Blogs our medical students are using to learn: by Eve Purdy (Meds 2015) and Sheila Pinchin

When you think of medical students learning about medicine, you might think about lectures, textbooks, labs, small group study and even online learning modules.  BUT, did you know that our students are also learning through blogs?

Blogs, or “web logs” consist of postings by a person in chronological order with the ability for others to respond.  You’re reading a blog right now.  Our students read them too for all kinds of reasons and to access all kinds of material.  See below for Eve Purdy’s picks and some reasons our students are blogging through medical school.  For a great video on social media (blogging, twitter, etc.) see the Harvard Panel on Social Media at https://www.youtube.com/watch?v=_OdaDJ2PLmQ

What are your thoughts on learning through blogs?

Why are our students learning through blogs?

Blogs are ENGAGING and allow for knowledge sharing, reflection and debate not simply dissemination of facts

Blogs break down traditional hierarchies in which a medical student might feel intimidated to challenge a resident or attending on a concept or idea. Blogs not only prevent students from feeling intimidated but they create an environment where all are equals

Many good blogs will have links to primary literature that can help answer practical questions that come up in clinic;  blogs written by learners often address the same questions other students ask and then point in the direction of some good background papers

Blogs help students see the same information in different ways.  They allow learners to find ways to engage in ways that are most meaningful to them. By seeking out their own resources students find they are able to remember and recall information because they were responsible for going through the method to get there.

Often, the colloquial and entertaining way blogs are written make reading them easy and actually quite fun (urinalysis voodoo: http://boringem.com/2012/12/12/urinalysis-voodoo/)

Blogs are often inspiring, remind learners and faculty why we are doing what we are doing

Students turn to blogs to address some needs that are not always met or to augment resources in the curriculum (ie learner wellness http://wellnessrounds.org)

People who write blogs generally aren’t getting much (or any) scholarly credit which means they are doing it because they WANT to. Bloggers take a great deal of pride in presenting information in new, helpful ways and once they find a target audience or niche are very good at what they do. They are quick to adapt to feedback and to incorporate/synthesize new information in ways that traditional outlets (journals and textbooks) cannot.

Examples of students learning through blogsEve Purdy’s gives us some picks:

– I’m in the ER and see a patient with something that might be atrial flutter but isn’t quite sure so I pull up this quick, easy to reference article on atrial flutter from “life in the fast lane” (one of the best blogs out there) http://lifeinthefastlane.com/ecg-library/atrial-flutter/ It gives a nice, simple review of information quickly without having to log in to my queensu/bracken library account (something that takes about 30 seconds- an amount of time that doesn’t seem like much written down but makes a big difference if you are referencing a bunch of things throughout the day)

-Learn the same topic through multiple lenses.  For example….a student is interested in learning more about a patient with chest pain.  If you prefer clinical cases check out (http://lifeinthefastlane.com/education/clinical-cases/) or you like videos like the Khan academy use (http://academiclifeinem.blogspot.ca/2013/01/patwari-academy-videos-low-risk-chest.html). There are many resources to turn to and the people who keep blogs generally like to teach so the format is student friendly.

-Students don’t just read blogs to learn about content. The advantages of reading blogs goes much deeper and serves to address much of the hidden curriculum, thoughts about careers, tips and tricks for medical school success, health policy and once in a great blog post while inspire us to be better medical students and doctors in ways that traditional resources cannot. I think this is probably the most common reason that students read blogs. There are a bunch of examples but a few are:

careers (http://wellnessrounds.org/choosing-your-specialty/ or http://boringem.com/2013/01/16/carms-game-time-the-interviews/)

tips and tricks (http://boringem.com/2013/01/02/top-10-ways-to-rock-em-clerkship/http://www.kevinmd.com/blog/2011/10/nurse-offers-medical-student-sage-advice.html)

social issues in medicine (http://emergencycarecanada.com/2013/01/14/non-urgent-patients-in-the-er-a-non-problem/)

just for fun (but really do more like address the hidden curriculum and remind us why we are here) http://www.medicalaxioms.com or http://doccartoon.blogspot.ca

 

 

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Using the IDEAL banks of questions for your assessments

Obtaining IDEAL Consortium Questions

Queen’s School of Medicine has joined the IDEAL Consortium, an international assessment item-sharing collaboration among Schools of Medicine. The Consortium has 27 member schools from 11 countries. Queen’s and UBC are currently the only Canadian members.

The IDEAL Restricted Question Bank contains over 20,625 assessment items including 17,109 MCQs, 539 short-answer questions and 461 OSCE stations.  Collectively, members contribute about 4,000 new questions to the restricted and non-restricted question banks annually.

Restricted Bank:  Please contact your Curricular Coordinator to request sets of restricted bank questions in your subject area or questions on particular topics. (Zdenka Ko for Year 1, Tara Hartman for Year 2, Jane Gordon for Clerkship Rotations and Candace Trott for “C” courses in clerkship.) Restricted bank questions need to be kept secure, so they can only be used on final examinations. A Word document containing the questions (as well as their answers and “item numbers”) will be couriered to you, or you can request that a secure MEdTech community be created for you to share restricted questions with other faculty members in your course.

To use restricted questions on final exams, simply provide your Curricular Coordinator with the item number of each question and the order in which you would like the questions to appear on the final exam. If you are sharing restricted questions via a secure MEdTech community, you can copy and paste your question selections into a Word document and upload it to the Curriculum Coordinator’s folder in the secure community. It is important that the IDEAL restricted bank questions not be emailed except in password-protected Word files. The restricted questions must not be viewed by students except during the writing of final exams.

You can specify edits to any of the IDEAL items – including OSCE stations. If you edit the items yourself, please highlight your edits so that your Curriculum Coordinator can transfer the edits to the local copy of the IDEAL bank.

The old LXR bank contained many duplicate and triplicate questions, so please let your Curriculum Coordinator know the origin of each exam question (IDEAL? LXR? Original? From a colleague?) We especially need to know, for copyright and item submission reasons, if any questions did not originate at Queen’s. Questions that did not originate at Queen’s will be marked, “Do not submit to IDEAL”, but can be stored in the local copy of the IDEAL bank and used on Queen’s exams.

Unrestricted Bank:  Unrestricted bank items can be used in online quizzes, in clicker sessions, on midterms etc. Students can have full access to all unrestricted bank questions. Currently the MEdTech team is creating an interface for the unrestricted bank so that faculty members will have full access to the questions. At present, requests for emailed sets of unrestricted bank question sets can be sent to Catherine Isaacs (isaacs@queensu.ca).

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Back to the Future: Our Early Entry to Medical School Program (QuARMS)

What’s True and What’s Not

The School of Medicine is currently in the process of accepting applications for a two year, entry level educational initiative which, if successfully completed, would lead to admission to the first year of the MD Program. This initiative, dubbed QuARMS (Queen’s University Accelerated Route to Medical School) by governance committee co-chair Dr. Mike Kawaja, would be the only one of its kind in Canada. Students admitted to QuARMS in September 2013 would enter the MD Program, if successful, in September 2015, joining the class of Meds 2019.

Although it would be unique in Canada, this approach is certainly not novel. In fact, direct entry is the most common approach in many parts of the world, including Australia and most European nations. North American medical schools, including Queen’s, admitted students directly from high school until the early 1970’s. The factors that led to a shift to delayed entry included the increasing demand for medical school positions, the increasing emphasis on basic science preparation, and the demise of common examinations at the secondary school level.

This initiative, which has been under development for approximately two years, has attracted considerable attention across the country and has raised a number of questions among our student body. This led to a very well attended Town Hall recently during which Dr. Hugh MacDonald (QuARMS governance committee co-chair) and I answered a number of questions and accepted a number of very helpful insights. It was suggested that it would be appropriate to follow up that discussion with a newsletter to the entire student body to provide further clarification. I thought it might be best to structure this as a number of questions that seem to be arising repeatedly, and to make it available to faculty as well as students.

1) How many students will be admitted?

A maximum of ten students will be admitted each year. They will be part of the 100 ministry funded positions and not increase the overall class size.

2) How will they be selected?

The application process is linked with two scholarship programs, the Queen’s University Chancellor’s Scholarship and the Loran Scholarship. The Chancellor’s scholarship program invites every high school in Canada to nominate a student who has demonstrated a combination of academic accomplishment and community involvement. This is a well-established program. We are inviting students applying to that program to indicate interest in QuARMS. The Loran scholarship is a national level high profile scholarship which provides undergraduate funding for students who demonstrate a similar combination of academic accomplishment, social awareness and community involvement. These applicants will be similarly invited to apply to QuARMS. From these two sources, a group of 50 candidates will be invited to Queen’s for a series of interviews and encounters with faculty and students that will result in a ranking list that will be used to guide offers of admission.

3) What program will these students undertake?

These students will undertake a two year program with a combination of courses, seminar work and community projects. The intention is provide these students foundations in all of the component competencies that we recognize as essential to the practice of medicine and which are developed within the MD Program. This provides an opportunity to develop a premedical curriculum which is more relevant, integrated and linked to the MD Program. It also provides an opportunity for these students to learn in what we believe will be a more effective manner and one more consistent with the collaborative and lifelong learning that will required of them as physicians.

4) Is there an intention for this program to grow beyond these ten students and to replace our standard application process?

No. We recognize that it is the uncommon student who is sufficiently aware at the high school level to make a valid career decision regarding medicine. We do not wish to close off medical school to individuals who come to that decision later in life.

5) Who will oversee this program?

A governance committee has been established and co-chaired by Dr. Hugh MacDonald of the Department of Surgery and Dr. Michael Kawaja of the Department of Biomedical Science. Dr. Jennifer MacKenzie is in charge of the curriculum and is a member of the governing committee. Other members of the governing committee include the Associate Dean for Undergraduate Medical Education, three faculty members and two students.

6) Will all students in this program “automatically” enter medical school?

Students within this program will have to be academically successful and meet standards established by the governance committee. If they meet those standards they will enter the first year of the MD Program after two years. We anticipate that some students will either not achieve those standards or decide in the course of this program to undertake an alternative career.

7) Why are we doing this?

I feel there are a number of advantages to this initiative.

  1. A small number of students are aware and ready to undertake medical training early. We believe this provides them an opportunity to complete their training in a shorter period of time.
  2. This initiative addresses, to some extent, the socioeconomic disparities in admission to medical school in that it provides entry after a shorter period of time with less overall expense. We hope this will make medical education available to students who might not otherwise consider the option.
  3. It provides an opportunity to develop a premedical education that is more appropriate and aligned to medical school without the highly competitive and stressful environment that sometimes accompanies premedical education.
  4. It provides an opportunity to begin the development of core qualities and competencies essential to medical practice such as collaboration, communication and lifelong learning, qualities that are sometimes challenging to provide for students who have come through a traditional premedical education.

This is, and will remain, a controversial undertaking. It represents a significant break from convention and is somewhat uncharacteristic of a school that has tended to avoid controversy, and been described by some as being “on the leading edge of tradition”. In the final analysis, the leadership of our school and most faculty and students comprising it’s main decision making body felt that the potential of this rather bold and “back to the future” approach outweighed the risks and effort required. Appropriately, it was a characteristically medical “risk/benefit” analysis that carried the day. So, let’s buckle up, we’re in for an interesting ride.

Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean,
Undergraduate Medical Education

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What really drives learning?

Lessons from the famously self-taught.

Holidays are a great time to catch up on reading.  My own preferences are history and biographies.  This past couple of weeks, I’ve found it rather humbling to learn that some of the most influential thinkers and shapers of our society were essentially self-taught.  In fact, they seemed in some cases to thrive despite the benefits of traditional education or academic success.

Benjamin Franklin (1706-1790) led a peripatetic life, meandering through a variety of career interests, excelling in all.  He’s perhaps best remembered as, arguably, the most important and essential influence on the Continental Congress that would draft and ratify the American Declaration of Independence.  Along the way, he was a writer/journalist/publisher/politician/diplomat and, in his spare time, a scientist of considerable renown, receiving honorary degrees from both Harvard and Yale, and becoming the first person living outside Britain to receive the prestigious Copley Medal from London’s Royal Society.  Remarkably, all this was accomplished without the benefit of college or university level education.  In his excellent biography of Franklin, author Walter Isaacson describes three key educational components: the formative influence of his father who encouraged conversation and debate in the home, Franklin’s insatiable curiosity that spanned a huge variety of topics, and his access to books.  “Indeed”, Isaacson writes, “books were the most formative influence in his life, and he was fortunate to grow up in Boston, where libraries had been carefully nurtured”.  Despite this abundance, Franklin was required to actively seek out these books, generally housed in private libraries.  His apprenticeship in his brother’s print shop provided him opportunities to “sneak books from the apprentices who worked for the booksellers, as long as he returned the volumes clean”.

The facts regarding the education of Abraham Lincoln (1809-1865) are almost lost in the mythology that’s developed regarding his early life.  In Team of Rivals, author Doris Kearns Goodwin describes the challenges faced by the impoverished Lincoln as a “Herculean feat of self-creation”.  “Books”, she writes, “became his academy, his college. The printed word united his mind with the great minds of generations past”.  He also treasured conversation and stories he shared with interesting, informed people, and would analyze and reconstruct arguments afterward. He also undertook “solitary researches” in the study of geometry, astronomy, political economy, and philosophy.  “Life was to him a school, and he was always studying and mastering every subject which came upon him.”

Although Albert Einstein (1879-1955) did have the benefit of formal education, attending the Swiss Federal Polytechnic School, he was a mediocre, somewhat embittered student and was unable to secure a teaching position after graduation.  It seems he found formal curriculum far too rigid and stifling.  He eventually undertook relatively menial work at a patent office, which allowed him time alone to read and think.  It was during those years that he developed many of the theories that would revolutionize the field of physics and define his life’s work.  He also developed a social consciousness that, although less publicized than his scientific work, is in many ways equally intriguing.

So should these notable examples, drawn from three separate centuries, diminish our commitment to formal education?  Obviously not.  However, it would also be a disservice to simply dismiss them as prodigious intellects who managed to excel despite more primitive educational systems.  Simply put, it took more than brainpower for them to rise above their circumstances and become pre-eminent learners and, as a result, leaders of their times.  They also shared three essential qualities:

  1. Relentless curiosity and desire to understand.  Although the focus of that drive may have differed, the intensity and commitment were consistent.  They simply could not be deterred from learning.
  2. Willingness to apply themselves to their goal.  We tend to believe that people as gifted as Franklin, Lincoln and Einstein came by their success effortlessly, but this is far from the case.  Franklin was known by his contemporaries to habitually arrive at work earlier than anyone else and to work long into the night.  Lincoln often read or worked through the night, and photographs from the time document dramatically the physical toll.
  3. Commitment to betterment of their communities.  All three were motivated by a desire to improve their societies.  In fact, the energy and commitment that was so evident in their work appears to arise from this altruism rather than any personal self-interest.

It would seem that when these three qualities triangulate in an individual, great things are possible.  However, those possibilities are only realized if their environment provides a few necessary things, including access to information and people with whom they can converse, share and test ideas.

How does all this relate to our work as medical educators?  I think two important lessons emerge.  Firstly, it would seem that any admissions process would benefit by concentrating on means to identify within applicants the three essential attributes listed above.  Any student with these attributes is essentially programmed to succeed and will do so within, or in spite of, any educational system we choose to impose.  Put simply, the appropriately motivated, reasonably capable learner is essentially unstoppable.  Conversely, the absence of these attributes virtually dooms the process from the start, despite our best efforts.  Secondly, these examples would suggest that the learning environment we develop is at least as important as the methods we employ to deliver and assess knowledge.  Providing our learners with direction and opportunities to explore concepts and develop their personal learning skills is critical and, from the perspective of their ongoing career, much more durable than simply requiring them to reproduce pre-determined dollops of factual information.

All this should reassure us that the changes we’ve undertaken over the past few years with our admissions processes, curriculum, information technology, physical space, mentoring programs and educational methodologies are all positive developments, clearly moving in the right direction.  We should also be encouraged to creatively and boldly go further.

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Great Health Care Requires Great Medical Educators

Education is not an industrial process; it is a human one.

In the Dec. 10 edition of The Atlantic Monthly, Richard Gunderman, MD. PhD., examines different sets of components of excellence in medical education:  curriculum, instructional methods, and assessment techniques AND creativity, commitment, and inspiration of medical educators.  He focuses on the critical importance of fostering a generation of medical educators through support of medical education.  For the article see

http://www.theatlantic.com/health/archive/2012/12/great-health-care-requires-great-medical-educators/265906/

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Congratulations to Drs. Ted Ashbury and Heather Murray

Congratulations to Dr. Ted Ashbury (Anesthesia) and Dr. Heather Murray (Emergency), both of whom are very involved in Medical Education!  They have been awarded the Canadian Association for Medical Education (CAME) Certificate of Merit, which promotes, recognizes and rewards faculty committed to medical education in Canadian medical schools.

In Undergraduate Medical Education, Ted has developed and is the Course Director for Professional Foundations 2 and 3, pre-clerkship courses which teach about the intrinsic or non-medical expert roles of a physician.  He has also served as the Competency Lead for the Professionalism Role since the inception of the Competency Lead Role.  Ted has also served as a founding member of the UGME Curriculum Committee.

In Undergraduate Medical Education, Heather developed and is the Course Director of Critical Appraisal, Research and Learning (CARL) and the Critical Enquiry Course in pre-clerkship UGME.  She is also the Competency Lead for the Scholar role from years 1-4 and serves on the UGME Curriculum Committee.

These deserving colleagues will be recognized at the upcoming CAME Annual General Meeting which is held in conjunction with the Canadian Conference on Medical Education (CCME) in Québec, QC on Sunday, April 21, 2013 at 17:30 at the Hilton Hotel Québec. Please join us in congratulating these individuals for their commitment to medical education in Canada.

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Reminder: Course Directors’ Retreat Jan. 18, 8:00-2:30, University Club

The Course Directors’ Retreat will take place on Jan. 18 from 8:00-2:30 at the University Club.  Course Directors have been asked to bring a designate who will be able to bring back additional information to the course team.

Credit for the workshops will be given.

Here is the agenda:  Course Directors Retreat January 18 2013 Agenda

Please RSVP to Elaine Carroll at fac.dev@queensu.ca

 

 

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Many thanks for tremendous work: Farewell but not goodbye

Dr. Stephanie Baxter,  has moved from her position as Co-Course Director   for Neurology and Ophthalmology in Undergraduate Medical Education to serve  as the new Residency Program Director for the Department of  Ophthalmology.  She has also therefore left her position on the UGME Teaching and Learning Committee of which she was an inaugural member.

It’s difficult to express all that Stephanie has quietly accomplished in undergraduate medicine–from piloting the extremely successful Ophthalmology Skills Fair to complete course revision as she acted as one of the first exemplars of creating balanced teaching methods.  Stephanie has served the Teaching and Learning Committee well for 5 years, representing clinical teaching and supporting initiatives through her own teaching practice.

Perhaps most telling, however, is Stephanie’s contribution to student learning. She is the recipient of the 2011 Aesculapian Society’s Lectureship Award, and has already made an impact with her work in teaching residents, winning the Garth Taylor Resident Teaching Award of 2012, both attesting to the way Stephanie is able to interact with students to help them learn.

We wish Stephanie well in her work in Post Graduate Medical Education, and hope that our undergraduate students will still have the benefit of her teaching.  Many thanks Stephanie, for all your tremendous work!

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