Introduction

Osmosis is a web and mobile learning platform that allows students to create, engage, and share with a global learning community. We currently specialize in medical education - students can create and gain access to tens of thousands of questions, flashcards, and videos, but the idea is much bigger than simply an online library of resources. Similar to evidence-based medicine, Osmosis believes in evidence-based education. Our team includes PhDs in neuroscience & education, practicing clinicians, and medical students, who have built the following proven cognitive techniques into the Osmosis platform to maximize learning and retention, such as: test-enhanced learning, spaced repetition, memory anchors, collaborative learning, Fogg behavior model, and gamification, among others. In addition to being featured in the bestselling book, Make it Stick: The Science of Successful Learning (p 245), Osmosis has published peer-reviewed papers (www.osmosis.org/institutions) and is actively engaged in research, including a cross-institutional study with UIC and UCF on its intelligent formative assessment system funded by a Stemmler Grant from the National Board of Medical Examiners.

In our paper in the high-impact Annals of Internal Medicine, “What can medical education learn from Facebook and Netflix?” we described a vision for the future of education. After lamenting that the tools that our future clinicians use to socialize (Facebook) and watch TV (Netflix) are managed by more sophisticated algorithms than the tools they use to learn medicine, we decided to build Osmosis so that we could bring data-driven recommendations and experiences to our future clinicians. Osmosis analyzes what the students are learning in class and generates custom quizzes and recommendations that help them simultaneously prepare for school, board exams, and most importantly clinical practice. By solving the problem for medical education, we believe Osmosis can also be applied to many other fields of education.

Synopsis

Objective

We want our future clinicians to be able to learn more efficiently and enjoyably. We have four primary objectives:

1. Open educational resources (OER):
Osmosis has generated thousands of open educational resources (questions, flashcards, videos, images, licensed CC-BY-SA) through a large network of experts. These will be openly accessible for any learner to use free of charge. We intend to greatly expand our OER to be useful for more clinical & preclinical learners.

2. Advanced learning platform:
(i)To work with medical school faculty and students to create school groups with their own calendars and course materials.
(ii)To allow medical school faculty and students to generate local content (e.g. questions, flashcards, videos, images) that can be collaboratively edited and used.
(iii)To provide content that is dynamic and useful for standardized exams and clinical practice; for example, clinical vignettes which are the basis for critical-thinking questions. Students are able to rate their confidence in their answers and get immediate feedback on their performance.
(iv) Analytics dashboards let students track their effort and performance over time, compare their performance with peers, and measure their progress against overarching goals (e.g. learning cardiac pathophysiology). Over time, the platform adapts based on individual student performance and learning preferences.

3. Instructor dashboard:
(i)Instructor dashboards enable instructors to identify at-risk students by analysing both content usage and performance of the entire class cohort. Thus, faculty can easily identify knowledge gaps in individual students or entire cohorts, provide feedback, and/or iterate on their teaching.

4. Networking and growth:
(i) Osmosis student communities are a vital part of the learning platform. Motivated students worldwide are identified and provided opportunities to submit content as well as articles for publication. To date, 900 of our 29,000 users have submitted 50,000 questions and 70,000 flashcards.

Approach

Osmosis is accessible via web- and mobile-devices. Key features include:

1. Supplementary resources for questions: Each question has a detailed explanation with relevant background information (e.g. YouTube video, Medscape research article, and helpful real-world cases) and memory anchors (e.g. Picmonics, mnemonics).

2. Peer-to-peer teaching: A student can write a question directly on the Osmosis platform, and this question can be reviewed, answered, and voted on by thousands of students and faculty across multiple universities around the world.

3. Natural Language Processing: Students can upload a professor's Powerpoint presentation to a private class group, similar to a Facebook group. Then, Osmosis will automatically scan the document for important concepts, and send the students relevant questions and flashcards from the existing database of content.

4. Spaced repetition: Students can enter their class, shelf, or board exam date, or current clinical rotation schedule and they'™ll receive relevant questions in the days leading up to the exam, as well as weeks/months later to ensure they remember the information.

5. Usability: Based on students' exam dates, they'™ll receive relevant questions pushed straight to their phone. This helps to ensure the studying gets done.

6. Timeline search: On the Osmosis platform, students can search through their school materials and scan them for key terms/phrases (e.g. aneurysm). They'™ll find every instance of the term across all of their learning materials from all of their classes to ensure all taught concepts are learned.

7. Adaptive: Students can flag content that they like and rate their confidence in their answers. Osmosis automatically begins to learn what they want (and need) to see more of in their daily to-do dashboard.

8. Faculty and administration dashboards: University faculty and administrators can easily see how the class is tracking (as individuals or as an aggregate) and focus in on individual student performance.

Engagament

Osmosis is a medical education learning platform that is used by 29,000+ medical students from over 300 medical schools around the world. We remain committed to creating a level playing field for medical students worldwide, and are contributing to the cause by offering open-license content that is free for any student to access. We've gone a step further by strategically partnering with the Consortium of New Southern African Medical Schools (CONSAMS) to deploy the content and the Osmosis platform free-of-charge in those settings.

To increase the value proposition for medical schools, we've partnered with content creators such as Medscape, The Doctor's Channel, and Picmonic to offer reliable, engaging, and up-to-date information that students and faculty can trust. We reference these resources throughout our platform - for example, after an Osmosis user completes a question about heart attacks, she will automatically be recommended Medscape's article on myocardial infarction, and a few pictorial mnemonics from Picmonic. This cements the topic in the learner's mind.

Osmosis contributes to the medical community in other ways. We've created 2 flagship groups aimed at networking, collaboration, and creating career growth/opportunity: Leaders in Medical Education (LIME) and Student Innovators in Medical Education (SIME). The LIME project includes a weekly blog feature of an influential educator in medicine. Past examples have included the Presidents of the American Medical Association, the American Nurses Association, and the World Federation of Medical Education. The SIME project is our other flagship group. Through this initiative, medical students worldwide share ideas and collaborate on ideas to improve medical education. Osmosis provides career growth to the SIME cohort through networking and publishing opportunities, as well as exposure to our LIMEs. The two groups work in close synergy, allowing one group of leaders to give rise to the next.

Impact

Osmosis began as a thought experiment of two Johns Hopkins medical students who were brainstorming on how to learn more efficiently. It has since developed into an engaging and enjoyable platform that drives stronger medical knowledge retention through evidence-based algorithms.

We've mentioned the number of students (29,000+) from medical schools (300+) that use Osmosis worldwide. We've also published papers about the efficacy of our platform (attached to this application). We analysed performance on board exams and found that students who used Osmosis for 3+ months scored an average of a 247 on the USMLE Step 1 exam (compared to the 230 national average). Osmosis continues to learn and improve based on the latest evidence.

Osmosis is a data-driven company that operates according to the adage, "œIf you cannot measure it, you cannot improve it." In addition to tracking learner behavior on the Osmosis system, we generate easy-to-understand visualizations that allow faculty & administrators to determine how cohorts and individual students are doing overall and within specific topics. Through Osmosis, faculty can answer questions such as, "Which students are at-risk and need support?", and "Are there any gaps in our curriculum?"

Also having an impact is our one-of-a-kind curriculum visualization & mapping tool, Timeline Search. By uploading course documents to Osmosis Class Groups, students can use Timeline Search to pinpoint specifically where topics are covered in their curriculum. This is especially useful for accreditation purposes, such as the LCME self-study, and for enabling faculty to identify and resolve potential gaps in the evolving medical education curriculum.

Finally, we've helped to shed more light on confidence versus accuracy between males and females. We used the answer-data generated from our platform's users and found that males tended to be more confident about their answers, but less correct, than their female counterparts who were less confident, but more often correct.

Next Steps

We want to expand at Osmosis, in terms of both content and partnerships. Currently we specialize in USMLE Step 1 and Step 2 content, but we want to soon create and host content covering the MCAT for pre-medical students, the COMLEX for osteopathic students, and NCLEX for nursing students. In this way, we open up the doors for other students to learn more efficiently using our platform. In time, this will lead to an improved cross-sectional knowledge-base and potentially improved patient-care across disciplines.

Our current content will continue to be periodically expanded and reviewed for accuracy. We are currently finishing up a project funded by the Robert Wood Johnson Foundation which helped us create more than 5,000 USMLE-style questions in just over 18 months.

We are excited about refinements to our platform and content in other ways too: we have recently brought the former Health and Medicine team from Khan Academy onboard, and look forward to taking next steps together to improve the delivery of medical education. One of the ways we will do this is by incorporating new 'Khan-style'™ teaching videos into our resource pool.

We have developed partnerships with medical schools in under-served areas, and will continue to develop more of these relationships in the interest of levelling the playing field™ in terms of medical education resource provision.

We've created a community for medical students (SIME: Student Innovators in Medical Education), and would like to create a similar community for exceptional nursing students as well. In this way, nursing students can more easily meet colleagues with similar interests and receive similar potential opportunities for career growth as their medical student counterparts.

Other Information

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PowerPoint Presentation - Click to download
YouTube Video - Osmosis: The Most Powerful Learning Platform
YouTube Video - How Best To Use Osmosis
YouTube Video - Osmosis: Education through Gamification
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