2014; 36: 92–94
And finally . . .
Do you know? Contributor to this issue: R.M. Harden
Question 3
Question 1
Should video recordings be used to replace paper for the delivery of problem-based learning cases?
Over the past two decades there has been a dramatic increase in the use made of simulation in healthcare education. What issues and principles need to be considered if this approach is to be used for maximum effect?
Question 2
Question 4 What core competencies should a medical student have on entry to medical school?
What are the benefits of mentorship for medical students?
Answer 1
Answer 2 Susanne Kale´n from the Karolinska Institutet, in her thesis for a doctoral degree, explores how mentorship can be used in undergraduate medical education to support students’ learning and development. She concludes that mentorship can facilitate medical students’ professional and personal development by creating space for reflection and development of the more ‘elusive’ competences of a physician, by giving incentives to
92
learn, and by facilitating the students’ process of becoming a physician. Having a mentor gave a sense of security and constituted a ‘free zone’ alongside the education programme. A mentoring relationship could be on a personal level without frequent meetings and knowing one another well.
Answer 3 Video PBL cases were introduced at Aga Khan University Medical College. (Ghanchi et al, Medical Education, 2013; 47: 1131). Four PBL cases were studied. Two were introduced using the traditional paper format and two were presented as video cases, each of five to ten minutes duration using simulated patients or amateur actors. Perhaps unsurprisingly students found the paper cases more effective compared with video cases. They were thought to be more interesting, engaging and helpful in enhancing the group discussion, dynamics and communication skills, compared with video. They were also thought to be more appropriate to derive learning objectives and to improve the thinking process. In contrast the PBL facilitators reported no significant difference between the effectiveness of the two approaches, but found the video more interesting as a delivery method in PBL. The authors conclude that videos should be utilised selectively for problems that provide observable cues for deriving learning objectives.
20 13
AMEE Guide No 82 – Simulation in healthcare education: A best evidence practical guide by Motola and colleagues (DOI: 10.3109/0142159X.2013.818632), provides practical guidance to aid educators in effectively using simulation for training. It is a follow up to the initial BEME Guide on the features of simulators that lead to effective learning. Feedback and debriefing, deliberate practice and curriculum integration are all central to simulation efficacy. The subjects of mastery learning, range of difficulty, capturing clinical variation and individualise learning are important. Simulation can be used also to support team training. The guide concludes that simulation-based healthcare education has great potential for use throughout the healthcare education continuum, from undergraduate to continuing education. It can also be used to train a variety of healthcare providers in different disciplines from novices to experts.
ISSN 0142–159X print/ISSN 1466–187X online/14/10092–3 ß 2014 Informa UK Ltd. DOI: 10.3109/0142159X.2013.862427
And finally . . .
Answer 4 The Association of American Medical Colleges (www.aamc.org) have identified 13 core competencies for entering medical students. These fall into four categories: five interpersonal competencies included are, service orientation, social skills, cultural competencies, teamwork and oral communication; four intrapersonal competencies include,
ethical responsibility to self and others, reliability and dependability, resilience and adaptability and capacity for improvement; four thinking and reasoning competencies include, critical thinking, quantitative reasoning, scientific inquiry and written communication; finally two science competencies relate to living systems and human behaviour.
Jottings by Saquarrah Following a failure by the MEDINE Thematic Network to gain consensus on core learning outcomes with regard to research as a theme in the medical curriculum, MEDINE 2 initiative explored further opinions for research learning outcomes at Bachelor, Master and Doctor level. The findings suggest that learning outcomes related both to ‘using research’ and ‘doing research’ should be core components of the medical curriculum. An article by Marz et al in Perspect Med Educ (2013, 2: 181-195) reports the results of the European consensus survey on the research competencies. Competencies related to doing research as well as using research were considered by most respondents but not all, to be important for the primary medical degree. Opportunities to learn about research in European undergraduate medical curricula vary enormously.
—————— A realist synthesis approach to reviews of evidence has been adopted for some Best Evidence Medical Education (BEME) reviews. Such realist reviews lead to a suggestion that a certain intervention is more or less likely to work in certain respects, for particular subjects and in specific kinds of situations. Such reviews, however, require a considerable and sustained investment over time. Saul and co-workers from Canada describe a ‘rapid realist view’ methodology as a tool for applying a realistic approach to a knowledge synthesis process in order to produce a product that is useful where there is some urgency while preserving the core elements of realist methodology. (Implementation Science, 2013, 8: 103). It will be interesting to see if rapid realist review methodology can be applied to medical education.
—————— How to take more away from meetings is the theme of an article by Jeanne O’Brien Coffey in the October 2013 issue of Executive Travel. Executives, according to a study conducted by the London School of Economics and Harvard Business School, spend more than a third of their working hours attending meetings. Generally speaking meetings are constructed for participants who are ‘information learners’ which puts at a disadvantage ‘action learners’ who would prefer to try and use solutions right in the meeting and ‘people learners’ who want to share stories and discuss them. Meetings can either be adjusted to suit these different learning styles or as
learning style is contextual, individuals can work to embrace other learning styles. With regard to the conduct of the meeting, one surprising suggestion is that anything negative should be got out of the way at the start of the meeting. Another interesting finding reported is that people who check their mobile phones or other electronic devices at meetings are less satisfied with a meeting than those who don’t. A possible reason is that participants are not engaged with the meeting if they are thinking about whatever unrelated item came up on their mobile device.
—————— The social responsibility of institutions in the training of doctors and healthcare professions is the subject of an editorial by Arcadi Gual in the September issue of Fundacio´n Educacio´n Me´dica (FEM 2013, 16(3): 125-126). A book entitled Learning to become a doctor: Shared social responsibility recently published in Spanish, English and Catalan (www.fundacioneducacionmedica.org) discusses the social responsibility of institutions involved in the training of doctors. It highlights that a specific aim of training healthcare professionals should be none other than to provide citizens with the best possible care. That society changes and hence its needs and demands change too should be recognised.
—————— In his blog, Charles Jennings, a Director of the 70:20:10 Forum discusses workplace learning. (http://charles-jennings.blogspot.co.uk/2013/10/workplace-learning-adding-embedding). He describes three approaches. Learning can be added to work activities that has the explicit purpose of assisting learning. This may involve integrating within the workflow, learning activities structured away from the work - for example, an e-learning module might be made available. Learning may be embedded in work. This can achieved through simple job aids or planners or through more advanced electronic performance support systems. With the increasing use of Smartphones and tablets he believes that this has great potential. Finally, learning can be extracted from work. In this the model of ‘learn then work’ is replaced by ‘work then learn, then work in an improved way.’ One way of achieving this he describes, is through blogging and participation in professional social networks.
——————
93
And finally . . .
Teachers, Don’t Forget Joy was a subject of an article in Education Week (October 15, 2013) by Judy Wallis. She argues that what we have been missing in discussions about education is joy - defined in the dictionary as ‘a feeling of great pleasure and happiness.’ She argues that ‘amid the cacophony of school reformers, teacher-evaluation discussions, and test scores, have we simply overlooked it? Has school become sanitized from the very emotion that fuels learning?’ Both teachers and students should experience joy in their learning, accompanied by a deep-felt sense of wonder, of expectation, of delight, of engagement. She concludes that learning should be enjoyable and joy-filled.
——————
‘It’s the night before her exam, and the student has just begun to study. She takes out her highlighter and reads here text book, marking it up as she goes along. She rereads sentences that seem most important and stays up most of the night, just hoping to get a good enough grasp of the material to do well on the exam.’ John Dunlosky, Professor of Psychology and Director of experimental training at Kent State University, writing in American Educator (Fall 2013, 12-21) argues that quite often students believe these relatively ineffective strategies are actually the most effective. A problem, he argues, is that curricula are developed to highlight the content that teachers should teach and that a focus is on providing content and not on training students how to effectively acquire it. More emphasis should be placed on how should students
94
learn, rather than what they should learn – essential if we wish to promote life-long learning. In the article he reviews the efficacy of 10 commonly described learning strategies. The two most effective learning strategies he found were practice testing with self-testing or taking practice tests on to-belearned material and distributed practice with implementation of a schedule of practice that spreads study activities over time. Students retain knowledge for a longer period of time when they distribute their study practice over time and when they mass it. He describes three additional strategies as promising. Interleaved practice involves distributed practice, in that it involves spacing ones practice across time but specifically refers to practicing different types of problems across that time. Elaborative interrogation involves generating an explanation of why an explicitly stated fact or concept is true. Selfexplanation involves explaining how new information is related to known information or explaining steps taken during problem solving.
——————
Teacherpreneurs: Innovative Teachers Who Lead But Don’t Leave is the theme of a recently published book by Berry, Byrd and Wieder. Based on case histories of eight ‘Teacherpreneurs’, it highlights how teachers can and should become transformative leaders with a responsibility for bringing about change in education. While based in school education in the USA, it has powerful messages for higher education on a wider front.
Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
And finally . . .
Do you know? Contributor to this issue: R.M. Harden
Question 3
Question 1
Should video recordings be used to replace paper for the delivery of problem-based learning cases?
Over the past two decades there has been a dramatic increase in the use made of simulation in healthcare education. What issues and principles need to be considered if this approach is to be used for maximum effect?
Question 2
Question 4 What core competencies should a medical student have on entry to medical school?
What are the benefits of mentorship for medical students?
Answer 1
Answer 2 Susanne Kale´n from the Karolinska Institutet, in her thesis for a doctoral degree, explores how mentorship can be used in undergraduate medical education to support students’ learning and development. She concludes that mentorship can facilitate medical students’ professional and personal development by creating space for reflection and development of the more ‘elusive’ competences of a physician, by giving incentives to
92
learn, and by facilitating the students’ process of becoming a physician. Having a mentor gave a sense of security and constituted a ‘free zone’ alongside the education programme. A mentoring relationship could be on a personal level without frequent meetings and knowing one another well.
Answer 3 Video PBL cases were introduced at Aga Khan University Medical College. (Ghanchi et al, Medical Education, 2013; 47: 1131). Four PBL cases were studied. Two were introduced using the traditional paper format and two were presented as video cases, each of five to ten minutes duration using simulated patients or amateur actors. Perhaps unsurprisingly students found the paper cases more effective compared with video cases. They were thought to be more interesting, engaging and helpful in enhancing the group discussion, dynamics and communication skills, compared with video. They were also thought to be more appropriate to derive learning objectives and to improve the thinking process. In contrast the PBL facilitators reported no significant difference between the effectiveness of the two approaches, but found the video more interesting as a delivery method in PBL. The authors conclude that videos should be utilised selectively for problems that provide observable cues for deriving learning objectives.
20 13
AMEE Guide No 82 – Simulation in healthcare education: A best evidence practical guide by Motola and colleagues (DOI: 10.3109/0142159X.2013.818632), provides practical guidance to aid educators in effectively using simulation for training. It is a follow up to the initial BEME Guide on the features of simulators that lead to effective learning. Feedback and debriefing, deliberate practice and curriculum integration are all central to simulation efficacy. The subjects of mastery learning, range of difficulty, capturing clinical variation and individualise learning are important. Simulation can be used also to support team training. The guide concludes that simulation-based healthcare education has great potential for use throughout the healthcare education continuum, from undergraduate to continuing education. It can also be used to train a variety of healthcare providers in different disciplines from novices to experts.
ISSN 0142–159X print/ISSN 1466–187X online/14/10092–3 ß 2014 Informa UK Ltd. DOI: 10.3109/0142159X.2013.862427
And finally . . .
Answer 4 The Association of American Medical Colleges (www.aamc.org) have identified 13 core competencies for entering medical students. These fall into four categories: five interpersonal competencies included are, service orientation, social skills, cultural competencies, teamwork and oral communication; four intrapersonal competencies include,
ethical responsibility to self and others, reliability and dependability, resilience and adaptability and capacity for improvement; four thinking and reasoning competencies include, critical thinking, quantitative reasoning, scientific inquiry and written communication; finally two science competencies relate to living systems and human behaviour.
Jottings by Saquarrah Following a failure by the MEDINE Thematic Network to gain consensus on core learning outcomes with regard to research as a theme in the medical curriculum, MEDINE 2 initiative explored further opinions for research learning outcomes at Bachelor, Master and Doctor level. The findings suggest that learning outcomes related both to ‘using research’ and ‘doing research’ should be core components of the medical curriculum. An article by Marz et al in Perspect Med Educ (2013, 2: 181-195) reports the results of the European consensus survey on the research competencies. Competencies related to doing research as well as using research were considered by most respondents but not all, to be important for the primary medical degree. Opportunities to learn about research in European undergraduate medical curricula vary enormously.
—————— A realist synthesis approach to reviews of evidence has been adopted for some Best Evidence Medical Education (BEME) reviews. Such realist reviews lead to a suggestion that a certain intervention is more or less likely to work in certain respects, for particular subjects and in specific kinds of situations. Such reviews, however, require a considerable and sustained investment over time. Saul and co-workers from Canada describe a ‘rapid realist view’ methodology as a tool for applying a realistic approach to a knowledge synthesis process in order to produce a product that is useful where there is some urgency while preserving the core elements of realist methodology. (Implementation Science, 2013, 8: 103). It will be interesting to see if rapid realist review methodology can be applied to medical education.
—————— How to take more away from meetings is the theme of an article by Jeanne O’Brien Coffey in the October 2013 issue of Executive Travel. Executives, according to a study conducted by the London School of Economics and Harvard Business School, spend more than a third of their working hours attending meetings. Generally speaking meetings are constructed for participants who are ‘information learners’ which puts at a disadvantage ‘action learners’ who would prefer to try and use solutions right in the meeting and ‘people learners’ who want to share stories and discuss them. Meetings can either be adjusted to suit these different learning styles or as
learning style is contextual, individuals can work to embrace other learning styles. With regard to the conduct of the meeting, one surprising suggestion is that anything negative should be got out of the way at the start of the meeting. Another interesting finding reported is that people who check their mobile phones or other electronic devices at meetings are less satisfied with a meeting than those who don’t. A possible reason is that participants are not engaged with the meeting if they are thinking about whatever unrelated item came up on their mobile device.
—————— The social responsibility of institutions in the training of doctors and healthcare professions is the subject of an editorial by Arcadi Gual in the September issue of Fundacio´n Educacio´n Me´dica (FEM 2013, 16(3): 125-126). A book entitled Learning to become a doctor: Shared social responsibility recently published in Spanish, English and Catalan (www.fundacioneducacionmedica.org) discusses the social responsibility of institutions involved in the training of doctors. It highlights that a specific aim of training healthcare professionals should be none other than to provide citizens with the best possible care. That society changes and hence its needs and demands change too should be recognised.
—————— In his blog, Charles Jennings, a Director of the 70:20:10 Forum discusses workplace learning. (http://charles-jennings.blogspot.co.uk/2013/10/workplace-learning-adding-embedding). He describes three approaches. Learning can be added to work activities that has the explicit purpose of assisting learning. This may involve integrating within the workflow, learning activities structured away from the work - for example, an e-learning module might be made available. Learning may be embedded in work. This can achieved through simple job aids or planners or through more advanced electronic performance support systems. With the increasing use of Smartphones and tablets he believes that this has great potential. Finally, learning can be extracted from work. In this the model of ‘learn then work’ is replaced by ‘work then learn, then work in an improved way.’ One way of achieving this he describes, is through blogging and participation in professional social networks.
——————
93
And finally . . .
Teachers, Don’t Forget Joy was a subject of an article in Education Week (October 15, 2013) by Judy Wallis. She argues that what we have been missing in discussions about education is joy - defined in the dictionary as ‘a feeling of great pleasure and happiness.’ She argues that ‘amid the cacophony of school reformers, teacher-evaluation discussions, and test scores, have we simply overlooked it? Has school become sanitized from the very emotion that fuels learning?’ Both teachers and students should experience joy in their learning, accompanied by a deep-felt sense of wonder, of expectation, of delight, of engagement. She concludes that learning should be enjoyable and joy-filled.
——————
‘It’s the night before her exam, and the student has just begun to study. She takes out her highlighter and reads here text book, marking it up as she goes along. She rereads sentences that seem most important and stays up most of the night, just hoping to get a good enough grasp of the material to do well on the exam.’ John Dunlosky, Professor of Psychology and Director of experimental training at Kent State University, writing in American Educator (Fall 2013, 12-21) argues that quite often students believe these relatively ineffective strategies are actually the most effective. A problem, he argues, is that curricula are developed to highlight the content that teachers should teach and that a focus is on providing content and not on training students how to effectively acquire it. More emphasis should be placed on how should students
94
learn, rather than what they should learn – essential if we wish to promote life-long learning. In the article he reviews the efficacy of 10 commonly described learning strategies. The two most effective learning strategies he found were practice testing with self-testing or taking practice tests on to-belearned material and distributed practice with implementation of a schedule of practice that spreads study activities over time. Students retain knowledge for a longer period of time when they distribute their study practice over time and when they mass it. He describes three additional strategies as promising. Interleaved practice involves distributed practice, in that it involves spacing ones practice across time but specifically refers to practicing different types of problems across that time. Elaborative interrogation involves generating an explanation of why an explicitly stated fact or concept is true. Selfexplanation involves explaining how new information is related to known information or explaining steps taken during problem solving.
——————
Teacherpreneurs: Innovative Teachers Who Lead But Don’t Leave is the theme of a recently published book by Berry, Byrd and Wieder. Based on case histories of eight ‘Teacherpreneurs’, it highlights how teachers can and should become transformative leaders with a responsibility for bringing about change in education. While based in school education in the USA, it has powerful messages for higher education on a wider front.
Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
