What’s on your summer reading list?
Theresa Suart, our Educational Developer weighs in on how to nurture your educational self over the summer. We compiled a list of reading that may help stretch your medical/educational muscles over the summer. To make our list a book had to be recommended by a clinical faculty member as one that has changed or enhanced her/his perception of medicine or medical matters. Dr. Shayna Watson was very helpful in bringing to light some of the Medicine in Literature books. We’ve asked for your help in referring other books, so please jump in!
Remember days lazing at the beach, latest bestselling novel in hand? Or too-short summers with too-long required reading lists? Whatever your summer reading memories, longer days seem to go hand-in-hand with book list suggestions, so the Education Team decided to add its five-cents’ worth to the conversation.
Whether you’re getting away for a couple of weeks to the cottage, or still slogging away on the wards of KGH, summer can be a great time to expand perspectives, explore new ideas and nurture your soul with a good book.
So here’s our “Summer Ten” list (it’s not a “top 10” or a “10 must read”, it’s a “consider this” list… just to get you started). If you pull one of these from the shelves, please let us know what you think of it.
1. The Emperor of All Maladies: A biography of cancer by Siddhartha Mukherjee (available in the Stauffer Library)
2. The Curious Incident of the Dog in the Night-time by Mark Haddon (available in the Education Library)
3. Nocturne: On the life and death of my brother by Helen Humphreys (On order by Stauffer Library)
4. Care of the Soul in Medicine by Thomas Moore
5. Kitchen Table Wisdom by Rachel Naomi Remen (available in the Kingston Frontenac Public Library)
6. Intoxicated by My Illness by Anatole Broyard (available in the Kingston Frontenac Public Library)
7. Cutting for Stone by Abraham Verghese (available in the Kingston Frontenac Public Library)
8. Bloodletting and Miraculous Cures: Stories by Vincent Lam (available in the Stauffer Library)
9. The Checklist Manifesto: How to get things right by Atul Gawande (available in the Bracken Health Science Library)
10. Any of Atul Gawande’s essays from the New Yorker: http://www.newyorker.com/magazine/bios/atul_gawande/search?contributorName=atul%20gawande)
And a bonus #11 since any reading list needs some poetry (thank my Dad, the English teacher and poet, for instilling this in me):
In Whatever Houses We May Visit: Poems that have inspired physicians, edited by Michael A. LaCombe, and Thomas V. Hartman.
(Here’s a sample, from the previews on the acponline.org site, Pathology Report by Veneta Masson:
If you pull any of these from the shelves, please let us know what you think of it.
What’s on your list? Share your suggestions in the comments section below.
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 the 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:
In addition, our students informally access the world of information available to them through the internet and social media. A world of information is literally 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 physician 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)
Undergraduate Medical Education
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.
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.”
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!
“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:Mr. 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)
Undergraduate Medical Education
Dr. Sue Moffatt is the 2013 Recipient of the R.W. Connell Award
The R.W. Connell Award is given to a faculty member who, in the opinion of the graduating class, has made the greatest contributions to their education during the entire MD program. Determined by class vote and awarded at convocation, this is easily the most prestigious teaching award within our program. It is with great pleasure that we let you know that this year’s award winner is Dr. Susan Moffatt.
Dr. Moffatt has been involved in multiple aspects of curriculum for many years. This past year she has directed the development and initial implementation of three Clerkship Curriculum courses, which have been highly successful. Dr. Moffatt has also pioneered sessions in year 1 anatomy with Drs. Reifel and MacKenzie, linking to cardiovascular and respiratory work in year 2. She teaches in Normal Human Function in year 1 about the physiology of respiration. She is also a constant innovator on behalf of her students as Co-Director of the Cardiovascular/Respiratory Course in year 2. Add to that her contributions to Clinical and Communication Skills course, and we can see Dr. Moffatt’s hard work, and much loved teaching evident throughout our curriculum. Her contributions to medical education at Queen’s have been remarkable both in terms of scope and quality. She is a most deserving recipient of this honour.
New Material and a New Way to Learn: Students as Teachers on Grief.
Recently in a second year meds class, we were debriefing the experience our 2015 meds students had with their “First Patient Project.” During that debriefing class, we had relatively unique and very engaging learning experience about a serious and under-reported topic. My thanks to Dan Corazolla, Soniya Sharma, Lindsay Bowman, Aaron Wynn, Heather Johnston, and Mason Curtis, all Meds 2015 for their help with this article.
The First Patient Project is an 18 month project which begins right in September of medical students’ first year and continues until after December of their second year. Students in pairs follow a chronically ill patient, attending health care appointments and visiting with them in their home. The students also interact with community and faculty physicians and complete critical analysis reports about their learning.
This day, on April 30, we heard from six “student teachers.” Having students teach a formal session is reasonably unique in our medical school and the topic of their teaching was also reasonably unique in medical literature: How do physicians deal with grief, on the loss of a patient? How do they recover and go on…down the hall to the next ward room with another patient in it, to another clinic room, to home?
Six of our students encountered death over the program…two of our “Patient Teachers” sadly have died over the past two years. And another pair of students lost their patient as she was the spouse of one of the patients who passed away and could not continue with the program.
The six students met with a clinical faculty member to discuss the experience, and individual discussion/counseling was made available to them. But they also continued with the project by doing research on three areas: 1. How physicians help families when a family member dies 2. How physicians can help themselves when a patient dies, and 3. How medical literature and medical education literature give insight on how to bring this up in medical education.
Their research and presentations were excellent! I thought I’d share, with their permission, some of their findings:
From Soniya Sharma and Dan Corazolla, came these concepts in how physicians can help their patients deal with grief: the differences between “normal grief” and “abnormal grief”, the tasks of grieving, the family as a resource, and the role of the physician. They consulted nine current references to expand upon these concepts to their classmates and to link up with previous sessions on this topic in their first year classes.
The title of Lindsay Bowman’s and Aaron Wynn’s talk was “Wearing your heart on your jacket: Patient death and the importance of physician grief. “ They pulled from fifteen diverse sources from Military Medicine (great article on resilience-building) to Vasalius, (How to cope with disaster loss and mourning: Galen’s paper which was lost for centuries) to more traditional medical and medical education journals. One particular source I found intriguing was J. Shapiro’s article in Perspective: Does Medical Education Promote Professional Alexithymia? A Call for Attending to the Emotions of Patients and Self in Medical Training. Acad Med 2011;86:326-332.
Lindsay and Aaron taught convincingly about the factors that make patient death difficult to deal for physicians, why grief education is important and relevant to physicians and medical trainees, the current state of grief education in our curriculum and that of other medical schools and where it could and should be represented in undergraduate and postgraduate medicine.
The third partnership to teach about this topic consisted of Heather Johnson and Mason Curtis. Their teaching centred around healthy strategies for physicians in dealing with grief. Both Heather and Mason conducted surveys or interviews. Heather’s survey inquired into when and how we should teach about physician loss and grief in our curriculum. She gave practical strategies and a model on how to move through loss and grief and created a “grief curriculum” whose components could be shared with faculty as well as students.
Interestingly both Heather and Lindsey focused on an article that, in their words, “if you had to read only article on this topic,” this would be it: The inner life of physicians and the care of the seriously ill by Meier, D.E. et al in JAMA 2001, 286(23): 3007-14. I’ve just read it too and let me chime in—a very thorough and insightful article on this topic.
Mason had interviewed physicians and created a model of grief approaches from three perspectives. He also spoke movingly about how he had responded to his grandfather’s death at a time when in medical school he was learning about oncology, palliative care and the elderly.
Students in the class afterward said that it was really positive to learn this material from their classmates. The work was solid, the literature review broad, and the points very clearly and thoroughly presented with good handouts.
The students who taught were positive too…tho’ some had not been initially Some were hesitant to teach their classmates, and concerned that it would not be well received. They were really buoyed up by the great feedback from their peers and from faculty Dr. Sanfilippo and Dr. Leslie Flynn, Kathy Bowes, Program Coordinator, Erin Matthias, Program Assistant, and patients in the room.
What’s the next step? Well, the students and I can see a need for further exploration of this subject in clerkship and residency. As well, I hope the students will put together a poster about this for CCME.
My take on this aspect of the project is this: our six student teachers were excellent teachers! They were well-prepared, and had done a thorough job in finding out in different modes and in some cases ferretting out literature on a topic that seems to be localized in only a few aspects of medicine and medical education. They were clear speakers, and had great teaching points. Their slides were excellent and they had a good beginning, middle and end to their talks. They were convincing, authoritative, and had much to share. Turning some of the teaching over to students teaches those who teach, and their classmates. We already do student small group teaching in our Community Based Projects and our Nutrition Projects—maybe some large group teaching is in order?
Beyond the teaching method, the students taught us all about a part of medicine that appears to be kept somewhat quiet. About the culture of a “stiff upper lip” that could pervade in some medical cultures. About how may physicians act differently about their own grief than they would advise a patient to act. They gave us all a lesson in how to cope in a healthy way, when you have to move on…to the next patient, the next room, the next door and all the way home.
Are you interested in the reference lists from the students? Or would you like to contact them to find out more about their talk and what surprised them? Write back here, or write to them via email addresses on MEdTech.
Why go to conferences?
Why go to conferences… In which Sheila Pinchin offers a purely personal viewpoint of the CCME Conference (13) .
Well, here I am at the Canadian Conference on Medical Education (CCME) in Quebec City, along with a great number of faculty from Queen’s, 15 meds students from Queen’s (some came up to volunteer!) Matt Simpson, Lynel Jackson from MEdTech and Andrew dos Santos from IT. As well, many staff are here (Kathy Bowes, and Jen Saunders), and our faithful Educational Team members, Eleni Katsoulas and Theresa Suart are here, too. Dean Richard Reznick, Associate Dean Tony Sanfilippo, Vice Dean Leslie Flynn, Associate Dean Ross Walker and Associate Dean Karen Smith are here. Suzanne Maranda, our head of Bracken Library is also here. And now I’m going to stop naming people as I know I’ll miss some. But these are just some of the people I’ve seen in the past day or two!
On the train up to Quebec City, we got a lot of work done, with people dropping by and talking about ideas and challenges. Dr. Sue Moffatt and we managed to squeeze in an entire planning session for the next Course Directors’ Retreat! We think the train back will offer a similar opportunity—all of us together for seven odd hours. This is a consultant’s dream: Captive faculty all in one space! ☺
I enjoy this conference so much! When I first started in Medical Education 7 years ago, I was one of the few, if not the only, Educational Developer at the conference. Now there are many more of us, and several Educational Researchers too. I don’t feel as odd, and I also feel more at home with all the faculty that come. And when you mix Ed Devs, clinical faculty, technologists and health education librarians together as we did in the workshop Lindsay Davidson, Lynel Jackson and I gave, you get powerful results! Flipped learning has never been so creative–thanks to Lynel’s wonderful graphics, and Lindsay’s really ingenious puzzle pieces activity!
Networking is happening with our faculty here—Tony Sanfilippo and Hugh MacDonald got together with their counterparts from across the country, as did Andrea Winthrop and countless others who were in interest groups and business meetings. Many other faculty were involved in formal meetings and symposia.
But informal networking has happened at mealtime breaks, and at other times, when you could see two or more heads bowed over computers or papers in the lobby and other places where you could sit. Memorably several people were sitting on the floor near the buffets– the better to be connected—to the electrical plugs in the wall and to each other, I presume.
In addition to networking, our Ed Team members (Eleni Katsoulas, Theresa Suart and I) also roam the poster aisles (we greedily snap up the mini versions), chat with people at the booths (hello CMPA Good Practice Modules, and MedicAlert Bracelet Free Curriculum!), and divide up and conquer when it comes to attending moderated poster, oral and workshop sessions. That means we’re synthesizing all this knowledge and bringing it home for everyone here—and do we have some terrific ideas!
I can’t forget to mention the White Coat Warm heART exhibit showcasing student and faculty artwork and a place of peace and provocation in a bustling conference. Here’s a shot of Dr. Carol Ann Courneya from UBC who’s been running the art exhibit since 2010 (with thanks to Dr. Ali L. Jalali for this photo from Twitter)
Kudos to the many Queen’s faculty, staff and students who gave oral presentations, poster presentations and workshops! One reason we come to conferences is to celebrate this scholarship and efforts of our educational community.
So it’s a real pleasure to celebrate and congratulate Paxton Bach, Meds 2013, on being awarded the Sandra Banner Student Award for Leadership. This prestigious award from the Canadian Resident Matching Service (CaRMS), consists of up to $5,000 annually to be given to a medical student or resident who demonstrates an interest in or an aptitude for leadership among their peers. Congratulations Paxton!
And here, Kathy Bowes and I are standing in front of our poster (with Tony Sanfilippo) about the First Patient Program telling the world (well some of it) that Queen’s is the first Canadian medical school to bring this kind of longitudinal learning from patients to years 1 and 2 students in medical education. This was a great idea Tony Sanfilippo brought back from an AAMC conference two years ago. I wonder what great ideas he’ll be bringing back from this conference!
Eve Purdy, Meds 2015, wrote this for our UG blog:
“For me the highlight was the huge social media at the conference allowing for faculty and students across the country to engage whether or not they could make it to Quebec City. It became evident that the efforts of Queen’s students and faculty to model online professionalism are significant and unique. We’re among those leading the charge! This blog is great evidence of those efforts. Having the opportunity to interact with online mentors, people from all over the country having significant impact on my medical education, in real life was well worth the trip (Dr. Jalali, Dr. Yiu and Deirdre Bonnycastle to name a few)!”
Here is a sample of faculty from U of T and Ottawa U tweets to Eve.
For stats on Social Media use at the conference see:
Ben Frid, also Meds 2015 and Aesculapian Society President, wrote this for us:
“Here is a photo of the Queen’s CFMS delegates, all of whom stayed in Quebec City an extra day and a half to attend the first part of CCME and the Dean’s reception.”
Ben continues, “One highlight for me was a fascinating presentation on Hidden Curriculum by a PGY-4 from McGill. She was exploring factors and common experiences amongst clerks that lead to hostile learning environments. She was very clearly advocating for medical students and progressive medical education, and it was inspiring to see another resident speak up at the end of the talk to lend his full support as well. I think residents are in a uniquely favourable position to mediate and collaborate between medical students and attending physicians and it was terrific to see these residents take up this important cause.
Another highlight was the Dean’s reception last night. It’s always fun to interact with faculty in an informal setting, and when I looked around the room I saw a mix of students, faculty, administrative staff, and alumni all enjoying each other in lively conversation — a shining example of Queen’s collegiality! Queen’s pride was abounding and amidst the Queen’s tartans and flags, I’m quite sure I saw the classic Queen’s pin on every lapel in the room. I had the chance to shake hands and share stories with John Ruedy, Aesculapian Society President in 1955, who has spent his time since then making incredible strides in transforming clinical and academic medicine across Canada. A very neat experience indeed!”
Theresa Suart, our new Educational Developer, who used her journalist’s background to ferret out literally every learning opportunity, says, “What’s really amazing is how so many people are working so hard to educate our future physicians! The energy is amazing and very inspiring.” Eleni Katsoulas, our new Assessment and Evaluation Consultant, who attended eighteen oral sessions, nine moderated poster debriefs, and one workshop, all on assessment, says she learned a lot. “But what sticks out in my mind is how important and energizing the networking is—so many helpful and collaborative people!”
I entitled this blog, “Why go to conferences?” They are a lot of hard work, a lot of travel, long hours, and a lot of time away from home, family and work.
But they also mean a great deal of learning about the best and latest in our fields, great ideas for helping our students, the ability to peer forward into the future, new people to connect and work with, a chance to do some thinking, a chance to drink in knowledge, and a chance to celebrate scholarship from our own institution as well as inhale that from others.
Don’t take my word for this! Go into Twitter and see the scope of the learning that went on at #CCME13.
Next CCME is in Ottawa—see you there!
My thanks to Eve Purdy for most of the photos and the comments, Ben Frid for the CFMS Delegates’ photo and comments, Dr. Jalali for the twitter photo of Dr. Courneya and her poster, Theresa Suart and Eleni Katsoulas for the company and the great quotes, and Dr. Sanfilippo for sending us here!
Do you have any CCME 13 experiences to share? Post them here!
Flipped Learning: “Turning learning on its head”
Here’s a scenario of an innovative educational method that is sweeping through the halls of academia: Imagine…students are hard at work at home accessing captured lectures, PowerPoint slides, audio or video casts, reference books, or other resources to learn about foundational factual material. They then go to class to spend the teaching/learning time on applied cases, projects, or problems where they can question the teacher, and work with their classmates on solutions and discoveries. Sound familiar? This is an example of “Flipped Learning”. I’d like to show you that we at Queen’s Meds are way ahead of the curve—we’re practicing “flipped learning” in “flipped classrooms already!”
A brief history of the Flip:
In 2000, J.W. Baker presented on a “Classroom Flip” where he used technology to allow students to read and learn at home, and became the “guide on the side” for them in class.
Formally defined in the literature by Lage, Platt and Treglia (2000) as the “Inverted Classroom”, the authors, from the Economics Department at Miami University, outlined a multimedia strategy for teaching that “appeals to a broad range of learning styles, without violating the constraints faced by instructors at most institutions.” (p. 31). By inverting the teaching and learning that took place inside and outside their economics classroom, the teachers gained more time to address diverse learning styles and challenges. They allowed groups and individual students to do their “homework” in the classroom, and reserved traditional lectures for outside the classroom.
In 2007, two high school chemistry teachers, Bergmann and Sams, recorded their PowerPoint lecture presentations using then newly developed screen capture software. Bergmann and Sams had built the videos for absent students to catch up, but found that students who had been present accessed the material to study and review. This left them time to spend in a classroom, on inquiry, and “deeper learning.” According to Bergmann, the Flipped Classroom “took off like a rocket!” (Bergmann, 2012.)
In March 2011, at Ted Talk, Salman Khan, spoke about flipping the homework/lecture equation. A hedge fund manager with multiple degrees in math and science from MIT Khan created the Khan Academy (www.khanacademy.org/), from his original math tutorials for his niece, to a very successful and free source of over 2,600 online tutorials covering everything from math, chemistry and even medicine. (Kahn, 2011). “Khan asserts that teachers in a traditional classroom spend five percent of their time actually working with students, while spending the other 95 percent lecturing, creating lectures or grading. Using Khan’s free online math tutorials, teachers flipped this equation, using technology to “humanize the classroom.” (Huston and Lin, 2012).
The growth in acceptance of this method is evidenced by, among many things, the best selling Bergman and Sams (2012) ISTE publication “Flip Your Classroom: Reach Every Student in Every Class Every Day.”
So, that’s what the “flip” is all about. What are we doing here in Queen’s Meds and what are some of the challenges we have to overcome in our use of “flipping”?
If you’re teaching in Undergraduate Medical Education (UGME), chances are you’ve come across our “SGL’s” or “Small Group Learning” sessions. With Dr. Lindsay Davidson’s example to guide us, we in UGME have adapted Team Based Learning (TBL) for these sessions. Here, we provide students with what had previously been the purview of the lecture: foundational facts through readings or other resources, from textbook chapters with reading guides, to online modules, complete with interactive quizzes, videos, etc. Students are provided with some “homework” time in our Directed Independent Learning sessions and are expected to come to class prepared to engage in inquiry through group work, with cases, or problems where they can apply their learning. The faculty member, often with a colleague, (other faculty, residents or fellows), facilitates the session, but notes that if he/she is talking more than 25% of the time, he/she is straying into the other side of the flip and not focusing on the student learning.
Why did we do this? For the same reasons that the flipped classroom is reaching so many teachers and students.
Here’s what Jon Bergmann has to say about this type of learning:
- Flipped Learning transfers the ownership of the learning to the students.
- Flipped Learning personalizes learning for all students
- Flipped Learning gives teachers time to explore deeper learning opportunities and pedagogies with their students (PBL, CBL, UDL, Mastery, Inquiry, etc)
- Flipped Learning makes learning (not teaching) the center of the classroom.
- Flipped Learning maximizes the face to face time in the classroom. (Bermann, 2012)
Now, what are some of the challenges? And how can we address them?
- It’s important that the students have prepared before coming to class. We do this by a. appealing to students’ sense of responsibility and professionalism, b. appealing to students’ common educational sense (they have to prepare if they are going to work on the applications) c. tying the preparation to assessment and grades into the preparation, d. using Readiness Assessment Process (lovingly known as RATs) which allow for enhanced group learning of concepts.
- Flipped Classrooms came about through innovations in technology that allowed for Lecture Capture, Narrated PowerPoint, and other technological tools. The key is not to get carried away with the technology but focus on the value of what is being offered to students: on guiding them through the learning and then inextricably weaving it with what is going to happen in class. One indispensible factor is quality: the captured lecture, online module, or even textbook chapter must have been carefully selected and/or crafted the way any good teaching tool would be.
- There really isn’t anything revolutionary about a video lecture. A recorded lecture is still just a lecture. What’s critical here is guiding of the learning. We are advocating Reading Guides for chapters or articles, quizzes and interactive questions for online modules, and short (5 minute) captured lecture bursts to guide readings, etc. Can the students learn from a captured lecture? Yes. Can they learn better with additional or with other tools? Absolutely. Bergmann cautions that flipped learning is NOT “a synonym for online videos. When most people hear about the flipped class all they think about are the videos. It is the interaction and the meaningful learning activities that occur during the face-to-face time that is most important.”(Bergmann et al, 2011.)
- Are lectures “bad”? Absolutely not! Flipping makes room for another teaching method, or several of them. But lectures have a place in medical education, especially for introducing a concept, generating excitement in a topic, providing a framework for learning, and other suitable purposes.
- It’s still about what happens in the classroom. I used the word “inextricably” above—the independent student learning must be closely linked to what happens in class. The class time is used to check on the student learning, clear up any questions, and work through well-thought-out and well-crafted group activities. Student intra-group discussion, student inquiry, students debriefing to the whole class, and instructors providing feedback to students about their learning are important activities. There is still a lot for an instructor to do in helping students to learn; it’s just been “flipped.”
Do you have questions or comments about “flipping”? Write back to the blog.
Baker, J.W. (2000). The Classroom Flip’: Using Web Course Management Tools to Become the Guide by the Side. Selected Papers from the 11th International Conference on College Teaching and Learning (11th, Jacksonville, Florida, April 12-15, 2000). Chambers, J.A., ed.
Bergmann, J. (2011). The history of the flipped class: How the flipped class was born [Web log post]. Retrieved March 24, 2013, from http://blendedclassroom.blogspot.com/
Bergmann, J. (2012). The Flipped Class as a Way TO the Answers. Flipped Learning. Retrieved March 24, 2013 from http://flipped-learning.com/
Bergmann, J. (2012). Flip your classroom : reach every student in every class every day. Eugene, Or. Alexandria, Va: International Society for Technology in Education ASCD.
Bergmann, J., Overmyer, J. & Willie, B. (2011). The Flipped Class:
What it is and What it is Not. Retrieved March 24, 2013 from http://www.thedailyriff.com/articles/the-flipped-class-conversation-689.php
Houston, M. & Lin, L. (2012). Humanizing the Classroom by Flipping the Homework versus Lecture Equation. In P. Resta (Ed.), Proceedings of Society for Information Technology & Teacher Education International Conference 2012 (pp. 1177-1182). Chesapeake, VA: AACE. Retrieved from http://www.editlib.org/p/39738.
Kahn, S. (2011). Let’s use video to reinvent education. Speech presented at TED2011. Retrieved March 24, 2013, from http://www.ted.com/talks/salman_khan_let_s_use_video_to_reinvent_education.html
Lage, M.J., Platt, G. J., Treglia, M. (2000). Inverting the classroom: a gateway to creating an inclusive learning environment. Journal of Economic Education.
Team Based Learning Collaborative. Getting Started. . Retrieved March 24, 2013 from http://www.teambasedlearning.org/starting.
Thompson, C. (2011, August.). How Khan Academy Is Changing the Rules of Education. Wired. Last retrieved on March 24, 2013 from http://www.wired.com/magazine/2011/07/ff_khan/
Zappe, S., Leicht, R., Messner, J., Litzinger, T., Lee, H., (2009). “Flipping” the Classroom to Explore Active Learning in a Large Undergraduate Course. American Society for Engineering Education.
Answers to questions about small group learning
We’ve received a lot of questions about how to make small group learning work smoothly for students and faculty. Here’s one with some answers gleaned from the literature and from experience:
I always seem to end up talking a lot in sgl. How can I let students talk more?
- Learn to “teach with your mouth shut.” (Finkel, 2000). Let the students do the work in their groups and let them take care of the debrief as much as possible.
- As soon as students are in their groups, get them going on the tasks. Stop talking.
- Have faith in the students’ ability to get it, or to help others in the group get it.
- Plan to speak about 25% of the time, and let groups take the rest of the 75% of the time.
- In debrief, assign groups to answer.
- Don’t respond to student answers in debrief, except to say “Thank you.”
- Ask other groups for agreement, for other suggestions, for challenges or rationales. If a wrong answer is given, ask the class or other groups if the answer is correct.
- If there are questions, “Park them” for later discussion on the whiteboard, or to post answers to the MEdTech Discussion Board later that day in the session.
- If it’s someone showing off their own knowledge by asking a question irrelevant to the class, ask to discuss after class. “That question shows you have a great deal of background in this subject. The question is not relevant to the what the class needs to know but I’d be very glad to discuss it with you…Will you stay after class, or get in touch with me?”
- Plan for a mini-lecture time slot (say 5-7 minutes) for you to explain denser or misunderstood topics.
- Make sure that your activities for the group are challenging yet give the opportunity to learn.
Do you have more answers or other questions? Please respond to this post!
Finkel, Donald L. & Finkel, Susan. (2000). Teaching with your mouth shut. Heinemann.