Category: Case Study

Dealing with extra sensitive data in the Medical Learning Environment (MLE)

Most FMS sites run by the unit contain and maintain personal data that needs to be kept private. Techniques such as securely certified websites and authentication/authorisation portals are usually sufficient in keeping this data safe.

The Challenge

With the introduction of the new year 4 in the MBBS curriculum and the move to more blended learning, a higher degree of sensitive data was required to be stored on the Medical Learning Environment (VLE for MBBS). Year 4 students are now asked to keep electronic records of patients and interactions as part of the Advanced Clinical Experience module. This data contained personal contact details such as address, telephone and email of patients the students would follow on the clinical journey, and let them reflect upon this experience throughout year 4.

So before the start of Year 4, in the summer of 2020, we investigated and implemented an enhanced way of storing this patient information in the MLE.

The Solutions

First we investigated how the data was stored in the backend database. Most information is stored in databases as unencrypted data due to the lack of sensitive nature of the data.

This new data required something else. It was decided that parts of the data that could contain personal patient information should be encrypted, both in transit and at rest.

For parts of the ACE model (the data structure we use for the ACE section of MLE) we replaced the open text fields with this new encrypted field. This now meant that when data was entered and saved, before it was added to the database, the system would replace the open text with a encrypted data set using a secure key. To read the data again it would need the use of the decrypt method, that only the MLE could do by using the secure key.

The second part we investigated was to detach any personal patient information from the student’s reflections. Once the student had completed the recording of the patient’s details, the direct link in the website was removed and generic patient information used from that point onwards to identify the individual records. This kept the sensitive information separate from the day to day recording of patient interactions.

The students also uploaded consent forms signed by patients who agreed to take part in the ACE module. Final versions of consent forms highlighted that these would also contained sensitive information.

After further investigation the development team included these static files in the encryption methods used to support ACE. In order to allow students to verify the uploaded consent forms, the MLE allows a short window before encryption and archiving of consent forms takes place. Once this process completes the consent forms are no longer accessible via the website (MLE) and recovery if required is performed by a limited number of staff in FMS TEL.

These methods used may be a little extreme for the day to day data stored on most FMS sites, but the investigations and lessons learned from the ACE data has provided us with options for other sites in the future.

If you are interested in this topic and wish to learn more, please contact:

Dan Plummer, Learning Technologies Developer, dan.plummer@newcastle.ac.uk

John Moss, Technology Enhanced Learning Manager, john.moss@newcastle.ac.uk

Case Study: Adapting a course for a larger cohort

Guest post by Sue Campbell from the FMS Graduate School, Module Leader for ONC8024: Chemotherapy Nurse Training.

The Challenge

In December 2020, we were informed that Lancashire Health would be sending their Nursing students to study our course, which was due to start in February 2021. We had already seen an increase in our own numbers so with these additional students we were going to be expecting a much larger cohort than usual. The increase was in part due to the COVID situation and study leave cancellation in the NHS. We needed to investigate if the course structure would be suitable for 50 students instead of the usual 10-15 we had taught in previous years.

What did you do?

We reviewed each activity and imagined how it would work with 50 students. Activities that students completed on their own such as crosswords and quizzes were fine. 

Our main concern were the collaborative wiki tasks – these are pages within Canvas, usually involving a table, that students completed together to create a resource. We wanted to keep these tasks as they encouraged teamwork, but the tasks were not suitable for 50 students to be able to contribute. After discussing the problem with others who have experience of working with larger cohorts we came up with a solution. 

With help from the FMS TEL Team we were able to separate the students into groups of 10-15 students and provide each group with their own collaborative wiki task to complete. Once the course began we experienced registration issues so students were all starting at different times. We decided to adjust the groups so the late starting students would be in the same group and would not feel left behind.

“It’s about finding solutions you are not aware of; groups was a really quick and effective fix for what I envisioned to be a much larger problem.”

We wanted to keep the discussion tasks as they worked well in the past but would they work with large numbers? We went through each discussion task and made changes. 

Where we had previously asked students to discuss three points, we changed so students could choose one discussion they could take part in but were able to view all discussions. 

Modified Discussion Board: Before and After

We decided to change the scenario discussions into branching activities instead. The questions asked in these discussions had only one right answer and were more of a fact checking exercise than something the students discussed. Students could complete the branching activities independently, so cohort size did not matter, but the objective of the task was still achieved. We also added a presentation to summarise the learning from the scenarios which replaced the interaction from the Module Leader that would have usually occurred on the discussion board at the end of the week.

Branching Activity

Tips

  • Ask for advice – I spoke with the FMS TEL and Programme Teams and they provided several solutions I wasn’t aware of. I also spoke with our DPD, Victoria Hewitt for marking help
  • Consider running the module twice a year if numbers/demand remains too high to sustain within one cohort
  • Branching activities will work regardless of numbers so we can easily roll those over year after year now
  • Groups in Canvas is easy to turn on/off and adjust depending on numbers

What might you do differently next time?

We shall wait and see the student feedback but we are currently in week 5 of the course and so far it is going well and the group work is successful. Some things we are thinking about are:

  • We have a lot of activities, but they are now largely peer to peer or independent tasks so to bring back the teacher presence I would like to include more videos and presentations
  • We do provide a general Q&A discussion board, and for the rest of the course we are also introducing fortnightly, 10 minute 1:1 Q&A bookable slots via zoom for any students preferring a one-to-one discussion with the tutor.

Resources:

The versatility of quizzes

Over the past couple of months I have been talking to a lot of teaching colleagues about how they use quizzes. A quick summary of some uses for quizzes can be found below. There are two quiz tools available in Canvas (old and new quizzes), as well as a lot of web services that offer quiz functionality.

Using quizzes before synchronous seminars allows students to check their knowledge and make sure they have understood things correctly before entering into a discussion. This boosts confidence and allows them to participate more effectively in the session, knowing they have definitely grasped the concepts. This is especially useful with topics that are very abstract or contain a lot of new concepts or terminology. The case study with Rosalind Beaumont and Lydia Wysocki can be found on the LTDS case studies site.

Quizzes can also be used in the sense of providing test-enhanced learning opportunities for students. Regular short quizzes encourage students to retrieve the information they have remembered and put it into practice, boosting knowledge retention. The case study with Nick Riches can be found on the LTDS case studies site.

Another use for quizzes is to use them to replicate a workbook – something that might be used in Present in Person (PiP) teaching to guide students through a series of problems as teachers monitor the room. Here the quizzes are instructive and challenge students to find the information they need, practicing the skills they are learning. Detailed feedback and extra information allows the students to step through the processes they are learning and approximates the monitoring that may be done in the classroom by anticipating difficulties that may need clarifying. Teachers can then look at analytics or ask students to send questions to identify anything that needs further explanation. More information can be seen in the case study with the Library Liaison team.

When testing higher-order thinking skills such as evaluation, automatically-marked quizzes may not spring to mind, as evaluation is often done in prose. The case studies mentioned above include examples of higher-order thinking questions. This can be done through careful question construction with high-quality distractors, for testing, as shown here, or as a learning activity, asking students to apply skills and enter a rating at each stage as modelled by the Drop Bear activity in the Library Liaison team’s case study.

How do you use quizzes?

360° Images

Prompted by the need to show students FMS teaching labs, we have added some information around 360° images to the FMS Community, including example images and how these images are captured, processed and made ready for viewing. This work results in images which can be viewed on screen or using a VR headset.

360 pan of lab showing navigation through the tour
This is a low-quality preview of the real output.

These images have a variety of uses, including:

  • allowing students to view places they may otherwise never see in person
  • allowing students to see facilities such as labs before they arrive on campus
  • students can familiarise themselves with the layout of a room or building
  • taking activities in a safe controlled realistic environment, for example identifying hazards without putting themselves at risk
  • helping students learning at a distance to feel like they are part of the institution

As well as single images, it is possible to connect a series of images to create tours. Users can then click one place to the next in a series of linked 360 images – like in Google Map Street View. Video tours can also be created.

Recently we used these images to provide a virtual induction to FMS labs as part of a health and safety course. To see the full case study, visit the FMS Community.