Summary: This fortnight Prof Harden discusses a team-based learning (TBL) demonstration by Larry Michaelsen at the IV Fronteiras Da Educaҫᾶo Médica conference, MOOCs and OSCE. Description: I returned last week from the IV Fronteiras Da Educaҫᾶo Médica conference in Sao Paulo, Brazil.  The meeting ended with a demonstration of team-based learning (TBL) by Larry Michaelsen.  Seeing the approach in action with an accomplished teacher in the field was impressive.  He ran a session with twenty groups, each with six to eight participants.  While the approach has attracted much attention in recent years, I had not appreciated that Larry first described team-based learning in the 1970’s.  It is interesting to speculate why the popularity of team-based learning is more recent.  In opening remarks at the beginning of the conference Stewart Mennin talked about how the frontiers in medical education represent a moving target, how four years ago they were different and how they may be elusive.  While it is safe to replicate in the centre, he suggested, it is more risky to innovate at the frontier but also more rewarding – we move forward by taking chances.  My own presentation at the meeting was on Excellence in Medical Education and the ASPIRE initiative.  On the bottom left hand corner of the screen for the presentations was an indicator which showed the amount of time remaining for the presentation.  This is an idea we will look at for the AMEE meeting.  It did not, however, stop a number of speakers in one session overrunning their time, one speaker taking double the amount of time allocated.  The result was that the following session, which was an open discussion session, had to be cancelled.  What is impressive is the level of interest in medical education in Brazil.  More than eighty papers from Brazil have been accepted as presentations for AMEE 2013 in Prague.

In an editorial in J R Soc Med (2013, 106: 163) Kamran Abbasi suggests that innovation has many forms and several meanings.  “It might simply be a genius idea that requires support to make it reality.  Another interpretation might be the ability of clinicians to be free of the bounds of ‘standard practice’, albeit in accordance with strict rules.”  The challenge he indicates is for medical journals to capture innovation.  Innovation is something new which is introduced, a new idea or a method.  The problem is by the time a randomised control trial is published the idea is no longer new.  Medical journals, he argues have not established a means of presenting the exciting early phase of innovation.  This may be a criticism too of medical education journals and of papers reviewed for presentation at medical education meetings.  Do we expect to read or hear about exciting new ideas in the early stages or only when they are evaluated?  I hope the former.

I was pleased to return to Dundee on Thursday in time to catch Lewis First’s MedEdWorld webinar on The Continuum of Education.  He first introduced the topic in a plenary at AMEE 2012 in Lyon but it was interesting to see him revisit the theme in a webinar, including a description of five steps for planning the continuum.  This was a useful contribution at a time when the continuum of education across the different phases is on the agenda.  You may find it of interest to watch the archive on MedEdWorld.  

Do you suffer from The Cupertino Effect?  Management Today (June 2013) defines the disorder as the business of our phones and computers autocorrecting our words as we type or text.  It is suggested that this can create havoc with inter-office communication, not to mention relationships.  The Cupertino Effect is so called because if you type in co-operation some spell-checkers will change it to Cupertino.  Cupertino is actually the name of a small town in California that is home to the Apple HQ.  When ‘relationship’ gets changed to ‘rejection ship’ you know you know you’re heading for trouble.

MOOCs (Massive Open Online Courses) continue to feature in the press.  The Times Higher Education (23 May 2013) features the UK-based Futurelearn platform which will go live in the autumn with 21 UK partners signed up to offer free online courses.  In the same issue, however, Sir John Daniel, said to be one of the foremost thinkers in technology-mediated learning and former Open University Vice Chancellor, suggested that ‘As a 40-year veteran of educational technology, I have seen fads come and go.  MOOCs are a fad that has come and will certainly go – or transmute into other things.’  The British Medical Journal reported on 25th May that one of the ‘most shared’ features in the journal was one addressing ‘Are MOOCs the future of medical education?’  

Writing in Educational Leadership (May 2013, p82-83) Robert Marzano suggests that in describing what students are expected to know and be able to do, it doesn’t matter which term one uses – learning targets, instructional objectives, learning goals, outcomes, educational objectives and standards – as long as one has an internally consistent system and that all practitioners use the terms in the same manner.  He suggests that ‘any system that organises statements of what students are expected to know and be able to do enhances student learning because it provides clarity to students and teachers alike.  Educators should feel free to create their own systems or adapt those that others have proposed.’

Given my interest in the OSCE I was attracted in the content pages of the June issue of Medical Education to an article on predicting OSCE performance test anxiety.  I quickly turned to the conclusions in the summary and read “The findings support predictions derived from the S-REF model that metacognitive beliefs, trait worry and attention control processes underlie the onset and maintenance of PTA.”  The authors had studied anxiety in a sample of first-year medical students by measuring prior to the exam their general tendency to worry, perceive qualitative controlled attention and anxiety related specifically to the upcoming OSCE.  As noted in an editorial, the study surprisingly did not make reference to performance in the OSCE.