QuRE project update

The Quality Referral Evolution (QuRE) project, www.ahs.ca/qure, is making good progress.

QuRE checklist for referrals

The QuRE Project started in Alberta, as an initiative to enhance the quality of clinical referrals and consults in healthcare. With 2.3 million referrals created every year in Alberta alone, the potential for improvements and savings is enormous. Now several other Canadian provinces, including Saskatchewan and British Columbia, are starting to engage in similar and collaborative efforts.

Earlier this year, the Office of Health & Medical Education Scholarship (OHMES) at the Cumming School of Medicine, University of Calgary, became involved with this project. The QuRE group had some tremendous work to establish an evidence-informed approach to quality referrals and consults. Some educational materials had been created and seminars given.

OHMES saw an opportunity to create a more interactive approach to the educational processes of the QuRE Project. Rather than simply telling healthcare learners what to do, we used OpenLabyrinth virtual scenarios and CURIOS video mashups, along with other educational tools such as GrassBlade, PowToons, to create more interactive materials, with built-in activity metrics and analytics.

This approach will enable us to continually modify our materials (its own quality evolution, as it were), based on learner performance, not just on yet more questionnaires.

What has particularly excited us at OHMES about this project is that it represents an opportunity to study how an educational intervention can have an impact on patient care. For years, especially in CME circles, there have been repeated calls for educational approaches that can actually demonstrate a change in how we provide care, and ultimately, on improved patient outcomes.

One particular aspect of this project is that we intend to longitudinally track, over several years, how feedback and these interventions may iteratively improve the quality of referrals and consults in participating groups. We will have sufficient data to demonstrate useful changes, thanks to the ongoing use of activity metrics, gathered from across multiple healthcare systems.

Intermittent interruptions

We have an unusual situation where our web server is being clobbered by standard updates to RedHat Linux.

Because of this, we are encountering “Error connecting to database” on an all too frequent basis.

There is a manual fix for this, but a simple OS update should not be clobbering the underlying MariaDB service. We have asked our local support team for a more robust fix.

We apologize for the current patchy service. No data has been lost. And the OpenLabyrinth virtual scenario servers themselves seem to be unaffected.

[Update: 15aug2018] – yay, I think we have a fix. There is an odd bug but, with UCIT’s help, I think we now have a more robust fix. Thank you, all.

Medbiq Conference 2018

We just got back from the Medbiquitous Conference 2018 in Baltimore. Great conference with lots of collaborative projects coming out of it.

There continues to be a high degree of interest in activity metrics and xAPI related projects. In particular, we heard about:

It was noted yet again that we are all immersed in our biases and, despite this, also overly dependent on subjective assessments from teachers. Things have to change.


Back to normal

At last, it seems like we have things back to running normally. Phew – that was way harder than we expected. Many apologies for all the inconvenience.

As well as this WordPress site, our OpenLabyrinth virtual scenario server at http://demo.openlabyrinth.ca should be working properly again.

The mail server and forgot-my-password link were offline for several weeks. Apologies to anyone who was trying to get in.

Our other linked services such as our GrassBlade LRS are now mostly back to normal. If you find continued glitches, please let us know.

Service interruption

We plan to upgrade our servers on Thursday afternoon, May 3rd.

You may notice interruption to the following services around the following times 1300-1600 Mountain time:

  • openlabyrinth.ca — this WordPress site and the associated forums
  • curios.openlabyrinth.ca — our CURIOS video mashup service
  • our GrassBlade LRS

Our OpenLabyrinth v3 virtual scenario platform at demo.openlabyrinth.ca should continue to function, but there may be linked oddities at this time, as well.

We hope that these interruptions will be brief (if all goes well and allowing for glitches).


xAPI and Learning Analytics

The Experience API (xAPI) provides OLab with some powerful tools to integrate activity metrics as a research tool. But, of course, there is more to it than just capturing and aggregating data.

Data visualization and learning analytics are increasingly important — this is one of the key pillars in our push towards Precision Education. Some of the Learning Record Stores (LRS) come with tools to assist with such analytics. We have spoken of this before: while we currently use GrassBlade as our workaday LRS because it is simple for small pilots, the beauty of the LRS approach is that data can easily be federated across other LRSs. For example, we have made use of the more powerful analytics provided by the Watershed LRS.

However, as we move into more detailed analytics, it is great to be able to work with even more powerful tools. We have just started working with the IEEE ICICLE group on looking at better approaches to such learning analytics. LearnSphere is one such tool, being extensively used at Carnegie Mellon University (but open-source, on Github).

LearnSphere has a powerful set of analytics tools. In the screenshot above, it shows us using the Tigris learning workflows tool to map out good learning designs and scenarios, designed to answer questions such as “which kinds of learner activity are worth measuring?” — the datasets can be quite varied and the LearnSphere group is interested in accommodating a wider range of learning research datasets.

Today’s discussion of the IEEE ICICLE xAPI and Learning Analytics SIG focused on how to integrate xAPI activity streams in a more seamless manner with LearnSphere. We are pleased to be involved with such dataflow integration initiatives. As Koetinger et al (1) demonstrated in 2016, there is a clear link between “doing” and learning. This is not a new concept at all, but proving this has been remarkably difficult in the world of education, where there are so many confounding factors to consider in a study methodology. This approach, using learning analytics, is much more solid.

1.  Koedinger, K. R., McLaughlin, E. A., Jia, J. Z., & Bier, N. L. (2016). Is the doer effect a causal relationship? In Proceedings of the Sixth International Conference on Learning Analytics & Knowledge – LAK ’16 (pp. 388–397). New York, New York, USA: ACM Press. http://doi.org/10.1145/2883851.2883957

Using xAPI to support blended simulation

OLab and OpenLabyrinth have always been good at providing the contextual glue that holds together various simulation modalities. Here are some examples of projects where OpenLabyrinth has supported blended simulation activities:

  • Virtual Spinal Tap – uses haptic simulation to model the feeling of needle insertion
  • Rushing Roulette – timed tasks with a $30 Arduino lie detector!
  • Crevasse Rescue – multiple teams & disciplines, with high & low fidelity simulators
  • R. Ed Nekke – bookending around Laerdal mannequin scenario

But now with xAPI providing the background data linking to a Learning Record Store, it is much easier to do this across a wider range of tools and platforms. Some of the above mentioned projects used a very sophisticated gamut of high-speed networks, at considerable cost.

Doing this now with xAPI is proving to be much more flexible, scalable and cost effective. To support haptic projects, like Virtual Spinal Tap, we are now working with the Medbiq Learning Experience Working Group on an xAPI Haptics Profile. Check it out and give us feedback.