Professor Harden reflects on his recent busy travel schedule to America including a trip to Washington DC and the AAMC meeting in Philadelphia.
I returned this week from a visit to Georgetown University in Washington DC. I had a full, stimulating and engaging three day programme concluding just before my departure for the airport with lunch in the adjacent French Embassy. The main purpose of my visit was to receive the University 2013 Cura Personalis Award. This is the highest award of the University. The convocation is an impressive ceremony with everyone in full academic regalia including gowns and hoods. Following the presentation of the award I was invited to deliver a 20 minute oration. As no PowerPoint slides are allowed I had to adopt a different approach from my normal practice. Fortunately this appeared to be well received by the audience and indeed was one of the few occasions when I have received a standing ovation.
The Centre for Innovation and Leadership in Education (CENTILE) has just been established by Adi Haramati in Georgetown and I am sure will prove to be an interesting and forward looking initiative. I was very impressed with the staff and students I met during my visit. A colloquium on inter-professional health education had been organised and the speakers were Geraldine “Polly” Bednash, executive director of the American Association of Colleges of Nursing, John Prescott, chief academic officer for the Association of American Medical Colleges and David Sklar, editor in chief of Academic Medicine, bringing different perspectives to the topic. The session was chaired by Dr Howard Federoff and following the input from the panellists there was an interesting discussion with the audience participating. In my own introductory comments I chose to highlight the need to avoid polarisation in discussions of IPE. Instead we should look at where we want to be on the eleven steps on the IPE continuum as I described in AMEE Guide No 12. I also highlighted the need to ensure the delivering of IPE with examples of how small differences resulted in success or failure. Finally, I suggested the importance of including inter-professional skills as part of student assessment. Dr Federoff had given the panellists a copy of a paper from the October 2013 issue of the Harvard Business Review, ‘The Strategy that will fix Health Care’ by Michael Porter and Thomas Lee. This is an excellent paper which I would recommend. For my Convocation presentation I had chosen as the subject - A revolution in Medical Education, highlighting the need for a transformation in medical education including a move to a continuum; a move away from the medical school as we see it today with greater collaboration and connections; adaptive learning; and professionalism in medical education. Porter and Lee addressed similar issues in relation to improving health care delivery with a move away from working in silos and to integrated healthcare practice units, personalised medicine and professionalism.
At Grand Rounds I talked about the OSCE and its development over the years since I first described the approach. I was interested in the use being made of the OSCE locally and I always learn from such visits and discussions. I was interested, for example, in the obstetrics clerkship the OSCE had been removed from the last week to the earlier week so that students who required any remediation could have this arranged. We had an interesting discussion as to why in the USA, OSCEs do not feature real patients as well as simulated patients.
This has been a busy travel period for me. Before the visit to Washington I attended the AAMC meeting in Philadelphia but unfortunately had to be back for a day to the UK before leaving again for Washington. We had an AMEE stand in the exhibition hall and meeting AMEE members and others who were interested in AMEE was a very useful feature of the meeting. Exhibiting is not cheap. We hired, for example, a plastic stand to display the MedEdWorld Update leaflets and the cost of this for the two days was $360. I felt we could have bought several for the same price! I was pleased to see that the MedEdWorld Update leaflets were popular and disappeared quickly from the stand. I have noticed a big difference over the years at AAMC. To begin with most people had never heard of AMEE. Many more are now familiar with AMEE, know someone who has been to an AMEE meeting and want more information about our AMEE activities. There was considerable interest in our 2014 meeting in Milan.
A major discussion point at the AAMC meeting in Philadelphia was a decision taken to shorten the meeting in 2014 and to include no longer the Research in Medical Education (RIME) sessions. There was a general feeling that there had been lack of consultation and that this was a backward step. Personally I find the RIME sessions the most interesting part of the meeting. Sadly many conference participants do not stay for them, however, and in the final wrap up I counted less than 50 present. There was an interesting RIME session on inter-professional education with a number of useful papers. One described a station in an OSCE that tested inter-professional skills. Consideration is being given for 2015 to having a separate AAMC meeting specifically on medical education. There is also a separate move to create a North and South American annual medical educations meeting.
In Dundee work is almost finalised on the preliminary programme for AMEE 2014 in Milan. I think we will have again an excellent programme with some outstanding plenary speakers including Richard Horton, Editor of The Lancet, Lawrence Sherman, formerly stand-up comedian and emergency care physician and now Senior Vice President of Prova Education, and the team of Jonas Nordquist from the Karolinska Institute and a leading architect from New York. The final session, organised by the National Board of Medical Examiners includes three Hubbard award winners from Canada, Australia and Europe.
We had a meeting of the Ottawa Conference Committee while we were in Philadelphia and the final selection has now been made of papers and workshops for the April 2014 meeting. Looking through the submissions it is interesting to see the topics and emphasis in different areas. Perhaps not unexpectedly there was a big emphasis this year on selection for undergraduate and speciality training, the OSCE and on-the-job assessment and international dimensions of assessment. Fewer papers were on written assessment, although the progress test and the script concordance test featured in some papers. What looks at a very interesting session will address situational judgement tests (SJTs).
Vincent Dumez from the University of Montreal gave a fascinating MedEdWorld webinar this week on ‘the patient partner in care at the heart of medical education.’ This was a follow up to his plenary presentation at AMEE 2012 in Lyon. It will be available as a recording in MedEdWorld.
I leave tomorrow for a short visit to Oman where I am conducting a workshop over two days with Madalena Patricio on Best Evidence Medical Education. This is being organised by the Ministry of Health Sultanate of Oman. One hundred and ninety eight have enrolled and to allow the workshop to be interactive, the local organisers have arranged participants to be seated round 20 tables, each with 10 participants. I will be interested to see how this works for the workshop activities in practice and will report in a later blog.