Medical Education and eLearning Portfolio: Imaging of the Chest and Lungs - Online resources to support lecture for year 1 MBBS (NUS)

NUSMed Entrada link for Sep 30, 2020 M1 lecture scheduled for 12 noon.

Updates: Announcement (30 September 2020 @ 0745am).

Dear students,

I note that around one third of the class has done the pre-session review of content (Google analytics, see screenshot below at end of blog). In order to facilitate both an optimal learning experience for the class as a whole, and a differentiated value added, individualised learning experience for students who have different learning styles, learning and time allocation preferences and learning strategies, I have decided to modify the planned one hour Microsoft teams experience to facilitate the following:

1) for those students who have not, or who are unable to find time to review the pre session material, please spend the allocated curriculum 'lecture' time reviewing the session content below. There are two recommended learning paths (see below).

2) for those students who have done your pre-session preparation, please review your notes, or make notes of the key ideas and skills demonstrated on the interactive websites and videos, then go to post session online discussion section below.

For both groups 1) and 2), I will not be taking live Q and A or 'presenting' live on Microsoft teams. This will not benefit the whole class, who have prepared differently, are at different levels of preparation and knowledge / skill building, and will therefore not fully benefit from whole class 'attendance'.

I will therefore commit to engage with the whole class over the next 5 days for asynchronous Q and A, on the session Padlet wall below. Please see below section for detailed instructions. Using Padlet allows the whole class to benefit from interactive Q and A, over an extended 5 day period, in an accessible, online forum, where we can engage publicly in technical, scientific, not specific or identifiable patient related health and medical skill building and learning content.

This whole process extended asynchronously over 5 days should not require an individual student to spend more than around 2 hours reviewing, and interacting with the content, your peers and me as your instructor in total.

I hope you enjoy this learning experience and find this useful.

Poh-Sun

Preparation for session, and Content to be reviewed (below section)

The aim of the session is to link the anatomy which you have learnt in the chest, to what is visible on the two most commonly used imaging tests you will use as doctors in day to day clinical practice - the CXR, and CT scan of the Chest. Radiology allows you to see 'living anatomy' and pathology, of your patients in vivo. The CXR allows you to look inside your patient in 2D, while the CT scan gives you multi-planar sectional details, and a '3D-like' appreciation of both anatomy and pathology. You should aim to develop the ability to orientate yourself to the visible structures when viewing both the CXR, and CT scans; and be able to identify normal anatomy. This will form the foundation for the study of pathology, and the appreciation of visible pathology in your patients using CXRs and CT scans in year 2, and subsequent clinical years.

There are two learning paths (illustrated on the blog below) - a Guided learning path, and an Exploratory learning path. Please choose one path based on your learning preference, and review the material before the 'live' lecture. We will review this content during the 'live' lecture on Microsoft Teams.

Guided learning path: For those of you who like a very prescriptive guided learning path - start with CXR video 1, then CXR video 2, then CXR anatomy website (see chest section) (using illustrations as drill and quiz examples, by viewing CXR first without annotations, then mousing over each image, then read text); then view CT chest video 1, then CT chest video 2, then attempt to identify CT anatomy here. (Viewing these videos within or embedded in the blog below is one method to reduce ads which appear before the video).

Exploratory learning path: For those of you who prefer a more exploratory learning path, starting with interactive illustrations and text, you are encouraged to review the open access CXR anatomy website (see chest section) below, as well as information about how to approach the CXR (including normal anatomy), and CT scan with scrollable images links below. For those students who prefer learning from illustrated online videos, please review the two videos below before the lecture - Chest X-Ray Interpretation Explained Clearly - How to read a CXR and LEARN to Read a Chest Xray in 5 minutes!. Also review the two videos below reviewing visible anatomy on CT of the chest - Anatomy of a Transverse CT of the Thorax and Introduction to Computed Tomographic imaging of the Chest. (Viewing these videos within or embedded in the blog below is one method to reduce ads which appear before the video).

The following are links to my individual 'lecture' slides. You can preview these in sequence.

Value add of radiology

Radiology as 'AR' app

PA vs AP CXR

5 radiographic densities

5 radiographic densities illustrated

Silhouette sign

Collage CXR, axial and coronal CT chest

CXR anatomy quiz

CXR anatomy answers

Axial CT chest quiz

Axial CT chest answers

Coronal CT chest quiz

Coronal CT chest answers

https://learningchestradiology.blogspot.com/2018/10/chest-radiology-anatomy-correlation.html
(password access required, this is for instructors)

https://www.radiologymasterclass.co.uk/tutorials/chest/chest_home_anatomy/chest_anatomy_start (for students, start here)

https://www.kenhub.com/en/library/anatomy/medical-imaging-and-radiological-anatomy

https://radiopaedia.org/articles/chest-radiograph

https://radiopaedia.org/cases/normal-ct-chest

https://www.radiologycafe.com/medical-students/radiology-basics/chest-anatomy

http://www.castlemountain.dk/atlas/index.php?page=modules

STR (The Society for Thoracic Radiology) Curriculum for Medical Students and Allied Health Professionals - Please view Chest Radiography: Cardiothoracic Anatomy (video presentation), and Advanced imaging: Basic Chest CT Anatomy (video presentation) before lecture

CXR video 1 (view within blog below)

⬇️

we will discuss ideas presented in the videos above and below during the 'live' online lecture

(for students, please view both videos, above and below, before the online 'live' lecture)

CXR video 2 (view within blog below)

⬇️

please also review the two videos below reviewing visible anatomy on CT of the chest

CT chest video 1 (view within blog below)

⬇️

CT chest video 2 (view within blog below)

⬇️

Before, during, and After session Padlet open access, to view and comment online discussion board

Dear students,

Please post questions morning before, during, and for the 5 days after the scheduled session - i.e. Wednesday 30 September 2020 till midnight Sunday 4 October 2020. I will start answering questions on an intermittent basis over the next 5 days. I hope that this will give you an individualised, personal, customised learning experience, during this unprecedented time of the COVID-19 pandemic, where face to face live interaction between teaching staff and students, and between students is significantly reduced.

Padlet is an interactive digital wall, which for the purpose of this session I have made open access for online viewing and posting - you are able to write, edit and delete your own posts, without needing to login (by just double clicking or double tapping on the Padlet wall, or clicking the circled red + button bottom right of the Padlet wall), as long as you use the same mobile or desktop device. Even though this platform works with all mobile and desktop devices, you will probably find using a laptop/workstation or tablet the easiest way to write and edit your posts on this website. Please consider identifying yourself, with at least your first name. You might also op to use initials, in order to further anonymise your Padlet posts, as this is available for open access.

I have organised this Padlet wall for each new post to be placed at the top of the page, with older posts at the bottom. You can thus find your post as new posts are added by other participants. Please consider refining and adding to your post over the next 5 days on the same post, which you can do as long as you use the same device. I encourage you to comment on other participants' posts also, as well as ask follow up questions to my responses, and to your fellow students questions.

The pedagogy, instructional intent, and learning science behind this approach is the following. Learning requires active engagement on your part with the content. This includes understanding why this content is important, and how this is useful, relevant, and can be applied in your current and future learning and practice. How this content builds on your existing knowledge and skills, including attitudes. In addition, time-on-task, and the opportunity to access relevant, useful, bite size, modular content to learn, re-learn, add to, and refresh your knowledge and skill base is assisted by technology platforms (like this open access blog-website). My role as instructor and guide is to curate relevant content, recommend learning paths, encourage and assist you to actively engage with, and use the learning material. Your learning process will be accelerated by repeatedly coming back to engage with the material, engaging in self-study, note taking, Q and A, peer discussion, practicing recall of key ideas (on 'paper' or digitally), sharing this with your peers, presenting and 'voicing' out key ideas, repeatedly practicing knowledge recall, and application of skills (in this case, and for this session being able to identify key anatomical structures visible on the CXR, and CT scan of the chest).

For those of you who are interested in the 'learning science' behind many of the learning activities you are engaged in, the following website has useful bite size resources for you as a student (and future instructor). 'See, Do and Teach'. Doing and eventually Teaching, peers, then later juniors is one of the best ways to consolidate and deepen your knowledge and understanding; as well as develop proficiency, competency, and mastery of a topic.

https://www.learningscientists.org/downloadable-materials

from 'Introduction to Learning and Teaching' online course; UNSW Sydney

and

https://granite.pressbooks.pub/teachingdiverselearners/chapter/surface-and-deep-learning-2/

I hope you enjoy this 'modified' learning and training format - from that of a traditional lecture, where typically some (variable amount) preparation occurs beforehand, during lecture note taking, where some - often limited live Q and A occurs (due to time, and only one Q and A possible sequentially; not to mention a particular Q might not be relevant to majority of the class; or a relevant Q and A posed individually at end of the class cannot be shared with the rest of the class). I hope this extended 5 day engagement (which is intended to reduce 'cognitive overload') also allows the majority / all of the class time to engage with the content, digest and assimilate the content, as well as an expanded opportunity to engage in Q and A both with your peers, and with me on the Padlet space below. This is something that 'large class or whole class' lectures have been relatively inefficient in, compared with small group tutorials and discussions, or one on one interactions.

Whole class lectures have been popular as it is a time efficient method for the lecturer to 'deliver' content. I hope you find this modified approach a significant improvement from the traditional 'live' attendance lecture format to learn at your own pace, and time, effectively and efficiently.

Lastly, some time management tips. I recommend for those of you who have not viewed the session content, including self directed interactive websites, and videos, to use the scheduled 'lecture' time to view the content, take notes, and pose questions on the Padlet wall below. I encourage you to share your notes/key ideas and takeaways on the Padlet wall. I encourage you to either work individually, or in online groups to both post your notes on the session, and Q and A as a group (for those of you who feel you learn best in small groups). I am confident that you are all experts in time management, who constantly aim for efficient and effective learning. I hope this 'modified' model of a 'lecture' allows you to spend the 30 minutes preparation, 1 hour in session time, and at least 30 minutes post session notes review, editing and reflection (in a typical learning and engagement model) in the most time efficient and effective way. Total time expenditure expected around 2 hours. Learning impact and effectiveness I expect significantly better, and more effective, than 'passively' and physically attending and listening/watching my live presentation.

I will regularly, and intermittently check the Padlet wall for questions, comments, and notes/reflections that individual students, or a student group might pose, over the next 5 days. I will assume if only a few questions are posed over the next 5 days, or even no questions, comments, or. requests for additional content/resources that individually, and collectively the class is satisfied with your learning experience, and has found this engagement model valuable. I do recommend strongly that even if you all have no questions, that the class individually, or as groups posts short takeaways of what you learnt from your two hour engagement in this learning exercise. I will then comment and add to this to reflect my judgement of your learning 'success' for this session.

Enjoy your learning. Have fun. With purpose. I look forward to engaging with you all on the Padlet wall below.

Poh Sun