like mentoring and checklist-driven demos.

Fast-forward to a few months ago, we finally got the chance to unwrap our shiny new LRS and try it out! An xAPI LRS came with the Rustici SCORM Engine we integrated with our LMS. This was very exciting for us, since we had lots of ideas that could now be tested.

Unfortunately, experimentation with new technologies is challenging in our production environment due to high-availability requirements and clinical dependencies on the LMS, so we installed the LRS in a test environment instead, and started to build prototype xAPI projects. We are currently in the process of implementing a stand-alone LRS in its own production environment, and that will enable the real pilots to begin without affecting the LMS.

Projects we are working on tend to fall into two categories: ones that involve the Learning Management System and ones that don’t. I think xAPI projects that involve integration with the LMS are only really interesting where xAPI can solve a technical problem or provide an LMS-related use-case that SCORM or AICC cannot fulfill. If it’s already working well, why fix it? Over the last few years, LMS’s have developed workarounds for some of the technical limitations of SCORM on their own, albeit in a non-standards sort of way, so the case for a LMS/LRS integration is somewhat diminished, but it is still worth doing, if only because it is a STANDARD.

However, the typical LMS is not truly an all-encompassing learning universe and there isn’t really a compelling reason to make it that. xAPI has quite a self-standing role to play. We need to bring the tracking to where people learn, not hope that people will come to where the tracking is for their not-explicitly-required learning. Truly, the use of the word “tracking” when used with xAPI is misleading – since some of the best uses for xAPI have absolutely nothing to do with tracking completions and scores.

We may want to aggregate results, but it is not clear that the LMS will be the best place to do that after a while, since its data is a subset of the kind of data that could be collected with xAPI.

The reality is that people that have a choice will never go to the LMS for all of their learning, and especially not their “real” learning, no matter what LMS vendors would like us to believe, and despite vendor attempts at providing social learning and communities within Learning Management Systems. But there are plenty of reasons for exposing, analyzing, or otherwise “tracking” some of that currently invisible learning in ways that don’t involve the LMS at all.

In case anyone is interested in getting our code, or taking projects further than we are able to at the moment, some of the projects our team has worked on are listed below.

Video ethnography for quality improvement

Posted on January 29, 2013December 3, 2013 by ellen

Watching patient/provider interactions in realtime can make it easier to see the process from the patient perspective and spot opportunities for improvement. In healthcare interactions, as in just about any people-oriented service, issues that are obvious when seen in context can get lost when an interaction is described by bare data. In an era where structured data is so important, it can be very useful to step back and look for a richer picture of the service you are providing, without a preconception of what is going to be significant.

I was interested to read about Kaiser Permanente’s use of video ethnography to observe patients as they receive care in order to gain insight into unmet patient needs and overlooked issues. From an article on collaborations between insurers and providers to use data owned by the insurer to improve population health:

The future Healthcare Learning Landscape – a 10,000 foot view

Posted on January 26, 2013January 14, 2014 by ellen

The field of Healthcare today is filled with opportunities for improvement. Inconsistent treatment, preventable illness, and medical errors that result in injury are all too common, along with enormous inefficiency and waste.

The Institute of Medicine, the medical arm of the National Academy of Sciences, is leading an initiative that descibes a better organizing principle for healthcare – a “Learning Healthcare System.” A learning healthcare system is simply one that continuously “Learns,” meaning that healthcare data from many sources, including electronic medical records is turned into guidelines and knowledge and that knowledge is swiftly translated into practice so that all clinical decisions and processes are based on the best available and most current evidence. New knowledge is in turn generated in the course of practice, and the cycle continues, fostering continuous improvement at all levels: national, organizational, unit, team and individual.

Enhancing Learning through Technology – Part 2

Posted on May 24, 2010 by ellen

Scenario-based learning can teach decision-making and thinking processes. Here is an example of the “Labyrinth” scenario-based learning system created in a Scottish medical school which features low fidelity simulations created with just text and pictures – but with great effect.

Each page describes what’s going on and gives a choice of action.

Here you are a doctor doing rounds and a nurse comes in with news about a patient who is increasingly breathless. Your choice here is “Stick with the rounds” or “Ask to see the patient”

If you stick with the rounds, you start wondering if you are doing the right thing, and are soon brought back to the right track -going to see the patient.

Enhancing Learning through Technology – Part I

Posted on May 21, 2010 by ellen

This is a talk I gave recently to a group of educator/trainers within the U of M Health System. Although it contains many UMHS-specific references, the concepts outlined in it can be applied to other training environments as well. There’s nothing particularly original here, just some suggestions for how to select among different technologies commonly available. This was the first part of a two-part presentation. The second part featured tips for creating engagement and improving digital photography.

Best Practice Showcase: Enhancing Learning through Technology

Our team has lots of tools you can use to create online training. There are so many choices, in fact, that it can be difficult to decide which to select when you’re starting a new project.

To help you sort through all the options, I’m going to give you some typical instructional situations and suggest tools that might best support them, without breaking the budget in the process. These are all things you can use – they don’t require a computer science degree to get a good result!