Dr. Jörg Ansorg • Professional Board of German Surgeons • Luisenstraße 58-59 • 10117 Berlin • Germany
Tel: +49 30/28004-150 • Fax: +49 30/28004-159 • [email protected]
E-Learning, Blended Learning,
Mobile Learning and Beyond
How are classical and new approaches in CME working for surgeons today?
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
16.800
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Professional Board of German Surgeons
• Largest surgical association in Europe
• Strong in surgical training, CME and CPD
• Long-term experience in eCME
• Connected to Europe by the
European Board of Surgeons (EBS)
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Evidence and Needs Assessment of Surgeons in CME
• Low evidence
• Difficulties in measuring behaviour change
• Need for structured studies on practice improvement
Surgical needs
• Learning for the daily practice is most important
• Best didactical approach: theoretical plus hands-on activities
• New procedures are percepted by practical courses and visitation
• Effectiveness of learning due to shortage of time and staff in hospitals
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
eCME Course
Theory & Interaction
Classical CME Workshop
Theory Hands-on
Todays Practice in CME and eCME
Electronic Learning (eCME)
• Courses • Reviews • Taped lectures • Video lessons
Classical CME activities
• Congresses and Seminars • Workshops • Group learning • (self-) assessment
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
CME and eCME in Surgery
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
CME and eCME in Surgery
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
CME by the BDC|Acadamy
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Procedures and video courses
• Lectures and presentations
• text book like courses
• CME certified content
• more than 900 courses online
• www.ecme-center.org
eCME by the BDC|Academy
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Acceptance of eCME in Surgery in Germany and Europe
Source: EBS & EACCME 2013 Source: PBGS 2013
0%
200%
400%
600%
800%
1000%
1200%
German CME and eCME Courses in Surgery (PBGS events only)
CME Events eCME Events
0%
200%
400%
600%
800%
1000%
1200%
European Accreditation of CME in Surgery (EACCME Acreditation by EBS)
CME Events eCME Events
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Declining interest on (pure) eCME
• Reduced learning discipline on computers
• Reduced quality of self driven learning by professionals
• Time consumption similar to classical CME events
• CME fees and travelling expenses w/o relevance
• Missed practical experiences / manual exercises
• Missed social interaction
(e.g. discussion, exchange of experiences...)
• Missed extraordinary seminar setting
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
What‘s next on eCME
• Blended Learning
• Mobile Learning
• Collaborative Learning
• Mental Training
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Blended Learning Course
Theory & Interaction Refresh Theory Hands-on
1) Blended Learning – the Best of both Worlds
Electronic Learning
• Theoretical Preparation • Assessment • Post-course rehearsal
Hands-on Workshops
• Refresh theory only • OR Workshops • Much more time for practice
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
2) Mobile Learning
• Taking advantage of smartphones and tablets
• Rapid online at the point of interest
• Mobile learning and reference in your pocket
BDC|Mobile App: • Member magazine “Passion Surgery” • E-Learning account from [eCME-Center] • News from the surgeons world
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
3) Collaborative Learning
• PBGS social network
• Pre- and post course guides
• Learning communities
• Career network
• Special interest communities
• Legal and contract consulting
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Web 2.0
3) Collaborative Learning – From Cloud Dust to...
Wiki
Keep in touch
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Learning Community
...Red Line Learning
Mental Training
E-Learning
Post-course Guide
Pre-course Guide
Hands-on
Stay tuned
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
4) Mental Training for Surgeons
Electronic Learning +
• Preperation • Pre-study guide • Cognitive simulation
Hands-on Workshops
• Refresh theory • OR Workshops • Much more time for practice
Blended Learning Course
Theory & Interaction Mental Training Refresh Theory Hands-on
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
The New “e” in eCME: Efficient CME
Blended Learning
• Pre- and post course e-learning activities and communication
• More time for practice and hands-on activities on-site
Collaborative Learning
• Web 2.0 features for participation, collaboration and reference
• community experience leads to learning plans/curricula (red line learning)
Mental Training
• Efficient mind and motor programming via cognitive simulation
• Supported by e-learning, mobile learning and textbooks
Efficient Learning
• Learning based on a CME curriculum
• Supported by eCME, mCME, bCME, hands-on courses and mental training
Dr. Jörg Ansorg • Professional Board of German Surgeons • Luisenstraße 58-59 • 10117 Berlin • Germany
Tel: +49 30/28004-150 • Fax: +49 30/28004-159 • [email protected]
Mental Training and Practice in Surgery
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
What do they have in common?
• Intense concentration
• complex fine and gross motor ability
• routinely performed in dynamic environments under
• Considerable pressure Sevdalis et al. 2013
Hans-Dieter Hermann Chief Sports Psychologist German National Soccer Team
Felix Neureuther German Ski Alpin Professional
You Andi Common Surgeon at work
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Mental training is the systematically repeated imagination
of a movement without actual performing it.
(e.g. cognitive simulation or symbolic rehearsal)
Feltz & Landers (1983)
Mental Training in Sports, Aviation and Surgery
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
The Key Feature of Mental Training - Nodal Points
• necessary (mandatory) structural motor components
• must be performed in a specific sequence
• reduction in the degrees of freedom.
Going through the track in mind (symbolic rehearsal)
See and feel an action in one‘s imagination
Means for reducing stress and enhancing performance
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
MT in Surgery – Nodal Points for Lap. Cholecystectomy
1. Bringing in the trocars
2. Exploring of the liver
3. Searching for the gallbladder
4. Fixing of the basis of the gallbladder
5. Fixing of the infundibulum
6. Incising of the peritoneal lining in the infundibulum
7. Exposing of the cystic duct and the cystic artery
8. Clipping of the cystic duct and the cystic artery
9. Cutting of the cystic duct and the cystic artery
10. Subserous shelling out of the gallbladder
11. Inspecting the liver bed
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
MT in Surgery – Guidelines for Application
1. Concentration exercise to focus on yourself and the upcoming surgery
2. Learn the nodal points by e-learning or textbooks
3. Imagine the surgery from your inner perspective
4. Do it in a systematically repeated way
=> Mental training in surgery
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
VR Simulation Training vs. Mental Training (Grange et al. 2012)
• MT is a powerful enhancement tool in laparoscopic skills acquisition
• Virtual Reality Simulation is not
• Box Training associated with MT is a better method than VRS with MT
vs.
BT BT+MT BT+VRS VRS+MT
#6 European CME Forum, London 11/2013 [email protected]
eCME, bCME, mCME and Beyond in Surgery
Curriculum Mental Training in Surgery 2013
E-Learning
• Understanding the theoretical background
MT 1 Course
• Understanding and exercise of mental training in surgery
• Easy procedure without performing any hands-on tasks
MT 2 Course
• Mental and practical training based on standard procedures
• Usage of e-learning or textbooks, box training and simulation
MT 3 Course
• Individual mental training of special needs and procedures
MT 4 Course
• Mental training for interdisciplinary OR-teams
Train-the-trainer course
• Training for mental trainers
• Certification to the MT trainer board