Summary: In Professor Harden’s latest blog, he discusses his latest trip to Lisbon, two journal articles on competency-based training, MedEdWorld’s 2014 Autumn webinar series and some exciting new features at AMEE 2014 in Milan. Description: I have just returned from a meeting in Lisbon of a WHO Technical Working Group on Health Workforce Education Assessment Tools.  This was established in response to a resolution from the WHO Health Assembly in May 2013 ‘to develop a standard protocol and tool for assessment, which may be adapted to country context,’ and ‘to support Member States as appropriate in using the protocol to conduct comprehensive assessments of the current situation of health workforce education.’   The group has to report by October 2014, an ambitious task.

Two articles about competency based training were drawn to my attention this week.  Hill Jason highlighted an article in the BMJ (2014, 348:g2909) by Jonathon Glass, a Urologist in London, ‘Competency based training is a framework for incompetence.’  Glass describes how a medical student asked to attend his clinic so that she could do a scrotal examination and have this recorded in her record book.  He describes how it was not because she wanted to know the various pathological conditions that she may encounter or to be reminded of the anatomy of the inguinal canal.  All she wanted was to get her book signed.  He equates this with a competency based approach.   This is a misunderstanding of what is competency-based education.  While it can be misinterpreted as simply a box ticking exercise, this is certainly not what is intended.  I was alerted through Research Gate about a paper by Jonker, Hoff and Ten Cate, published in the European Journal of AnaesthesiologyA case for competency-based anaesthesiology training with entrustable professional activities: An agenda for development and research.’  The article describes how the emerging concept of entrustable professional activities (EPAs) may allow trainers to link competencies to the assessment of trainee’s performance.  An EPA is a description of an essential clinical task that frames competencies in the context of clinical practice.  The authors describe the potential benefits of working with EPAs in anaesthesiology training.

In Danville, Kentucky, USA, a school is trying to change the way students’ learning is assessed.  They are moving away from the state imposed standardised MCQ tests towards a performance based assessment.  The curriculum has been designed round inter-disciplinary projects and the students’ performance in these is assessed.  From previously being a failing school, the school was transformed into a highly successful one that demonstrated authentic learning.  The school has accepted the common core state standards for English and Maths but believes that the school can do better that follow the tests that go with them.  In medicine I have always been against imposing a national standard MCQ test.  As found in Kentucky it imposes constraints on the curriculum.

More and more organisations are offering webinars on their subjects.  Following my visit to Harvard in June I have been invited to contribute in September to a webinar on educational scholarship organised by the American Thoracic Society (ATS) which has formed a working group on education. We have just finalised the MedEdWorld series of webinars for the autumn term.  The full programme will be available on MedEdWorld and on the AMEE website. Webinars are free to AMEE and MedEdWorld members.  We are offering the first webinar on Thursday 2 October by Hill Jason ‘Preparing 21st Century doctors: What capabilities are needed? How to achieve them,’ free to everyone as a taster of the webinars.  Hill’s previous webinars have been much acclaimed and I think you would find it of interest to join this one.  We are streamlining the sign up process and have moved from the Wimba platform to Adobe Connect.  

In the AMEE office we are continuing the final preparations for AMEE 2014 in Milan.  We now have more than 3,300 participants registered.  We have some innovative features in the programme and I will be interested to see how these work out.  We are trying the organisation of one of the research in medical education short communication sessions as a flipped classroom.  Networking has always been seen as a valuable feature of an AMEE conference.  This year, for example, a number of the pre-conference workshops are by international groups whose members met for the first time at an AMEE meeting.  To facilitate contacting others with a similar interest we have selected eight themes – inter-professional education; selection of students and trainee; simulation; team-based learning; work-based assessment; staff/faculty development; international collaborations; and competency/outcome-based education.  Individuals with an interest in one of these themes can add a coloured circle to their badge representing the theme.  We will also have themed tables at lunchtime.  If this proves successful we can extend it to other themes next year.  The general consensus was that this year we should, as we did at AMEE 2013, have the first plenary on the Sunday evening, followed by the reception.  We have Richard Horton, Editor of the Lancet and Lawrence Sherman, well-known for his work in CPD as the first speakers.  You will not see a summary of Richard Horton’s presentation in the programme as he wants to keep his content a surprise.  Lawrence Sherman does have an abstract but says that his presentation will surprise the audience!  

I look forward to seeing you in Milan.