Summary: This fortnight Professor Harden discusses a recent trip to Al Imam Medical College, ‘The Flipped Classroom’  and jetlag. Description: I have just returned from a short visit to the Al Imam Medical College in Saudi Arabia following an earlier visit in September.  I was interested to hear that a progress test is being administered this week across a number of the medical schools in Saudi Arabia.  It will be interesting to see the results.  As with many progress tests it is using multiple choice questions.  We found in Dundee that very short constructed response questions offered many advantages and I cannot understand why this approach has not been more widely adopted, not only for progress tests but for written examinations more generally.  Objective marking is now not a problem.  The students at Al Imam Medical College are now in their first clinical year and are sitting this week an OSCE.  Again it will be interesting seeing the results in practice.  While in Riyadh I was pleased to hear from Professor Khalid Bin Abdulrahman that the preparations for the April 2013 supplement to Medical Teacher, with papers from the Gulf region, are now well advanced.  Of the 40 papers submitted, 14 have now been selected for publication. They give a useful insight into medical education in the region, addressing issues such as the educational environment, technology based assessment and career advice.  I was pleased to see the appointment of Dr Al-Kabbaa as Vice Dean for Quality Assurance and Development at the medical school.  The university is planning an international forum for innovators in university teaching in February.  This is being planned by Dr Abdullah Al-Mubaraki, Dean of Development of university education.  He has an ambitious programme for educational development in the university.

For the last few years I have used melatonin to combat jet lag when travelling.  Opinion has been divided but the balance of evidence has been that it is effective.  I was interested to see an article in the BMJ (10th November) on the treatment of sleep disorders with melatonin.  In the double blind trial doses ranging from 0.5 mg to 12 mg were used.  The normal recommended dose on the drug packaging is 3 mg.  The group treated with melatonin had better and longer sleep.  The authors suggest that a mixture of fast and slow release formulations is advantageous.  I suspect the same is true of the use of melatonin for jet lag.  Melatonin is only available over the counter in some countries including USA, but not Canada, Singapore or Malaysia and it is sometimes difficult to find both fast and slow release formulations.  The BMJ article relates to an earlier article by Kolla and Auger ‘Jet lag and shift work sleep disorders: how to help reset the internal clock’ (Cleve Clin J Med, 2011; 78: 675-84).  The article reviews the evidence that the melatonin does alleviate symptoms of jet lag and improves the quality of sleep and that a daily dose of 10 mg or less it is safe.

I was interested to note that the Education Academy of the International Transplantation Society is running a webinar series on education for its members starting in February 2013.  I have been invited to give a webinar on teaching skills.  We have debated for the ESME online courses and the MedEdWorld webinars, as to which is the best day of the week to offer the webinars.  I understand from Dr Askar that the Transplantation Society have found that Monday and Friday are the worst and that Tuesday is the best, following by Wednesday and Thursday.

In a discussion about whether students should be allowed to bring their own electronic devices for use in the classroom, Martin Hamilton in his blog describes a policy document which is aimed primarily at staff and risk management.  He includes a Diblert cartoon.

Dick Kitch, who serves with me on the AUC Board, sent me information about a launch by The Canadian Medical Protective Association (CMPA) of an innovative online resource for medical students on the subject of patient safety.  The online interactive guide is designed as a self-study tool and addresses 7 themes: patient safety, teams, communications, managing risk, human factors, adverse events and professionalism.   Further details about the CMPA Good Practices Guide are available on the MedEdWorld site.

With a continuing interest in the use made of the OSCE, I noted in figures produced by the Association of American Medical Colleges that the OSCE was by far the most widely used form of summative assessment in clinical clerkships.  Ninety three to ninety four per cent of internal medicine, paediatric, psychiatry, obstetrics and gynaecology and surgical clerkships use the OSCE and 83% of family clerkships.

Stanley Hamstra, Acting Assistant Dean of the Academy for Innovation in Medical Education (AIME) at the University of Ottawa, gave me when I met him at the AAMC meeting in San Francisco, a copy of their annual report.  The vision for AIME is that it will be an international leader of innovation in medical education.  I was interested to see last year that AIME supported with grants, nine projects for research and innovation in medical education, with funding of $123,162.  

It seemed ten years ago that applications would run on a standards-compliant internet-connected web browser and the only thing as users that we would have to worry about was whether our computer had sufficient power to run the application.  Unfortunately with Smart phones the situation is very different with a large variety of differences between operating systems and devices.  For mobiles, applications have to be written for a number of operating systems.  This was a point made in the November 15 issue of Computing  (  Having just upgraded my BlackBerry Bold to the new model, I was disturbed to read that applications written for existing BlackBerry devices will not run on RIMs forthcoming BlackBerry 10 OS.  In the same issue of Computing there was an article by Peter Gothard on ‘The endpoint of the future.’  Peter Cochrane, a technology futurologist is quoted “we’re looking at a Captain Kirk world filled with screens.  Mobile devices will be in the form of wearable elements – like jewellery – and any screen you approach will interface with it.”  He believes that within 25 years wearable technology will have penetrated the skin – subsumed into the human body in some form or another.

One of the things I am thinking about at the moment is a workshop I am running at the International Medical University, Kuala Lumpur in January on the subject of ‘The Flipped Classroom.’  I had hoped to take part in a webinar organised by Education Week, supported by a grant from the Bill and Melinda Gates Foundation.  I was interested, however, to see in a book we are reviewing at the moment for MedEdWorld ‘Best Practices for Teaching with Emerging Technologies,’ the introduction labelled ‘The Flipped Classroom.’  I have referred to the ideas in earlier blogs and Medical Teacher. Adi Haramati highlighted the approach in a recent webinar he gave as part of the MedEdWorld webinar series.  This was a follow up to his much praised plenary presentation at AMEE 2012 in Lyon.  He gave the webinar on this occasion from Dundee as he was visiting St Andrews to discuss the arrangements for the IAMSE conference there in June 2013 (   It has been a pleasure working with Adi at previous IAMSE meetings on ESME courses.

Marilyn Hammick, while working with us recently on the BEME initiative, drew my attention over dinner one evening to the concept new to me of ‘flash fiction.’  This is prose of extreme brevity.  Apparently it began with Hemingway in the 1920’s when his friends had bet him he couldn’t write a complete story in six words.  He grabbed a napkin off the table and nonchalantly dashed off six words:  For sale. Baby shoes. Never worn.  Then he slid it across the table and collected what was due to him.  You can find further information at: