1. Build stepwise a prototype -Virtual Clinical Research Center- (VCRC) for K-12 learners and mentors (diverse peers experts and patients) by accessing mobilizing and linking the human and physical resources of a prototype national network of Clinical Research Centers (CRC) and translational laboratories through state-of-the-art Telemedicine communication and collaborative technologies and featuring T3 or the 3Ts – Teams Technologies Translation – of the Clinical Research Enterprise); 2. Develop the Medical Ignorance Exploratorium (MIEx) as a hybrid K-12 cybercafe-health science museum with key features of a) navigable game-like 3D environment including -Isles of Medical Ignorance- and -Questionator- b) Resource Library c) Live Performance Theater; and d) Collaboration Space all to stimulate and guide student-centered inquiry about medical breakthroughs clinical topics and sick patients (featuring cyber Q3 or the 3Qs-Questions Questioning and Questioners); 3. Evaluate the impact and effectiveness of the curricular and delivery resources and models in SA1 and 2 as well as the dissemination in SA4; 4. Disseminate embed and expand the refined Virtual CRC and Medical Ignorance Exploratorium in K-12 schools the clinical research community and beyond.
Health literacy and science literacy have been placed at the top of the nation’s health and education agendas. This public recognition of deficiencies and commitment to improve health/science education and innovation in schools and communities meshes with the NIH Roadmap and NCRR strategic plans to “reengineer the clinical research enterprise” including refueling the clinical researcher pipeline and enhancing public understanding of clinical research. Despite widespread recognition that scientific facts are “biodegradable” and medical science has a very long way to go until we initiated the University of Arizona’s Curriculum on Medical Ignorance (CMI) for medical and subsequently undergraduate and K-12 students (targeting disadvantaged populations) few had capitalized on the power of shifting the science/ medical education paradigm to focus on “what we know we don’t know don’t know we don’t know and think we know but don’t”-the terrain of all learning and discovery (viz. in medicine current and future clinical research). Nor had they experimented with authentic student-centered inquiry strategies to recognize and deal with scientific/ medical ignorance by valuing Questions Questioning and Questioners (the 3Qs or Q3) alongside the 3Rs or R3 (i.e. presenting the scientific/clinical puzzles before today’s facts/answers). In this Phase I & II SEPA proposal we plan in a stepwise fashion to introduce a broadband Internet-based Arizona-wide and then national K-12 audience to 1) the first ever Virtual Clinical Research Center (VCRC) and 2) the Medical Ignorance Exploratorium where students can become skilled “Questionators” surf resources and both query and navigate expanding “Isles of Medical Ignorance” as members of clinical/translational research teams. Through established and emerging multi-institutional/organizational partnerships and Arizona’s internationally recognized Telemedicine Program VCRC and the Medical Ignorance Exploratorium will create progresive live and Internet-based age-appropriate and culture-sensitive collaborative experiences spanning clinical research topics (few of which are currently included in K-12 science curriculum) from artificial hearts to breast cancer to gene therapy. These will be designed to engage and progressively involve the learner in the diverse multidisciplinary Teams complex Technologies and bench<->bedside<-"community Translation (3Ts or T3) investigating the questions that generate the heartbeat of the global including NIH-funded clinical research enterprise. The 3-stage project evaluation model will focus on 1) design-test->refine; 2) implement-“test->refine; and 3) disseminate->test incorporating evaluations of both process and outcome using an experimental model assessing dose-response relationships and mediators and moderators of success and effectiveness both short- and long-term. Thus the K-12 Virtual Clinical Research Center and Medical Ignorance Exploratorium aim to show the K-12 community how current medical ignorance fuels the questions questioning and questioners that energize the clinical research enterprise. Further showcasing clinical research and clinical research teams in this collaborative inquiry-driven Internet-based environment should further the NIH Roadmap by recruiting and assembling the diverse clinical research teams of the future forging the complex infrastructure for new pathways of discovery and educating the public about clinical research thereby facilitating the translation of basic science advances from bench to bedside to community.
Networks (some overlapping) particularly of our: SIMI students and K-12 teachers/school districts; professional association newsletters and meetings (e.g. SACNAS AMA-AFMR FASEB) currently involved with us and other new associations; media outlets and the web (collaboration with ASU School of Journalism and our outstanding local collaboration with the extensive news and tele-communication networks). We intend to utilize these multilateral established and evolving Arizona nationwide and even global partnerships to enhance impact and accessibility encourage innovation and ownership and promote replication and sustainability; and thereby contribute novel state-of-the-art models toward the fulfillment of the SEPA mandate NCRR strategic vision and NIH Roadmap for preparing K-12 students to join the diverse clinical research teams of the future; enhancing public understanding of the complex issues technologies and challenges of modern medical science; and expediting the translation and communication of basic science advances to the bedside and community.
This project is just starting and we are describing the process for only the first phase of evaluation (pilot test). We will also have both implementation and dissemination processes each with their own evaluation procedures in subsequent years. The overall goal of the detailed and comprehensive evaluation is: to design and then measure the effectiveness of the VCRC and MIEx and their associated outreach extensions in expanding current K-12 biomedical science curricula to the VCRC and MIEx with its electronic format (the pilot evaluation); and then measuring its impact on students and the community promoting inquirybased thinking in K-12 classrooms and stimulating community activity (the implementation evaluation); and finally to increasing the number of people (particularly minority and underrepresented groups who pursue careers in the biomedical sciences) who interact with the project through dissemination (the dissemination evaluation). (Overall) Evaluation Design – The program is a combination Phase I and Phase II project and a three-stage evaluation model will be used. Each stage has an integrated test phase: (1) design>test>refine> (2) implement>test> (3) disseminate>test. The first phase of evaluation will test the concepts web-based media curricula and evaluation instruments that form the foundation of the program (stage 1). The pilot test will incorporate evaluations of process and of outcome. It will also serve a secondary purpose of outreach orientation and recruiting for the full-scale implementation and dissemination. Years 2 and 3 of the project will use the pilot test results to refine the program (stage 1) implementing the refined program (stage 2) and evaluating both fidelity and effectiveness (stage 2). This implementation evaluation will focus on defining how how well and why the program works using an experimental model assessing dose-response relationships and mediators and moderators of success. Years 4 and 5 of the program will be devoted to dissemination and evaluating the dissemination process (stage 3) including who adopts the program how many schools for what purpose and to what degree they implement the program. Instruments Used Types of Data Collected Plans (for Pilot evaluation only) – The VCRC and MIEx will be tested similarly and on parallel timelines. Testing will begin with low fidelity one-on-one user testing of the computer interface with individuals from the target population followed by high fidelity user testing in small classrooms using a focus group approach. Feedback from these initial tests will be used to develop a full-scale pilot test. The pilot test will be conducted by research staff in classrooms (8 to 15 students) from the target population with teachers (3 to 5) observing the process. Teachers will complete observation checklists during the event (rating the engagement depth of learning and unmet needs of the students) and post-event assessment of their own understanding of the curriculum confidence in using the program without assistance and perception of the value of the approach. Students will complete pre- and post-class assessments that measure change in knowledge confidence and attitudes. All data will be collected anonymously. Data from the pilot testing will be entered directly into SPSS analytical files and analyses conducted using SPSS 13.0.1. The primary analysis will be on degree of change in students’ knowledge confidence and attitudes. Total scores on each of the three subscales will be calculated and change over time measured with paired sample t-tests. Analyses will be conducted to determine effect size and confidence intervals around it rather than statistical significance. Descriptive statistics will be calculated on data from teacher assessments to summarize strengths and weaknesses of the program. Data collected during pilot testing will be used to estimate effect sizes for power analyses to determine sample size needed to permit statistically meaningful inferences for future implementation and dissemination evaluations of the final curriculum.
Resources for Sharing
The VCRC and MIEx (including Questionator) will have multiple components that are interactive and directly accessible for subsequent dissemination through the project.
Primarily K-12 students and teachers with secondary impact on the public and the clinical research and science community.
K-12 education; Public education; Virtual CRC; Translational process through teams and technologies; Innovative student-centered inquiry through MIEx.