Summary: In his latest blog Professor Harden looks at binary thinking, $722 million dollars funding for medical school, 11 things to be instead of comfortable and more Description: Binary thinking is the enemy of rigorous thought
Each week I read in the Sunday Times, Niall Fergusson’s column. In a recent column he looked back on 2017 and expressed concern that the world has seldom been so binary. You either love Donald Trump or you loathe him. You either adore Brexit or abhor it. People, he argues, too often live in a filter bubble inhabited exclusively by people who share their view of the world. Unfortunately, decisions about the curriculum are frequently painted as binary issues – either you are for or against problem-based learning or integration. An attempt to move away from this was a major reason why I first described the SPICES model of the curriculum, where each issue is painted on a continuum and not as two extremes. Perhaps the problem with competency-based education is that it is seen as a binary issue – it is either liked or loathed.

722 million dollars funding for medical school
Last year I highlighted that the University of Vermont School of Medicine had raised $100 million to support the move from a traditional lecture-based to an alternative curriculum model. This had been a priority for the dean. Harvard Medical School has recently announced that it has now raised $722 million – 96% of its fundraising target. The dean of the medical school, George Q. Daley, is reported as having spent, since he assumed the deanship in January 2017, more than a third of his first year as dean on fundraising. On his appointment dean Daley listed improving diversity and reenergising faculty among his principle priorities. One method of energising faculty was to provide seed funding for new ideas. I wonder if this focus by a dean on funding is different in the USA and the UK. I can’t imagine that any UK dean spends anything like one third of his or her time in fundraising initiatives.

11 things to be instead of comfortable
This is the title of the 31st December 2017 blog by David Geurin. He has decided for 2018, as a teacher to do more to step outside his comfort zone. He quotes John Maxwell, “There is no growth in your comfort zone and no comfort in your growth zone.” Here are the 11 things he wants to be to push beyond what is comfortable;
  1. Passionate – A passionate, caring educator makes all the difference.
  2. Desperate – We need a sense of urgency about the work we are doing. Be desperate to see every student succeed.
  3. Daring – Be bold. Be audacious.
  4. Determined – Nothing worthwhile is easy. There will be challenges and obstacles.
  5. Committed – We need more commitment, not more accountability.
  6. Brokenhearted – It’s possible to become hardened and even cynical as an educator. But he never want to lose a soft heart, a broken heart for students, colleagues, for all others.
  7. Significant – He wants to live a life of consequence and wants to make a difference.
  8. Creative – Everyone is creative. He wants to be more creative.
  9. Extraordinary – The difference between the ordinary and the extraordinary is that little extra.
  10. Courageous – He has to be willing to put aside fear and pursue risk.
  11. Curious – Question everything. Asking the right questions will push him out of his comfort zone as quick as anything.
Many of the 11 points, but not all, resonate with me.
Geurin, D. 2017. 11 things to be instead of comfortable. Accessed on 03/01/18 at

Systematic reviews
Since the establishment of the Best Evidence Medical Education (BEME) Collaboration in 1999 I have been committed to evidence-informed teaching. I have been concerned, however, by the approaches to how articles are selected for inclusion in a systematic review. An early systematic review of interprofessional education identified 2000 published papers but as none met the inclusion criteria no conclusions were drawn about interprofessional education. In an article in Education Researcher, Wolgemuth and co-workers describe and demonstrate a new systematic review method, Critical Construct Synthesis (CCS) which challenges us. This does not include methodological elimination as an integral part of the study screening process. As the authors point out, excluding studies not up to methodological par conflicts with the idea of reviewing the full knowledge base. Glass (2000) is quoted as remaining “staunchly committed to the idea that meta-analysis must deal with all studies, good, bad, and indifferent”. The authors describe how Critical Construct Synthesis as a systematic review method is particularly well-suited to interrogate constructs in research synthesis that exclude primary literature on methodological criteria.
Wolgemuth, J.R., Hicks, T. & Agosto, V. 2017. Unpacking assumptions in research synthesis: a critical construct synthesis approach. Educ Researcher. 46(3). 131-9.

Lectures, suggests Lucas and Bernstein in the second edition of their book Teaching Psychology: A step-by-step guide, have a bad reputation nowadays; many people view them as old fashioned, potentially boring, and relatively ineffective. They go on to point out the value of lectures can depend on how they are delivered; they can be effective pedagogical tools or gateways to boredom. They provide many of the commonly recommended tips on lecturing. I usually suggest ending a lecture by providing the students with something to think about as they leave the lecture. Lucas and Bernstein make what I believe is a useful additional suggestion. Generate some curiosity in the students about the next lecture by offering a “teaser” about something it will contain. They give as an example “on Friday you will have a chance to figure out which parenting style you grew up with”, or “next time we will find out how many of you are colour-blind”
Lucas, S.G. & Bernstein, D.A. 2015. Teaching Psychology: A step-by-step guide, 2nd Edition. Psychology Press, Taylor and Francis. New York.

ESME course and optometrists
The Essential Skills in Medical Education (ESME) course continues to prove attractive to teachers from a range of disciplines. Joining us in the course scheduled for April 2018 will be 10 optometrists organised through the College of Optometrists.

Technology and learning
I am putting the finishing touches to my plenary presentation at the Asia Pacific Medical Education Conference in Singapore later this month. My theme is Learning and Technology, not Learning Technology. There is an interesting video discussion between education consultant Steven Anderson and interviewer Rod Berger (  Steven Anderson argues that “Technology comes and goes. What we need to be focused on are pedagogy and processes”. Steve Downes in his blog of 26th December, however, questions whether focusing on simply the pedagogy creates the risk of being blind to what new things can be done with the technology. The Scottish Deans Medical Education Group had a very informed and useful technology subcommittee. The question often arose, however, as to whether it was the responsibility of the technology group to develop an approach to meet the education needs identified by the main committee or whether the technology committee itself should come up with new innovations. I will report on the APMEC in a later blog.

In the meantime, best wishes for 2018.