Summary: In his latest blog Professor Harden discusses the focus on the student in learning through six steps to outstanding learning, the concept of students writing textbooks, core versus supplementary questions in examinations, student-created multiple choice questions, excellence in medical education and the upcoming MedEdDXB2017 conference in Dubai Description: “Six steps to outstanding learning”
The Evidence Based Teachers Network (EBTN) in the UK supports the move in teaching from an opinion-based profession to an evidence-based profession. Mike Bell, the director, suggests that this gives power to ordinary classroom teachers and that over the next 10 years the groundswell of evidence-informed teachers will gradually bring about change. The network has compared and combined five major studies based on evidence and generated “Six-Steps to Outstanding Learning”

  1. Orientation: preparing the student for learning
  2. Prior knowledge: assessing what they know and filling in gaps
  3. Presentation: using effective methods such as graphics and organisers
  4. Challenge: setting tasks which are neither too easy nor too hard
  5. Feedback and improvement: correcting errors as they learn
  6. Repetition: securing long-term memories over time
A number of years ago I discovered the merits of assessing students’ prior knowledge. I gave students in my endocrinology course an end-of-course MCQ examination on day one of the course. The response showed the huge variation in prior knowledge with some students scoring less than 5% and some almost achieving a pass-score. The need to tailor the programme to suit individual student requirements was obvious. There was a need to polish the diamonds and smooth the pebbles.

Students writing text books
Steve Downes in his blog of 9th February draws attention to the paper in EdSurge News by Ellen Wexler “A Growing (But Controversial) Idea in Open-Access Textbooks: Let Students Help Write Them”. The article describes physics teacher Delman Larsen’s project called LibreText in which his students write the wiki-like textbook.

Core questions
A paper by Kumar et al Difficulty and Discriminative Ability of Core Versus Supplementary Questions – Can We Test for Competency and Excellence Simultaneously? (2016.Med Sci Educ. 26. pp547-51) starts off “In theory, a competency-based medical school curriculum allows all students the prospect of answering every test question correctly”. They identified in an MCQ paper the core questions and the supplemental questions. Predictably, the supplemental questions were more difficult to answer and had a higher discriminative ability. One thing that has always worried me about MCQs has been the tendency to regard a good question as one that discriminates. By including these in a paper one moves away from testing core knowledge. It is not clear from the paper what was set as the pass mark for the core questions. Should this be 90 or 95%? The pass mark for MCQ papers is often in the 60-70% range. Although they suggest that every question should be answered correctly, I would be surprised if they had set the passmark at 90% or above.

Student created MCQs
There has been quite a bit written about MCQs created by students. Two references worth looking at are Student-authored MCQ revision questions ( and PeerWisdom: Collaborative online Learning in Biology  (

Abstracts for AMEE 2017
We received almost 3400 abstracts for consideration for the AMEE 2017 programme in Helsinki. They have currently gone out to reviewers who were asked to rate each submission “Definitely accept”, “Possibly accept”, “Uncertain”, “Possibly not accept” or “Definitely not accept”. Each paper is seen by three reviewers. We have asked members of the AMEE committees to review papers in their area of postgraduate education, research in medical education, simulation, technology in health learning and CPD. I have found some of the titles intriguing, for example The inaugural competency-based curriculum graduates: where are they now?, What happened to the failed students? , Is there a need for textbooks?, How much assessment is too much? and What could possibly go wrong? Both traditional themes such as the OSCE and performance assessment and simulation and new themes such as the flipped classroom, EPAs and reflection feature strongly in the submissions

Excellence in medical education
What are the great ideas demonstrated by medical schools that merit the ASPIRE award of excellence? Marko Zdravkovic  is chairing a session at AMEE 2017 in Helsinki where ASPIRE winners present in a PechaKucha session examples of excellence in practice from their school. I like the imaginative titles for the papers to be included, such as How do we have over 30 great faculty developers and pay none?, Students as partners in the highs and lows of medical school life and Beyond the bandage: aligning curricula with community needs.

I am putting the finishing touches to my workshop and plenary presentation at the MedEdDXB2017 in Dubai, 2nd–3rd March. The workshop is on the FAIR principles of effective learning (Feedback, Activity, Individualisation, Relevance). The challenge is to develop case studies that highlight the four principles and to encourage the participants to identify examples that could be applied in their own practice. In closing plenary presentation I have been asked to highlight the future of medical education. I prefer in a final presentation the idea of looking, “where do we go from here”, rather than trying to summarise the presentations at the meeting.