Case Study: Western Carolina University

Western Carolina University's main campus is located in Cullowhee, NC, just over 50 miles west of Asheville.  The first Baccalaureate Emergency Medical Care (EMC) program in the nation, the Program is one of only fourteen institutions in the country offering the Bachelor of Science (B.S.) degree in Emergency Medical Care.

We spoke with Melisa McNeil, Residential Program Director, about the challenges of engaging a diverse student population, in both online and traditional models, and how case-based learning and innovation has improved outcomes.  See her responses below or watch the full video interview.

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Thank you for giving us a bit of your time today.  I really appreciate it.  Could you tell me a little about your program at Western?

Melisa: So, the program here at Western... There are actually two programs.  There's a distance-learning program, and a residential program, which I am the director of.  The distance-learning program is truly set aside for folks who have completed an Associate's or a continuing education program, who have their paramedic, are currently working in the field, adults who have other commitments and can't come to campus. The residential program, on the other hand, is intended for students who are more of the traditional student, who've left high school and come to college. They complete their first year to two years of liberal studies and prerequisites, and then come into the program.

Some of them will have a little bit of background. Maybe they've done some volunteer work, or they've done firefighting, or they've taken an EMT program at their local community college. Every now and then we get a transfer paramedic who wants to come back and get a bachelor's degree. But they come into the program in their junior year. They spend two years with us, and complete the entire paramedic curriculum.

We do have two tracks and we call them concentrations. The first one is Science, and that's really intended for folks who want to further their career as a provider. Maybe they want to go back and get a nursing degree, or go to PA school, Med school, DO. I've got one in dental, one in veterinary. So, they want to go graduate in the provider area.

The other track is the Health Management, and that's for folks who really intend to climb the EMS career ladder and be administrators, and supervisors, and training officers - those kinds of things. But it's funny how some folks will complete the management track and end up climbing in the provider arena, and some folks will complete the Science track and end up in administration. So, there's quite a bit of overlap.

I'd be interested in knowing how you first learned about ReelDx.

Melisa: Actually, completely by accident.  A couple of the faculty were working on redeveloping some courses for the online program, and we wanted to bring more of that kind of scenario-based education - you know, that authentic problem - to the online environment.  Online courses have really kind of expanded, and online programs, so we just wanted to enhance it a little bit.  And some of the faculty, they were developing a pediatric course, (which is really funny - Dr. Spiro's background) and they ran across ReelDx online, found the free access videos, and integrated some of those into the course and into the syllabus. And then they stopped working!

Oh dear! What happened?

Melisa: Well, I think that some of the content was moved from the free view, over into the pay-for-view. So, we got in touch with ReelDx. We found out more about what the intent was, and what you guys were doing, and building, and creating, and we said, "We're on board!"

Tell us a little bit about how your program is using ReelDx in the curriculum? What are some of the example use-cases? How are the faculty incorporating the cases into the curriculum?

Melisa: So actually, there's lots of different ways that folks are using. In the distance-learning program it's more of a discussion-type activity... I see that most often...  where cases will be linked into the course. Students are expected to go in and review them, and then post their discussions for everybody to kind of build around. Later in the course, they will actually get, say, the diagnosis, or the treatment options. We'll actually open up those other drawers now, which is so fun - that those drawers open and close - which they didn't, previously. (I really love that, by the way).

In terms of the residential programs we use them in several ways.  Sometimes we'll have students do case studies on their own, at home, and bring them in. We've incorporated them into examinations, which is really fun. (Well, at least on our end. Sometimes the students don't particularly think so.) We've incorporated them into our simulation lab. So, we'll actually start with "Here's your patient clip," with the ReelDx piece, let them watch that portion, and then - don't open any of the drawers - and let them run the actual scenario. And then wrap it up with a debriefing, with all the information that's in the drawers: the differential, the actual outcome, treatments. So yeah, we actually use it in quite a few ways.

Wow, your program has been truly innovative. Was there a focused adoption effort or has it been more organic?

Melisa: Well, initially, we really adopted to make that one particular course work. Where the faculty had been redesigning that course and then ran into "Oh, the videos are gone! We need the videos back." But since adopting, you know, it's such a great tool, really the idea has been, in faculty meetings, "Okay, now that we have this tool, what can we do with it? How can we use it, and get the most out of it, not only for us as educators, but for the students as well?" So it's really been fairly organic, and kind of flowed.

What kind of feedback are you getting from students and from your faculty? Has there been any evidence about how it's impacting conceptual understanding or other performance?

Melisa: Yes, particularly with the campus program. I mean, we get lots of emails from distance-learners saying how much they enjoy the product, and now they are hooked. But for the campus students, who aren't working paramedics, who are just starting to do clinical rotations and maybe they haven't seen, you know, an infant with croup, or they haven't seen a nystagmus, and they haven't done an extra-occular eye exam - having that available in ReelDx to show them - you know, "This is what this infant with this disease is going to present like. This is what they're going to sound like," or, "Here is an allergic reaction. Listen to the audible wheezing from across the room. What do you see in the video, just within the video itself, within the first ten seconds?" It has really given them the opportunity to see some of those unusual pieces that you may not see as a practicing, pre-hospital provider for many years. So, they're really enjoying it. We get lots of positive feedback.

I wonder if you have any thoughts or advice for those using or considering ReelDx around how to best incorporate it into their program? Any best practices you've learned that will help people overcome hurdles in the future?

Melisa: So my first piece of advice would be to have an open mind about how you can use it. You know, don't get stuck in one place with it. We saw that initially, when we started. We wanted the students to watch the videos and then that was kind of it. Now that we've watched the video, the "Now what?" was the next big question. So don't feel stuck with one usage.

I would say that one of the things that has really worked out the best, in terms of Western's usage of ReelDx cases, is that kind of discussion and case study with the students. And if you want to do that in a simulation laboratory, that's fine as well, but something where they actually get to see a part of the case, and then get them into that thinking process of, "Okay, what do you think is going on?" "Why do you think that?" "What signs and symptoms do you see in the patient to support your field diagnosis, or your other differentials?" "What would you treat them with, and why?" Tie it back to that "Why?" to get them really kind of thinking about what's going on.

Melisa, that's really fantastic advice for people who are considering ReelDx, and I just want to take a moment to again say thank you for giving us your time today.  We do appreciate your program's use of ReelDx and look forward to many more innovations.

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