Escape Room:

It is a Collaborative Game-based form of learning. The escape room is "A room in which people are locked in order to play a game requiring them to solve a series of puzzles within a certain amount of time to accomplish a goal, typically finding the key to unlock the room." (Oxford Dictionary)

Approach used:

- Each student team enters a room

- Students search for Hidden Clues within the room

- Clues are objective questions about a pathology topic (MCQs)

- Students should answer the question correctly

- The correct answer letter is a part of the door key password. Some questions were bonus helpers directing the students to find part of the door key password.

- The winning team was the fastest team that answered all questions correctly and collaboratively, so all the members knew all the answers.

- The winning team was offered certificates of Honor.

Crossword Puzzles:

It is a form of game-based learning that is used to assess students' learning. The candidate created pathology crossword puzzles using the online platform "Teacher Corner" and offered students to solve in teams or individually according to their preferences in a competitive format, then discussed the solutions with them. Winners were provided certificates of honor.

Memes:

"Internet Meme is an image, video, piece of text, etc., typically humorous in nature, that is copied and spread rapidly by internet users, often with slight variations" (Oxford Dictionary). It is based on the constructivism learning theory. It was used as an extra-curricular activity. Students were encouraged to create memes from the learning material, which was revised by the nominee and disseminated to other students.

Case-based competitions: take the risk:

Dr. Elkhamisy created pathology competitions on case-based learning formats. The competitions were team-based. The added value is that these competitions were designed to push students to train to have courage and take risks. The questions of the competitions were hidden at first and were assigned different scores. The higher the assigned score, the more complex the question. Students could see the scores and select the question with their preferred score. They were encouraged to choose questions with higher scores to grant a leading position in the competition. At first, students were afraid to select the high-score questions because of their assumed difficulty, but after a while, they dared to target them.

Kahoot Quizzes:

Dr. Elkhamisy sustained her work using Kahoot! Game-based online platform to create a more fun, engaging formative assessment environment. The Kahoot! platform is a digital platform that enables the instructor to create challenging game-based quizzes for students and play them synchronously to determine the champions of this challenge. It was used in a blended learning format. The candidate used the Kahoot! Quiz online platform to create continuous formative assessment challenges to motivate students to engage in their formative assessment and have fun learning. Student champions have been offered certificates of honor. Students liked the competitions and recommended reusing them.

Practical pathology Teaching: Offering a relevant learning experience:

Digital pathology and pathology lab results embedded within real-world case scenarios (reflective book): 

Dr. Elkhamisy focused the practical teaching on pathology skills that will be needed by all students regardless of their specialization after graduation, like identifying types of biopsies, reading reports, writing pathology requests, doing clinicopathological correlation, and understanding immunohistochemistry results. She also sustained the use of digital pathology, which she introduced previously to her institutions to overcome the large student batches & the limited resources (slides, space, staff), which led to teaching the practical skills on data show pictures, making the practical sessions mostly "recall" sessions. She sustained making the practical teaching relevant to clinical practice by embedding the digital pathology links and images of lab results into created or edited real-world histopathological reports and case scenarios. Students were asked to try to reflect on the cases in their reflective practical book before attending the actual sessions and having a discussion with the instructor. This was done to train students to reflect on the theoretical knowledge gained in the lectures, using higher cognitive functions and developing a sense of self-efficacy and confidence in students correctly answering the cases, besides self-evaluation of their learning. This led to offering students a more relevant practical experience. Students were more satisfied with their practical learning.

To ensure relevance to clinical practice of the taught courses,

Real-world case scenarios in the theoretical and practical teaching, & formative assessment were created by the nominee in all pathology courses she gave. She added investigation results, including pathology and radiology, to reflect upon by students. 

Doctor-patient role-plays implemented by the nominee (instructor) and volunteer students in the lectures to apply the theoretical diseases educated and train students to think differentially, analyze what they see, and interpret the included laboratory results to reach the final diagnosis. Students worked in teams to solve the cases and answer the questions.

For example, One of the role-plays done in the endocrine module, a role-play started with the patient (instructor) having visual impairment, hitting all the side objectives as she does not see them because of her bitemporal hemianopia, passing through discovering the presence of papilledema and doing brain MRI, asking for hormonal analysis, then diagnosing a pituitary tumor and offering its microscopic picture on the data show ending by a diagnosis of non-functioning pituitary adenoma. 

To overcome the limited resources regarding flexible gross models or virtual reality models to make pathology understanding easier and imaginable for students, low-cost models were created by the instructor to demonstrate using them. 

Examples:

- To demonstrate types of hydrocephalus (communicating/non-communicating). For the brain ventricles to explain hydrocephalus, was performed by transparent plastic bags that were filled with water. The foramina and aqueduct of Silvius were modeled using paper ducts and circles.

- To demonstrate types of brain herniation through meningeal falx and tentorium. Meninges and meningeal falx were modeled using a thick cartoon. They were cut and glued together in a manner similar to their anatomical shape and site; then, brain herniation was demonstrated via paper and flexible, malleable, soft plastic bags.

- To demonstrate how the gross shape of the infarction for a basic general pathology course is usually pyramidal due to the anatomical pattern of the organ arterial supply. A 2D-3D model was created for the arterial supply and branch distribution (3D) inside a 2D organ. Then, an illustration of the occlusion of an arterial branch and how this affects the supplied portion of the organ was made. The model was constructed using colored cartoon cards and thick paper.

Impact of the workshop on the host institution:

            The candidate has implemented many innovative instructional approaches in teaching basic medical sciences since being promoted to assistant professor and taking responsibility for courses’ design in September 2018 at Helwan University, and at King Salman International University in November 2022. She aims to increase students' interaction, motivation, and understanding to improve the students’ learning outcomes. She believes that students in the first academic years are in a critical period of their academic lives and that more effort should be done to engage them in their learning and to create a fun interactive learning environment.

                 The candidate is committed to discovering the causes of students’ dissatisfaction in their learning, improve their learning experience through innovative ideas that are attainable to implement in her context (a middle-income country, high number of students in each batch, low number of staff & teaching assistants compared to students). She is also committed to getting students’ feedback and communicating her students’ learning experiences to other medical educators to benefit from them. Communicating the ideas was done locally as well as internationally through international medical education conferences, publications, and talks as follows:

Team-based Learning (TBL) modification

             In 2019/2020, She noticed that students became bored with time with the traditional team-based learning approach (TBL), hence she tried to make the TBL more challenging & fun for all students by inserting wrong answers for some of the questions in the answer key of the team-readiness assurance test (tRAT) and asking the students to find them. This innovation boosted students’ interaction, motivation, and prolonged their attention. She was the first to do this TBL modification in the medical education field (Experience Presented at the AMEE 2021 Conference, see evidence section).

            Moreover, a medical colleague in Saudi Arabia applied this modification to improve academic performance and satisfaction in a pharmacology & toxicology course. She evaluated this innovation & found it effective for improving the students’ academic performance besides their satisfaction (principal investigator: Ass. Prof. Asmaa Sharif; College of Medicine, Dar Al Uloom University, Saudi Arabia, email: asma.s@dau.edu.sa, the article under review in the Frontiers in Education Journal).

Learning stations

            The candidate also wanted to transform didactic lectures into more interactive student-centered ones with a deeper understanding and a more fun learning environment. She was the first to use the “learning stations” approach in a new context “lecture”, in medical education. Before that, the Learning stations’ use in medical education was for practical purposes, especially the assessment context (i.e., OSPE, OSCE). Students were more engaged in their learning with a higher level of student-centeredness. They perceived the experience as fun & beneficial for deeper understanding (Experience presented at the IME 2022 Conference, see evidence section).

Virtual Learning stations*

            Moreover, in 2020/2021, with the emergence of the COVID-19 pandemic and the shift to online learning, she found that many students are dissatisfied with the lack of their interaction. So, she transformed her “learning stations approach of the lectures” into a virtual context. To do so, she used the Zoom Meeting Breakout rooms consecutively. Every time she distributes students into the rooms, she sends them some of the learning materials, asking them to study together and solve a task as an application, then she reunites them to discuss the tasks & clarify any ambiguous concepts. Then, she sends them again to the breakout rooms for the next “chunk” of learning material. Students praised less social isolation, student-centered learning, deeper understanding, and fun. The candidate was the first to use the virtual learning stations in lectures in the medical education field (Experience published on Nov 2021 Conference, & Presented at Helwan University International Pathology Day 2021, see evidence section).

Game-based learning*

           The candidate was the first to introduce the concept of game-based learning in the medical schools of both Helwan & King Salman International Universities to create a more fun engaging formative assessment environment. She used the Kahoot! quiz platform to create continuous formative assessment challenges in addition to using the Crossword puzzles to motivate students to engage in their formative assessment and have fun learning. She also created pathology competitions on case-based learning formats. Students’ champions were honored with certificates & trophies (The Kahoot experience was published in Alexandria Journal of Medicine, presented in the Helwan University International Pathology Day 2021, & published in the Kahoot Blog, see the evidence section).

           The candidate presented a workshop on Kahoot! Game-based learning at the King Salman International University to spread the culture of game-based learning. Some of the other basic sciences departments started using it based on the workshop & students’ feedback.

Her teaching in the dental medicine school in the university (2nd-year students), which is game-based, got the highest feedback among all the Fall semester 2021/2022 disciplines (4.24/5).

Virtual Patient Learning & Role Plays (Face-to-face and distantly) *

           On the institutional level, the candidate wanted to give her students a relevant-to-future practice learning experience, to deepen their understanding, engage them more in their learning, and motivate them when they “feel” the clinical significance of what they learn. She was the first to introduce the concept of Virtual Patient Learning (VPL) At Helwan University, Faculty of Medicine after attending a training workshop about it. On the next day following the workshop, she used a virtual patient learning case after the lecture as an application of what she explained. The students were thrilled by the experience and had a lot of fun. However, the VPL platform was expensive. So, she used the basic concept (Doctor/patient roleplays) during the COVID-19 pandemic to boost students’ motivation in lectures & their application skills. She was the first to introduce& implement the role plays to use in lectures of basic medical sciences after her experience in the VPL (as they are more attainable financially) at both Helwan & at King Salman International University to boost students’ learning, motivation, & relevance of information (The experience was partially presented at Helwan University International pathology Day 2021, see evidence section).

Memes Project-based Learning*

         The candidate also noticed that targeting the creativity level as the highest cognitive function-according to the revised Bloom’s taxonomy-is difficult in the anatomical medical sciences. She also noticed that students are highly creative in producing internet memes (funny videos & pictures) that make fun of their social life.  She innovated the anatomical sciences’ teaching (including pathology) by using the meme project-based learning in which students were requested to create internet memes (humorous pictures and videos) from the learning material. The approach is used to stimulate students’ creativity, boost students’ learning, create a motivating fun learning environment. The candidate was the first to use it in the anatomical medical sciences. The candidate used this approach in 2 learning contexts, blended (in 2019) & distant (in 2021 during the COVID-19 pandemic). Students enjoyed the project, gave positive feedback, and created memes in numbers that exceeded the requested one (Experience presented at the Helwan University International Pathology Day 2021, at the APMEC Conference 2022, see evidence section).

Digital pathology with reports*

          On the institutional level, the candidate was the first to introduce digital pathology to her institutions (both Helwan & King Salman universities) for the first time to overcome the large student batches & the limited resources (slides, space, staff) which led to teaching the practical skills on data show pictures, making the practical sessions mostly “recall” sessions. She also used digital pathology in a distance learning approach to teaching practical skills during the COVID-19 pandemic. She made it more relevant by embedding the digital pathology links into created or edited real histopathological reports that are suitable to the digital pathology cases learned. This led to giving students a more relevant practical experience even during the COVID-19 pandemic. Students were more satisfied with their practical learning (Experience partially presented at the Helwan University International Pathology Day 2021, see evidence section).

Empowering Students via the National Pathology Week Celebration

           To empower the first-year medical students and direct them to be effective and helpful to their surrounding community using what they learn, the candidate organized a pathology awareness day for Helwan University students. The day was a celebration of the National Pathology Week in collaboration with the Royal College of Pathologists, UK. It was implemented in Nov 2019. Her students presented mini-lectures & team-based activities to around 200 students of other faculties. Activities were concerned with understanding the bases of some common diseases and how to avoid them, like the fatty change of the liver, ventricular hypertrophy due to ling standing uncontrolled hypertension…etc. Both her students’ & attendees’ feedback was excellent, & they recommended repeating the experience (Experience photos hooted & shared on Facebook, see evidence).

An Innovative Interactive Online Pathology Course during the COVID-19 Pandemic

           During the CIVID-19 pandemic, many students were not satisfied with the distance learning implemented due to lack of interaction, social isolation, boredom, lack of motivation, & inability to develop various skills. The candidate designed & implemented an innovative pathology course that used various student-centered interactive methods that are supposed to enhance many students’ skills and overcome social distancing. For lectures, she used the Zoom meetings with breakout rooms to implement the virtual learning stations student-centered approach, flipped classrooms with case-based learning, and flipped classrooms with virtual patient learning. For practical labs, she used digital pathology embedded in a case-based & pathological reports format. For the continuous formative assessment, she used synchronous online Kahoot! platform challenges and she honored the quizzes’ champions. For assignments, she used online project-based learning and asked students to create mind maps and memes from the learned material. The candidate collected the students’ feedback for the course. Most of the students were satisfied by the course and considered it a good alternative for face-to-face learning. (The experience & students’ feedback were presented at the Helwan University International Pathology Day Nov 2021, see CV).

The candidate got excellent for her teaching of this course in results of the formal evaluation of students’ responses done through the quality unit of the faculty of medicine, Helwan University (Locomotor module academic year 2020/2021)

Integrated clinically relevant project-based learning (PtBL) Tasks

           The Helwan Medical School curriculum is multidisciplinary. Following the 1st COVID-19 wave, the Egyptian Ministry of Higher Education introduced academic writing and research projects as an emergency online alternative to theoretical exams. In the basic medical sciences’ academic years, staff and students were concerned about the workload of required projects, which will be 16-21 tasks/student. The candidates proposed to have instructors create interdisciplinary differential diagnosis cases. Students requested to examine the cases with reflection on the basic medical sciences (pathology for differential diagnosis, histology, and anatomy: description of altered tissue, etc.) The interdisciplinary approach helped students understand the connections between all basic disciplines in future practice and elevated the integration level of the curriculum. Gaps in curricular objectives were identified and filled or omitted during the development of these cases to make a more clinically relevant integrated curriculum. The project was implemented and evaluated. Results were encouraging (Experience was presented at the APMEC 2022 Conference & Awarded a Short Communication Merit Award, & published in Jan 2022, see evidence section).

The Helwan Medical School Celebration of the International Pathology Day 2021

           Besides communicating the previously mentioned experiences through the conferences & journals, the candidate was the founder & principal organizer of the online event “International Pathology Day 2021 celebration at Helwan Medical School” on November 11th, 2021, in collaboration with the Royal College of Pathologists (UK). The candidate recruited some of the prestigious speakers in the field of artificial intelligence, technology, and technology-enhanced learning to offer teaching & diagnostic technology-based solutions to the attendees. The candidate presented the teaching methods used (labeled with *) during the COVID-19 pandemic, to around 130 international pathology & other specialties’ medical educators. During the presentation, attendees tried out the methods through short demos and mock trials. Around 130 international attendants participated in the event (Experience was recorded & shared, see evidence section).

Evidence section:

As mentioned before, most of the innovations used & mentioned were communicated on an international level (see CV section of the portfolio i.e. About) to enhance their impact in the health professions education field (conferences, publications, blogs & international events).

Students’ positive feedback on the previously mentioned innovations is reported within the conference & journal publications, as well as the events’ presentations.

Team-based Learning (TBL) innovation:

The candidate presented her TBL modification at the AMEE 2021 Virtual Conference, 27-30 August, Short Communication Abstract 8896. Page 798. https://amee.org/getattachment/Conferences/AMEE-2021/Programme/AMEE-2021-Abstract-Book-V2.pdf.

Learning Stations Use in a Face-to-Face Lecture Context innovation:

The candidate orally presented her innovation at the Innovations in Medical Education Online Conference 2022, on 18 Feb, poster #075: Learning Stations to Enhance Students’ Interaction in the Undergraduate Medical Pathology Lectures (agenda: https://sites.usc.edu/ime-conference-2022/conference-program/).

IME 2022 Conference Proceedings

https://cpb-us-e1.wpmucdn.com/sites.usc.edu/dist/4/318/files/2022/03/IME-2022-Conference-Proceedings-3-5-22-sm.pdf, Page 236

The Virtual Learning Stations innovation:

The candidate published her innovation to the medical education community: "Medical students' perceptions of virtual learning stations as an innovative teaching tool: a qualitative study" in the Interactive Learning Environments Journal, 2023. DOI: 10.1080/10494820.2021.2002366

The Game-based Learning experience:

Kahoot! Game-based tool as an engaging distant learning tool in pathology pre & during COVID-19 pandemic. This was published in the Alexandria Journal of Medicine, DOI: 10.1080/20905068.2021.1954413.

The candidate also shared her experience on the Kahoot! Blog: https://kahoot.com/blog/2021/10/14/research-learning-benefits-kahoot-medical-education/.

Memes Project-based Learning*

These findings were orally presented at the Asia Pacific Medical Education Conference (APMEC) 14-16 Jan 2022, https://medicine.nus.edu.sg/cenmed/apmec2022/documents/APMECHandbook.pdf Page: 296.

National Pathology Week:

Facebook post with photos for documentation after the event: https://www.facebook.com/permalink.php?id=108867333837771&story_fbid=152976722760165

Integrated clinically relevant project-based learning (PtBL) Tasks

The results were presented at the Asia Pacific Medical Education Conference (APMEC) on 14 Jan 2022: "Using Project-based Learning to Enhance Curricular Integration of Basic Medical Sciences in a Multidisciplinary Curriculum", https://medicine.nus.edu.sg/cenmed/apmec2022/documents/APMECHandbook.pdf, Page: 341,

The candidate was awarded a Short Communication Merit Award for this presentation in the APMEC 2022 conference: https://medicine.nus.edu.sg/cenmed/apmec2022/documents/AwardessAPMEC2022.pdf, page 2.

This work was published as "Using Project-based Learning to Enhance Curricular Integration and Relevance of Basic Medical Sciences in Pre-clerkship Years" in Alexandria Journal of Medicine 2022. DOI: 10.1080/20905068.2021.2009652

*The Helwan Medical School Celebration of the International Pathology Day 2021

Besides the eminent speakers in the field of technology-enhanced learning & diagnostics, my talk in the event communicated the use of these previously mentioned methods: virtual learning stations, Kahoot as a game-based learning tool for formative assessment, flipped classrooms with case-based learning, virtual patient learning & role plays, digital pathology embedded in histopathological reports, & the meme project-based learning (all marked previously with a star*). The talk displayed the students’ positive feedback on the tools used, perceived advantages, & disadvantages.

Event announcement: https://www.rcpath.org/event/international-pathology-day-2021-virtual-celebration-at-helwan-medical-school-how-technology-can-improve-pathology-learning-diagnostics.html

Event website: Helwan Medical School International Pathology Day 2021 (google.com)

Event Facebook page: https://m.facebook.com/HelwanMedicalSchoolInternationalPathologyDay2021/?ref=bookmarks

https://m.facebook.com/events/281888020511961?active_tab=discussion&paipv=1

The recorded talk: https://www.youtube.com/watch?v=d8LMkq1bMoA&lis

Some of my work with the students at the Faculty of Medicine, Helwan University, Egypt is also shared on Facebook: under the hashtag

#EnjoyPathologyAtHelwanMedicalSchool