Hypocampus – the start

Hypocampus is a site for Medical students built on Cortexio.

Thanks to everyone who helped make 2016 a really good year for Hypocampus! Here is some info on the first months of Hypocampus history.

We started the trip in April 2016 when we decided to jointly develop a study portal for the medical program – something that was both lacking and in demand. Getting help to structure the studies to learn as effectively as possible was our goal with the service.

The 5 founders; Per-Ola, Elias, Daniel, Hampus and Thomas, started the project by collecting data about our users (medical students) to understand how we could build the best service for them. We did user studies in the form of forms, emails and longer interviews. From the data we collected we built a Persona.

Persona canvas – Student

Facts
Ambitious
Lack of money
Pains
Books are expensive
Examination anxiety
Behavior
Buy or copy books
Studies more than they need
Goal
Pass the exam
Become a good doctor

The Persona is quite simple, but based on it we justify decisions about the service from a user perspective. We also produced a problem statement: “Anxiety due to poor control over their learning process”. This helped us to define our main features in the next step.

Main features

“Anxiety due to poor control over their learning process”

 Main Feature Knowledge level feedback
 Sub Feature 1 Streamlined learning
 Sub Feature 2 Organizing learning materials

After agreeing on our main features, we did a brainstorm to come up with functionality for each feature. The following is a breakdown of the different functions we looked forward to for each main feature.

Main Feature:Sub Feature 1:Sub Feature 2:
Knowledge level feedbackStreamline learningNavigate in learning material
See progress (read blocks, number of times, time), questions, read informationAnswering questions according to Spaced repetition (ANKI?)Avoid redundancy
Weighted educational info on a variety of questions linked to the informationNotification to users according to spaced repetitiontagging system (organ, specialty, symptom)
Markers in text (correct, incorrect, undone, included in exam questions)Met today’s goals, set your own goalsNavigation tree
View statistics (Group level, class, friends etc), over time (history)Tools for questions / tipssearchable
Gamification, creating motivation, eg scoring system, “pat on the shoulder”…Make your own and share questionsClarity in navigation
manual assessment with regard to writing questionsContest, quizlinks to sufficient information
User listing on materials (difficulty, interest, uninteresting etc?)opportunity for time-honored learningIndex
Tools for questions / tipsQuestions linked to a defined amount of textClarify structure through colors
Exam mode (timer, no cheat)Write questionsImagemap
The editor can announce the difficulty of informationMCQ (one and several correct answers)Go to weighted material to get the best possible hits

We have now implemented some of the functions mentioned above, others that are still in the plan for the future.

Since it is easy to come up with fun features, but there is limited time, we went ahead by selecting the features we thought we needed to be implemented before we could let users in.

Minimum Viable Product (MVP)

In order for a product to be as good as possible, it must be adapted to the needs and response of the users. The best way to get user feedback is to have users, so you want to get your product out as quickly as possible. We therefore created a list of features we need to get ready before we can let users in – our very first beta version.

User Stories

Once we defined the functions we wanted to include in our MVP, we specified each function in more detail to understand what needed in the service to fulfill the function. Here we work with something called User Stories and which gives a clear picture of how different actors interact with each other: Student, System, Author.

NamePrioIdUserDescriptionActionPostconditionExceptional case
Navigate
View chapters via navigation1StudentAs a student, I want to be able to find a chapterThe student chooses to navigate to a chapterThe system shows the selected chapter
Follow links2StudentAs a student, I want to be able to follow links1. The student chooses to display a text containing a link.The system displays the target text.The link is not in the system, the text to which the link is edited, the text is deleted
2. The student clicks on the link.The system displays the text that the link points to.

After we agreed and specified our User Stories, we were ready to move on to sketching how this could be resolved systemically.

Mockups

A problem can often be solved in many different ways, especially when it comes to the computer world and interactive services. Where should buttons, text, images be and what should they look like? To quickly go through many different ideas in a short time, it is a good way to sketch with paper and pen. It is easy to see if you have missed something in their User Stories: “But you have to navigate back from the chapter to the course view!”, “Here it would be good if you could start a question session”, “Here I want to see statistics on how many chapters there are ”. This is a very inexpensive way to make sure everything is connected. Once programmed, any change suddenly becomes much more expensive.

From mockups, the step to prototype is not far. If you are unsure of a feature’s design, it can be a good way to let users test a simple prototype before moving on to the more time-consuming implementation step.

That was all for part 1 about Hypocampus 2016. There will be more in part 2.

Security on Cortexio

In times of leaked passwords, we want to give a reassuring message about the security of your login information in Cortexio: It is very good.

SVT Hidden – do we have your password? )

At Cortexio, we use bcrypt ,  https://en.wikipedia.org/wiki/Bcrypt , to hash and salt your password. Your password is converted to a text in the following format: $2a$10$N9qo8uLOickgx2ZMRZoMyeIjZAgcfl7p92ldGxad68LJZdL17lhWy before saving it to the database. We do not save your password in plain text anywhere. A unique, server-generated, text (salt) is added to your password before it is encrypted. This makes it impossible to recover your password from a database dump. To make sure that you log in with the correct password, a similar encryption call is run at login.

Hopefully, more web services will take their responsibility when it comes to storing passwords correctly so we won’t have to worry about such leaks in the future.

Spaced repetition

Everyone has different ways of studying. As a student, it is common to look for methods where you can optimize learning per unit of time. One problem with trying to learn as much as possible per unit of time is that it can sometimes compete with getting what you learn to stick in long-term memory. Something that most people have experienced at least once is to procrastinate until the exam approaches and then try to squeeze in all the information needed to pass the exam, in memory. This study method is called cramming. The difference when you start studying from the start of the term is that most of the information appears on several occasions, in other words, more repetition times are spread over a longer period, which leads to better storage in the long-term memory. What happens when cramming, when you only process the information at one occasion, is that the speed at which you forget i higher.

Cramming

To explain the negative aspects of cramming, we can take the help of Robert Bjork, a researcher in psychology at UCLA and an expert in the area of ​​learning and memory retention.

“Cramming can actually be a good thing to do from the standpoint of your getting a grade. If you don’t know the material and haven’t appropriately spaced your study across the term, … if you stay up all night, study, cram whatever and walk into the exam, you can actually perform pretty well on that exam…”

“But the problem is not too long after that, this massed practice will lead to …very poor retention. So as far as the material in that course carrying over to other courses, to your life in general, it’s an awful thing to do. “

See Björk’s entire lecture at: https://www.youtube.com/watch?v=TTo35X2rqls

How quickly one forgets has been an area that has been studied since the 19th century when a scientist began to experiment with his own memory. By studying a series of syllables and then measuring how many of these he remembered day 1, day 2, etc. he realized that the decrease in how much he remembered over time was exponential. The man named Herman Ebbinghaus therefore named the so-called “Ebbinghaus forgetting curve”

The fact that information is so quickly forgotten is important in most study contexts and perhaps extra important in medical studies. The purpose of knowledge tests during e.g. medical education is not only to see that at any given time, each student manages to keep a sufficient amount of information in his head to pass a test. The knowledge will hopefully stay with the student to be able to access when needed in clinical situation. As efficient long-term storage as possible is therefore something invaluable in the medical context.

Better methods?

So how do you do to remember as much as possible as long as possible? Are there any shortcuts? The answer to that question is both yes and no. Learning large amounts of information requires effort and the effort itself is an important part of learning. In most cases, repetition is required for long-term storage. However, there is a shortcut for how to most effectively repeat the knowledge, a shortcut called spaced repetition.

So what is spaced repetition then?

By splitting the repetition sessions so that you repeat the knowledge just when you are about to forget it, you create a more time-efficient learning. For every time you repeat a certain fact, the time when you would have forgotten without repetition, it is postponed later in time. The intervals between rehearsals will therefore increase gradually.

ebbing house diagram

So how effective is the method? Thousands of studies have found that spaced repetition is more effective than other types of repetition methods. However, the results vary in how effective it actually is. In a meta-study, it was found that students who use spaced repetition perform better than 67% of students who spend as much time for repetition but other repetition methods.

So why not use all spaced repetition?

Probably there are several reasons for this. In order to make use of the algorithm, software support is necessary, which has made it difficult to use before digitalisation. The second fact is that it requires intensive and consistent application by the student. The student must, over an extended period of time, continue to repeat to achieve the desired result, which can be strenuous. Cortexio’s goal with regard to spaced repetition is to integrate the repetition method into the students everyday workflow so that the load does not exceed the student’s ability to continue repeating without being burned out. In this way we not only create increased long-term storage, but also a sustainable study methodology.

Sources

Custers EJ, Ten Cate OT. Very long-term retention of basic science knowledge in doctors after graduation. . Med Educ. 2011 Apr;45(4):422-30. doi: 10.1111/j.1365-2923.2010.03889.x.

Donovan, J. J., & Radosevich, D. J. (1999). A meta-analytic review of the distribution of practice effect: Now you see it, now you don’t. Journal of Applied Psychology, 84(5), 795-805.

Robert Bjork – Spacing improves long-term retention. https://www.youtube.com/watch?v=TTo35X2rqls

Stahl SM, Davis RL, Kim DH, Lowe NG, Carlson RE, Fountain K, Grady MM. Play it Again: The Master Psychopharmacology Program as an Example of Interval Learning in Bite-Sized Portions. CNS Spectr. 2010 Aug;15(8):491-504. PMID:

Read more

Efficient memorization & what it’s good for. (psychology) http://www.gwern.net/Spaced%20repetition

The New England Journal of Medicine http://knowledgeplus.nejm.org/spaced-repetition-the-most-effective-way-to-learn/

Wired magazine, Want to Remember Everything You’ll Ever Learn? Surrender to This Algorithm
http://archive.wired.com/medtech/health/magazine/16-05/ff_wozniak?currentPage=all