Office of Medical Education

Newsletter
Tulane University School of Medicine
Office of Medical Education Fall 2008 Volume 2, Issue 2
1430 Tulane Avenue, SL-6
New Orleans, LA 70112
Tel 504-988-6600 The OME newsletter provides on-going professional development to faculty, residents,
Fax 504-988-6601 preceptors, and others with direct responsibility for medical student education in the areas of:
ome@tulane.edu • Methods of pedagogy
www.som.tulane.edu/ome • Communication and assessment
• Development and implementation of educational objectives
• Educational Technology
• Competency-based Evaluation
MISSION
The ultimate goal of this resource is to enhance the teaching and evaluation skills of medical
WE CONTRIBUTE educators at Tulane University School of Medicine.
TO THE MEDICAL (Read more on page 12, under Call for Submissions.)
STUDENTS’
EDUCATION BY
PROVIDING
FACULTY
Upcoming Events:
DEVELOPMENT, You are cordially invited to join us for:
EDUCATIONAL
SUPPORT AND
Education Excellence Week
SERVICES TO
FACULTY AND
January 12-16, 2009
STUDENTS. Read more on page 13.

Career Day
March 7, 2009
See page 13.

IAMSE Webinar Series

In this issue… Spring 2009

Competencies……….....2 Begins March 4, See page 13.

Evidence Based Med….4
RIME/TBL ………….... 4
Welcome………….…….7 Education Day
UME-GME ………….…8
Lagniappe ……………..8 May 7, 2009
Effective In-Training Feedback
OME Updates ………...9 Call for submissions, See page 13.
Call for Submissions…12
Upcoming Events ..…..13
OME Newsletter, Fall 2008
Guest Commentary:
Assessment of Competencies
James M. Shumway, PhD
Associate Dean for Medical Education
Professor
of
Internal Medicine
and
Pediatrics
 is the responsibility of the medical school to
West Virginia University School of Medicine
Dr. Shumway received his doctorate
in medical education from the University of North
Carolina at Chapel Hill in 1981. His expertise is in
curriculum development and student assessment with
academic interests focusing on competence (or outcomes)
based medical education. He is Associate Dean for
Medical Education, Director of the Office of Medical
Education at the West Virginia University (WVU) School
of Medicine, and is a tenured Professor of Internal
Medicine and Pediatrics. He has been a Liaison
Committee for Medical Education (LCME) team member
for over 15 years, and was recently appointed an
institutional review team secretary for the LCME. He
regularly facilitates problem based learning groups and
believes that education is not about teaching, but about
helping students learn.
Competencies in Medical Education: Some
Thoughts about the Importance of
Outcomes-Based Assessment1
Assessment plays a major role in the process of medical
education, in the lives of medical students, and in society
by certifying competent physicians who can take care of
the public. The very foundation of medical curricula is
built around assessment milestones for students. For
example, in the United States medical students must pass
a series of steps towards licensure before graduating from
medical school. It is assessment and evaluation that often
drives the curricula of medical schools, and students
measure their progress through the curriculum by the
1
This short piece has been abstracted from a longer article
published in 2003 (Shumway JM and Harden RM. AMEE
Guide No. 25: The assessment of learning outcomes for the
competent and reflective physician. Medical Teacher, Vol. 25,
No. 6, 2003, pp. 569-584).
2
examinations they have passed. Assessment becomes
a motivating force for them to learn. Society has the
right to know that physicians who graduate from
medical school and subsequent residency training
programs are competent and can practice their
profession in a compassionate and skilful manner. It
demonstrate that such competence has been achieved,
and the responsibility of accreditation agencies to
certify that the educational programs in medical
schools can do what they promise. Assessment is of
fundamental importance because it is central to
public accountability.
All North-American medical education programs are
required to have their program based on the
educational outcomes that students are expected to
achieve. Some programs call these competencies and
others call them educational outcomes. In either
case, competencies or outcomes are a broad
description of what the student should be able to
demonstrate in terms of knowledge, skills, and
attitudes upon graduation. In educational terms,
outcomes or competencies are the broad areas to
which course-specific educational objectives are
expected to contribute. Perhaps the best example of a
competency or outcome model in the United States is
the that of the six core competencies established by
the Accreditation Council for Graduate Medical
Education (ACGME) and American Board of
Medical Specialties (ABMS): 1) patient care, 2)
medical knowledge, 3) practice-based learning and
improvement, 4) interpersonal and communication
skills, 5) professionalism, and 6) systems-based
practice. While competence in these six core areas is
required for post-medical school residency training
programs, the six core competencies are also being
adopted by many medical schools.
The Liaison Committee for Medical Education
(LCME) is the accrediting agency for North
American medical schools (USA and Canada).
Medical schools in North America have traditionally
been accredited on the quality of the elements that
make up the student educational program (e.g.
faculty, research, facilities, courses and clerkships).
There are essentially four questions asked during
accreditation: 1) What are the goals?; 2) What did
students actually learn?; 3) What is the evidence?; 4)
What needs to be changed? The LCME has instituted
standards focusing on the assessment of outcomes.
In outcomes-based assessment the educational
OME Newsletter, Fall 2008 3

program goals or learning outcomes are defined and their

accomplishment is assessed. North American medical
education institutions are now required to document
educational outcomes in light of their institutional
purposes and missions.

Assessment is an intrinsic component of outcome-based

education. Outcome-based education and performance
assessment are closely related paradigms. Outcome-
based education involves an educational approach in
which the decisions about the curriculum and evaluation
are driven by the learning outcomes that students should
achieve. In this approach, the product (student learning
outcomes) defines the process (instructional methods and
learning opportunities). This is distinctively different
from earlier educational approaches that relied on inputs.
These approaches, having defined the educational
learning outcomes is one of the important roles of a
program, accepted whatever outcomes resulted from the
medical teacher.
process. The assumption was that a ‘better’ process
would result in ‘better’ outcomes. In outcome-based
It is unlikely that one assessment instrument can
education, agreement on predetermined student learning
address all of the learning outcomes. In general,
outcomes defines the processes used to achieve them.
what is required is a focus on the construction of
assessment blueprints to adequately sample the
In 1990 Dr. George Miller proposed a pyramid of
learning outcomes to be assessed. It is necessary to
learning with increasing professional authenticity,
choose assessment approaches that will do the job.
starting with the learner’s cognition and moving towards
New assessment instruments have been developed
a focus on the learner’s behavior. Dr. Cees Van der
and introduced, and can be used to assess the range of
Vleuten linked a hierarchy of assessment approaches of
learning outcomes. More traditional instruments
increasing authenticity with the Miller Pyramid. This
such as multiple-choice questions (MCQs) that have
model is useful with regard to assessment in so far as
been used for decades have dominated the assessment
different assessment instruments are appropriate at each
process. We are likely to see in the future a move
level of the pyramid. The figure below shows the
away from selected-response questions as in MCQs
Learning Assessment pyramid with the purposes of
to constructed-response questions. There will also be
assessment (on the left) and each of the four levels
a move to the assessment of learning outcomes which
matched with one or more assessment approaches (on the
are not currently being tested. Institutions need a
right). Written assessment is the predominant instrument
basic package of assessment methods that will get the
at the ‘know’ and ‘know how’ levels, clinical assessment
job done. The basic assessment package should
and the Objective Structured Clinical Exam (OSCE) at
consist of some sort of written assessment, for
the ‘shows how’ level and observation, portfolios and
example, constructed response questions, and/or
logbooks at the ‘does’ level.
extended-matching items. The toolkit should also
The development in medical education institutions of
include a performance assessment such as the OSCE.
appropriate approaches to assessment, underpinned by a
Finally some measure of the students over time to
related philosophy, has lagged behind developments that
assess other outcomes such as critical thinking and
have occurred in other aspects of the curriculum. The
self-assessment is necessary. Portfolios can be used
implications of this may be serious. Implementation of a
for this purpose. Portfolios are a collection of
new curriculum without changes in the approach to
material made by a professional that documents the
assessment may result in little or no change at all. More
learner’s achievements and includes a reflection by
attention must be paid to assessment. Faculty and staff at
the learner on those achievements. This basic
each institution should spend time developing a cohesive
package is not meant to be exhaustive; indeed
assessment philosophy and engaging in a faculty and staff
institutions are encouraged to develop additional
development program. Engagement with the assessment
assessment strategies that meet the unique and
process and ensuring that students achieve the required
OME Newsletter, Fall 2008
particular needs of their own settings. What is needed is
a move to assess what learners do in practice and how
they apply their knowledge of basic and clinical sciences
to the care of patients. While many schools have moved
to the assessment of competence in stimulated situations,
only a few have placed a major emphasis on the
assessment of performance in clinical practice through
direct observational approaches or through the use of
indirect measures such as portfolios.
Qualitative assessment approaches have also been
underused in medical education. Qualitative assessment
has been associated wrongly with subjective assessment.
Evidence based literature exists that outlines the
principles of good qualitative assessment. Qualitative
assessment methods provide the assessor with a sense of
the environment and conditions in which the learning and
its practice take place. It allows the assessor to better
understand not just what students know or do not know,
but what they do with that knowledge in the real settings
that require the application of the learner’s knowledge,
skills and attitudes.
In response to increasing public demands for a greater
measure of accountability for the physicians we educate,
rapid progress needs to be made in designing
competency- or outcomes-based curricula and assessing
students in increasingly realistic ways to show they can
practice medicine. We need an understanding of the
assessment process and knowledge of the tools available
and how they can be used to assess the full range of
learning outcomes. The assessment of learning outcomes
needs to be applied across the different phases of medical
education from undergraduate medical education to
postgraduate education to continuing professional
development (CME). We need more studies of how
professional competence is measured and how those
measurement data are applied so that desired changes in
behavior are achieved. We have an opportunity to work
across the medical education continuum to significantly
improve what we do educationally, to have an impact on
the future of the practice of medicine, and to guarantee to
the public the competence of our physician workforce.
Evidence Based Medicine . . .
Introduction & Seminar Opportunity
Pamela Wiseman, MD
Assistant Professor of Family & Community Medicine
Tulane University School of Medicine
4
Evidence-based Medicine is defined as the
“Conscientious, explicit, and judicious use of
current best evidence in making decisions about the
care of individual patients. (Sackett, DL, et al.
Evidence-based medicine:
What it is and what it isn’t, BMJ 1996). We use
EBM skills everyday during patient care when we
ask questions and find answers, when we evaluate
new medical literature, and even when we decide
which journal articles to read. These skills are useful
for the medical school environment during morning
report, patient rounds, Grand Rounds, and Journal
Club. EMB skills are useful for students, residents,
and faculty alike.
It is especially important that faculty model and teach
EBM to residents and students. EBM stresses to the
trainee the importance of the evaluation of evidence
from the medical literature and cautions against the
use of intuition, unsystematic clinical experience, and
untested pathophysiologic reasoning as sufficient for
medical decision making. (Chessare, JB. Pediatrics,
1998, 101.)
The basic steps in practicing evidence-based
medicine are: 1) Formulate a clear clinical question
from a patient’s problem. 2) Search the literature for
relevant clinical articles. 3) Evaluate the evidence for
validity and usefulness. 4) Implement useful findings
in clinical practice.
There are also several categories of Evidence-Based
Medicine skills which can be discussed with learners:
Information Mastery is how to efficiently and
effectively find and incorporate new medical
information into your practice. This approach
focuses on information likely to change your current
practice. As educators, we often assume that our
learners know how to search for medical information
and where the valid sources are. Unfortunately, often
this is not the case.
Critical Appraisal is how to read and interpret
journal articles. This is the typical focus of most
journal clubs and was the first focus of Evidence-
Based Medicine when the landmark series, “The
User’s Guide to the Medical Literature,” was
published by JAMA in 1993. The User’s Guide
series described how to approach different kinds of
articles about therapy, prognosis, prevention,
diagnostics tests, harm, etc., and apply the findings to
OME Newsletter, Fall 2008
clinical practice. Critical Appraisal skills are necessary
but not sufficient for the skilled clinician.
Point of Care Questions/Answers are also called “Just
in Time” learning, because it enables clinicians/learners
to answer questions in time to affect their treatment of a
patient. This approach starts with the ability to
formulate appropriate patient-oriented questions which
can be answered efficiently. The PICO format
(patient/intervention/control/outcome) is practiced to give
the learner the ability to generate appropriate clinical
questions. Clinical Questions structured in this format are
considered answerable, searchable, and even
researchable.
Many resources are popping up to help clinicians
efficiently access point of care information. PIER,
DynaMed, and UpToDate are a few that are available
through our own Rudolph Matas Library Website. Many
of these resources are available in versions that can be
placed on a handheld device for portable use. The goal is
to be able to answer a question at the “point of care”
while in the room with the patient and in 90 seconds or
less.
While points of care resources are very useful
and also very popular, it behooves us to understand the
place of these resources in the evidence hierarchy. It is
essential that we are familiar with Level of Evidence
Criteria and Strength of Recommendation Taxonomy
so that we can judge the validity of these resources and
be confident that they use a systematic approach to
reporting findings. Only then can we be sure that we are
getting the current best evidence to answer our questions.
If you are interested in practicing or teaching
evidence-based medicine, then prepare to attend a series
of workshops sponsored by the Office of Medical
Education on EBM. The first with be on “Teaching
Information Mastery,” to be given in January given by
Dr. Pamela Wiseman of the Department of Family and
Community Medicine.
EBM
Library Resources and Services
Philip Walker
Reference Librarian
Library Services, Rudolph Matas Library
Tulane University School of Medicine
The amount of biomedical information is staggering and
may be impossible to navigate without adequate skills or
5
assistance. The Reference Librarians at the Matas
Library can perform a variety of functions regarding
the EBM resources available within the library. First
and foremost, we can direct you towards those EBM
resources that already have Systematic Reviews
compiled for you, such as the Cochrane Database of
Systematic Reviews, ACP Journal Club, or
PubMed’s Clinical Queries. Secondly, there are
several Point-of-Care resources available through our
website with explanations of the evidence used in
their conclusions, such as UpToDate and STAT!Ref.
Lastly, if the EBM search is unsuccessful, we can
recommend databases, search terms, and strategies
that will enable you to build your own evidence. Feel
free to contact us for individual assistance or to
schedule a workshop for students, residents, faculty,
or staff at medref@tulane.edu or 504-988-5155.
Team Based Learning (TBL)
Comes to Tulane
Marc J. Kahn, MD
Professor of Medicine
Hematology/Medical Oncology
Senior Associate Dean for Admissions and Student Affairs
Medical Director, Tulane Physician's Organization
Tulane University School of Medicine
The second year class had their first TBL exercise as
part of the Mechanisms of Disease course. The
Mechanisms of Disease course is run alongside the
second year Pharmacology course and Physical
Diagnosis. The Hematology and Neoplasia Block is
approximately 30 hours of time including traditional
lectures, review sessions, case-based discussions,
self-directed learning exercises, and cases from the
American Society of Hematology
(www.hematology.org).
OME Newsletter, Fall 2008
A newly-constructed TBL was administered to students
following lectures and discussion of basic coagulation,
hypercoagulability, bleeding disorders, and
anticoagulation. Students were divided into TBL groups
of six or seven students in the cafeteria. As is typical
with TBL exercises, students were asked to read the three
articles prior to class. Students were then administered
an Individual Readiness Assessment Test (IRAT) and
then completed the IRAT as a team with a scratch off
card. Teams were then administered a Group Assessment
Exercise (GAE) composed of “harder” questions that the
students answered as a group. Students were encouraged
to use the internet, textbooks, and articles for all group
exercises. The GAE was resolved with a show of cards
indicating the group answers. Discussion followed.
Attendance was mandatory for this session. Grading was
based on individual and team effort and was factored into
the “professionalism” component of the course grade.
Grade breakdown was as follows: First individual test
(IRAT) 10 points, first group test (GRAT1) 10 points,
second group test (GAE) 6 points, and participation 10
points.
The session was moderated by Dr. Kahn, a hematologist
who was also the course director for the block. The
session was completed in two and one-half hours, and ran
very smoothly. Student feedback was uniformly positive.
As expected, group performance was significantly better
than individual performance.


RIME &Team Based Learning
Kevin Krane, MD
Vice Dean for Academic Affairs
Tulane University School of Medicine
Reported by Deborah Larimer (OME staff)
6
On October 22, 2008, Dr. Krane provided a highly
novel Grand Rounds session in which he “taught” the
basics of both RIME and TBL--without lecturing.
Dr. Krane’s program entitled, Are You an Adult
Learner?, introduced the principles and practice of
the RIME evaluation rubric for providing structured,
objective feedback (RIME stands for: Reporter,
Interpreter, Manager, Educator). Using Team Based
Learning (TBL) as the instructional vehicle for the
RIME principles, Dr. Krane engaged those present in
co-operatively creating their own learning
experience. This technique resulted in a very lively
event--with animated interaction between faculty,
residents, and students.


Nutrition &Team Based Learning
Theresa Dise, MD
Professor of Pediatrics
Director, Foundations in Medicine Program
Tulane University School of Medicine
Reported by Deborah Larimer (OME staff)
Dr. Terry Dise introduced Team-Based Learning in
her nutrition course for first year students beginning
in Fall 2008. She reports that both she and the
students are finding this technique enjoyable and
productive. Students work in groups of 4-5 to read
articles and answer questions. Students currently
taking the course stated that, while they sometimes
find the effort to be challenging, they generally enjoy
the collegiality and relaxed atmosphere of the small
group work. Using this instructional approach, Dr.
Dise has found that students become much more
engaged and active learners than in a traditional
lecture setting.
As an independent observer, I also noticed a
heightened level of excitement and engagement as
OME Newsletter, Fall 2008
students worked together to find the best answers for the
questions that were posed about specific cases scenarios.
Dr Dise has found that the students don't seem to
mind staying later for a class when they are engaged
in the discussions.
While the TBL approach holds much promise for
improved learning outcomes such as effective teaming in
health care provision and enhanced experiences for
patients, the process of learning to use this tool
effectively (both for faculty and students) remains a
challenge. Following this initial trial of TBL in her
nutrition course, Dr. Dise has decided to revise some
instructional procedures for the next block. In spite of
the need for ongoing adaptation to meet the needs of the
students, Dr. Dise’s experience with TBL has encouraged
her to continue its use in the classroom.
MOD &Team Based Learning
Ross Klingsberg, MD
Associate Professor of Pulmonary Diseases and
Internal Medicine
Tulane University School of Medicine
Reported by Deborah Larimer (OME staff)
Dr. Ross Klingsberg is currently giving TBL a try in his
Fall 2008 Mechanisms of Disease/pulmonology course.
He reports that the course has gone well overall using this
approach, and has been especially productive in getting
students to work together.
Some concerns that Dr. Klingsberg has identified include:
the TBL case-testing format requires additional time for
completion due to the complexity of the cases;
development of time-management skills is especially
important for students when using this learning method
(and in medical practice as well); and it would be helpful
to have a multi-disciplinary team review the test cases
and questions to make sure that they accurately reflect the
course objectives.
Dr. Klingsberg suggested that, “The time allowed for the
IRAT [Individual Readiness Assessment Test] should
reflect the length and complexity of the questions. I think
it may be acceptable to simply ask the students if they are
all finished and give a five minute warning.” He also
noted that his experience with TBL in the classroom was
7
consistent with the information communicated in the
initial TBL workshops.
Dr. Klingsberg felt it was beneficial to give students
the learning objectives in advance, so that they could
orient their efforts toward achieving the course
objectives efficiently. He concluded that TBL was
particularly useful for helping students develop the
interactive approach to health care that they will need
in future practice settings; and commented, “I think
the student feedback will be the most valuable guide
to how well it went over.”
What Else is New?
Kevin Krane, MD
Vice Dean for Academic Affairs
Tulane University School of Medicine
Plans are actively underway for the next large
learning facility on the 2nd floor of the Murphy
Building. This facility will be large enough for 180
learners and will provide an ideal setting for Team-
Based Learning as well as traditional lectures, and
small group teaching. The room will be enhanced
with a new sound system and multiple large
projection screens. The room can also be sub-divided
for smaller groups of learners. Scheduled to open in
early 2009, this new facility will be an exciting
educational space for the newest generation of
learners.
Welcome to . . .
Mr. Neville Prendergast, newly appointed
director of the Rudolph Matas Library, who will
begin his tenure on January 9, 2009. Prendergast
comes to Tulane from the
Becker Medical Library
at Washington University School of Medicine in
St. Louis, where he was Associate Director for
Health Information Resources. He has been a
fellow in the Association of Research Libraries
Leadership Medical Informatics and Career
Development Program, and in the
NLM/Association of Academic Health Sciences
Libraries Leadership Institute.
James R. Korndorffer, Jr., MD (Surgery)
has been appointed director of the new Simulation
OME Newsletter, Fall 2008
Center located on the third floor of the Murphy
Exploration Building, at 131 South Robertson St.
Jennifer Calzada oversees the day-to-day operations of
the center, which is currently under construction and
expected to open towards the end of January, 2009.
An educational consulting team composed of clinical,
basic science, nursing faculty and administrators has been
meeting to align center development with the needs of the
students and departments. As a member of this group,
Dr. Annie Daniel has requested that all departments share
with our office the goals, objectives and assessment
methods for their simulation modules—so that these can
be included in the curriculum mapping process currently
underway.
Fostering the UME-GME
Connection with Tara Benjamin, MD
Resident, Tulane Medical Center
Currently a second year OB/GYN resident at Tulane
Medical Center, Dr. Benjamin struggled with learning
disabilities & depression during her undergraduate
medical education at Harvard.
Academically successful prior to medical school,
Benjamin graduated first in her high school class of 400;
and magna cum laude from Xavier University with
honors in biology, chemistry and English.
When she began failing tests and required four attempts
to pass USMLE Step 1, she knew she needed to find help.
Harvard provided tutoring, learning specialists,
counseling, and a strong support network that combined
with Benjamin’s personal drive and a lot of hard work to
help her complete her medical training.
As part of her commitment to her chosen profession,
Benjamin now wants to help medical students who may
be experiencing similar difficulties. Dr. Benjamin is
available as a peer tutor through the PAL program. She
will also make a presentation during Education Week in
January, and is currently designing Academic Support
Workshops on preparing for the USMLE, study skills and
test-taking skills that work. Benjamin is highly
motivated to help her future colleagues succeed, and to
improve the teaching and learning processes at Tulane
SOM. She states, “We can be the Harvard of the South.”
Dr. Benjamin plans to offer academic support workshops
8
at 6:30 pm on the first Tuesday of each month,
beginning January 6, 2009.
For information on the PAL program, connecting
with a peer tutor, study skill workshops, etc., please
contact: Kornelija Juskaite: 988-6600;
kjuskait@tulane.edu
or Tara Benjamin, MD: tbenjami@tulane.edu
LAGNIAPPE:
In the News . . . from a Times Picayune
editorial: “Not so young at heart”
Thursday, November 13, 2008
Cardiologist, Dr. Geetha Raghuveer of Kansas City,
Mo., studied childhood obesity in 70 boys and girls.
Her results showed fatty buildup in neck arteries that
was comparable to that of 45-year-olds. All of the
children in the study had high cholesterol, and about
60% of them were obese.
Did You Know?
DID YOU KNOW that . . . according to the CDC,
21% of Americans over the age of 20 have
cholesterol levels greater than 240 mg/dL?
. . . almost 30% of Louisiana’s population, and 37 %
of New Orleans’ population, is clinically obese?
. . . 27.9% of New Orleanians live in poverty?
DID YOU KNOW that world-wide, HIV treatment
is available to only about 31% of HIV-positive
people? In the US, HIV is the major cause of death
among black women aged 25-34; and the second
leading cause of death in black men aged 35-44? The
HIV infection rate in Washington, DC is equivalent
to that in South Africa. (CNN.com)
DID YOU KNOW that Tulane is the oldest
continually functioning school of medicine west of
the Appalachian Mountains? It the second-oldest
medical school in the Deep South and the 15th oldest
medical school in the United States. Originally called
the Medical College of Louisiana, Tulane was
founded in 1834 and chartered in 1835. Initially,
classes were held in a church, in private homes, and
in the charity hospital. (Wallace Tomlinson, MD)
OME Newsletter, Fall 2008
Research Anyone?
During his Grand Rounds lecture on December 1, 2008,
Gary Clark, MD, a candidate for the new Chair of
Neurology, stated that there have as yet “been no
population studies to indicate the frequency of brain
development abnormalities.” Frequency estimates will
be important in future neurological research. Anyone
willing to take up the gauntlet?
OME UPDATES
Director’s Update
from the desk of . . .
Annie Daniel, PhD
In an Era of Change…
As I reflect on my tenure at Tulane University School of
Medicine, I recall what the Office of Medical Education
(OME) looked like when I arrived two years ago. The
OME was in a temporary space in the Office of Student
Affairs and Admissions. Dr. Kahn and the staff there
were so gracious as the current OME home in the SOM
was being restored after the flooding. At that time, the
OME was staffed with two other people besides myself
(Kornelija Juskaite, the program manager and Tripp
Frasch, the educational technologist), to whom I am very
grateful for supporting me during my time of transition.
Over the past two years, the OME has changed and
evolved into a place that offers support and services in
multiple areas to the SOM’s faculty, students, and
administration. The OME has grown from a staff of three
to a staff of seven. We are now able to offer support and
services in the following areas:
• Consultation on Teaching
• Curriculum Development
• Evaluation of Medical Student Performance
• Program Evaluation
• Medical Education Research
• Publication of Scholarship in Medical
Education
• Proposals for Medical Education Grants
• Evidence Based Medicine
• Faculty and Student Professional Development
• Educational Technology
• Academic Counseling for Students
9
Recently, the OME started the Medical Education
Research Group and the Journal Club. These two
programs will allow faculty to enhance their skills
and knowledge in medical education research. In
addition, the Research Group will encourage, assist in
developing, and support faculty and students in
medical education research. The Medical Education
Journal Club seeks to help individuals to critically
evaluate current literature and assess the possibility
of changes that may occur in medical education and
medical education research, while increasing their
knowledge base in medical education.
The OME has several on-going faculty and
student development activities throughout the
academic year. These include:
• Teaching Excellence Series
• Faculty Professional Development Series
• Education Day
• Education Excellence Week
• Careers in Medicine – Support
• Mini Grants for Medical Education Research
• Faculty Newsletter
• Student Newsletter
It is my long-term goal, as the Director of OME, to
be as supportive as possible to faculty, students, and
administration. All of the OME-sponsored activities
and events are developed with one purpose in mind,
to help ensure that medical students ultimately
become highly qualified, patient-centered physicians.
Instructional Technology
Update from the desk of . . .
Jeanne Samuel, MEd
“People rarely go to lectures to learn facts. They
go to be inspired, to discover what’s new in the
field, and to be challenged to think differently.
The success of a lecture should therefore surely be
measured not by how much more people’s
knowledge has grown but by how much their
framing of the topic (and extent to which they care
about it) has shifted2.”
2
Greenhaigh, T. (2008, May 31). Campaign for real lectures.
Outside the Box.British Medical Journal. Volume 336. Retrieved
September 25, 2008 from the BMJ.com website
http://www.bmj.com/cgi/content/extract/336/7655/1252-a
OME Newsletter, Fall 2008
On December 10th, at noon, I plan to present the topic
Does PowerPoint Make Us Stupid? There has been
much written about the evils of PowerPoint. “Audience
boredom is usually a content failure, not a decoration
failure,” states Edward Tufte3, Yale University Professor
Emeritus. Tufte said that PowerPoint’s cognitive style
teaches children how to “formulate client pitches and
infomercials” rather than “writing a report using
sentences.” He further complains that it “trivializes
content.” Clive Thompson wrote a New York Times
article4 summarizing Tufte’s work and adding, “Perhaps
PowerPoint is uniquely suited to our modern age of
obfuscation -- where manipulating facts is as important as
presenting them clearly. If you have nothing to say,
maybe you need just the right tool to help you not say it.”
In 1999, Google’s Peter Norvig5 reduced Lincoln’s
Gettysburg Address to six slides using the Auto Content
wizard. There is even a YouTube comedy sketch about
common PowerPoint presentation mistakes by Don
McMillan titled, Life after Death by PowerPoint6.
Early research about information recall and multimedia
left educators with the posit that students who view
multimedia presentations will better remember what was
presented than they will after text-only presentations.
Some even go as far as to state that multimedia is an
example of active learning, and more is better. The
problem with a one-size-fits-all pedagogical assumption
is that it is incomplete. For instance, many studies
indicate that students benefit from multimedia when it is
relevant. Irrelevant content on the screen can negatively
impact learning. Multiple Intelligence and personality
type learning theorists suggest that individuals will
benefit most from presentations favoring their learning
style preference. For instance, visual learners will learn
best when images accompany text. Others, such as Daniel
Willingham7, state that if an image is the best
representation for a concept, everyone will benefit from
the visual representation, not just visual learners.
Just as one-size-fits-all assumptions are incomplete, so
are generalizations about the faults of educational
method. For example, critics of PowerPoint as a lecture
medium also have studied lecturer presentation skills,
3
http://www.wired.com/wired/archive/11.09/ppt2.html
4
http://query.nytimes.com/gst/fullpage.html?res=9C00EEDF163CF937
A25751C1A9659C8B63
5
http://norvig.com/Gettysburg/
6
http://www.youtube.com/watch?v=cagxPlVqrtM
7
http://www.aft.org/pubs-
reports/american_educator/issues/summer2005/cogsci.htm
10
student motivation and attendance, handout format,
and student performance. During my December
presentation, I plan to share at least three alternative
formats for creating engaging PowerPoint
presentations. I will leave plenty of time for any topic
discussion and questions relating to technology and
education. Future topics may include how to de-bloat
your slide decks and PDF files, playing multimedia
files from within slideware media, product
comparisons for examware, and online course
development. Please contact me anytime if you have
questions or need education-related technology
support – Jeanne, omeweb@tulane.edu.
Assessment/Evaluation Update
from the desk of . . .
Jennifer Gibson, PhD
Data Exploration
This information is intended to provide a guide to
data exploration, the first step in data analysis. Data
exploration allows the researcher to screen and check
assumptions about the data collected. When using
parametric tests, tests based upon the parameters of
the population, four assumptions must be met for
results to be deemed interpretable. They are:
normally distributed data, homogeneity of variance,
interval data, and independence.
Normality: This assumption presumes that
the data in your sample are derived from a normally
distributed population. To check for normality, begin
by plotting a histogram. This will give you a
graphical representation of the data so you can
determine if the scores form a bell-shaped curve.
You can also detect obvious outliers (scores very
different from the rest). If outliers are detected, use a
boxplot to reveal the case of data that is producing
the outlier. You can then check the raw data to
determine if an error was made in data entry or if the
result is a true outlier. If the result is a true outlier,
you can remove the case or replace the score. If the
distribution remains deviant, consider transforming
the scores.
While a histogram may give you a visual
representation of your distribution, it does not tell
OME Newsletter, Fall 2008
you whether your distribution is close enough to
normality to be useful. The Kolmogorov-Smirnov and
Shapiro-Wilks tests are objective tests that can help make
that determination. If these tests are significant, (p < .05),
then your data set is considered non-normal and data
transformation should be considered. There is, however,
a limitation to these statistics. When your sample size is
large, these tests may produce significant results even
when there is only a small deviation from normality.
Therefore, use these tests as a guide, but also plot your
data so an informed decision can be made regarding
violation of this assumption.
Homogeneity of Variance: This assumption
implies that the variance of your dependent variable is
similar or stable across all levels of your independent
variable. In order to test this assumption, use Levene’s
test. If Levene’s test is significant, you can assume that
there is not homogeneity of variance but rather
heterogeneity of variance. Again, however, like the
Kolmogorov-Smirnov and Shapiro-Wilks tests, this test
may be overly sensitive when working with a large
sample. To overcome this shortcoming, use the variance
ratio. Divide the smallest variance of the group by the
largest variance of the group. If the result is less than 2,
it is safe to assume that you have not violated the
homogeneity of variance assumption.
Interval Data: Data measured should be at the
interval level. Interval level data have order and equal
intervals but not a true zero point.
Independence: This assumption implies that the
data from different subjects in the sample are independent
of one another. The behavior of one subject does not
affect or influence the behavior of another subject.
In summary, it is important to examine your data prior to
running the main statistical analysis. Begin with
graphical representations of the data to determine
whether outliers, or data-entry errors, exist. If none exists
and the data remain non-normal, consider transforming
the data. Run statistical procedures such as Kolmogorov-
Smirnov and Shapiro-Wilks to test for normality, and
Levene’s statistic to test for homogeneity of variance.
Ultimately, if you fail to meet the assumptions outlined
above, consider using non-parametric tests for data
analysis.
NOTE: The information provided in the above article was extracted
from, Field, A. (2005). Discovering Statistics Using SPSS, 2nd ed.
Thousand Oaks, CA: Sage Publications Inc.
11
Introducing . . .
OME’s newest staff member,
Instructional Specialist,
Deborah Larimer, EdD
Hello! I’m excited to be working at Tulane
University School of Medicine--where cordiality,
courtesy, and a profound commitment to excellence
seem to be the norm. Just about everyone I’ve
encountered (from passersby on the street to janitorial
staff to dean) has been genuinely friendly and
welcoming. I am also excited by the degree of
collegiality, sincere humanitarian motivation, and
desire to improve the educational process and product
that I’ve observed since arriving.
I have to admit to a bit of culture-shock, as well as
climate-shock. Believe it or not, Jazz is an
“endangered species” in my previous home state; and
winter temperatures are frequently in the ‘teens from
November through March, with snowfall that turns
cars--and sometimes even houses--into white
boulders.
My experience in academic medicine includes
educational research and support services, research in
rural health and health promotion, and serving as
LCME coordinator for West Virginia University
SOM in 2006-2007. Research interests include: the
impact of a spiritual focus in education on the
optimization of learning and professional behavior;
dispositional optimism and a language of
encouragement as health promotion and problem
solving tools.
As my third month at Tulane begins, I look forward
to your continued help to become a full-fledged,
contributing member of the Tulane community. At
this point, my broad goal is to facilitate ongoing
improvements in teaching, learning, professional and
curricular development. Toward that end, I will
begin compiling online training modules that you can
access at your convenience, making it easier for busy
faculty, residents and students to expand /update their
knowledge and skills. To identify areas of future
emphasis, I will review the recently completed
Faculty Needs Assessment.
OME’s director, Dr. Annie Daniel, has decided to
institute a Medical Education Fellowship Program
OME Newsletter, Fall 2008 12

that will result in certification as a medical educator. The editor welcomes short articles from the faculty
Together, we will work with on that initiative and on that introduce or inform others about a unique
mapping the SOM’s curriculum. I am also pursuing teaching strategy or method currently being used for
funding for a grant-writing workshop to help you with teaching. Submissions may include:
your research efforts. Over the long term, your
individual instructional and professional development  Announcements
needs--and your unique expertise--will guide the  Short medical education articles (up to 500
development of my goals and objectives, and will help words)
direct the course of my research and service endeavors.  Teaching Strategies and Tips
 Descriptions of research in progress
 Reviews of research
 Book reviews
Call for Submissions  Letters to the editor or faculty
OME Newsletter  Events of interest
 Research ideas for collaboration
The Office of Medical Education Newsletter is  Publication notices and requests
published twice a year as an Adobe Acrobat file
delivered by email and posted on the OME website: Materials/manuscripts should be submitted in
Microsoft Word (hard copy or email) to:
http://www.som.tulane.edu/ome/
Annie J. Daniel, Ph.D., OME Newsletter Editor
The OME newsletter:
Office of Medical Education
• provides general information on events, support 1430 Tulane Avenue, SL-6
services and activities sponsored by the Office of Suite 1730
Medical Education New Orleans, LA 70112
• features short articles summarizing research on Tel: 504-988-6600
current issues, concerns, and innovations in Fax: 504-988-6601
medical education adaniel@tulane.edu
• offers guest commentaries on relevant topics in www.som.tulane.edu/ome
medical education

http://www.som.tulane.edu/ome/
OME Newsletter, Fall 2008 13

Mark your calendar for these important Upcoming Events:

• Education Excellence Week – January 12-16, 2009

Speakers include:
Dr. Jeff Wiese on biostatistics
Dr. John Pelley on developing professional skills
Dr. Donald Melnick (NBME president) on USMLE changes

• Career Day –March 7, 2009

• Education Day - May 7, 2009

Key-note Speaker: Patricia O’Sullivan, EdD,
Associate Director for Educational Research in the Office of Medical
Education, University of California, San Francisco

Events include:
Teaching Scholar Award Ceremony
Lunch
Oral Presentations
Posters
Call for Submissions: deadline - 4:00 pm, January 16, 2009

Professional Development Meetings . . .

• Research Group - 3rd Tuesday of each month (4:00pm)

• Journal Club - 4th Monday of each month (4:00 pm)

• IAMSE “Webinars”- Spring 2009 Sessions begin

Wednesday, March 4, 11:00 am
OME conference room, Suite 1730, 1430 Tulane Ave.
OME Newsletter, Fall 2008 14

You are cordially invited to attend a series of interactive lectures. The objectives of this
professional development series are to improve your teaching skills, your ability to give
effective feedback, and to design effective assessments.

THE OFFICE OF MEDICAL EDUCATION

PRESENTS

IAMSE
Webinar
 Series,
 Spring
 2009
 


International
Association
of
Medical
 Science
Educators 


Featuring

Selected National and International Experts

Session I: Defining a Path for Professionalism in the Curriculum

Wednesda y, March 4 at 11: 00 a.m. , 1 430 Tulane Ave , Suite 1730
&
Addition al sessions will follow monthly on t opics to be determined.

To reserve your space for the first seminar, please contact Kornelija Juskaite in the Office of

M edical Education

RSVP: ome@ tulane.edu

OME Newsletter, Fall 2008
Office of Medical Education
1430 Tulane Avenue, SL-6
Suite 1730
New Orleans, LA 70112
Tel 504-988-6600
fax 504-988-6601
ome@tulane.edu
www.som.tulane.edu/ome
Our Staff…
Annie J. Daniel, PhD
Director
Phone: (504) 988-6600
Fax: (504) 988-6601
Email: adaniel@tulane.edu
Byron E. Crawford, MD
Professor of Pathology
Associate Director
Phone: (504) 988-6603
Email: bcrawfo@tulane.edu
Kornelija Juskaite, MA
Program Manager
Phone: (504) 988-8896
Email: kjuskait@tulane.edu
Jennifer Gibson PhD
Assessment/Evaluation Specialist
Phone: (504) 988-6600
Email: jwgibson@tulane.edu
Jeanne Samuel, MEd
Instructional Technologist
Phone: (504) 988-6600
Email: jeanne@tulane.edu
Deborah Larimer, EdD
Instructional Specialist
Phone: (504) 988-6600
Email: dlarimer@tulane.edu
15
Our Office is available to
support faculty in educating
and assisting students to
ensure their academic success
and their development of
professional competencies.
The Office of Medical
Education’s missions align
with and support TUSOM’s
institutional goals.
OME Missions:
• Consultation on
Teaching
• Curriculum
Development
• Evaluation of Medical
Student Performance
• Program Evaluation
• Medical Education
Research
• Publication of
Scholarship in
Medical Education
• Proposals for Medical
Education Grants
• Evidence Based
Medicine
• Faculty Development
• Educational
Technology
• Academic Counseling
for Students and
Residents