Institutional investors occupy the fulcrum of two vital dimensions of modern capital markets: the value of public corporations they own, and the financial security of the citizen-savers they serve. Yet for as much effort as policymakers around the world have spent modernizing corporate structures, they have devoted comparatively little attention to institutional investors.
Consequences for companies are profound. Regulators count on institutional investors to help police the market against the risk of repeat systemic crises and fraud, CEOs pay for failure and anemic value creation. In fact, a host of archaic barriers prevent all but a handful of funds from meeting the high expectations placed on them as owners of public corporations. Some observers even contend that the consequence of decades of governance reinvention must now be seen as deeply harmful. Yes, these critics assert, reform succeeded in making corporate boards responsive – but to funds that are habitual short-term traders, not long-term capital stewards. If that is true, policy has unwittingly put company directors and CEOs under more pressure than ever to pursue speedy profit over long-term value and social responsibility. “Corporations continue to place a strong emphasis on quarterly returns, because investors do,” notes governance thought leader Ira M. Millstein. As one key report concluded, “The obsession with short-term results by investors, asset management firms, and corporate managers collectively leads to the unintended consequences of destroying long-term value, decreasing market efficiency, reducing investment returns, and impeding efforts to strengthen corporate governance” (CFA 2006). Similar charges are common in Europe, where the highly contentious – and ultimately catastrophic – Royal Bank of Scotland-led consortium takeover of ABN-Amro in 2007 prompted widespread calls to curb alleged investor short-termism (see also Keay 2011).
As stated in Chapter 1, designing content “begins with the end in mind.” The goal of medical education is to obtain maximum levels of learning. Chapter 4 discusses how to measure whether that endpoint has been met. Program evaluation is a hot topic in medical education these days, and this chapter analyzes not only the methods for measuring educational outcomes but also the results of applying these methods. The goal is to determine at a minimum whether learning has occurred, and, ideally, whether behavior has changed in response to an educational program.
The first section discusses the principles of evaluating educational programs, including methods for determining whether the program has been successful. Five levels of evaluation are proposed – audience reaction, learning, behavioral change, results, and return on education – as the current academic standards for any training program. These specific outcomes are in fact the endpoints that should be targeted when the program is first designed.
The next section explains that, for a medical education program, Level 1 success (audience reaction) is the usual standard of evaluation and is quite rudimentary. Level 1 evaluation merely determines whether audiences liked the learning event, and thus is little more than a “smile sheet.” Other Level 1 measurements can include simply counting the number of people who attended or asking learners whether they thought the education objectives were met.
The third section discusses how to document whether Level 2 success has occurred: namely, learning.
This book was conceived and developed to be a change agent for medical educators. We hope that the principles, concepts and illustrations contained within will raise the effectiveness of those who teach. One might consider the contents of this book to be the “rest of the story” concerning current medical education practices. That is, the tools presented in this book are intended to be the communication complement to the traditional subject matter content of medical education. The premise of this book is that combining the science of communication with the communication of science creates an incrementally more valuable exchange for both the instructor and the learner.
Hopefully there will be something in this book for everyone, from novice instructors to the most experienced mentors. Novice medical educators may discover many new principles about how to assist others to learn. In fact, this book is organized with the first section examining how to apply the principles of adult learning to the design of effective educational presentations. The second section focuses on gaining an understanding of the many and various aspects of the different learners represented in any medical audience. This is followed in the third section by information on the instructor's performance and the impact it can have on effectiveness. The last area discussed is how to measure and evaluate educational programs to see if they have reached their desired outcomes. Each chapter is followed by a knowledge check and an assessment section.
Chapter 1 introduces several critical learning principles that can be applied when designing a medical presentation and that have the potential of increasing the impact of individual slides, entire slide decks, and even entire educational events (see Stahl and Davis,2009a).
The first section discusses storyboarding, with emphasis on previews and reviews. A preview facilitates learner achievement by acting as a roadmap to alert audiences about important topics to come. Repeated reviews help ensure that messages are clearly delivered by providing a second chance for learning, by helping learners consolidate information, and by clarifying outstanding issues.
Between previews and reviews, delivering information in small multiples gives learners manageable packets of data and helps them to see differences as well as similarities between conditions. Thesecond section discusses how to organize the words of text and especially images as a sequence of small multiples to enhance impact.
The majority of audience members prefer visual components in their learning materials, so adding relevant images and figures can increase learning impact. The section on visual additions discusses how to provide visual cues without distractions or data decorations.
Principles of multimedia learning can help guide instructional design to best utilize these technologies. To increase the impact of presentations, information can be presented in both auditory and visual channels in ways that eliminate interference from the textual channel, present related information in close spatial and temporal proximity, and eliminate extraneous information.
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