Physician Facilitator (Ice Breaker)

This purpose of this page is to describe the requirements for the Physician Facilitator (Ice Breaker). The primary role of this person is to make the participants feel comfortable in the iPad workshop. It is important that this person is not seen as an ‘expert’, but rather as a novice who was able to learn the activity in a short period of time and demonstrate that anyone can do it.

This website contains a collection of Ice Breaker activities. This Physician Facilitator (Ice Breaker) can choose from any of the activities or suggest their own activity. Pedagogically, it is important to try and find an activity that involves interacting with the iPad interface – for example, something that involves the touch interface rather than simply typing on the device. Also, the app chosen for the activity should be free. Finally, participants should be made aware of which app will be used at least 1 week in advance of the workshop. This will reduce the number of participants who need to download the app during the workshop.

The time allotted to the Ice Breaker activity is 10 minutes.

The technologist or Physician Facilitator (Demonstrator) should be available to coach the Physician Facilitator (Ice Breaker) in advance of the workshop. Typically, the coaching required is about 30-minutes.

Workshop design – sharing vignettes

One aspect of my original workshop design – from my iPad Professional Development Program (iPDP) – was the desire for some form of knowledge sharing evening. Although the program I’m creating at the DFM has been scaled back a lot from the design presented in the iPDP paper, I was struggling to figure out how to incorporate the knowledge sharing component. I’m happy to report that one of my sponsors/co-facilitators came up with an idea of how to solve that program (without even knowing that I thought it was a problem).

When we deliver the workshops, after the ice breaker activity the group is divided in two. Those who feel more beginner/notice begin with a 30-minute skills lab, while those who identify as more advanced begin with a case-vignettes presentation. After 30-minutes the groups switch. By dividing the groups this way, it means that the skills labs can be little more adapted to the level of the audience. The first skills lab will necessarily be more basic than the second skills lab. However, the interesting part here, is that the first group doing the case vignettes will have an opportunity to see some vignettes but also be solicited to share some vignettes. In this way, the more advanced participants have a chance to share what they know, and the physician facilitator demonstrator (yes that is a mouth full) will also have an opportunity to learn from peers. When the second group does the case vignettes (the beginner group), they will likely not have new vignettes to contribute, but they will gain from the additional knowledge, as the case vignette facilitator now might have a couple of new vignettes to present. I may not have explained that well – but the benefit here is that the opportunity to “share” vignettes has now been incorporated into the workshop – so I don’t feel like that aspect of the original iPDP design has been lost.

The poison of “expert”

I am finding that I am continually challenged with the word “expert”. The other word I used was “early adopter”. When looking for physicians who are willing to help facilitate in the role of “Physician Facilitator (Demonstrator)”, I am constantly confronted with physicians who do not feel like they have enough to contribute. I often hear the words “I’m not an expert” – so I find myself saying, that is OK. You have something valuable to say – your peers want to hear your real stories.
I see that when I defined the workshop roles in the blog post: http://ipad-fm.ca/workshop-roles/ I was thoughtful enough to use the term demonstrator rather than “expert” or “early adopter” … I just need to get better at actually using the term when I speak – so that I am not scaring away those who would be good at presenting. I did get one more physician to agree to be a physician demonstrator (yay).

Finding: The use of technology adoption language, or the use of language that indicates expertise in technology causes issues with physician self-identification. In family medicine, the use and integration of technology is not a core competency – it is not seen as a critical skill for success in family medicine – as such, many people that use technology in interesting and innovative ways, do not see themselves as early adopters or experts. The language of technology adoption does not resonate with many family medicine physicians. To make the participation in the workshops in a leadership role, the terminology needed to be changes to be more descriptive of the role or to tone down the sense of expertise needed to fill the role. I am hoping the use of the term “demonstrator” would be more effective than “expert”.

Exploiting .. time for a new title

When one of the physicians suggested “exploiting the iPad” as a title for our workshops, it immediately resonated. Why? Because in some ways this project is all about using technology for technology sake. Although I do not believe that technology should be thrown into education without a purpose, I also believe that someone needs to play with new technologies in an educational setting in order to discover the possibilities. If limit the use of technology in education to solving problems, we will never learn new ways of teaching that are enabled by the technology. What we do will always be about the old teaching strategies, rather than looking at new ways of teaching.
However, the word exploiting has a problem – and in particular it has a problem within the context of the Faculty of Education at my university. Many of the professors study critical pedagogy – and to exploit cannot be seen in a positive light. And, so I must succumb to a much more neutral term for the title of this website. I shall add back in iPadagogy, because it is a fun play on words, but shall change “Exploiting the iPad as a Clinical Teaching Tool” to “iPadagogy: Employing the iPad as a clinical teaching tool”.

Using iBooks

iBooks is a free application for your iPad, iPhone, and Mac that allows you to read specially formatted eBooks. iBooks can also be used to read and annotate PDF documents. The iBooks application can be downloaded from the Apple App Store. iBooks represents an enhancement over physical objects as the eBooks can include quizzes, video, and audio.

eBooks, like iPadagogy: Employing the iPad as a clinical teaching tool, can be purchased and downloaded from the iBooks Store.

The iBooks application and each eBook that you purchase (even a free eBook) is associated with your Apple ID. You will need to know your Apple ID and password to download or update eBooks.

You can change which Apple ID is associated future iBooks Store purchases by changing the Apple ID associated with iTunes & App Store (See Managing your Apple ID).

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To purchase and download an eBook from the iBooks Store, you need to know the title of the book or the author. For this example, the eBook we are downloading is “ipad-fm.ca: Employing the iPad as a Clinical Teaching Tool” by Rebecca J. Hogue.

Note the even free eBooks must be purchases from the iBooks Store. When you purchase an eBook, similar to apps, the eBook is associated with your Apple ID. If the author publishes an update to the eBook, you can download that update from the iBooks Store, but you must know the password associated with the Apple ID that you used to download the original version of the eBook.

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Most eBooks can be viewed in either landscape or portrait mode. If the eBook supports both modes, then the portrait version may provide the ability to change the font size of the text. The availability of this feature depends on how the eBook was built.
Before changing the rotation, ensure Lock Rotation is not enabled.

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Books allows you to highlight and write notes within both eBooks and PDF documents. You must first highlight text in order to add a note.

To highlight text, touch and drag your finger across the text you wish to highlight.

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[tboot_accordion_bootstrap_section color=”primary” name=”UniqueName” heading=”Managing Notes” number=”4″]Once you have created notes, you may wish to view all the notes within your document, delete notes, or email notes. The My Notes window allows you to do all that and more.

To access the My Notes page, touch the center of the screen to display the menu, and then touch the notes icon located to the right of the table of contents button on the top left menu.

Once you have highlighted text, you can add notes by touching the highlighted text. You can also change the colour of the highlight or underline text.

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Website design

I had been struggling a bit with how to present the list content on the website. If I were to just “list” the posts in a category (e.g. skills lab tutorials), then they just show up in the order that I write them. This isn’t ideal. It would be better if there were some logic to the order in which they appear. Last night I had a couple of ah-ha moments: (1) to organize the skills labs by checklist, (2) include a discussion on search.

(1) Organize the skills labs by checklist

I found I disliked the layout of the skills lab tutorials, but couldn’t easily find a way to put it together. Last night I realized I could (and should) create a page and then create lists of tutorials. These lists can be used by the presenter in the workshop, as a list of things to cover – demonstrate, and talk about. Then, on the website, a future instructor, or workshop participant, can go to the site to see/review the content. It will all be there.

Now, the next question becomes, how do I organize the case vignettes and ice breakers? I may just do a bulleted list, with titles, and links to the various items. Their order is not relevant.

(2) Include a discussion on search

The discussion on search was inspired by what I was reading:

Gilster, P. (1997). Digital literacy. Toronto: John Wiley & Sons, Inc.

In chapter 2, “The Nature of Digital Learning”, Gilster talks about the evolution of the printed book – talking about how when a book moved from being on a scroll to being on pages, then the page number mattered, and became a way to access information. Suddenly you no longer needed to read it in order, and you could look things up much faster by using an index. The Internet has changed this too. We no longer need the index, we can now look things up by search – which is often faster and more effective. More importantly, as authors of content, we no longer need to spend the time building the indexes, as searches can be creating automatically in the content.

For me, the ah-ha moment was the opportunity to teach about the digital literacy. We start with organizing icons into folders. We do this because some people find organizing things this way is effective. However, this aligns with “indexing” – it is more inline with older methods of organizing content. Today, we need to learn to be effective at searching – rather than indexing. That being said, I think there is a large personal preference at play here – and like teaching & learning – I don’t think there is a single answer for everything. For example, I put some “like” apps in folders – mostly my TV apps, and anatomy apps. I usually only access these apps when I’m doing a specific task, so it helps to “go to” the folder when I know what I want to do that activity. Now, there are times when I’m looking for a specific app. When I want to do that, then I use the search functionality and go directly to the app. I have a few apps that I have no clue which screen they are on, I can never find the icon – but I don’t need to. I know the name of the app (actually I only need to know a couple of characters) – so I just search for it. With iOS7, the search is available on every screen – so by searching I can find what I want faster than if I had to look it up by folder.

Workshop roles

Based upon the current design, there our four key players involved in the delivery of the iPad workshop (1) Workshop Administrator (2) Physician Facilitator (Novice), (3) Physician Facilitator (Demonstrator), and (4) Technologist. This post describes the roles of each of the key players.

(1) Workshop Administrator

The workshop administrator is responsible for organizing the logistics of the workshop. For the initial workshop, this role is shared by myself (the researcher) and the faculty development coordinator.

For longer term sustainability, I envision the workshop administrator as taking on the role of both scheduling future workshops, but also in finding the three facilitators necessary in delivering the workshops.

(2) Physician facilitator (novice)

The physician facilitator (novice) is responsible for running the ice breaker activity. It is important that this person not be considered “an expert”, as it is important that the workshop participants can directly relate to this facilitator. The main job of this person is to make the participants feel comfortable, but also to demonstrate that you do not need to be an expert with technology to use the device in a useful way.

The physician facilitator (novice) facilitates a 10-minute ice breaker activity. For the initial iPad workshops, this activity will be based upon the DrawMD apps. These apps were chosen because they are free, and when demonstrated to physicians during phase 1 of the workshop, they felt these apps would be very useful. They are also apps that use a gesture-based interface, rather than typing or clicking, so using these apps will help participants learn a different way to interface with the iPad (demonstrates the different between the iPad and a desktop/laptop computer).

(3) Physician facilitator (demonstrator)

The physician facilitator (demonstrator) is a physician who actively uses the iPad in some manner in their teaching. Their role in the workshop is to provide 30-minute of case vignettes (or examples). These vignettes demonstrate how the iPad can be used in a medical teaching context. In many ways, the physician facilitator (demonstrator) is an expert at using the iPad.

The case vignettes being demonstrated are completely up to the physician. In this way, the vignettes being demonstrated will likely be different for each physician that facilitates in this role. The vignettes will also change over time – as the technology changes.

(4) Technologist

The technologist is an expert at teaching the technology – in this case teaching how to use the iPad. The technologist runs the skills lab part of the workshop. It is important that the technologist appreciates how to teach technology – and is something who has patience when teaching. The skills lab necessarily need to be very hands on, so the technologist must be good at walking people through hands on activities while explaining the fundamentals of the technology.

In the first round of workshops, I’ll be the technologist. From a longer term sustainability perspective, the question will be who can replace me in this role. Since this role isn’t about using the technology as a physician, rather it is about the technology itself, it would be a good role for a staff or contract staff in the department.

Upgrading to iOS 7

On September 18, 2013 Apple released a major upgrade to their mobile operating system (iOS). This is the operating system that is used by the iPad, iPhone, and iPod Touch. The new version, iOS 7 has additional features an a new look-and-feel. All procedures, images, and video clips in this eBook/website use an iPad Mini or iPad Phone running the iOS 7. If your iPad was shipped from Apple before September 20, 2013, you will need to manually upgrade to iOS 7. This upgrade is free. Note that iOS 7 is not supported on the original iPad and older iPhones/iPod Touches.

Updating to iOS 7 takes approximately 45 minutes. It is advised that you perform this procedure with a fully charged iPad or an iPad that is connected to power. The procedure to update your iPad can be run directly on your iPad. There is no need to connect your iPad to a computer, however, as the installation requires the download of a large file, you should ensure that you are connected over WiFi. This procedure begins by downloading the new iOS (10-15 minutes with high-speed Internet connection), and then continues to the installation (20-30 minutes).

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To see a video clip of this process, click the image below:

To Download the iOS 7 update:

  1. Launch the Settings app.
  2. Touch General.

You must have enough storage space free in order to update. The iOS 7 download is 728MB; however, it requires 3.1GB of storage space to run. If you do not have enough free space available, the iOS 7 update will warn you and provide you with a link to Usage Settings. The Usage Settings screen will show you which apps are using storage space, so that you can clear up enough for the upgrade.

  1. Touch Software Update.
  2. Touch Download and Install.
  3. Touch Agree.
  4. Touch Agree on pop-up alert.

If you are not connected to power, you will receive a warning. If your iPad is fully charged then you can choose to touch Continue. If not, you may wish to plug in your iPad before proceeding.

If you receive an error message downloading, try again. The survey may be busy.

When the download is complete, the installation will automatically occur unless you touch Later in the pop-up alert.

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To see a video clip of the first portion of this process, click the image below:

If your installation did not automatically start after the download, you can launch the installation by:

  1. If you are not already in Settings, Launch the Settings app.
  2. Touch General.
  3. Touch Software Update.
  4. Touch Install Now.
  5. Touch Agree.
  6. Touch Agree (on pop up).

The iPad will verify the update and begin updating. After verifying, the iPad will reboot. You will then see an Apple with a progress bar underneath indicating the progress of the iPad updating. The upgrade process typically takes 20-30 minutes. Once complete, you will be prompted to answer some configuration questions. The update is now complete.

If you receive an error during the verification process, try again. The verification website may be busy.

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Configuring Your Apple ID

Your Apple ID is your identity in the Apple ecosystem. It allows you to buy apps in the App Store and update your iPads operating system. In addition, your Apple ID is used for messaging, iBooks purchases, and iCloud backup and file transfer.

When you initially configure your iPad, you enter one Apple ID; however, the iPad will allow you to use a different Apple ID for each service. For example, my husband and I share an Apple ID for our App Purchases. Most Apps allow you to install the App on up to 5 devices. Having a shared ID allows us to buy apps once. We each have our own unique Apple ID for messaging and for iCloud backups. The unique ID ensures that we are not sharing contacts, calendar, and device configuration data. For most people, I recommend two Apple IDs. One family ID for shared purchases and another unique per person ID for messaging data associated with individuals. Specifically, I recommend setting up the following using individual and family accounts (click the link to see a demonstration on how to change your Apple ID configuration):

  • Individual:
  • Family:
    • iTunes & App Store (Note, you may be asked to confirm your credit card information. You can either confirm it or hit cancel. In both cases, your Apple ID will be updated)
    • Music – Home sharing feature (Note, if you change the Music Sharing setting, it also changes the Video sharing setting)
    • Video – Home sharing feature (Note, if you change the Video Sharing setting, it also changes the Music sharing setting)

Note, when you download an app, it is associate with your current App Store Apple ID. When the app needs to be updated, you will be required to enter the password associate with the Apple ID that was used to purchase (or download) that app. If you no longer have access to that Apple ID, you will not be able to update that app. If it is a free app, the easiest solution is to delete the app and then re-add it with your current App Store Apple ID.

My perceptions of design

In looking at my current design – not sure which iteration I would call it – and reflecting back on each of the previous iterations, I’m struck by how I considered each iteration awesome. Each time I create an outline or design a workshop, I feel that I have an excellent workshop – and yet, after feedback, there are changes, and I leave feeling yet again that I found the perfect design.

I still need to blog about a couple of my previous iterations, specifically: (1) The Proposal design, (2) The Montebello workshop, (3) Post interview design … I’m now at (4) the post sponsor consultation design.

What I like most about the current design is that it goes back to my original goals – it can be built into something that is self-adapting. By the way each workshop is built and structured, it automatically will be adapted to where the technology is currently at. This self-adaptation in the program was one of the goals I really didn’t think I could achieve – so the potential for it is very useful. We’ll see if it actually plays out that way.

In order for the workshop participants to get continuing education credits for attending (MAINPRO credits), I needed to apply to the Canadian College of Family Physicians (CCFP) for certification. I’m happy to report that based upon the design (described below), the workshops have received credits. Participants can take up to three workshops and get 1.5 credits for each workshop. Documenting the design and apply for the credits did pose a bit of a challenge. Their system is very much based upon fixed content – and certifying fixed content – but in this case, I cannot guarantee the content. In many ways the actual content is not the relevant. It is more the structure that matters (at least to me). More on this after I show you the structure:

1      Program Description

The program consists of three 90-minute face-to-face workshop modules. To align with the literature on best practices for technology adoption, the modules not be delivered in one sitting – rather, modules will be delivered at least two-weeks apart, allowing participants time to absorb the information from the previous module before being exposed to new concepts.

Modules One and Two are essential iPad skills. Module Three focuses on how the iPad is used to enhance teaching within the context of an academic teaching unit (as opposed to a community practice).

2      Program Goals and Learning Objectives

The iPad can be a useful tool to help support physician educators in their role as clinical teachers. The goal of this program is to expose physician educators to a variety of ways in which iPads can be used to support clinical teaching, as well as to improve individual physicians iPad literacy skills.

3      Program Facilitation

All modules will be co-facilitated with a physician and a technologist. The physician’s expertise is in Family Medicine and the use of iPads in clinical teaching (undergrad and resident supervision). The technologist’s expertise is in the iPad technology and how to effectively teach new technologies to professionals.

4      Program Agenda

Learners will be divided into two groups for part 2 and 3. All learners will be together for parts 1 and 4.

Each module will be taught using the following structure:

  1. 15 minutes – Introduction
  2. 30 minutes – Group A – Clinical Teaching Vignettes, Group B – iPad Skills Lab
  3. 30 minutes – Group B – Clinical Teaching Vignettes, Group A – iPad Skills Lab
  4. 15 minutes – Debrief and wrap-up

5      Program Content

Facilitator and participant resources (e.g. the Content for clinical teaching vignettes and iPad skills labs that are presented) will be documented and posted on http://ipad-fm.ca. Some materials may not be available until after delivery of the workshop (e.g. clinical teaching vignettes), as the material will be recorded at the workshop.

6      iPad Essentials Part 1

6.1    Learning Objectives

After completing this module, participants will be able to:

  1. Switch between apps on the iPad
  2. Close apps on the iPad
  3. Shutdown the iPad
  4. Use the DrawMD OBGYN app to provide patient education
  5. Describe at least two clinical teaching vignettes
  6. Manage their Apple IDs for the AppStore and iCloud
  7. Describe the connection between AppleID and Apps
  8. Download and update apps
  9. Use iBooks to annotate eBooks and PDF documents
    1. Navigation quick tips

6.2    Introduction

1.1. Four finger swipe

1.2. Closing apps

1.3. Powering off your device

  1. Ice Breaker Activity: DrawMD OBGYN (using the iPad to describe to a patient what an Ectopic pregnancy)

6.3      Clinical Teaching Vignettes

The following are example clinical teaching vignettes. These will be regularly updated as the technology changes and new or improved apps become available.

  1. Teaching Shoulder Anatomy using Visual Body Anatomy Atlas
  2. Teaching Heart Murmur sounds

6.4      iPad Skills Lab

  1. Managing Apple IDs

1.1. Setting up AppStore AppleID and iCloud AppleID (see http://ipad-fm.ca)

  1. Downloading & Updating Apps (association of Apps and Apple ID)
  2. Using iBooks

3.1. Adding comments

3.2. Editing text comments

Note: The iBooks content is added to support the University of Ottawa Department of Family Medicine’s Essential Teaching Skills program which uses iBooks to provide professional development resources. This also provides an opportunity to teach editing text using the iPad.

7       iPad Essentials Part 2

7.1    Learning Objectives

After completing this module, participants will be able to:

  1. Organize their iPad icons
  2. Use EduCreations App to describe an illness script
  3. Describe at least two clinical teaching vignettes
  4. Describe how cloud-based apps work
  5. Identify security/privacy concerns when using Cloud Apps
  6. Use Evernote to create a note and email it to resident

7.2    Introduction

  1. Navigation quick tips

1.1. Organizing your iPad icons (creating and editing folders)

  1. Ice Breaker Activity

2.1. Using EduCreations (whiteboard app) to describe an illness script

7.3    Clinical Teaching Vignettes

The following are example clinical teaching vignettes. These will be regularly updated as the technology changes and new or improved apps become available.

  1. iThoughtsHD to describe complex illness scripts (e.g. Depression)
  2. Using diabetes simulation app to teach treatment options

7.4    iPad Skills Lab

  1. How Cloud-based Apps work
  2. Cloud Apps privacy and security concerns
  3. Using a stylus with the iPad
  4. Hands on with Evernote

4.1. Creating notes

4.2. Searching by tags

4.3. Emailing a note to your resident

8       iPad Essentials Part 3

8.1    Learning Objectives

After completing this module, participants will be able to:

  1. Create a presentation on the iPad using Prezi
  2. Describe at least two clinical teaching vignettes
  3. Transfer files to/from the iPad

8.2    Introduction

  1. Navigation quick tips

1.1. TBD

  1. Ice Breaker Activity

2.1. Creating a presentation using Prezi

8.3    Clinical Teaching Vignettes

The following are example clinical teaching vignettes. These will be regularly updated as the technology changes and new or improved apps become available.

  1. Using Prezi to create presentations for academic days.
  2. Using simulation apps to support teaching of the non-medical expert CANMEDS roles.

8.4    iPad Skills Lab

  1. Transferring files
  2. Dropbox (what is it, how it works, maintaining privacy)
  3. Microsoft Office – Cloud apps versus device apps

 

I think that any iPad workshop delivered using this structure will be successful – regardless of the details of the content itself. Well maybe not totally regardless, but not totally relevant either. I can swamp out one case vignette for another – it won’t matter as long as the participants see two or three real case vignettes – exactly what those vignettes are, are not as relevant as the fact that they are real case vignettes presented by physicians who actually use the iPad. The skills lab will always be adapted at least some extent to the participants themselves. The same topics can be made more or less advanced based upon the participants.

One strategy that I have in mind to test at the first workshop, is the division of people. Rather than randomly dividing people into two groups, I’m thinking of asking them to self-divide based upon their current iPad skills/comfort. I would ask those who are less comfortable to do the skills lab first, and those more comfortable to the skills lab second (vignettes first). I think this would help to adapt a single workshop to multiple levels. That being said, I’m also wondering if just have a mix might be more beneficial, as it might encourage more peer sharing during the skills lab section. This might be something to experiment with across different iterations of the workshops – to see which model worked better.

OK, that’s enough on the current design for now. More blogging latter.