Summary: International Higher Education – science fiction or future for medical education? Can your body language really shape who you are? These are some of the topics Professor Harden discusses in his latest blog. Description: It sounds like science fiction but it may represent the future for medical education.  What is Jane Knight referring to when she describes a possible future for international higher education?  The answer is what is described as ‘edu-glomerates.’  In an interesting article in the Journal of Studies in International Education (2015, 19:107-121), she looks at ‘International Universities: Misunderstandings and Emerging Models?’  She highlights how internationalisation has transformed higher education institutions and systems but there is much confusion as to what international in the context of a university means.  She describes three current models.  The first is the classic model, where a university has multiple international partners and activities.  There is collaboration with international partner universities, with the partnerships spanning a range of academic and management initiatives including academic and student mobility and collaborative research projects.  This, she suggests, is by far the most common type of ‘international’ university.  A second type of international university is the satellite model where universities establish a presence in other countries of the world through satellite research centres or branch campuses.  These are stand-alone, independent campuses but may be embedded in a local partner institution.  An example she gives is of Monash University in Australia which has a campus in Malaysia, a joint graduate school in China, a learning centre in Italy, a research centre in India and an affiliated campus in South Africa.  A more recent development described is the co-founded model where a new independent university is founded involving one or more foreign partner institutions.  This differs from the international branch campus model because the university is not operating as a satellite operation of a parent university.  A key element is that academic partners from different countries have been deeply involved in the establishment of the new institution.

What concerns me with international collaboration is a variation of the classic model where a university sells to a university in another, often developing country, their curriculum or elements of it.  The result is often disappointing with the curriculum not meeting local needs and the local staff not having any feeling of ownership of the curriculum.

Coming back to the future, however, Knight describes what she sees as the possible next generation of international universities – the idea of edu-glomerates, where students are offered an opportunity to mix and match courses and educational experiences from a variety of local or international providers.  There needs, however, to be a recognised credit system.  With developments in outcome-based education and newer approaches to assessment, this should be possible.  The edu-glomerate could validated completed course work both face-to-face and virtual.  In this scenario the franchising of the credential is more important than franchising the academic programme itself.  Such a development takes account of the need for more personalised or adaptive learning and the developments in technology and competency-based education.  One of the aspirations of the International Virtual Medical School (IVIMeds) more than a decade ago, was to support universities in sharing learning experiences.  As part of this initiative it was demonstrated (Khogali et al, Medical Teacher, 2011, 33:311-318) that an online resource with input from some 14 different medical schools, could play an important role in a blended learning delivery.  Sadly, there was a reluctance from schools to collaborate in this way and rather than sharing learning resources and experiences, the direction in IVIMeds changed to the development of soft-web packages that facilitated schools developing their own programmes.  While IVIMeds was never seen as an edu-glomerate, as envisaged by Knight, it was, however, an important step in that direction.  Perhaps it was just ahead of its time as a concept in medical education.

I have just finished writing an invited commentary on interprofessional education in the early years of the medical course for Anatomical Science Education.  This is to be published alongside case studies of the application of interprofessional education in anatomy.  I remember being fascinated by a presentation by Wojciech Pawlina from the Mayo Clinic at an APMEC meeting a number of years ago where he described how the anatomy course at Mayo not only contributed to the students understanding and mastery of anatomy, but also to more generic outcomes such as communication skills and teamwork.  A number of education developments have supported the use of IPE in the early years.  These include the move to an outcome-based education model and vertical integration of the curriculum.  It is also recognised that attitudes are formed early in the course and it is important to establish an appropriate educational environment for this to happen.

Although I do a lot of presentations at medical education meetings, I am always interested in how I might improve my performance.  I was intrigued by the work by Amy Cuddy – standing in a posture of confidence for two minutes affects testosterone and cortisone levels in the brain and leads to an improved performance at presentations (or interviews).  I find it difficult to believe but may well try it.  It is worth listening to her TED talk on the subject, which when I last looked, had 25,951,217 views.