Summary: This fortnight Professor Harden discusses his recent trip to Malaysia which included a visit to the International Medical University, a presentation on the Excellent Teacher for the 21st Century at IMEC, and a stopover in Perth, a possible destination for Ottawa 2016. Description: Bed bugs, again! Just after writing my last blog where I mentioned the potential problem of bed bugs I saw a letter in one of the business traveller journals. The writer had written to a hotel complaining of a problem with bed bugs. In the reply the hotel expressed their extreme concern and their regrets, indicated that this was not a problem that had been previously reported, and that remedial action would be taken. He felt reassured until he saw stapled to the reply his original letter with written on it, “Send bed bugs letter.”

I have just returned from visits to Malaysia and Australia and bed bugs were not a problem! In Australia we were looking at Perth as the destination for the Ottawa 2016 conference. This has a modern and attractive conference centre, which although not big enough to accommodate an AMEE conference, is ideally suited for an Ottawa conference. We were shown a wide range of excellent hotels in different categories. One offered five beds in a room! Perth is an attractive city with ongoing developments, including significant improvements on the waterfront which will be complete by 2016. Perth may seem rather isolated – the nearest big city is Singapore – but it is now easily reached with flights from Emirates and other airlines with one-stop connections in Dubai.

From Australia I moved on to the International Medical University Academic Council meeting in Kuala Lumpur. As I have highlighted in previous blogs, IMU is a unique experiment in medical education with students passing on to more than 20 partner schools overseas to complete their studies, receiving their degree from the partner school. Some students stay behind and complete their training in Malaysia. A book has now been published telling the story of IMU and I was pleased to see Ian Hart’s contribution recognised. If anyone is interested, Mei Ling Young ([email protected]) provost of the medical school would probably send a copy. At the AC meeting it was announced that Professor Ed Piele from Warwick has been appointed the inaugural Ron Harden visiting professorship in medical education at IMU.

Immediately following on the IMU AC meeting was the 8th International Medical Education Conference hosted by the medical school. In my Professor-Harden-in-Malaysia.jpgopening presentation I revisited the Strategy of the Dolphin to identify some of the less commented upon characteristics of the Excellent Teacher for the 21st Century. I was followed by Cees van der Vleuten from Maastrict University who gave an excellent presentation on assessment, including the concept of programmatic assessment, which he had described in his article in Medical Teacher (2012; 34: 205-214). This switches the whole emphasis away from a single summative assessment and the experience he described from Maastricht was very encouraging. An important part of the process is the use of rubrics for the assessment, which at Maastricht are distributed to the students and discussed with them. “How to Create and Use Rubrics for Formative Assessment and Grading” is the subject of a new book by Susan M Brookhart, published by ASCD, Alexandria, Virginia USA. It describes how rubrics should be designed and how they should be used both for learning as well as for assessment. She defines a rubric as a coherent set of criteria for students’ work that includes descriptions of levels of performance quality on the criteria. This is often presented as a table with the definition of the criteria on the vertical axis and the levels of proficiency on the horizontal axis. Rubrics are on the agenda and I see this week advertised a 60-minute webinar, “Effective Rubric Design: Promote Student Learning & Critical Thinking”, April 25, 2013 13:00-14:00 (ET).

Dujeepa Samarasekera from Singapore gave a helpful presentation on learning outcomes, competencies, and entrustable professional activities (EPAs) and described the experience at NUS implementing the approach.

A neglected topic in medical education was introduced by Jonus Nordquist from the Karolinska Institutet in Sweden. He argued that the majority of medical schools are built as museums promoting old ideas of education and the curriculum with the emphasis on lecture theatres and with different departments and different professions located separately. He illustrated very nicely in a visual display how  space can impact on learning and made the point that while the curriculum and teaching approaches can be changed within a relatively short time span it is much more difficult to change a building once it is constructed and in place.

Four presentations had been shortlisted for the IMU-Ron Harden Innovation in Medical Education (IMU-RHIME) Award. Topics covered were a randomised controlled trial on medical students’ well being; students as teachers to enhance clinical reasoning skills; role play to teach medical students how to manage sexual health problems; and the use of Wikis for students to document and effectively share their clinical experiences.

In addition to a range of interesting short communications there were some useful posters. I was able to capture some of these using my recently-acquired iPad and look at them later. I found it helpful to be able to magnify a section of the poster and look at it in detail. One poster described the sources students used to get information to inform them in a problem-solving exercise they were given. By far the most popular was the Internet followed by lecture notes and then locally-produced e-learning programs. Much less used were textbooks. A poster from Tehran University showed how medical students were being introduced in their course to medical education as a subject. For obvious reasons, I am always interested to see new uses of the OSCE. I had not previously seen its use with dieticians and I was interested to see an example of the range of stations used. Another poster looked at how third-year students were able to make a diagnosis in complex cases presented in the New England Journal of Medicine simply through the use of Google searches.

AMEE had a stand in the exhibition at IMEC manned by Pat Lilley and this was an opportunity to make some useful contacts. I also had a successful book signing slot for my book co-authored with Jennifer Laidlaw, “Essential Skills for a Medical Teacher.” This has proved popular and since it was published last year has gone into a second reprint.

Trudie Roberts, who was at the AC and IMEC meetings drew my attention to an article, “The invisible gorilla strikes again: Sustained attentional blindness in expert observers,” by Trafton Drew, Melissa Võ, Jeremy Wolfe in Psychological Science.  The study was inspired by the classic experiment from the 90s which I have used in presentations, where observers of a basketball practice failed to see a man in a gorilla suit walk across the court. While radiologists were described as “The best searchers in the world,” the authors wondered what they might be missing. In the study, more than 75 per cent of radiologists missed spotting a dancing gorilla on the scan of a patient’s lung. This was featured on the BBC’s News Health page of February 16 in an article by Lorna Stewart, Why do radiologists miss dancing gorillas?