Summary: Professor Harden discusses Diet Coke, inter-professional education and the, “Transformation In Medical Education” (TIME) initiative after attending, “Moving up the Educational Ladder: improving your skills and building your career in medical education”. Description: Just back from a conference Moving up the Educational Ladder: improving your skills and building your career in medical education held at Texas Children’s Hospital and Baylor College of Medicine, Houston.  Teri Turner, who is a paediatrician and Director for the Center for Research, Innovation and Scholarship in Medical Education and her committee did a great job in organising the meeting which went very smoothly.  I was well looked after including an enquiry in advance as to which drink I would like to be available during the conference. I was not quite sure how to reply but suggested Diet Coke.  Everywhere I went a can of Diet Coke was handed to me.  My opening plenary presentation was immediately following dinner which was interesting.  For many of the participants this was their first medical education meeting and I was hugely impressed with their enthusiasm.  

I met with Joan Friedland who is a senior retired physician in Houston.  She is very well respected and has mentored a number of the staff Houston.pngvery successfully.  She attended the first Ottawa Conference in Ottawa in 1985 and brought to the meeting a copy of the proceedings for me to sign.  She said that she had kept this on her bookshelf and had found it extremely useful - many of the pages in the publication were marked.  In some ways it is a pity that we no longer publish all of the papers from the Ottawa Conference.  Abstracts are not the same as key details are missing.  Joan gave me a paper recently published in The New England Journal of Medicine on Improving Clinical Learning Environments for Tomorrow’s Physicians by Nasca and co-workers.  The paper describes the Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review (CLER) programme.  The ACGME had visited more than one hundred teaching hospitals in the USA in an effort to assess the quality of the learning environments in which the country’s 117,000 residents and fellows are immersed.  The early experience has identified a generalised lack of resident engagement in a ‘systems-based’ practice of medicine in the clinical environments in which they learn and provide clinical care.  Issues relating to errors in practice and patient safety are discussed.  

I was pleased to have an opportunity to talk at the meeting with Steve Lieberman who has been a key player in the ground-breaking Transformation In Medical Education (TIME) initiative in Texas.  The UT System TIME initiative is a student-centered, clinically focused programme designed to increase the effectiveness of medical education while shortening its duration.  Pilot schemes have been set up with a number of campuses to reduce the length of medical training by integrating more closely the pre-medical training, so that instead of having a four plus four year model, students will be able to graduate in six years.  It will be fascinating to see the results of the pilot study.  I hope that Steve Lieberman will talk about his experience and the programme at AMEE 2014 in Milan.  While some initiatives, I believe, are going entirely in the wrong direction by lengthening the programme of training, others like the TIME initiative are for very good reasons looking to shorten it.  We would be very interested to receive submissions from anyone who has experience to report of attempts to shorten the length of medical training.  If we had enough submissions we could put together a session on the topic.

Teri Turner along with Deborah Palazzi were authors of The Clinicians Educators Handbook.  This contains a lot of useful and valuable advice and information and is well worth looking at.  Teri tells me that there have been more than 7,000 downloads.  I like Teri’s quote in her presentation at the meeting from Edison ‘I haven’t failed.  I have just found 10,000 ways that won’t work.’  She also referred to Jane an online site that makes suggestions as to where one might publish a paper.  You simply enter the title and abstract of the paper.  Jane then compares your document to millions of documents in Medline to find the best matching journals.  You can also use a keyword search instead of putting in your title or abstract.  

Also at the meeting were two very interesting posters on Inter-professional education.  I found them particularly interesting as I am running a workshop and giving a plenary on the subject at the International Medical Education Conference in Malaysia in March.  One by Anne Gill and co-workers from Baylor College of Medicine looked at a programme involving medical, nursing and pharmacy students on the subject of patient safety.  Another by Kelly Grillo and Laura Livingston described an inter-disciplinary planned disaster management experience which involved over 300 students from six disciplines delivering care to over 400 volunteer patients in a highly stressful simulated environment.  The event is planned by students.

Following another recent presentation I gave in which I was advocating a revolution in four aspects of medical education, a member of the audience spoke to me.  She said that she liked very much my proposals and agreed with my arguments but she would not have sufficient courage to move in these directions.  Shortly after we spoke I happened to listen to a TED presentation by Brené Brown, the Power of Vulnerability.  She examined the concept of ‘courage’ and separated this from ‘bravery.’  She pointed out that the original definition of courage, when it first came into the English language, was from the Latin word cor meaning heart and the original definition was to look at things with your whole heart, recognising imperfections and vulnerability.  Brené Brown is a qualitative researcher and a powerful speaker.  Her personal insight into qualitative research is well worth listening to.

Back just for a day and then on to the AMEE Executive meeting in London.