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IAMSE Spring 2019 WAS Session 1 Highlights

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[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, 1st Elsevier.
  3. Harden, R.M. and J.M. Laidlaw. (2017). Essential Skills for a Medical Teacher, 2nd Elsevier.
  4. Dent, J.A., R.M. Harden and D. Hunt. (2017). A Practical Guide for Medical Teachers, 5th 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.

*Reminder* #IAMSE2020A in Kuala Lumpur – Call for Focus Sessions

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The deadline for submitting abstracts for Focus Sessions is quickly drawing near for the special, one-day IAMSE conference to be held in conjunction with the 2020 Ottawa Conference in Kuala Lumpur, Malaysia on February 28, 2020. All abstracts must be submitted in the format requested through the online abstract submission site found here. More information about the one-day conference can be found on the IAMSE annual conference page.

Submission deadline is March 30, 2019. Abstract acceptance notifications will be returned by May 1, 2019.

Please contact Danielle Inscoe at Danielle@iamse.org for any questions about submission.

IAMSE Spring 2019 Webinar Series: “Moving USMLE Step 1 After Core Clerkships: Rationale, Challenges

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The 2019 IAMSE Spring Webcast Audio Seminar Series begins soon! This season will focus on the role of basic science in current medical education. How can basic science instruction continue to fulfill its mission of providing a scientific approach to the practice of medicine? The IAMSE spring series is addressing this question by presenting several new approaches to improve foundational science instruction beyond integration with the clinical sciences. This March, we’ve lined up eight speakers to shine a light on the topic across multiple landscapes in medical education. Our fifth and final session’s speaker is Dr. Michelle Daniel.

Stepping Beyond the “Moving USMLE Step 1 After Core Clerkships: Rationale, Challenges and Early Outcomes”
Presenters: Michelle Daniel, MD, MHPE, FACEP – University of Michigan Medical School
Session: April 4, 2019 at 12pm Eastern Time

Schools undergoing curricular reform are re-evaluating the optimal timing of Step 1. Historically, students have completed the exam immediately following the basic science curriculum. A small but growing number of schools have moved Step 1 after the core clinical clerkships, citing a number of reasons for the change, including promoting long-term retention and understanding of basic science concepts. As schools undergo curricular transformation, educators are looking to peer institutions to share their experience and lessons learned. They are also seeking data to guide decisions. In this webinar, Dr. Daniel will review the reasons to consider a change, the potential hurdles one might encounter, and the findings of recent studies. This will serve as a springboard for dialogue surrounding the optimal timing of Step 1.

IAMSE Excellence in Teaching Award Nominations Deadline Extended

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Nominations for the 2019 Excellence in Teaching awards has been extended! The new deadline for receipt of the completed nomination packets will be March 18, 2019.

Since 2007, IAMSE has honored member medical educators with two prestigious awards to recognize and promote teaching excellence and educational scholarship in the medical sciences. Qualified candidates may self-nominate, or be nominated by an IAMSE colleague.

Details regarding each award, required application materials, and deadlines are found in the document linked here. All nomination/application packets must be received by Danielle Inscoe (Danielle@iamse.org) no later than March 18, 2019.

Invitation to Submit Manuscripts on Team-Based Learning

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In the last quarter of 2019, Medical Science Educator, the journal of the International Association of Medical Science Educators (IAMSE), will be publishing a special journal section dedicated to the topic of “Team-Based Learning.” In this section, the journal would like to explore best practices from institutions around the world where TBL is implemented in the health sciences curriculum.


Team-Based Learning™ (TBL) as an active learning strategy was developed in the 1970s and is organized as modules, each typically consisting of 3 steps: preparation, testing and application. The method is evidence-based and a substantial body of research on TBL has already been published. TBL originally took off in the USA, but nowadays the method is being used in more and more schools around the globe, including medical schools and other health care related curricula. 
 
The Editorial Board of Medical Science Educator is currently soliciting article submissions on this topic and welcomes contributions in the selected formats of Innovation, Short Communication, or Monograph. Please see our websitewww.medicalscienceeducator.org for a more detailed description of these article types and for the Instructions for Authors. All submissions will be peer-reviewed according to our regular review process. Accepted manuscripts will be collected in a special section in issue 29(4) or will be published in one of the regular issues thereafter.
 
Manuscripts to be considered for this special section must be submitted by May 1st, 2019 through our online submission system that can be found by visiting:www.medicalscienceeducator.org. In your cover letter, please refer to the topic “TBL Special Section” to indicate that you would like to be included in the special section.


I look forward to receiving your submissions.


Thank you, Peter G.M. de Jong, PhD
Editor-in-Chief, Medical Science Educator

IAMSE Spring 2019 Webinar Series: “Stepping Beyond the ‘Step 1 Climate'”

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The 2019 IAMSE Spring Webcast Audio Seminar Series is quickly approaching. This season will focus on the role of basic science in current medical education. How can basic science instruction continue to fulfill its mission of providing a scientific approach to the practice of medicine? The IAMSE spring series is addressing this question by presenting several new approaches to improve foundational science instruction beyond integration with the clinical sciences. This March, we’ve lined up eight speakers to shine a light on the topic across multiple landscapes in medical education. Our fourth session’s speakers are Dr. Kathy Andolsek and David Chen, MSIII.


Kathy Andolsek MD, MPH

Stepping Beyond the “Step 1 Climate”
Presenters: Kathy Andolsek – Duke University and David Chen – University of Washington
Session: March 28, 2019 at 12pm Eastern Time Join a conversation about how our medical education community could collaboratively address the “Step 1 climate” that is described by medical students in a recent Academic Medicine article. The lead author will explore how Step 1 has inadvertently but incontrovertibly adversely altered the preclinical learning environment, specifically with regard to the quality of education, diversity, and student well-being. The author of an accompanying commentary will provide historical context as to the purpose for which this test was designed and the unintended consequences as it has been used for other purposes, such as residency selection. Bring creativity, imagination, and a willingness to seek consensus options that address all stakeholder group needs. 



To follow Dr. Andolsek on Twitter follow @GME_MD and to follow David Chen on Twitter follow @davidroychen.

A Review from Medical Science Educator from Dr. Dani McBeth

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As many of you are aware, Publications Committee members agree to provide a monthly review of an article in Medical Science Educator (MSE). We hope to alert you to something you may have missed, or just spur you to revisit an issue you may have already looked at. We want IAMSE members to get the most of their association journal and to consider publishing their own educational research in MSE when the time comes. Remember access to the journal is a benefit of membership and you can do so by logging in at IAMSE.org and then clicking the IAMSE Publications tab.

In the latest issue, December 2018, I was very interested to read the article “Graphic Stories as Cultivators of Empathy in Medical Clerkship Education.” As one of the newer medical schools, even though my school as a BS/MD Program has existed for 40+ years, we Have now added the last 2 years of medical school education and currently have our first class of 3rd year medical students in clerkship.

There is a substantial literature documenting the erosion of empathy in many medical students, particularly during the first clerkship year. Substantial contributions to this work have been made by Bruce Newton, well known IAMSE member, and his colleagues publishing articles in Academic Medicine and our own Medical Science Educator. As an aside, Bruce was awarded the IAMSE Master Teacher Award in 2016.

In the study reviewed here, small numbers of medical students were recruited from two Canadian medical schools to take part in a qualitative research study aimed at examining empathy in medical students during the clerkship years. Participants completed an online survey that included written responses to open-ended questions regarding a case vignette and then one-on-one in-depth interviews regarding their perceptions of empathy change during clerkship years and the effects of the intervention studied here on maintaining empathy. The results suggest a dynamic interplay between personal factors, the specific clerkship environment and support systems in determining the effects of clerkship years on the empathy expressed by individual students. The specific intervention studied here was the use of graphic short stories, also known as comic books as a potential tool to examine the physician and patient role and to stimulate discussion of empathy role modeled in the comic books. The graphic stories depicted a patient living with Type-2 diabetes and were previously developed for use in an earlier study of pre-clerkship students and their approach to patient interactions. In the study here, the richness of the approach was particularly illuminated in the reporting of themes that emerged from the analysis and specific quotes from the written responses and one-on-one interviews. For me, this is so often the case when reading a qualitative research study. Results described barriers and facilitators of empathy during training including medical education and training, the clinical environment and personal approaches. Not surprising, participants described an inverse relationship between burnout and empathy; as feelings of burnout increase, the capacity for empathy declines. Participants described strategies for preventing burnout and enhancing empathy that fell into several categories:

  • Medical education including frequent reminders of the need for empathy, communication workshops, reflective assignments and frequent feedback following clinical encounters. 
  • Administrative efforts including wellness programs and easily accessible and confidential counseling support.

Finally, the potential role of the comic books was investigated, and participants found them to be an effective medium to remind students of the importance of empathy in their clinical encounters. The extensive discussion in the paper provides further context and characterization of ways to think about maintenance of empathy during the clerkship years. Future directions for this research include investigation of methods for integrating the use of graphic stories into medical curricula and to further evaluate their impact as well as expanding the studies to include larger numbers of students and additional sites. 

This paper has stimulated my thought processes about better supporting our clerkship students. In the first two years of medical school when students are together as a cohort, there are numerous communication skills workshops, reflective assignments, narrative medicine sessions and specific discussions of empathy. As students move into clerkship, this cohort effect is lost and although some of the methods used in the pre-clerkship years continue, such as reflective assignments, much is lost. This at the same time that students are dealing with the stressors of clerkship education, the need to prepare for Step 2 exams and to prepare for residency application. This paper has given me much food for thought about how to improve our support of clerkship students to prevent burnout and preserve empathy.

Respectfully submitted,
Dani L. McBeth, PhD
Chair, IAMSE Publications Committee
Associate Dean for Student Affairs
CUNY School of Medicine / Sophie Davis Biomedical Education Program 

IAMSE Excellence in Teaching Award Nominations Closing February 28

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Nominations for the 2019 Excellence in Teaching awards will be closing February 28, 2019. Both awards will be presented at the annual meeting in Roanoke, Virginia in June.

Since 2007, IAMSE has honored member medical educators with two prestigious awards to recognize and promote teaching excellence and educational scholarship in the medical sciences. Qualified candidates may self-nominate, or be nominated by an IAMSE colleague.

Details regarding each award, required application materials, and deadlines are found in the document linked here. All nomination/application packets must be received by Danielle Inscoe (Danielle@iamse.org) no later than February 28, 2019.

IAMSE Spring 2019 Webinar Series: “Role of Foundational Sciences in Clinical Years”

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The 2019 IAMSE Spring Webcast Audio Seminar Series is right around the corner! This season will focus on the role of basic science in current medical education. How can basic science instruction continue to fulfill its mission of providing a scientific approach to the practice of medicine? The IAMSE spring series is addressing this question by presenting several new approaches to improve foundational science instruction beyond integration with the clinical sciences. This March, we’ve lined up eight speakers to shine a light on the topic across multiple landscapes in medical education. Our third session’s speaker is Dr. Kim Dahlman.

Role of Foundational Sciences in Clinical Years
Presenter: Kim Dahlman – Vanderbilt University Medical Center
Session: March 21, 2019 at 12pm Eastern Time

Traditional medical curricula generally place the majority of foundational science learning into the pre-clerkship years. Yet, it has been recognized that foundational science education should occur across the medical curriculum to promote excellence in clinical performance. This session will provide participants with an innovative approach to integrating foundational sciences and meaningful clinical experiences in the post-clerkship curriculum. Participants will learn about several educational strategies and the resources necessary to achieve successful integration of foundational sciences and patient care. Furthermore, participants will recognize the challenges and learn practical solutions of this approach in order to implement post-clerkship foundational science integration at their own institutions.

IAMSE to visit #TBLC19 in Tampa, Florida, USA

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The 18th Annual Team-Based Learning Collaborative (TBLC) Meeting will be taking place in Tampa, FL from March 14th-16th, 2019. The IAMSE booth will be present at the conference to exhibit, so if you plan on attending this meeting, do not forget to swing by and say hello! 

Registration for the Essential Skills in Medical Education (ESME) Program is Now Available!

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IAMSE is once again pleased to offer the very successful, AMEE-sponsored course: Essential Skills in Medical Education (ESME), led by two distinguished educators: Prof. Ronald Harden, University of Dundee and Prof. Aviad Haramati, Georgetown University. The ESME course requires a separate registration and is held on a full day prior to the IAMSE conference, continues with special discussion sessions during the conference, and concludes with a full afternoon on the final conference day.

This course explores numerous themes including learning outcomes and curricular planning, teaching and learning methods, assessment strategies, educational scholarship and the teacher as a leader. The course is ideal for faculty educators who are eager to learn about the principles of health professions education or for seasoned individuals interested in exploring new ideas and trends. Upon completion of the ESME course (with certificate), participants are eligible to enroll in the IAMSE Fellowship program.

Additional ESME details and registration information can be found athttp://www.iamseconference.org. Don’t forget to register before the Early Bird deadline onFriday, March 15!

#IAMSE19 – Plenary Speaker Highlight: Claudia Krebs

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The 2019 IAMSE meeting offers many opportunities for faculty development and networking, and brings medical sciences and medical education across the continuum together. This year’s main topic is Adapting to the Changing Times in Health Sciences Education. One of our four confirmed keynote speakers is Claudia Krebs from the University of British Columbia in Vancouver, BC, Canada. Dr. Krebs will be speaking on using disruptive technology to enhance medical education.

How to Use Disruptive Technology to Make Education Better – Not Just Different
Presenter: Claudia Krebs – University of British Columbia
Plenary Address: Sunday, June 9, 2019, 12:45 PM – 1:45 PM

The digital world has become a natural extension of our analog world, every aspect of our lives has been touched by the power of the digital revolution and medical education is no exception to this. As educators we have been called to change our approach to learning so that our students will become competent and flexible partners in a rapidly evolving health care system. Transformative education requires both our intellect and our creativity so that we can leverage the potential of pedagogy and technology for the best impact in our classrooms. Not every aspect of learning requires a complex solution, it is imperative that we learn about the tools we have at our fingertips. We need to learn how to create with these emerging, disruptive tools, how to explore the possibilities that are only now opening up to us. Emerging technologies such as VR and AR have the potential to disrupt our approaches to learning, to engage students, to provide learning experiences that touch our learners in a very profound way.

We are just at the cusp of these developments and it is imperative that we become co-developers with our students so that we can create media with authenticity. Development with emerging and new technologies requires a multidisciplinary team with medical experts, engineers, artists, students, faculty, and staff. As the boundaries between the digital and the analog are blurring, how can we ensure that we anchor our students in the here and now? Can we use technology to help students develop empathy and connection with those who are in their care? We will explore the transformative power of technology when used effectively towards a pedagogical goal. This talk will discuss best practices for design- from simple to complex, from chalk talks to virtual reality – and how to integrate these materials into evolving curricula