medical education

Highlights and food for thought from #AMEE2016

Following the example set by Andrew Coggins who shared his pearls from AMEE 2016 here are some of my AMEE highlights and the things that have left me with food for thought.

AMEE in Barcelona was busy for me as I was involved in running several workshops and I didn’t get chance to get along to all the sessions I would have liked to.  A common issue that springs up at AMEE most years is that there are often several sessions running at the same time that you’d like to get along to, this was the case again and I was sorry not to get along to the short communications on self-regulation and self-efficacy and also on learning theory. That said there were sessions that I did get along to and the Twitter stream let you keep an eye on what else was being presented and discussed around the conference.

The opening plenary this year was delivered by Graham Brown-Martin, founder of Learning Without Frontiers who’s travelled extensively looking at schools and education and published Learning Reimagined.  Whilst the focus of Graham’s talk was education in the school sector I felt many of the points he talked about had relevance to the higher education context where medical schools sit.  We heard from Seth Godin during the talk who highlighted that schools are producing students who can do well in the test rather than students who can problem solve and innovate as well as lead.  What struck me was the impact our school system has on shaping the future students entering medical school and in turn future doctors.  Typically medical students are fixated on what’s going to be in the exam and our medical curriucla don’t generally focus on developing creativity and innovation in students. Yet there are growing challenges which our graduates will have to grapple with and problems that need to be addressed eg. around caring for ageing populations, antibiotic resistance and how to improve the design of our health services.  Graham highlighted how schools need to equip children with the knowledge and skills to reimagine society, to meet the challenges of their generation.  Surely this is true for medical education too?

The tendency for technology to be used to perpetuate old approaches to learning based on information transmission was raised and the fact that teaching should not be seen as a delivery system like FedEx was well made.   It was refreshing to hear reference to Paulo Friere and critical pedagogy, an approach one doesn’t hear much about in medical education.  The notion of the teacher as an artist crafting learning situations for students was also mentioned, which resonated with John Sandars’ comments in our pre-conference workshop on developing blended learning approaches earlier in the day.

Graham also made reference to Seymour Papert and constructionisim – learning as a reconstruction rather than transmission.  This is an approach I’ve adopted in an SSC we run – The Doctor as Digital Teacher – where creativity is very much the focus as students create a digital learning resource.  My take home from Graham’s plenary was that we need to be doing more to foster and nurture the creativity of our students in medicine.  Locally we’ve been developing links with our design school and I wonder if we will start to see more medical schools doing similar.  I’ve been particularly struck by the approach that the new Dell Medical School in Texas which is” including a leadership-focused year of self-directed study, a team-based curriculum, and a first-of-its-kind Design Institute for Health, a joint collaboration between the Dell Medical School and the College of Fine Arts, developed to apply design thinking to health care challenges and innovation”. Perhaps this is a theme we might see more of in future AMEE meetings.  You can catch up with more from the plenary on the Storify of the tweets that Graham Brown-Martin has published.

Barcamp
My next AMEE highlight was the Barcamp which ran on Monday afternoon.  The Barcamp was a new concept for AMEE and it ran across two workshop slots with a focus on technology and informal learning and it proved a rich learning experience on a number of different levels.

The key feature of a Barcamp is the participation of all participants and everyone was invited to suggest topics, questions, or outline problems that they wanted to explore and discuss.  The atmosphere was relaxed and informal and there was no shortage of suggestions for us to consider.

The topics were narrowed down as everyone casted their allocated three votes and very quickly about 14 issues were selected and scheduled in to a series of 4 discussion sessions.  With a wide range of participants from different continents and working in different medical education contexts we explored topics such as design-based research, the use of social media in learning, recording infromal learning and analytics, addressing the challenges of rigid IT cultures in delivering medical education.  The conversation was rich and thought provoking and I think we all learned from each other’s experiences and collective wisdom.  I left the session reminded of Alvin Tofler’s quote that, ‘the illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn and relearn”. I felt that the Barcamp helped me in that process of unlearning and relearning some approaches to tackle issues around culture in my organisation.

Learn Unlearn Relearn

Everyone had a take home message from the BarCamp and I think the one from Laura Bowater is one that many of us would echo, the session gave us time to think, something we have precious little time for in our day to day work.

The Barcamp session was run by the Learning Layers project team who as part of an EU funded project have been looking at supporting informal learning in the workplace.  The team have also been  developing a toolkit and new app the Learning Toolbox which allows you to create learning stacks and share them with your students/trainees.  I think the toolbox has great potential and I’m hoping to explore how we might be able to try it out in a number of contexts back in Dundee and not just in medical education. I’m also seeing lots of potential to reuse the Barcamp format in teaching, curriculum development sessions and also as a precursor to a health and social care design hack that we’re planning to run.

The last thing to mention about the BarCamp were the Joy cards which were shared to acknowledge infromal learning.

A number of us received these cards and I’m looking forward to passing on mine to on.  The idea behind the Joy cards is that you can record receiving one online with details of who gave it to you and why and where and then over time you can follow the journey of the card.  This is such a simple but effective idea and again it’s something which could be adopted more widely in medical education.  It was encouraging to receive one and in many ways it reminded me of the wonderful #FOAMed cards that a good number of us have received anonymously through the post.

Talking of #FOAMed as Andrew Coggins has mentioned in his post there was little mention of it in any of the sessions and it didn’t feature as much as it has in previous years in the Twitter stream.  For those unfamiliar with FOAMed it stands for free open access meducation and was coined as a concept at ICEM in Dublin in 2012.  FOAMed has been adopted as a hashtag in social media spaces across different medical specialties with particularly strong representation in emergency medicine and critical care as well as radiology and paediatrics.  Social media channels have effectively supported the development of a community of practice and learning collectives around FOAMed and medical education more generally.  This illustration from Tanmay Vora on conversation and sharing as the currency of social community nicely sums of the essence of how I see the FOAMed community works.

I mention all of this beacuse FOAMed is very much a conversation and I think one of the areas that AMEE hasn’t quite cracked is how to keep the momentum on discussions beyond the physical conference and extend the community into the virtual space.  Maintaining those conversations would be particularly helpful to the ‘Point of View’ sessions, which were a welcome addition to this year’s AMEE, and a big shout out to Laura Bowater who outlined the need to reframe the antibiotic resistance crisis and address it in our curricula.  In the same session was a point of view from Anita Ho from Singapore touching on digital professionalism and the need for positve role models against a backdrop of medics being strangers in a strange land when it comes to online spaces.  This for me acentuated the ongoing apparent lack of awareness of FOAMed in the wider medical education community and the countless positive role models there are in the digital landscape invovled in FOAMed and beyond.  It would be good to see AMEE conisder giving plenary stage time to one of the well established names in the FOAMed MedEd community.

Moving onto interprofessional learning (IPL) there were some super short communications in session #8O.  The importance of authenticity in IPL was highlighted by Tineke Westerveld and the presentation by Brazilian medical student Daniel de Oliveira outlining how medical and other health care students work as part of the clinical team in a heart failure clinic proved a great example of authentic learning.  Daniel framed the students’ learning in the context of a community of practice and situated learning and urged the audience to include students as part of clinical teams so that they are emmersed in authentic learning.  His plea resonated with what I hear many of our students say about IPL, they are always quick to highlight that they will be working in teams with other healthcare professionals yet their expereince of IPL so often seems contrived and unauthentic.

Lessons for interprofessional learning

A last highlight to share was Seán MacPherson, the singing haematologist from Otago Medical School, teaching haematology through catchy songs.  The example below is a song about anaemia.

Whilst Seán didn’t have hard evidence of the effectiveness of learning medicine through catchy songs the anecdotal indications were that students found them useful way to remember key information and on the VT they mentioned sitting in exams and singing through his songs to recall information.  Seán drew parallels with those annoying jingles from adverts that we can’t get out of our heads and we know all the words to.  To prove the case he started a rendition of the Shake n Vac and I have to confess I was one of the many that could join in word for word!!

So that wraps up another AMEE.  As always it was great to network and meet up with old friends and colleagues as well as to meet and make new friends.  I’m looking forward to following up on some of the conversations and to hopefully catching up with others again next year.

Student created OER and FOAMed for #openeducationwk

This week is Open Education Week so it seems appropriate to share some work recently completed by one of our Year 3 Medical Students at Dundee as part of our 4-week SSC The Doctor as Digital Teacher.

I’ve blogged before about our SSCs which see medical students developing their digital teaching skills and creating learning resources.  Over the years we’ve seen a range of different learning resources developed including online tutorials, iBooks and videos. The students are always very creative and they’ve developed some excellent resources.  We only had one student on the latest run of the SSC and I was a bit concerned that we couldn’t offer the same learning experience we usually do when we have five or six students.  Thankfully this doesn’t seem to have been the case and our student, Zoe, seems to have enjoyed the experience and has produced a super series of videos on the anatomy of the larynx.

Central to the videos is a 3D model of the larynx which our medical illustrator Annie Campbell worked up as a derivative from content from the Japanese-based BodyParts3D database.  We’ve shared this model on SketchFab so that it can be used as OER in other teaching resources.

The videos that Zoe’s created based on this model together with other content that she created, including her own hand-drawn tutorial are all posted up on Vimeo and you can view them here.

Part 1 – Anatomy of the larynx: Cartilage structures

Part 2 – Anatomy of the larynx: Membranes and muscles

Part 3 – Anatomy of the larynx: Laryngeal cancer

Digital storytelling and reflection in medical education

Tonight I was taking another look at the #ds106dc Daily Create site which runs as part of the DS106 digital story telling course started of by Jim Groom at University Mary Washington. The daily create is one strand of ds106 and

provides a space for regular practice of spontaneous creativity through challenges published every day. Each assignment should take no more than 15-20 minutes. There are no registrations, no prizes, just a community of people producing art daily. Developed as part of the ds106 open course on digital storytelling, TDC is open to anyone who wants a regular dose of creative exercises (and it more fun than jumping jacks, pushups, and P90X).

How DS106 Changed My Life by giulia.forsythe, on FlickrA strong community has emerged around the #ds106 course and individuals have been sharing their creative works, which include photographs, drawings, audio recordings, video and writing via blogs, Flickr, YouTube etc. Looking at some of the daily create activities and artefacts got me thinking if something like this could work in medical education to support reflection.

A few weeks ago in the #ukmeded chat we discussed reflection, something which medical students and doctors alike see the benefit of but also sometimes despair about because of the tick box, jump through hoops approach that often seems to prevail in medical education.  Initial discussion around reflection kicked off at the end of a previous chat the whole chat is archived over on Symplur.

Digital storytelling has been been used to support reflection in medical education.  John Sandars has written about a pilot he ran with students at Leeds Medical School where a small group of 1st year students used digital storytelling to reflect on a personal and professional development module.  The students seemed to engage with this approach to reflection.  They liked the creative aspect of digital storytelling, they thought more about it things than when just writing an essay and the process of picking pictures had more of an impact on them. It was also viewed as a more stimulating form of reflection and appeared to encourage deeper and more meaningful reflection.

There are others using digital storytelling in medical education but I wonder if it’s something that could be more widely used to support reflection.  What would happen if the concept of the daily create was used with medical students perhaps as a weekly or monthly create activity, would it result in deeper and more engaging reflection or would it just become another chore that students complete through gritted teeth.  It would also be interesting to see what mght develop if there was an open medical education type digital story telling course like #ds106.  Maybe something worth exploring.

REFERENCES
Sandars, J. & Murray, C. “Digital storytelling for reflection in undergraduate medical education: a pilot study.” Education for primary care 20 (2009): 441-44.

IMAGE CREDIT
Creative Commons Attribution-Noncommercial-Share Alike 2.0 Generic License  by  giulia.forsythe 

Trends in medical education in the digital age

This is a presentation I gave when I visited Galway Medical School in March at a session of the Galway Area Medical Education group.  I’ve been meaning to post it up to Slideshare for a while and been prompted to upload it by Tom O’Neill’s tweet earlier today asking if anyone has screenshots or slides showing examples of Twitter in medical education. So here it is. In the session I gave an overview and considered some of the emerging trends in using technology in medical education and approaches to their implementation and rferred to some examples from across the continuum of medical education.

Getting started with Google+ in SSCs

Google+_2Last week I tweeted about using Google+ with a group of SSC students and had a couple of questions about the SSC and how I was using it so I said I would blog about it.

For those not familiar with SSCs these are student selected components also known as special study modules, which are a common feature in undergraduate medical degrees.  Alongside the core undergraduate medical curriculum students get to select specialties and topics that they would like to study.  They can choose from formally organised SSCs run by teaching staff across a wide range of topics and in different healthcare settings.  There is also the option to self-propose an SSC (SPSSC) and this is a particularly popular option with our 3rd year students, who want to explore and gain experience in a particular area of interest and they are responsible for arranging 2-4 week project and a supervisor.

I’ve supervised a number of these self-proposing students over the past few years who’ve wanted to develop an online learning resource to help them prepare for their future role of doctor as teacher and to develop their IT skills.  I like to have these students linked up with a clinical co-supervisor too so they can also get some clinical experience  and so that we have a subject matter expert to review the resource that’s developed. I’ve had 4-5 students at a time doing these SPSSCs with me over the last three SSC blocks and whilst they’re all doing slightly different projects as well as individual sessions with them I I like to bring them all together to introduce them to some prinicples in developing online learning, usability and accessibility, issues around copyright and the reuse of clinical recordings, different tools and software they could use and also give them tips for organising their project and managing information and resources. Meeting up together also lets the students share their ideas and storyboards and get feedback from their peers, they also share things they’ve learned each week and put their resource through some uasbility testing. As they’re doing an SPSCC they have to keep a daily log of what they’ve done each day. Typically students complete this as Word document but last year I suggested that each student do this as a blog and share with the rest of the group so that we could give feedback and comment. This has resullted in some really excellent reflection and analysis and allowed me to give quick and just-in-time feedback.

This year there are 5 quite different projects and during our kick off meeting I wondered whether it might be worth while having a go at using Google+ to support communication and sharing of resources over the 4 weeks of the SSC. I’ve been using G+ pretty much from the off, but it’s taken me a while to get the hang of it.  The penny has been dropping over the past few months and it was particualrly helpful in planning and organising a pre-conference workshop I co-ran at AMEE last year.  I was thinking that rather than responding to individual emails from the students they could post a query in G+ and then they would all see my response and links to any useful resources I might share.  It would also allow them to respond to each other’s queries and share things they discovered too. All of the students had a Google account and whilst they hadn’t used G+ before they were all game for giving it a go so I created a private community.

So how did the first week go?

Setting up the community – First off they all emailed me their gmail email details and I tried to add them to a circle but as many of them didn’t have a G+ account I couldn’t add them.  I’d assumed that if you had a gmail account you automatically had a G+ account so I had to email them all and ask them to set up on G+. Once they’d all done this we were up and running.

Using Google Drive – Whilst one student set up a blog, another shared their daily updates in G+.  Another student was keeping their log in a Word doc but then uploaded this to Googledocs and then shared this with everyone in the community.  Another student wanted to run a quick survey and asked for advice on survey tools, here again we made use of GDocs and Google forms.  By the end of the week one or two others were thinking of using Google forms to get some quick feedback from their year group on the sort of learning resource that would be helpful to their peers.  None of the students were aware of GDocs or GDrive and the respective mobile apps for smartphones and tablets, which once again confirmed to me that we shouldn’t make assumptions about students’ awareness of technologies.

Scheduling events – I scheduled a follow-up meeting and set up an event.  However with the delay in getting everyone into the group I still had to send an email later in the week to confirm the arrangements.  Now that everyone is a member this should hopefully work better this week as we schedule follow up meetings.

Hangouts – We haven’t used this yet but we’ll perhaps try this before the SSC finishes.  I’ve introduced the group to what a Hangout is and explained that they can collaboratively work on a document and share their desktop etc and that this might be handy if they are working on group projects at anytime.

Sharing resources – I’ve found using G+ a much easier of way of sharing and signposting resources to students. G+ sharing buttons on our departmental Vimeo channel has made it easy to share screencasts and similarly it’s very easy to share YouTube videos.

G+ app – This has been handy both on the phone and iPad particualrly given the recent upgrades which have made it much more user friendly and made it easy for me to post stuff and respond to the student posts.

What the students think – So far the students have been quite positive about using G+. Previous institutional surveys and my own conversations with students have highlighted that not all students are keen to see the University and Medical School using Facebook to support learning as they see this as their private and social space.  The students on the SSC all held this view but felt that G+ maybe had the potential to be used to support learning given the additional features.  We’ll see what they think at the end of the 4 weeks.

I’ve found using G+ a positive experience so far, I also think it’s saving me time.  If it continues to be then I’ll be making use of it again when the next SSC block runs in May and I might consider using it with a 5th year SSC on prescribing that’s running next month.  I’ll post an update when this 4 week block is over and perhaps mention a few other tools that the students have been introduced to including Dropbox, Skitch and Pinterest.

Musings on UKOER

oer_logo_EN_1 by btrautweinjr, on Flickr

I’ve read a few things over the past while that have got me thinking on and off about OERs and the #UKOER programme  and particularly about it’s impact and contribution to the area of online learning in medicine and other subject disciplines.  I’m not sure exactly how much has been invested in the various phases of the UKOER project, this piece on the Glasgow Caledonian website indicates tens of millions, how many tens though? £50, £60 million … or more?. I asked on Twitter if anyone knew and David Kernohan replied

So maybe not as much as I was beginning to think, but I’m still interested to know whether this has been a worthwhile investment, has it been value for money and what’s been the impact on the academic community and what’s the level of awareness and engagement like amongst staff in HE?  What will the longer term impact be?

It was interesting to see Simon Thomson’s (@digisim) Storify of the recent UKOER12 event, where he says

After being involved in a phase one project (where I was very much heavily involved in OER networks) I am now more aware that beyond the ukoer network the volume at which OER is heard is significantly lower.

I think Simon is right and wonder if in some places the volume is actually off and it’s never been turned on. Simon asks if the OER community has failed in some way to evangelise beyond its borders.  Maybe it has been too inward looking, with the same old crowd following the circuit of OER meetings. How effective has the communication and dissemination of UKOER activities been?  In the words of Spandau Ballet has it been a case of ‘Communication let me down’!  Those of us engaged online via twitter and blogs can follow what’s going on to some degree but even then trying to keep up with all the projects large and small seems like a full time job in itself.  But what about those who aren’t engaged online and aren’t part of online networks, what’s the strategy to get these academics thinking about OERs.  Now the funding has come to an end what’s going to be long term legacy, what are the sustainability issues and what do we do to try and raise the profile of OERs?

Is the communication issue outside the OER network the only thing that’s affected the volume?   Has UKOER met the needs of academics at the digital chalkface ie resources that can be reused in multiple different contexts?  Is there lots of high quality content that academics want to use and assimilate into their teaching?  If there was wouldn’t we all be talking about it and generating a lot of noise?

Despite dipping in and out of Jorum and subscribing to the RSS feed for new resources I’ve yet to reuse anything because I’ve not seen anything that meets my needs.  Consequently it’s somewhere I rarely bother to look.

The big issue in developing online resources in medical education that I see, day in and day, out is the need for reusable illustrations, animations and videos.  These are the types of OERS that we’re always on the look out for.  Along with other members of the team I work in, I’m frequently presented with storyboards for online resources full of medical illustrations etc taken from a Google image search.  Clinicians are often a bit taken aback when we say we can’t use them because they’re copyrighted and then when we run an advanced search they look crest fallen as invariably what comes up is nothing of any use.  They’ve put time and effort into trying to source images and all to no avail! The good quality images worth using tend to come from the big textbook publishing houses and so can’t be reused to develop our own learning resources let alone new OERs.  We end up scouring wikimedia commons and creative commons image banks in the hope we’ll find something we can reuse that fits the bill.  For anatomy illustrations my first stop was always the Health Education Assets Library – HEAL – based in the US which has a great collection of illustrations shared by the Royal College of Surgeons in Ireland.  The problem now is that HEAL has been down for months and who knows if it will ever come back online.  I often think if only some of that UKOER money had been spent on core resources like images and animations, what sort of impact would that have made?  Would we have had the beginnings of a bank of learning assets that would have been really useful and reused in medical courses and in the life sciences here in the UK and elsewhere that met an identifed need?

My philosophy is very much there’s no point in re-inventing the wheel when someone’s already done it and I’m a big supporter of OER and try to raise awareness amongst colleagues where I can.  We make use of lots of OERs and we’re always on the look out for things that we can pass on to clinicians to review to see if it’s something we can reuse in local teaching and point our students to.  Some of these OERS do include videos that have been funded by HEA grants like the St George’s Medical School clinical skills videos, but the vast majority of OERS we use have been sourced from YouTube, Vimeo, TED, SlideShare, iTunesU, iBooks, blogs and the like.  These have typically been developed by keen and enthusiastic academics.  There are also sites like GetBodySmart developed over a number of years as a labour of love by Scott Sheffield and probably used by medical students the world over.  We’ve also seen our own students developing OERs and students elsewhere have done similarly.  These are the sorts of resources that we can use to build and create our own teaching narratives and learning activities and present them in the context of our own curriculum and reuse in different ways in a range of learning resources.

So as the UKOER round of projects comes to a close I’m left thinking what’s the impact been in different subject disciplines? What do others involved in medical education think?  There have been some projects that seem to have become well established such as HumBox. What’s the general level of awareness of these subject specific OER repositories and how many resources are actually being reused?  And what about  Jorum, the national UKOER learning repository, whilst well known in some circles I still come across many colleagues who’ve never heard of it (something I’ve mentioned before) and that’s with my institution having signed up to it before the days of OER funded projects!

I had high expectations at start of the UKOER journey and now I feel a bit disappointed. Is the issue me, lack of engagement on my part, or am I just missing something?  I feel I’ve had the volume turned up but I know so many who haven’t heard the message.  More fundamentally I wonder whether the UKOER initiative has encouraged UK universities to promote and support the development of OERs and so build and sustain a community of sharing?  I’m not even aware if there are colleagues locally in other Schools who’ve been involved in any UKOER projects. I wonder too what those involved in the UKOER inner circle would do differently if they had the chance to run the programme again?  As usual lots of questions!

Image Creative Commons Attribution-Share Alike 2.0 Generic License  by  btrautweinjr 

Looking forward to #asme11

Later this week I’ll be attending the AMSE annual scientific meeting in Edinburgh and running a workshop with Anne Marie Cunningham and Annalisa Manca on networks and social media in medical education.  Over on Med Ed Connect Anne Marie has invited individuals coming to the workshop to introduce themselves and say a little about themselves and their interest in using technology in medical education.  Anne Marie has also posted a video on her own blog introducing herself and outlining some of her own interests.  So here’s my effort giving a quick overview of how I’ve founded blogs and twitter a great place to support my own learning and be inspired to have a go at using technology locally beyond just using the institutional virtual learning environment.

This is the first time I’ve had a go at making a video like this and although I lost count of how many attempts I had at doing it, the good thing was that it was easy to do and this is why I think it’s important  not to be afraid of using technology.  So many tools and technologies are relatively easy and intuitve to use now and so if you’ve never had a go at using some of tools that are around now have a go and see how you get on.

If you’re going to ASME, I look forward to seeing you there.