By Gary A. Smith, PhD
Blended learning activities. Since 2018, CPL (the CME/CPD office of the school of medicine at University of New Mexico), has offered the majority of its faculty development-in-education workshops (CME courses) in a blended format. Topics include:
- Research‐Based Practices to Improve Your Didactic Presentations
- Learning in Small Groups: How to Make It Work
- Using Feedback to Take Our Learners (and Ourselves) from Good to Great
- Up Your Teaching Game: Use Evidence Based Learning Principles to Build Success and Satisfaction into Your Teaching
- A Toolbox for Effective Clinical Teaching
- Integrating In-Person and Online Teaching and Learning
Each of these courses is offered at least twice per year as a separate CME activity. We adopt the use of the term “blended” as it has been widely established in higher education and recently reviewed by: Saichaie, K. (2020). Blended, Flipped, and Hybrid Learning: Definitions, Developments and Directions. New Directions for Teaching and Learning, (164), 95–104. https://doi.org/10.1002/tl.20428.
Learning format. Participants complete approximately one hour of self-paced, on-demand learning through online multimedia and assignments that include completing an online assessment. Completion of the online assessment is the required “ticket in the door” at the scheduled in-person learning event. The in-person components range in duration from 1 to 2 hours. The interactive multimedia elements provide foundational knowledge that is utilized during highly interactive in-person sessions. Therefore, the general approach compares to the flipped classroom model.
The multimedia elements and assessments are accessed through the Moodle learning management system in the CPL site called Just in Time Learning (JiTL). Each JiTL page is an on-demand performance-support and microlearning resource that educators can access at any time, any place. Selected elements of applicable JiTL pages are explicitly assigned as the online component of each blended course. (To review a sample of JiTL, see text box below.)
| HSC Moodle: Continuous Professional Learning Just-in-Time Learning. Informational webpages, videos, take-away resources, and more for medical educators. Click on the blue title, above left, and then select “Self-Enrollment” to access the web pages. hscmoodle.health.unm.edu |
Target audience. Most participants in the blended courses are School of Medicine faculty who teach in the UME, GME, and health-professions curricula. Additional enrollees include faculty in nursing, pharmacy, biomedical sciences graduate program, residents/fellows, and biomedical sciences PhD students and post-doctoral fellows. A few participants each year are designers of CME activities and/or training and development functions within the health system.
Advantages and challenges. Event evaluations show that participants like the blended format mostly because they can schedule a shorter time commitment for the in-person learning and pursue the online learning at their pace and as they find the time. From a learning-design standpoint, the blended format supports the spaced-learning and testing-effect principles advocated from cognitive science research. Facilitators can use the assessment results to tailor the in-person session to focus on specific learning challenges among the learners. As the facilitator for many of these courses, I can attest to a much higher level of engagement and interactivity that is generated when participants arrive primed with both leveling knowledge and questions. The only challenge has been to continually remind participants to complete the online learning prior to the in-person session. Nonetheless, we have turned away only about 6 registrants among 200-250 enrollees per year over the past 4 years because they did not meet the preparation requirement.
Some planners may view the time involved in creating the online modules to also be a challenge but we don’t at UNM. Following best practices in learning and development, we know that most people learn not during scheduled courses and other events, but by consulting concise knowledge sources and performance supports in the flow of work. Therefore, we put a high priority on developing the JiTL’s and then leverage them for the blended workshops. This approach maximizes the impact of the effort expended to develop online multimedia and resources.
Evaluation. We use the same evaluation forms for the blended courses as we do for fully in-person faculty development courses. These evaluations include retrospective pre/post surveys and commitment-to-change queries (we also send email follow ups on commitment-to-change responses). Results for blended and fully in-person courses are comparable. Learning in either format has led to observe changed in teaching performance, but there is higher attendance in the blended events, probably because of greater access through reduced in-person scheduled learning.
Lessons for CPD practice. Research on blended (flipped) learning in higher education should be broadly applicable to CPD practice. The ability for learners to engage with foundational knowledge at their pace and then engage interactively when in person has clear advantages for advancing competency and performance. We increasingly encourage our CME-activity planners to adopt similar approaches for healthcare-provider education. We will likely deliver blended courses in quality improvement and patient safety in late 2022.
Gary A. Smith, PhD is Associate Dean for Continuous Professional Learning, the CME/CPD office for the University of New Mexico, and a SACME member.
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