Month: July 2015
Are we forcing our students to choose between Learning and Success?
As the father of four sons, I have found that thought-provoking, articulate conversations with 17 year-old males are rare and remarkable occurrences indeed. Nonetheless, I was fortunate enough to have just such an experience this past week.
It all began when I came upon an article by Kristin Rushowy that appeared on the front page of the Toronto Star on July 19th describing the accomplishments of four young people who had achieved the highest averages among Toronto public high school graduates. A quote from one of these young scholars particularly drew my attention. It’s important, he said, to “follow your passion for knowledge, and not your passion for success”.
Never having thought of these as mutually exclusive entities, I was intrigued enough to call the source of this comment, Elias Hess-Childs who had managed to attain an average of 99.5%, as had fellow graduating students Michael Nuh, Albert Loa and Sarah Tang. Turns out Elias is an engaging young man who not only knows his way around a high school curriculum, but has some rather prescient views about the educational process and is not at all hesitant to expound on them. He finds the attainment of high grades a “shallow” way to go about educating oneself and strives for deep understanding rather than simply achieving high grades. He is attracted to “interesting” courses and teachers rather than “bird courses”. Like the other students quoted in the article, he finds studying and memorization to be tedious, and largely unnecessary if one has achieved a true understanding of the subject matter. When asked what he finds most difficult, Elias tells me that conceptual and “qualitative” material such as history to be more challenging than the sciences (presumably that’s what dragged his average down to 99.5), but nevertheless plans to challenge himself with social science courses at university next year. A confident and self-aware young man with a bright future, to be sure.
However, there’s a somewhat more troubling side to the “learning versus success” concept. Notwithstanding students like my friend Elias who are able to achieve both, are our young people really being required to make this choice? Are they sacrificing their interests in order to ensure they attain great marks? Are they focusing on short-term retention and exam results rather than deeper, conceptual learning? Is all this diminishing what should be a time for open exploration and discovery? Perhaps most concerning, to what extent are those of us involved in higher education responsible?
Without question, our young people are growing up in an increasingly pragmatic and competitive world. Universities, graduate schools and professional schools such as Medicine are all utilizing academic achievement as a major component of their entrance criteria and, in fact, proudly publish the average scores of their entering students as a marker of excellence. High school marks, entrance examinations such as the MCAT, LSAT and SAT in the United States, are taking on great importance and threaten to indelibly categorize our student into those destined for “success” and those who must content themselves with alternatives. The educational process has, for many students (and, importantly, their parents), shifted from a process of discovery and enlightenment about themselves and the world, to a proving ground in which they must demonstrate their aptitude and competitiveness for future opportunities. And all this is happening during their formative teenage years.
This is further complicated by the inconsistency in high school academic standards that has occurred since the discontinuation of common examinations, and the gradual mark “inflation” that continues to occur. Medical schools, for example, face steadily increasing numbers of applicants with steadily increasing average marks, and diminishing band-width within those marks. Are young people truly getting a little smarter each year, or are high school examiners succumbing to the perhaps understandable desire to provide their students and schools competitive advantages?
One of our recent graduates, Dr. Julianna Sienna, has an interest in the topic of admission equity and a way of poking my conscience from time to time. She recently sent along a fascinating review entitled “Who Gets to Graduate?” that appeared recently in the New York Times Magazine (http://www.nytimes.com/2014/05/18/magazine/who-gets-to-graduate.html?_r=0). In that article, author Paul Tough reviews efforts undertaken at the University of Texas to address the issue of low graduation rates. Although drawn from an American context, the issues they describe certainly resonate and seem entirely relevant to the Canadian scene.
Among the many interesting points raised in that article, a few are particularly relevant to this discussion:
- High school marks and entrance examination results have a powerful and enduring effect on self-image and sense of “worthiness” for various universities, programs and, by extension, career options.
- Lower family income and having less well-educated parents are factors associated with lower graduation rates, even for students with similar entry grades and SAT scores.
- Students with more modest marks and SAT scores, particularly those from poorer socio-economic backgrounds, tend to “undermatch” meaning, in the words of the author, “ they don’t attend or even apply to the most selective college that would accept them.”
To help underachieving students succeed, educational leaders have found that it is necessary to do more than simply deal with their financial and academic issues. “You also need to address their doubts and misconceptions and fears. To solve the problem of college completion, you first need to get inside the head of a college student”. The good news is that a number of innovative programs, focusing on dealing with adversity, building confidence and promoting inclusion are showing definite signs of success where traditional remediation streams and less demanding “developmental” courses were failing and, in fact, only perpetuating the sense of inadequacy.
To summarize, early academic performance during these formative years is a hugely powerful determinant of self-image and confidence, particularly when coupled with socioeconomic circumstances that reinforce the impression, but (and this is a big “but”) does not necessarily exclude young people from eventual academic success comparable to higher-performing entry students.
So what are the messages for those involved in the selection, education and career success of our young people? Certainly we should be celebrating the success of young scholars like Elias, Michael, Albert and Sarah and providing them post-secondary programs and environments in which they can continue to flourish and realize their considerable potential. However, we also need to recognize that not all students are in a position to take full advantage of our educational programs, that our evaluative processes at the high school and university level are far from precise, and that many very capable students with much to contribute to society may be discouraged or lost in the crowd. Our entrance processes should actively search for such students by going beyond the simple ranking of marks and explore more broadly the personal attributes, experiences and life goals of our students. Expecting that a young person will have demonstrated his or her career potential by the end of high school, and using our educational systems as competitive proving grounds is unfair to our students and a disservice to a society that benefits from the broad education of all its members. We can, and should, do better.
Anthony J. Sanfilippo, MD, FRCP(C)
Undergraduate Medical Education
Bringing things into focus: Using focus groups to collect feedback
By Theresa Suart & Eleni Katsoulas
Amongst the plethora of student feedback we solicit about our courses, you may wonder why we sometimes add in focus groups. What could be added to the more than a dozen questions on course evaluation and faculty feedback surveys?
The information we gather in student focus groups doesn’t replace the very valuable narrative feedback from course evaluations, rather, it allows us to ask targeted questions, clarify responses and drill down into the data.
Developed from “focused interviews” around the time of the Second World War, focus groups emerged as a key qualitative research tool in the latter half of the 20th century. Robert K. Merton, a sociologist from Columbia University, is hailed as the “father of the focus group.” (He died in 2003 at age 92.)
Merton used focused interviews to gain insight into groups’ responses to text, radio programs and films. Politicians and marketing companies soon seized upon focus groups to gauge voter and consumer trends. The Queen’s UGME Education Team uses focus groups in a targeted way to augment information gleaned from course evaluation feedback, course director’s meetings with academic reps and other feedback tools.
According to a briefing paper from Carnegie Mellon University, focus groups are “particularly effective” for eliciting suggestions for improvement. “They are also much more flexible than surveys or scales because they allow for question clarification and follow-up questions to probe vague or unexpected responses.” It also helps that faculty rate focus groups as “accurate, useful and believable”.
If you’re asked to participate in a focus group, only agree if you think you have something to contribute to the investigator’s project or purpose. (Sure, it’s fun to come for the free food, but be prepared to contribute in a meaningful way).
- To be informed if the focus group is for research or curricular innovation (or both). Research studies must have approval from the Research Ethics Board and require specific paperwork to document informed consent. Curricular innovation focus groups are less formal, but will still respect confidentiality of participants. These might not have the same paperwork.
- The facilitator to set the ground rules, and guide the discussion. Savvy facilitators will do this with a minimum of fuss: they will listen more than they speak. (But you can certainly ask for clarification if you’re not sure of a question).
- A co-facilitator will likely take notes and monitor any recording equipment used. The co-facilitator may summarize after each question and solicit further input as required.
- You’ll be asked specific questions, and engage in conversation with the other participants.
What you shouldn’t expect:
- A venting session. This isn’t the time to just complain. A focus group is looking for constructive feedback and suggested solutions.
- To always have your say: the facilitator may realize they have reached saturation on a particular question and will move on. This is to respect your time. (You’ll have an opportunity to send additional comments electronically afterwards if you felt there is an important point that was missed).
What you can do to prepare:
- If the questions are provided in advance (this is best practice but not always possible on tight timelines!) you should take some time to think about them.
- Be sure you know where the meeting room is, and arrive on time.
What you can do during:
- Contribute, but make sure you don’t end up dominating the conversation. The facilitator will be looking for a balance of views and contributors.
- Listen attentively to others and avoid interrupting. The facilitator will make sure everyone has a chance to contribute – you’ll get your turn.
What you can expect from data collected at a focus group:
- It will be confidential. Different strategies are employed. For example, you may be assigned a number during the focus group and participants asked to refer to people by number (“Participant 2 said…”).
- In a formal research study, you should be offered an opportunity to review the data transcript after it is prepared. (This is sometimes waived on the consent form, so read carefully so you can have realistic expectations of the investigator).
- The end product is a summary of the conversation, with any emergent themes identified to answer the research questions.
What you can’t expect:
- A magic bullet solution to a challenge in a course or class.
- One hundred percent consensus from all participants – you can agree to disagree.
- For all outlier opinions to be represented in the final report. These may be omitted from summary reports.
We’re always grateful to our students for donating their time to our various focus group requests throughout the year. These contributions are invaluable.
If you think this type of data collection could be useful in your course review and revisions, feel free to get in touch. It’s one of the tools in our qualitative research toolbox and we’re happy to deploy it for you as may be appropriate.
Eleni Katsoulas firstname.lastname@example.org
Theresa Suart email@example.com
Student wins prize for project on physicians with disabilities
What started as a project for her Critical Enquiry class turned into an award-winning poster presentation for Kirsten Nesset of MEDS 2017.
Nesset attended the 24th annual History of Medicine Days Conference at the University of Calgary in March where she won Best Poster Presentation for “Physicians with Disabilities in Canada: History and Future”.
Classmates Elena Barbir and Sophie Palmer also attended the conference, presenting on their Community-Based Projects. The three received the Boyd Upper Prize, which is awarded to the Queen’s medical student or students who have conducted original historical research and then had the work accepted for presentation at a peer-reviewed meeting.
Nesset’s interest in the area of disability started at home, she explained in an interview.
“It was something I was really interested in because my father has a visual disability and he’s an engineer,” she said. “He lost his vision when I was about 10 – so I grew up with him adapting to that and his work making accommodations.” And this got her thinking.
“You don’t really see many people with visual or physical disabilities in medicine and I wondered what the accommodations might look like for them and what kind of policy might be in place if there was any,” she said. “I wondered what that looked like in Canada.”
She quickly discovered that there wasn’t much information readily available. “It ended up being a much more global project in the end because there’s very little research in Canada,” she said.
As her CE Mentor, Jacalyn Duffin, pointed out: “Her first discovery was that almost no one had published on that topic, although there was a robust literature on burnout, stress, addictions and other mental problems.”
“The absence of any historical predecessors meant that she had to do some original digging, to produce what is effectively the first history on the topic and to try to explain why the question has not been asked before,” Duffin added. “Her research involved searching the literature, news reports, and eventually interviews.”
“Although Kirsten’s focus was Canada, she discovered that a relative silence on physicians with disabilities pervades the literature in general, making her findings relevant well beyond our borders,” Duffin said.
Nesset has plans to continue research in this area. To start, she plans to interview some physicians through the Canadian Association of Physicians with Disabilities. “Some physicians have come forward to say they would be interviewed – because there isn’t a lot of narrative from Canada yet.”
She would also like to delve further into what medical schools list as technical requirements for graduates. “Part of my project was looking into admissions requirements and there’s nothing in those but there’s a lot of talk about meeting technical standards and technical requirements and each school approaches that differently,” she said.
As she is starting her clerkship rotations in the fall, Nesset is hoping to complete some interviews by the end of the summer, but sees this as a longer-term project.
“Realistically, this is something I’ll carry through the next year and hopefully finish up part-way through clerkship.”
One strong lesson from this project is that history does not necessarily mean antiquity or even a few hundred years ago, Nesset said. “From my experience, history can also be incredibly recent. I looked at history as of 1980, essentially, or 1975. Then up until now, which is why it’s titled ‘history and future’.”
“A history of medicine project doesn’t necessarily mean you’re looking far back in the past, it can be more recent and you can apply it to future considerations, for example for policy development,” she said.
We’d like to feature news about our students’ achievements at conferences such as this. If you have a suggestion for a student to feature in a future blog post, please email me at firstname.lastname@example.org. We’ll follow-up on as many as we can.
Why a picture is worth more than 1000 words
Whether it’s the dreaded Service Ontario snap-shot that haunts us on our driver’s licence, or the passport photo that looks like we’ve been through a car wash, many of us despise the photo requirements public life tosses at us.
To these government-issued ID requirements, add the MEdTech Profile picture request. Please. Because we really need everyone to upload pictures to their profiles.
There are a lot of different reasons people don’t want to post a picture to their MEdTech profile – not the least of which is sometimes a nice picture of ourselves is hard to come by (mainly because we’re too hard on ourselves and, trust me, as someone who hasn’t lost the “baby weight” and the baby in question is 11 years old, I get the vanity argument.)
Why bother? There are two key reasons we need these photos: for proper faculty and preceptor identification during course evaluations; and to avoid email directory confusion.
- Course evaluation: Getting accurate feedback
Every faculty member who teaches four or more hours is evaluated by our students as part of our ongoing course and faculty review processes. This ensures appropriate feedback and contributes to overall quality of educational experiences as well as meets accreditation standards. Additionally, evaluation of clerkship preceptors is expanding to include multiple short-term supervisors. The challenge for our students is that by the end of a semester or rotation, they have dozens of faculty members they have had limited contact with and they’re faced with a list of names and forms to complete.
Marketing researchers have long valued the power of images. According to experts at 3M and Zabisco, 90 percent of information transmitted to the brain is visual, and the brain processes visuals thousands of times faster than text. Also, 65 percent of people are visual learners.
For visual learners, that picture memory-jogger is essential: What we’ve heard from students is, by the end of the semester, with so many different instructors, they’re really not sure who they’re evaluating and they’d like to provide appropriate feedback. If there’s a picture affiliated with your MEdTech profile, this helps sort out who’s who.
- Email confusion: Sending the right message to the right person
With a last name like “Suart”, I rarely run into email directory confusion, it’s more misspellings I worry about. However, if we also had a Theresa Stuart in UGME as either a student, staff or faculty member, you can bet there’d be some confusion. Or ask Matt Simpson – but which one? Matt Simpson, Manager of the Education Technology Unit, or Dr. Matt Simpson, Department of Family Medicine? (By the way, welcome to UGME, Dr. Simpson!). Again, photo identifiers can help resolve these types of issues.
Remember that MEdTech is a password-protected learning management system and is only accessible by our students, staff and affiliated faculty.
Adding your photo to your MEdTech profile is an easy two-step process: Get a picture and Upload it to MEdTEch.
Get a picture you can live with:
A well-cropped selfie from your iPhone, a snap-shot by a family member, or call me, and I’ll come to your office and take one.
Upload it to MEdTech:
(Click on any of these images to see a larger view of the screen shots)
Voila! You’re done.
Thanks to all faculty and staff who have already uploaded their photos.
Questions or concerns, please feel free to email me at email@example.com — or find me in the MEdTech directory.