Summary: Professor Harden suggests the key element in the "next wave" of medical education in this fortnights Harden's Blog. Description: Technology enhanced learning will play an increasing part in medical education in the future without doubt.  The key element I believe in the ‘next wave’ in medical education, however, will be collaboration.  This was the theme of my opening plenary presentation at the 10th Anniversary Asia Pacific Medical Education Conference in Singapore in January.  I argued that collaboration between all the stakeholders including patients and students, between medical schools nationally and internationally, between the phases of education and between the different healthcare professions, will be essential.  The concept of greater collaboration appeared to be welcomed and the student giving the final presentation of the meeting featured the need for more collaboration in medical education.  One conference participant, however expressed the concern, probably shared by a number of participants, that at a time when university rankings were receiving much attention, competition rather than collaboration was on the agenda.  I believe that on the contrary, collaboration will become a requirement for excellence in medical education.  The Harvard/MIT EdX collaboration is an example.  A different form of collaboration was the assistance given by Fred Hafferty and Wojciech Pawlina when we had to repair the damage to one of the AMEE exhibits at the conference as shown in the picture.  In the opening session to the meeting Pat Lilley and I were each presented with an award recognising our collaboration and support for APMEC since it was founded.

I was interested to hear at the conference three speakers addressing assessment from very different perspectives.  Brian Hodges in his usual eloquent style argued for a fundamentally different approach to assessment, with the need for a much more authentic assessment of the learner, not just in relation to how they performed as an individual, but their performance as a member of a team.  Cees van der Vleuten in a presentation which caught the attention of the audience, illustrated the need to move to a more programmatic assessment in a medical school across the whole curriculum with greater reliance being placed on the judgement of the teachers.  He described this in his article in Medical Teacher last year.  It seemed to me from Cees’ presentation that the responsibility and focus for the assessment of the student must be at the level of the school and that national exams will become less and less relevant.  This is different from saying that there must be no national standards.  While there is no national exam in the UK, the General Medical Council monitor carefully the assessment process in each school.  David Swanson in a third presentation on assessment gave a well thought out talk from the traditional MCQ perspective and highlighted how we could use MCQs for maximum effectiveness.

In conjunction with the conference we ran an ESME course with 40 participants.  I was surprised by the interest some participants expressed in the concept of a ‘flipped classroom’ and their intention to try out this model in their own teaching.  During our lunchtime discussions, conference sessions which participants found particularly helpful and relevant to their own teaching were one by Henry Colt on how feature films illustrate professionalism and ethics for health care professional education and a presentation on e-learning to teach radiology.  In the final ESME session I asked each participant to suggest a 30 second take home message.  Not surprisingly this produced a range of responses.  Most commented on was the importance of learning outcomes, the need to understand and improve learning, for example, using the FAIR principles, and the value of staff development.  We had an AMEE stand in the exhibition area which attracted a lot of attention from the more than 800 conference participants.  Among projects promoted at the stand was the ASPIRE initiative and Trudie Roberts and David Wilkinson discussed with anyone interested this exciting new programme.  This was particularly appropriate as the closing date for the first round of submissions is 31st March.  We also had an ASPIRE Board meeting during the conference.  During the conference Elsevier had arranged a book signing for my new book with Jennifer Laidlaw Essential Skills for a Medical Teacher and they tell me that they sold in excess of 100 copies of the book.  Although only published in June 2012 for the first time, it is already going into a second reprint.

From Singapore we went to the International Medical University in Kuala Lumpur where I had been asked to run a workshop on the ‘flipped classroom.’  I found this interesting as it was the first time I had run a workshop on this theme.  Sixty participated and we had a lively series of discussions where we explored the reasons for and how best to implement a ‘flipped classroom.’  Again I was impressed by the extent to which the approach is seriously being considered by even traditional medical teachers.  Victor Lim gave an excellent short presentation of his use of the ‘flipped classroom’ at IMU using Articulate for the recorded presentation of his lecture.  During the whole class session that followed he invited students to manage a series of patients, polling their decisions using Poll Everywhere.   I used at the workshop, as I did at the ESME courses in Singapore, coloured cards to engage the audience to respond during my presentation.  I was interested to see that this simple audience response system has been taken up at IMU and that sets of plastic coloured cards have been prepared and are made available to students for use during lectures.  I am holding these up in the photo.  These had been prepared by Dr Vishna Devi Nadarajah.

The November/December 2012 issue of The British Journal of Diabetes & Vascular Disease featured the changes in diabetes care over the past 60 years.  Significant progress was reported.  The need for integrated care to allow patients to move seamlessly between primary, community and secondary care depending upon need, was emphasised.  I have suggested in previous blogs that one of the most important trends in medical education should be to a more seamless collaboration between the different phases of undergraduate, postgraduate and continuing medical education, one aspect of collaboration I referred to at APMEC.

While away from Dundee I took the opportunity to read Bel Canto by Ann Patchett published in 2002.  The story is about what happens when, after a performance by a leading opera singer, the guests including a Japanese CEO, a French ambassador and other dignitaries, together with the singer, are held hostage in the Vice Presidents house.  I found myself completely caught up with the story which was written with great emotional sensibility and feeling and would thoroughly recommend the book.

For the remainder of the week I will be catching up and preparing for a visit to Saudi Arabia at the end of the week where I am participating at an international university conference on teaching and learning.