Facilitating Millennials’ Learning

Welcome to our class of Meds 2017! Dr. Sanfilippo talked about our incoming class of 2017 medical students in our last blog.

I thought those of you preparing to teach this class, and our other classes in undergraduate medicine might appreciate the great ideas from an article called Twelve tips for facilitating Millennials’ learning by David H. Roberts, Lori R. Newman and Richard M. Schwartzstein of the Harvard Medical School, published in “Medical Teacher”.

Now the discussion about Millennials is not new: Millennials refer to students who turned 18 in 2000 and entered college or the workforce as defined by Howe & Strauss in 2000. Since then there have been many articles, texts and videos that outline what the characteristics of a Millennial are.

And, while the characteristics of Millennials have some new traits, they share traits with all of those learners who have come before them. However, there are some key factors that distance them from their teachers, and therein lies the crux of this article and the really great advice the authors offer. Millennials are influenced by and influence technology so much more than their teachers who are usually Baby Boomers or those from Generation X. Millennials have not experienced global economic stability, have lived through “9/11” and other terrorist threats, have experienced what to their teachers are novel ways of communication (email, social media, cell phones) and the ubiquitous nature of online technology. The article has some very provocative characteristics of Millennials from several studies.

The authors have 12 key tips for teachers and they range from educating ourselves about the concept of generational differences to recognizing the environmental and cultural forces that affect the Millennial learner, from recognizing the importance of team dynamics and encouraging collaboration to identifying the limits of multi-tasking.

Here are a few of the strategies the authors use to help us as teachers bridge any gap with our students. These tips are useful, frankly, no matter who your learners are.

For example, with the overwhelming power of the Internet at their fingertips, for Tip 4, “Millennials need guidance and focus in their learning” , these strategies are offered:
1. Remind learners to focus on the “why, how, and in what context”
2. Avoid asking students to list or identify specifics (answers easily found with an Internet search), and encourage students to apply knowledge through problems that require critical thinking
3. Help learners prioritize and identify the context in their learning

To help learners form a connection to you and see the relevance of your teaching, for Tip 5, “Identify your teaching or life philosophy,” here is one of three suggestions: Always introduce yourself to your learners and provide details on your background and path to your current role.

For Tip 7, “Recognize that Millennials value (and expect) aesthetically appealing educational presentations,” one strategy is to ask colleagues or invite students to review your slides or curricular materials and provide feedback and suggestions as you learn to embed video, create interesting slides, etc.

For Tip 8, “Emphasize opportunities for additional help and support”, there are 4 strategies that I would advocate with any learner:
1. Post directions, reading assignments, and a list of available resources on a website that students can easily access
2. Establish “office hours” when a student can drop by to discuss a concern
3. Directly observe student performance and provide specific feedback
4. Provide structure to learning activities and set specific achievable targets for learners (e.g., “By the end of this 3-month internal medicine block, you will be able to perform a complete history and physical on 2 new patients per session.”)

For tip 12, “Identify the limits of multi-tasking,” I have to highlight this excellent strategy from the authors: Ask students to complete The New York Times online test “How Fast You Juggle Tasks” (Ophir & Nass 2010, to measure how fast they can switch between tasks and discuss their results and how multitasking may affect patient care.

As we begin our new academic year, and another group of “Millennials” are in front of us and beside us in learning, it’s good to think about the key question a good teacher always asks: “Who are my learners?” While you may not subscribe to the characterization of generations, it’s always best practice to get to know your learners, how they may be similar to and different from you, and to consider strategies to make the learning relevant to them.

I offer my best wishes for a very successful year to the teachers and the students both here at Queen’s and elsewhere, and, as always, look forward to hearing from you.

Featured Article:
Roberts, David. H., Newman, Lori R., Schwartzstein, Richard M. (2012). Twelve tips for facilitating Millennials’ learning. “Medical Teacher”, 34, 274-278.

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Meds student Joe Gabriel completes his ride

On June 5, I wrote about Queen’s Meds 2015 student Joe Gabriel and his ride across Canada. Joe was riding across Canada to benefit a series of 10 small charities (one in each province).http://meds.queensu.ca/blog/undergraduate/?p=635

Well, Joe’s completed his ride. He’s in Halifax and has raised almost $3000.00 of the $10,000 he’d hoped for. http://www.cyclingforcanada.org/

joe gabriel 3

Joe is a great example of the physician as advocate in action. He has taken on some extremely worthwhile focused causes that all contribute to quality of life of people in each province. From Native housing to recycling bikes for those in need to a music program for at-risk youth to pay-what-you-can transportation services for medical visits, Joe has taken the concept of determinants of health and made them real. Here are descriptions of all 10 charities that Joe was riding for: http://www.cyclingforcanada.org/?page_id=15

We here at Queen’s Undergraduate Medical Education support Joe and are donating to his causes. Can Joe count on you too?

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Planning for the upcoming academic year? Here are some resources that you may find useful

The beginning of the academic year 2013/14 is drawing near. You may have already begun to plan for your course or sessions. If you’re in a planning mood over the next few weeks, here are some resources that may help you:

Curricular Coordinators:: Our UGME Curricular Coordinators assist with all operational aspects of your teaching: putting the timetable into MEdTech, assisting with your session page, helping to build quizzes and RATs, and a host of other activities. They are:
Zdenka Ko: Year 1: zk@queensu.ca, ext 77804
Tara Hartman: Year 2: tara.hartman@queensu.ca, ext. 79546
Candace Miller: Clerkship Core Academic Courses (“C Courses”): candace.trott@queensu.ca, ext. 74102
Jane Gordon: Clerkship Clinical Courses, ugme.clerkship@queensu.ca, ext. 75162

The Educational Development Team (Education Team) at Undergraduate Medical Education: We are:
Sheila Pinchin, Educational Developer, assisting with curriculum planning, clerkship teaching and learning, and teaching about physicians’ intrinsic roles through Professional Foundations
sheila.pinchin@queensu.ca, ext. 78757
Theresa Suart, Educational Developer, assisting with planning and observations for years 1 and 2 in medical school and for QuARMS (Early Entry Program) theresa.suart@queeensu.ca, ext.75485
Eleni Katsoulas, Assessment and Evaluation Consultant, assisting with assessment planning in all years, and planning and analysis for OSCEs eleni.katsoulas@queensu.ca ext. 78094

Here are some resources you may find helpful:

In MEdTech, we have placed many of our curriculum documents and ideas for you in our Faculty Resources Community:
https://meds.queensu.ca/central/community/facultyresources

Don’t feel you have to plan alone! Give one of us a call or email to help out.

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2nd Annual Medical Student Research Showcase

Queen’s School of Medicine is proud to host the 2nd Annual Medical Student Research Showcase on September 26, 2013. This event has been designed to offer opportunities for medical students engaged in summer research activities to showcase their work in posters displayed in the School of Medicine Building, and to celebrate excellence in the form of an oral plenary session. This plenary session, moderated by Dean Reznick, will feature up to three outstanding submitted projects, each delivered in a ten minute oral presentation. The students selected for the oral plenary and the top student poster presenter, as adjudicated by a judging panel, will jointly receive the Albert Clark Award for Medical Student Research Excellence.

The conference organizers are pleased to announce the development of a **NEW** Medical Student Research Showcase Community accessible via MEdTech. Here you will find all important information regarding the research showcase. We have also implemented a new electronic system for all abstract submissions. We encourage you to visit the new community regularly to stay up to date on important information regarding the showcase. Abstract submissions open on August 12, 2013 (08:00am) and more information will be forthcoming in the coming weeks.

https://meds.queensu.ca/central/community/researchshowcase

We look forward to seeing you on September 26, 2013!!

Heather Murray & Melanie Walker

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A book that’s in my beach bag — Teaching What You Don’t Know

beach-bag-on-shore
You know how there are books that everyone says you should read, and you just can’t get to it? I finally got to sit down with Teaching What You Don’t Know by Therese Huston after hearing about it, well, since she published it in 2009.

The author wrote the book for those faculty in a university/college who are asked to teach on subjects far outside their research areas, and end up teaching by the skin of their teeth, staying a day or two ahead of their students.

This may not seem as relevant for our meds, nursing or rehab therapy teachers, at first glance, but as I read through the book there were so many messages that I thought our colleagues in Health Sciences Education would value.

So here’s a smattering…(I’m still dipping back into this book, and it’s going up to the cottage with me.)

First of all, why not volunteer to teach in an area that is not that familiar to you? For example, could a cardiologist teach in a respiratory course? Could a neurologist teach in an anatomy course? What would an obstetrician bring to a gastro course?

Teaching in an area you’re not as familiar with can be very beneficial:
You learn something new and interesting, you connect with faculty outside of your traditional area, and you broaden your own areas of research and interest. But most importantly (to me anyway), you may spend more time thinking about the topic, more time thinking about the students and their learning level, and you may end up learning along with the students, perhaps thinking a bit more like them than you usually do. When I’ve seen some of our clinical faculty instructing outside their own comfort zone, what impresses me most is that they’re breaking down material into very understandable chunks–really helpful to our students.

Teaching as telling breaks down when you’re more of a novice in an area. It’s actually “disastrous” especially if you’re anxious already. As Huston says, students don’t learn as well when we’re doing all the work for them, and falling back on default lecture mode isn’t helping them any. If we’re teaching outside our comfort zone (or frankly in it :)) we should avoid asking ourselves “What do I have to cover today?” Huston offers these questions to start the planning with instead:

What do students already know about this topic?
How can I connect this new material to their knowledge?
Which examples will be meaningful to them and how can I structure time in class so they’ll get the most from these examples

Huston gives a great summary that is an effective introduction to “planning backward” or “backward design” made popular by two those two innovators in the field, Wiggins and McTeague. In Chapter 4, she cites 3 mistakes that novices to a subject area can make: over-preparing, lecturing too much, and focusing on lists. I blush to say that it’s not only novices who can make this mistake (ahem:).

Some of the best tips are in Chapter 5, “Thinking in Class”, where Huston looks at some great strategies to get students active, whether in a lecture, or small group session. Two of my own personal favourite activities are listed here: Think Pair Share, where students think about a question, work with a partner on the answer and present a shared answer to the class and Category Building, where students work to create charts/tables/schema and generate categories from the work they’ve done OR where you give students a list of categories and ask them to put the work into the right spaces. (This works well with an algorithm).

I enjoyed learning about Sequence Reconstruction, where students reconstruct a list of items into a proper sequence. This got me started thinking on how students learn well from errors, a fact borne home to me in a recent conversation with our Meds students about Directed Independent Learning. Several said they like having quizzes where the wrong answers have explanations for why the answer is wrong–“I go through all the wrong answers, even if I’ve gotten it right, because I learn so much more then,” said one. This is a whole other conversation, Teaching from Errors!

There are other chapters with gold in them, in the book: “Teaching Students You Don’t Understand” and “Getting Better” (Huston says she was going to call the chapter “Getting Feedback” but she realized that if we’re being honest, many of us shy away from feedback, especially if we’re already anxious:). I think I’d like to try her “clarity grid” exercise with students–it will give me a great understanding of what students are getting and where they are getting lost. And there is a good advice for Course Directors, Department Heads, and Faculty Developers etc. in “Advice for Administrators.”

In her appendices, Huston give us some great stuff: Ten solid books on teaching strategies (2 of our blog’s favourites are in there), a great activity for a Syllabus Review, and a sample mid-term evaluation (which is a very useful time to get student feedback).

I hope I’ve convinced you that even if you’re not a novice teacher, and even if you’re teaching in an area in which you’re knowledgeable, this book has great value. And who knows? Maybe you’ll be inspired to teach a bit outside your comfort zone. Either way, this is a good book to take on your vacation.

Have a good one!

image from http://cruise-dude.com/

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Mentoring – a “win-win-win” proposition

What do practicing physicians remember about their medical school experience?  What do they feel had the greatest impact on their development?  What do they retain?  My guess, based on many reunions and even more conversations with graduates, is that it’s not the classes, labs or examinations, but rather the faculty they encountered along the way.  Of course we all remember the “characters” and the “larger than life” personalities that populate every medical school, but it’s those faculty with whom we were fortunate enough to develop a personal, one-on-one relationship that have the most enduring and significant impact on our development as physicians, and on our personal lives.  We call such folk “Mentors”.

mentorThe derivation of the word “mentor” is interesting.  The origin is Greek and is traced to Homer’s Odyssey.  Mentes was a wise and valued friend of Odysseus to whom he entrusted the education of his son Telemachus when he set out on his epic voyage.  The elements of wisdom and trust are therefore intertwined in the term, qualities obviously central to the role as we understand it today.

The value of mentorship is well known in all facets of professional education.  It’s this realization that leads many schools and departments to deliberately develop programs designed to promote these mentoring relationships.  At Queen’s, we have developed a program that assigns a mixture of students from all years in groups led by two faculty members.  Like all such programs, much depends on the specific and usually unpredictable “chemistry” that develops among the group.  When it works (and it usually does) the relationships that emerge are highly rewarding.  Below I provide testimonials from two students and one faculty member regarding their mentorship experience that may provide some insights.

Eve Purdy
Eve Purdy, MEDS 2015

In a 1973 article “Indoctrination of the Medical Student” Dr. Vilter pointed out that turning a new, eager medical student into a competent, caring physician takes more than just training in science, more even than just training in science and clinical skills. The mentorship program at Queen’s has been a special part of my indoctrination to the profession. Our group’s main goal is to have fun in a relaxed way but I am always surprised at the impact of these casual interactions. Whether it be a night of bowling, an intense night of trivia or a simple evening over shared drinks and food, I always leave more energized and excited about what’s to come. 

When a clerk in your mentorship group gives you a tip for the wards next year, you don’t forget. When the fourth year students graduate, you celebrate with them and picture yourself walking across the stage in a few years’ time. When a mentorship group leader encourages you to dream big, you might just. 

And a few more interesting links that I have come across about mentorship in medicine: 

Trivia…or is it? – this is a link to a post on my blog about trivia night earlier this year

Being a Mentor for Undergraduate medical Students Enhances Personal and Professional Development

Mentoring Programs for Medical Students- a review of the literature

Informal Mentoring Between Faculty and Medical Students

simmons
Graydon Simmons, MEDS 2016

The Queen’s Medicine Mentorship Program has provided me the opportunity to have informal interaction and communication with Queen’s faculty and residents that I wouldn’t be able to experience anywhere else. In the hospital or after a lecture, it is hard to just walk up to a physician to inquire about what they enjoy about their profession or how they balance their personal lives with their work. Through the mentorship program, I have been able to build relationships with faculty and residents in a more relaxed atmosphere that is conducive to conversations about one’s future directions in medicine. Additionally, the mentorship program has also increased that sense of Queen’s community for me. As a pre-clerkship medical student, it can be intimidating to enter the hospital during your first clinical experiences. With something like the mentorship program in place, you begin to see the quality of physicians we have here at Queen’s and the encouraging, open teaching environment that they create. Ultimately, this interaction and positive community that the mentorship program has created for me has contributed to my learning and career exploration as a Queen’s medical student.

Dr. Peter O’Neill
Dr. Peter O’Neill

It is About Mentorship

Being a mentor in the mentorship program has been one of the most exciting aspects of being on faculty at Queen’s. At my mentorship group’s last meeting, we had breakfast. For our group, breakfast was a good time to get everyone together without the distractions that can happen with an evening out.

One of the first year students asked if we should have an agenda for the meeting, but the senior students just laughed. The agenda is always the same. I ask the senior students: “what is cool in what you are doing right now”? They answer, in the usual spectrum of experiences, and the junior students say: “wow, how do I get to do that”! That is mentorship in action.

While I enjoy checking in with all the students to see what is cool or if they are struggling, I think the students would rather hear from their near peers. I see our relationships not so much as a vertical structure, but a horizontal one. The clerk explains how to get an elective to the second year student. The second year student describes the observership program as a kind of “back stage pass” to the first year student.

Our group has enjoyed the group events and while I couldn’t make the “Great Mentorship Race & BBQ” in the park this spring, our group was well represented. Over the years we have had fun with Guitar Hero, and had pot luck suppers (which means that everyone has some food that they can surely eat without looking into all the dietary restrictions).

At the Convocation in May, I enjoyed meeting the family of one of my mentees. He said: “Dad, this is Dr. O’Neill, I beat him at guitar hero the second month of medical school.  You couldn’t believe it when I told you we were playing guitar hero in his basement. I smoked him at guitar hero. In spite of that, three years later he taught me how to deliver a baby.”

In the years to come, memories of delivering a baby might fade in this future internist, but I will bet he will remember beating me at guitar hero. He may never know that I let him win.

win-win-winAnd so it seems mentoring is truly a “win-win-win” proposition, benefiting both parties involved, as well as our school, which is becoming known for the value we place on faculty-student interactions at many levels.  We’re always looking for more faculty willing to become involved in this program.  If you’re interested, or simply wish to learn more about it, feel free to contact myself, Peter O’Neill or Erin Meyer in the UG office who coordinates the program.  Erin can be reached at ugmelwc@queensu.ca.

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Nourish your educational health and wellbeing

It’s summer time, and a good time to think of health and wellbeing. I heard of this concept from MaryEllen Weimer who writes in Faculty Focus when she wrote about taking care of our teaching vitality. She reminds us, “for too long we have assumed that by force of will we can make it through, semester after semester. Like someone out of shape climbing too fast, we gasp for air between semesters, over spring break, or that 2 week family vacation but it’s never enough.”

In our blog today, we’d like to challenge you to consider how you can nourish your educational wellness. What will you do for your educational self this year? What muscles can you stretch? What nourishing ideas can you take in?

Last week Theresa Suart featured several books that take medicine in different directions—novels, poetry…
(What’s on your summer reading list?)
It started me thinking of some other nourishing ideas for us all.

1. First is attending conferences. Many of you have attended or will attend conferences in your area of medical expertise. Don’t neglect conferences in education. Here are a few to think of:
a. CCME (Canadian Conference on Medical Education (CCME), Ottawa, April 26-30, 2014. http://www.mededconference.ca/ccme2013/
b. STLHE (Society for Teaching and Learning in Higher Education) (at Queen’s next!) http://www.queensu.ca/stlhe2014/stlhe2014 Kingston, June 17-20, 2014
c. ICRE (International Conference on Residency Education): http://www.royalcollege.ca/portal/page/portal/rc/events/icre Calgary, Sept. 26-28, 2013
d. The Ottawa Conference: Transforming Healthcare through Excellence in Assessment and Evaluation (not always in Ottawa but this coming year it is) April 25-29, 2014 http://www.ottawaconference.org/#!ottawa-2014/c16br

2. Other nourishment: great educational writers. Here’s what’s on my bookshelf for “dipping into”:
Bain, K. What the best college teachers do (great advice based on a huge study with lots of exemplars—very readable)
Kotter, J.P. Leading Change (anything by Kotter—a leader in the field of leading change—another definition of education?)
Holmboe, E.S. & Hawkins, R.E. Practical guide to the evaluation of clinical competence (Holmboe is intensely readable, intensely useful—and clinically oriented)
Marzano, R. et al. Classroom instruction that works: Research-based strategies for increasing student achievement (anything by Marzano et al is very useful!)
Angelo, T. & Cross, P. Classroom Assessment Techniques: A handbook for college teachers. (These two have a lot of practical ideas based on sound theory about assessment!)
Brookfield, Stephen & Preskill, Stephen. Discussion as a Way of Teaching (Brookfield has 2 new books out that I want to get my hands on: Teaching for Critical Thinking: Tools and Techniques to Help Students Question Their Assumptions (2011) and Powerful Techniques for Teaching Adults (2013))
Palmer, Parker. The courage to teach: exploring the inner landscape of a teacher’s life. (10th edition is now out. I think I have the third! One of the first teaching books I ever read)
Wiggins, G. and McTighe, J. The Understanding by Design Guide to Creating High-Quality Units (“Backward Design” is a great concept you’ll find so intuitive!)

3. Stretch those educational muscles: Follow a Blog or list:
There are a few I follow:
Faculty Focus, edited by MaryEllen Weimer, published by Magna http://www.facultyfocus.com/ I’ve quoted from MaryEllen before—she has a real gift and reads prolifically
Tomorrow’s Professor (actually it’s a list) from Stanford: http://cgi.stanford.edu/~dept-ctl/tomprof/postings.php
Medical Education Blog by Deirdre Bonnycastle (U. Sask) Lots of great ideas! Last one I read had a list of songs that match to different medical disciplines http://words.usask.ca/medicaleducation/
Team Based Learning Collaborative http://www.teambasedlearning.org/ (drink the TBL cool-aid—it’s very refreshing!:)

4. Consistent high quality nourishment is a good idea for the whole year. Subscribe (Try RSS feed) to Journals
Here are the top ranked medical education journals and one education journal I never skip. Our Bracken Library subscribes to all and the librarians can show you how to get an RSS feed so you get alerts and topics only! (Someday I’ll write about some general education journals—fascinating reading!:)
o Academic Medicine
o Medical Teacher
o Medical Education
o Advances in Health Sciences Education
o Medical Education Online
o Teaching and Learning in Medicine
o Medical Science Educator
o Basic Science Educator
o Journal of the International Association of Medical Science Educators

Do you have advice for nourishing our educational wellbeing? Please let us know through posting to the blog.

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Student Directed Learning ”Everything old is new again”

My undergraduate education was enlivened by a number of professors who were fond of taking rather unconventional points of view, many of which would be considered “politically incorrect” in today’s parlance.  They were even fonder of defending those perspectives with spirited and colourful debate.  Perhaps travillthe leading proponent of this approach was Dr. Tony Travill, professor of Anatomy, who would spend more of his curricular time discussing points of professional practice and social foibles than the assigned topics of embryology or anatomy.  On the rare occasion that one of us mustered the temerity to point this out, he would make the rather emphatic point that “universities aren’t centres of teaching, they’re centres of learning”.  The message was clear – it wasn’t his business to teach so much as it was our responsibility to learn.  Our goal should be to learn for the benefit of our future patients, not simply to satisfy curricular goals.  I recognize in retrospect that his not-to-subtle shift of emphasis helped us to transition from being passive consumers of information to what today’s educational theorists would term “active learners”, although we had no idea this was happening at the time.

Turing our attention to the present, one of our 2015 students, Eve Purdy, spoke eloquently at the recent Celebration of Teaching Day of how she addressed her interest in the process of clinical decision-making.  She searched the internet and came upon a free web-based seminar series from the University of California (San Francisco) that she accessed over several weeks and found quite useful.  She shared the information with others, both students and faculty who also made use of this resource.  As teaching faculty, we should take considerable comfort in the fact that our students are, on their own, seeking opportunities to advance their learning, often going beyond the baseline requirements of our curriculum.

In fact, our students make use of a wide variety of unstructured learning opportunities in addition to standard curricular offerings such as Courses, Integrated Learning Streams, various types of Small Group Learning, clinical rotations and assigned projects.

Last academic year, about 20 Student Interest Groups were active, each developing a series of at least 8 learning sessions outside standard curricular time that were devoted to a particular discipline or theme.  Although supported by faculty on a voluntary basis, students developed the themes and content of these sessions.  The following is a list of some of the groups that were active this past academic year:

hidden

In addition, our students informally access the world of information available to them through the internet and social media.  A world of information is studentsliterally at their fingertips, and they make use of this almost continuously, both to search information and to dialogue with each other, with faculty (sometime during lectures), and people farther afield.  The challenge is not access, but rather discernment of relative value.

Perhaps the most powerful non-curricular learning experience our students engage is what’s been termed the Hidden Curriculum.  This term refers to all of the unintentional but incredibly powerful messaging that occurs in the context of their environment and clinical experiences.  Observing a respectful and effective interaction between an attending physiciansphysician and nursing staff provides a much more effective and durable lesson than hours of formal teaching on the topic of professionalism.

The challenge for teaching faculty in the midst of all this is to keep pace what’s happening around us, and to shift our focus from delivering content to guiding the learning process.  To borrow an old adage – we can’t control the wind, we can only set our sails.  In this environment, it becomes more important to set the objectives and provide direction than to attempt to rigidly control the process.

And so, as the song says “Everything old is new again” when it comes to student directed learning in medical education, although technical advances and connectivity expand the potential (and our challenge) tremendously.  I like to think Dr. Travill would be amused.

 

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

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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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“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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