APA Citation

Abstract

Grajales III, F. J., Sheps, S., Ho, K., Novak-Lauscher, H., &
Eysenbach, G. (2014). Social media: A review and tutorial of
applications in medicine and health care. Journal of Medical
Internet Research, 16(2), e13.
doi: 10.2196/jmir.2912

Background
Social media are dynamic and interactive computer-mediated communication tools that have high penetration rates in
the general population in high-income and middle-income countries. However, in medicine and health care, a large
number of stakeholders (eg, clinicians, administrators, professional colleges, academic institutions, ministries of
health, among others) are unaware of social medias relevance, potential applications in their day-to-day activities, as
well as the inherent risks and how these may be attenuated and mitigated.
Objective
We conducted a narrative review with the aim to present case studies that illustrate how, where, and why social media
are being used in the medical and health care sectors.
Methods
Using a critical-interpretivist framework, we used qualitative methods to synthesize the impact and illustrate, explain,
and provide contextual knowledge of the applications and potential implementations of social media in medicine and
health care. Both traditional (eg, peer-reviewed) and nontraditional (eg, policies, case studies, and social media
content) sources were used, in addition to an environmental scan (using Google and Bing Web searches) of resources.
Results
We reviewed, evaluated, and synthesized 76 articles, 44 websites, and 11 policies/reports. Results and case studies are
presented according to 10 different categories of social media: (1) blogs (eg, WordPress), (2) microblogs (eg, Twitter),
(3) social networking sites (eg, Facebook), (4) professional networking sites (eg, LinkedIn, Sermo), (5) thematic
networking sites (eg, 23andMe), (6) wikis (eg, Wikipedia), (7) mashups (eg, HealthMap), (8) collaborative filtering
sites (eg, Digg), (9) media sharing sites (eg, YouTube, Slideshare), and others (eg, SecondLife). Four
recommendations are provided and explained for stakeholders wishing to engage with social media while attenuating
risk: (1) maintain professionalism at all times, (2) be authentic, have fun, and do not be afraid, (3) ask for help, and (4)
focus, grab attention, and engage.
Conclusions
The role of social media in the medical and health care sectors is far reaching, and many questions in terms of
governance, ethics, professionalism, privacy, confidentiality, and information quality remain unanswered. By
following the guidelines presented, professionals have a starting point to engage with social media in a safe and ethical
manner. Future research will be required to understand the synergies between social media and evidence-based
practice, as well as develop institutional policies that benefit patients, clinicians, public health practitioners, and
industry alike.

Theoretical
Framework

Methods

Measures

Reliability

Validity

Findings

defines blogs, microblogs, (Twitter), social

networking, wikis, mashups, collaborative
none
filtering, media sharing sites and their roles
qualitative
mentioned;
in medicine - mostly clinical but also
explanation
none
subject to
education;
of impact and
mentioned;
critical
problems
discussion centers on problems surrounding
contextual
subject to
interpretevist Qualitative
with
ethics, professionalism, privacy and
knowledge;
problems of
theory; social narrative
instrument,
confidentiality, especially in the clinical
mix of
content and
learning
review
data
arena;take home findings are centered on
sources
criteriontheories
processing
need for standards when using these in the
(traditional
related
and
clinical environment;
and nonvalidity
observer
suggests implications - maintain
traditional)
reliability
professionalism, authenticity, engagement,
and dragonfly model - focus, grab attention,
engage, and take action

Overall critique

Bigger Picture

Qualitative narrative review good for

some history and basic information on
General descriptions of the
the types of social media being used.
most common forms of
Given the nature of the subject, in 2
social media, as well as a
years, much of the general discussion
discussion on
is outdated. In addition, this article
professionalism, ethics,
focuses more on the use for clinical
privacy and confidentiality.
care rather than direct educational
use.

Chapman, C., White, C. B., Engleberg, C., Fantone, J. C., &

Cinti, S. K. (2011). Developing a fully online course for senior
medical students.Medical Education Online, 16(5733). doi:
10.3402/meo.v16i0.5733

In 2002 the University of Michigan Medical School created a one-month course in advanced medical therapeutics
(AMT). All senior medical students were required to complete the course. To provide some flexibility for students
who were interviewing for residency positions the AMT course was created using a distance-learning model, and in
the 2008 2009 academic year it was offered in a fully online format. The components of the course are weekly casebased modules, a weekly online seminar, quizzes based on modules and seminars, and a research project based on a
therapeutic question. The paper discusses the development and components of the AMT course, a survey of fourthyear medical students who participated in the course between 2007 and 2010, and how the course evolved over three
years.

Web-based learning methods are being used increasingly to teach core curriculum in medical school clerkships, but
few studies have compared the effectiveness of online methods with that of live lectures in teaching the same topics to
students. Boston University School of Medicine has implemented an online, case-based, interactive curriculum using
videos and text to teach delirium to fourth-year medical students during their required 1-month Geriatrics and Home
Medical Care clerkship. A control group of 56 students who received a 1-hour live delirium lecture only was compared
Chao, S. H., Brett, B., Wiecha, J. M., Norton, L. E., & Levine, S.
with 111 intervention group students who completed the online delirium curriculum only. Evaluation consisted of a
A. (2012). Use of an online curriculum to teach delirium to fourthshort-answer test with two cases given as a pre- and posttest to both groups. The total possible maximum test score
year medical students: A comparison with lecture format. Journal
was 34 points, and the lowest possible score was 8 points. Mean pre- and posttest scores were 10.5 4.0 and 12.7
of the American Geriatrics Society, 60(7), 1328-1332.
4.4, respectively, in the intervention group and 9.9 3.5 and 11.2 4.5, respectively, in the control group. The
doi:10.1111/j.1532-5415.2012.04035.x
intervention group had statistically significant improvement between the pre- and posttest scores (2.21-point
difference; P < .001), as did the control group (1.36-point difference; P = .03); the difference in test score improvement
between the two groups was not statistically significant. An interactive case-based online curriculum in delirium is as
effective as a live lecture in teaching delirium, although neither of these educational methods alone produces robust
increases in knowledge.
Introduction: Picture this: You are giving an invited talk at a medical conference. You look out at the audience only to
Chretien, K. C., Yarris, L. M, & Lin, M. (2014). Technology in
seemany people with their heads down, buried in their smartphones or tablets, fingers flying furiously. What is your
graduate medical education: Shifting the paradigm and advancing reaction? For some, it may be annoyance. Why are they here if they are not interested in listening? But for others, it
the field. Journal of Graduate Medical Education, 6(2) 195-196.
might be satisfaction in realizing that their talk is interesting enough to be live-Tweeted (key points distilled into
doi:10.4300/JGME-D-14-00157.1
140-characterlimited messages, shared with the Twitter world). Here, a shift in paradigm highlights the contrast
between the challenges and the opportunities afforded by technology.

none
mentioned;
subject to
problems
with
instrument,
data
processing
and
situational
and testretest
reliability
inter-rater
reliability pre-test &
91%
post-test
agreement
scores;
over
independent t- random
instrumental
test of section sample; no
learning
difference mention of
theories quantitative scores and
reliability
behavioral and
difference
for exam cognitive
scores to
concern of
compare
situational,
control and instrument,
intervention
subject
group
realiability
in this
design
survey after
completion of
the course
using Likert
student
scales; used
Qualitative
engagement;
descriptive
&
online learning
statistics
quantitative
environment
(mean) and
qualitative
report of
survey
answers

social learning
theories and
intstrumental qualitative
learning
theories

editorial

n/a

none
mentioned;
subject to
problems of
content and
criterionrelated
validity

addresses issues of absenteeism; faculty

support for fourth year course; design helps
with flexibility; > 30 faculty collaborated in
a bit oudated but overal good
development; 4 weeks: case-based modules,
description of curricular innovation;
weekly seminars, quizzes, project with peer
data presented is purely survey results
review; 9-14 hours per week (more than
without great methodology, thus weak
expected by students); flexibility was an
asset according to students; concerns about
MCQ format and quiz questions

no mention
different sample sizes; comparing two
of
passive methodologies for teaching;
measurment
samples not well matched; applaud
of validity
differences between pre and post test were
effort to compare two different
for
significant for problem and management
learning strategies as helpful
examinatio
sections and overall in online group;
information to see comparison rather
n; question
lecture group show significance only in
than effectiveness; overall
of content
management group and overall
methodology not strong and
and
generalizability limited as
criterionquestionable design of online modules
related
for student engagement
validity

n/a

example of 4th year online

course with similar content
and how it was developed;
can use lessons here in
development of our course;
gives credence to format with
references supporting online
learning

compared live lecture

(control) to online
curriculum (intervention
group) and found that both
methods are effective, but
not significantly more than
the other and neither led to
substantial knowledge gains
overall; both are more
passive methodologies

strengths of social media include breaking

discussion of advantages of
geographical barriers and promotion of
editorial, so purely opinion but nice
teaching through mobile
interaction and relflection which can be
mini-report on recent lit on the
platforms; "The teachable
used to achieve specific objectives;
subject; last author is well-known and
moment has expanded";
discusses two papers highlighting
respected in the field
addresses potential to reach
technology uses in medical education
hidden curriculum;

Nickson, C. P., & Cadogan, M. D. (2014). Free Open Access

Medical education (FOAM) for the emergency physician.
Emergency Medicine Australasia, 26, 76-83. doi: 10.1111/17426723.12191

Introduction: FOAM is free open-access med(ical ed)ucation.2,3 Assuch, FOAM is a dynamic collection of
resources and tools for lifelong learning in medicine, as well as a community and an ethos. FOAM is continually
evolving and growing rapidly, and from anarchic beginnings is increasingly attracting interest from practicing
clinicians, trainees, educators, researchers and publishers alike. This article defines FOAM, details its development
and considers its role, particularly in relationship to scientific journals, textbooks and medical education as a whole.

Wolf, S. J., Lockspeiser, T. M, Gong, J., & Guiton, G. (2014).

Students' perspectives on the fourth year of medical school: A
mixed-methods analysis. Academic Medicine, 89(4) 602-607.
doi:10.1097/ACM.0000000000000183

Purpose: Little is known about the purpose and value of the fourth year of medical school from the perspective of
medical students. In this study, the authors systematically explored the years purpose and value as determined by
students. Method: In April 2011, the authors conducted semistructured focus groups with graduating fourth-year
students at the University of Colorado School of Medicine to understand their perspectives on the purpose of the
fourth year. Using results of a thematic analysis of the focus group data, the authors developed and administered a 10item questionnaire to all graduating fourth-year medical students in May 2011. Questionnaire data were analyzed
using descriptive statistics and exploratory factor analysis. Results: A total of 17 students participated in two focus
groups. Six themes related to the purpose of the fourth year emerged from the focus group data: career development
and preparation, pursuing personal interests, career identification, exploration of diverse practice settings, influence of
emotion, and flexibility and individualization. The questionnaire was completed by 134 of 148 students (91% response
rate). Factor analysis of the questionnaire data identified five factors: strengthening ones residency application,
developing skills, pursuing personal interests, exploring diverse practice settings, and identifying a career.
Conclusions: Medical students uniformly identified the fourth year of medical school as having purpose and value,
but their views on the fourth years purpose differed. This finding underscores the importance of the individualization
of the fourth year. Students perspectives should inform any decisions made about modifying fourthyear curricula and
structure.

social learning
theories and
intstrumental qualitative
learning
theories

descriptive

semistructured
focus groups
with thematic
analysis of
data;
mixedfollowed by
methods questionnaire
analysis using 4 point
constructivism;
(qualitative likert scale
humanism
&
with
quantitative descriptive
)
statistics and
exploratory
factor
analysis of
data; zeroorder
correlations

n/a

zero-order
correlations
;
Cronbach's
alpha to
assess
reliabilty of
factors

n/a

discusses the role of FOAM in the postpublication analysis, dissemination, and

provides the definition of
discussion of scientific research, with
FOAM and describes its
limitations being number of subscribers;
evolution and role In medical
reports on variable degree of scholarship;
education compared to
purely descriptive of the FOAM
discusses role of FOAM and traditional
standard texts and literature;
movement and ideas; no methodology
medical text - text is still needed for
more importantly
or structured lit review
foundational knowledge; describes 10 steps
differentiates FOAM as a
to get involved
concept and philosophy from
FOAM should serve as adjunct to MedED social media as the
easily used in flipped class and
technology that houses it
asynchronous learning;

triangulaito
n of data
from
multiple
17 students in focus groups with 6 themes
focus
related to purpose of year: career
groups,
development & prep, pursuing personal
analysts,
interest, career idenitification, exploration
and
of diverse practice settings, influence of
perspective emotion, flexibility & individualization;
s134 of 138 questionnaires with factor
including
analysis finding 5 factors: strengthening
educational residency application, developing skills,
researchere
pursuing personal interests, exploring
s and
diverse practice settings, identifying a
clinical
career
educators;
zero-order
correlations

small numbers for focus groups but

highlights the need for
did attempt some randomization;
flexibility and
overall methodology was sound;
individualization options in
question generalizability as student the fourth year and earlier; perspectives are influenced by the
students identified value in
first 3 years of experience in medical fourth year but the purpose
school and this is a single-institution varies; this differs in those
study; students older and less diverse
who know specialty and
than national average; would want to
those who don't;
see a multi-institutional study; first to
findings should guide
examine this topic;
curricular reform

Cosgrove, E. M., Ryan, M. J., & Wenrich, M. D. (2014).

Empowering fourth-year medical students: The value of the
senior year. Academic Medicine, 89(4), 533-535.
doi:10.1097/ACM.0000000000000191

In this issue of Academic Medicine, Wolf et al explore the purposes and value of the senior year of medical school as
viewed by graduating students at their institution. Using data from student focus groups and questionnaires, they report
that students all found there to be significant value in but identified different purposes for the fourth year. The authors
of this commentary believe that study adds to the discussion of fourth-year curriculum reform an important voice that
has been lackingthat of students. Previous articles focusing on the perceived lack of clarity of educational purpose in
the senior year curriculum have reflected a faculty perspective and have led some to call for increasing the structure of,
decreasing the elective time in, or even completely eliminating the fourth year. In this commentary, the authors ask for
a pause in this debate to consider the implications of the student perspective as well as important trends in the medical
education continuum that affect the senior student (e.g., milestones that will set new expectations for first-year
residents, increasing pressure associated with matching to a residency). They propose that providing students with time
for career exploration and for focusing on areas of interest would allow them to individualize their preparation for
residency and to be more sure of their career choices. They share the University of Washington School of Medicines
planned new fourth-year approach as an example of a flexible, individualized senior year curriculum.

Bahner, D. P., Adkins, E., Patel, N., Donley, C., Nagel, R., &
Kman, N. E. (2012). How we use social media to supplement a
novel curriculum in medical education. Medical Teacher, 34(6),
439-444. doi:10.3109/0142159X.2012.668245

Background: The millennial learner is reliant on technology to gain knowledge. Social media in the form of Twitter
and Facebook provide a unique way to reach these learners.
Aims: To demonstrate a supplement to a curriculum using push technology via Twitter and Facebook to deliver
educational content to mobile devices.
Methods: A curriculum consisting of high-yield ultrasound concepts was developed and posted to Twitter
@EDUltrasound daily. Followers received tweets pushed directly to their mobile devices. Following the year-long
program, followers were surveyed regarding the programs effectiveness. To determine the ways in which tweets were
reaching users, followers were categorized demographically.
Results: Daily tweets were posted each morning beginning on July 1, 2010. By the end of the year, there were 87
followers on Twitter and 78 on Facebook. The majority of followers (55.6%) had not previously used Twitter. The
majority of followers (88.9%) found Twitter user-friendly, while most (81.5%) found the information useful.
Conclusions: Due to ease of use and widespread applicability, Twitter and Facebook are excellent applications of
push technology as a means to deliver educational content. This pilot project demonstrates the potential of social
media to both supplement and enhance traditional educational methods.

cognitivism editorial/co
n/a - editorial
and humanism mmentary

experiential
learning

survey with
limited
qualitative;
statiscial
descriptive
analysis;
of edu
reported
technology
some
innovation
descriptive
statistics

n/a

n/a

discussion on the implications of and a

survey of student perspectives of utility of
the fourth year; no structure or defined
outcomes for MS4 except need for Step 2
and obtaining a residency; PROS:
developing confidence in knowledge base;
team dynamics, professionalism; time for
commentary so is just opinion,
career decisions, global health, research;
however serves as nice discussion and
CONS more time and money without
mini report of other published
defined objectives/outcomes; fourth year is
perspectives and insight into UW
meaningful; UW curriculum purposes:
curriculum
preparation for residency clinical demands
through increased independence &
responsibility; career choices; time for Step
2 and applications/interviews; time for
exploration of specialty; discovery of
varying practice settings; service learning; 7
mos of increased time

call for a reconsideration of

the importance of fourth year
in light of competency and
milestone movement and
need to achieve goals and
transition to residency; call
for flexibility, "exploration
and focus"

social media definition - two way

none
conversation;
no
limited number of surveys to diverse
mentioned; Discussed technologies - twitter, twuffer,
example of Twitter as push
mention;
population; difficult to assess as true
subject to
hootsuite, bit.ly, twitpic and facebook;
technology to supplement
no rigor to
supplement to the course curriculum;
problems of
curriculum pushed daily; divided into
and enhance traditional
survey
no mention of reliability or validity in
content and
monthly topics as supplement to
educational methods;
design or
their survey design or
criterionlongitudinal course (online modules,
good description of social
statistical
implementation; mostly useful only as
related
synchronous didactics, hands on scanning,
media and background
reporting
descition of curricular innovation
validity
clinical work)

Purpose
To identify expert recommendations and examples of programs that could be incorporated into curricular renewal of
the fourth year of medical school.
Method
In 2009, the authors searched the relevant literature published from 1974 to 2009 using PubMed; they then searched
bibliographies and related articles. They consulted clerkship and residency program directors at their institution and
accessed recommendations from national organizations.
Results
Of the 66 publications reviewed, 40 focused on aspects of fourth-year education and 26 included the fourth year in
general reviews. Long-standing concerns included clarifying the purpose of the year, the optimal type and organization
Walling, A., & Merando, A. (2010). The fourth year of medical
of courses, and academic quality of courses. Specific concerns included excessive focus on securing residency
education: A literature review. Academic Medicine, 85(11) 1698positions (preresidency syndrome), uncertainty about the optimal ratio of required and elective courses, and grade
1704. doi:10.1097/ACM.0b013e3181f52dc6
inflation.
Conclusions
Despite representing a substantial proportion of the student experience, the fourth year has received significantly less
attention than other phases of the curriculum. The authors conclude that goals for the year should be clarified, reflect
the mission of the school, and be designed to both complete the medical school experience and facilitate the transition
to residency. Schools should decide the types of courses and organization of the year based on these goals.
Organizational strategies for the fourth year should incorporate the requirements of the United States Medical
Licensing Examination examinations and the residency application process. Fourth-year curricula and their constituent
courses should be well designed and stringently evaluated to ensure educational goals are met and appropriate grades
awarded.
INTRODUCTION
For health professions learners of all levels, staying abreast of the literature can seem like an insurmountable task as
the number of clinically oriented articles continues to grow at an increasing rate.1,2 Fortunately, there has been a
veritable explosion of online secondary resources that endeavor to digest the expanding medical literature and present
it in a format that is optimized for adult learners. Particularly in emergency medicine, these resources have been
Thoma, B., Joshi, N. Trueger, S., Chan, T. M., & Lin, M. (2014).
dubbed free open access medical education, also known as free open access meducation (FOAM).3 The FOAM
Five strategies to effectively use online resources in emergency
movement has figured prominently in the proliferation of blogs and podcasts made available online by practicing
medicine. Annals of Emegency Medicine, 64(4) 392-395.
clinicians.3,4 As an unintended consequence, learners must now contend with an exponentially expanding library of
doi:10.1016/j.annemergmed.2014.05.029
both primary literature and secondary online resources. To make effective use of this stream of knowledge, learners
must filter and choose from myriad resources. Simple digital tools can be used to organize and manage this otherwise
overwhelming amount of information. This article outlines 5 strategies to help learners and practicing physicians stay
abreast of both foundational and cutting-edge literature by using digital solutions. Table 1 provides an overview of
each step.

reflective

literature
review of 66
studies
(mostly
qualitative
studies) - 40
qualitative
on general
4th year
issues and 26
on more
specific 4th
year issues

instrumental
learning
theories qualitative
behavioral and
cognitive

n/a descriptive
paper

no direct
mention;
used
PubMed
and appears
to report on
academic
journals;
state
purpose is
to identify
expert
recommend
ation but no
definition
of expert
provided

n/a

no mention
of specific
criteria of
sources to
be included
in review

n/a

identified concerns include lack of clairity

of purpose the year (either prep for
residency or culminating experience),
course topic and organization (pathways,
literature review methods are weak
accelerated to integrate 4th year with
with no mention of reliabilty or
internship, specialty recs, sepcific courses),
validity of sources or search; no
quality of courses, grade inflation, and
strong recommendations based upon review of recommendations
inpact of residency application process;
review, jut a report of findings and
and possible curriclar
authors recommend clarification of goals to
some weak objectives; general
strategies for fourth year
both address school experience and mission limitations surround most literature in
and facilitation of transition to residency;
this category is single institution
required elements include Step 2 &
qualitative studies or descriptive
application process;
MD school in 2008-09 report abg 22.3
elective weeks in 36 week curriculum

outlines 5 strategies to optimize curation,

organization and consumption of primary
and secondary resources in medicine 1)
RSS - convenient, balance of finding good
content with too much content; 2) podcast
app: user-specifice, as with RSS; 3)
compilations: recommended list; 4) social
networs to connect producers and peers; 5)
custom search engines quality is a primary
concern with online content - lack of peer
review and verified reliability; need for
standards of impact, academic recognition
(e.g. Social media Index).

purely descriptive of one group's

strategy; no methodology or
structured lit review

brief discussion of
emergence of FOAM and
problms therein: strategies
may be useful as method for
determining content during
module design

Background
Various continuing medical education (CME) options are available for general practitioners (GPs). These options
differ in their clinical effectiveness and GPs preferences for learning format. We report on a national survey,
conducted by NPS MedicineWise, identifying Australian GPs preferences for CME.
Methods
A stratified random sample of 2500 GPs in Australia participated in the survey in 2012. Reponses to the questions on
GPs preferences for CME activities and motivation for choice were analysed.
Yee, M., Simpson-Young, V., Paton, R., & Zuo, Y. (2014). How
Results
do GPs want to learn in the digital era? Australian Family
Most GPs (95%) preferred learning in a group rather than on their own. Specifically, 83% preferred face-to-face
Physician, 43(6), 399-402.
lecture-based formats; 70% preferred interactive group discussions; 66% preferred one-to-one learning with an expert;
and 55% preferred online self-education. Relevance to clinical practice was the key motivation for participation (80%).
Discussion
Although GPs are increasingly using online learning, conventional face-toface activities with peers and experts remain
popular. Lecture-based CME continues to be preferred, despite evidence suggesting other modalities may be more
effective. CME activities delivered through a combination of methods are likely to appeal to the wide range of GP
preferences while optimising clinical outcomes.
Keywords general practice; education, medical, continuing; empirical research

Harden, R. M. (2008). Death by PowerPointThe need for a

fidget index. Medical Teacher, 30(9-10), 833-835.
doi:10.1080/01421590802307743

PowerPoint is an application designed to help the speaker or lecturer assemble professional looking slides to be used in
oral presentations. The result sadly is often an unending stream of slides with bullet lists, animations that obscure
rather than clarify the point and cartoons that distract from rather than convey the message. This paper examines what
the speaker can do to avoid death by PowerPoint. The options of an alternative communication format or an
alternative presentation tool are considered. For most speakers, however, the problem is not with PowerPoint but with
how they make use of it. Three approaches to making presentations using PowerPoint are described which should
yield rich rewards and a more attentive and appreciative audience.

2012 survey
with
stratrified
random
sample ;
sample size =
10% of
national GP
workfoce;
684 surveys
returns; paper
95% preferred group learning; 83%
and web
preferred face-to-face lecture-based
survey, australian population; no
social learning
surveys formats; 70% preferred interactive group mention of reliabilty validity or other
theories and
slected
discussions; 66% preferred one-to-one
survey design; did not differentiate
intstrumental quantitative
no mention no mention
preference
learning with an expert; and 55% preferred
between interactive and nonlearning
for type of
online self-education. Relevance to clinical
interactive group learning with a
theories
CME activity
practice was the key motivator; 1/3 group
speaker
and delivery
<45 while 2/3 45-64
mode;
analyzed via
SPSS; chisquare to
examine
differences
between GP
characteristic
s and GP
preferences
multimedia
learning
theory;
instructional
design

editorial/co
mmentary

n/a

n/a

n/a

Samauri sword analogy; Meo 2008

reference about physiology study; 3 tips:
analog first, then slides with mayers
pricniples, then new techniques

demonstrating the need for

lecture technology due to
popularity of face-to-face
activities; interative styles
maximize clinical
effectiveness; use
combination of methods;
online and face-to-face are
additive

commentary, so no scientific rigor but discusses the paradigm shift

presents a similar and supporting
of ppt and mentions Mayers
argument with several good resources
principles

Yue, C., Kim, J., Ogawa, R., Stark, E., & Kim, S. (2013).
Applying the cognitive theory of multimedia learning: An
analysis of medical animations. Medical Education, 47(4), 375387. doi:10.1111/medu.12090

CONTEXT Instructional animations play prominent role in medical education, but the degree to which these teaching
tools followempirically established learning principles, such as those outlined in the cognitive theory of multimedia
learning (CTML), is unknown. These principles provide guidelines for designing animations in a way that promotes
optimal cognitive processing and facilitates learning, but the application of these learning principles in current
animations has not yet been investigated. A large-scale review of existing educational tools in the context of this
theoretical framework is necessary to examine if and how instructional medical animations adhere to these principles
and where improvements can be made.
METHODS We conducted a comprehensive review of instructional animations in the health sciences domain and
examined whether these animations met the three main goals of CTML: managing essential processing; minimising
extraneous processing, and facilitating generative processing. We also identified areas for pedagogical improvement.
Through Google keyword searches, we identified 4455 medical animations for review. After the application of
exclusion criteria, 860 animations from 20 developers were retained. We randomly sampled and reviewed 50% of the
identified animations.
RESULTS Many animations did not follow the recommended multimedia learning principles, particularly those that
support the management of essential processing. We also noted an excess of extraneous visual and auditory elements
and few opportunities for learner interactivity.
CONCLUSIONS Many unrealised opportunities exist for improving the efficacy of animations as learning tools in
medical education; instructors can look to effective examples to select or design animations that incorporate the
established principles of CTML.

cognitive
theory of
multimedia
learning

mixed
methods

Google
keyword
searches to
identify
animations to
review
(randomly
sampled 50%
of an
identified 860
animations
from 20
developers);
Excel &
SPSS;
descriptive
stats

inter-rater
many animations did not follow
following MML theories
reliability
recommended principles, especially
should not be isolated to
addressed
management of essential processing; excess
slide design. In today's
via a
visual and auditory elements; few
technology-driven society,
random
opportunities for learner interactivity;
educators should be adhering
10% of
animations adhered to average of 4.2
to evidence when designing
animations
principles - half of core principles
solid methods for searching and
materials to maximize the
being
no mention
examined; pre-training principles least
coding; good theoretical framework;
learner processing and
recoded by
implemented (7.7%); 17.4% adhered to
provided idea for future study
chance of retention. Missed
two
modality with voice + image; 32 % violated
opportunities for managing
reviewers;
coherence principle and 54% violated
essential processing and high
alpha coeff
redundancy principle; signaling adopted to
percentage that could trigger
0.82 with
a limted degree; temporal and spatial
cognitive overload through
high level
contiguity adopted much more (77 and
lack of coherence or
of
92%)
redundancy
consistency

Issa, N., Schuller, M., Santacaterina, S., Shapiro, M., Wang, E.,
Mayer, R. E., & DaRosa, D. A. (2011). Applying multimedia
design principles enhances learning in medical education.
Medical Education, 45(8), 818-826. doi:10.1111/j.13652923.2011.03988.

CONTEXT The Association of American Medical Colleges Institute for Improving Medical Educations report
entitled Effective Use of Educational Technology called on researchers to study the effectiveness of multimedia
design principles. These principles were empirically shown to result in superior learning when used with college
students in laboratory studies, but have not been studied with undergraduate medical students as participants.
METHODS A pre-test post-test control group design was used, in which the traditionallearning group received a
lecture on shock using traditionally designed slides and the modified-design group received the same lecture using
slides modified in accord with Mayers principles of multimedia design. Participants included Year 3 medical students
at a private, midwestern medical school progressing through their surgery clerkship during the academic year
20092010. The medical school divides students into four groups; each group attends the surgery clerkship during one
of the four quarters of the academic year. Students in the second and third quarters served as the modified-design
group (n = 91) and students in the fourth-quarter clerkship served as the traditional-design group (n = 39).
RESULTS Both student cohorts had similar levels of pre-lecture knowledge. Both groups showed significant
improvements in retention (p < 0.0001), transfer (p < 0.05) and total scores (p < 0.0001) between the pre- and
posttests. Repeated-measures ANOVA analysis showed statistically significant greater improvements in retention (F =
10.2, p = 0.0016) and total scores (F = 7.13, p = 0.0081) for those students instructed using principles of multimedia
design compared with those instructed using the traditional design.
CONCLUSIONS Multimedia design principles are easy to implement and result in improved short-term retention
among medical students, but empirical research is still needed to determine how these principles affect transfer of
learning. Further research on applying the principles of multimedia design to medical education is needed to verify the
impact it has on the long-term learning of medical students, as well as its impact on other forms of multimedia
instructional programmes used in the education of medical students.

cognitive
theory of
multimedia
learning

pre-test &
post-test (10
open-ended
that pre-testpost-test improvements in
questions)
retention and
scores
content
total scores were greater for those students
evaluating
validity
instructed
retention,
addressed using the modified lecture design than for
inter-rater
transfer and
using
those
reliability
quantitative total score
experts in
instructed using the traditional lecture
addressed with
the field for
design;
93-96%
descriptive
review and
Differences between the groups in prestatistics
revision of
testpost-test
(mean & SD)
test items
improvements on transfer did not reach
and repeated
statistical
measures
significance.
ANOVA
score

well conducted study addressing my

exact topic and argument; additional
non-related lecture in between
contecnt and post-test may have
caused unnecessary overload
affecting the results

improved short term

retention and total scores
with excellent discussion on
theory and the use of
prnciples in medical
education; also brings up
2007 AAMC report which I
will reference in my paper adds importance to my
argument

OBJECTIVES In line with a recent report entitled Effective Use of Educational Technology in Medical Education
from the Association of American Medical Colleges Institute for Improving Medical Education (AAMC-IME), this
study examined whether revising a medical lecture based on evidence-based principles of multimedia design would
lead to improved long-term transfer and retention in Year 3 medical students. A previous study yielded positive effects
on an immediate retention test, but did not investigate long-term effects.
METHODS In a pre-test post-test control design, a cohort of 37 Year 3 medical students at a private, midwestern
medical school received a bullet point-based PowerPoint lecture on shock developed by the instructor as part of their
Issa, N., Mayer, R. E., Schuller, M., Wang, E., Shapiro, M. B., &
core curriculum (the traditional condition group). Another cohort of 43 similar medical students received a lecture
DaRosa, D. A. (2013). Teaching for understanding in medical
covering identical content using slides redesigned according to Mayers evidence-based principles of multimedia
classrooms using multimedia design principles. Medical
design (the modified condition group).
Education, 47(4), 388-396. doi:10.1111/medu.12127
RESULTS Findings showed that the modified condition group significantly outscored the traditional condition group
on delayed tests of transfer given 1 week (d = 0.83) and 4 weeks (d = 1.17) after instruction, and on delayed tests of
retention given 1 week (d = 0.83) and 4 weeks (d = 0.79) after instruction. The modified condition group also
significantly outperformed the traditional condition group on immediate tests of retention (d = 1.49) and transfer (d =
0.76).
CONCLUSIONS This study provides the first evidence that applying multimedia design principles to an actual
medical lecture has significant effects on measures of learner understanding (i.e. long-term transfer and long-term
retention). This work reinforces the need to apply the science of learning and instruction in medical education.

Ellaway, R. (2011). Reflecting on multimedia design principles in

medical education. Medical Education, 45(8), 766-767.
doi:10.1111/j.1365-2923.2011.04064.x

none

cognitive
theory of
multimedia
learning

pre-test &
post-test (10
open ended
questions)
inter-rater
descriptive
reliability
statistics
addressed
(means & w Pearson's
SD) and
coefficinets
independent (0.68-0.74);
quantitative
samples t-test internal test
and
stabiity
ANCOVA
using
(differences Cronvach's
in tranfer &
alpha
retention post- (0.66)
test using pretest as
covariate)

cognitive
theory of
multimedia editorial/co
learning and
mmentary
cognitive load
theory

n/a

n/a

content
validity
addressed
modified slides outscored at 1 week and 4 well conducted study addressing my first study with evidence on
using
weeks on tests of transfer, immediate
exact topic and argument; single
outcomes in medical
experts in
retentaion and transfer, and 1 week and 4 institution with single topic and single
education; reinforces
the field for
weeks on tests of retention
lecturer - no generalizability
message
review and
revision of
test items

n/a

provides some follow-up

inquires about the primary intervention - the
short commentary that provides
points and questions to
redesign of the slides - is it process or end insight into questions from "users" of
consider regarding the above
point? Posts a call to researchers to describe this paper; brings up interesting point
articles; provides a good
their interventions; questions that cognitive regarding cognitive load theory; other
argument to include actual
load already low for lectures
arguments are less clear
design tips in the paper

McLaughlin, J. E., Roth, M. T., Glatt, D. M., Gharkholonarehe,

N., Davidson, C. A., Griffin, L. M., . . . Mumper, R. J. (2014).
The flipped classroom: A course redesign to foster learning and
engagement in a health professions school. Academic Medicine,
89(2), 236-243. doi:10.1097/ACM.0000000000000086

Recent calls for educational reform highlight ongoing concerns about the ability of current curricula to equip aspiring
health care professionals with the skills for success. Whereas a wide range of proposed solutions attempt to address
apparent deficiencies in current educational models, a growing body of literature consistently points to the need to
rethink the traditional in-class, lecturebased course model. One such proposal is the flipped classroom, in which
content is offloaded for students to learn on their own, and class time is dedicated to engaging students in studentcentered learning activities, like problem-based learning and inquiry-oriented strategies. In 2012, the authors flipped a
required first-year pharmaceutics course at the University of North Carolina Eshelman School of Pharmacy. They
offloaded all lectures to self-paced online videos and used class time to engage students in active learning exercises. In
this article, the authors describe the philosophy and methodology used to redesign the Basic Pharmaceutics II course
and outline the research they conducted to investigate the resulting outcomes. This article is intended to serve as a
guide to instructors and educational programs seeking to develop, implement, and evaluate innovative and practical
strategies to transform students learning experience. As class attendance, students learning, and the perceived value
of this model all increased following participation in the flipped classroom, the authors conclude that this approach
warrants careful consideration as educators aim to enhance learning, improve outcomes, and fully equip students to
address 21st-century health care needs.

continuous
data
as mean
SD; paired t
tests to
compare pre&
postcourse
survey
responses,
independent
t tests to
compare
cognitive load
quantitative
course
theory
evaluation
responses &
final exam
scores for
2011 & 2012
students, and
Pearson
rho to
investigate
correlations
between
continuous
variables

no direct
mention

no direct
mention

flipped model students more likely to agree

excellent intro with additional
active engagement was encouraged,
literature on alternative techniques;
preparation was necessary, resources were
minimal mention of actual iLAMs
helpful, classroom methods promoted
other than "adapted the iLAMs from
understanding and application, and were
PowerPoint slides used in 2011 and
confident in ability to apply knowledge and
designed them to emphasize only
skills, and that those were relevant to the
critical concepts, information, and
future; also higher attendance;
illustrations.

offloading content and

engaging in activel earning
are more important than
specific methods; good
flipped classroom overview
and the data behind it

The ubiquity of the internet and computer-based technologies has an increasing impact on higher education and the
way students access information for learning. Moreover, there is a paucity of information about the quantitative and
qualitative use of learning media by the current student generation. In this study we systematically analyzed the use of
digital and non-digital learning resources by undergraduate medical students. Daily online surveys and semi structured
Gutmann, J., Khbeck, F., Berberat, P. O., Fischer, M. R.,
interviews were conducted with a cohort of 338 third year medical students enrolled in a general pharmacology course.
Engelhardt, S., & Sarikas, A. (2015). Use of learning media by
Our data demonstrate a predominant use of digital over non-digital learning resources (69 7% vs. 31 7%; p < 0.01)
undergraduate medical students in pharmacology: A prospective
by students. Most used media for learning were lecture slides (26.8 3.0%), apps (22.0 3.7%) and personal notes
cohort study. Plos One, 10 (4) e0122624. doi:10.1371/journal.
(15.5 2.7%), followed by textbooks (> 300 pages) (10.6 3.3%), internet search (7.9 1.6%) and e-learning cases
pone.0122624
(7.6 3.0%). When comparing learning media use of teaching vs. pre-exam self-study periods, textbooks were used
significantly less during selfstudy (-55%; p < 0.01), while exam questions (+334%; p < 0.01) and e-learning cases
(+176%; p < 0.01) were utilized more. Taken together, our study revealed a high prevalence and acceptance of digital
learning resources by undergraduate medical students, in particular mobile applications.
Background: The traditional lecture is used by many residency programs to fulfill the mandate for regular didactic
sessions, despite limited evidence to demonstrate its effectiveness. Active teaching strategies have shown promise in
improving medical knowledge but have been challenging to implement within the constraints of residency training.
We developed and evaluated an innovative structured format for interactive teaching within the residency noon
conference.
Methods: We developed an ACTIVE teaching format structured around the following steps: assemble (A) into groups,
convey (C) learning objectives, teach (T) background information, inquire (I) through cases and questions, verify (V)
understanding, and explain (E) answer choices and educate on the learning points. We conducted a prospective,
Sawatsky, A.P., Berlacher, K., & Granieri, R. (2014). Using an
controlled study of the ACTIVE teaching format versus the standard lecture format, comparing resident satisfaction,
ACTIVE teaching format versus a standard lecture format for
immediate knowledge achievement and long-term knowledge retention. We qualitatively assessed participating faculty
increasing resident interaction and knowledge achievement during
members perspectives on the faculty development efforts and the feasibility of teaching using the ACTIVE format.
noon conference: a prospective, controlled study. BMC Medical
Results: Sixty-nine internal medicine residents participated in the study. Overall, there was an improvement in
Education, 14, 129. doi: 10.1186/1472-6920-14-129
perceived engagement using the ACTIVE teaching format (4.78 vs. 3.80, P < 0.01), with no increase in stress or
decrement in break time. There was an improvement in initial knowledge achievement with the ACTIVE teaching
format (overall absolute score increase of 11%, P = 0.04) and a trend toward improvement in long-term knowledge
retention. Faculty members felt adequately prepared to use the ACTIVE teaching format, and enjoyed teaching with
the ACTIVE teaching format more than the standard lecture.
Conclusions: A structured ACTIVE teaching format improved resident engagement and initial knowledge, and
required minimal resources. The ACTIVE teaching format offers an exciting alternative to the standard lecture for
resident noon conference and is easy to implement.

experiential
learning

adult learning
theories

mixedmethods

aim of this study was to

none
online
most utilized learning resources were
analyze the use and
mentioned; no mention
questionnare
lecture slides (26.8 3.0%), apps (22.0
acceptance of learning
subject to
of
followed by
3.7%) and personal notes (15.5 2.7%),
resources by undergraduate
problems measurment
semifollowed by textbooks > 300 pages (10.6 survey so limitations of self-report;
medical students; lecture
with
of validity ;
structured
3.3%), internet search (7.9 1.6%) and e- choice of 10 items could miss some; slides were the most utilized
instrument, question of
interviews;
learning cases (7.6 3.0%); a predominant study at one institution in Germany learning resource; lecture
data
content and
mean; SD,
use of digital learning resources, suggests
generalizability?
slides by the educators were
processing criterionANOVA,
that the relevance of individual learning
regarded as important
and
related
student's t
resources varied between teaching and selfframework for learning and
observer
validity
test;
study periods of the same course module
guidance for (exam) relevant
reliability
information

mixed
methods

none
mentioned;
5-point likert
subject to
scale surveys,
none
NO difference between perceived
problems
5 question
mentioned;
knowledge gain, lecturer enthusiasm or
with
single institution; faculty delivered
MCQ & semisubject to content appopriateness according to resident
instrument,
control lecture after receiving fac dev
structured
problems of
survey; increased engagement;
data
on the intervention which led to bias;
interview;
content and
improvement in immediate knowledge
processing
small study; raises good points in the
Wilcoxon
criterionretention (absolute score improvement
and
qualitative portion of the study
rank sum test,
related
11%); did not demonstrate an improvement
situational
two-sided tvalidity
in knowledge retention;
and testtest
retest
reliability

active teaching formats

improve enagement and
initial knowledge; only a
trend toward long term
retention; provides additional
background articles on GME
requirements; brings up two
faculty reservations prior to
implementation - concern
about learning it and
concerned about excess time
and about reduction of
content delivered

Professional presentations represent an important and common method of disseminating information, in general, and
research ftndings and methodological, theoretical, and conceptual frameworks, in particular. However, for many
persons, especially beginning researchers and scholars, delivering effective presentations is extremely challenging. As
Skidmore, S. T., Slate, J. R., & Onwuegbuzie, A. J. (2010).
such, professional presentations can be exceedingly anxiety-inducing events. Thus, in this editorial, we provide helpful
Developing effective presentation skills: Evidence-based
evidence-based guidelines to help beginning researchers and scholars reftne their presentation skills. We present
guidelines. Research in the Schools, 17 (2), xxv-xxxvii.
detailed information to readers regarding the components of a quality professional presentation for a variety of
presentation media and audience types, design principles for slide show presentations, and general dress and demeanor
guidelines.
To test the hypothesis that lecturing maximizes learning and course performance, we metaanalyzed 225 studies that
reported data on examination scores or failure rates when comparing student performance in undergraduate science,
technology, engineering, and mathematics (STEM) courses under traditional lecturing versus active learning. The
effect sizes indicate that on average, student performance on examinations and concept inventories increased by 0.47
SDs under active learning (n = 158 studies), and that the odds ratio for failing was 1.95 under traditional lecturing (n
= 67 studies). These results indicate that average examination scores improved by about 6% in active learning
Freeman, S., Eddy, S. L., McDonough, M., Smith, M. K.,
sections, and that students in classes with traditional lecturing were 1.5 times more likely to fail than were students in
Okoroafor, N., Jordt, H., & Wenderoth, M. P. (2014). Active
classes with active learning. Heterogeneity analyses indicated that both results hold across the STEM disciplines,
learning increases student performance in science, engineering,
that active learning increases scores on concept inventories more than on course examinations, and that active learning
and mathematics. Proceedings of the National Academy of
appears effective across all class sizesalthough the greatest effects are in small (n 50) classes. Trim and fill
Sciences, 111(23), 8410-8415.
analyses and fail-safe n calculations suggest that the results are not due to publication bias. The results also appear
robust to variation in the methodological rigor of the included studies, based on the quality of controls over student
quality and instructor identity. This is the largest and most comprehensive metaanalysis of undergraduate STEM
education published to date. The results raise questions about the continued use of traditional lecturing as a control in
research studies, and support active learning as the preferred, empirically validated teaching practice in regular
classrooms.
OBJECTIVE The goal of this paper is to examine how to apply the science of learning to medical education.
SCIENCE OF LEARNING The science of learning is the scientific study of how people learn. Multimedia learning
learning from words and pictures is particularly relevant to medical education. The cognitive theory of multimedia
learning is an information processing explanation of how people learn from words and pictures. It is based on the idea
that people have separate channels for processing words and pictures, that the capacity to process information in
working memory is limited, and that meaningful learning requires appropriate cognitive processing during learning.
Mayer, R. E. (2010). Applying the science of learning to medical
SCIENCE OF INSTRUCTION The science of instruction is the scientific study of how to help people learn. Three
education. Medical education, 44(6), 543-549
important instructional goals are: to reduce extraneous processing (cognitive processing that does not serve an
instructional objective) during learning; to manage essential processing (cognitive processing aimed at representing the
essential material in working memory) during learning, and to foster generative processing (cognitive processing
aimed at making sense of the material) during learning. Nine evidence-based principles for accomplishing these goals
are presented.
CONCLUSIONS Applying the science of learning to medical education can be a fruitful venture that improves
medical instruction and cognitive theory.

cognitive
theory of
multimedia
learning and
cognitive load
theory

editorial

n/a

scores on
identical or
formally
equivalent
examinations,
metaanalysi
concept
constructionist
sinventories,
vs expositionquantitative
or other
centered
review
assessments,
failure rates,
effect sizes,
odds ratio,
heteerogeneit
y analyses

cognitive
theory of
multimedia
learning

editorial

n/a

n/a

no direct
mention

n/a

n/a

no direct
mention

n/a

provides data on number of conferences and

reviews need of large group
reasons to attend; provides utility of
dated - 2010 with conference data 10
lecture-based conferences
academic presentations and introduces the years old; long paper with some data
with statistics, and has a nice
problems with PPT; introduces design
not very useful; overall in line with
review of evidence-based
principles and correlating ppt items; touches
my thinking on the subject
princniples and techniques
on delivery

average exam scores improved by about 6%

in active learning; traditional lecturing
students were 1.5 times more likely to fail;
active learning increases scores on concept
inventories more than exams;

not a med ed study, but is STEM;

promotes active learning;
mataanalysis of studies of wide
variety of active learning methods

active learning is the

preferred, empirically
validated teaching practice in
regular STEM classrooms;
promotes move away from
traditional lecturing

discusses science of learning via CTML and

science of instruction via multimedia
excellent theory explanation
principles; summary of the theoretical
for basis of paper; initiates
background for his theories and brief
discussion on application of
introduction of principles (cohernece,
most of his citations are his own work these theories to medical
signaling, contiguity, pre-training,
education; my paper offers a
segmenting, modality, multimedia,
summary of this, an update
personalization, voice); does proced some
since, and practical tips
quantitative data on his principle research

Lecturing is an essential teaching skill for scientists and health care professionals in pulmonary, critical care, and sleep
medicine. However, fewmedical or scientific educators have received training in contemporary techniques or
technology for large audience presentation. Interactive lecturing outperforms traditional, passive style lecturing in
educational outcomes, and is being increasingly incorporated into large group presentations. Evidence-based
techniques range from the very simple, such as inserting pauses for audience discussion, to more technologically
advanced approaches such as electronic audience response systems. Alternative software platforms such as Prezi can
overcome some of the visual limits that the ubiquitous PowerPoint imposes on complex scientific narratives, and
Lenz, P. H., McCallister, J. W., Luks, A. M., Le, T. T., & Fessler,
newer technology formats can help foster the interactive learning environment. Regardless of the technology,
H. E. (2015). Practical Strategies for Effective Lectures. Annals
adherence to good principles of instructional design, multimedia learning, visualization of quantitative data, and
of American Thoracic Society, 12(4), 561-566.
informational public speaking can improve any lecture. The storyline must be clear, logical, and simplified compared
with how it might be prepared for scientific publication. Succinct outline and summary slides can provide a roadmap
for the audience. Changes of pace, and summaries or other cognitive breaks inserted every 1520 minutes can renew
attention. Graphics that emphasize clear, digestible data graphs or images over tables, and simple, focused tables over
text slides, are more readily absorbed. Text slides should minimize words, using simple fonts in colors that contrast to
a plain background. Adherence to these well-established principles and addition of some new approaches and
technologies will yield an engaging lecture worth attending.
OBJECTIVE. Slideshow presentations are a popular teaching method in undergraduate medical education; however,
there are scant data on determinants of lecture satisfaction. The purpose of this study is to determine which features of
undergraduate medical school radiology lectures are associated with better student evaluations.
MATERIALS AND METHODS. All undergraduate medical school radiology presentations and student evaluations at
the University of Ottawa from January to December 2013 were compiled. A standardized data extraction sheet was
applied by two independent reviewers, including a 10'70 overlap for audit. Student evaluations were reported on a 5point Likert scale from which an overall mean score per lecture was calculated. Correlation coefficients were
Larocque, N., Kenny, S., & McInnes, M. D. (2015). Medical
calculated for continuous variables in relation to mean evaluation score. Student t tests and univariate ANOVAs were
school radiology lectures: What are determinants of lecture
performed for categoric data. Quantitative content analysis of student comments was also undertaken.
satisfaction? American Journal of Roentgenology, 204, 913-918. RESULTS. Sixty-four slideshows by 33 lecturers were analyzed. The overall mean (SD) evaluation score was 4.38
0.30. The strongest positive correlation with mean evaluation score was for type size (r = 0.32; p = 0.01), whereas the
strongest negative association was for number of clinical cases presented (r = -0.32; p = 0.01). No association with
percentage of text slides (r = 0.19; p = 0.14) or mean number of images on an image slide (r = -0.22; p= 0.08) was
identified. Content analysis revealed a moderate positive correlation between percentage of total slides containing text
only and the percentage of positive comments (r =0.31) and a weak correlation between the mean number of images
per image slide and the percentage of negative comments (r = 0.24).
CONCLUSION. Larger type size and a higher proportion of text slides were more favored by medical students.

cognitive
theory of
multimedia
learning;
engaged
learning

cognitive
theory of
multimedia
learning;
cognitive
learning
theories

literature
review

n/a

mean for 5point likert

scale
evaluation - 6
questions;
correlation
coefficients
quantitative
for
descriptive
continuous
variables;
Student t
tests and
univariate
ANOVAs for
categoric data

n/a

n/a

inter-rater
reliability intraclass
correlation
not
coefficienct addressed
and
Cohen's
kappa

discusses the problems with passive lecture

style; reviews practical tips

recommends Prezi or other software

as a way to overcome problems don't agree with that approach; still
discusses good instructional design

provides some counter

arguments for large group
lectures; discusses practical
tips

no assocaiteion with percentage of text

slides or mean number of images on an
addressed inter-rater reliability; single
image slide; moderate positive correlation
provides a counter argument
center study in Canada; retrospective
between percentage of total slides
that students perfer text
study not evaluating the lecture itself containing text and percentage of positive
slides
high confounding variables
comments; weak correltaion between
images and negative comments

The next presentation slide or overhead transparency goes up, and the audience immediately gives it their attention.
Does the audience quickly grasp the main assertion of what is projected? Does the projection actually help the
audience understand and retain the material? If the slides are distributed as sets of notes, do those notes serve the
audience weeks later? If the slide is designed using the traditional phrase headline supported by a bulleted list and is
being used to convey technical material, the answer to all of these questions is "no." For most presenters of technical
material, however, the most pertinent question may be "What other design could I possibly use?" This article
advocates an alternative design that uses a succinct sentence headline supported by visual evidence to meet the
audience's need to understand the technical concepts being presented. This alternative design makes communication
more efficient, memorable, and persuasive, and is much better suited to the presentation of technical material than is
the traditional bullet list format. Shown in Figure 1 is a contrast between this altemative design and the traditional
Alley, M., & Neeley, K. A. (2005). Rethinking the design of
design. In technical presentations, projected slides have become a standard feature. Since PowerPoint was introduced
presentation slides: A case for sentence headlines and visual
by Microsoft in the late 1980s (Wikimedia Foundation 2005), slide designs have become more standardized, in large
evidence. Technical Communication, 52 (4), 417-426.
part because PowerPoint itself is used so pervasively. Experts who follow trends in presentation techniques estimate
that PowerPoint is used to make an estimated 20 to 30 million presentations every day and has between 250 and 400
million users around the globe (Goldstein 2003; Schwartz 2003; Simons 2004; Zielinski 2003). Ideally, welldesigned
slides can emphasize key points, show images too complex to explain in words, and reveal the organization of the
presentation. Unfortunately, the usual design of a phrase headline supported by a bullet list seldom leads to achieving
these ideals. We believe that the shortcomings of this design are particularly significant in technical presentations,
where achieving a clear mental picture of the phenomenon or device being described is often essential to effective
communication. To demonstrate these shortcomings, this article 1. Summarizes the weaknesses of this traditional
design 2. Describes the key features and advantages of the alternative design 3 . Outlines the challenges of adopting
the alternative design 4. Assesses attempts to disseminate this design through lectures, workshops, and the Web
Preparing and delivering a lecture can be an overwhelming experience, especially for first-time lecturers. During their
years as students, practitioners may have observed talented speakers who made presenting and teaching look easy, but
when asked to deliver a presentation themselves, they may quickly realize that the task is not as easy as those
Medinam, M. S., & Avant, N. D. (2015). Developing an effective presenters made it seem. The responsibility to create an effective presentation is important because audience members,
presentation. American Journal of Health-Systems Pharmacy, 72, especially students, are ultimately responsible for learning and retaining the material even if it is delivered poorly. The
1091-1094.
presenter must strive to ensure that students understand what they are expected to know and how they need to know it,
as well as how to connect it to their existing knowledge so that the information is well embedded and easily retrieved
for future use. This article reviews some of the most important issues and challenges to consider when preparing and
delivering a presentation.
The last substantive reform in medical student education followed the Flexner Report, which was written in 1910. In
the ensuing 100 years, the volume of medical knowledge has exploded, the complexity of the health care system has
Prober, C. G.., & Heath, C. (2012). Lecture halls without lectures - grown, pedagogical methods have evolved, and unprecedented opportunities for technological support of learners have
A proposal for medical education. The New England Journal of
become available. Yet students are being taught roughly the same way they were taught when the Wright brothers
Medicine, 366 (18), 1657-1659.
were tinkering at Kitty Hawk. Its time to change the way we educate doctors. Since the hours available in a day have
not increased to accommodate the expanded medical canon, we have only one realistic alternative: make better use of
our students time.

cognitive
theory of
multimedia
learning and
cognitive load
theory

engaged
learning

engaged
learning

editorial

editorial

editorial

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article is 11 years old although does

presents an alternative design to powerpoint
discuss the historical trend of
good references on the
compared to the traditional design;
powerpoint usage and critique;
criticism of powerpoint and
suggestions and challenges on
similarities in the alternative design to proponents of powerpoint;
implementation
current recommended practice.

concise summary of general lecturing for

pharmacists; discusses tips for intro,
objectives, content, active participation,
closing and slide desing

only small section on the actual slide

design with more traditional slide faculty development piece on
design approach and I don't agree
developing presentations
with all recommendations

call to get rid of lectures completely in

useful to highlight the move
medical school and use class time for more short commentary in a well respected to active learning, which still
active learning - utilize the flipped
jounral that provides arguments to
requires the use of lecture
classroom model -which still employs
move away from traditional lecture
and an even bigger need to
online lecture learning.
follow multimedia principles

Brock, S., & Johlekar, Y. (2011). Empowering PowerPoint:

Slides and teaching effectiveness. Interdisciplinary Journal of
Information, Knowledge, and Management 6 , 85-93.

In order to examine the effectiveness of using PowerPoint slides as a teaching aid in the postsecondary classroom, this
exploratory study compared the impact on teaching effectiveness of the number and density of slides, as well as the
use of visuals and other non-textual elements within slides. The number of slides used per session appeared not to
affect effectiveness but lower den sity (3 bullet points and 20 words or less per slide) was associated with
effectiveness. Results for the 10 instructors teaching 17 classes on information management from 2003 to 2009 were
also analyzed by teaching style. Instructors identified as Experts and Facilitators more often used pictures, photos,
charts, graphics, and sound in their slides compared to instructors with other Grasha-Riechman styles. Best practices
for using PowerPoint slides are suggested.

Schmaltz, R. M., & Enstrom, R. (2014). Death to weak

PowerPoint: strategies to create effective visual presentations.
Frontiers in Psychology, 5 (1138), 1-4.

none

Moffett, J. (2015). Twelve Tips for "flipping" the classroom.

Medical Teacher, 37(4) 331-336.

The flipped classroom is a pedagogical model in which the typical lecture and homework elements of a course are
reversed.
The following tips outline the steps involved in making a successful transition to a flipped classroom approach. The
tips are based
on the available literature alongside the authors experience of using the approach in a medical education setting.
Flipping a
classroom has a number of potential benefits, for example increased educatorstudent interaction, but must be planned
and
implemented carefully to support effective learning.

GrashaRiechman
instrument
was used in
classifying
instructor
style; 40
question web
student
survey;
engagement;
qualitative student eit
online learning
inteviews; chi
environment
square
assessed
significance
of difference
between
instructor use
of PPT and
teaching style
cognitive
theory of
multimedia
learning

student
engagement;
online learning
environment

editorial

literature
review

n/a

n/a

no direct
mention

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n/a

no direct
mention

average number of words per slide was 27 excellent lit review of powerpoint use suggests best practices for
over 5.6 bullet points! suggest that the use
to include theoretical background; slide design based upon their
of presentation software such as PowerPoint limited to students in one business
study; in line with Mayer
varies depending on instructors teaching institute in a major Northeastern city
principles; can be used in
styles
in the United States
practical section

n/a

reviews basics of powerpoint, text and font,

animations, videos and images; makes an
excellent point on preparing students for a
change in the slides they are accostomed to

na

useful to highlight the move

not directly related to slide design but
to active learning, which still
describes a tip on investing in the pre-class does make good arguments regarding
requires the use of lecture
activity
active learning and the need for
and an even bigger need to
quality lecture materials;
follow multimedia principles

editorial, however does reference

multiple quality textbooks

excellent summary for use in

the practical section