About Us > News

News

IAMSE Spring 2019 WAS Session 2 Highlights

Posted by

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

IAMSE Webinar Series, Spring 2019

Speakers: Brenda Roman, MD
Associate Dean for Medical Education, Wright State University
Mary Joe Trout, Pharm D, BCPS, BCGP
Director of Foundations Curriculum, Wright State University
Irina Overman, MD
Director of Therapeutics Curriculum, Wright State University

Title: Lecture Free for Gen Z
Series: The Role of Basic Science in 21st Century Medical Education

The curriculum of the Boonshoft School of Medicine at Wright State University was the focus of IAMSE’s second thought-provoking webinar in the Spring 2019 Series. During their presentation, Dr. Brenda Roman, Dr. Mary Joe Trout, and Dr. Irina Overman discussed many facets of the unique lecture-free curriculum.

The curriculum was designed for students of “Generation Z”, a population made up of individuals born between 1995 and 2010. This generation has grown up with access to more information than any other generation before them. They are technologically advanced since they have grown up with smart iPhones, iPads, and fast internet with immediate access to Google. They are heavy users of social media and value privacy as well as security. Social justice movements such as legalization of same-sex marriage and “Black Lives Matter” have led this generation to believe that they have the power to change the world. Their concerns center around the well-being of everyone around them rather than just themselves, a mindset which differs from the previous “Millennial” generation.

So, Dr. Overman continued, what do we medical educators do, knowing Gen Z is in our classrooms? We should embrace their generational characteristics and capitalize on them in the classroom. Knowing that information is readily available and that these students thrive on independent learning and technology, we can design classroom projects which allow for independent learning. In addition to the value they place on independent learning, these students prefer “hands on” learning, application to “real life”, and a focus on community engagement. They also view their peers and instructors as valuable resources. Our presenters emphasized that health care requires group interaction, therefore these students must also be involved with group learning which works well after the students have been observers first.

The curriculum at Boonshoft School of Medicine allows for all of these preferences. Besides the focus on learning preferences, the curriculum was also designed with activities which maximize retention. Our presenters pointed out that that lectures—although an easy way to transmit information from faculty to students—are quite ineffective ways to learn. Therefore, the school removed them from the curriculum.

How do Boonshoft’s instructors guide the students in learning the massive amounts of information without lectures? They use low stakes engaged learning sessions in which the students are involved in the discussions, teaching others and practicing their craft. Students, Dr. Overman continued, set the stage for their own lifelong learning. Mandatory sessions occur daily and are not recorded. Since the majority of learning occurs in these sessions, students recognize that a missed session is a missed learning opportunity, and therefore overall attendance problems are very rare. Students are allowed up to four unexcused absences per semester.

At the beginning of the first year, students are required to read Make It Stick by Brown et al. The initial session centers on the science of learning, specifically the students learn how to instruct their peers. The following sessions involve a mix of various learning strategies that have been proven to work, including:

• Interleaved practice (practice multiple skills at once)
• Elaborative integration (learn until you understand it well enough to teach)
• Self-explanation
• Distributed practice
• Practice-testing (quizzing yourself, flashcards)
• Retrieval-based learning (working towards understanding builds memory)

The instructors explain to the students that learning is difficult and that the curriculum is challenging. Students are encouraged to foster a growth mindset; they need to have a willingness to learn from reading and must be comfortable with not having a mastery of the material before each session.

Dr. Trout continued the discussion and described that the curriculum is built around four major modalities:

• Peer instruction
• Team-based learning
• Multiple choice questions
• WrightQ

At the beginning of most sessions, a USMLE-style multiple choice question is projected on the screen. The students have 1.2 minutes to read and answer the question on their own (captured by their student response system, Turning Point). Students are then given time to discuss their answers among themselves. Afterward, a student is selected at random to explain their choice. At this time, the faculty member can clear up any misconceptions and address topics the student found challenging.

Dr. Trout explained that this type of engaged learning requires paying attention to some important considerations since students are not used to this type of learning. Students must know how to read a textbook to maximize learning, and instructors need to be careful not to overload them with too much or too complicated pre-assignments. Students are told that each 1-hour session requires about 2-3 hours of preparation time, and that they should set aside time immediately following the session to consolidate their knowledge.

Dr. Roman took over the final portion of the webinar during which she described the design of the curriculum, comments from students, and their success in the program. Overall, the curriculum has proven to be very effective but further analysis of the data (a process currently underway) should help them understand why learning (and Step 1 scores) are on the rise.

When designing the new curriculum, faculty members and administration had to all be “on board” with the switch to a lecture-free environment. Most faculty members made the switch, but some clung to their belief that being a “sage on a stage” is most effective, and parted ways with the college. Dr. Roman went through a list of what the college did right, including:

• Utilizing true backward design of the curriculum
• Establishing a policy of 20 hours face time per week
• Holding firm for faculty NOT doing lectures
• Establishing consistency across modules for the teaching/learning sessions
• Getting constant feedback from students
• Being flexible when possible
Dr. Roman also explained what they should have considered when moving completely to a lecture-free curriculum:
• Better anticipate faculty needs (preparation time is very large)
• Do not adopt other significant changes (like an LMS) at the same time
• Better explain the “Why” and “Positive Impact” than Gen Z students require

At the conclusion of the webinar, a large number of questions were asked and answered, but a much larger number were logged but not answered due to time. Clearly, the presentation captured the attention of literally hundreds of educators most of whom are not teaching at a college which has done away with lectures.

For more information about Drs. Roman, Trout and Overman’s May workshop on Peer Instruction, please visit this link.

ScholarRx Leads Pre-conference Session For Students

Posted by

During the upcoming IAMSE meeting in Roanoke, there will be a terrific pre-conference session for students. We are very excited to offer this workshop in partnership with ScholarRx on the topic of New Educator and Scholar Training (NEST): A Professional Development Workshop for Students. Best of all, students can attend at no charge!

The highly interactive New Educator and Scholar Training (NEST) workshop will introduce student participants to a framework for medical education professional development and promote major domains including curricular design, pedagogic strategies, and education scholarship (Chen et al., 2017; Freret et al., 2017). The NEST workshop is customized towards the needs of health professions students who self-identify with a strong interest in long-term career development in education. Prior formal training is not a prerequisite for participation.

For more information on this and other workshops, or to register for the 2019 IAMSE Meeting, visit www.iamseconference.org.

ScholarRx Logo

ScholarRx is a mission-based organization of passionate medical educators, designers, and technologists dedicated to building a healthier world through accessible, sustainable medical education. ScholarRx offers a revolutionary, low-cost, multi-competency curriculum system featuring interconnected “learning bricks.” Through USMLE-Rx and the First Aid text series, ScholarRx provides high-stakes exam preparation for over 150,000 students and physicians each year.

For more information on ScholarRx, please visit www.scholarrx.com and www.usmle-rx.com.

#IAMSE19 – Plenary Speaker Highlight: Don Cleveland

Posted by

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. The first of our four confirmed keynote speakers is Don Cleveland from the University of California, San Diego, USA. Dr. Cleveland will be speaking on translational research and gene silencing therapy.

Getting Translational Research Into the Classroom: The Promise of Gene Silencing Therapy for Diseases of the Aging Nervous System
Presenter: Don Cleveland
Plenary Address: Sunday, June 9, 8:45 AM – 9:45 AM

Remarkable advances are altering therapy options for previously intractable diseases, including for diseases of the aging nervous system. With an aging population and therapies on the horizon to alter the course of neurogenerative diseases, today’s medical curriculum should include the rationale and promise of these emerging approaches. Recent advances in gene therapy research have highlighted how sustained gene silencing within neurons and non-neurons throughout the nervous system has been achieved using a clinically feasible approach with “designer DNA drugs”. This approach has slowed disease progression in genetic mimics of inherited ALS and has produced prolonged, partial disease reversal in models of Huntington’s disease. A similar designer DNA drug has successfully corrected an error in the assembly of an RNA intermediate, thereby restoring production of the gene product whose absence is the cause of spinal muscular atrophy, one of the most abundant inherited diseases of children. Furthermore. for the most frequent genetic cause of both ALS and the second most frequent dementia (frontal temporal dementia), single dose administration of a designer DNA drug has reduced the synthesis of the toxic product of the mutated gene and prevented age-dependent cognitive disease. Building on these advances in clinical science, this talk will highlight the importance of cutting edge basic science for medical science students in training, highlight approaches for its successful integration, and explore how scientists and educators can work together to deliver this important aspect of healthcare into traditional anatomy and physiology courses. 

For more information on Dr. Cleveland’s plenary address, and to register for the 23rd Annual IAMSE Meeting, please visit www.IAMSEmeeting.org.

Early Bird Registration for the 23rd Annual IAMSE Meeting Ends March 15!

Posted by

The 2019 IAMSE Annual Conference is right around the corner! The Early Bird Deadline is March 15. Currently, registration is $725/$825 for member/non-member. After the Early Bird Deadline, rates will increase to $800/$900 for member/non-member registration. Be sure to register before this deadline to receive the reduced rate!

The IAMSE attendee room rate is $189 per night at The Hotel Roanoke & Conference Center. The special room rate is for the nights of June 7 – 11, 2019. This special rate will only be available until May 10, 2019.

After May 10, the hotel cannot guarantee a room for IAMSE attendees, so be sure to book your hotel before the cut off!

To make your reservations please follow this link.

If you have any questions, comments, or concerns, please let us know at support@iamse.org. Additional meeting details and registration can be found at http://www.iamseconference.org.We’re looking forward to seeing you in Virginia! 

Say Hello to Our Featured Members: Eve Gallman and Amy Baldwin

Posted by

Amy Baldwin

Our association is a robust and diverse set of educators, researchers, medical professionals, volunteers and academics that come from all walks of life and from around the globe. Each month we choose a member to highlight their academic and professional career and see how they are making the best of their membership in IAMSE. This month’s Featured Members are Eve Gallman and Amy Baldwin, pre-conference workshop presenters at the 2019 IAMSE Annual Meeting in Roanoke, VA, USA.

Eve Gallman, PhD
Associate Professor of Neurology
Phase I Coordinator
Augusta University/University of Georgia
Athens, Georgia, USA

Amy Baldwin, PhD
Associate Professor of Microbiology
Assistant Phase II Coordinator
Augusta University/University of Georgia
Athens, Georgia, USA

“Using Improvisation to Enhance Communication Skills for Students and Educators”*
Saturday, June 8
12:15 PM – 3:15 PM

During the process of becoming a clinician, medical students are required not only to master a large knowledge-base, but to master a number of other skills, one of the most important of which is the ability to communicate with patients and team members. They have to learn how to deeply listen and engage appropriately, to respond with honesty and integrity, to participate in the moment, and to think on their feet. Not surprisingly, these communication skills are also essential to the work of the medical educator. Improvisational theatre is a discipline that has been used in many settings, including health care education, to promote and improve robust communication skills. In this workshop, we introduce some basic concepts of improvisational practice and discuss how they are related to mindfulness and more generalized communication skills. More importantly, participants will gain first-hand experience with several improv structures in a supportive, collegial environment.

Why is this a perfect topic to cover at the 2019 meeting?
Amy – It is a perfect topic for every IAMSE meeting. The importance of communication skills and finding ways to teach, practice and enhance those skills for medical students is of the utmost. Most of (a medical professional’s) day is going to be spent communicating with team members and patients.
 A big part of the workshop is spending time with exercises with listening. You have to be present – it’s huge and number one with this. I would argue that this is most crucial in the medical profession. As educators, you have to be aware of what’s going on and think and react on your feet. It’s a form of mindfulness. You have to be completely present in the moment. You have to be able to listen and “take offers.” You don’t block, you don’t negate, you accept those offers.

Where did you draw inspiration for creating the workshop?
Amy – My husband actually did improv with a local troupe. He said, “Wouldn’t this be a great way to improve the communication skills of medical students?” After some research, we found that other speakers were already doing this type of workshop (Katie Watson at Northwestern University) and we found some research that supported the idea. In a sense, we use it in our small group learning for first and second-year students where we act out scenarios. They think through questions that patients and family members may be asking them. The play aspect, playing games and being able to build your communication skills through play, are practice exercises that are just fun that don’t require skill, just a willingness to participate. 

Will there be activities that require performing in front of the group?
Eve – The warmup exercises set people up to want to participate. We want to encourage a willingness to participate and interact.

Amy – We will always ask for volunteers. This is a totally safe space. You cannot do anything wrong. No one is judging you and certainly, no one is judging on exactly what you say. This is a creative space. The willingness of our students, even those who English is not their first language, are learning more than just verbal communication skills. This is learning a way to express themselves (through action) that has been really rewarding to see.

Sounds fun! What type of activity will participants engage in?
Amy – “Pecking order” is a group game for 3-5 participants. Each player silently picks a number between 1 and the number of players in the scene, keeping their number secret. A suggestion is taken from the audience, setting the scene in which each player portrays their chosen status: ‘1’s being higher in status than ‘2’s, ‘2’s higher than ‘3’s, etc. Each player must decide how to position his/her status with respect to their scene partners without knowing others’ chosen status. At the end of the scene, the audience guesses each player’s number.

So, who should take this session with your group?
Eve – We are trying hard to increase our outreach to students. Anything we can do to put on a workshop to students is as helpful to anyone else is great. This one is geared toward people who need to communicate with one another.

*There is an additional fee of $150 to register for this pre-conference workshop session.

To learn more about the 2019 IAMSE Annual Meeting, including the plenary speakers, workshops and networking opportunities, or to register, please visit www.IAMSEconference.org.

Reserve your spot before March 15 to ensure the Early Bird Discount!

IAMSE Spring 2019 WAS Session 1 Highlights

Posted by

[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

Posted by

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

Posted by

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

Posted by

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

Posted by

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'”

Posted by

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

Posted by

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 ProgramÂ