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Basic Science in the Undergraduate Medical Curriculum. How much and how?
“There can be no doubt that the future of pathology and of therapeutics, and, therefore, of practical medicine, depends upon the extent to which those who occupy themselves with these subjects are trained in the methods and impregnated with the fundamental truths of biology.”
That statement, attributed to biologist and anatomist Thomas Huxley, appears in a 1909 paper entitled “The Preparation for the Study of Medicine” (Popular Science, volume 75). The author, Dr. Frederic T. Lewis, goes on to support this position by presenting the results of a study of first year medical students based on the number of science courses they’d taken before entering. Because Dr. Lewis didn’t have the benefit of Power Point, I’ve transcribed his findings into the chart below:
I provide this not because his findings are directly relevant to us today, but to make the point that the issue of how much science is needed or appropriate for the study of clinical medicine has been contentious since the beginning of formal medical education.
In his transformative review and 1910 report on the status of North American medical schools, Abraham Flexner strongly supports a scientific basis of medical education. In his second chapter “The Proper Basis of Medical Education”, he makes a strong case that, in order to provide optimal care and engage future developments, a physician must have a deep understanding of the scientific underpinnings of human function in health and disease.
Flexner goes on to say that those entering medical school must have a “competent knowledge” of the “fundamental sciences” of chemistry, biology and physics, so that the clinical sciences of anatomy, physiology, pathology, bacteriology and “physiological chemistry” can be engaged in medical school.
Flexner’s influence on medical education in the 20th century cannot be overstated. The fundamental model of basic science prerequisites to admission, followed by first and second year courses in anatomy, physiology, biochemistry, microbiology, pathology and pharmacology became standard, and the basis for accreditation standards. Medical students took courses and labs in these subjects that were very similar to those taken by undergraduates taking degrees in those subjects, sometimes even in combined classes.
In recent years, a number of factors have influenced the choice of basic science content in undergraduate medical education, and how it should be taught:
- A desire to ensure the science being taught was relevant to medical practice
- A very practical need to be selective with respect to curricular content, given the tremendous expansion of material to be taught.
- A desire to integrate the teaching of basic science with the clinical skills and reasoning courses
- The development of new areas of science that are highly relevant to practice and must now also be taught, such as immunology, genetics and advanced imaging.
- The desire to take advantage of more effective teaching methodologies, recognizing that the lecture format is limited as a means of promoting individual understanding, and that traditional laboratory experiments are both logistically impractical and of limited relevance to those learning clinical applications.
Medical schools have therefore been very much challenged with two key issues of what basic science should they teach and, critically, how should it be taught?
At Queen’s, we re-organized our basic science teaching at the time of last major curricular revision in 2008. The Foundations Curriculum developed at that time included two consolidated first year Scientific Foundations courses, Normal Human Structure and Normal Human Function.
This came at a time when our basic science departments were amalgamating into a single consolidated Department of Biomedical and Molecular Sciences which, under the leadership of Department Head Dr. Michael Adams, took on the directorship of these courses.
Last year, in an effort to integrate the courses both with each other and with the other courses running in the same terms (particularly Clinical Skills) and our Facilitated Small Group Learning curriculum, it was decided to amalgamate the two into a single Human Structure and Function course that would run through the entire first year.
This past week, I met with Course Director Dr. Chris Ward, Year 1 Director Dr. Michelle Gibson, and Dr. Adams to discuss our approach to next year’s course. We recognized that there is a wonderful opportunity here to better link it not only to contemporaneous courses, but also to those clinical courses that will follow in subsequent terms and years.
We’ll therefore be putting out a call to invite clinical teaching faculty to provide input as to basic science content they feel would facilitate teaching in their courses and would better prepare students to engage the teaching of clinical presentations.
In fact, we invite all faculty to share their views regarding the nature of basic science that is now relevant to clinical practice and their perspectives as to when and how that science should be introduced. We also welcome opportunities for clinicians and pathologists to participate in the basic science teaching in first year in partnership with our basic science instructors. This type of cooperative teaching is not only highly effective but models the collaborative practice that we wish our students to emulate.
So, whether you share Dr. Huxley’s perspective above or not, we’d love to hear from you.
Undergraduate Medical Education
Five things attending a gaming expo reinforced about medical education
It’s March Break in much of Ontario – including for UGME students and faculty at Queen’s School of Medicine – so I found myself at “EGLX” in Toronto with my 13-year-old son. Billed as “Canada’s Largest Video Game Expo” the three-day extravaganza included virtual reality, cosplay, exhibitors, panels, artists, a giant Nerf battle, and various and sundry gaming competitions. Given that the height of my gaming career was “VICman” (a Pac-Man knock-off by Commodore back in the early 1980s) and playing a mean game of Tetris (so, translation: Worst. Gamer. Ever.), this is perhaps one of the last places anyone would expect to find me. However: moms do stuff. (Dads do, too. My husband valiantly went to TWO days of it). In this and other unfamiliar territory, medical education is rarely far from my mind. Here are five things the expo reinforced about Med Ed:
Be open to new experiences
This one works for both teachers and students. Whether it’s tackling a new subject or trying out a different teaching or assessment method, it can pay off to be brave and just dive right in. While I’m not a gaming convert, EGLX gave me a new view to some of my son’s interests and showed the breadth of the industry. When we do the same thing over and over again, we can get trapped in our own “bubble” of experiences and not realize what else is out there. There’s value in new perspectives.
Learning works in multiple directions
I’m used to being in the role of educator – both as a parent and at work, where I’m mostly behind the scenes in the planning stages. It’s important to remember that learning isn’t mono-directional. At the expo, I was the rookie, and my kid the mentor. (And my husband, the trade-show veteran, was the navigator). In medical education, learning comes from our faculty, our students, allied health professionals, our patients and their families.
Technology is cool
What starts as games can turn into tools and vice versa. Some of the virtual reality stuff at the expo was pretty cool (fly like Superman, anyone?) and, for parents, the cycle-to-power-the-game stuff never gets old. (Just when am I going to be able to buy one?). Likewise in the classroom and clinics – what’s the next good thing to enhance learning?
One whole segment of the expo featured projects by students at Sheridan College. While this, of course, served to promote the programs at the college, it also gave students well-deserved recognition for hundreds (thousands) of hours of work, problem-solving, and creativity. Sometimes the accomplishments of our students and faculty become routine to us – we need to take time to showcase and celebrate the great things we’re doing.
If something doesn’t work the first time, try something else.
My son wanted to meet some of the YouTube gaming celebrities. (Yeah, I learned this is a thing). Our first day there, we were waiting in a very long line that was moving about one person every five or six minutes. I counted those ahead of us, did some math and figured we’d be there for about 2.5 hours before we hit the front of the line. We ditched the line and went to an awesome ribs place for supper instead. The next day, my son and husband went to one of the YouTube gamer panels, left strategically early, and landed second in line. Likewise in Med Ed, sometimes we introduce innovations and don’t get them quite right. We need to step back, figure out what went wrong, and go at it a different way.
Next week: Five things about medical education reinforced by the multiple shoe stores at the Vaughan Mills Mall. (Just kidding…. Maybe).
2018 KHSC Exceptional Healer named
[Italics indicates hyperlink]
We wrote about the Kingston Health Sciences Centre Exceptional Healer Award last fall (link here) encouraging nominations for the second iteration of the award which recognizes a physician who demonstrates in clinical practices the core concepts of patient- and family-centred care: dignity and respect, information sharing, participation, and collaboration. It’s sponsored by the KHSC Patient & Family Advisory Council.
In February, Dr. Shawna Johnston was named the 2018 winner of the award. Dr. Johnston was praised by the selection committee for putting patients and families at the centre of care.
Patients, families and staff nominated 21 physicians for the award. Thirty-four nominations were receive, with about 25 percent coming from KHSC staff. (Medical students are included in the “staff” category and may submit nominations). This annual award was created by the Patient & Family Advisory Council to honour physicians of KHSC for demonstrating the core concepts of patient and family-centred care (PFCC) in their clinical practice. These concepts are: dignity and respect, information sharing, participation, and collaboration.
Dr. Johnston, a urogynecologist and international expert on vaginal health, was cited for providing the highest respect and empathy for her patients who deal with pelvic floor disorders such as organ prolapse and urinary incontinence.
One patient wrote: “She took her time and explained the surgical procedure. She was innovative in drawing diagrams for me and allowed time for me to ingest this information and to ask as many questions as I needed. I never felt rushed.”
Dr. Johnston was also praised for treating family members as partners and “an extension of the clinical team.” It was also noted that Dr. Johnston models these behaviours to residents. This, one patient noted “is a gift from her to future practicing physicians and to the communities that will welcome them.”
Dr. Johnston works with Queen’s medical students in MEDS 443, the Obstetrics & Gynecology clerkship rotation. Herself a graduate of Queen’s School of Medicine, Dr. Johnston said that she was trained to be a good listener by the late Dr. Neil Piercy.
“I was taught to always put myself in my patient’s shoes, especially when surgery is involved,” she told KGH Connect. “It’s a big decision, and you can’t take a one-size-fits-all approach. That’s why my patients help me to decide what will work best for them. I’m always open to more questions—I spend a lot of time on the phone—because the patient needs to buy into the treatment. Otherwise, it’s not good care.”
“Families play a big part in treatment decisions because they’re the ones supporting the patient at home,” she added. “The choices we make need to work from both the patient and care provider perspective.”
Patient Experience Advisor Sue Bedell, chair of the award selection committee, was delighted by the staff support for the award. “It shows that fellow caregivers, along with patients and families, deeply appreciate physicians who provide respectful and compassionate health care.
Other physicians nominated for the award were:
- Dr. Manny Bal
- Dr. Michael Brundage
- Dr. Barry Chan
- Dr. Jay Engel
- Dr. Michael Flavin
- Dr. Michael Leveridge
- Dr. Peter MacPherson
- Dr. Laura Marcotte
- Dr. Andrea Moore
- Dr. David Reed
- Dr. Michael O’Reilly
- Dr. Mark Ropeleski
- Dr. Robert Siemens
- Dr. Sid Srivastava
- Dr. Yi Ning Johanna Strube
- Dr. Benjamin Thompson
- Dr. Anna Tomiak
- Dr. Naji Touma
- Dr. Brent Wolfrom
- Dr. David Yen
Curriculum Committee Information – November 23, 2017 & February 1, 2018
Faculty, staff, and students interested in attending Curriculum Committee meetings should contact the Committee Secretary, Candace Miller (email@example.com), for information relating to agenda items and meeting schedules.
A meeting of the Curriculum Committee was held on November 23, 2017. To review the topics discussed at this meeting, please click HERE to view the agenda.
A meeting of the Curriculum Committee was held on February 1, 2018. To review the topics discussed at this meeting, please click HERE to view the agenda.
Faculty interested in reviewing the minutes of the November and February meetings can click HERE to be taken to the Curriculum Committee’s page located on the Faculty Resources Community of MEdTech Central.
Those who are directly impacted by any decisions made by the Curriculum Committee have been notified via email.
Students interested in the outcome of a decision or discussion are welcome to contact the Aesculapian Society’s Vice President, Academic, Justine Ring at firstname.lastname@example.org.
Five ways being a Geneticist helped me improve my teaching skills
By Andrea Guerin, Year 2 Director and Clinical Geneticist
When growing up, the career choices offered are often dichotomous, do you want to be a lawyer or a firefighter, nurse or entrepreneur, doctor or teacher? In reality, most jobs are a blend of a few different skills. In medicine, doctors can be scientists, can run a business, and for most of us, being a teacher is a large part of our job. At first blush, being a Geneticist and a teacher doesn’t seem to have much in common, but my training in Medical Genetics has significantly influenced my role in education. Here are five examples I’d like to share:
Geneticists are wordsmiths. Language is very highly selected, “cause” not “reason”, “typical” not “normal” and “chance” not “risk”. The language I use with my patients is specific and inclusive, positive and hopefully, precise. Words are important, to convey meaning without an agenda, to educate without prejudice. I use the same thought in the classroom. I am mindful of the implicit biases that can be drawn from words. Words are powerful and their power needs to be recognized and headed.
Medicine is learning a new language. So is education. I’m not going to lie, I had never designed a small group session before coming to Queen’s and I certainly did not know what a Directed Independent Learning event was. When I came, I was disoriented, DILs, SGLs, RATs, GTAs. The terminology was overwhelming. But, like learning the language of medicine, I learnt the language of education too. We’ve added a few more in the past year in undergraduate medical education CBME, EPA, with only more to come.
Technology is forever changing, but good ideas stand the test of time
When I started my residency 10 years ago the understanding of genetic testing was very different. Many tests were not available. Testing was laborious, going from gene to gene, with months of anxious anticipation in between. Now, a decade later, I can order a test that looks at all the necessary genes of the body that have a purpose. Results can be available more quickly. Interpretation is more of a challenge, as we learn more, it becomes more evident the gaps in our knowledge and tying findings to patient symptoms can be a challenge. The concept of having parents and environment contributing to the health of the child is an old one, with influences from Ancient Greece to India. This testing is a reinvention of an old idea — we have only identified the individual factors (genes) that support what has been seen for thousands of years.
When I went to medical school, problem based learning was new. Powerpoint was a staple of lectures. There were almost no laptops. We would never have thought to work in groups while in the same classroom. That was an activity reserved for afternoon sessions, segregated into rooms under the watchful eye of a faculty facilitator. Marks were given from formal assessments, not team assignments or readiness assessment tests. That’s not to say assessments were not happening, they were just less formalized. It was a gut feeling. Did the clinical skills tutor think you were professional? Did the small group facilitator see that you participated? Now, assessments, both summative and formative are happening all the time. The actual process has become more concrete and transparent, but the idea has not changed.
It’s all developmental
Genetics is one of only a few specialties where the patient population spans from before cradle to grave. When I see a patient with a concern, I endeavour to find out when it started. An understanding of development, both physical and emotional, is key to my practice. You must walk, before you run.
Education is no different. The expectation must be adjusted to where the student is in their education journey. It’s okay to not know the differential in the first year, but in fourth year, students must be equipped with the knowledge and expertise to generate a differential and initiate management. Expectations need to match where the learner is, just like my patients.
No person is an island
Genetics is a team sport. In clinic, amongst clinician and researchers spanning the province, country or world, we work together to solve diagnostic mysteries and provide good patient care.
Education is the same. Teachers, admin support, education support, technical support and student support and feedback are essential to the teaching process. Behind every teacher, there is a team supporting them in their journey.
Comfortable with the uncomfortable concept of unknowns
After years of education, I will never be done learning. There is always more to learn, and no physician, despite years of practice and experience knows everything. When I counsel patients I always raise the possibility of an unknown. A confusing result, a question left unanswered. There is no crystal ball.
Education continues to surprise me, but I am open to the concept of something new, unknown. Can we produce excellent physicians using different teaching methods? Of course we can. Each of my colleagues had different curricula, different forms of instruction. There is more than one way to teach — the “best way” is still unknown.
Residency Match Day 2018: What our students are experiencing, and how to help them get through it
“Keep trying. Stay humble, Trust your instincts. Most importantly, act. When you come to a fork in the road, take it.”
The last sentence of Mr. Berra’s famous statement is usually quoted in isolation. Without the context of the first few phrases, it’s humorous, but doesn’t carry much meaning, and is something of a disservice to its author. The full statement, in contrast, is a call to commitment and action, and conveys real wisdom.
His words come particularly to mind at this time of year when our senior students face what might be termed a “life altering event”.
We’re all familiar with that concept. These are moments when the course of our lives pivots on a single event or decision. Many of these are unexpected and their impact only appreciated retrospectively. However, when they’re known and anticipated, they’re understandably accompanied by much emotion – excitement, speculation, and trepidation.
For medical students in Canada, “Match Day” is one of those events.
For those of you not familiar, Match Day is when all fourth year students learn which postgraduate program they will be entering. The match is the final step in a long process of contemplation, exploration and application. The match and the day itself are full of drama, with all results being released simultaneously at noon.
This year, Match Day is March 1. By approximately 12:00:05 that day, all students will know their fate. As you can imagine, there will be much anxiety leading up to the release. For most (hopefully all), the day will be one of relief and celebration. For a very few (and hopefully none), there may be disappointment and confusion. Many schools release their fourth year clinical clerks from clinical duties on Match Day. At Queen’s we have taken the position that our students take on professional obligations during their training and their personal celebrations should not supervene those obligations. Having said that, I’d like to remind any faculty supervising our fourth year students on March 1st of the following:
- Anticipate that your student will be distracted that morning
- Please ensure your student is able to review their results at noon.
- Check on your student. If he or she is disappointed, please be advised that the student counselors and myself are standing by that day to help any student deal with their situation and develop a plan.
- Be advised that the students will almost certainly be holding some type of celebratory event that evening. Although your students are not excused for personal purposes, I would ask that you give them every reasonable consideration.
Fortunately, we have an excellent Student Affairs team, headed by Dr. Renee Fitzpatrick, who is available and very willing to answer any questions you may have and respond to concerns regarding our students. The team can be accessed through our Student Affairs office email@example.com, or 613-533-6000 x78451. The faculty counselors can also be contacted directly at the following:
Director, Student Affairs
Career Counselor firstname.lastname@example.org
Thanks for your consideration, and please feel free to get in touch with myself or any of the Student Affairs Team if you have questions or concerns about Match Day or beyond.
Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean, Undergraduate Medical Education
A Final Gift from a First Patient
Bill died last week. He was 93 and, at the end, his passing could be considered neither tragic nor unexpected. His daughter thoughtfully called my office to let me know, and that he wouldn’t be keeping his next clinic appointment.
The last few years hadn’t been easy for him, bringing increasing disability and dependency. Things hadn’t been really right since Daphne passed away about three years ago, after over 60 years of marriage.
Before that they’d always come to clinic together and supported each other through their health issues, surgeries and increasing fragility. Bill was one of those people who seemed incapable of despondency or self-pity. Always smiling, he began every appointment by asking me how I was doing, and never left without thanking me. He never refused a request to allow a learner to listen to his heart. In fact, he usually offered before being asked. Like many of his generation, he never lost that sense of gratitude for what his new country made available to him and felt a need to repay that debt.
He’d emigrated from England in the 1950s. He was an engineer and worked in various projects over the years both in Canada and Europe, finally retiring in Kingston over 30 years ago, building his “dream house” with Daphne. In retirement, he developed a large community of friends, including many neighbours (some of whom were physicians in our hospitals) who would support him as he continued to live there alone. They would often bring him into clinic appointments, or call with concerns about him.
In one of his last selfless acts, he agreed to participate in our First Patient Program. Two of our first year students, Madison Price and Michael Christie, got the opportunity to meet Bill, visit with him, accompany him to appointments, and hear about his medical history and life story. He taught them something about heart disease and its various complications, but mostly he taught them about the patient experience of living with a chronic condition, about how physicians can provide valuable care even after cure is no longer possible, about the remarkable courage and grace with which patients can face the end of life, and about how communities can come together to support those in need.
He shared personal stories with them, telling them about how he had worked on developing radar equipment for Lancaster bombers during the Second World War. He told of how his brother was a tail gunner on those aircraft, which provided Bill even more incentive to ensure the radar was effective.
He believed he had something valuable to impart to these young people and future physicians and indeed he did. In the end, his final gift was to teach them about bereavement and, particularly, how physicians and health care providers can be affected by the loss of patients they’ve cared for, come to know, and admire. He made medicine real to them by giving it a human face that, I believe, they will never forget.
With his willingness to engage these students during his final days, he provided a priceless and lasting gift, not only to these two aspiring physicians, but also to their future patients.
Anthony J. Sanfilippo, MD, FRCP(C)
Undergraduate Medical Education
“Lifestyle as Medicine” Symposium February 12
By Daniel Rusiecki and Leah Allen (Meds 2021), “Lifestyle as Medicine” Symposium co-organizers
“The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.” ― Thomas A. Edison
However far-fetched Mr. Edison’s vision may be, the idea of the first line of treatment being the intrinsic care of the human body and what we put into it is not off the mark whatsoever. Being the new kid on the block in first-year medical school, travelling through this area of modern medicine has one questioning how much exogenous medication would be needed if our society hasn’t progressed the way it has. What if cars never existed, and everyone had to walk to their daily job? Would over 20% of our Canadian population still be classified as obese? What if our food didn’t come out of a factory, or from a fast-food restaurant drive-thru window? Would we still be dealing with a diabetes epidemic where 3.4 million of our sisters, brothers, parents, friends and neighbours are injecting themselves with insulin daily? The questions can go on and on, but they don’t answer one vital question: how do we move forward?
Practicing physicians will have approximately 2200 patient visits per year. With a career length of 35 years that’s almost 80,000 opportunities to influence the health and lives of these individuals. It’s crazy to think about how much influence one future physician can have, let alone the whole Queen’s undergraduate cohort, the residents, and affiliated physicians. If you are a future physician or practicing physician reading this post, would you rather prescribe your patient medication for their hypertension when they are 45 years old, or have the skills and knowledge to help them prevent hypertension when they are 30?
Equipping our workforce with the knowledge, skills and fearlessness to invoke a healthy lifestyle change is at the root of how we can move forward. Not only can we prolong and enhance the lives of our patients directly, but we can advocate to improve societal systems as a whole. We also have the opportunity to reduce the cost of our healthcare over the long-term due to the reduction of drug prescriptions and improvements in health of the general population.
The “Lifestyle as Medicine” symposium will be the start of a journey to better equip future or practicing physicians with the artillery necessary for these changes. The symposium will be take place Monday, February 12 from 5:30 – 7:30 p.m. in the School of Medicine Building, room 132A.
Dr. Robert Ross, a prominent researcher in the area of diabetes and related co-morbidities will speak on how cardiorespiratory fitness can be a significant vital sign for a patient’s health status. Andrea Brennan, a registered dietitian, will then take the floor to deliver key nutritional principles every physician should know, as well as shed light on current diet trends and the evidence supporting them. Dr. Chris Frank, a geriatric and palliative care physician, will then give insight on how he maintains healthy habits while being a busy physician. Finally, to get a taste of the patients perspective, Doug Dowling will speak about his passion for fitness and how the diagnosis of Crohn’s disease in his early 20s impacted him.
We hope you will join us for this thought-provoking, educational event.
Making the most of features on Queen’s Library website
By Suzanne Maranda, Head Health Sciences Librarian, Queen’s University Library
[Editor’s note: text in italics indicates a hyperlink]
After I demonstrated the Queen’s University Library (QUL) website at the December 2017 UGME Curriculum retreat, Dr Sanfilippo asked me to prepare an entry for this blog with further information about the site. The changes to the website that occurred in the fall of 2016 were quite dramatic and many of you sent us feedback about the new QUL web pages. During the 16 months since the new QUL website was launched, the librarians collected this user feedback and worked closely with the Library staff to implement a few features that would benefit all our users.
The QUL website was redesigned to offer access to all services and resources via the main page. The main library page has an extensive top bar menu that remains on all library pages and can lead users to all the central services, including the library catalogue (QCAT) and Summon, our discovery tool, as well as to the specific subject areas, such as health sciences. For the Health Sciences community there are now two types of library web pages:
- The Bracken Library physical space page: this is where you reserve a library group room, check our hours and other services related to the physical collection (e.g. signing books out, requesting materials) and using the library spaces.
- The health sciences collections subject page: this is where you find access to health sciences databases and resources such as the point-of-care tools, mobile apps, multimedia materials. This page is grouped with all the other subject pages on campus, which you can find on any library page under “Search/Research by Subject” in the top banner and menu.
Based on user feedback, the Health Sciences subject guide was edited in 2017 to provide quick access to health sciences resources. Some of the most important resources are now at the top of the page, e.g. Medline, CINAHL, PubMed1 and Point-of-Care tools. You will however want to look at the subject guides prepared by librarians to support your research and teaching information needs. There are subject guides for Nursing, Medicine, Rehabilitation Therapy, and Life Sciences and Biochemistry. To access health sciences resources quickly, add the relevant subject guide link to your web browser favourites list and learning management software for students in your classes. We also have guides that highlight resources for specific programs or topics (e.g. Aging and Health, History of Medicine), and guides that are more about tools such as citation management, avoiding predatory publishers and the one with approaches and resources to develop systematic reviews and other syntheses. Check out the complete list of guides on the Health Sciences Subject page.
These guides are prepared for you BUT we would love your input: if anything you find worthwhile could be added to the list of resources, please let us know. Any resource format can be included in addition to books and journals: websites, videos, images… if you find something useful, whether in our library collection or on the web (for the latter we will ensure that it can be shared widely), please send us a note. And of course, if you think that a new guide could be developed to support your teaching and research areas, please contact us.
Best wishes for happy searching and be sure to reach out if librarians can help you locate and organize information (remember, we love doing this and just maybe… you have other things to do!). Please continue to tell us what you think of the new library web pages.
1Note that searching Pubmed via a library page brings all the links to full-text available via the QUL collections.
On a gumdrop cake fail and multiple points of assessment
What can a failed gumdrop cake remind us about assessment?
I’m a pretty good baker and love to indulge myself when there’s time, like last month’s holiday season. For me, baking is partly about eating (of course!) but also about tradition, hospitality, and comfort.
Just before Christmas, I set out to make a gumdrop cake. It was an unmitigated disaster. When I turned it out of the pan, it collapsed. (See embarrassing photo at right).
Based on that single point of baking, a casual observer could determine that I’m a lousy baker. In fact, I should be barred from the kitchen and given directions to the closest bakery for all subsequent treats. This wouldn’t be a fair representation of my skills, just a snapshot of a single – bad! – evening.
It’s the same for our system of assessment in the UG program: no single assessment determines a student’s progress. We use multiple points of assessment, both in preclerkship classes and through clerkship rotations, to ensure we have an accurate portrait of a student’s performance over time. Admittedly, some assessments are higher stakes than others, but no single assessment will determine a student’s fate in the program.
Anyone can have an “off” day – for any number of reasons. What’s important following poor performance, is to take stock of what happened, reflect on what may have contributed to the poor outcome, and make a plan for next time.
I was really upset. I’d made this many times. I was “good” at this. Had I somehow lost my baking mojo? Plus, I was embarrassed — as well as annoyed with myself for wasting all kinds of butter, sugar, eggs, flour and gumdrops!
My adult daughter gamely offered this advice: “Sometimes a new recipe takes a few times to get right.” Except it wasn’t a new recipe. I’ve made this gumdrop cake dozens of times for over two decades. What could possibly have gone wrong? I reread the recipe (photocopied from my mother’s handwritten book) and my scrawled notes in the margins. I’d used mini-gummy-bears in place of the “baking gums”. In trying to be cute and expedient (didn’t have to chop those up!), I’d sabotaged my own cake. I’d also forgotten to put the pan of water on the bottom rack, but I thought that was likely pretty minor.
For students after a poor assessment, that same reflection can help: did I study or practice enough? Was it efficient study/practice? Was I under the weather? Did I have enough sleep? These self-reflection questions will vary based on the type of assessment, but it boils down to this: What can I learn from this assessment experience and what can I do differently next time?
I waited over a week before I attempted the gumdrop cake again. In the meantime, I (successfully) made four kinds of cookies, a triple-ginger pound cake, and a slew of banana breads. Then, I bought the right kind of baking gumdrops and remembered to follow ALL the instructions, and it turned out just fine. In fact, I sent some to my parents in New Brunswick and my mother judged it “delicious”.