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Fun and Games at Harvard Med

By Don Harting MA, ELS, CCMEP
November 24, 2013

Games and contests have always been an important part of the Ivy League campus experience. Now a concept developed by a professor at Harvard Medical School presents an ingenious method to inject a bit of competition into a mobile online learning format. The method is so effective, it has led to peer-reviewed journal articles, a patent application, a startup company, and a growing customer list that includes at least 2 CME providers in the mid-Atlantic region.

Med-IQ in Baltimore, Maryland and the Uniformed Services University of the Health Sciences in Bethesda are both using the “spaced education” learning method sold by QStream of Burlington, Massachusetts. According to QStream, Med-IQ plans to launch its new product this month.

Spaced education was pioneered by B. Price Kerfoot, MD, EdM, an associate professor of urology at Harvard, and colleagues at the medical school’s Center for Educational Technology. An early study of a game among medical school students was published in Academic Medicine. A later intervention among primary care physicians – minus the competitive element -- was published in Journal of Continuing Education in the Health Professions.

As the Academic Medicine paper details, the 9-month trial enrolled 731 future physicians from 3 US medical schools. The challenge consisted of answering 100 multiple-choice questions on preclinical and clinical topics. Contestants received 2 questions daily via email. A contestant who answered a question incorrectly received the same question again in 3 weeks. A correct answer meant the same question would come back in 6 weeks. A contestant could retire a question by answering it correctly twice in a row. Posting scores online got the med students’ competitive juices flowing, and by the end of the semester, 70% of contestants said they wanted to play again.

Of course, what’s the point of a fun learning activity if it’s not also effective? According to the Academic Medicine article, the median baseline score of 53% correct rose by the end of the semester to a median completion score of 93% correct. Predictably, students who were more advanced in their academic careers did better. But a weakness of the study was that it included no control group, so there was no way to tell how much of the improvement would have happened anyway, without the game.

Qstream got an early toehold in the life science market and is now being used for sales force education by Genentech, Pfizer, Boehringer Ingelheim, and other well-known pharmaceutical companies. While Harvard’s spaced education research evolved from a medical context, the method is actually content-neutral and can be used for a wide variety of subjects, from technology to financial services. According to the Boston Business Journal, Qstream attracted $2.8 million in venture capital in September and will use the money to serve customers with large sales forces, not just in healthcare but also financial services and technology.

But you don’t have to own a Fortune 500 company to experiment with the spaced education method. Any CME provider can log on to the Qstream community site and take a course – or even offer one – for free. 

Don Harting is a freelance medical writer specializing in oncology education. He works from his home in Downingtown, PA.