IAMSE Spring 2019 WAS Session 1 Highlights

[The following notes were generated by Mark Slivkoff, PhD]

IAMSE Webinar Series, Spring 2019

Speaker: Ronald M Harden, OBE MD FRCP(Glas) FRCS(Ed) FRCPC
General Secretary, Association for Medical Education in Europe (AMEE)
Editor of Medical Teacher
Professor of Medical Education, University of Dundee, United Kingdom

Title: The Changing Roles of the Basic Science Educator
Series: The Role of Basic Science in 21st Century Medical Education

The IAMSE Webinar Series this Spring began with a presentation by Dr. Ronald M. Harden, an internationally recognized medical educator who has authored numerous books, hundreds of research articles, and who also pioneered the use of the OSCE (Objective Structured Clinical Examination). The series, unarguably, got off to a great start!

Dr. Harden prompted the audience with his first question: What is expected of the teacher? He explained that teachers must 1) understand their role as the teacher, 2) have a mastery of the subject, 3) possess teaching abilities and 4) understand the course in which they are teaching. Dr. Harden turned his focus to what he deems as the eight roles of the medical teacher, which is described in detail in his new book co-authored with Pat Lilley and published in 2018 (all resources are cited at the end of this article).

These eight roles, each upon which he expanded during his hour with us, are as follows:

1. Information Provider and Coach
2. Facilitator and Mentor
3. Curriculum Developer and Implementor
4. Assessor
5. Role Model as Teacher and Practitioner
6. Manager and Leader
7. Scholar and Researcher
8. Professional

The information provider is the conductor or transmitter of information. As curator of information they are responsible for finding, sorting, organizing, recommending and personalizing learning resources. In this role they also serve as a coach of the students as information seekers, and recognize that the problem of information overload is real; there has been a huge expansion of knowledge while the time for training has not increased, therefore all the information required by a doctor cannot be covered in the curriculum. Students must be empowered to ask the right question, identify a source of information, and evaluate the answer.

The good teacher helps the student to learn, another point made by Dr. Harden as he turned to the teacher’s role as facilitator. The facilitator should not default to self-directed learning in which the students are on their own. Rather, the facilitator directs self-learning and does not merely “throw his students into shark-infested waters.” To facilitate learning, medical teachers must make learning effective, engage the learner in the activity, clarify the learning outcomes, and identify learning opportunities. Dr. Harden also mentioned that putting together study guides is a great way to facilitate learning.

The next role discussed was that of curriculum developer and implementor. He emphasized that medical teachers should be familiar with the school’s curriculum, that they should plan and implement their course in line with the curriculum, and that they should evaluate the curriculum and plan for change. Dr. Harden briefly spoke of the “SPICES” model of curriculum analysis. Where, he asked, does your school want to be?

• Student-Centered or teacher centered
• Problem-based or information based
• Integrated or discipline-based
• Community-based or hospital-based
• Elective driven or uniform
• Systematic or opportunistic

Every teacher also has a responsibility to be an effective assessor. There are various types of assessments used in medical education today including authentic, competency-based, or programmatic assessments. There are also portfolios as well as feedback to our learners. Whichever tool or tools we use, we must choose wisely.

Next, Dr. Harden discussed what he considers to be a forgotten role, that of role model. As major players in the learning environment, he explained, medical teachers are ideally placed to influence students’ lifestyle and career choices. Additionally, teachers help students acquire the necessary professionalism and behaviors as they progress through the many years of undergraduate and graduate medical education.

Of increasing importance is the teacher’s role as manager. Dr. Harden supported this increased importance by pointing out numerous education developments and trends including:

• Integrated teaching
• Interprofessional education
• Outcome-based education
• Education developments
• Involvement of stakeholders (students, teachers, technologists, educationalists, patients, health care providers)
• Unbundling the curriculum

He described unbundling the curriculum in terms of what medicals schools should not try to do, which is to be self-sufficient in the delivery of its education program. The medical school does not have to be in charge of everything. Other organizations should help share curriculum planning, teachers, educational expertise, learning resources, and learning opportunities.  

Dr. Harden continued around his pie chart and stopped on the next role of scholar. He emphasized that teachers are professionals rather than technicians, and that they should reflect on their teaching. Additionally, teachers need to make evidence-informed decisions, carry out education research, and innovate to improve their teaching. He emphasized that research for teachers should be research by teachers. Lastly, in a plug for the upcoming IAMSE meeting in June, he mentioned that Dr. Sue Jones has a story to tell.

Related to the role of scholar is the final role which Dr. Harden addressed, the role of professional. Teachers should have a recognizable standard of behavior and should meet their professional responsibilities. Teachers must acquire necessary competencies, stay up-to-date, inquire into and evaluate their competence as a teacher, and display civic professionalism. Furthermore, teachers must support personal wellbeing not only for their students and colleagues but also for themselves.

Dr. Harden concluded his presentation with a question (via an online poll) posed to the viewers: What is the most important role? Survey results indicated that about 50% of respondents agreed that the role as facilitator is first on the list. Dr. Harden asked each of us in medical education to always think about our roles as educators.

Books, Articles, and Websites cited (in order of presentation):

1. Pontefract, D. (2016). The Purpose Effect. Building Meaning in Yourself, Your Role, and Your Organization.
2. Harden, R.M. and P. Lilley. (2018). The Eight Roles of the Medical Teacher, 1^st Elsevier.
3. Harden, R.M. and J.M. Laidlaw. (2017). Essential Skills for a Medical Teacher, 2^nd Elsevier.
4. Dent, J.A., R.M. Harden and D. Hunt. (2017). A Practical Guide for Medical Teachers, 5^th Elsevier.
5. aspire-to-excellence.org
6. Harden, R.M., J.M. Laidlaw, and E.A. Hesketh. AMEE Education Management 16: Study Guides: their use and preparation.