Spotlight on Innovation posted by Bonnie Miller, MD, in AMA Wire®

October 30, 2014
Posted in accolades, teaching

Recognizing educational myopia, accepting feedback

Spotlight on Innovation post by Bonnie Miller, MD, associate vice-chancellor for health affairs and senior associate dean for health sciences education at Vanderbilt University School of Medicine. This appeared in the October 2014 AMA MedEd Update, a monthly medical education newsletter.

Medical educators across the continuum are currently debating the importance and potential impact of learning portfolios. At Vanderbilt, we developed a platform called VSTAR that provides a robust electronic home for each medical student’s portfolio, comprised of competency-based assessments, experience logs, written reflections, coach-guided summaries and student-generated learning goals.

The effort and resources required for a project of this magnitude put us at risk for a form of educational myopia. Those of us intimately involved with design, development and implementation have celebrated the fact that the system is online and the gears are moving. While we are tempted to proclaim success, feasibility alone does not prove that the system is meaningful for learners and valuable for the learning process.

We were reminded of this recently when we held student and faculty focus groups on the first year of experience with the VSTAR portfolio. Aside from a few operational issues that could be expected with such a complex launch, the respondents indicated that the system had functioned in the ways for which it was designed. Beyond that, many students became highly engaged in the process of integrating multi-source competency-based assessments into meaningful learning objectives.

However, a subset of students was not as fully engaged as we had hoped. These students gave voice to a more traditional understanding of the roles of students and teachers. Portfolios force learners to move from being passive recipients of performance information (e.g., grades) to true professionals-in-training who use feedback as a starting point for reflection, goal-setting and improvement. Not all of our students are ready for this transition.

A second group also emerged. These students wondered whether the system was primarily about their learning, or whether it was really about faculty research, or a tool for measuring organizational effectiveness.

Both groups challenge us to remember the importance of student development, of proactively preparing our students with an understanding of the theoretical and practical rationales for these educational innovations so that they can become wise, effective and activated users. While student representatives sit on all of the committees that oversee these projects, we must find creative ways to communicate the purpose to the broader student body of the school.

Finally, the feedback from the focus groups reminded us that students must always remain an integral part of the ongoing evolution of our educational systems. Students must engage with the system not only as users, but also as members of the improvement team. We cannot reach our ultimate goals any other way. And, if we are really lucky, we will nurture the next generation of creative educators in the process.