Summary: In this instalment Professor Harden recommends a new Journal and reflects on a recent trip to the new HOFSTRA Medical School. Description: Just returned from three days as Visiting Professor at HOFSTRA Medical School – a new medical school on Long Island, New York.  Visiting medical schools I almost always come away with some useful new ideas, while at the same time often being disappointed about the lack of evidence of innovative thinking overall.  This visit was the exception.  Talking with the staff and students and seeing the curriculum in action, I could not help but be impressed.  The students’ clinical commitment from day one is outstanding.  Students on entry to the medical school, have to obtain an Emergency Medicine Technician Certificate and for the first ten weeks work as an Emergency Medicine Technician in the ambulances.  Over the year they continue to extend their clinical experience, with involvement in hands-on care of patients.  I was interested to note that, rather than use MCQ’s for student assessment, essays have been adopted as the assessment tool.  Talking with the students who had previous experience with MCQ’s, they commented a result was that they had to reflect and think more seriously about the subjects in the curriculum.  Some of the students’ experiences are recorded in a new magazine produced by the school - ‘Narrateur.’  As pointed out by the Dean, Lawrence Smith, the stories that are shared reflect the merging of a new teaching model with the most basic values of doctoring that are critical in shaping a learned, self-reflective, intuitive physician.  Key to the success of the HOFSTRA initiative is the close collaboration between the medical school and the healthcare delivery system in Long Island.  The early complete emersion in the clinical environment of the medical students, followed by the introduction to the basic sciences reminded me of the suggestion, which I mentioned in an earlier blog, by Peter Garland, when he was Professor of Biochemistry and head of the department in Dundee, that we should re-order the curriculum to have biochemistry addressed in the later rather than the earlier years, when students had had the appropriate clinical experience to appreciate the biochemistry.

Perspectives on Medical Education is another new journal published by the Netherlands Association for Medical Education (NVMO).  The first issue, among other interesting items, has a useful review by Lambert Schuwirth and Cees van der Vleuten on ‘The use of progress testing.’  Geoff Norman also has an interesting piece on ‘Medical education: past, present and future,’ written mainly from a North American perspective.  Looking back to the 20th Century he argues that the innovations in medical education were primarily confined to the pre-clinical curriculum.  While true in the USA, this is not the case in the UK where we saw significant developments in the later years of the medical programme in the 1970’s with the use of the OSCE, an emphasis on communication skills and the introduction of new learning technologies including simulation and computer-assisted learning.
Thinking of transatlantic differences in education, the Forum for the UK Staff and Educational Development Association drew attention recently to the differences in the use of the terms ‘assessment’ and ‘evaluation’ on the different sides of the Atlantic.  A Western Kentucky University is reported as having a searchable database of terms with cross-national translations.  Apparently its long standing work is in progress and feedback is welcomed.

Children banned from playing conkers without protective goggles… trapeze artists ordered to wear hard hats, hanging baskets banished by councils.  These are some examples highlighted by a ‘Myth Busters’ panel set up by the Health & Safety Executive of excessive caution of jobsworths who are overzealous in applying rules.  I suspect there are examples of myths and overzealous application of rules too in medical education.  One of the sessions at HOFSTRA which I led was on ‘common myths about outcome-based education.’  

In the past I was always concerned in a new meeting venue about connecting my laptop with the data projector provided.  Perhaps it simply reflects improvements in technology, but this appears to have been less of a problem recently with sound connections also being more routinely provided.  As I often include video clips in my presentations this was an important issue and I carried, as an insurance, my own small speaker.  I was interested to read in the April issue of PC Today an article ‘Solve Notebook-Projector Setup Problems.’  As suggested in the article, where possible I use the HD multimedia interface, as this can carry the audio through the same port.  Traditionally the audio was connected using the notebooks audio out jacks but on my new Sony computer these are on a different side of the computer from the VGA input and sometimes the cable is not long enough to stretch across the computer for the audio connection.  Usually I find now that my Notebook detects that I have a projector plugged into one of its video outputs and automatically turns on the port.  Occasionally, however, I have to toggle using the function key.  According to the article it is preferable, however, using Windows 7, to right-click a blank area on the Desktop and select Screen Resolution.  One then selects the second display from the Display drop-down menu and selects Extend These Displays from the Multiple Displays drop-down menu.  The Desktop background should now appear on the projector.

I was interested to read that 63 schools in South Korea are testing digital textbooks before they are adopted nationwide in 2015.  Teachers are being taught to use the new technology in the classroom.  It is recognised, however, that not all subjects are best suited to the digital resources.  Visiting a medical school library recently I was surprised to find how few print texts were available to the students with the main facility being e-books.  I wonder how common this is now in medicine.

We are now half way through our new ESME online course, with three modules and six weeks remaining.  I was initially concerned that we might be let down by the technology, but this has proved to be fairly robust, although a few participants had problems initially with internet connections.  For the most part these have been solved.  To date we have had excellent feedback but will be doing a full evaluation of the course.  My new text ‘Essential Skills for a Medical Teacher,’ co-authored with Jennifer Laidlaw, is now available and we have adopted it as the standard text for the online course.  John Dent and Trevor Gibbs have done a great job supporting the online discussion groups.  At the same time Stewart Mennin is running an online ESME course on Leadership.  A second round of courses is planned to start in September.
We are working hard this week putting the final touches to version 2 of MedEdWorld which will be launched early in June.  It will have a more user-friendly interface and have some interesting new features.

An exciting innovation at AMEE 2012 will be e-Posters.  Eight of the poster sessions, with 120 posters in all, will be presented using a fascinating new multi-touch e-Board.  This will bring the poster presentations to a new level with additional information including video clips easily accessed and discussion generated round the poster.  We are working with the AMEE e-Learning committee to brief the presenters so that we can get the maximum benefit from this new facility for AMEE 2012.  The multi-touch interactive boards were used to present posters at the Saudi International Medical Education Conference in Riyadh last month and have been developed by a local Riyadh company -Innovative Technology.

Travelling to the SIMEC Conference in Riyadh, Madalena Patricio missed her connection at Istanbul.  The notice for the connecting flight in the airline lounge showed ‘WAIT IN LOUNGE’ which she did, only to find that she should have been waiting at the gate.  Sabri Kemahli has taken this up with Turkish Airlines and I was very impressed to find that the notice has now been changed from ‘WAIT IN THE LOUNGE’ to ‘GO TO GATE.’  It’s reassuring to find that complaints or suggestions are considered by airlines and acted upon.