Viewpoint

A Learner-Centered Infrastructure: The Next Generation Learning Management System

Ted Hanss, University of Michigan Medical School
Jill Jemison, University of Vermont College of Medicine
Susan Albright, Tufts University

For many early adopters, the introduction of course management systems came out of administratively-driven initiatives. For others, pedagogical drivers may have been at the forefront, but the available solutions were limited in their support for new approaches to teaching and learning. Recently, however, we have seen a new generation of what we increasingly call learning management systems (LMS) that reflect the maturation of the industry and the learner-centered requirements coming from educational institutions. Whether commercial or open source platforms, the trend is away from large monolithic software systems to increasingly component- and service-based solutions that allow integration of features that best meet curricular needs. The Web 2.0 capabilities that are a part of this shift were detailed in a recent Viewpoint (McGee 2008).

With more adaptable technologies, we can use our curricular innovations to drive LMS implementations, which, for the most part, are not wholesale moves to new platforms but incremental enhancements to our current environments. The list of current medical education innovations include providing rigorous outcomes-based assessments for medical students while simultaneously supporting flexible and self-regulated paths through ever more diverse learning experiences (Carraccio et al. 2002; White 2007). Institutions are also increasingly looking to the LMS to support education continuity through a pandemic and increased class sizes, which may require distance and blended learning environments. Removing time and place as constraints is also driving interest in delivering learning materials to mobile devices, such as smart phones and tablets.

This new generation of comprehensive learning management systems must be learner-centered (versus course-centered) and facilitate administration, content development, content delivery, student tracking, and evaluation. Integrated student portfolios will provide a digital archive that will evolve to a career-long tool for storing and sharing learning experiences and assessments. (Creating portable portfolios will be one of our challenges.) Students and mentors alike should have on-demand access to at-a-glance views of student progress in all targeted competency domains and the outcomes contained within each competency. The LMS must also link required outcomes to learning objectives, learning experiences, and assessments.

The authors organized a group discussion on Monday 3 November at the AAMC annual meeting. With faculty colleagues from our schools, we shared the status of learning management systems at our institutions and described how the dialogue between the curriculum leaders and the IT infrastructure implementors takes place. The following summarizes the conversation among those attending the session.

Should we support portals, such as iGoogle, Netvibes, or My Yahoo? Students can then collect their own tools to best support how they learn, putting them more in control. Popular tools include note taking, annotating, citation collection, bookmarking, chat, instant messaging, calendaring, and much more. Tools or widgets could come from us or external sources. Some institutions have outsourced their email and are subscribing to Google Apps Education Edition, which would fit into this strategy. Students evaluate new tools by assessing efficiency (ease of use), functionality, and robustness. The tools can be quite simple. Students will often accept less functionality in order to get more robust, easier to use services.

Other schools raised concerns about production expectations for outsourced services, which would be out of our control. The counter argument was that having students manage their personal portals was like managing their own laptops, they must have the real-world expectation that things do go wrong occasionally. Besides, not everything needs to be on emergency power, so it is reasonable to think that not all tools must be available 100% of the time.

Security of student and patient information concerned some participants. If students use tools provided from outside the institution, how do we stop inappropriate data exposure? Education is one way to help address risks—this issue only gets more complex when they become practicing physicians. In addition, where we provide learning experiences around patient data that must remain within the institution, we should ensure those tools are effectively meeting the needs and expectations of students. This implies working with electronic health record vendors to ensure their systems support medical student learning environments.

Encouraging student-led projects using blogging and tagging tools can lead to the students acting as teachers and thinking of each other more as colleagues. Gardner Campbell of Baylor University gave a talk at EDUCAUSE on this topic called "Don't Call It a Blog, Call It an Educational Publishing Platform." Students will provide their own tags to create filters ("ignore this" or "this is critical!") that go beyond what faculty provide in terms of guidance on important learning resources.

It is a false dichotomy to argue the case between teacher-centered versus learner-center environments. In reality, we see the benefit of integrating teacher-led and student-driven experiences in medical school. Still, the idea of self-regulated learning concerns some, who wonder about our losing track of students with academic difficulty. Several schools successfully use weekly quizzes to monitor progress and to indicate when intervention is required.

Some faculty resist using technology, which can be addressed through peer advocates working with the IT staff to provide evangelism and support. This does require investment in faculty and staff time, but the benefit is that once a leader such as a block or sequence director "gets it," the rest of the faculty come onboard much more easily.

Kelly Noll of the Washington University School of Medicine and Brenda Bassham of the University of Texas Medical School at Houston distributed the recently completed GIR LMS working group report "Technology, Infrastructure, and Inter-Institutional Teaching and Learning Goals: Toward the Development of Standardized Learning Management Systems." This report laid out the core principles of having the LMS be the portal to educational materials, providing a collaborative learning framework, and allowing students access to completed courses for all four years of medical school.

A suggested next step is for people to learn more about the Medbiquitous standards for virtual patients and competencies, which will enable sharing across our institutions regardless of the LMS platforms in use. We also discussed the implications of the ACGME mandate for electronic portfolios, which are much more than repositories for reflective writing. We should accommodate this push for e-portfolios, whether that is preparing medical students for their use or providing up-to-date medical school content to practicing physicians looking for CME credit or going through recertification. Finally, we will explore cross-institutional research opportunities to evaluate the efficacy of the innovations discussed during the session.

Anyone interested in receiving the handouts and presentations from this session can contact ted@umich.edu.

References

1. Campbell, Gardner: www.gardnercampbell.net
   
   
2. Carraccio et al. (2002). Shifting Paradigms: From Flexner to Competencies. Academic Medicine, 77(5):361-367, May 2002.
   
   
3. McGee, JB. (2008). Web 2.0 and Medical Education: It's Here. Are You Ready?—www.aamc.org/members/gir/viewpoint/may08.htm
   
   
4. Medbiquitous: http://medbiq.org
   
   
5. White, BC. (2007). Smoothing Out Transitions: How Pedagogy Influences Medical Students' Achievement of Self-regulated Learning Goals. Advances in Health Sciences Education, 12(3):279-297. doi:10.1007/s10459-006-9000-z