It is a happy moment!


Designing Clinical Research Online for physicians and researchers at Peking Union Medical College Hospitals (PUMCH) resumed this week following the Spring Festival break. To be honest, it wasn’t really all that much of a break. There was a significant amount of discussion forum activity every day, and even though we had all agreed that faculty could take the week off, no one actually did.

Imaging our delight when we checked in and read the posts one day right in the middle of the holiday!

“It is a happy moment to check my email and get some feedback for my research design. This course is so interesting and beneficial and becomes the most important thing in my life now. You bring me always such nice comments and valuable suggestions which encouraged me a lot.”

Now we are in Week 5 — Sample Size and Power — perhaps the most challenging of the weekly topics. We are facing two challenges — overcoming some level of inertia due to the holiday and helping our trainees to wrap their heads around this difficult step in the development of a research protocol. But I digress …

What do you think about the quote? It is a happy moment to check my email. To be technically correct, it is actually the discussion forum within our course site where the feedback resides. Since the course started in Mid-January, we have had hundreds of posts to every single assignment forum. Our faculty members are giving feedback nearly every day. But we also expect the students to collaborate with each other by giving and receiving helpful feedback — not an easy thing to accomplish!

I am honestly pretty satisfied with the quantity and quality of interaction among our trainees — it is more than I expected and more than I see in many of our courses. But still we want more. We can see the power of dialogue in almost every item posted by one student for another. People are asking questions, making suggestions, challenging assumptions, providing encouragement, identifying ways the work of one student may dovetail with the work of another.

There is no doubt in my mind that learners often achieve their “AHAs!” when reflecting on the work of a peer. Perhaps we are more open to seeing things in a different way when we look at someone else’s work when we just look at our own. Online discussions allow everyone to eavesdrop on all the discussions, so people may achieve their learning breakthrough by reading posts even if they are not personally involved in the conversation.

This does not happen just because we set up discussion forums! There is no magic involved with even the most compelling and well-crafted questions. We have a number of forces in this course that encourage active participation in the forums. First — it is a course requirement. Assignments are due each week by midnight Monday. Students are required to read the assignments posted by the others in their section (~6 students/section) by midnight Wednesday and post helpful feedback for at least two of their peers. This has probably been about 50% effective — just because it is required doesn’t mean people actually do it. Our courses are not for credit, so there is not an external motivation.

Faculty behavior is what makes it work!  Our PUMCH trainees are fortunate to have four faculty (section leaders) who are dedicated to ongoing peer interaction. Here is what they do:

  • Urge all students to post their assignments on time — we can’t cook up a feast of interaction without ingredients.
  • Hang back for a day before jumping in — allowing the students to consume and digest the feast first.
  • ASK rather than TELL! This is the single most important faculty behavior. It is hard to bite your tongue and hold back when you know you have something brilliant to say. But telling is not necessarily teaching. Don’t tell when you can ask … and resist asking when you know the answer (that’s testing, not teaching).
  • Keep asking — if students don’t step up, try to not step in. Ask the questions in different ways. Call on people by name.
  • Praise lavishly! Thank people for their contributions. Be specific about what you are acknowledging. If people know what they are doing right, and they know you appreciate it, they are likely to do more.
  • Post something provocative and ask everyone to respond. This may prime the pump and spill over.
  • Remind students that it is a course expectation.

We also have a great big fat carrot! Two of our trainees will be selected to come to San Francisco for a year. A significant percentage of the selection criteria is the extent to which the students engage in helpful dialogue.

So thank you Paige Bracci, Vanessa Jacoby, Kala Mehta, and Ma Somsouk for your superb facilitation skills and actions. And thank you to our student who posted her appreciation for the happy moments!

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