This month Professor Harden refects on the recent IAMSE meeting and looks ahead to AMSE, JSME and AMEE2012.
Evidence from brain research to support the FAIR (Feedback, Activity, Individualisation, and Relevance) principles of effective teaching was provided by Dr Michael Friedlander from the Virginia Tech Carilion Research Institute at the recent meeting of the International Association of Medical Science Educators (IAMSE) in Portland, Oregon. In an impressive plenary presentation, he demonstrated how through using dynamic studies of the brain we now have a better understanding of the learning process.
In association with the meeting, along with Aviad Haramati with whom it is always a pleasure to work, I ran an ESME course. We had a full house of 25 participants and I was impressed with their dedication and work ethic. The ESME course is the first step in the IAMSE Fellowship program. We have had excellent feedback from the course participants with the majority planning to submit a report demonstrating application of the principles addressed in the program to their own teaching with the aim of receiving the award of the AMEE Certificate in Medical Education. I was pleased also to meet and talk during the conference with five participants who have recently completed the new ESME online course.
June saw the completion of the new ESME online course and the ESME Leadership online course, let by Stewart Mennin. I was pleased to find that the technology worked well for the webinars and the online discussions. We are currently doing a more formal evaluation of the course and it remains to be seen the optimum size for the group discussions. For this ESME course we divided the participants into four groups, each with 15-17 members, with two groups facilitated by John Dent and two by Trevor Gibbs. A second round of courses has been scheduled for September and full details are on the AMEE website.
This has been a busy period in the AMEE office. The final preparations are underway for the AMEE 2012 conference in Lyon, including the printing of the programme and the book of abstracts. Currently we have more than 2,850 participants registered, an increase from last year. The most common criticism for AMEE conferences in the past has related to the food and lunches. Tracey and Pat have just returned from a visit to Lyon and, having sampled the lunch menu, assured me that this would not be a problem this year! An innovation we are trying for some of the poster presentations is use of interactive multi-touch boards; this will raise poster presentations to a whole new level and I will be interested to see if the presenters respond to the challenge and think creatively about it. We plan to make greater use of social media during the conference and if anyone is interested in helping with this we would be pleased to hear from them.
Marilyn Hammick and Trevor Gibbs have spent some days with us in Dundee and among issues we have been working on are developments with BEME, MedEdWorld, and the ASPIRE initiatives.
We sent out a reminder about the MEDINE Work Package 5 survey on Obstacles to Change in the Curriculum and I was pleased to see the number of responses has increased from 550 to over 1050.
My new book, Essential Skills for a Medical Teacher: An Introduction to Teaching and Learning in Medicine, with Jennifer Laidlow as the co-author, has now been published in the USA, as well as in the UK and around the world. We are using it as a text for the ESME online course. Elsevier have arranged a book signing during the AMEE conference in Lyon. A Practical Guide for Medical Teachers is now in its third edition, edited by John Dent and myself and I received this week the Chinese edition.
The minimal relationship between the fidelity of simulation and the transfer of learning was a conclusion of a review of the literature by Norman et al. as published in Medical Education (2012;46:636-47). They reported that nearly all of the 24 reported studies contrasting high-fidelity simulation and low-fidelity simulation showed no significant advantage of high-fidelity over low-fidelity simulation. I can see teachers now asking why then should they invest in the extra cost of high-fidelity simulators if low-fidelity simulators are as effective. There are two arguments. The first is that higher level learning outcomes were not assessed in the studies and these are more likely to be addressed with high-fidelity simulators. The second argument relates to student motivation. This reminds me of an experience more than 40 years ago when programmed learning was in vogue. Teachers and cardiologists in Newcastle, UK demonstrated that students learned about interpreting ECGs as effectively using a programmed learning printed text as they did using a more sophisticated learning machine. Based on the results, the programmed learning machines were replaced and additional texts were added to the library. Experience showed, however, that although the use of the ECG programme on the machine had been popular with students, the library texts proved less interesting and remained, for the most part, unused by the students. The problem with many experiments in medical education is that student motivation is ignored and studies start with two groups of students enrolled in the study. This is why I suggested in the first BEME guide that we should have as a first stage in the Kirkpatrick hierarchy, not the reaction of students, but the participation by students. If one introduces a new innovation, for example podcasts or simulators, do students use them? I suspect the students may be more motivated to use high-fidelity simulators.
There was an obituary by Peter Davies for Oliver Wrong in the BMJ, 26 May 2012, Volume 344. It highlights his many achievements particularly in the study of nephrology. He was appointed to the Chair of Medicine at Dundee University in 1969. Davies reports in the obituary that finding that the “politics of running a medical school there were not conducive to decent research or patient care, Wrong returned to University College Hospital as director of medicine in 1972...” Not everyone would agree that a chair in medicine is incompatible with good patient care or research. When I arrived in Dundee in 1972 I found that Professor Wrong had cancelled the course of lectures in medicine. The students, in response, set up their own lectures in the students union.
As mentioned previously, I find the “Meanderings” column by Robert Cannon in the HERDSA News contains interesting items. In his April 2012 column, he argues that particularly with the growth of online publications there is a trend to reference in papers more recent rather than the original or previous work. An area of research where earlier work has been overlooked, he suggests, is the current fashionable concern for student engagement. He notes, “Current writing does not generally reflect the substantial work on student involvement done by scholars such as Alexander Astin and published in 1984 (Student involvement: a developmental theory for higher education, Journal of College Personnel, 25, 297-308). I have yet to learn when and why involvement has re-emerged as engagement and would be pleased to have this gap in my knowledge filled.”
I leave this week for the ASME meeting in Brighton and next week travel to Tokyo for the 44th Annual Conference of the Japanese Society for Medical Education where I am giving a plenary presentation on the challenges facing medical education. I am also contributing to a session on research in medical education and have been asked to speak on how to write for publication. Currently, about 85 per cent of papers submitted for Medical Teacher are not accepted for publication. In some of these the reason is lack of space in the journal but in others it is because of flaws in the paper. Along with Morag Allan Campbell, I have looked at the reasons given by referees for recommending rejection of a paper and will summarise some of these at the meeting in Tokyo. I am stimulated to think about writing an article for Medical Teacher on “How to Get Your Paper Rejected!”.
I will report on the ASME and Japan meetings in my next BLOG.