Summary: In his latest blog Professor Harden asks what is your angle when writing a paper, whether you are familiar with "transversal competencies" and whether medical educators avoid difficult conversations. Description: Writing a paper? What’s the angle?
Faced with 30-35 new manuscripts each week submitted to Medical Teacher, an important factor, when they are considered for publication is whether the topic of the paper and angle taken by the authors is of interest to readers of the journal. In her interesting Patter blog (4th June 2017), Pat Thomson suggests that authors may not do enough to convince a reader that they want to read a paper. It is important to find an angle on the subject that is both interesting and unfamiliar or novel. She suggests this might, for example, be through
  • Producing a novel data corpus
  • Putting several data sets together in an innovative way
  • Bringing new methods to the topic
  • Using a different theoretical approach
  • Bringing disciplinary perspectives together in a new way
She recommends that it is always worthwhile checking out whether your paper might be of interest by doing a three or four minute pitch for the paper to a colleague. “It’s the bouncing ideas around and being asked to think about why the topic is important and why this angle on it that seems to make the most difference”. Worth thinking about prior to submitting a paper!

Have you heard of “transversal competencies”?
Different terms have been used to describe the learning outcomes or competencies not specifically related to the mastery of content or a particular skill – generic skills, non-cognitive skills, 21st century skills or soft skills. The Asia-Pacific Education Research Institutes Network used the term “transversal competencies” (Care & Luo 2016) and described six domains:
  • Critical and innovative thinking
  • Interpersonal skills
  • Intrapersonal skills
  • Global citizenship
  • Media and information literacy
  • Other(physical health, religious values)
(Care, E. & Luo, R. 2016. Assessment of Transversal Competencies. United nations Educational, Scientific and Cultural Organization, Paris, France.)

Each domain has up to 13 competencies. It is well worth looking at the list as most, I believe, should be considered in our education programmes. I do not think we pay enough attention in our curriculum, in the teaching and learning programme and in assessment to generic competencies.

Do we avoid difficult discussions in medical education?
I sometimes think that we do not engage enough in difficult discussions as to what has become or is about to become established practice in medical education. This is why, although I disagreed with some of the points raised by them, I supported in a previous blog the discussion on competency based medical education stimulated by Aylet Kuper and Cynthia Whitehead. MCQs, introduced at a time when the reliability of an assessment instrument dominated our thinking and there was a requirement to computer-mark papers, continue to dominate written assessments. We should question this. More preferable is the constructed response question where the examinee has to find the answer to a question in a few words. This is a more authentic test of the student – patients don’t come with a multiple list of possible diagnoses, investigations or treatment. It is also more useful in assessing core knowledge where provision of the answer in an MCQ prompts the examinee. Sticking with written assessments, another thing that concerns me is the common notion of a 60-70% pass mark. This means that a student can pass not knowing 1/3 of what is being tested. There should be a separate test of core knowledge where the pass mark is 90+%. With regard to debates about the use of the OSCE it appears to have become standard practice to assess the reliability by comparing the extent to which different stations correlate with the overall performance in the exam. This only works, however, if we are testing similar competencies at each station. If very different competencies are being assessed, as is often the case, it is not unreasonable to expect a student to be competent in some areas and less competent in others. The approach to reliability is also not helpful when, in a competency-based exam, all students are expected to demonstrate competence. There may be areas where you too would wish to challenge established practice.

I leave this week for the International Association of Medical Science Educators (IAMSE) 2017 Conference in Burlington. Twenty eight conference participants are taking part in an ESME course which we are running with Adi Haramati. The ESME Certificate contributes to the IAMSE Fellowship programme. More about the meeting in my next blog.