Month: October 2013
Educational Resources at your Fingertips: Faculty and Students
As teachers, you may want to find resources that assist you with teaching, or find out what the latest news from the Curriculum Committee is, or find out who to contact about what. As students you may want help about people, places, policies and other “p’s” in the Undergraduate Medical Education program.
We have published two resources recently:
The first is the new Faculty Resources Community: https://meds.queensu.ca/central/community/facultyresources
NOTE: first log into MEdTech via the dashboard URL, then simply click on the community, which would be among those listed on the left side of each user’s dashboard page. All faculty members including community preceptors are members of the Faculty Resources Community, but to “see” it you’ll need to log in first.
The Faculty Resources Community was created to provide faculty members, Course Directors, Year Directors and Committee Chairs with advance notice of topics to be discussed at Curriculum Committee meetings as well as easy access to Curriculum Committee Highlights, links to faculty development on teaching and assessment and materials distributed at Course Directors’ Retreats. Other resources posted in the new community include the Future of Medical Education in Canada reports and the latest LCME accreditation standards. We welcome suggestions for additional resources.
The second resource is for students! The Student Handbook, a brilliant idea from Associate Dean Sanfilippo, and edited by Alice Rush-Rhodes, is now published on MEdTech and is available in a printable pdf format thanks to Lynel Jackson from MEdTech.
To access the Student Handbook, please go to https://meds.queensu.ca/central/community/studenthandbook and to print a copy, scroll down to the bottom of the side menu. The Student Handbook contains information on people to assist students (including peer mentors), advice on careers, CaRMS and the Dean’s Letter, lockers, MEdTech, the Curriculum, and Special Programs to name a few components.
Is there anything we should add to the Student Handbook? Any other way you’d like to see faculty ideas? Just respond to the blog and let us know, or email Sheila Pinchin at firstname.lastname@example.org
Aesculapian Society Students Represent their Peers in Many Ways
A few days ago, the student representative for the First Patient Program wrote to ask if we would like him to touch base with his classmates before our next session with them. He even had the feedback survey questions designed! How helpful and proactive this is. And this made me think: our meds students and our Aesculapian Society are extremely supportive of and committed to our Undergraduate Medical Education Program.
In this article, I’d like to write a huge “Thank You” note to the students in our Queen’s Aesculapian Society!
The Aesculapian Society (AS) was first organized by the medical students of Queen’s University in 1872, and has remained a strong voice for Queen’s medical students ever since. All students registered in the School of Medicine become members of the Society, which includes as honourary members, all graduates in Medicine and members of the School of Medicine at Queen’s University.
The Society is dedicated to the promotion of the general interests of the School of Medicine and to the control of matters affecting medical students in their relationships to one another, to other student organizations at Queen’s and elsewhere, and to the School of Medicine, Senate, and other governing bodies of Queen’s University.
While the AS is active in working with its members in many ways, I wanted to talk about the work of AS student representatives on the Undergraduate Medical Education (UGME) Committees and in advising and acting on UGME programs.
Aesculapian Society student representatives sit on all of our UGME Committees (and there are over 11!) including Curriculum Committee, Admissions Committee and Student Assessment Committee. Many students sit on more than one committee providing a very thoughtful and important voice for students and voting on key issues. In some committees there are often 3 or more representatives, (one for each year of meds school), and in the case of the UGME Teaching and Learning Committee, currently 7 students are representatives, as there are 4 student monitors who track learning event types for our annual reports in addition to the three students representing preclerkship and clerkship.
Appointed student representatives for each class meet, often weekly, with Course Directors to give them feedback about the course, including Clinical and Communication Skills as well as all other courses. Our Technology representatives podcast classes, and also are there to spring to the aid of faculty when struggling with technology.
We also have student representatives for programs. For example, there is that representative for the First Patient Program who started this article, who will help us plan our final event of the program, and who is poised to give us feedback on the program as it is unfolding for the students. We have student Competency Reps, usually two for each competency/role, who work with the Competency Leads and plan events and strategies related to that competency, and funnel student feedback to the Leads.
In fact students are also involved in the accreditation process, including the self-study which is mandated by all schools, and also in tours and dialogues and discussions with accreditation visitors. Our students have impressed our accreditation visitors over the years!
Queen’s medical students run the Orientation Week for new students in the fall with the first year class council and Vice President coordinating it. Students are also heavily involved in the Admissions Weekends for the MD program. In first year, the students are ambassadors to the new students as well as making those great videos that have gone viral in many years. In second year, the students assist with the interview process and admissions process. Conservative estimates put 80% of the students involved in Admissions work.
The point of this is twofold: Queen’s Medical School has a tradition of listening to its students, even in the highest committees, and seeks their representation out actively. Not only do those leaders in the school listen, they take often act on the student concerns, suggestions and proposals.
But my main point today in writing is to laud the active participation, and willingness to serve that is a part of many many students enrolled in Queen’s Meds and serving on the AS. These students are giving precious time taken from study and sleep to give to their school. To me, they are already demonstrating the competencies of a good physician, in their collaboration, in their communication, in their advocacy, and in their management of time and energy. They are demonstrating their commitment to be part of solutions rather than problems, and they are demonstrating the importance of service. We are fortunate to have such a committed group to help us in our school. So Thank You! to the Aesculapian Society Executive and all its student members!
Medical Student Research Showcase: Meds student researchers take over the Medical Building
September 26th marked the 2nd annual Medical Student Research Showcase at the Queen’s School of Medicine. This yearly event was brought to us by Dr. Heather Murray (Emergency Medicine and Public Health Sciences), Melanie Walker (Public Health Sciences), and Amanda Consack (UGME) as well as many other members of the UG staff. It showcases research performed by our medical students, during their time in medical school, for other students and faculty. This year’s session had a collection of 54 posters in the David Walker atrium, and three students were selected to deliver their research findings in an oral plenary, moderated by Dean Reznick. It was an inspiring display of innovation, effort and accomplishment.
A wide range of research topics were presented, and over the lunch hour the students were able to go over their work with a crowd of interested faculty and students. Many Queen’s faculty served as poster assessors and completed a structured feedback form so that presenting medical students could understand where their posters succeeded, and also how they might be improved. Additionally, the 10 QuARMS students were introduced to the event through an assignment evaluating the design and findings of 3 posters that appealed to them.
This year, students who attended the poster session were encouraged to vote for their top 3 posters in a “People’s Choice” award competition. We had over 80 ballots cast, and in combination with the poster assessors feedback, a poster winner was selected: Osbert Zalay, with his poster “Foundations of the tricorder: Artificial intelligence solutions for biomedical classification problems.”
Later in the afternoon, the 3 students selected for the oral plenary session delivered their research in the main auditorium. These students were selected after submitting a 5-page summary of their work, each of which was reviewed 3 separate times by a panel of faculty judges: Dr. Albert Clark, Dr. Paula James, Dr. Anne Ellis, Dr. David Lillicrap, Dr. Will Pickett, Dr. Mike Brundage, Dr. Heather Murray, Dr. Tan Towheed and Dr. Rob Brison. Eighteen submissions of extremely high quality were reviewed, and the following students were selected:
Nathan Roth, MEDS 2015 “Inside the brain of an expert: Comparing medical decision making and cognitive processing demands between medical students and experienced medical resident learners.”
Faculty supervisor: Dr. Dan Howes
James Simpson, MEDS 2015 “Patient evaluation of clinical interaction with medical students: A pilot study.”
Faculty Supervisor: Dr. Andrea Winthrop
Yan Xu, MEDS 2015 “Prescribing pattern of novel anticoagulants following regulatory approval for atrial fibrillation in Ontario, Canada.”
Faculty supervisors: Dr.Ana Johnson, Dr.Chris Simpson, Dr.Anne Holbrook (MacMaster) and Dr. Dar Dowlatshani (Ottawa)
These 3 students, and Osbert Zalay MEDS 2015 (“People’s Choice” Poster) have all been awarded the 2013 Albert Clark Award for Medical Student Research Excellence. This award was established in 2012, in honour of Dr.Clark’s longstanding contributions towards the critical enquiry program at Queen’s.
Students at the Queen’s School of Medicine are actively involved in a wide array of research enquiry with impressive results. Our students are asking questions, seeking answers, advancing care and inspiring change. Congratulations to all who presented, and to the faculty who have mentored them.
Goalies, Poets and Medical Students Fallibility and “the highway to success”
Jonathan Quick made a mistake.
For those of you not familiar, Jonathan Quick is a professional hockey player. Moreover, he is a goaltender. Moreover still, he is one of the best goaltenders in the world. Yes, I said world. Last year, playing for the Los Angeles Kings, he amassed an impressive numbers of wins and statistics in all things relevant to goaltending, and was the most valuable player on a team that competed deep into the playoffs. His accomplishments have been acknowledged in numerous ways, including being recognized recently by Sports Illustrated as one of the best four goalies in the National Hockey League and, perhaps most significantly, with a 10 year contract with Los Angeles said to be worth 58 million dollars.
Last Monday evening Jonathan was tending goal early in the third period of a home game against the New York Rangers. His team was down 2-1 but on the power play, pressuring the Rangers for the tying goal. One of the Rangers managed to nab the puck and send it into the Kings’ end of the rink. Jonathan, alone in that half of the rink, came out of his net to play the puck, presumably to pass it up to one of his players to continue the power play. In a manner later described as “comical” by a sports writer, he dropped his stick, misplayed the puck, attempted to recover with his blocker, but instead sent the puck slowly but inexorably into his own net, forced to watch it helplessly, along with the 20,000 or so folks in the arena, as well as most of the sporting world who would relive the moment repeatedly in broadcasts the next morning. Perhaps most painful of all was Jonathan’s body language after this mishap – arms in the air, head down, clearly devastated.
Significant in all this was the reaction of his teammates and even opposing players. Their manner at the time and in commentary afterward was in no way condemning, but rather sympathetic and supportive. “Tough break”…”It could happen to any of us”. Even the opposing goaltender, Hendrik Lundqvist, himself a stellar player, was quoted as saying “I feel for him”.
The message was clear. Jonathan Quick is still one of the best goaltenders in the world. What happened to him is regarded by those who labour in the same business as an occupational hazard in a profession that has no tolerance for error and very high public scrutiny. To his lasting credit, Jonathan met with the press afterward and took responsibility for what had happened. Regret, but no excuses.
One can’t help but draw a parallel to the medical profession, where adverse outcomes are regarded as “errors” and draw understandable scrutiny. Doctors have always recognized the value of reviewing and studying cases where outcomes are anything less than optimal. Those reviews must necessarily involve all aspects of the care delivery, from simple administrative process, through equipment performance to decision-making and technical provision of procedures. Perfection, although never attainable in any human endeavour, must always be the goal. Every adverse outcome provides a lesson and learning opportunity that makes the overall process safer and approaches that perfection. Like poor Jonathan, alone, sprawled on the ice, physicians feel isolated and very responsible when events go badly, and struggle to interpret these in broader, depersonalized contexts, a necessary struggle if they are to learn and go on to provide care to their next patient. The open acknowledgement and reporting of errors is a fundamental ethic, and legal responsibility of both the physician and profession.
Medical students begin this struggle very early. Entering medical school with stellar and usually unblemished records of academic accomplishment, many students have great difficulty dealing with even minor “failures” in their course work or professional behaviour. The ability to accept and even welcome feedback is a necessary professional competency and one of the most difficult to both teach and learn. We are accustomed to success and the praise that comes with it. Anything short of this is seen as a personal “failure” and something to be avoided and even contested.
My colleague Dr. Michelle Gibson likes to quote a particularly revealing study in which a group of medical students were randomized to receive feedback that was either laudatory but non-specific, or very specific and critical of their ability to perform a technical task, in this case tying surgical knots. When asked to evaluate the value of their feedback, those who received laudatory feedback rated their feedback as much more valuable than those who’d been critically reviewed. However, when assessed objectively with respect to their ability to tie knots at a follow-up test, the critically appraised students performed significantly better. The tough medicine, it would appear, is more effective.
Teaching faculty struggle with providing feedback. It’s much easier to praise and non-specifically encourage than to critique. Finding ways to provide that critical feedback is equally challenging. It’s not much help to simply say, “your knots aren’t very good, you should work on that”. Pointing out the specific issue and even demonstrating correct technique takes time and patience, but will ultimately lead to real improvement.
None of this, of course, is surprising. It’s the critical analysis and setbacks that help us improve and learn. That lesson, however, is much more evident and easy to accept in mid or late career than it is to a novice learner. Medical educators are in full agreement that the ability of a student to accept and assimilate criticism is a marker of both academic and career success. The converse is equally true – that an inability to accept and grow from critical feedback is a marker of poor performance and poor behaviour in future years. Humility, it would seem, is truly the beginning of wisdom, but it’s hard to be humble if you’ve never experienced or acknowledged failure.
“Don’t be discouraged by a failure. It can be a positive experience. Failure is, in a sense, the highway to success, inasmuch as every discovery of what is false leads us to seek earnestly after what is true, and every fresh experience points out some form of error which we shall afterwards carefully avoid.”
It may seem quite a stretch to connect a twenty-something English romantic poet of the early 19th century with 21st century hockey players and medical students of the same age, but the wisdom transcends both time and culture.
Jonathan Quick made a mistake.
Jonathan Quick is a great goaltender.
Last week, he got even better.
Your new curriculum committee – would you like to nominate someone to join?
Specifically, we have 5 “nominated” positions; the Curriculum Committee’s decision was to seek nominations from the faculty at large for these positions, in addition to asking curricular leaders and curriculum committee members for nominations. For more on these positions, see below. To nominate, send to the Acting Chair, Dr. Michelle Gibson at email@example.com.
These positions are:
- Scientific Foundations Course Director (from our basic sciences courses)
- Clinical Foundations Course Director (from our pre-clerkship clinical courses)
- Clerkship Course Director (from any of the clerkship courses)
- Competency Lead (From the Professional Foundations committee)
- Discipline Lead (A discipline lead from any discipline)
- Humanities Lead – Dr. Cheryl Cline has accepted this position.
The Curriculum Committee meets on the 2nd and 4th Thursdays of the month, from 4:00 to 6:00 p.m, from September to June, with monthly meetings in July and August.
The rest of the committee members are present as a direct result of a specific role they play in the curriculum. There are vacancies here too, as the new terms of reference specify that no one person can represent two positions on the curriculum committee. We are working to fill these vacancies. Currently, the membership includes:
- Director, Curriculum – Vacant
- Associate Dean, UME – Dr. Tony Sanfilippo*
- Year 1 Director and Acting Chair – Dr. Michelle Gibson*
- Year 2 Director – Dr. Lindsay Davidson*
- Clinical Clerkship Director – Dr. Andrea Winthrop*
- Clerkship Curricular Courses Director – Dr. Susan Moffatt
- Clinical Skills Director – Dr. Cherie Hiscock-Jones
- Chair, PF Committee – Vacant
- Director, Student Assessment – Dr. Michelle Gibson*
- Director, TLIC – Dr. Tony Sanfilippo*
- Director, CFRC – Dr. Andrea Winthrop*
- Manager, Educational Development and Faculty Support – Ms. Sheila Pinchin
- Aesculapian Society representative – Elizabeth Clement (Meds 2016)
*Currently, in this transition period, all these individuals are representing two roles, and they are in the midst of seeking delegates for one of their roles.
Nominations will be accepted until October 29, 2013. The process after that date is to discuss nominations with the individuals concerned. MD-PEC will be appointing the nominated members in November.
Questions can be directed to the Acting Chair, Dr. Michelle Gibson at firstname.lastname@example.org
Help for students reading challenging texts
Many students in medical education are not used to reading large amounts of dense materials, where, as one student put it, “every word is loaded and I end up looking up everything.” When experts read through a reading they have assigned to beginning medical students, they often underestimate the amount of time and effort that is needed.
In other posts, I’ve discussed how it’s important for teachers to preview their assigned reading materials, and to seek out the best material, through help from librarians and educational team members, that accomplishes their goals and is at an appropriate reading level for students.
For today, I’d like to introduce you to a reading method that may assist our students: it’s called SQ3R.
SQ3R stands for Survey, Question, Read, Recite and Review. It’s an approach to reading that can help students retain the information they have been asked to read. It promotes curiosity and a determination toward reading, that is based on the cognitive processes of successful learners. SQ3R is not a new technique–it’s been around since well before I was a university student–which is a long time! 🙂 Credit goes to Francis Pleasant Robinson who in 1946 first published about it in his book Effective study.
So how does it work? NOTE: readers, you may find that this looks like a long process. While it’s longer than skimming, it can become habitual, OR you may want to take pieces of it for your own. Please “read” on.
Survey: Basically, SQ3R asks readers to survey or look over a whole reading paying particular attention to:
- The title, headings, and subheadings
- Captions under pictures, charts, graphs or maps
- Bold print, italics, numbered items, color coded passages, marginal notes, glossaries, outlines, questions, lists, charts, etc.–these are cues that the author regards these as key items
- Review questions or teacher-made study guides
- Introductory and concluding paragraphs
Question while you are surveying:
- Turn the title, headings, and/or subheadings into questions
- Read questions at the end of the chapters or after each subheading
- Ask yourself,
“What did my instructor say about this chapter or subject
when it was assigned?”
- Ask yourself,
“What do I already know about this subject?”
Read, but read for a purpose: look for answers
- Look for answers to the questions you first raised
- Answer questions at the beginning or end of chapters or study guides
- Reread captions under pictures, graphs, etc.
- Note all the underlined, italicized, bold printed words or phrases
- Study graphic aids
- Reduce your speed for difficult passages
- Stop and reread parts which are not clear
- Read only a section at a time and recite after each section or look away from the text and ask a stimulus question–this breaks your habitual reading and allows you to re-focus
Recite after you’ve read a section: ask yourself questions about what you have just read, or summarize, in your own words, what you read through writing
- Take notes from the text but write the information in your own words
- Underline or highlight important points you’ve just read
- Reciting: for difficult passages especially:
The more senses you use the more likely you are to remember what you read: Triple strength learning: Seeing, saying, hearing
Quadruple strength learning: Seeing , saying , hearing, writing!
Recitation requires mental activities far beyond those possible through “stroking the words with eyeballs” in a textbook: a technique so commonly used by students. Reciting promotes and speeds learning while rereading and rereading actually slows, impedes, and in some cases, prevents leaning.
Review: put it all back together again. Very few people a whole chapter by reading it once. The Question-Read-Recite process divides a chapter into sections that can be assimilated separately, into manageable chunks. This allows you to set your own pace.
Regular review puts a chapter back together again. In review, you are answering the question that was made from the chapter title.
Review means regular and frequent recitation (or written recitation) of the material to be learned. This is an excellent check for learning.
So how do you review? Here are review techniques that have worked for me, for my students and from the literature:
- Review one day later, one week later, two weeks later
- Make a Table of Contents for a chapter from your notes or from memory
- Make a point form outline from your larger notes or from highlighted sections
- Put a concept map together: make a visual diagram of what the chapter’s key concepts are
- Review out loud (remember the Triple Strength Learning above)
- Cover up parts of a page and test your self on the corresponding parts.
A Problem and Solutions for Students and Faculty:
One last thing:SQ3R is slow. At least it is slower than the speed at which many students “read.” That doesn’t mean we shouldn’t look at it for medical education. It’s slower than skimming but really effective in retention. Perhaps students who are faced with large amounts of difficult material can take pieces from this process and add to their own. Perhaps teachers can recommend or even put in place requirements for a point form outline or list of key questions or a concept map to be brought to class after assigned reading.
Do any of these techniques strike a chord with you? Do you have other reading/reviewing suggestions?
Concept Mapping. http://ctl.byu.edu/tech-tips/concept-mapping accessed Oct. 7, 2013
Robinson, Francis Pleasant. (1970) Effective study. New York: Harper & Row.
SQ3R reading method. The Reading and Research Series. http://www.studygs.net/texred2.htm accessed Oct. 7, 2013.
SQ3R http://www.mindtools.com/pages/article/newISS_02.htm accessed Oct. 7, 2013
SQ3R Textbook study system. Worcester Polytechnic Institute. www.wpi.edu/Images/CMS/ARC/SQ3R_Textbook_Study_System.pdf accessed Oct.7, 2013.
Weideman, M. & Kritzinger, C. (2003). Concept Mapping – a proposed theoretical model for implementation as a knowledge repository. A working paper from the “ICT in Higher Education” research project.
Curricular Council meets Oct. 29
The Curricular Council for Undergraduate Medical Education meets Oct. 29 at the University Club, from 4:30-6:00. RSVP notes have been sent out to Curricular Leaders. Topics for discussion will include the new governance structure for UGME, an update on accreditation, best methods of communicating with all faculty, new electronic exam format, and upcoming professional development opportunities. Slides from the Curricular Council will be posted for all on the Faculty Resources website in MEdTech: https://meds.queensu.ca/central/community/facultyresources
Flu Clinic at the School of Medicine Building
The Department of Environmental Health and Safety, in conjunction with the KFLA Health Unit, is sponsoring a Flu Shot Clinic at the University this year. This will be a chance for all faculty, students and staff to take advantage of the free vaccination program offered by the Ministry of Health.
Wednesday, October 30, 2013 – 10:00 a.m. to 6:00 p.m. School of Medicine Bldg., Corner of Arch and Stuart Street Entrance
Remember to bring your health card.