Technology in (Medical) Education

Tools for Leveraging Open Education Resources

2013-04-06T10:59:00.002-04:00

We are experiencing the democratization of education. There are numerous free and open resources for learning on the Web:

While these sites have terrific videos, they have a limitation inherent to such content; they tend to be linear and difficult to change once published. In order for them to be more useful to students, the teacher often may want some control over the content so she is not stuck with what the creator of the video created or intended.

She may want to use only a part of the content of the video, and then link it to another part of another video
She may want to add some questions or additional content to the video
She may want her students to create a project that is like a collage - containing parts of videos they find and stitch together.

The good news is that there are now many services that are popping up to help

TedEd has a beta project called Lessons Worth Sharing that allows you to flip a YouTube video and add questions, resources and discussions. Here is a screenshot of one of the most popular flipped videos

YouTube has a somewhat similar capability to ask questions that pop up during the video. You can find more information here.

I just found out about Weavly which allows you to do online drag and drop editing and trimming of videos from YouTube and audio from SoundCloud. You can interpose text to add questions and comments.

Recently James Sousa of Phoenix College made his fabulous collection of mathematics videos available via Creative Commons by attribution license. I have looked a some and they appear to be higher quality content than some of the Khan Academy videos with nice graphics, models and animations.

Looking at one of the videos on Similar and Congruent triangles, I was struck by the questions I had above. The content starts with basic concepts of congruent triangles and moves on to similar triangles and several numerical exercises. It then comes to the application of using this to find the height of a building or a tree. What if the teacher who wants to reuse the video in her class, wants to actually present the practical problem of finding the height of the tree first and then allow the students to think about which math concept would help them solve this? And then present some clues and then allow them to view the basic concepts if they want?

Well Weavly can help you do this. Here is my 10 minute effort on flipping this video.

You can try out Weavly here. It is free and does not need a manual to get started.

As more Open Education Resources (OER) become available, educators will need to stay current not just with the OERs but also tools that can help them customize these for their own learners or create projects for learners to customize these for themselves and peers.

Add:

Since I posted this, I found out about Mozilla Popcorn Maker which appears to be a terrific tool. Here is a clip of a flipped TEDTalk.

Does the Medical Profession need to lighten up?

2013-03-02T11:57:00.000-05:00

Recently the Israeli Army (Israel Defense Forces to be precise) reacted to its soldiers doing the Harlem Shake and posting the video on Social Media. Some of those responsible were put in jail!

STOP right there!!
What are you thoughts at this point?
Most likely if you do not have a close connection with that part of the world, you are thinking, "What's the big deal? They are just young adults, let them have some fun, keep their sense of humor!"
RIGHT?
OK hold that thought.

Now take a story closer to "home". If you are related to the health care profession or close to someone who is, you know that we take our professional image very seriously.
We hear stories of how students were forced to take down a video of them dancing with skeletons. Most would side with the school authorities due to the disrespect to the dead and those who made the ultimate sacrifice by donating their bodies for education and research.
But, remember the skeletons are plastic models and not human bones. Clearly there is a fine line between entertainment and disrespect to our patients or the dead.

Many medical schools have theater programs where students present parodies of the medical profession and these are supported by the school administration with the proceeds from the ticket sales going to worthy charities.

Are we fooling ourselves? Does the general public feel the same way about our reaction to the medical student videos as we feel about the Israel Defense Forces reaction to the soldiers' video?

Are we too close to this? What do non-medical people think? If we think that we should not risk disrespect to the dead or a threat to our professional identity for just entertainment value, what if videos were used for patient education?

What if a video full of sexual innuendo increased the number of patients getting flu shots?

What do you think? Does the medical profession need to lighten up?

Top Reasons to use Google Drive

2013-02-07T13:44:00.007-05:00

Why do I use Google Drive?

Cloud storage with files available from anywhere, using any (web-enabled) device. I have not had to use a flash drive (Thumb drive/USB drive in a long time).
Avoid sending large files by email - just share the file or send a link.
Ability to have offline files (when there is no Internet access) and still edit them - even on a tablet that does not have specific word processing software
Collaborative editing with any device - earlier today, my laptop battery drained and I used an iPad to co-edit a meeting notes.
Ability to share and edit files collaboratively synchronously during a hangout
The commenting feature is terrific - you can carry on a conversation around a document by responding to comments - if you @name someone it notifies them via email
The auto save and versioning means you never lose any data
The spreadsheet allows for custom scripts which have been used for many purposes, my favorite is a auto-scoring online quiz.
The ability to create online forms and surveys that save the data to the spreadsheet.
You can publish documents to the web essentially creating web pages

AND its FREE!

The Digital Divide - Redivided! Score yourself on the Digital Divide Scale!

2013-02-05T12:30:00.000-05:00

By now (almost) everyone has seen the video of the Grandpa using the iPad as a cutting board. It made the rounds of social media about mid-last year. If you want to see it again (or for the first time), here it is:

It is a great example of the Digital Divide between the generations.

Well why this blog post now?

Just this morning, I got a forwarded email with an attachment from a bright and well meaning colleague with the subject, "Needs immediate attention" and the body of the e-mail talked about how we could use this video as an example of a digital divide.

Attached to it was a 2 MB file of this video!
I was struck by the irony of it - how the manner in which we disseminate a digital video on Digital divide reveals our own digital status.
(This colleague is actually what I would classify as a long-term well-accommodated digital immigrant - uses social networking, Dropbox, manages web sites etc and sent this more due to time constraints).

Here is a set of 2 cases - score yourself on where you stand

1. You want to share a large file with a group of people

You email everyone and attach the file - 0
You write a brief summary of the file in the body of the e-mail and folks can request the full file from you by replying to the e-mail + 1
You use "yousendit" or "transferbigfiles" and include a brief summary of the file in the message + 2
You put it on Google Drive/Dropbox and share it with them. + 3

2. You get a funny video as an attachment in a chain e-mail

You forward the email as it is (showing the e-mail addresses of every previous recipient) -0
You forward it after stripping off the emails of previous recipients +1
You search and find the video online and send a hyperlink to the video by email with a an apology to those who may have already seen it a hundred times +2
You embed the video in your blog or social network and share +3

BONUS point if you post on Google+ and share with appropriate circle!

SCORES	INTERPRETATION
5-6	Digital Native
3-4	Digital Immigrant
0-2	Digital tourist

Disclaimer: This is written purely in jest and has no scientific basis ;-)

Gagne, eLearning Tools, and Personal Information Management

2013-01-27T18:45:00.003-05:00

I have blogged many times about various Personal Information Management (PIM) tools like:

RSS Feeds and Google Reader
Social Bookmarking and Diigo
Reference Management and Zotero

I have tried to put it all together into custom workflows like:

Google Reader >> Zotero>> Tablet

Recently I have been doing several faculty development sessions on eLearning tools. Some questions I often get asked are:

What are some tools and apps that we can use for eLearning
There are so many tools. How do we organize (storyboard) our eLesson?

To answer these questions I decided to put together a demo lesson on PIM using eLearning tools and used the age old Gagne's 9 events of instruction model to help build the storyboard.

So here is the demo.

How I set it up:

Engage - Animated video (GoAnimate), Cartoon (makebeliefscomix) and Interactive image (Thinglink)
Goals - Flowchart (Lucidchart) and a (Camtasia) screen capture of a narrated PowerPoint animation
Activate prior knowledge - Google images (used advanced search to get images labelled for reuse)
Content - YouTube videos, Videos with embedded questions (Ted Lessons), blogs
Practice - Flashcards (Quizlet)
Assessment - HotPotatoes Quiz

Still have a few steps (events to cover) but it was an interesting exercise. The part that I could not include was the collaborative learning since this is not going to a real course with real learners. If it was, I could have used Tweetchats, Google+ Communities, etc to add a collaborative element.

Hope this will be helpful to others!

Are we close to being GOD?

2013-01-24T14:12:00.000-05:00

Ignore the title, I am NOT a creationist but the title makes sense if you remember that a large number of people believe that a supreme being created humans.

2 pieces of information caught my eye this week.

A printable 3D robot that can understand voice commands and move
A (very small) string of DNA can be used to code (very) large literary works

And last year IBM Watson was able to beat 2 champions at Jeopardy.

Putting these together let my imagination make the next leap to connect the missing links.

But lets start with the background:

3D printing is taking off in a big way. Recently, Gael Langevin posted about how he had created a 3D printable robot that could move and follow voice commands. The best part of the story is that you can download the files for the project as they are "open source".
So now anyone with a 3D printer and some skills can assemble a robot that talks, moves and obeys voice commands.
The DNA project will require help from a company that can create synthetic DNA strands. They would make the strands in the right sequence using a cipher to convert bits (1 and 0's) into the ACGT nuleotides. Once you have the DNA you need a sequencer to read the sequence and then convert it back to binary code which can be read by a computer.
DNA is a very efficient way to store information. 1 gram of DNA can store as much information as can be burned on 1 million CD's
DNA does not require any energy.
The cost of DNA sequencing is dropping and in a few years we will probably see these become mainstream.
Next combine the DNA sequencer with the robot and store the DNA containing the worlds information on it, and power it with IBM Watson's AI and you have something close to a human being? There is just something amazing thinking about DNA storing all the necessary information on board a humanoid that can speak talk and respond to voice.
Sure there are lots of missing pieces still but we do live in exciting times!

Web 2.0 and Social Media for Cardiologists - one-click solutions

2012-12-24T21:59:00.001-05:00

I was preparing for my presentation at a major medical conference in India. The presentation is on use of Social Media for Physicians. The conference is focused on mostly cardiology topics for general internists. The organizers asked me to make sure the talk was practical and could leave the attendees with some easy to follow take home points.

As always the challenge with a presentation is knowing your audience. I did not have a good feel for this, not having attended this conference before. I struggled to select the appropriate content for the presentation. I needed to show them what was possible, and then what they could do to get started.

I decided to give them some highlights on using Google Reader to stay current with medical (cardiology) literature and use of Twitter to network with cardiologists and to get updates and insights. To make it easy for them to get started I created

An OPML bundle of cardiology journal feeds and
A Twitter list of cardiologists to follow - this post by Larry Husten was very helpful to get started.

Having gone through that effort, it is probably worthwhile to share these for others to use and share.

Getting your cardiology journals delivered to your "doorstep"

Get started with Google Reader
Then subscribe to 11 top cardiology journals and 3 blogs with one click. (Click on subscribe)
Go to Google Reader and all 11 journal feeds should be available at one place. These can be tagged and shared on Twitter, FB or Google+, Tumblr etc and also be searched!

RSS Feed Bundle or 11 top Cardiology Journals

Getting your cardiology fix on Twitter

Create a Twitter account (optional for read-only mode)
Go to the Twitter cardiology list
View Tweets and follow the conversations and links
Join Twitter to participate

Twitter List for Cardiology Updates

So there you are - 2 quick one-click solutions to introduce cardiologists into Web 2.0/Social Media.

Addendum:
A conversation with @Allan Palmer on Google+ made me realize that this might have come across as a final solution for the attendees. I need to stress that this is just the first step. There are several frameworks for understanding why some people are late to adopt IT innovations. The Technology Adoption Model is based on:

Perceived Usefulness and
Perceived Ease of Use

The Diffusion on Innovation theory by Rogers adds that an innovation must be easy to try, and its use should be visible to others (peers).

Based on these frameworks, one would seek to provide late adopters an easy to use approach to try these tools, and allow them to see other colleagues using it. Ideally one would add some hypothetical cases to illustrate the utility.

Thus for this conference, I could create an example of a patient on a statin who has questions about adding niacin to the regimen or a patient with history of coronary artery disease who is on a betablocker and getting severe fatigue from it. These would lead to recent articles on these topics and conversations on Twitter and blog posts about these studies.

Confessions of an Early Google+ Adopter

2012-12-09T20:19:00.001-05:00

Google+ has had the best features of FB and Twitter with granular control to fine tune of the stream, ability to get to know folks from all over the world with similar interests, no ads, ability to have longer coherent discussions, very few of the "I ate a bagel for breakfast" posts, combined with the integration with Hangouts and Google Drive for collaborative document authoring and video conferencing.

With the launch of Communities, there are even more possibilities for collaboration and sharing but there is a serious possibility that we will see the influx of businesses and marketers. Lets keep our collective fingers crossed!

Don't ban mobile devices from meetings; leverage them!

2012-12-09T17:29:00.000-05:00

Just read a post on Techcrunch "Tech Is Making Meetings Worse, It’s Time For Digital Hat Racks" which recommends that we should make people check in their mobile devices before starting a meeting. The author Nir Eyal feels that there are only rare occasions when attendees actually use their devices in a productive manner and thus these act as distractors.

From Techcrunch linked to http://techcrunch.com/2012/12/09/digital-hat-racks/

This is issue is very similar to faculty members complaining about their students not paying attention during class, spending time on Facebook or texting instead.

My response to this post is that one can have very productive meetings when we use devices appropriately. I find that meetings can be excellent working meetings when we have laptops and other mobile devices and use them purposefully. I am involved in several standing meetings through out the week which follow the following model:

The team has a shared folder on Google Drive
Before each meeting, a document is created in the shared folder - the title is the date of the meeting
Participants populate the document with agenda items prior to the meeting
During the meeting one laptop is used to project the Agenda document on the screen
At least one other person uses another device, usually a laptop to load the same document and edit it collaboratively. This device is often passed around among the attendees depending on who needs to edit it.
During the meeting we use the devices to

Look up information - rather than assigning the task to someone to look up after the meeting and thus postponing the decision making to the next meeting
Communicating - often via email or alpha pagers (yes we still use those) - send message to get answers or more information.
Project data or web sites
This information is entered into the agenda document which essentially becomes the meeting minutes.

Since everyone has access to the document, no minutes need to be emailed, or approved.
While a lot of work does get done during the meeting, we of course make decisions about projects and this is captured on Trello. We use Trello as a project management tool. This serves to bridge the meetings by creating a list of to dos for each project and assigns these to a team member. Team members review Trello between meetings and use this to organize their work and then update the agenda document for the next meeting.

This model has worked very well for us and we have expanded it to create a Google+ circle of team members. This allows us to do hangouts for meetings where someone is unable to attend in person and also continue the conversation between meetings.

The same model can be adopted for learning sessions, but the faculty need to be aware of and comfortable with technology tools that can help improve the learning experience and make the process more active, fun and efficient.

Getting my Google ecosytem on an iPhone 5

2012-12-03T09:58:00.001-05:00

If you have been following this blog, you saw that our workplace recently switched from a BB to an iPhone. While the iPhone 5 is a wonderful device, the BB clearly was excellent for what it did - email, phone and BB messaging, connecting to resources behind our corporate firewall etc.

Playing around with the iPhone, I have been trying to customize it to suit my daily workflow. Here is a snapshot of where I am right now. Clearly this will evolve as I use it more and as new apps become available or existing apps get updated.

Chrome works better for me than Safari as it keeps track of my favorites and recently closed tabs and tabs on my other devices. It allows me to share to Google+ easily (no workarounds like this).

Gmail app works much better than gmail on the iPhone mail app as it lets me do labels and organize in Gmail more easily.

I have been using Google Voice since it was "Grand Central" or something similar sounding. It has terrific features and I still trying to figure out the best way to integrate it with iPhone 5 and iMessaging. Unlike an Android device, the iPhone does not allow automatic calling via Google Voice. So right now I have both on my the Phone and GV on my home screen.

Of course, I have a link to the Google Maps mobile web page but also have the iOS Maps app but that will go away as soon as the Google Maps gets released for iOS 6.

I also have a shortcut to the mobile Google reader web page on another screen.

I am probably being a bit passive aggressive about this but I think there is at least some logic behind this? And yes I should be catching up with my e-mail rather than blogging!

Listening to the Sage from Omaha

2012-11-30T18:54:00.000-05:00

I am not an investment buff but when you get a chance to listen to a sage at your doorstep, you take it. Today the Cleveland Clinic ideas for tomorrow series hosted Warren Buffett. It was quite an amazing experience, and I came away with the impression that he is

Simple
Genuine
Funny
Smart

I live tweeted the session omitting the second t from his last name. It is quite amazing how often one can read something and not know how to spell it till you actually write it. Anyway, quite unedited, here is my Twitter stream from the session. There are some absolute gems in this, something that will stay with me a long time.

Coming full Circle in Google+!

2012-11-29T14:30:00.000-05:00

Had an amazing journey today and made me realize how sometimes one can learn so much if you have the right people in your circles on Googe+ (or follow the right people on Twitter).

It started early morning when I saw this post by Dirk Stanley who is a physician and a Chief Medical Information Officer.

I followed the link to his excellent blog where he describes his thoughts on EHRs and alerts. I 1+'ed is post and went on with my day. Later I came across this post by Marcius Herbert who is a Computer Science Educator in the UK. The post was about using SMS to persuade learners - linking to an article in the British Journal of Education Technology. This sounded fascinating as I was aware of the use of SMS in helping patients comply with physician instructions.

At work I was able to get the full text of the article which used an instrument called MSLQ (motivated strategies for learning questionnaires) and referenced the work of B J Fogg who has done amazing work in the field of motivation or "Behavior Design" at Stanford. The article referenced his book "Persuasive Technology; Using Computers to Change What We Think and Do" I perused this and learned about the term he coined, "Captology" and his principles organized under

Computers as Persuasive Tools
Computers as Persuasive Media and
Computers as Persuasive Social Actors

This was fascinating stuff and I realized how this was so closely related to how we try to design Clinical Decision Support Systems and alerts in Electronic Health Records to try and change physician behavior if they are doing something inappropriate.

My day had come a full circle!

iPhone 5 - Should it have a back button?

2012-11-20T17:21:00.003-05:00

As I posted earlier, our workplace moved from BB to iPhone 5. The iPhone will be the only supported device for corporate e-mail.

As I use the iPhone, I realize that it seems to be missing something very simple that I have gotten used to using on both the BB and the Android.

The home button at the bottom has to serve the purpose of 3 buttons on Android

Consider these cases:

You get an e-mail with a hyperlink. You click on the hyperlink and it displays the web page in the browser. Now you want to return to the e-mail. How do you do it?
You are reading Google news. You click on an item of interest and it opens a new tab. Now you want to go back to the news stream. How do you do it?

I cannot find a way to do it in iOS with one click. Maybe I am missing something but seems like a simple oversight.

The first versions of iOS did not allow multiple apps to run concurrently I believe. Maybe there was no need for a back button then. Seems it is high time for iOS to get this IMHO.

Another issue is the height and width of the iPhone 5 combined with a "back" navigation button at the top of the screen makes it very difficult to have a one-handed operation.

Android has a back button along with the home button and a button to show the running apps at the bottom of the screen. In the Google News example above, the back button closes the newly opened tab and takes you back to where you were in the news stream with a single click!

The back button is integrated into all Android devices at the bottom left.

Goodbye Blackberry: What I miss about you!

2012-11-14T17:24:00.000-05:00

Recently our workplace stopped supporting the Blackberry and moved to iPhone 5. This is now the only supported smartphone for getting corporate email.

While I am always excited to get a new device, I am already missing my Blackberry Bold. What do I miss the most?

Speed dial. I had several buttons programmed to dial with one long press. Speed dialing did not need me to touch the screen, swipe, or use voice control. Thus I could press the H key for home, the D key for dad etc. The iPhone since it lacks a physical keyboard can not have this functionality. Yes one can use Siri or create favorites or even do some workarounds using "xxx-xxxxxxx.tel.qlnk.com" but nothing even gets close to the simplicity of having a single key press for speed dial.
The trackpad: This is probably one of the most brilliant features of the BB. While it had a touchscreen, the trackpad made it almost unnecessary to touch the screen. One could navigate the cursor precisely to the necessary spot and click the exact spot you wanted. One could swipe, scroll etc without touching the screen. This made it a very simple one-handed operation. The iPhone 5 being a particularly taller screen makes it harder to reach all navigation areas with the thumb while hold the phone in the palm and fingers.
Zooming a video: While the iPhone has a somewhat non-intuitive pinch to zoom function for the camera it does not appear to have this for the video which seems quite an important omission for a 500+ dollar device that claims to have the best camera on any smartphone. Yes there are apps that enable video zooming but IMHO this should be a built in functionality.
The form factor: The fact that a lot of navigation controls are near the top e.g. the email navigation buttons; and the home button is near the bottom means the phone has to be moved around in the palm to reach these. The phone is just too tall for one handed operation and too narrow to feel secure holding it in the palm/fingers. Due to the insecure grip, a case is a must which means there is no point to the gorgeous look? Never even thought about getting a case for the BB as it was secure in the palm and just the right width.
The BB magnetic holster: It is possible on the BB to set up certain profiles/behaviors based on whether the device is in the holster or outside. This would also save battery life by automatically putting the screen to sleep/locking the device when placed in the holster.

A Dynamic and Productive Soccer Sideline?

2012-10-21T15:01:00.000-04:00

Converting Potential Energy into Electrical Energy!

I have spent many hours driving to and watching our daughter's soccer games. These are something I look forward to as it gets me out of the house even on cold and rainy days.

But these trips come with a bit of a guilt trip. I fret about the many miles we drive and the gas we burn as hundreds of families descend on these soccer fields. Also folks bring a folding chair and promptly plop it down on the sidelines, and then sit and shout for the whole game while encouraging kids to run faster and play harder.

Potential Energy ready for harvesting!

Would it not be great if there was a row of stationary bikes on the sidelines that were plugged into a device that could generate electricity and possibly even push it into the grid? Yes, yes I know the amount of energy generated by a stationary bike is minuscule but there are hundreds of people sitting on the sidelines. Plus imagine the side benefits. The folks would get some exercise, and possibly be too out of breath to curse at the referee. The kids would be thrilled not to have their parents shouting at them.

Think this is impractical? Seems there are several devices like this in the market that can be plugged into regular bikes with the rear wheel raised on a stand to make them into stationary bikes.

"Nah none would use it!" you say. Well how about giving them some motivation.
We could pit parents of the two sides against each other and even have a power meter indicating which side is generating more power. Thus while the kids play peacefully in the middle, parents can duke it out constructively on the sidelines.

What if the soccer facility provided the bikes and parents would swipe an ID to register themselves and their energy production could be tracked and they would get back some credit? This system already has been imagined for bike rental systems here.

Any takers?

Infographics: Can they make reading journals easier?

2012-10-20T16:14:00.003-04:00

As we struggle with information overload and clinical overload, it is harder to keep up with updates in medical literature. Several journals are trying to make it easier to scan articles and get the salient points quickly e.g. Annals of Internal Medicine provides a commentary summarizing the practical implications of a study.
My assumption is that most readers scan the abstracts of articles before deciding which ones to read in full. Appropriate use of graphics can improve comprehension and possibly make this scanning process more efficient. As the old saying goes "A picture is worth a thousand words". Clearly graphics are very popular as can be seen by the popularity of Infographics and Pinterest.
So I decided to try out a free infographic creation tool Piktochart to create a visual representation of the salient points of a study.

I chose this study from JAMA - because it was the first study that caught my eye in my Google Reader stream after I thought of this idea. So this is what the abstract looks like:

As you can imagine it took me a few minutes to get the main message of the study. What if I had seen this infographic instead? I took all the information from the study abstract. The only thing I added was the Number Needed to Treat (NNT) that I calculated myself.

Infographic Created by Neil Mehta

So what do you think? Does an Infographic make it easier to scan journal articles? If so, should journals have data visualization experts on their editorial team to help create these? Should there be standards for creating these e.g. Blue circles for control groups and yellow for intervention groups, etc?

The Search Hub - search the Web, Email, Cloud storage and Bookmarks from one place!

2012-10-19T09:41:00.001-04:00

We know how Google transformed how we find information. It is the default search engine for majority of users. But many users may not be aware of 2 features that help me tremendously.

Google is now doing a field trial that lets you search your Gmail and Google Drive for the search terms
When you search using Google it can simultaneously search your Diigo Bookmarks.

So now you can from one hub search the web, your email, your cloud storage and your bookmarks!

Google Search Field Trial - search Gmail and Google Drive from Google Search!

Search your Diigo Bookmarks from Google Search.

Bring your own device (BYOD) and the Ecosystem

2012-10-13T22:52:00.001-04:00

Recently I was talking with a very bright colleague who is about to cave in and buy a tablet. He does not even own a smartphone. He has managed to stay out of this technology maelstrom for so long that he was asking folks for advice about which was the ideal one to buy. I was impressed that he did not just jump in to buy the iPad since that is what everyone had heard of.

I told him there were many factors to consider like the carrier, the size of the device, whether it has a microSD card etc but one of the factors was the ecosystem. Seeing the look on his face, I knew I had some explaining to do. So what is an ecosystem?

In biology, an ecosystem describes the complex interactions between the living organisms and their environment. In technology, it describes the hardware and software on the device and the content and the applications that they interact with that often reside in the cloud. [This is my made up definition and would be glad to know of a more formal generally accepted one].

He still looked puzzled so I drew a few circles representing Google, Apple, Microsoft and Amazon on the back of a paper napkin. Then I drew some boxes on the circumference representing the following:

An Example of an Ecosystem

App Store

Music
Games
Movies
eBooks
Apps

Devices

SmartPhones
Tablets
Desktops/laptops with OS

Cloud storage
Documents/Office apps e.g. documents, presentations and spreadsheets
Social Networking
Email
Calendaring
Contacts
VOIP and Video conferencing
Content Management Systems
Groups
Maps
Browsers with syncing across devices
RSS feedreaders
Search

At this point his eyes were getting a bit glazed over. He appeared to be asking, "What has all this got to do with buying a tablet or smartphone?" So I gave him an example of how these are all integrated and having a device that is part of the ecosystem makes a lot of tasks easier. Thus if you like using Google Voice, you may want to lean towards getting an Android device as it is seamlessly integrated into the phone.

While it is often possible to access parts of an ecosystem from another type of device, it may not always be smooth. Thus one can access Google Drive from both an Android and an iOS tablet (iPad) but generally the Android tablet gets features before the iPad. The recent Google Maps issue on iPhone 5 is another example.

He got it. He was actually pretty amazed at how much these devices could do. I felt bad about leaving him without any direction. I was trying not to bias him but then he asked me what I would do if I was him. I told him I would probably get the Nexus 7 tablet. It was recently named the top gadget and top tablet of 2012. He asked me, "Does that preclude me from getting an iPhone later? Isn't the iPhone the best phone out there? And what about a computer OS? Google does not have one does it?"

"Great questions!" I said, "You may want to take a look at the this video before you consider buying an iPhone 5"

"And as far as the OS goes, Google does have computers with the Chrome OS but you can get the entire Google Ecosystem from a Chrome browser which you can install on a computer with any OS." At this point, he was almost convinced. But then I had to break the bad news to him. "Of course, you need to know that our workplace does not support Android; only the Blackberry is supported. Also only devices bought through work will be able to access the enterprise e-mail. This is for security reasons."

I really don't like to see grown men cry! Wish the BYOD philosophy was easier to embrace for organizations.

Google+: "Connecting and Sharing among People with Common Interests

2012-10-06T10:29:00.003-04:00

The last few months a lot has been written about Google+, comparing it to Facebook. I have personally found myself using Google+ much more than Facebook and I was not sure exactly why. It was only recently when I tried to explain Google+ to some people that I gained an insight about this.

I started using Google+ because I like to try out new things. I enjoyed exploring its various features and how to apply them to my work. As I used it, I realized I was not going back to FB as much as I used to. Initially I wanted to try and get my "friends" from FB over to Google+ and it bothered me a bit that they did not. Then one day I realized it did not bother me at all. I realized something that I think I knew all along, that at a very fundamental level Google+ and FB are completely different. How so?

FB's tagline says "Connect and share with people in your life".

My interpretation of "people in your life" is people you know or have known. Once you connect with them i.e. "friend" them on FB, by default everything you post is visible to ALL your "friends". The Pew Research Center in its report in May 2012 found:

• On average, users make 7 new Facebook friends per month; they initiate 3 requests and accept 4.
• Women average 21 updates to their Facebook status per month while men average 6.
• In a month, about half of our sample made a comment on a friend's content, and about half received a comment.
• Fewer than 5% of users hid content from another user on their Facebook feed.

Another key difference is the reciprocal relationship with other FB users. Thus only after both users have mutually agreed to be friends can one see the other person's posts.

What this means is that till you agree to be friends you see NOTHING of what the other person posts and after becoming friends you usually see EVERYTHING that the other person posts.

Google+ at its very foundation was built on the concept of Circles and also allows Public posting which is very similar to a blog.

Public posts can be seen by anyone who follows you and are searchable on Google. People can comment on them, share them or +1 them. You can see who these people are and view their public posts and decide if there are enough common interests that you can follow them back. This leads to finding people of similar interest across the whole world - most often people you DO NOT KNOW.
People posting publicly are aware that these are open to the world and thus will not post private information like photos of their kids or what they had for breakfast.

Circles allow you to target your posts to specific people, and these are not visible to anyone outside the group (Circle) you specify. This may seem to be similar to FB but it is not. The list of people in your circles is unique to you. Thus you could have a circle called Close Friends and have 5 people in that circle. One of those 5 people may also have a circle called Close Friends and it may have 15 people in it. You may not be in that circle. These asymmetric circles can be confusing but allow for great autonomy in targeting your posts and filtering your stream. The ability to mention specific people in posts allows you to include them in the conversation in a granular manner.

Create Circles based on you interest or projects

Now you can target your posts to those circles or keep them Public

You can filter your information stream using your circles and notification settings

Google+ allows you to share a circle. Thus if you have collected a group of people with interest in HDR photography from across the world you can share it with other users.

The consequence of these differences are:

You are more likely to connect with people you DO NOT KNOW on Google+ compared to FB. In this way it is a bit like Twitter.
You are more likely to connect with people with similar interests. The shared circles feature is a bit like Twitter lists.
You are less likely to see uninteresting or irrelevant content on Google+ especially things that you feel people should have shared with a fewer folks.
Due to the ability to filter your feeds and adjust your notifications (in a very easy manner) you feel in control of your information stream.

Ladies and Gentlemen, Please Silence your Cameras!

2012-08-30T18:08:00.003-04:00

We should have expected this, it was just bound to happen. But when it came, it still took many aback.

I am talking about the use of smartphone cameras to capture speaker slides during presentations. I recently attended the AMEE 2012 meeting and noticed a large segment of the audience taking endless photos during presentations. They took multiple photos of one slide either because the shot was not focused or the speaker was building the sliding via animation and they missed some bullet points.

Personally I have no problem with this practice. I have been doing this myself in a limited manner using my Motorola Xoom tablet and Evernote. The problem is that people are forgetting to mute their cameras and can be irritating and distracting to the people around them. When many people start taking multiple photos, the issue can be quite serious.

At one session one of the audience members got so upset that she got up and asked everyone to silence their cameras. I expect that presenters will soon be adding something on their first slide to ask the audience to silence their cameras.

Hidden Curriculum in Medical Schools - Are we teaching what we want students to learn?

2012-08-18T10:09:00.000-04:00

We all know that

The amount of information is increasing rapidly
The 1/2 life of knowledge is shrinking - what we knew few years back does not hold true anymore.

As Alvin Toffler said,

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn. ”

Once our students leave the formal education settings of medical school, they will have to learn how to keep up with literature and new advances on their own. Thus medical educators want to teach students how to become self-motivated self-directed lifelong learners.

The hidden curriculum is the unintended lesson/s, usually about norms, values, beliefs or behaviors, learned during a learning experience. Thus in medical schools students are taught a particular way to communicate with patients. When students see health care practitioners interact with their patients differently, they get a different message.

One of the biggest hidden curricula is the way students are expected to learn in medical schools. Traditionally, they are expected to attend lectures and seminar, show up in clinical rotations and have information delivered to them, drilled into their heads. [A number of medical schools are trying to break out of this mold]. These students get the unintended message that someone else is taking the responsibility for their learning. This hidden message is more powerful than the intended message for their need to be self-directed learners.

To truly help students become the independent, self-directed learners we want them to be, schools need to reform the way they educate. Instead of large lecture halls, early in the training the students need to learn how to look up and find information to solve problems. Students can learn individually or in small groups (e.g. Problem based learning and Team based learning).Passive learning should be avoided. This will create a hidden curriculum that will help our students learn the only useful lesson we can teach!

What medical educators can learn from the car industry

2012-08-17T14:08:00.000-04:00

Formative and Summative Feedback

Formative feedback - that is the ongoing, near real time, specific, non judgmental feedbak - is critical to learning and helping change behavior [Ref]. Unfortunately medical educators have for too long used only summative feedback for assessing medical students - you know the end of rotation grades, the USMLE scores etc.

Part of the problem is that faculty and preceptors are the ones who need to provide this feedback as they work with students on a daily basis. But they are unaware of the need for such feedback or are not trained to provide it or unable to provide it for logistic reasons. Clerkship directors meet with the students only infrequently and do not have such feedback to review and share with the students. They often have comments like "Excellent" or "Great presentation" or "needs to work on presentation skills" which is not specific or helpful.

How can we train our faculty in giving useful formative feedback? Since most faculty members went through traditional medical school programs and did not receive much formative feedback, they may not be aware of what it is and the importance of giving this. A metaphor we can use is something we see almost daily and comes from the car industry. [For some interesting reading on this see the National Renewable Energy Laboratory Report (pdf) by Gonder et al]

Learning Objective: Learn to drive in a way that improves fuel efficiency.

Cars now give immediate and constant feedback to the driver regarding the rate of fuel consumption as miles per gallon. This is visible on a visual scale next to the odometer. It also shows a color indication in a ring around the speedometer (e.g. green if driving at optimal speed and acceleration). This is an excellent example of formative feedback and can lead to correction in behavior.

Cars also provide an average fuel consumption for a particular duration, and can be reset by the user. In most cases it is reset on refilling the fuel tank. Looking at this at the time of refueling gives the driver summative feedback on their performance for that duration. If the number is low, it should not come as a surprise to the driver who has been getting constant feedback and has failed to change behavior. The driver has control over how she/he chooses to drive.

While drivers can choose to ignore the feedback, in case of students, they come to a medical school to become good physicians. They want to get such feedback and to constantly improve. Using this metaphor hopefully we can train our faculty to provide more useful, timely, non judgmental feedback. One hopes this will lead to them spending more time in helping all our students become better physicians and less time comparing and ranking them.

If the car industry can understand this, why not medical educators?

My Gold Medal Goes to....

2012-08-06T11:28:00.001-04:00

Achievements in Olympics reflect huge sacrifices, long years of training and planning and performing under high pressure in front of a global audience. The feats of these athletes serve as inspiration for us common mortals and help to hopefully unite the world.

While the London Olympics are underway, something even more difficult than any individual or team performance and more awe inspiring just took place - the landing of a huge rover on Mars using a maneuver never used before after 7 minutes of terror. Here is a video explaining the difficult procedure.

Very early this morning (EST) Curiosity landed successfully on the surface of Mars and sent back its first images. The world cheered but the video of the NASA team watching with bated breath and then their emotions when they got the good news brought tears to my eyes.

Without belittling the performance of the athletes, if I had to give a gold medal it would easily go to the NASA team for their amazing work in the face of budget cuts and political uncertainties. Congratulations NASA!

This post was prompted by an online conversation on Google+ with @Brad Gill one of the many brilliant students to come out of our medical school.

The Olympics: Hunger Games or Human Games?

2012-08-04T12:52:00.001-04:00

Following the Olympics has been a emotional roller-coaster of a journey and has led to a lot of soul searching.
There have been some amazing moments - with Michel Phelps getting probably the most press - coming fourth in one event, missing gold by .05 seconds in another, winning the most ever Olympic medals along the way..
Watching the US athletes on the podium listening to the "Star Spangled Banner" invariably brought tears to the eyes. Serena unleashing a powerful performance in the finals to win 6-0, 6-1 was jaw dropping. The US flag was not there - blown away by a gust of wind at Wimbledon - bringing much needed humor at a solemn moment.

Image linked from http://theybf.com/category/sports

Along the journey something kept bothering me. Seeing young teens competing in individual events carrying the hopes and expectations of their family, friends, schoolmates, their country on their young shoulders. Watching a 15 year old Katie Ledecky blowing away a super strong field in the 800 meter freestyle and 17 year old Missy winning multiple events in swimming was a celebration of youth. The tears of 17 year old Victoria Komova on losing the gold in the individual all around (she won the silver) showed the incredible pressure on these young shoulders. The 16 year old Chinese sensation Ye Shiwen forced to defend herself against allegations of using performance-enhancing drugs because she has improved dramatically over the last year. Then the image of a Canadian trampoliner going from shock to breaking out in smile when her Chinese competitor fell at the end of her routine realizing she had won the gold with that spill. The latter reportedly declined to wear her bronze medal. These young athletes are damned if they win and damned if they nearly win and damned if they don't win. All this under the microscope of social media and 360 degree 24-7 fast news coverage. These scenes reminded me eerily of the Hunger Games. As we celebrate the champions, do we hear the stories of all the people who did not make it, who were proud to just compete, to try, to give it their all, their sacrifices, their heart breaks? Are they learning the right lessons, is the Olympic movement working, is the Olympics spirit alive and well?

And then I reflect on the following images and my faith is restored:

Jordyn Weiber crying her heart out on missing out competing in the individual all-around event and then coming back to cheer her team mates on in the event she missed.
Margot Shumway in the women's double sculls learning a new sport so she could get to the Olympics and coming from behind to make it to the A Finals with her mother in the audience - fighting lung cancer - making it to London to watch her daughter between 2 rounds of chemo
Oscar Pistorius a double amputee who had an epic struggle to get accepted to the Olympics because folks thought the "blades" gave him an "unfair" advantage. He was just happy to be able to compete. His mother wrote in a letter for him to read as an adult, ""The real loser is never the person who crosses the finishing line last,'' she wrote. "The real loser is the person who sits on the side, the person who does not even try to compete.''
[From http://sportsillustrated.cnn.com/2012/olympics/wires/08/04/2090.ap.oly.john.leicester.040812/index.html#ixzz22bTuSQQM].

They don't need medals, they don't need their photos on cereal boxes. But we need their stories to be told just as loudly and frequently and proudly as those of the medal winners. Once we do that, the Olympics will truly be the Human Games instead of being the Hunger Games!

Au Revoir Dear Friend

2012-07-10T22:10:00.002-04:00

I never had a pet before, I thought dogs were not worth the trouble
I did not want to wake up early to take you for a walk
I did not want to pick up after you when you went on a lawn
I wondered if having you meant we could not travel any more
I thought you would bring in fleas and shed on my carpet
I assumed you would bark when I was trying to sleep
I worried you would nip my child and gnaw on the furniture
Still I loved my daughter and wife too much so I reluctantly said yes

I was never so wrong in my life

The innocence of those bright eyes, the boundless joy of that wagging tail
A reward for a long day at work
You were my daughter's pillow, her best friend as you grew up together
The selfless love, the trusting companionship made it all worthwhile.

As the lymphoma ravaged your body,
Your eyes told us you wanted to go
With dignity and peace at home on the front porch
On a beautiful sunlight eve, among all the scents that you loved
One last car ride to the funeral home

Au Revoir dear friend, You changed my heart!
A lasting lesson not to prejudge anyone again.

I will miss not having to worry about stepping on you when I get up in the dark
I will miss having to comfort you during the next thunderstorm
I will miss those Border Collie eyes tracking my every move
I will miss your whine and whimper when my pager goes off
I will miss racing you up the stairs - I never did get to beat you till you got ill
I will miss how you chased the deer and geese knowing you could never catch them anyway
I will miss the long walks around the soccer fields

It was all worth while
I was never so wrong in my life, except
You did shed, but now that you are gone,
I don't want to vacuum those last memories from the carpet....

A day later....

But hark, what is this?
A lightening of the heart, a lifting of the gloom
This presence besides me
Of course, you will always be with us,
How did I assume you would ever leave us for long
How did I misjudge you again?
I was never so wrong in my life!