Summary: In his latest blog Professor Harden reflects on the AMEE 2017 Conference in Helsinki, the issues raised there and what makes a successful innovation. Description: Are cadavers useful in teaching anatomy?
A symposium at AMEE 2017 in Helsinki looked at the role of cadavers in learning and teaching anatomy and this will be the basis for a paper to be published in Medical Teacher. It was chaired and organised by Paul McMenamin. At the beginning of the symposium 80% voted in favour of the use of cadavers in the education programme but at the end of the symposium this had dropped to only 50%. You will be able to read the reasons in the article. Morium Howlader a general practitioner who is studying medical art, produced some creative and imaginative illustrations based on Paul McMenamin’s presentation.  These are attached below under "Morium's notes". We hope to persuade her to come to a future AMEE conference and repeat this with some other presentations.

The magic of AMEE 2017
Is his blog Connected Principals, 20th September, David Geurin argued that teachers should inform, inspire and entertain?  This is something we try to achieve with our plenary speakers at AMEE meetings, succeeding to a greater or lesser extent.  Some inform more than they inspire and entertain and others entertain more than they inform and inspire. The AMEE 2017 conference with 3900 participants got off to a great start on the Sunday evening with a plenary session by Peter Wardell, an internationally acclaimed magician. He highlighted in his presentation, rather subtly, what doctors might learn from magicians. The less experienced magician, for example, is concerned with the technique of the tricks he uses while the more experienced magician is concerned more with the interaction with the audience and the audience’s experience. This point was taken up in a workshop, What is an Excellent Teacher, to which I contributed along with Alison Whelan and Madalena Patricio. The excellent teacher it was agreed is concerned not just with the various teaching tricks or techniques available, many of which were demonstrated at the conference, but rather with creating a learning environment and experience for the student, just as the magician does with his audience.

Trust and risk
In the plenary on the Monday morning, Pasi Sahlberg looked at what medical education can learn from the Finnish experience of education. I think there were some interesting messages and it is worth looking at his presentation in the video recording if you were not in Helsinki (The videos are currently available to all those who enrolled on AMEE Live Online, to conference participants and to AMEE members. They will be made more widely available on the AMEE website shortly). One of the factors leading to the success of the Finnish education system he highlighted was that the government trusted the teachers. In medical education, however, there is a risk that we are moving away from trusting our teachers. An example is the greater use of national medical licensing exams with the responsibility for assessing the medical students competence to practice removed from the teacher and the medical school.

In the final plenary session on the Wednesday, Wolfgang Gaissmaier gave a fascinating presentation on helping doctors and patients make sense of health statistics. His thesis was that we are very bad at assessing risk. An example outside medicine he gave was the attitude of the public to travel following the Twin Tower disaster in New York. About 3500 individuals were killed at the site but an additional 1600 died the following year on the roads – an increased death rate resulting from a switch of the public from air transport to road transport.

Social media and conferences

Angela Fan from Taiwan sent me a photo of her short communication session at the conference.

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What is interesting is that at least four members of the audience were photographing her slide. It is not clear whether this is for their own use or whether they intended to email it or share it with others who were not present. This is a controversial issue at present. While we have always encouraged the use of social media at AMEE Conferences, as reported in the British Medical Journal of 9th September, delegates at the American Diabetes Association scientific meeting in June were asked not to share photographs of presented slides through social media. It was claimed that the ban was to protect intellectual property but the policy has been seriously criticised and ADA is reported as reviewing its policy for its 2018 conference.

A new book
At the conference, Elsevier launched the 5th Edition of A Practical Guide for Medical Teachers and Dan Hunt and I had a book signing session. Unfortunately John Dent was unable to be with us in Helsinki as he had a family wedding. One teacher bought it for her daughter who had just graduated in the hope that she might become more interested in academic medicine and teaching and another bought it as a birthday present! Pat Lilley and I have just finished writing our new book, The Eight Roles of the Medical Teacher which provides a new slant on the subject, and we hope that this will be launched at AMEE 2018 in Basel.

What makes a successful innovation
I was interested in the papers at AMEE 2017 on the use of the OSCE as an assessment and teaching and learning tool. One exhibitor featured a wide range of simulators that could be used in an OSCE. Why is the OSCE, which I first introduced in 1975, now used worldwide as a tool to assess clinical competence. Pat Lilley, Madalena Patricio and I address the question in our book The Definitive Guide to the OSCE, building on the work of Schneider. Schneider argues that ideas that are adopted stand out not because are but because they seem significant. The OSCE has been seen by teachers as addressing an important problem – the assessment of learners’ clinical competence. Schneider’s second characteristic for a successful innovation was philosophical compatibility. He argued that for education research to gain traction in practice, teachers must view it as reasonable and appropriate for use. It must not be perceived as the work of outsiders and must not clash with teachers’ values and commitments. In the case of the OSCE, clinical teachers could easily identify with the approach and the principles underpinning it. Schneider’s third crucial characteristic was occupational realism. As with the OSCE, the idea must be practical and possible to put into immediate use. The fourth characteristic was transportability. He argued that for an educational approach to be widely adopted it should, as in the OSCE, have simple principles that can be explained easily to a busy colleague and adaptable for use in different contexts. Thinking about these issues further I was interested to note an article in the American Education Research Journal, August 2017 – Why reform sometimes succeeds: Understanding the conditions that produce reforms that last. The analysis may explain further why the OSCE has been widely adopted. Cohen and Mehta conclude in the paper that reforms succeed when they solve problems that educators had or could easily learn that they had, were broadly consistent with the organisations aims and purpose and did not require deep change and extensive capacity building. They argue that reforms with these characteristics are more likely to gain appreciable support with little opposition. It would be interesting to analyse the innovations presented at AMEE 2017 and to see how many are implemented in practice and the reasons for this.

Cohen, D.K. & Mehta, J.D. 2017. Why reform sometimes succeeds: Understanding the conditions that produce reforms that last. Am Educ Res J. 54(4). 644-90.

Schneider, J. 2014. Closing the gap…between university and schoolhouse. Kappan. 96(1). 30-5.

Finally, a Cambodia video
We had a strong group of participants from Cambodia and they made a video of some events at the conference. (https://youtu.be/Rw_AgA0YDlU)

Morium's notes
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