We have a vision, some early components, and some ideas. We have a beginning, but nothing to brag about. Here’s what’s accessible today. The strongest statement we can make is, “We know these tools can be used in classes of varying sizes. They are supported by most common learning management systems (LMS).”
1. Interactive reading assignments. Student reading tends to be passive. In reality, students must learn to apply many technical components of HCO management. (Think OFIs, balanced scorecards, bonuses, board agendas, capital budget requests, OSHA requirements, clinical guidelines, credentialing, etc.) Free software exists from MIT (http://nb.mit.edu/welcome) that supports student notetaking on PDF reading assignments. A commercial level improvement, Perusall (Perusall.com), is entering the market. The software allows students to enter comments on reading assignments. Instructors can easily identify especially challenging parts of the assignment, and can respond to specific comments individually or collectively. It encourages student-student dialogue. Students clarify each other’s understanding. (Michigan is testing Perusall in winter term, 2016. We will report.)
2. Automated multiple choice questions with scoring and commentary. (AMCQ) A large component of professional management is verbal reaction to questions, observations, and comments. The AMCQ allow beginners to build skill by considering alternative responses to frequently occurring situations in real HCOs. Selecting responses and reviewing an experienced professional’s selections allow them to gain both comfort and facility. We have 300 questions graded “moderate,” “advanced,” and “challenging,” organized around the chapters of The Well-Managed Healthcare Organization, (WMHO) but available to all AUPHA faculty. The questions are downloadable to most LMS. The LMS supply performance data by student and by question, allowing both class discussion of disputed questions and individual student follow-up.
We believe the questions reflect situations real managers frequently encounter, and the answers are driven by best practice. They are both technically effective and consistent with the service excellence approach now used by leading HCOs. (This raises an important question of item validity that we will address later.)
The American College of Healthcare Executives has generously supported the development of the Learning Suite for WMHO, simplifying the transfer of information between LMS. It will be up shortly. Contact hapbooks@ache.org. It will allow download of the AMCQ, QFD, and Review Questions with scoring rubrics. (In the meantime, I can supply most of it, jrg@umich.edu. To use the AMCQ in your LMS, you need to be able upload an LTI file. UAB did it successfully.)
3. Questions for Discussion (QFD). These are designed to cover some of the known challenges in applying the procedures used in high performing HCOs. They are more complex than AMCQ, and they provide no hints. Most require a multi-step response by management. They can be assigned for individual or team preparation and discussed in a class setting to identify stronger and weaker approaches. There are five at the start of each WMHO chapter, with notes for the instructor and Powerpoint slides at the HAP website. We believe the questions are independent of WMHO, reflecting processes that must be solved by every HCO, with answers based on best practice.
4. Assignments. These are activities for teams to address, to work through how you solve HCO operating problems. As of 2/2016, we don’t have a tested set. Assignments should reflect realistic problems that require a planned response, such as a relatively simple consulting engagement or a charge for a PIT addressing a process oriented OFI. Team assignments can be peer graded. Most LMS support apps for this, and the peer grades can be reviewed by faculty. If we can develop some satisfactory peer-graded assignments, we can eliminate examinations. I have a few that we are working with, if you contact me directly. (jrg@umich.edu).
5. Review Questions. Review questions are similar to the QFD, but with answer rubrics scoring alternative solution approaches. The completed rubrics reduce grader subjectivity. They can be distributed to the students, showing individual scores, class scores, and individualized grader comments. We have about 20. We think Assignments may be superior to Review Questions, because they include interpersonal skills and because they have stronger formative capability.
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