LCOM & Department News

Putting the Active in Learning – Med Students Bring First-hand Insight to Curriculum

August 7, 2018 by Michelle Bookless

As the Larner College of Medicine at the University of Vermont works toward a curriculum that is 100 percent lecture-free by 2019, faculty aren’t the only ones helping move the transition forward; medical students are playing a critical role in creating active learning curriculum as well.

Eric Schmidt, M.D.'18, answers questions from Class of 2021 medical students during an active learning session he developed and taught

A bold pledge – to go 100 percent lecture-free – catapulted the Larner College of Medicine at the University of Vermont into the medical education spotlight. Thanks to a September 2016 Associated Press article, more than 150 media outlets, including the Washington Post, National Public Radio and the New York Times, covered the College’s push to transform its entire curriculum to an active learning approach, garnering the attention of medical schools and educators around the country.

Innovation was not a new concept at the Larner College of Medicine, however. The Vermont Integrated Curriculum had won wide acclaim and the school had been incorporating active learning methods since well before it opened its first active learning classroom in 2014. In fall 2016, the College was at about 50 percent active learning; since then, that number has grown to 67 percent, thanks to the tireless work of dedicated faculty and support of a newly created Office of Active Learning. But faculty aren’t the only ones helping move the transition forward; medical students are playing a critical role in creating active learning curriculum as well.

Student-faculty collaboration and input is key to the success of the transition, says UVM Professor of Pathology and Laboratory Medicine Rebecca Wilcox, M.D., course director for Nutrition, Metabolism, and Gastrointestinal Systems (NMGI). “We think of active learning as the best thing for this generation [and] we really need to have people in this generation designing it,” says Wilcox. “As a course director, I know what objectives I want [to achieve] and what is important for them to learn during the course, but the students help me ‘get it’ at the student level.”

One of those students is Liz Carson ‘19, who first became involved as a representative for the Student Education Group (SEG). SEG student representatives act as liaisons with faculty to “provide a unified point of view, and to appropriately bring pertinent education issues to the attention of faculty and course directors.” More recently, Carson took on an even more hands-on role in helping with the active learning switch, incorporating it into the research portion of her year-long pathology fellowship. Medical students accepted into the pathology fellowship defer graduation for a year for the opportunity to do four months of surgical pathology, two months of autopsy, several month-long elective rotations, and one month of research. An experienced outdoor guide and wilderness medicine teacher, Carson immediately knew she wanted to focus on medical education for her research project. She approached Wilcox, former chair of the College’s Active Learning Task Force, whom she says is a “real educational innovator,” to be her mentor and help her develop a project that would combine her two passions – pathology and medical education. 

Carson’s project had two main objectives – first, take a class that’s still lecture-based and turn it into an active learning module; second, present the module using two different active learning classroom methods to determine which works best for students and faculty.

To start, Carson worked with Wilcox to identify areas in the first-year curriculum that students struggle with and create an approach that would help reduce the difficulty with which they learn and apply the concepts and information. “We had a few different ones to choose from and we settled on [metabolic liver disease] because Dr. Wilcox is really good at identifying what students struggle with,” Carson says. “[That’s] really advanced,” she adds. “You have to be really good at teaching to be able to pick up on…aspects of these diseases that year after year students struggle with.”

Metabolic liver disease is covered in a series of lectures taught by Steven Lidofsky, M.D., Ph.D., a UVM hepatologist and professor of medicine. Lidofsky had already laid the groundwork for transitioning his lectures into an active learning session by condensing approximately 2.5 hours of lecture into four pre-learning video modules totaling 36 minutes in length. In active learning, students use self-paced pre-learning modules to gain foundational knowledge prior to their in-classroom session.

Carson reviewed Lidofsky’s videos as if she was a first-year student, then picked out teaching points she felt were the most salient based on her recent experience in clinical clerkships and taking the first two out of three United States Medical Licensing exams. Then, she, Lidofsky, and Wilcox collaboratively developed a clinical scenario and patient profile for the classroom-based learning that would follow the videos they’d watched the previous night.

Clinical scenario and patient profile in hand, Carson created a module that can be used in a versatile way – a non-linear Powerpoint that can act as an interactive application to deepen the students’ conceptual understanding of the information presented in Lidofsky’s videos. “I wanted to create a patient assessment ‘video game’,” she says. “[It’s] a great way to apply learning to a clinical context – to virtually walk through seeing a patient, asking them questions, ordering lab tests, interpreting the lab tests, and coming up with the assessment and plan.” 

Her inspiration came, in part, from an extremely versatile pharmacology module she used in an optional session during her first-year Neural Science course. The module allowed students to learn in a group format or independently.

Carson’s module features a clinical vignette featuring a 19-year old female UVM student presenting at a health center with vague, non-specific symptoms. Students are asked to use the knowledge gleaned from Lidofsky’s videos to make choices, such as what diagnostic tests they should order for the woman, which will lead them down different paths within the application. Still, regardless of which path they choose, all students will be presented with the same key takeaway points – information they’ll most likely face during USMLE and more importantly, in the practice of caring for patients.

In addition to creating the interactive module, Carson worked with Wilcox and UVM Associate Professor of Pathology and Laboratory Medicine Ronald Bryant, M.D., to compare the effectiveness of different active learning methods. “There’s a lot in the literature that supports active learning in general,” notes Carson, “but there are not many papers that compare different active learning methods and recommend which ones you should use for which types of information.”

For instance, a small-group session approach, which requires a class of 120 students to break into groups of 10-12 students per faculty member, provides students with an intimate environment and extended facetime with clinical faculty. However, small-group sessions are resource intensive and expensive to run – at least 8 faculty members (who are also busy clinicians) need to be free on the same day, at the same time. Additionally, Carson notes that student evaluations show these sessions can breed stress and anxiety among students who feel that their peers, who are being taught by a different faculty member, may be getting different or more information than they are.   

In the large-group format, the entire class of 120 meets in the same room with one to two faculty members and one to two teaching assistants (TAs) as proctors. During the classroom session, students can work through problems and cases at their own pace either as a group or on their own, asking faculty and TAs questions as needed. With less faculty needed to facilitate, it’s less expensive and easier to schedule. But is it as effective as a small-group session? That’s what Carson set out to determine.

To compare the two formats, Carson had half of the first-year students attend the class in a small-group format and the other half in a large-group format. Students were then asked to fill out a LimeSurvey Carson created with the help of the University of Vermont Teaching Academy through which Carson would gain insight about the effectiveness of each session based on four parameters: student preparedness for the session; student perceptions of the session’s learning effectiveness; learner knowledge assessment upon completion of the session; and short-term (ten days) knowledge retention.

Through the survey and working with UVM Statistician, Alan Howard, to comb through the results, Carson learned that in terms of student preparedness, there was no significant difference between the two formats. The same rang true with the students’ perception of learning effectiveness – students in both groups felt the sessions met the stated objectives and most had no difficulty completing the activity during the in-class session. This trend continued for the remaining parameters – statistically, Carson saw no significant difference between the two formats.

Regardless of the results, she remains interested in researching the comparative effectiveness of different active learning methods and is hopeful that not only will faculty use her interactive application as a template for creating other case-based sessions, but that her application will continue to be used for the NMGI course in the years to come. Wilcox believes it can and will. Essentially, says Wilcox, anyone – teaching assistant or clinical faculty, it doesn’t matter if they’re a liver expert or not – could use Carson’s tool to facilitate an active learning classroom session.

Fortunately for the College, Carson is one of many medical students who have contributed to changes in medical education and active learning.

Eric Schmidt, M.D.’18 was one of those students. In 2014, he and his classmates were the first to access the newly-renovated Larner Classroom. Most of their active learning classes followed a “team-based learning” approach, which sparked Schmidt’s interest in the role of academic clinicians in medical education and active learning methodologies.

When Schmidt was determining the focus of his fourth-year scholarly project, he reached out to Wilcox, the director of his favorite first-year course, for guidance and ideas.

His timing was perfect. Wilcox and her NMGI faculty were in the process of transitioning the few remaining lecture-based classes to active learning, so she suggested that Schmidt, like Carson, take on a session taught by Lidofsky, who had already created a series of seven-minute videos that condensed his old hour-long lecture into short, condensed chunks of the most important information and key points students needed to know before class. Schmidt’s objective was to build upon Lidofsky’s work to create a flipped-classroom session featuring clinical cases, and then deliver that to first-year medical students.

During the session, Schmidt advanced through a Powerpoint that presented students with clinical scenarios he had created. The students were then prompted to discuss the information available to them and analyze it based on what they’d learned from the videos the night before, in order to reach a conclusion about what the patient’s diagnosis was or what their next step might be – for example, to order an additional lab test. After group discussions about each slide’s scenario, Schmidt requested students present their conclusions and takeaways to the class. The ensuing conversations shed light on which concepts students were still struggling with, which Schmidt then addressed.

The session was a success due to the close student-faculty collaboration between Schmidt, Lidofsky, and Wilcox and Schmidt’s “near peer” insight – first-hand knowledge that he’d retained and understood material better when he and his classmates could apply what they were learning to clinical case studies. And as a peer teacher, he was more credible, because he had “recently taken the NMGI exams and tests, such as [USMLE] Step 1 and Step 2.” The students recognized that the content they were learning was “high yield,” says Schmidt.

As the College steadily works toward its goal of a 100 percent active learning based curriculum by 2019, it will continue to look toward both faculty and students like Schmidt and Carson to continue the push ahead.

“[Our students] come [to medical school] with a wealth of ideas about how to improve medical education, and we invite their energy and enthusiasm into the process,” says Senior Associate Dean for Medical Education, William Jeffries, Ph.D. “Not only do they propose ideas, they work with faculty to implement them, and then rigorously evaluate the results. Resulting scholarly projects inform the national conversation.”

 

Past Department Highlights

Congratulations, to Dr. Jason Brazelton, M.D., for being named Physician of the Year by the Vermont Medical Society. "Dr. Brazelton's thoughtful and collabrative approach has improved care in our community and Porter's Medical staff has been incredibly fortunate to work with him." (09/2022)

Litele Cezar de Cruz, Ph.D., a visiting scholar from Brazil in the lab of Dr. Albert van der Vliet, Ph.D., and Nathaniel Shannon, a graduate student in the CMB program, in the lab of Dr. Brian Cunniff, Ph.D., based on their abstracts, have both received a Travel Award from SfRBM to attend the SfRBM Annual Meeting in Orlando later this year. https://sfrbm.org/meetings/2022-annual-conference/. In addition, Nate's abstract was selected to be presented as a talk at the conference. Chris Dustin, a former RBP Ph.D. student, and now a post-doc candidate at University of Pittsburg will also give an oral presentation at the conference. RBP is again well represented at this major conference in our field.

Research Day 2022, the fifth pathology research day was an incredible success. Thank you to the organizers Vice Chair for Research Dr. Mark Fung, M.D., Ph.D., Elizabeth Corteselli, Ph.D., post doctoral associate, Nate Shannon, CMB graduate student, and Dr. Rosemary Mattaino, M.D. Thank you as well to the presenters, and moderators for an engaging experience. Four sessions were held spanning the topics of: emerging technologies, and advances in knowledge using new technologies, a panel discussion on having a well-balanced academic career, and presentations from trainees, and internal award recipients. A well attended reception was help in the Hoehl Gallery after the event. (09/2022)

Research Day organizers - 2

(Dr. Fung, M.D., Ph.D., Elizabeth Corteselli, Ph.D., Nate Shannon, Dr. Janssen-Heininger, Ph.D.,)

Yvonne Janssen-Heininger, Ph.D., professor of pathology and laboratory medicine, has received a two-year, $200,000 Lung Cancer Discovery Award from the American Lung Association (ALA). The grant will support her research project, titled "Glutaredoxin, Glutathione Metabolism and Lung Cancer." According to the ALA, "The Lung Cancer Discovery Award is for highly meritorious research projects with the potential to significantly improve and transform diagnostic and therapeutic paradigms; foster innovation, use novel approaches; and/or accelerate progress in lung cancer research that improves patient care and helps save lives." (08/2022)

Congratulations to Dr. Christina Wojewoda on her acceptance, as a Master Teacher, into the Larner College of Medicine Teaching Academy. (8/2022)

Congratulations to Dr. Alex Kaloff on receiving The University of Vermont Medical Center Leadership Award for the second quarter of 2022. (7/2022)

Congratulations to Dr. Rebecca Wilcox on being selected as a member of the 2022-2023 class of fellows participating in the Hedwig van Ameringen Executive Leadership in Academic Medicine® (ELAM) Program at Drexel University College of Medicine. Read more (06/2022)

Dr. Elizabeth Corteselli, a post-doctoral fellow in our department and trainee on the VLC T32 training program, is the recipient of a prestigious Parker B. Francis Fellowship Award. She will be recognized during a reception at the ATS conference in San Francisco this coming week. Congratulations Elizabeth! (05/2022)

Yvonne Janssen-Heininger, Ph.D., professor of pathology and laboratory medicine has been recognized by the Provost and Senior Vice-President for the university of Vermont Distinguished Professor recognition. This recognition is reserved for the most prominent faculty members who have made outstanding contributions to advancing knowledge in their disciplines. This is a significant honor for Dr. Janssen-Heininger. This accolade will be awarded during the spring 2022 UVM Commencement ceremony. Congratulations!! (05/2022)

Dr. Mount and Dr. Threlkeld won a Stout award at USCAP, a Stout award recognizes and awards an individual for the best English language peer-reviewed paper published, which resolves scientific medical problems by studying the anatomic features. Congrats to both! Read paper here: Arch Pathol Lab Med. 2021 May 1 (04/2022)

Congratulations! Jo Conant, M.D. has received the ‘Gender Equity in Medicine and Science Rising Star’ award. This award recognizes a woman or gender minority* faculty or staff member at the Larner College of Medicine who is in the early stage of their career, and who demonstrates excellence in contributions to students, colleagues, and/or the institution in the areas of gender equity and inclusion through service, program development, teaching, research or beyond. The awardee also shows the promise for future contributions and leadership in their field as well as in achieving goals for the advancement of diversity, equity, and inclusion. (02/2022)

LCOM class of 2024 Foundations Awards, Winners and nominees from our Department: Dr. Rebecca Wilcox- nominated for the AMWA Gender Equity Award | nominated for the Foundations Teaching Award; Dr. Pam Gibson– awarded the Silver Stethoscope Award | nominated for the Foundations Teaching Award | nominated for the Dean Warshaw Integration Award; Dr. Jo Conant– nominated for the Silver Stethoscope Award | nominated for the Dean Warshaw Integration Award; Medical Student Matt Hodd-Wells awarded the Ephraim Woll Award for Excellence in General Pathology (01/2022)

Congratulations! Dr. Rebecca Wilcox, M.D. has been appointed Associate Dean for Faculty Affairs at the Larner College of Medicine. Read her story. (01/2022)

Congratulations! Dr. Yvonne Janssen-Heininger, Ph.D.– Dean’s Research Laureate Award (Professor) Dr. Yvonne Janssen-Heininger was presented the Dean’s Research Laureate Award on 10/27/2021 at the LCOM State of Research Address and Awards. Please see the PDF slide that was presented at the program. (10/2021)

Heading to clinical trials..."UVM researchers celebrate ‘first-of-its-kind’ mesothelioma treatment headed to clinical trials" – My Champlain Valley News.  University of Vermont researchers have made a breakthrough in their study of possible treatments for malignant mesothelioma, a rare and aggressive cancer linked to asbestos exposure. (10/2021)

Terri Messier, research analyst and lab manager for the Cunniff lab, has been highlighted in the "Meet the Staff" section of the the Larner College of Medicine Dean's Newsletter, October 20, 2021 | Volume III, Issue 20. (10/2021)

Congratulations! Albert van der Vliet, Ph.D. has been named a 2021 Fellow of the Society for Redox Biology and Medicine. SfRBM annually confers the special title of Fellow to members who have made outstanding contributions to the association as well as in the field of free radical chemistry, redox biology and antioxidants. (09/2021)

Well done! Christina Wojewoda, M.D., associate professor of pathology and laboratory medicine, has received, along with her colleague Daniel Rhoads, M.D., of the Cleveland Clinic, the 2021 College of American Pathologists (CAP) Laboratory Improvement Programs Service Award. The award honors an individual(s) serving within the ranks of the CAP Council on Scientific Affairs who has demonstrated exceptional service. The two pathologists serve as chair and vice chair, respectively, of the CAP microbiology committee. (08/2021)

Congratulations to Dr. Yvonne Janssen-Heininger, Dr. Albert van der Vliet, Dr. David Seward and their team members for this outstanding acknowledgement (see pdf) from the The American Physiological Society; "your article has been selected for APSselect  (http://apsselect.physiology.org/),  a collection from the APS that showcases some of the best recently published articles in physiological research." (7/2021)

2020-2021 Teaching Award This award is nominated for and voted by medical resdients for idividuals going above and beyond for resident education. Nominees this year: Dr. Agnes Balla, Dr. Kelly Butnor, Dr. Rebecca Wilcox and Dr. Bronwyn Bryant. The winner this year is Dr. Agnes Balla. (06/2021)

Dr. Joanna Conant has become a member of The Teaching Academy at Robert Larner, M.D. College of Medicine at the University of Vermont. The Teaching Academy sustains and supports an interdisciplinary community of educators who value the scholarship of teaching and learning while facilitating educator development; improve the efficiency and quality of medical education through collaboration and scholarship; and promote an academic environment that increases the value and impact of educators locally, regionally, and nationally.Congrats to Jo on this achievement! (06/2021)

Congratulations to Dr. Arti Shukla on receiving the SAASCR 2021 Outstanding Achievement Award for her seminal contributions to the field of cancer research. Well done Arti!! (5/2021)

SAASCR award 2021

Congratulations!  To Pam Gibson, M.D. who has been awarded 2021 Gender Equity Champion Award which honors Larner College of Medicine community members (faculty, staff or students) who have demonstrated outstanding commitment and service to the advancement of women and those with underrepresented gender identities beyond the scope of their job, area of research, or training. Also, to Joanna Conant, M.D. on her nomination for 2021 The Rising Star Emerging Professional Award which honors a Larner College of Medicine woman or gender minority faculty or staff member who is in the early stage of their career, and who demonstrates excellence in contributions to students, colleagues, and/or the institution in the areas of gender equity and inclusion through service, program development, teaching, research or beyond. (02/2021)

LCOM Foundations Awards: Congratulations to Ron Bryant, M.D. on receiving the Foundations Teaching Award which recognizes the faculty member who provided the most outstanding teaching activities within the foundations curriculum. Also, congratulations to award nominees: Pam Gibson, M.D. for both the Above and Beyond Award and the AMWA Gender Equity Award; Andrew Goodwin, M.D. and Christina Wojewoda, M.D. for the Silver Stethoscope Award and Rebecca Wilcox, M.D. for the Dean Warshaw Integration Award. (01/2021)

LCOM Teaching Academy Recognition for P&LM faculty: Deborah Cook, M.D. and Anne Stowman, M.D. were inducted as Master Teachers and Rebecca Wilcox, M.D. was inducted as a Distinguished Educator. (01/2021)

Mark Fung, M.D., Professor, Pathology and Laboratory Medicine, has been elected as a new Trustee of the American Board of Pathology. His 3-year term will begin January 2021. Read about it here. (12/2020)

Sarah A. Nowak, PhD, Assistant Professor, Department of Pathology and Laboratory Medicine, Larner College of Medicine was named the inaugural Blodwen S. Huber Early Career Green and Gold Professor in Pathology and Laboratory Medicine. (12/2020)

David J. Seward, MD, PhD, Assistant Professor, Department of Pathology and Laboratory Medicine, Larner College of Medicine was named the inaugural Elmer R. Huber Early Career Green and Gold Professor in Pathology and Laboratory Medicine. (12/2020)

Terri Messier, Research Analyst and Lab Manager of the Cunniff lab was recently awarded a Dean's Excellence in Research Award from the Larner College of Medicine. Terri has served the UVM community for over 25 years both as a scientist and steward of professionalism. Congratulations Terri!! (11/2020)

Congratulations to Dr. Yvonne Janssen-Heininger, Ph.D. on her selection as a new Fellow of the Society for Redox Biology and Medicine (SfRBM) in recognition of her outstanding contributions in the field of redox biology and to SfRBM. (09/2020)

Congratulations to Dr. Joanna Conant, M.D. on her acceptance into the Teaching Academy's Medical Education Fellowship Program. Only 8-10 faculty from across the Larner College of Medicine are selected for participation in the program. Well done, Jo! (08/2020)

Associate Professor, Dr. Laura Greene, MD, has been appointed Interim Assistant Dean for Admissions for the Larner College of Medicine. (08/2020)

Congratulations to Bei Zhang, MD, PhD, Associate Professor, the newest graduate of the Medical Education Fellowship Program. The cohort style program is for Larner College of Medicine educators who seek additional preparation for teaching across the medical education continuum. (07/2020)

UVM Health Network’s Genomic Medicine Program is highlighted in the recent issue of Vermont Medicine Magazine, read it here. (05/2020)

Department efforts in COVID-19 research & testing are ongoing at UVM LCOM and the UVM Medical Center. The Rutland Herald/Times Argus ran the following story on these efforts. Teamwork & Testing (04/2020)