Exam Wrappers: A novel way to review exams

Exam Wrappers

Here’s a new and very interesting tool called “Exam Wrappers” that you can add to your exam review after mid-terms and even finals. It enables students to think more carefully about their studying and learning. It is from a chapter by Marsha C. Lovett, (2013) Chapter 2, in Make Exams Worth More Than the Grade, in the book, Using Reflection and Metacognition to Improve Student Learning, edited by Matthew Kaplan, et al, Stylus Publishing, Sterling, Virginia.,

This is a technique that engages students in reflection, metacognition (learning to learn) and self-regulated learning. Prof. Lovett’s approach was to “build metacognitive practice around exams” and in so doing satisfy the many constraints that challenge metacognition in a curriculum.

What are Exam Wrappers?

Exam wrappers are short activities that direct students to review their performance (and the instructor’s feedback) on an exam, with an eye toward adapting their future learning. Exam wrappers ask students three kinds of questions: How did they prepare for the exam? What kind of errors did they make on the exam? What could they do differently next time?

Prof. Lovett provides examples in Appendices A1 and A2 of her book. Here is a summary of her work on the three questions above:

1. How did you prepare for the exam?
Benefits of this question:
• Challenge student to confront study process and implicit or explicit choices they made about their studying
• Asks themselves if they studied enough or with enough lead time
• Focusing on diverse study methods (reviewing notes, solving practice problems, rereading the textbook) points out that there are many approaches they can use for next time

2. What kinds of errors did you make?
Benefits of this question:
• Challenges students to move beyond marks: with high marks, they tend to be relieved and move on; with low marks, they may leave the “painful event behind.”
• Allows opportunity to analyze in greater depth, e.g. considering level of difficulty of the questions they may have had problems with, looking for patterns in types of errors.
• Gives them a lexicon re. self-assessment: e.g. “Did they read the question carefully? Did they have trouble setting up the problem? Did they fail to understand the concepts involved?” Or “Did they make mistakes on the required math, chemistry, physiology, anatomy, etc.?”

3. How should you study for the next exam?
Benefits of this question:
• Ties responses from #1 and 2 together
• “A key goal of the third type of question is to help students see the association between their study choices and their exam performance so they can better predict what study strategies will be effective in the future.” (Lovett, 2013)
• Asks students to attribute their problems from #2 to some specific study errors, or look back at #1 and #2 and ask how they would specifically prepare differently.

Benefits of exam wrappers:
1. Impinge minimally on class time.
2. Are as easily completed by students within the time they are willing to invest.
3. Are easily adaptable. (Faculty can add their own concerns in #2, for example, asking about test anxiety or other issues). Can be used with other types of graded assessments.
4. Are repeatable yet flexible. (can add new questions or change questions slightly to keep things “fresh”)
5. Exercise the key metacognitive skills instructors want their students to learn: assess strengths and weaknesses, identify strategies for improvement, and generate adjustments.

Steps for Exam Wrappers
1. Hand back exams.
2. Assign “Wrapper” with questions.
3. Students complete, either during the exam review, for homework, or online (non-graded but required element). Students can also share study techniques with classmates.
4. Instructor collects and reviews to gain new knowledge of student needs, and patterns of behavior (e.g. amount of hours spent studying)
5. Hand back wrappers, or remind students about them as they might begin studying for another exam.
6. Repeat for subsequent exams (you can streamline a wrapper for a later exam, eg.)

Thanks to the Tomorrow’s Professor Digest for this idea from Prof. Sharon Lovett.

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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.

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Why should you be an FSGL Tutor?

This blog article is brought to you by Dr. Michelle Gibson, Year 1 Director, and Coordinator of our FSGL stream in pre-clerkship. gibsonm1@providencecare.ca

Why should you be an FSGL Tutor?

But first … what is FSGL anyway?

FSGL is Facilitated Small Group Learning, a modified form of Problem-Based-Learning (PBL), adapted for the curriculum at Queen’s University. In Terms 2, 3, and 4, students work in small groups of 6 or 7, with one tutor, over the course of the term, to learn from cases linked to their courses.

FSGL is like PBL in that the tutors are not there to be content experts, but rather as “facilitators” of student learning. In general, students receive the first part of a case, and they work together to identify what their learning needs are. The case is usually that of a patient with an as-yet undifferentiated presentation, and the students work through it together, gradually getting more information about the case. It is, in educational terms, enquiry-based learning, where the students are (mostly) driving the learning.

So what does an FSGL tutor do?

They are there to help the group really delve into the case, to probe student understanding, to help the students with their clinical reasoning, and, really, to help students understand what a doctor does. They are not teaching about the intricacies of interpreting ECGs, for example, but rather, to challenge the group about their approach to a differential diagnosis in a patient with syncope (with the help of a trusty written tutor guide…)

In addition, tutors are essential in observing individual student contributions to the group, and the group dynamic over the course of the term. They can help the group form a high-functioning team, and they provide feedback to individual students about their performance. Twice a term, the tutors will review peer-feedback and self-assessment data from their students, and provide mid-term and end-of-term feedback to the students about their progress that term.

Why do tutors like FSGL?

In the 5 years since I’ve taken over this part of the curriculum, I hear the same comments over and over. Tutors enjoy working with a stable group of students over the course of a term, and getting to know them. They appreciate watching their students grow in their skills, as they strive to become doctors. They even admit to enjoying the learning they do about material they don’t see everyday.

What is involved in being an FSGL tutor?

Tutors commit to at least one term (timelines below) for one afternoon a week, from 1:30 to 4:30 p.m. We understand that tutors have other commitments, so we accommodate tutors being away up to twice a term by providing substitute tutors, and 3 absences might be accommodated in certain circumstances. This includes participating in an orientation on the first afternoon of the term. You will receive a tutor binder, with all the cases and the tutor guides, and learn about how to be an effective tutor.

Tutors will learn how to provide constructive narrative feedback to students about students’ own learning goals and their progress over the term.

I might be interested, but I have questions – what should I do?

Email me at gibsonm1@providencecare.ca , and I’d be happy to chat.

Final words:
When I was asked to take over the old PBL by Dr. Sanfilippo, many people (myself included), really wondered if we should keep it in the curriculum. Through the helpful feedback provided by students and those they rated as excellent tutors, I have tried to keep what was working, and fix what was not. If you did PBL more than 5 years ago, I can assure you it’s a new creature now. While it’s not perfect, it is mostly fun, and the students really appreciate their tutors- they tell me so all the time. And, as one new tutor told me this year: “This is the best experience I’ve had in undergraduate medicine at Queen’s in 10 years.” I would be delighted if this would be the case for other new tutors too, so please feel free to email me with questions! gibsonm1@providencecare.ca

Timelines

Fall 2013:
Term 3, second year med students (experienced FSGL-ers) – cases are based on mostly cardio-resp, renal, and endocrinology material. Runs from September to the 1st week in December. Wednesday afternoons, from 1:30 to 4:30.

Winter 2014: (Two terms)
Term 2, first-year med students (novice FSGL-ers) – cases are based on therapeutics, pathology, immunology, hematology, geriatrics, MSK, and pediatrics. Runs from January to April or the first week of May. Monday afternoons, from 1:30 to 4:30, with many Mondays off, including Family Day, 2 weeks around March Break, and Easter Monday.

Term 4, second year med students (very experienced FSGL-ers) – cases are based on OB/Gyn, GI/Gen Surgery, neuro, ophthalmology, and psychiatry. Wednesday afternoons, from 1:30 to 4:30 with 2 weeks off around March Break.

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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.”

joe gabriel 2
Joe dips his bike into the Pacific in Victoria, at Mile 0 BC

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!

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“The Light Who Pursues Kindness”

Each year, our graduating class is asked to nominate a member to speak on their behalf at the Convocation ceremony.  Last week, Alex Summers delivered an address he entitled “The Light Who Pursues Kindness” on behalf of the Meds 2013 class.  It was clear to me and to many other faculty attending that Alex’s words deserved a broader audience and so, with his permission, I am providing the complete and unaltered text of his address below.  Alex’s words require no editorializing on my part, but I would simply say that all who are involved in our school in any way, be it teaching, leadership, administration or support, should take justifiable pride that our graduates should feel this way about their careers, to date and beyond.  In the midst of the day-to-day challenges we all face, Alex’s words reaffirm the faith that what we do is worthwhile, and we must be doing something right.  And so, the words of Dr. Summers:

Picture - Alexander SummersMr. Chancellor, Principal, Rector, ladies and gentlemen; 
Let me get started by taking you back to the spring of 1885 with some words borrowed from a day just like today:
“Medicine is a liberal profession, requiring culture and knowledge and skill. It is not a trade for money making, nor a field for vaulting ambition. The physician’s object is to combat disease; he is, therefore, the servant of the suffering.”
Those are the words of George Spankie, Queen’s Medicine 1885, spoken during his convocation address. Since the fall of 1854, medical students have trained here at Queen’s. Trained, and despite all the doubts, graduated too. And today, it’s our turn to cross this stage. We’ve been done for almost a month, but I know many of us have been resisting the urge to call each other doctor, for as we know from last week’s hockey game, it isn’t over till it’s over. Unless you’re the Senators of course; even Alfie says it’s over. But be re-assured folks, I think we’ve made it.
My hope today is to quote the collective voice of the Class of 2013, an outstanding group of people for whom my respect and admiration has grown daily since September 2009. To my classmates, may the words I speak for you today echo your thoughts, and may the words I speak to you have value and meaning. For the wisdom imparted, the memories shared, the friendship and support, and for the humbling privilege to stand here today, thank you.
The medical school journey is not one that is walked alone. It is only through the support of so many that we have achieved what we have achieved. To the staff of the UGME, thank you for tireless efforts on our behalf. To the faculty, we are grateful to you for so many things, but most especially for the examples of professionalism and excellence that you have modeled for us. Queen’s, in my overtly biased opinion, is a remarkable place, and it is so because of its people. Leonard Brockington, Rector of Queen’s from 1947 to 1966 (and the last non-student rector), said that this university was “…an example of the personal and national good that springs from intimate association between devoted teachers and eager learners.” That sentiment still holds true. Thank you for your commitment to us, and to Queen’s.
And to our families and friends, words simply are not enough. Our gratitude for your support, encouragement, and love, cannot be adequately conveyed from a stage. To all of you, may the lives we have lived thus far, and the lives we will lead from this day on make you proud, and be our most sincere expression of thanks.
I last addressed a graduating class in June 2002. I was fourteen years old, and it was the graduation ceremony for Grade 9 students at Montgomery Junior High School in Calgary. I do not remember one word of my speech. But I remember what followed. With spiky fluorescently dyed hair and skater shoes to accent the dress pants, Cassie, David, Terry and Cam came to the stage to play, you guessed it, the convocation classic Good Riddance, aka Time of Your Life, by the punk rock band Green Day. It was a beautiful rendition of that four-chord tune, and I even think David, the guitar player, managed to slip in that little four-letter word that follows the second prematurely attenuated guitar lick.
At the time, there was no better articulation of our feelings and hopes. The words were simple and the band was cool, and it was our anthem. Today however, 11 years later, would that song still cut it? Would it still capture the significance of a day like today?                                                   
Of course not.
Certainly, part of today is very much about remembering the last four years. But that’s not it. That song doesn’t cut it because today is only so much about yesterday. Today is about tomorrow. Not only does the university acknowledge today four years of effort by bestowing upon us this degree, in accepting that degree we answer, with humility and respect, a call. We accept a profound responsibility; a social contract between us and our neighbours. As we begin to feel the weight of that responsibility, it is good to once more reflect upon what exactly we have been called to do.
In my first year of medical school, under the guidance of Dr Duffin, I had the opportunity to learn about Dr Norman Bethune. For a man long dead, he has made a transformational impact on my understanding of what it means to be a physician. A Canadian physician of overwhelming humanitarianism and global compassion, he plied his trade across the globe, believing there was “code of fundamental morality and justice between medicine and the people.” He died in 1939 in rural China, and is remembered in that country as a hero for his selflessness and sacrifice. His name amongst the Chinese is Bai Qiu En – The Light Who Pursues Kindness.

I love that. And I find purpose and inspiration in the idea that we too can be, and should be, lights who bring and share kindness in the darkest hours of human suffering. As we go from here, we tread in the footsteps of giants like Norman Bethune and others – just look around this stage. As our forbearers have, may we stumble courageously and persistently in the pursuit of compassion and excellence. Let us never forgo the good of the patient and the public for the advancement of ourselves or the profession. If the economy does finally manage to implode on itself and the funds for public salaries disappear, may it be seen that Queen’s physicians are the ones that will still show up for work; that Queen’s physicians are, in the words of that valedictorian of old, “servant[s] of the suffering.”  Whether we are destined for a career in a ward, a clinic, an OR, a lab, or a public health unit, if we embark from this place, humbly emboldened with a commitment to pursue kindness in everything we do, we will not go wrong.

Let me finish with one more quote; with words borrowed from Dr Bethune. Spoken in 1938 at the opening of a military hospital in remote China, he would die within the year at the age of 41 as a result of a blood-borne infection he would acquire while operating on a soldier.

“There’s an old saying in the English hospitals… “A doctor must have the heart of a lion and the hand of a lady.” That means he must be bold and courageous, strong quick and decisive yet gentle, kind and considerate. Constantly think of your patients and ask “Can I do more to help them?”

Congratulations, my friends. Thank you for the last four years, for today, and most especially for the good work you will do as you go from this place.

 

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

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It Takes a Village

Last week’s convocation ceremonies provided opportunities to not only pay tribute to the 2013 class, but also reflect on the progress of our school and curriculum.  I was congratulated several times for the changes that have taken place, and the success of our graduating class.  In truth, those changes have been made possible only by the efforts of many faculty and support staff, who are the real heroes of any success we’ve achieved.  I thought it appropriate to devote an article to those remarkable people.  In doing so I tread cautiously, always wary of omitting someone, but not willing to pass up the opportunity to recognize the deserving.  So, here goes:

Screen Shot 2013-05-30 at 8.54.21 AMTed Ashbury.  Several years ago, he (perhaps foolishly) Ted agreed to become a curricular advisor.  From that, he has become the “heart and soul” of Professionalism within our curriculum and within our medical school.  He began by chairing a working group that examined and developed a competency framework, the work of which served as a model for all the professional competencies.  He has continued to teach and advocate for professionalism, serving on our Curriculum Committee since it’s inception.  He does not speak often, but is always thoughtful and his usually incisive commentary often brings the group back to fundamentals and keeps our collective eye on what’s important.  I’ve come to count on his advice.  Ted’s trying to retire and I guess we’re going to have to let him do that at some point, but we don’t have to be happy about it.

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Henry Averns has, for the past 5 years directed our Clinical Skills program.  A difficult portfolio at the best of times, Henry had to manage through the departure of a number of faculty leads, transition from a five to four term format, introduction of new teaching requirements, and transition to a new Clinical Education Centre.  Henry managed all this with characteristic aplomb, the final result a program that continues to be highly regarded by our students and accreditors, and improved for his contributions.  More recently, he has taken on chairmanship of our OSCE committee, a role that continues to bring both learning and administrative challenges, but he is engaging with his usual enthusiasm and characteristic pragmatism.

belliveauPaul Belliveau has been a consistent liaison and representative of Surgery within our curriculum, both at the pre-clerkship and clerkship levels.  He has also willingly taken on a number of key roles, including initially chairing our Student Assessment Committee and taking on leadership of our Student Awards Committee as it undergoes necessary reforms.

Screen Shot 2013-05-24 at 3.55.07 PMJennifer Carpenter
has, for many years, provided counseling for students experiencing a variety of personal and health problems.  In doing so, she has made herself continuously available to them and, since most of what she does is held in confidence, she largely carries out this role without attention or fanfare.  She has also led the development of our Advocacy curriculum and promoted the development of Learner Wellness initiatives.  She is unfailingly supportive of our students, and I have come to rely on and trust her advice on many student related issues.

Screen Shot 2013-05-24 at 4.20.34 PMSue Chamberlain has been instrumental in developing our curriculum and clerkship in Obstetrics and Gynecology, shaping both into a very well regarded components of our curriculum, reflected by high levels of success of our students in Medical Council of Canada examinations and disproportionate interest in Ob-Gyn careers among our students.  For these past 4 years, she took on Chairmanship of our Student Assessment Committee.  This was a mammoth task, requiring a combination of policy development, faculty support and oversight of the curricular courses.  Her success in developing effective assessment methodologies for our courses was absolutely essential and key to our accreditation success.

 

Screen Shot 2013-05-24 at 3.57.52 PMLindsay Davidson is a dedicated and successful career educator who has also been part of our curricular transition from the start.  During her time as Clerkship Director she guided the clerkship through its transition to a 2 year model.  She has also taken on the roles of MSK Course Director for many years and, more recently, Year 2 Director.  Her overriding contributions, however, relate to her willingness to fearlessly engage novel educational models, combined with technological expertise rare in medical faculty.  She has been an unapologetic champion of small group learning techniques, leading the way and assisting many faculty in making that transition.  She has become a growing presence within the university and national education communities.

Screen Shot 2013-05-27 at 9.12.59 PMAs the Hannah Chair for the History of Medicine, Jackie Duffin has provided our students insights into the history of our profession and done so in a highly engaging manner, mixing award winning lectureship with individual research and highly regarded field trips which she personally organizes and supervises.  Her contributions, however, go far beyond that role.  She engages the students on a personal level with enthusiasm and warmth, and is held in high regard by all.  Her publications and global work bring much credit to our school.

Renee Fitzpatrick has provided steadfast and innovative leadership for all aspects of our Psychiatry curriculum.  She has developed novel approaches to teaching complex psychiatric presentations through the use of standardized patients, as well as developing individualized preparation opportunities for students undertaking the Integrated Community Clerkship.  She has become the champion of Psychiatry within the UG curriculum, and her efforts have provided our students with a much more realistic and attractive impression of that career track.  As she moves on to other challenges, she leaves strong pre-clerkship and Clerkship programs for colleagues to follow.

Michelle Gibson has skillfully and efficiently guided Year 1 of our curriculum for several years, been an important member of our Curriculum Committee (taking over responsibilities as Chair for these past 2 years), all while completing her Master’s degree in Medical Education and carrying out her practice in Geriatric Medicine.  During that time, she managed to have a baby, and young Conor has become an honorary member of Curriculum Committee, amassing an impressive attendance record.

Cherie Jones-Hiscock has provided leadership and oversight for two key competencies within our curriculum, those related to the Collaborator and Communicator roles.  In doing so, she has developed curricular content and novel, creative methods to provide that content.  These roles have required that uncommon combination of educational creativity and administrative skill.  She has brought these skills to her roles with our Professional Foundations and Curriculum Committees.

H_Macdonald_7472_Hugh MacDonald has guided our Admissions Committee through a transition to a much more sophisticated and, in my view, effective process based on an understanding of key applicant attributes and incorporating mini-medical interviews.  The committee’s mandate has also expanded to involve admission of students to our MD-PhD and QuARMS programs, each requiring creative thinking and novel processes.  Hugh has guided these processes with a steady hand and good judgment, all the time filling other key clinical and administrative roles in our school.

Screen Shot 2013-05-24 at 4.26.11 PMSue MacDonald, as our first Academic Advisor, has taken on this new role with energy and commitment.  She provides personal counseling with students experiencing academic challenges, effectively identifying opportunities for improvement and complementing the efforts of other counselors.  Many students have benefitted from her counseling and sound, practical advice.  She has also been very active in the delivery of our Professionalism/Ethics curriculum, and a strong contributor to our Student Progress and Promotions Committee.

Screen Shot 2013-05-24 at 4.17.46 PMJennifer MacKenzie has, together with Theresa Suart, developed a de novo pre-medical curriculum for our QuARMS program which is highly creative, delivering competency based learning in a variety of creative teaching formats.  This program, and Jennifer’s continued oversight, will be key to the success of this exciting new initiative.

 

Sue MoffattSue Moffatt has been making major contributions to our curriculum for more years than she would like me to mention.  Most recently, her contributions to our curricular renewal process, guidance of the Cardio-Respiratory course through transition, and wholesale development of the three Clerkship Curriculum courses have been remarkable even for someone with her track record.  Her recent selection by our graduating students to receive the Connell Award (given to the faculty member deemed to have made the greatest contributions to their medical education) speaks clearly to her dedication and commitment to our students.  It’s always clear to me and others that Sue’s perspectives and opinions on various issues, although often controversial, are always motivated by a genuine concern for the interests of our students.

Screen Shot 2013-05-24 at 4.09.58 PMHeather Murray has transformed the teaching and expression of Scholarship within our curriculum.  She has done so by developing and managing the CARL (Critical Appraisal, Research and Learning) course, now in it’s third year, and building on Albert Clarke’s longtime contributions to transform our Critical Enquiry course.  She is transforming those components of our curriulum into a very active and highly relevant learning experience for our students.  The Student Research Showcase, which she developed and offered for the first time last fall, promises to become a regular highlight of the academic year.

Screen Shot 2013-05-24 at 4.11.03 PMPeter O’Neill tirelessly guides our students through their career planning and CARMS application processes.  He also, quietly and without fanfare, provides personal guidance and advocacy for those few who have difficulty with the postgraduate match process.  In his spare time, he has developed a program in Spirituality, which has been well received by both students and other medical schools.

Conrad Reifel and Steve Pang have provided a Normal Human Structure course that is, in the view of many, among the best programs in the country.  They have also been open to change and cooperation with clinical course directors that continues to promote integration throughout our curriculum.

59Mike Sylvester has developed and operated a Family Medicine course in first semester that not only introduces our students to that specialty, but provides their first exposure to clinical presentations and diagnostic reasoning.  He has represented and promoted the integration of Generalism within our curriculum tirelessly through his participation on the Curriculum Committee.

David Taylor and Cathy Lowe have very effectively reformed our Internal Medicine Clerkship rotations, converting what were weaknesses to strengths within the clerkship.  In doing so, they have introduced innovative teaching and assessment methodologies.

Screen Shot 2013-05-24 at 4.27.25 PMLewis Tomalty, during his term as Senior Associate Dean, was a strong supporter of curricular change and continuing source of advice, guidance and support.  Since then, he has assumed responsibility for our Mechanisms of Disease course and is in the process of reforming that curriculum.

vanwylickRichard VanWylick seems to be everywhere.  He has, over the past few years, directed the development and implementation of our Pediatrics pre-clerkship curriculum, directed the Pediatric Clerkship, directed our Integrated Community Clerkship Program and, just for good measure, Chaired the Progress and Promotions Committee, a role that requires the knowledge of a litigator, diplomacy of a career diplomat and patience of Job.  I’m not really sure how he’s managed all this, but I’m smart enough not to ask.  He’s one of those folks who just does everything well, and can be relied upon with difficult jobs.  In addition, I know he is a source of advice and counsel to many of our junior faculty.

Screen Shot 2013-05-24 at 4.07.30 PMChris Ward has quietly, effectively, deliberately reformed our teaching in basic science through his leadership of the Normal Human Function course, and dedicated participation in our Curriculum Committee.  He has also found ways to interact effectively with clinical course directors and thereby promote integration of basic and clinical science in our curriculum.

wilsonRuth Wilson has generously taken on the considerable challenge of chairing our Professional Foundations Committee.  Her steady leadership has guided and promoted the development and integration of those essential components of our curriculum. 

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Andrea Winthrop, in a short period of time back at Queen’s, has taken on and successfully engaged a number of challenging and critical portfolios, including Clerkship Director and Chair of the Course and Faculty Review Committee.  She has also been the person most responsible for developing and managing our successful exchange program with the University of Queensland.  In all these roles, Andrea brings incredible energy, commitment and an attention to detail that is both apparent and rather astounding to everyone who works with her.  Her dedication to the welfare of our students is obvious to all.

013Brent Wolfram has quietly and effectively assumed responsibility for the Family Medicine clerkship, as well as providing valuable contributions to our Course and Faculty Review and Curriculum committees.

In addition, many faculty have provided leadership as Course Directors:

Screen Shot 2013-05-27 at 9.26.05 PMMichael Adams who has energetically revised the curriculum and teaching of Fundamentals of Therapeutics, receiving important recognitions for his teaching from the students and university in the process.

Stephanie Baxter who developed our Ophthalmology curriculum, recently transferring that role to Jim Farmer

Cheryl Cline has been instrumental in developing and leading the Professional Foundations course content.

Basia Farnell has taken on leadership of our Term 2 Clinical Skills course.

Melissa Fleming leads the challenging Perioperative Medicine rotation in our Clerkship, which integrates experiences in Anaesthesia, Emergency Medicine and Surgical Subspecialties.

Keith Gregoire who has recently taken on responsibility for the Pediatrics Clerkship, building on the program developed by Richard VanWylick and Maxine Clarke.

Russell Hollins has directed and supervised Elective rotations for many years, an administratively and educationally challenging role very important to our students as they consolidate their career directions.

Robyn Houlden and David Holland have developed a very effective Renal-Endocrine curriculum in second year.

Paula James and her colleagues have developed and implemented a course in Blood and Coagulation that is consistently very highly regarded by our students.

Paul Malik coordinates and teaches many sessions of the Cardiovascular component of our Cario-Resp course.

Romy Nitsch has expanded and refined the teaching within our Reproduction and Genito-urinary course.

Chris Parker and Armita Rahmani have worked diligently with Sue Moffatt to develop and deliver the first interation of Clerkship Curriculum Courses, which was very highly rated by out students.

Lindsey Patterson directs the development and delivery of Technical Skills within our curriculum.

Stuart Reid directs our Neuroscience course which, under his leadership, has undergone considerable revision in both content and teaching methods which have resulted in a much more effective and well reviewed curriculum.

Richard Thomas directs the Obstetrics and Gynecology rotation within our Clerkship, traditionally one of our most highly rated rotations, and a discipline where our students have excelled in their Medical Council of Canada examinations.

Shayna Watson has been a very effective liaison with the Oncology group, directing the integration of that content within our “GOP” course.

I also wish to make special mention of two Educators who have been essential components of our school and our transformation process:

Screen Shot 2013-05-27 at 2.29.05 PMSheila Pinchin has been central to our curricular reform since the outset.  She now leads a highly effective educational support team (Theresa Suart, Eleni Katsoulis, Alice Rush-Rhodes, Catherine Isaacs) and remains a key member of our leadership team, providing sound and practical advice, while maintaining a critical link to our students that allows us to understand and respond to issues and concerns.

Screen Shot 2013-05-24 at 4.15.59 PMElaine VanMelle was an original member of our Curricular Review group and, in those formative days, provided sound guidance and insights as to relevant educational theory that allowed us to ensure our changes were solidly grounded.  Her work as the original chair of our Teaching and Learning Committee led to policies and practices that were instrumental in our accreditation success and continue to guide the curriculum.

Finally, our Undergraduate support staff, under the capable leadership of Jacqueline Schutt, provide highly effective and much appreciated support to our students throughout their years with us.  In recent Canadian Graduation Surveys, the students have rated our support services well above national averages.

The origin of the phrase “it takes a village to raise a child” is obscure, but appears to derive from an African proverb.  Whatever the origin, it is certainly well applied to the tremendous effort that has gone into our curricular evolution here at Queen’s.

What motivates all these people?  Certainly not simply the money or prestige, both of which are entirely inadequate to their contributions.  In all cases, the primary motivation is a remarkable dedication to our school, our students, and the very best interests of our profession.  They deserve our admiration and our gratitude.

 

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

 

 

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Why should you teach Clinical Skills?

Today’s blog article comes from Dr. Cherie Jones, MD, FRCPC,
Course Director, Clinical and Communication Skills and Ms. Kathy Bowes, RN, Clinical Skills Coordinator.

Clinical Skills training is core to any undergraduate medical curriculum. Here at Queen’s University, first and second year medical students learn “the tools of their trade” in a variety of settings and formats every week. Medical students and clinical skills tutors identify the small group teaching as the most useful and enjoyable aspect of the entire program. Furthermore, despite the significant time commitment clinical skills tutors report that the afternoon small group teaching is a highlight of their week.

“Students are so excited to be finally looking and acting like doctors with their white coats, new stethoscopes…. (they are) keen to learn the skills they associate with physicians. At this stage we can really influence the way they will interact with their patients and the type of physician they will eventually be.”

Dr. Jay Engel MD, FRCPC, Division Head of Surgical Oncology, KGH

In the pre-clerkship clinical skills curriculum, much of what is learned by students occurs in a small group setting of ten students supervised by two tutors. Once a week they meet for an afternoon and tutors guide and direct their students so that they can learn the history taking and physical exam skills that are essential to the competent practice of medicine. This year we asked tutors “Why do you teach clinical skills?”, especially since many return year after year. As most eloquently stated by Dr. Peter Froud….

“Because for many years I have felt that some of the most necessary skills for MDs are those that involve listening and questioning skills and the self-confidence needed for these skills… if I am able to impart all or most all of these skills to a group of new students every year, in my own small way I will be helping….”

Clinical skills tutors take their jobs very seriously. They feel that the role they play in providing feedback is critical for making good doctors; whether it be in the context of interacting with their students every week or during the time outside of the scheduled curriculum correcting case write-ups, reviewing reflection essays and communicating narrative feedback over the course of the term.
Additionally when tutors were asked what advice they would have for physicians interested in becoming tutors, one of our award winning tutors responded …..

“…..I seem to be more confident at it (teaching clinical skills) then I originally thought I was …. now I recognize that I possess professional expertise that not every tutor will have, and that I bring something unique and valuable.”

Clinical Skills tutors teach basic skills for future physicians. It begins with teaching students how to use shiny new stethoscopes, interact with patients, and culminates in the making of a medical student who is well equipped to enter clerkship. At Queen’s University tutors who have participated in clinical skills teaching find it rewarding, one hopes because they have come to realize that their input is critical if we are to create the next generation of competent physicians.

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Why should you teach Clinical Skills?

Today’s blog article comes from Dr. Cherie Jones, MD, FRCPC,
Course Director, Clinical and Communication Skills and Ms. Kathy Bowes, RN, Clinical Skills Coordinator.

Clinical Skills training is core to any undergraduate medical curriculum. Here at Queen’s University, first and second year medical students learn “the tools of their trade” in a variety of settings and formats every week. Medical students and clinical skills tutors identify the small group teaching as the most useful and enjoyable aspect of the entire program. Furthermore, despite the significant time commitment clinical skills tutors report that the afternoon small group teaching is a highlight of their week.

“Students are so excited to be finally looking and acting like doctors with their white coats, new stethoscopes…. (they are) keen to learn the skills they associate with physicians. At this stage we can really influence the way they will interact with their patients and the type of physician they will eventually be.”

Dr. Jay Engel MD, FRCPC, Division Head of Surgical Oncology, KGH

In the pre-clerkship clinical skills curriculum, much of what is learned by students occurs in a small group setting of ten students supervised by two tutors. Once a week they meet for an afternoon and tutors guide and direct their students so that they can learn the history taking and physical exam skills that are essential to the competent practice of medicine. This year we asked tutors “Why do you teach clinical skills?”, especially since many return year after year. As most eloquently stated by Dr. Peter Froud….

“Because for many years I have felt that some of the most necessary skills for MDs are those that involve listening and questioning skills and the self-confidence needed for these skills… if I am able to impart all or most all of these skills to a group of new students every year, in my own small way I will be helping….”

Clinical skills tutors take their jobs very seriously. They feel that the role they play in providing feedback is critical for making good doctors; whether it be in the context of interacting with their students every week or during the time outside of the scheduled curriculum correcting case write-ups, reviewing reflection essays and communicating narrative feedback over the course of the term.
Additionally when tutors were asked what advice they would have for physicians interested in becoming tutors, one of our award winning tutors responded …..

“…..I seem to be more confident at it (teaching clinical skills) then I originally thought I was …. now I recognize that I possess professional expertise that not every tutor will have, and that I bring something unique and valuable.”

Clinical Skills tutors teach basic skills for future physicians. It begins with teaching students how to use shiny new stethoscopes, interact with patients, and culminates in the making of a medical student who is well equipped to enter clerkship. At Queen’s University tutors who have participated in clinical skills teaching find it rewarding, one hopes because they have come to realize that their input is critical if we are to create the next generation of competent physicians.

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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.

Sue 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.

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Meds 2013 – Congratulations, thanks and one more story.

This week, Meds 2013 will become the 157th class to graduate from the Queen’s School of Medicine.  Despite that long history, their experience in medical school has been distinct in many ways from the 156 classes that have preceded them.  In part, that uniqueness has been due to their engagement of novel teaching methods.  Beginning with the “Pearls” session during Orientation Week (see photo below), the use of clinical and personal “stories” and reflections has been woven into their learning.  With that in mind, I offer another “story” as a parting gift to this special class.

Class of 2013

Professional sport is sometimes capable of becoming more than just games played by privileged millionaires.  On those increasingly rare occasions it becomes a metaphor, with lessons that can resonate through other aspects of our lives.

In the late 1980s, while training in Boston, I developed a fascination with basketball or, more specifically, the Boston Celtics.  The starting five of the Celtics at that time consisted of players who had all enjoyed great careers – Larry Bird, Kevin McHale, Robert Parrish, Danny Ainge and Dennis Johnson – but, by that time, they were all well past their peak, suffering from a variety of physical ailments common to the older athlete – backs, knees, shoulders.  Nonetheless, they remained a highly competitive team, largely because of their incredible savvy, guile and, most importantly, teamwork.  They were masters of the game and very familiar and comfortable with each other.  They were therefore able to consistently defeat younger, more physically talented teams.  They remained the team to beat, and were annually competing for the championship.

basketball1The best individual player at that time, by far, was Michael Jordan.  Still early in his career, Michael Jordan was like an alien dropped to earth to show the world a new way to play basketball.  He did things no one else could do, and did most of them while seemingly suspended in mid air.  He transformed basketball into a three dimensional game.  He literally, and figuratively, soared.  However his team, the Chicago Bulls, had no players who could complement his excellence.  Their main strategy was “get the ball to Michael”.  In a game where only five players compete at a time and one athlete can play almost the whole game, this approach can be quite effective if you have such a stellar player.  Indeed, Jordan dominated the regular season, finishing miles ahead of anyone else in the scoring race, leading his team to the playoffs in 1986, and a much anticipated match with the Celtics.  For basketball fans, it was a match for the ages, pitting a great team of very good veteran players against an incredibly talented star in his ascendancy.  For basketball mad Boston, it was nirvana.

The teams split the first 6 games, with the Celtics using the standard strategy against Jordan, which was to double or triple team him.  Basically, the approach was to assign one of their tallest and most skilled players to cover the 6’6” (not very tall for basketball) Jordan, moving another player or two over as soon as he got the ball, thus boxing him in laterally and vertically.  By doing so, a team could hope to hold Jordan to 20 or 25 points, which would be regarded as a highly successful defensive effort.  For Game 7 in Boston, the Celtics shocked their fans and all those watching by taking a dramatically unconventional and courageous approach.  They decided to play Jordan man-to-man and, for most of the game, Dennis Johnson was assigned the task of covering Jordan.

Dennis Jordan was a very capable guard who had a long and successful career.  He had become a key component of the Celtics team and knew his role very well.  However, he was only 6’4” and, by 1986, couldn’t jump.  Basically, he had no chance of covering Michael Jordan alone.

basketballThroughout the game, the highly knowledgeable Celtics fans watched in shocked disbelief as poor Dennis was left to do the impossible.  For a proud athlete with the entire basketball world watching, including his wife and children who were in the crowd, it would have been a humiliating experience.  Michael Jordan scored in every possible way, eventually amassing an amazing 63 points – still the record for most points in a professional post-season game.  But…the other four Celtics starters, freed from defensive responsibilities, all dominated their opponents and Boston won the game in double overtime – the most exciting and interesting basketball game I’ve ever seen.  The team of grizzled and self-sacrificing veterans had triumphed over the transcendent star, at least that night.  After the game, as players and fans swarmed the court, it was obvious that Jordan felt defeated and unfulfilled despite his incredible personal triumph.  Dennis Johnson, on the other hand, emerged as the battered hero of the game despite his personal drubbing.  He became, and has been, my favourite basketball player.  I was saddened to learn of his premature death in 2007 from apparent cardiac causes.  His Celtics teammates eulogized him as “one of the most underrated players of all time”.

So, what relevance does this story hold for the newly minted doctors of Meds 2013?  You are about to engage postgraduate training of various types.  You will, believe it or not, become highly proficient in your chosen specialties.  You will have days when you feel capable of handling any challenge – of being able to soar like Michael Jordan.  On those days, it will serve to recall the lessons of that April 1986 game, that you can lose the game despite personal triumph, and that even Michael Jordan never felt fulfilled as a player until years later when the Bulls assembled teammates capable of complementing Jordan’s talent and finally winning championships.  By all means, strive to soar, but remember that most of our triumphs as physicians come when we toil with integrity like Dennis Johnson; without fanfare, with quiet effectiveness, with very few aware of what we’ve done, with the patient’s welfare as our ultimate goal.

Meds 2013 has been a remarkable class.  An eclectic and unassuming mix of the quirky and conventional, the pragmatic and idealistic.  Gracious and accepting in the midst of massive curricular change, unfailingly supportive of their school, of their world, of each other.  You have earned the respect and affection of your faculty who will proudly follow your careers with great interest in coming years.  It has been our pleasure.

 

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

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