Summary: In his latest blog Professor Harden provides his thoughts on Vienna, empathy being on today's agenda, the frightening reality of doctors' lack of knowledge, and how the discussion section of a paper should start. Description: Messages from Vienna
I have just returned from the AMEE 2019 Conference in Vienna where we had over 4100 participants. In a plenary session on the patient-as-educator, Sue Sheridan and Suzanne Schrandt gave a powerful presentation which resonated with the audience. This can be viewed at – Presentations on threshold concepts and activity theory left participants with much to think about. One school, following Ray Land’s presentation, intends to adopt threshold concepts as a basis for their new curriculum design. Activity theory will be the theme of a future issue of Medical Teacher. The application of activity theory to curriculum design, assessment work-based learning, interprofessional education, and other aspects of medical education will be explored. The guest editors are Tim Dornan and Eeva Pyörälä.

In the opening session in Vienna we were entertained by the WISE: Wein International Soloist Ensemble, established with musicians from all over the globe to make music together. The group delighted the participants and attracted a rapturous applause. The ethos for the ensemble had messages for medicine. This is to engage in finding and breathing life into new exciting works of high musical quality and beauty – what we were trying to do at the conference in terms of medical education. Members of the group from all corners of the globe believe that through musicianship they easily connect, cooperate and create beauty no matter their geographical, cultural or social background. They cherish their differences and try to bring them together through the universal language of music in order to enrich their interpretations with different perspectives. With participants from 95 countries at the conference a recognised valuable feature is the sharing of different perspectives in health care education. All members of WISE take pride in having reached the level of being soloists and grandmasters of their instruments but the egotism of individuality, although present, is put behind solidarity and harmony. The group works by fully understanding the music and each other, and by thinking, feeling, and playing in absolute harmony. Again, a message for medicine.

The conference attracted much social media attention, with more than 22.2 million impressions.

Next year’s conference will be in Glasgow, where we will be entertained in the opening plenary by the Red Hot Chilli Pipers who gave a much acclaimed performance when we met for our previous meeting in Glasgow in 2015.

Empathy is on the agenda
Empathy was one of the most common themes running through papers submitted for AMEE 2019 in Vienna. This also featured in recent papers published in Medical Teacher. Laughey et al and coworkers provide, in the August issue, Twelve tips for teaching empathy using simulated patients, while Spatoula and coworkers published a meta-analysis addressing the question – Does empathy change during undergraduate medical education? The review suggests that there is a decrease in empathy across the years during medical education, but to some extent this depends on how empathy is measured. The article in an earlier issue by Daniel Chen and coworkers, Characterizing changes in student empathy throughout medical school attracted much attention and had a high altmetrics score of 443. This put it comfortably in the top 5% of articles covered by altmetric scores.

It is planned to have a track on the theme of empathy running through the AMEE 2020 Conference in Glasgow.

Laughey, W., Sangvik, G.N., Stockbridge, C., et al. 2019. Twelve tips for teaching empathy using simulated patients. Med Teach. 41(8), 883-887.

Spatoula, V., Panagopoulou, E., Montgomery, A. 2019. Does empathy change during undergraduate medical education? – A meta-analysis. Med Teach. 41(8), 895-904.

Chen, D.C., Kirshenbaum, D.S., Yan, J., et al. 2012. Characterizing changes in student empathy throughout medical school. Med Teach. 34(4), 305-311.

If people realise how little doctors knew they’d be very scared
“If people realise how little doctors knew they’d be very scared” was a quote by Lisa Sanders in an interview by Katherine Foley. In the interview she addresses questions including what role do you think the internet has for people seeking answers to their medical problems?, and does the internet help patients who disagree with their doctor’s diagnosis?, and how do you feel about patients using the internet to diagnose themselves?

Scott Johnstone, AMEE COO, drew my attention to Lisa Sanders’ work and a trailer for a new series starting on Netflix called Diagnosis, in which she uses the power of social media to diagnose difficult medical cases.

Foley, K.E. 2019. If people realized how little doctors knew, they’d be very scared. Retreived on 6 September 2019 at

Comments on articles published
PubMed Commons, a feature that enabled authors to share opinions and information about scientific publications indexed in PubMed, was unfortunately discontinued on March 3rd 2018. The aim of PubMed Commons was to encourage constructive criticism and high quality discussions on articles published. Readers could post signed comments on any of the citations indexed in PubMed. Jefferson and Doshi in the BMJ Opinion (Feb 21st 2018) lamented the loss of PubMed and the facility for post-publication review in which the wider community could openly discuss and critique papers that were published, not limited by the bounds of traditional Letters to the Editor.

An attractive feature of MedEdPublish ( is the post-publication review of papers which allows readers to comment on papers published.

Jefferson, T., Doshi, P. 2018. RIP PubMed Commons. BMJ. Retrieved 2 September 2019, from

How should the discussion section of a paper start?
I was interested to see a question raised recently about the discussion section of a paper. The debate was whether it should start with a brief reminder of the results of whether this was redundant and the discussion should start by placing the results in context. Given the pressure for space I favour the latter.

This is discussed further in the paper Submitting Manuscripts to Biomedical Journals: Common Errors and Helpful Solutions.