Curriculum development with the implementation of an Open-source Learning Management System for training early clinical students: An Educational Design Research Study

Severin Pinilla,1,2 Andrea Cantisani,3 Stefan Klöppel,1 Werner Strik,3 Christoph Nissen,3 Sören Huwendiek2 1University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; 2Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland; 3University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, SwitzerlandCorrespondence: Severin Pinilla Email severin.pinilla@upd.unibe.chBackground: Learning management systems (LMSs) have not been explored from an educational design research (EDR) perspective for developing clinical curricula and supporting novice clinical students with self-regulated learning during their early clinical rotations.Methods: An EDR approach was used to inform a de novo implementation of an LMS during an early clinical rotation of medical students. The EDR consisted of three phases: analysis and exploration; design and construction; and evaluation and reflection. Process and evaluation data (including academic years 2018 and 2019) from two student cohorts (total n = 190, 107 without and 83 with LMS exposure) at one academic teaching hospital were analyzed.Results: Learning theories and concepts of self-regulated learning were used to develop and implement an LMS clerkship prototype. For design and construction, the maturing prototype design included flipped-classroom elements, in-class activation, voluntary digital self-assessments, and clinical teaching videos. For evaluation and reflection, global satisfaction improvement was significant (from 3.9 to 4.4 on a 5-point Likert scale, p < 0.05). There was a positive evaluation trend for all evaluation items related to learning climate, self-regulated learning, and perceived usefulness of the LMS prototype; however, these changes were not statistically significant. The teaching hospital also improved its ranking after the introduction of the LMS prototype. Nearly all students (94%) used the LMS material. The average number of times the LMS course was accessed per student was 70 (range: 7– 172), and the average duration students spent online was 58 minutes (range: 9– 165).Conclusion: Our data indicate that using an EDR approach was helpful for systematically introducing an LMS in a clerkship curriculum informed by learning theory. Our evidence-oriented curriculum reform was associated with higher student satisfaction and appeared to support self-regulated learning in the workplace. Further research should explore which elements of an LMS most effectively help to achieve educational outcomes.Keywords: learning-management system, self-regulated learning, clinical education, educational research design, psychiatry