MedEdPortal: a great resource

MedEdPortal is a repository of online modules, and other tools that are vigourously peer-reviewed and suitable for medical and other health professions education. To find out more about this great resource, to to their short video: www.mededportal.org/about

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Exam Wrappers: A novel way to review exams

Exam Wrappers

Here’s a new and very interesting tool called “Exam Wrappers” that you can add to your exam review after mid-terms and even finals. It enables students to think more carefully about their studying and learning. It is from a chapter by Marsha C. Lovett, (2013) Chapter 2, in Make Exams Worth More Than the Grade, in the book, Using Reflection and Metacognition to Improve Student Learning, edited by Matthew Kaplan, et al, Stylus Publishing, Sterling, Virginia.,

This is a technique that engages students in reflection, metacognition (learning to learn) and self-regulated learning. Prof. Lovett’s approach was to “build metacognitive practice around exams” and in so doing satisfy the many constraints that challenge metacognition in a curriculum.

What are Exam Wrappers?

Exam wrappers are short activities that direct students to review their performance (and the instructor’s feedback) on an exam, with an eye toward adapting their future learning. Exam wrappers ask students three kinds of questions: How did they prepare for the exam? What kind of errors did they make on the exam? What could they do differently next time?

Prof. Lovett provides examples in Appendices A1 and A2 of her book. Here is a summary of her work on the three questions above:

1. How did you prepare for the exam?
Benefits of this question:
• Challenge student to confront study process and implicit or explicit choices they made about their studying
• Asks themselves if they studied enough or with enough lead time
• Focusing on diverse study methods (reviewing notes, solving practice problems, rereading the textbook) points out that there are many approaches they can use for next time

2. What kinds of errors did you make?
Benefits of this question:
• Challenges students to move beyond marks: with high marks, they tend to be relieved and move on; with low marks, they may leave the “painful event behind.”
• Allows opportunity to analyze in greater depth, e.g. considering level of difficulty of the questions they may have had problems with, looking for patterns in types of errors.
• Gives them a lexicon re. self-assessment: e.g. “Did they read the question carefully? Did they have trouble setting up the problem? Did they fail to understand the concepts involved?” Or “Did they make mistakes on the required math, chemistry, physiology, anatomy, etc.?”

3. How should you study for the next exam?
Benefits of this question:
• Ties responses from #1 and 2 together
• “A key goal of the third type of question is to help students see the association between their study choices and their exam performance so they can better predict what study strategies will be effective in the future.” (Lovett, 2013)
• Asks students to attribute their problems from #2 to some specific study errors, or look back at #1 and #2 and ask how they would specifically prepare differently.

Benefits of exam wrappers:
1. Impinge minimally on class time.
2. Are as easily completed by students within the time they are willing to invest.
3. Are easily adaptable. (Faculty can add their own concerns in #2, for example, asking about test anxiety or other issues). Can be used with other types of graded assessments.
4. Are repeatable yet flexible. (can add new questions or change questions slightly to keep things “fresh”)
5. Exercise the key metacognitive skills instructors want their students to learn: assess strengths and weaknesses, identify strategies for improvement, and generate adjustments.

Steps for Exam Wrappers
1. Hand back exams.
2. Assign “Wrapper” with questions.
3. Students complete, either during the exam review, for homework, or online (non-graded but required element). Students can also share study techniques with classmates.
4. Instructor collects and reviews to gain new knowledge of student needs, and patterns of behavior (e.g. amount of hours spent studying)
5. Hand back wrappers, or remind students about them as they might begin studying for another exam.
6. Repeat for subsequent exams (you can streamline a wrapper for a later exam, eg.)

Thanks to the Tomorrow’s Professor Digest for this idea from Prof. Sharon Lovett.

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Curricular Leaders’ Retreat Workshops are Posted

The Curricular Leaders’ Retreat occurred on Monday, June 3, 2013 at the Medical Building. The agenda included hearing a “report card” or “state of the union” report from Dr. Tony Sanfilippo on the UGME program. As well, participants worked to give feedback to the Educational Team and the UGME Curriculum Committee on the role of a Course Director, and topics for new faculty and new course director workshops.

Dr. John Drover gave an update on Accreditation.

There were a series of mini-workshops to give participants a taste of new ideas. These ideas ranged from a great new “polling” system to use with students to SGL activities and reading guides, from Graded Team Assignments to an activity to assist residents in giving feedback to junior staff/clerks and a draft rubric from the Pediatric clerkship course.

Dr. Sue Chamberlain gave a workshop on Key Features to introduce the topic and let faculty know what our students face in the Licensing Exam from the Medical Council of Canada.

All of these workshops can be repeated in greater depth in the next academic year for all.

All of the presentations’ and workshops’ slides and handouts have been uploaded to the Faculty Resources Community in MEdTech.

Please visit the Retreat section of the Faculty Resources Community to see the results of the retreat.

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Why should you be an FSGL Tutor?

This blog article is brought to you by Dr. Michelle Gibson, Year 1 Director, and Coordinator of our FSGL stream in pre-clerkship. gibsonm1@providencecare.ca

Why should you be an FSGL Tutor?

But first … what is FSGL anyway?

FSGL is Facilitated Small Group Learning, a modified form of Problem-Based-Learning (PBL), adapted for the curriculum at Queen’s University. In Terms 2, 3, and 4, students work in small groups of 6 or 7, with one tutor, over the course of the term, to learn from cases linked to their courses.

FSGL is like PBL in that the tutors are not there to be content experts, but rather as “facilitators” of student learning. In general, students receive the first part of a case, and they work together to identify what their learning needs are. The case is usually that of a patient with an as-yet undifferentiated presentation, and the students work through it together, gradually getting more information about the case. It is, in educational terms, enquiry-based learning, where the students are (mostly) driving the learning.

So what does an FSGL tutor do?

They are there to help the group really delve into the case, to probe student understanding, to help the students with their clinical reasoning, and, really, to help students understand what a doctor does. They are not teaching about the intricacies of interpreting ECGs, for example, but rather, to challenge the group about their approach to a differential diagnosis in a patient with syncope (with the help of a trusty written tutor guide…)

In addition, tutors are essential in observing individual student contributions to the group, and the group dynamic over the course of the term. They can help the group form a high-functioning team, and they provide feedback to individual students about their performance. Twice a term, the tutors will review peer-feedback and self-assessment data from their students, and provide mid-term and end-of-term feedback to the students about their progress that term.

Why do tutors like FSGL?

In the 5 years since I’ve taken over this part of the curriculum, I hear the same comments over and over. Tutors enjoy working with a stable group of students over the course of a term, and getting to know them. They appreciate watching their students grow in their skills, as they strive to become doctors. They even admit to enjoying the learning they do about material they don’t see everyday.

What is involved in being an FSGL tutor?

Tutors commit to at least one term (timelines below) for one afternoon a week, from 1:30 to 4:30 p.m. We understand that tutors have other commitments, so we accommodate tutors being away up to twice a term by providing substitute tutors, and 3 absences might be accommodated in certain circumstances. This includes participating in an orientation on the first afternoon of the term. You will receive a tutor binder, with all the cases and the tutor guides, and learn about how to be an effective tutor.

Tutors will learn how to provide constructive narrative feedback to students about students’ own learning goals and their progress over the term.

I might be interested, but I have questions – what should I do?

Email me at gibsonm1@providencecare.ca , and I’d be happy to chat.

Final words:
When I was asked to take over the old PBL by Dr. Sanfilippo, many people (myself included), really wondered if we should keep it in the curriculum. Through the helpful feedback provided by students and those they rated as excellent tutors, I have tried to keep what was working, and fix what was not. If you did PBL more than 5 years ago, I can assure you it’s a new creature now. While it’s not perfect, it is mostly fun, and the students really appreciate their tutors- they tell me so all the time. And, as one new tutor told me this year: “This is the best experience I’ve had in undergraduate medicine at Queen’s in 10 years.” I would be delighted if this would be the case for other new tutors too, so please feel free to email me with questions! gibsonm1@providencecare.ca

Timelines

Fall 2013:
Term 3, second year med students (experienced FSGL-ers) – cases are based on mostly cardio-resp, renal, and endocrinology material. Runs from September to the 1st week in December. Wednesday afternoons, from 1:30 to 4:30.

Winter 2014: (Two terms)
Term 2, first-year med students (novice FSGL-ers) – cases are based on therapeutics, pathology, immunology, hematology, geriatrics, MSK, and pediatrics. Runs from January to April or the first week of May. Monday afternoons, from 1:30 to 4:30, with many Mondays off, including Family Day, 2 weeks around March Break, and Easter Monday.

Term 4, second year med students (very experienced FSGL-ers) – cases are based on OB/Gyn, GI/Gen Surgery, neuro, ophthalmology, and psychiatry. Wednesday afternoons, from 1:30 to 4:30 with 2 weeks off around March Break.

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Meds Student Joe Gabriel Cycles Across Canada for Charity

On Saturday June 1, Meds 2015 student, Joe Gabriel, left Victoria, BC, at the beginning of a solo cross-country cycling tour. He’ll be biking across Canada to Halifax until August 20th. The tour will be fully self-supported; Joe will be carrying 35+ pounds of camping gear, tools and clothes along with him on his bike. Along the way, Joe is raising money for ten community charities, one in each province, with an overall fundraising goal of $10,000, or $1000 per charity. He will be chronicling his trip through his travel blog http://www.cyclingforcanada.org/. The site also has detailed descriptions for each charity, as well as a link to make a secure online donation. Every cent of every dollar raised will be split equally among each charity.

Joe says he’s doing the tour for a number of reasons. Not only do “I think it’ll give me one of the greatest and most memorable challenges of my life, both mentally and physically, but it gives me the opportunity to raise a significant amount of money for smaller charities that will hopefully be able to use it in ways that have a useful impact on local community members.”

joe gabriel 2
Joe dips his bike into the Pacific in Victoria, at Mile 0 BC

On June 4, Joe blogged that he’d received $1000.00 in charitable donations. Going to http://www.cyclingforcanada.org/ lets us help him make that impact on charities across Canada. Writing from a campground located on a trout farm near Hope, BC. Joe says, “I’m as pumped as my tires.” Have a great and donation-filled trip, Joe!

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“The Light Who Pursues Kindness”

Each year, our graduating class is asked to nominate a member to speak on their behalf at the Convocation ceremony.  Last week, Alex Summers delivered an address he entitled “The Light Who Pursues Kindness” on behalf of the Meds 2013 class.  It was clear to me and to many other faculty attending that Alex’s words deserved a broader audience and so, with his permission, I am providing the complete and unaltered text of his address below.  Alex’s words require no editorializing on my part, but I would simply say that all who are involved in our school in any way, be it teaching, leadership, administration or support, should take justifiable pride that our graduates should feel this way about their careers, to date and beyond.  In the midst of the day-to-day challenges we all face, Alex’s words reaffirm the faith that what we do is worthwhile, and we must be doing something right.  And so, the words of Dr. Summers:

Picture - Alexander SummersMr. Chancellor, Principal, Rector, ladies and gentlemen; 
Let me get started by taking you back to the spring of 1885 with some words borrowed from a day just like today:
“Medicine is a liberal profession, requiring culture and knowledge and skill. It is not a trade for money making, nor a field for vaulting ambition. The physician’s object is to combat disease; he is, therefore, the servant of the suffering.”
Those are the words of George Spankie, Queen’s Medicine 1885, spoken during his convocation address. Since the fall of 1854, medical students have trained here at Queen’s. Trained, and despite all the doubts, graduated too. And today, it’s our turn to cross this stage. We’ve been done for almost a month, but I know many of us have been resisting the urge to call each other doctor, for as we know from last week’s hockey game, it isn’t over till it’s over. Unless you’re the Senators of course; even Alfie says it’s over. But be re-assured folks, I think we’ve made it.
My hope today is to quote the collective voice of the Class of 2013, an outstanding group of people for whom my respect and admiration has grown daily since September 2009. To my classmates, may the words I speak for you today echo your thoughts, and may the words I speak to you have value and meaning. For the wisdom imparted, the memories shared, the friendship and support, and for the humbling privilege to stand here today, thank you.
The medical school journey is not one that is walked alone. It is only through the support of so many that we have achieved what we have achieved. To the staff of the UGME, thank you for tireless efforts on our behalf. To the faculty, we are grateful to you for so many things, but most especially for the examples of professionalism and excellence that you have modeled for us. Queen’s, in my overtly biased opinion, is a remarkable place, and it is so because of its people. Leonard Brockington, Rector of Queen’s from 1947 to 1966 (and the last non-student rector), said that this university was “…an example of the personal and national good that springs from intimate association between devoted teachers and eager learners.” That sentiment still holds true. Thank you for your commitment to us, and to Queen’s.
And to our families and friends, words simply are not enough. Our gratitude for your support, encouragement, and love, cannot be adequately conveyed from a stage. To all of you, may the lives we have lived thus far, and the lives we will lead from this day on make you proud, and be our most sincere expression of thanks.
I last addressed a graduating class in June 2002. I was fourteen years old, and it was the graduation ceremony for Grade 9 students at Montgomery Junior High School in Calgary. I do not remember one word of my speech. But I remember what followed. With spiky fluorescently dyed hair and skater shoes to accent the dress pants, Cassie, David, Terry and Cam came to the stage to play, you guessed it, the convocation classic Good Riddance, aka Time of Your Life, by the punk rock band Green Day. It was a beautiful rendition of that four-chord tune, and I even think David, the guitar player, managed to slip in that little four-letter word that follows the second prematurely attenuated guitar lick.
At the time, there was no better articulation of our feelings and hopes. The words were simple and the band was cool, and it was our anthem. Today however, 11 years later, would that song still cut it? Would it still capture the significance of a day like today?                                                   
Of course not.
Certainly, part of today is very much about remembering the last four years. But that’s not it. That song doesn’t cut it because today is only so much about yesterday. Today is about tomorrow. Not only does the university acknowledge today four years of effort by bestowing upon us this degree, in accepting that degree we answer, with humility and respect, a call. We accept a profound responsibility; a social contract between us and our neighbours. As we begin to feel the weight of that responsibility, it is good to once more reflect upon what exactly we have been called to do.
In my first year of medical school, under the guidance of Dr Duffin, I had the opportunity to learn about Dr Norman Bethune. For a man long dead, he has made a transformational impact on my understanding of what it means to be a physician. A Canadian physician of overwhelming humanitarianism and global compassion, he plied his trade across the globe, believing there was “code of fundamental morality and justice between medicine and the people.” He died in 1939 in rural China, and is remembered in that country as a hero for his selflessness and sacrifice. His name amongst the Chinese is Bai Qiu En – The Light Who Pursues Kindness.

I love that. And I find purpose and inspiration in the idea that we too can be, and should be, lights who bring and share kindness in the darkest hours of human suffering. As we go from here, we tread in the footsteps of giants like Norman Bethune and others – just look around this stage. As our forbearers have, may we stumble courageously and persistently in the pursuit of compassion and excellence. Let us never forgo the good of the patient and the public for the advancement of ourselves or the profession. If the economy does finally manage to implode on itself and the funds for public salaries disappear, may it be seen that Queen’s physicians are the ones that will still show up for work; that Queen’s physicians are, in the words of that valedictorian of old, “servant[s] of the suffering.”  Whether we are destined for a career in a ward, a clinic, an OR, a lab, or a public health unit, if we embark from this place, humbly emboldened with a commitment to pursue kindness in everything we do, we will not go wrong.

Let me finish with one more quote; with words borrowed from Dr Bethune. Spoken in 1938 at the opening of a military hospital in remote China, he would die within the year at the age of 41 as a result of a blood-borne infection he would acquire while operating on a soldier.

“There’s an old saying in the English hospitals… “A doctor must have the heart of a lion and the hand of a lady.” That means he must be bold and courageous, strong quick and decisive yet gentle, kind and considerate. Constantly think of your patients and ask “Can I do more to help them?”

Congratulations, my friends. Thank you for the last four years, for today, and most especially for the good work you will do as you go from this place.

 

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

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