Summary: In his latest blog Professor Harden discusses his time in Manila and Macau, Next generation eLearning, the teacher as the Curator of information, the first issue of the Chinese edition of Medical Teacher and the AMEA December meeting. Description: Manila and Macau
I have just returned from a visit to Manila and Macau. In Manila I was presented, in front of an audience of about 5000, with the 2017 Gusi Peace Prize. In all 12 laureates from around the world working in different fields were recognised. The events over the three days included a meeting of the Sino Asia Pacific Medical Forum, a formal welcoming dinner, a wreath laying ceremony and the award ceremony held in the Philippine International Convention Center. Pat Lilley gave the opening presentation at the Sino Asia Pacific Medical Forum on the theme of communication in medical education and was introduced by Niv Patil. My own presentation at the forum was on the future of medical education.

From Manila we went to Macau where we heard about and saw interesting developments in education including an impressive simulation centre for postgraduate and continuing education. Following my lecture on the roles of the teacher in the changing world, I was presented with the Henry Fok medal. This was only the second time the medal had been presented. We couldn’t help being impressed by the general development of Macau which is eight times larger than Las Vegas in terms of casino revenue.

During our visits we had an opportunity to talk with Niv Patil who facilitated the arrangements for our visits. Niv is joining the committee for the surgery education track at AMEE 2018 in Basel and suggested that we should have one final surgery education session at the conference where the highlights in surgery education from the surgery track sessions running through the meeting are highlighted as the take-home messages. The visit provided another opportunity to talk with Niv. He talked had found that many students who score the highest marks in the examinations and receive honours in medical school turn out in practice not to be the most effective and efficient doctors. Four criteria he had used to test this were
  • Does the doctor turn up within the five or ten minutes required time when called to an emergency
  • do they make mistakes in ordering a drug using the computer prescribing system
  • does their performance in carrying out practical procedures such as venepuncture leave something to be desired
  • finally do they call for help when appropriate but not otherwise?
Next generation eLearning
I often find it valuable to look outside medicine and outside higher education to see what is happening elsewhere in the field of education. My original interest in outcome-based education and portfolio assessment arose from articles I read in Education Leadership, a journal aimed at teachers in schools in the USA. I was interested, therefore, to look at a report Next Generation E-Learning: Skills and Strategies produced by the Association for Talent Development (ATD).  ATD is a professional membership organisation supporting those who develop the knowledge and skills of employees in organisations around the world. The association was previously known as the American Society for Training and Development (ASTD). (The change of name is interesting). The report is based on a survey of 546 talent development leaders, most of whom represented large organisations in commercial and non-profit settings. eLearning in the report is defined as:

                “asynchronous, structured, self-paced learning that is delivered electronically. E-Learning may include pre-recorded lecture content and video, visuals, and/or text, knowledge quizzes, simulations, games, and other interactive elements.”

While the report suggested that there was a need to redefine what is eLearning, the new characteristics reported were not particularly surprising. These included greater levels of personalisation, more interactivity, expanded use of videos and an increased focus on content presented as micro-learning.

Kieran Walsh, writing in the Autumn issue of BERA Research Intelligence (p30) on the cost and value in eLearning, describes the presentation of content in BMJ learning in “bite-sized chunks” with interactivity and a problem-solving format.

Association for Talent Development. 2017. Next Generation E-Learning: Skills and Strategies. Accessed on:
Walsh, K. 2017. Cost and Value in E-Learning: The Importance of Context. BERA Res Intel. 134. 30-31

Curator of information
In my book with Pat Lilley on the Eight Roles of a Teacher we describe, in terms of the teacher as an information provider, three elements – the teacher as a conductor or transmitter of information, the teacher as a curator of information, and the teacher as a coach for the student as an information seeker. There is not much in the medical education literature about the role of the teacher as a curator of information available to students. Paul Worley, when dean at Flinders in Australia, suggested at a meeting of the International Association for Medical Science Educators that teachers do not need to present to the students all the information about the basic sciences and held up his iPhone, suggesting that all the information that was required was available on the phone. It is the responsibility of the teacher to make this available to the student. I previously found Elliot Masie’s Teaching and Learning conferences in the USA valuable. I note that he is organising as a new initiative, a Curation and Learning Lab with the theme that “curation is key for workplace learning in an age of dynamic and expanding content, context and collaboration.” Curation he describes as the process of finding, sorting, organising, rating, ranking, recommending, validating, clearing, tracking and personalising learning resources.

Chinese version of Medical Teacher
Trevor Gibbs is just back from a visit to Guangzhou in China to mark the opening of an AMEE office in Guangzhou and the publication of the first issue of the Chinese edition of Medical Teacher. The translation was facilitated by Dr Yingzi Huang, Managing Editor of the Chinese edition of Medical Teacher. Eight papers from recent issues of Medical Teacher were selected for inclusion on the basis that were of particular relevance in the local context. These included papers on doctor role modelling, applying the science of learning to health professions education, qualitative study design, teaching enhancing clinical performance, and competency-based education. The two papers on competency-based education were from the themed June 2017 issue of the journal.

AMEA December meeting
I leave this week for the AMEA Conference in Hong Kong. This year is the 20th Anniversary for the Asian Medical Education Association and the 130 year anniversary of medicine in Hong Kong.  I gave a plenary session at the first AMEA meeting 20 years ago and referred to the SPICES model for curriculum development and I evaluation and have been asked to give a further presentation at this year’s meeting. I will take the opportunity to review what has happened on the various dimensions of the SPICES model since then and look at exciting future trends in each of the dimensions (Student centred, Problem-based, Integrated, Community-based, Electives and Systematic). The first and last are probably the dimensions where there has been greatest progress. You may disagree. A number of distinguished speakers are contributing to the AMEA programme and I will try to highlight in my next blog what had the biggest impact on me from the presentations.

I have also been working on my presentation for the Asia-Pacific Medical Education Conference in Singapore in January. This has as its theme Technology: Enhancing education for improvement of patient care. Among the issues I will address is a move from “just-in-case” learning to “just-in-time” learning. I remember a number of years ago I was impressed when talking with some of the military personnel at a training session in the Medical Education Center in Miami how doctors in Afghanistan called to deal with an emergency received advice on what to expect and how to manage it as they were transported to the emergency. I asked Barry Issenberg for further information which I might use as part of my APMEC presentation and he identified for me the two key papers.

Davis, J.S. et al. 2012. Use of mobile learning module improves skills in chest tube insertion. J Surg Res. 177. 21-6.
Motola, I. et al. 2015. Just-in-time learning is effective in helping first responders manage weapons of mass destruction events. J Trauma Acute Care Surg. 79(4).

He also gave me a link to the YouTube video of the chest tube insertion here.

Season’s greetings
Finally, season’s greetings to everyone. After returning from Hong Kong I will have a few days at home with my family.