New learning methods in cardiology education : state of the art Aymeric MENET Lille January 2016

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A well-trained cardiologist is shurely as effective as a good treatment FUTURE survey (2012): BB: 77 % (20 % at target dose) ACEI or ARB: 85% (44% at target dose) Antialdosterone: 36% Only 16% BB+ACEI at target dose

Is it just a problem of cardiologist skill ? Motivation ? Amount of work ? Can we better train our cardiologist ? Medical knowledge

Classic learning methods ? Dunlosky Psychological science in the public interest 2013 Learning method : low utility Listening Note taking Summarization Rereeading Highlighting 45% <50%

Learning method: low utility Imagery use for text learning Dunlosky Psychological science in the public interest 2013 The keyword mnemonic

Learning method: moderate utility Self-explanation Elaborative interogation Dunlosky Psychological science in the public interest 2013

Learning method: high utility Distributed practice Dunlosky Psychological science in the public interest 2013

Learning method: high utility Practice testing

Classical learning methods Edgar Dale Audiovisiual methods in teaching. 1969Raymond 2012

Listening Note Taking Summarization The keyword mnemonic Imagery use for text learning Rereeading Highlighting Self-explanation Elaborative interogation Distributed practice Practice testing

Classes planned > 30 w/year Teaching during MD/PdD ≥ 1/sem Lectures prepared by residents Staffs ≥ 1/sem Decision discussed Inter-regional seminars ESC guidelines reading ≈ 30 % ≥ 80 % ≤ 20 % Self-evaluation of knowledge ≈ 50 % Overview of french cardiology education? Menet, ACVD 2015 Practice testing Distributed practice Teach others Rereeading Lectures Elaborative interogation

Classes planned > 30 w/year Teaching during MD/PdD ≥ 1/sem Lectures prepared by residents Staffs ≥ 1/sem Decision discussed Inter-regional seminars ESC guidelines reading ≈ 30 % ≥ 80 % ≤ 20 % Self-evaluation of knowledge Others pedagogies methods ≈ 50 % Overview of french cardiology education? Menet, ACVD 2015 Practice testing Distributed practice Teach others Immediate use of learning Rereeading Lectures Elaborative interogation Satisfaction: Poor for theoretical training Good for practical training Lots of item not taught Reference

Why is it so difficult to organize education ? Lack of time – Teachers: reseach / clinic / education / administrative – Students : Plus de 11h à l’hôpital par jour Not gainful Lack of human ressources

New learning methods E-learning SimulationSerious game Interactive self-testing

Clark : « No right or wrong technologies in education but right or wrong pedagogies using technologies » E-Learning > Face to face E-Learning = Face to face E-Learning < Face to face No of studies Results Randomized23-5 Abandonment45110 Satisfaction26614 Fenouillet, Savoir 2006 E-learning

What does E-Learning make possible Earn of time +++ All items taught Lectures with experts Wiki for mixing knowledge of several experts National reference Possibility of practice testing Interactive simulation/ game

Simulation Not first in patient Ferrero, Anesthesiology 2014

Knight, Resuscitation 2010 Serious game

Diehl, ArchEndocrinol metab 2015 In development: Industry 60%, Universities 40% Heterogeneous Lack of validation to integrate cor-curricula Graafland, British journal of surgery2015 Boeker, Plos One2014

Interactive self-testing for pratical needs D LY, Vocation sage-femme 2014

Conclusion New learning methods High utility learning methods Reference basis Pedagogy

Dunlosky Psychological science in the public interest 2013 Can we better train our cardiologist ?

E-learning Fenouillet, Savoir 2006

09:00 : Nouvelles méthodes d'enseignement en cardiologie : état des lieuxIntervenant : Aymeric MenetAymeric Menet 09:20 : Application en cardiologie interventionnelleIntervenant : Laurent FeldmanLaurent Feldman 09:40 : Situations d'urgence en équipe : apprentissage au lit du mannequin Intervenant : Arthur NeuschwanderArthur Neuschwander 10:00 : "Serious game" en cardiologie Intervenant : Julien AdjedjJulien Adjedj

Blended learning Liu J. Med. Internet Res. 2016

Utility of the learning methods Cours organisés > 30 semaines par an Trouver 1 h de temps par semaine pour travailler Enseignement pendant le tour PH/PUPH ≥ 1/sem 3/ Cours préparés par les internes Plus de 11h à l’hôpital par jour Staffs ≥ 1/sem 4/ Discussions avec seniors si situation problématique Séminaires inter-régionaux Lecture des recommandations ESC ≈ 30 % ≥ 80 % ≤ 20 % 1/ Possibilité d’auto-évaluation des connaissances 2/ Autres méthodes pédagogiques ≈ 50 % Ancienneté Une information lue ou apprise dans les recommandations ESC est mieux fixée que par un autre moyen d’apprentissage Un item non enseigné est mal connu

Pistes pour l’avenir Ce que les étudiants proposent: -référence nationale -E-conférences -Auto-évaluation -Ateliers -Plus de cours Evidence based: -Référence -1 cours pour chaque item -Auto-évaluation -Autre méthodes pédag. -Faire travailler les internes Très utile Utile E-CONFERENCES EN LIGNE