Friday, November 18, 2016

Use of WhatsApp or WeChat (+/- Twitter), as an integrated presentation and audience engagement process and platform for the mobile generation

A blog with embedded Padlet "graffiti" wall can be used as an integrated presentation and audience engagement platform. 

Goh, P.S., Sandars, J. An innovative approach to digitally flip the classroom by using an online "graffiti wall" with a blog. Med Teach. 2016 Aug;38(8):858. Epub 2016 Jul 14.

Goh, P.S. Using a blog as an integrated eLearning tool and platform. Med Teach. 2016 Jun;38(6):628-9. Epub 2015 Nov 11.

In this short 30 minute "workshop", titled "Use of WhatsApp or WeChat (+/- Twitter), as an integrated presentation and audience engagement process and platform for the mobile generation", we will demonstrate how
WhatsApp or WeChat (+/- Twitter) has many of the usability and functionality requirements available on an integrated blog/Padlet process and platform, optimised for mobile devices and for a "mobile generation", intent on using their "thumbs" as the main form of device input. 

Case studies demonstrating use of WhatsApp as a "closed loop" communication and content integration platform with radiology residents and MedEd masters students will be shared with the audience.

This will be followed by "hands-on" practice.

The Padlet wall below is an online space for interactive online sharing and discussion.

Made with Padlet

          of scan QR code below

Further reading:

"WhatsApp Messenger is a proprietary, cross-platform, encrypted instant messaging client for smartphones. It uses the Internet to send text messages, documents, PDF files, GIF images, videos, user location and audio messages to other users using standard cellular mobile numbers."

Mobile technologies in medical education: AMEE Guide No. 105
Ken Masters, Rachel H. Ellaway, David Topps, Douglas Archibald, and Rebecca J. Hogue
Medical Teacher Vol. 38 , Iss. 6, 2016

          Maged N. Kamel Boulos, Dean M. Giustini and Steve Wheeler
          Future Internet 2016, 8(3), 37; doi:10.3390/fi8030037

          Saleh Abdullah Alabdulkareem          
          Procedia - Social and Behavioral Sciences; Volume 182, 13 May 2015, Pages 213-224

Ellaway R, Masters K. AMEE Guide 32: e-Learning in medical education Part 1:
Learning, teaching and assessment. Med Teach. 2008 Jun;30(5):455-73. doi:
10.1080/01421590802108331. PubMed PMID: 18576185.

Oxford Textbook of Medical Education (published 31 Oct 2013)
Chapter 15: eLearning
by John Sandars
page 178-179
via Google Books

A dissertation submitted in partial fulfillment of the requirements of the Master of Science degree in Information and Library Studies (September 2010)
Submitted By
Janardhanan K. Vijayakumar

e-learning in clinical teaching
Iain Doherty, Judy McKimm
British Journal of Hospital Medicine, January 2010, Vol 71, No 1

Lauricella, S., & Kay, R. (2013). Exploring the use of text and instant messaging in higher education classrooms. Research In Learning Technology, 21. doi:

Recommended Curriculum Guidelines for Family Medicine Residents in Medical Informatics
Document endorsed by the American Academy of Family Physicians (AAFP). Revised June 2014

Instant Messaging Systems for learning in higher education - a literature review
presented by Marco Wolf
at ECER 2015
Emerging Researchers Group
ERG SES G 02, ICT and Education
September 8th, 2015

Mohapatra DP, Mohapatra MM, Chittoria RK, Friji MT, Kumar SD. The scope of mobile devices in health care and medical education. Int J Adv Med Health Res [serial online] 2015 [cited 2016 Nov 18];2:3-8. Available from:

Combining traditional anatomy lectures with e-learning activities: how do students perceive their learning experience?
Lukas Lochner, Heike Wieser, Simone Waldboth, Maria Mischo-Kelling
International Journal of Medical Education. 2016;7:69-74
ISSN: 2042-6372
DOI: 10.5116/ijme.56b5.0369

            above graphic from article why you need snackable content to engage online

(of online content) designed to be read, viewed, or otherwise engaged with briefly and easily:
‘more people are turning to their mobile devices for snackable, entertaining content’
‘snackable video clips’

A Flipped Learning Approach Using Social Media in Health Informatics Education
Ali H. Alharbi
Department of Health Informatics, College of Public Health and Health Informatics, Qassim University, Qassim,
Saudi Arabia
Creative Education, 2015, 6, 1466-1475
Published Online August 2015 in SciRes.

Towards a mobile flipped classroom: Using mobile instant messaging to enhance distributed learning of academically challenged students
Patient Rambe
Central University of Technology, South Africa
1st International Conference on Higher Education Advances, HEAd’15
Universitat Politècnica de València, València, 2015

Teaching and Learning in the Digital World: Possibilities and Challenges
Spring 2013 Vol. 6 No. 2

Beyond Student-Centered and Teacher-Centered Pedagogy: Teaching and Learning as Guided Participation
Michael Mascolo

"Contemporary software was showcased in the presentation, WhatsApp in mLearning: The (learning) medium is the message(r), where Christopher Pang spoke of the phenomenal rise in popularity of the OTT (over the top) platform, WhatsApp. He asked how habitual use of a mobile platform like WhatsApp shapes a learner’s practices. M-learning offers an additional platform for e-learning, he suggested, and can be a motivational aid to e-learning. Beyond this, it can support collaborative learning and informal learning, and supports the blurring of boundaries and role distances.

In this study, he created weekly replacement, supplementary and complementary tasks for business students, given to trial and control groups, followed up by self-reported questionnaires, revisiting of conversation threads, and selected interviews. However, even in the control group which was not specifically asked to use WhatsApp, students were already using it extensively.

Overall, he found that the use of the mobile app drove online completion and led to higher completion rates. Students demonstrated self-directedness and elements of lifelong learning. They were very willing to receive formative feedback through WhatsApp, including students who normally would not ask questions in class. Students also used WhatsApp groups for group sourcing of answers; the dilemma for a tutor in a WhatsApp group is whether to intervene or allow students to work out the answers for themselves. In conclusion, he noted that active WhatsApp students were likely to show greater learner negotiation, greater agency, and greater learning effectiveness; and were more likely to show a drive towards self-directed learning, to seek personalised learning and co-creation of learning opportunities, and to connect data to generate new learning."
mLearn, which took place this year at the University of Technology Sydney ... this conference brought together an international spread of expertise and contemporary research in mobile learning, focused in 2016 on the theme of Mobile Learning Futures: Sustaining Quality Research and Practice in Mobile Learning
reported on blog below

Evolution Is not enough: Revolutionizing Current Learning Environments to Smart Learning Environments
International Journal of Artificial Intelligence in Education
Kinshuk, Nian-Shing Chen, I-Ling Cheng, Sie Wai Chew
June 2016, Volume 26, Issue 2, pp 561–581
Internation Artificial Intelligence Society
and a free communication from 13th APMEC conference

Teoh CM, Ng J, Kee A, Phua J, Lim TK
Department of Medicine, National University Hospital, National University Health System, Singapore
WhatsApp (Mountain View, California) is an instant messaging application for smartphones. It has a Group Chat feature that permits the creation of a real-time discussion group. This feature has been used by surgical teams to facilitate communication in the acute patient care setting. However, this tool has not been evaluated in a pure clinical learning environment. The aim of this study is to assess the application of the WhatsApp Group Chat function in enhancing learning following the daily morning bedside round.
WhatsApp group chats were set up by medical teams comprising supervisors (consultant physicians and fellows) and several trainees (residents, medical students and advanced practice nurses). Participants were instructed to adhere to the following rules: (1) Messages are strictly for the purposes of education and not to direct daily work or disseminate medical orders; (2) Messages are to focus on work-based problems and not theoretical discussions; (3) Trainees are to question their supervisors on points that they are uncertain of, to probe for alternative options in both diagnosis and management plans, to use structured re ection for contrasting cases, and to demonstrate the deliberate practice of progressive problem solving to facilitate self-improvement; (4) Supervisors are to facilitate the group chat to generate meaningful learner-centered discussion, to actively encourage trainees to list learning points, and to provide regular and consistent feedback to participants. At the end of the scheduled service period, each team's group chat log was downloaded and analyzed. Each message related to education was classi ed as a Question (speci c enquiry by supervisor or trainee), Answer (response to a speci c question), Learning Point (take-home point with general applicability) or Filler (administrative message). Each message type was cross-linked to the status of the sender of the message. The number of messages related to patient care or included a patient identi er was also recorded.
We analyzed the WhatsApp messages from 8 clinical teams each comprising an average of 5.4 members. A total of 293 messages were sent over the equivalent of 51 days of which 150 were related to education (mean 2.9 per day) and 38 were related to patient care. 9 inadvertently contained a patient identi er. Within the educational messages there were 23 Questions, 38 Answers, 55 Learning Points and 34 Fillers. Trainees contributed the most messages (51%) followed by consultants (33%) and fellows (16%). Trainees posted the most Learning Points whilst consultants sent an equal spread of Questions, Answers and Learning Points.
We found that WhatsApp group chats dedicated to educational messages enhanced work-based learning from bedside rounds by encouraging more active trainee participation and case-content speci c feedback. The delay between the bedside encounter and subsequent case discussion via the mobile platform enabled re ective learning remote in time and place from the work environment. In contrast the use of WhatsApp in acute surgical services was primarily to facilitate rapid communication between busy clinicians for the purposes of patient care. We propose using WhatsApp to create "mobile learning bubbles" to enhance clinical work-based learning.

(as an exercise, critically review and critique the information presented on this Wiki page focusing on comprehensiveness of the literature review; the accuracy and relevance of the content and views presented; and comment on the main points highlighted)

AMEE 2016 main conference eLearning symposium on topic “Big learning from small screens”


The need for user awareness of privacy and digital security:

"Whether we like it or not, we live in a world where our physical selves are tethered to our IP addresses, our surfing behaviour leaving a trail that reveals medical histories, residential addresses ...and a secret fondness for cats."
We've told the internet too much
Jacquelyn Cheok
The Business Times, November 19-20, 2016

The New York Times, November 16, 2016

Online Privacy: Do You Share Too Much Information?
Aaron Couch  

Potential MedEd Research

Is there any interest in doing a Clarification study on this topic? (to take up the Cook-Bordage-Schmidt research challenge).

Research challenges in digital education
Geoff Norman
Perspect Med Educ. 2014 Sep; 3(4): 260–265.
Published online 2014 Aug 21. doi:  10.1007/s40037-014-0139-7

Description, justification and clarification: a framework for classifying the purposes of research in medical education.
Cook DA, Bordage G, Schmidt HG.
Med Educ. 2008 Feb;42(2):128-33. doi: 10.1111/j.1365-2923.2007.02974.x. Epub 2008 Jan 8.

Data informed online teaching
How can data analytics inform our teaching practice - a case study using Web 2.0 technologies as the primary online teaching / engagement tool and platform
What (free/and add on) data analytics bundled with Web 2.0 platforms can inform us as educators about student engagement, use of online content and learning when online teaching is delivered via Web 2.0 tech
Poh Sun Goh ... and .......

When is TeL or eL used? Where to use?
Views - volume, timing (quantitative)
Reviews - qualitative and quantitative
Preference over other competing content

Access, convenience
Useful, Fit for purpose
Easy to use, intuitive
Simple to use
Recommended by others

How is it used?
Before, during or after class
Before examination/assessment
To look up something, on demand reference/learning, performance support

With whom?
By whom?

What to use? For what purpose? Instructional objective?
Illustrate theory
Mastery training

Traditional, TeL or blended approaches?
When to use?
How to use?
When to blend?
How to blend?

Where is the value/what is the value; and impact of TeL?
What is the evidence of this?
Actual use - how, when, where, with whom, why
Evaluation of integration and use of Knowledge and Skills learnt, and creation of new knowledge, insights and applications/skills

Goh, P.S. The value and impact of eLearning or Technology enhanced learning from one perspective of a Digital Scholar. MedEdPublish. 2016 Oct; 5(3), Paper No:31. Epub 2016 Oct 18.

"Time on task"

It takes time to learn anything worthwhile. To accumulate knowledge and skills. To integrate this new learning, and be able to, and be confident applying this in the workplace, and real life settings.

This is the difference between undertaking a program of training, and formal courses, compared with short symposia and workshops, or an isolated lecture. Formal training programs gives students time, space, and a place to learn. On a regular basis. This promotes a cumulative increase in learning. Combining theoretical learning with practical case studies integrates basic principles with practice points, and promotes transfer of learning from the classroom to the real world. Online learning programs should include elements from traditional classroom practices which facilitate learning. This includes scheduled time to review the learning material, to work on applying what is learnt by working on assessments and assignments, individually and by learning collaboratively with peers; as well as provide opportunities for timely feedback from instructors."

above from
Goh, P.S. A series of reflections on eLearning, traditional and blended learning. MedEdPublish. 2016 Oct; 5(3), Paper No:19. Epub 2016 Oct 14.

(above image screenshot of Padlet wall workspace on link below, which contains embedded links and attribution to source material)

Google image search for "Blooms taxonomy" and also do image search for "Miller's pyramid"

lead from IAMSE annual meeting 2016 meeting program book, Sunday June 5 2016 session, Breakfast Roundtable Discussions

"where outcomes assessment focuses on the program as the unit of measure, CBE focuses on the learner as the unit of measure. Stated another way, outcomes assessment occurs across courses (or learning units) and CBE assessment occurs within the learning unit.  In outcomes assessment sampling student work is a reasonable approach because it is a research effort to answer the question: “did the program deliver on learning goals and outcomes?” Assessment in CBE, however, requires that each learner be assessed for performance on each competency. The question answered by CBE assessment is “has the student mastered the competencies required by our program?”
quote from

"Traditional testing helps answer the question, “Do you know it?” and performance assessment helps answer the question, “How well can you use what you know?” These two ways of looking at literacy do not compete; 
quote from

Personal observations and reflection on the utility of "data analytics":
by Goh Poh Sun

1. The idea of "knowing your audience", is highlighted in the screenshot of the Google blogger online page above describing useful features of the Google Blogger platform with "free" embedded analytics (see below).

2. As an educator, using this platform as my presentation and student engagement tool, I have found, for each class or student cohort, obtaining an impression and idea of overall viewership immediately before, during and after class; time spent on each online post by each viewer (from detailed Google Analytics data via tracking code embedded on each online post), geographical site of viewers (for classes comprising an international audience), and whether students have found individual pieces of content useful - by specific feedback, comments, recommendations (on Padlet and WhatsApp online discussion spaces and threads), and whether specific content is quoted in discussions, and used in class assignments (citations); complements in class observation (by the instructor) of student interaction with the content, and efforts by students to integrate new ideas and skills with previously learnt material, through the questions students ask (which can be observed in both face to face (FtoF) and online learning environments), the type and quality of the discussions which they have with each other and with the instructor(s) (both FtoF and online), and answers to "live" questions posed by the instructor(s) (both FtoF and online environments).

3. This can be augmented by informal discussions with students, and formal surveys, focused interviews, and detailed feedback on the content and educational process by students, to develop understanding and deeper insight into -

what content students find useful

why they find this useful

did they look for alternative content, why did they do so - better, more useful, due to other student's recommendations

what is the role of peer to peer "teaching", informal and formally structured peer to peer learning 

how do students use what they have been presented with
how do students "blend" use of presented material in class (including pre-class preparation), with recommended reading material and out of class preparation

how do students integrate material presented in class (both FtoF and online), with material from "reading lists"

how is this reflected in student problem solving activities (both in class and out of class), student assignments, and performance in formal assessment

what transfers to day to day practice - what do students actually remember, and use in day to day practice and workplace settings; what is easily recalled, what do students go back and refer to (why do they refer to specific content, descriptions of how to develop skill sets/including simulated and live practice of these skill sets) - what is the role of curated online content to facilitate this process

how might we investigate these phenomena with different educational and practice research paradigms and tools

see reviewer's (Ken Masters) suggestions for experiments to test assertions made in paper
Goh, P.S. The value and impact of eLearning or Technology enhanced learning from one perspective of a Digital Scholar. MedEdPublish. 2016 Oct; 5(3), Paper No:31. Epub 2016 Oct 18.

one approach would be to use a regular/daily case review with drill / practice paradigm (with radiology cases) coupled with individual feedback and coaching, using sequential - compare and contrast approaches, with material hosted on an "indexed" online case repository (radiology blog), within an overarching deliberate practice and mastery training framework (see below)

(above observations first drafted at 4.38am, on 21 November 2016, refined further till 06.37am by adding section ... one approach; section below added from previous online posts on 25 November 2016 02.56am and 06.25am)

Online material from archived (anonymised) digital educational repositories can be used for both exemplar teaching in undergraduate and postgraduate education, as well as thematic case collections to train beyond competency and proficiency toward expert performance and mastery in clinical Radiology, as well as professional practice as a medical educator and educational scholar.

outline of proposed Phd program (see study 4 and study 5 below) - draft prepared February to August 2015

Study 4 - role of interactive eCases in postgraduate medical education

Re-imagining a postgraduate training curriculum

A combination of eLectures (e=online; e=edited, 0.5 time traditional lectures), daily deliberate practice sessions with theme based interactive online sets of clinical cases for compare and contrast practice coupled with online and regular face to face feedback and discussion with clinical tutors; together with supervised daily clinical sessions with clinical teachers in a coaching role; augmented by individual resident ePortfolios for formative assessment and self reflection; can potentially dramatically reduce the training time required in postgraduate training programs, delivering a more personalised educational experience, focused on identifying an individual trainee's strengths and augmenting these, as well as strengthening areas of weakness in performance.

Study 5 - role of a hyperlinked indexed eRepository in continuing medical education 

An eRepository, particularly one that is comprehensive, and representative of current, and actual teaching and training material, has a similar utility to that of a well stocked, well laid out, and clearly signposted and labelled grocery or market, with a well stocked frozen food/prepared meal section. To take this food and cooking analogy further, this resource would allow a chef, or cooking instructor/demonstrator, to devote his or her time more efficiently, and potentially more effectively, by focusing effort on actual cooking and demonstrating, rather than sourcing for ingredients.

Translating this analogy to an education and training setting, the instructor can focus on customising a teaching and training program, and refining an educational offering; rather than spending time sourcing for material, creating content from scratch, or looking through past presentations and training resources to attempt to update or customise these for a particular audience.

This paradigm also facilitates personalised content review by learners, who now can not only review previously presented packaged presentations, but also go back to the original source material and "raw ingredients", for example clinical scenarios, take home points, key references, key points made in these references, key illustrations (including graphics, radiology images, anatomy and pathology digital photographs), charts and tables.

This promotes a modular, potentially more standardised, systematic and programatic; customised and personalised review of educational material; particularly with the aid of prepared curricular plans, and the assistance of teachers and trainers in a coaching role. Digital access and accessibility promotes and widens access to this educational and training material; facilitates formal, informal and just in time learning and performance support; anytime and anywhere. This resource supports content review before class. Valuable face to face time and live class time is now available for more interactive discussion with peers and instructors, with a focus on deepening understanding, translating theory to practice, using group interactions and other active learning strategies ("blended" eLearning with face to face interaction; and the "Flipped Classroom" model).

For example, the potential of "collections of potential training situations for a wide range of professional tasks" is discussed by K. Anders Ericsson (2009), where he suggests "using collections of representative tasks with verifiably correct answers", which can "not only be used to measure objective performance of experts", but can "be used for training new recruits as well as maintenance testing and continued training of experienced professionals" (Chapter 18, page 422-423).

Ericsson concludes with this suggestion, that "with an increased interest in the lifelong development of professional performance, there should be an increase in the studies examining deliberate practice in many different types of professional activities, as well as designing training environments with challenging relevant situations that require immediate action and that can provide feedback and opportunities for repeated encounters of the same and similar tasks" (Chapter 18, page 425).

Medical Education Peer Reviewed Publications (selected) - 2015 and 2016 

The intention of writing a recent series of reflection pieces (article 3, 4, 5, 7 and 9), as well the other articles below, was to set down in print as many of the useful ideas / and pointers I could think of, and which I have found useful and currently use, on the subject of TeL and implementing this, distilled from my reading, practice, and scholarly inquiry since 2002, as well as from the last 6 years of faculty development presentations, symposia and workshops I have been involved in designing and have participated in at NUS, at APMEC and AMEE; and have presented as invited speaker to conferences in Colombo, Sri Lanka; Kaohsiung, Taiwan; Jakarta, Indonesia; and as visiting professor in Almaty, Kazakhstan.
(articles in Medical Teacher and MedEdPublish have been viewed over 3,900 times in the 2015 and 2016)

1. Goh, P.S. A proposal for a grading and ranking method as the first step toward developing a scoring system to measure the value and impact of viewership of online material in medical education - going beyond “clicks” and views toward learning. MedEdPublish. 2016 Oct; 5(3), Paper No:62. Epub 2016 Dec 9.

2. Goh, P.S. Presenting the outline of a proposal for a 5 part program of medical education research using eLearning or Technology enhanced learning to support Learning through the continuum of Undergraduate, through Postgraduate to Lifelong learning settings. MedEdPublish. 2016 Oct; 5(3), Paper No:55. Epub 2016 Dec 7.

3. Goh, P.S. The value and impact of eLearning or Technology enhanced learning from one perspective of a Digital Scholar. MedEdPublish. 2016 Oct; 5(3), Paper No:31. Epub 2016 Oct 18.

4. Goh, P.S. A series of reflections on eLearning, traditional and blended learning. MedEdPublish. 2016 Oct; 5(3), Paper No:19. Epub 2016 Oct 14.

5. Goh, P.S. Technology enhanced learning in Medical Education: What’s new, what’s useful, and some important considerations. MedEdPublish. 2016 Oct; 5(3), Paper No:16. Epub 2016 Oct 12.

6. Sandars, J., Goh, P.S. Is there a need for a specific educational scholarship for using e-learning in medical education? Med Teach. 2016 Oct;38(10):1070-1071. Epub 2016 April 19.

7. Goh, P.S. eLearning or Technology enhanced learning in medical education - Hope, not Hype. Med Teach. 2016 Sep; 38(9): 957-958, Epub 2016 Mar 16

8. Goh, P.S., Sandars, J. An innovative approach to digitally flip the classroom by using an online "graffiti wall" with a blog. Med Teach. 2016 Aug;38(8):858. Epub 2016 Jul 14.

9. Goh, P.S. Using a blog as an integrated eLearning tool and platform. Med Teach. 2016 Jun;38(6):628-9. Epub 2015 Nov 11.

10. Sandars J, Patel RS, Goh PS, Kokatailo PK, Lafferty N. The importance of educational theories for facilitating learning when using technology in medical education. Med Teach. 2015 Mar 17:1-4.

11. Dong C, Goh PS. Twelve tips for the effective use of videos in medical education. Med Teach. 2015 Feb; 37(2):140-5.

12. Liaw SY, Wong LF, Chan SW, Ho JT, Mordiffi SZ, Ang SB, Goh PS, Ang EN. Designing and evaluating an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care: randomized controlled trial. J Med Internet Res. 2015 Jan 12;17(1):e5.

Google Analytics
"Google Analytics lets you measure your ... as well as track your Flash, video, and social networking sites and applications."