Several symposia sessions will be held at AMEE 2018. Symposia sessions are a series of short presentations by panellists on issues that are topical, and may be controversial, to stimulate debate and discussion with the audience. 

The following symposia will be streamed live:

  • 3A - Not Your Mother’s CPD!  The Real World as we Know it! – An AMEE CPD Committee Symposium
  • 4A - Acquisition, maintenance, and verification of surgical skills
  • 5A - Educating health professionals for the e-patient
  • 7A - Mind-body interventions in Health Professions Education:  Challenges, Strategies for Implementations and Lessons Learned
  • 8A - Playing Devil’s Advocate: Research that challenges how we think about Clinical Supervision
  • 9A - Managing the Tension -- From Innovation to Application
  • 10A - Assessing Social and Behavioural Sciences in Medical Education: Square Peg in a Round Hole?

Session 3: Monday 27 August - 1015-1200

3A - Not Your Mother’s CPD! The Real World as we Know it!

Organised by the AMEE CPD Committee

  1. Lawrence Sherman, Academy for Global Interpofessional Learning and Education, Geneva, Switzerland

Summary of theme and why it is important:  CPD represents the longest and arguably the hardest part of a clinician’s education.  Hardest because it is often unstructured, and left to the learners to define their own journeys.  In some regions of the world, CPD is more formal and uniprofessionals, while in other areas it is largely incidental and unregulated.  The continuously developing field of Interprofessional continuing education (IPCE) will be a topic of focus as well.  A very interactive format will engage all participants in the session from start to finish.  The AMEE CPD will be the organizers of this session.   This symposium will challenge the status quo, explore best practices, and talk about why CPD may not even be what you think it is.

Who should participate in the symposium?  Participants should include those who are responsible for designing, developing, delivering, assessing, funding, participating in, and those with an interest in the topic.  Those with innovative ideas, opportunities for global collaboration, and those who are just curious are encouraged to attend.

What will you gain from participating?  Participants will gain a board perspective of the global differences in CPD, an opportunity to share their own best practices with colleagues from around the world, and to participate in the AMEE CPD discussion!

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3B - The rise of virtual and augmented reality in medical education: are we breaking the final frontier in teaching?

Organised by the AMEE Technology Enhanced Learning Committee

  1. Peter GM de Jong, Leiden University Medical Center, Netherlands (moderator)
  2. Marlies EJ Reinders, Leiden University Medical Center, Netherlands (speaker)
  3. Jennifer M McBride, Cleveland Clinic Lerner College of Medicine, USA (speaker)
  4. Beerend P Hierck, Leiden University Medical Center, Netherlands (speaker)
  5. Goh Poh-Sun, National University of Singapore (speaker)
  6. James D Pickering, University of Leeds, UK (speaker)
  7. Jos van der Hage, Leiden University Medical Center, Netherlands (opening discussant)

Summary of theme and why it is important:  Virtual Reality (VR) and Augmented Reality (AR) are some of the most recent digital technologies being introduced in healthcare education with a potential to fundamentally change teaching. These technologies allow either an actual, simulated or augmented view of a real-world environment to be virtually projected, and provide opportunities for students to engage in unique learning experiences. Through the use of these computer-generated images, students can be exposed to virtual patients and to modern hospital settings in a safe environment that is able to be repeated numerous times.

Currently, there is interest in the feasibility of applying these technologies in teaching medical students. Can they lead to curricula that require less training performed on patients or in stressful and chaotic high tech patient care environments? Do AR and VR help students better interact with concepts, functions or structures that are extremely difficult to visualize through traditional means, or prepare for surgical procedures that require knowledge of complex anatomical structures?  This symposium will present state-of-the-art examples of the use of VR and AR in medical education, such as a 360 degree virtual operating theatre and a hospital setting of a ward round, and the use of holographic imagery in the anatomy curriculum. Theoretical perspectives regarding the pedagogy of VR and AR will be presented, alongside the importance of real-world training, with views on the extent to which these new technologies should either supplement or replace the current teaching models.

Who should participate in the symposium?  This symposium will be beneficial to all involved in healthcare education who have an interest in virtual and augmented reality technologies, and who would like to learn more about utilising these technologies in their own teaching. It will also be of interest to those who are involved in longer-term policy-making for healthcare education programs.

What will they gain from participating?  Participants in the symposium will gain a better insight into the current state-of-the-art of VR and AR techniques, their feasibility in today’s teaching, the current obstacles for implementation, and the value and role of these technologies in the upcoming years.

3C - Equity in the global health sciences education community: levelling the playing fields?

  1. Manuel João Costa, School of Medicine, University of Minho, Portugal
  2. Susan Van Schalkwyk, Stellenbosch University, Centre for Health Professions Education (CHPE), Stellenbosch, Western Cape, South Africa
  3. Ming Jung-Ho, National Taiwan University, Graduate Institute of Medical Education & Bioethics, Taipei, Taiwan
  4. Marco Antonio Carvalho-Filho, School of Medical Sciences, University of Campinas, Brazil
  5. Lambert Schuwirth, Flinders Medical Centre, Flinders University, Australia

Summary:  The global health professions education (HPE) community is growing exponentially. This growth ought to be mirrored in concomitant changes in the way in which HPE is practiced, in particular in the context of global health education, and in the way in which it is researched.

In this symposium we explore the extent to which the expanding global community is experiencing participation in the sector, acknowledging that current literature suggests that most innovations and knowledge about health professions education originates from very few countries. Specifically we hope to provide an analysis of key bibliometrics related to HPE research with a view to providing insight into the current status quo. Thereafter we present work that has explored issues of ‘powerful knowledge’ and ‘dominant discourses’, and how these can influence the extent to which meaningful participation in a community of practice can be enabled or constrained leading to global players feeling either alienated or engaged. According to Wenger, ‘belonging’ is enabled in three ways: through engagement, imagination and alignment. Engagement in this context is seen as doing things with others within that community of practice. Imagination refers to a cognitive act of seeing oneself as a member of that community (a reconstruction of an existing identity or the construction of a new identity or identities). Alignment speaks to facilitating a synergy between the new ways of thinking and doing that a newcomer may introduce, and the more established practices within the community. Finally, we present perspectives from a newcomer researcher situated in a traditionally less participatory country and from a director of a research centre and experienced journal editor as to how they currently experience ‘the playing field’.

The symposium is important because it will

  • Encourage reflection and debate on how the health sciences education community is moving forward;
  • Examine whether the worldwide education community is: 1. taking in contributions from everyone; 2. non-intentionally privileging particular cultures (the westernization hypothesis);
  • Provide insight into how colleagues across the world are seeing, finding and overcoming barriers to participation;
  • Start a conversation about dominant discourses and practices, and how to reframe.

Who should participate in the symposium?  Delegates who:

  • Have ideas or concerns with participation/equity issues across the global health sciences education community;
  • Would like to contribute to the conversation of examining and promoting international equity in the field;
  • Participate as leaders of international programs, journals, meetings, etc…;
  • Hold responsibilities in national communities related to the field and would like to participate in a discussion about national participation in the international playing field;
  • Researchers and academics devoted to equity issues

What will they gain from participating? 

  • An understanding of asymmetries across the world
  • An awareness of perspectives from across the community
  • Insights and ideas to shift the status quo

Session 4: Monday 27 August - 1400-1530

4A - Acquisition, Maintenance, and Verification of Surgical Skills

Presenters: 

  1. Ajit K. Sachdeva, Division of Education, American College of Surgeons; Society for Academic CME; Feinberg School of Medicine, Northwestern University, Chicago, USA
  2. Teodor Grantcharov, University of Toronto, Canada
  3. Stephen Tobin,  Royal Australasian College of Surgeons, Melbourne, Australia
  4. Wa'el S Taha, King Abdulaziz Medical City, Al-Madinah, Saudi Arabia; Chairperson of AOTrauma Education Commission

Summary:  Transformational changes in health care, unprecedented advances in science and technology, and ongoing innovations in teaching, learning, and assessment require a new paradigm to address acquisition, maintenance, and verification of surgical skills.  A range of effective education and training interventions can help surgeons to perform at the highest levels of skill and fidelity throughout their professional careers.  Such interventions need to be based on contemporary principles of adult education, experiential learning, and mastery-based learning.  Simulation remains at the core of these interventions.  State-of-the-art education and training should help in delivery of safe surgical care of the highest quality.  This symposium will address the key advances in this burgeoning field and will focus on challenges and opportunities that need to be harnessed to achieve the best outcomes.  Perspectives from different countries will be presented.  There will be sufficient time for an interactive discussion with the meeting attendees, following presentations by the speakers.

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4B - Intersections, Introspections and Divergences: Sustaining the Growth of Medical Education Research and Training

Presenters:

  1. Mathieu Albert, Wilson Centre, University of Toronto, Canada
  2. Nicole Woods, Wilson Centre, University of Toronto, Canada
  3. Tina Martimianakis, Wilson Centre, University of Toronto, Canada
  4. Klara Bolander Laksov, Department of Education, University of Stockholm, Sweden
  5. Albert Scherpbier, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands

Summary: 

As a field, medical education research has made remarkable strides over the last 50 years. Our community of researchers has made impressive gains in terms of breadth and depth of scientific inquiry, legitimization of education as a science and professionalization of education research as a career pathway. This evolution has led to a significant increase in the quantity and quality of the research conducted. We can say without doubt that collectively we have become a healthy and strong research community.

These gains can in part be attributed to strong methodological and theoretical contributions from disciplines outside of the health professions including sociology, psychology, cognitive science, kinesiology, political science, humanities, and higher education among others. Collectively, these disciplines have provided theoretical foundation and inspiration for research and innovation in teaching and learning across the continuum from undergraduate to continuing medical education.

Evidence of this growth is also manifested in several organisational developments. In the last few decades there has been an increase in the number of graduate training programs specific to health professions education research, a significant rise in continuing education courses and certification programs related to education research and an increase in the number of journals devoted to publishing medical education research.

However, as the community grows in size, we may be paradoxically narrowing in scope when it comes to the kinds of research we are doing and the research we are preparing our students to do in the future. For example, when we cite predominantly medical education scholars and train future researchers who have limited understanding of the original disciplinary foundations of the work, are we inadvertently limiting the field’s capacity to grow? Does our current success contain the seeds of our decline?

The goal of this symposium is to take stock of our achievements and start a conversation about our future as an academic community.

Panellists in the symposium will address several critical questions:

  • Does interdisciplinarity necessarily foster better knowledge production within the field of health professions education?
  • Are we at risk of becoming increasingly insular; leaving less room for the disciplinary and interdisciplinary traditions that fostered the development of our community at its start? Does that matter to our growth?
  • Is the current medical education research landscape welcoming to other disciplines or have we defined standards that have the effect of excluding scholars from external disciplines?
  • What kind of training would best prepare our graduate students for their academic and professional life in the coming years?
  • At a time where the medical education community is faced with pivotal questions concerning teaching, learning, and theory, we believe it is timely to also be reflective and consider the best strategies in terms of research and training to answer these questions moving forward.

Who should participate in the symposium?  Our symposium will raise broad organisational, scientific and educational questions potentially impacting the broad medical education community. As such, we think this symposium will be of utmost interest to medical education researchers, medical school administrators (deans, department’s chairs, and research centre directors), graduates students and clinician-educators. Moreover, the symposium is international in scope since the nature of the questions we are raising are not limited to one context, but of international interest.

What will they gain from participating?  Participants will gain a broad understanding of some of the theoretical and conceptual debates in the field of medial education research.
Participants will have an opportunity to critically reflect on their own research practice and contribute to an on-going discussion on the direction of medical education research internationally.

 

4C - Open Space Technology Applied to Wicked Issues in Medical Education and Health Care Practices

Presenters:

  1.  Glenda Eoyang, Human Systems Dynamics, USA
  2. Stewart Mennin, Human Systems Dynamics, USA

Summary: 

The most important and challenging issues in the current health system that affect us both as individuals and as groups are complex.  They won’t stay solved or can’t be solved with existing traditional methods.  This symposium will make accessible a different way to perceive, understand and take informed wise action to shift patterns of complex challenges.  Participants will identify their own complex challenges and apply selected models and methods to shift the conditions that give rise to these challenges. Participants will have hands on practice in small groups during the symposium. 

Open space technology is a self-organizing experience.  Participants will join others who share passion and responsibility for innovation and change in medical education and health practices.  The technology brings people together, holds them in a generative conversation, and promotes sharing experiences and discoveries. Diverse groups will share the results of their innovation dialogues. Notes from the various conversations will be shared with participants, and collected for wider distribution. Join us as we push the bounds of innovative practice together. 

Who should participate in the symposium?  Anyone who is engaged in teaching and organizing learning, assessment, design and implementation of curriculum and health practices; especially those involved in applying and evaluating new methods and models of medical education.  The symposium is relevant for all levels of educators and practitioners in the health system.

What will they gain from participating?  Participants will learn and practice a simple yet deep methods to be able to shift the complex challenges they face in the workplace of medical education and clinical practice.  Each participant will bring their own innovative insights and questions. Join others who share the same passion and responsibility for creative responses to complex challenges. Do you want to talk about novel approaches to:

  • Assessment in the moment?
  • Community-based practice?
  • Working with diverse cultures?
  • Supporting inter-professional practice?
  • Curriculum design, implementation and evaluation?
  • Communication skills?
  • Working with immigrants?
  • Disaster response and recovery?
  • More…

4D - The role of the Biomedical Sciences in Teaching and Learning Medicine in the 21st century

Organised by IAMSE: 

  1. Aviad Haramati
  2. Peter GM de Jong
  3. Neil Osheroff
  4. Kelly M Quesnelle
  5. Dujeepa D Samarasekera
  6. Richard C Vari

Summary: In this high-tech, clinically-oriented healthcare arena in which information is readily available online, the role for teaching specific facts regarding the basic sciences is often questioned. What is the value of teaching our students foundational sciences as part of their medical training? Recent findings from the literature will be presented.

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Session 5: Monday 27 August - 1600-1730

5A - Educating health professionals for the e-patient

Presenters:

  1. Lawrence Sherman, Academy for Global Interprofessional Learning and Education, USA
  2. Ken Masters, Sultan Qaboos University, Oman
  3. Anne Herrmann-Werner, University of Tübingen, Germany
  4. Elizabeth Rankin, Canada
  5. Dave de Bronkart (ePatient Dave), Society for Participatory Medicine, USA

Summary:  The era of the Internet has fostered a new kind of patient: the e-patient. With access to the Internet, the e-patient takes patient engagement to a new level: e-patients perform a range of online activities, from simple Google searches to sophisticated searches in PubMed, accessing medical journals online, connecting with other patients through online communities, using email and telemedicine to communicate with health providers, viewing doctors’ digital footprints, and accessing electronic medical records online.

Medical practitioners who use old-style, dismissive responses (“Stop Googling”) or modern, well-meant but misguided approaches (“Use PubMed”) run the risk of causing harm or doing little good. The e-patient’s impact on the patient-doctor relationship can be devastating or productive, depending largely on how well-trained the doctor is to cope with the new environment. Medical students need to be trained in the new skill set required to deal with the complexities and potential of the e-patient. A small number of publications has addressed the issue (AMEE’s 2017 Guide to the e-patient is one of them), but a greater awareness into the subject is required.

This symposium will present the overall issues and lay out the scope of e-patient activities. It will then highlight some practical teaching examples of preparing medical students, both pre-clinical and clinical, for the e-patient. It will then present perspectives from two e-patients, in which their paths illuminate some of the concerns and issues facing e-patients. This will provide a 360 degree insight into what is required from medical schools to train future health professionals for the e-patient.

Who should participate in the symposium?  Any medical educators who wish to equip their students with the necessary tools to deal with the e-patient.

What will they gain from participating?  An understanding of the activities and underlying issues and complexities introduced by the e-patient, and some insight into how to best prepare their students to work successfully with the e-patient.

5a--educating-health-professionals-for-the-epatient

5B - How to implement IPE in medical curricula?

Presenters:

  1. Elisabeth Van Gessel, University of Geneva, Switzerland
  2. Petra Mèche, School of Health Sciences of Geneva, HES-SO, Switzerland
  3. David Gachoud, University of Lausanne, Switzerland
  4. Giatgen Spinas, Swiss Institute for Medical postgraduate and continuous Education, Switzerland
  5. Jörg Goldhahn, Swiss Institute of Technology, Zürich, Switzerland
  6. Christian Schirlo, Head of the Deanery, University of Zürich, Faculty of Medicine, Switzerland

Summary:  By the end of undergraduate training, medical students should be able to demonstrate appropriate collaborative competencies to work effectively in clinical environments. This expectation can be found in most, if not all, competency-based frameworks developed for doctors-in-training. In these circumstances, medical schools around the world should consider the integration of interprofessional education (IPE) in their curricula, since IPE can effectively prepare learners for the demands of collaborative practice. This symposium aims to examine key issues relating to how IPE can be implemented in medical curricula. To set the scene, a synthesis of the state of the research evidence about IPE implementation will be presented.  IPE case studies in the form of an example of the implementation of IPE in an existing (packed) curriculum, and the implementation of IPE in a new medical curriculum will be presented. The last part will engage the audience in discussion of IPE implementation issues.

Who should participate in the symposium?  Educators in the health professions interested in either implementing IPE in their curricula or setting up new IPE initiatives in their institutions.

What will they gain from participating?  Participants will access the current research evidence about IPE implementation in health professions’ curricula. Then, they will be presented with typical examples of IPE implementation.

 

5C - Simulation Education In and Across the Health Professions: It’s More than Just Doctors and Nurses!

Organised by the AMEE Simulation Committee:

  1. Gabriel Reedy
  2. Nancy McNaughton
  3. Walter Eppich
  4. Barry Quinn, King’s College London, UK
  5. Sean Cross, South London and The Maudsley NHS Foundation Trust, UK
  6. Maria Tassone, The Michener Institute of Education at UHN, Canada
  7. John Tegzes, Western University of Health Sciences, USA

Summary:  Healthcare simulation has emerged as a powerful educational strategy, but educators often lack the expertise and perspective to maximize its potential for training and developing health professionals. Simulation represents an interactive and experiential approach that provides learners an opportunity to practice in ways that mirror their clinical work. Although simulation is often associated with acute medicine and operating theatre practice, the scope of simulation-based education continues to expand. The AMEE Simulation Committee proposes a symposium with two important dimensions.  First, we will bring together perspectives not often associated with simulation-based education: mental health, allied health, dentistry, and veterinary medicine. Second, simulation fosters an approach uniquely suited to drawing together teams across professional boundaries to learn collaboratively, reflecting actual clinical practice. We will explore the value of simulation in these diverse clinical settings so educators can promote inter-professional learning.

Who should participate in the symposium?  This symposium is appropriate for educators who are interested in simulation as an inter-professional educational approach, and have some experience with simulation-based education.

What will they gain from participating?                    

  1. Knowledge of a diversity of simulation applications across health professions and disciplines
  2. Appreciation for the variety of opportunities for simulation-based educational design across a range of disciplines and professions
  3. Insights from different professional and paraprofessional backgrounds the best practice techniques for learning and practicing collaboratively.

Session 7: Tuesday 28 August - 1015-1200

7A - Mind-body interventions in Health Professions Education: Challenges, Strategies for Implementations and Lessons Learned

Presenters:

  1. Raphael Bonvin, Switzerland
  2. Sian Cotton, University of Cincinnati, USA
  3. Craig Hassed, Monash University, Australia
  4. Miek Jong, Louis Bolk Institute, Netherlands and Mats Jong, Mid-Sweden University, Sweden
  5. Aviad Haramati, Georgetown University, USA
  6. Hedy Wald, Brown University; Boston Children’s Hospital-Harvard Medical School, USA

Summary:  Reports from many countries suggest that burnout and other mental health issues among physicians and other health professionals is a pervasive problem and a cause for concern.  More than half of all physicians in practice in the US, and students and residents in training in the US and Canada, experience burnout, and this can lead to changes in the patient-practitioner relationship and can adversely impact quality of care.  Data suggests that this process begins with the decline in empathy and rise in cynicism seen during medical school and post-graduate training. In response, there is increased interest among faculty, administrators and policy makers to develop individual and organizational interventions with medical students, residents and faculty and provide them with tools to address the rise in chronic stress and burnout and suboptimal resiliency.  Keys to this work are themes of self-awareness and mindfulness and exploring domains of self-care and finding meaning and purpose in one’s work.  The ultimate goal is to create a culture of well-being within institutions and foster an environment more conducive to optimal learning.

Goal of Symposium: In this proposed symposium, speakers from various countries (Australia, Netherlands, Sweden, Switzerland and the US) who have implemented mind-body programs will share perspectives on the challenges they faced, the strategies they used to implement the program into the curriculum, the outcomes they obtained, and lessons learned. The symposium will include short (10) minute presentations, enabling at least a 30-minute discussion with audience participants.  Discussant Dr. Hedy Wald will provide comments (about 6-8 minutes) on the presentations and tie the lessons to messages of her Plenary (which ideally precedes this symposium) as a springboard to engage audience participation which will follow.

Who should participate in the symposium?  This symposium would interest any faculty, student or administrator who is interested in implementing curricular interventions (especially mind-body programs) to reduce stress and foster resilience and well-being.

What will they gain from participating?  Learning Objectives:  By the end of the session, participants will be able to:

  1. Describe the rationale for mind-body programs in health professions education as well as challenges and barriers to implementation of a mind-body medicine program into the curriculum
  2. Understand the strategies that facilitated the successful curricular implementation of mind body medicine programs
  3. Delineate some of the outcomes that programs have reported in their students and faculty and benefit from the lessons learned
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7B - Faculty Development for Organizational Change

Organised by AMEE Faculty Development Committee:

  1. Yvonne Steinert, Centre for Medical Education, Faculty of Medicine, McGill University, Canada
  2. Miriam Boillat, Centre for Medical Education, Faculty of Medicine, McGill University, Canada

Summary:  Faculty development programs and activities in the health professions have traditionally focused on individual growth and renewal.  However, although individual change may result in organizational change, faculty development can also play a direct role in promoting organizational growth and development.  The goal of this symposium is to review and discuss how faculty development can function as an instrument of organizational change by exploring a variety of strategies and approaches that can help to achieve this goal.  Participants will also be challenged to think about the contexts in which they work and how they can focus directly on their organizations as the “client” in faculty development.

7C - Lessons Learned: progressing knowledge by intelligently considering failures

Presenters: 

  1. Jennifer Cleland, University of Aberdeen, UK
  2. Lara Varpio, Uniformed Services University of the Health Sciences, USA
  3. Erik Driessen, Maastricht University, The Netherlands
  4. Tim Wilkinson, University of Otago, New Zealand

Summary: We’ve all tried things that didn’t work. We’ve enthusiastically introduced a flipped classroom format that the learners didn’t flip over. We’ve carefully crafted research projects only to realize that the hypothesis or research question was inadequate. We’ve implemented new assessment strategies that generated lots of data, but left us with little insight into student performance. We’ve all been there.

However, negative findings are rarely reported in academic journals and there appears to be an implicit rule in medical education that one does not admit “failure”. Yet it is often our less successful ventures that lead to in-depth understanding of a phenomenon and/or a way forward.  Indeed, sometimes our mistakes are more informative than our successes.

In this symposium we will share stories of mistakes and surprises from across medical education and training contexts, to illustrate how these underpinned learning and progress.  We will use interactive presentation software to engage with the audience, to elicit and explore common surprises, failures and experiences.  We will discuss our findings in relation to the dominant culture and discourses within medical education and training, and provide guidance on ways for individuals and teams to reposition “failure” as constructive learning.

Who should participate in the symposium?  This symposium will be of interest to those involved in designing, delivering and evaluating teaching, and educational innovations.

What will they gain from participating?  Participants will see respected academics and global leaders from the AMEE Research Committee admit mistakes.  This positive role modelling will be used within the session to encourage audience engagement.  However, our ultimate aim is to help individuals and teams work more openly, to reflect on and accept that there is often a lot to be learned when things don’t go to plan. We will provide guidance for organisational change and faculty development to help achieve this goal. 

7D - Diagnostic error: from clinical reasoning to patient outcome

Organised by Global Alliance for Medical Education:

  1. Mark Graber, Society to Improve Diagnosis in Medicine, USA
  2. Marie-Claude Audetat, Medical Education Research Group, University of Geneva, Switzerland
  3. Hardeep Singh, Center for Innovations in Quality, Effectiveness and Safety, VA Medical Center and Department of Medicine, Section of Health Services Research, Baylor College of Medicine, USA
  4. Laura Zwaan, Institute for Medical Education Research, Erasmus Medical Center Rotterdam, The Netherlands 
  5. Wolf Hautz, Department of Emergency Medicine, Inselspital University Hospital, Berne, Switzerland

Summary:  Most people will experience a diagnostic error in their lifetime, sometimes with devastating consequences. This is the conclusion from a recent report from the National Academy of Sciences in the US. This shows the impact of diagnostic error on society.

Diagnostic errors are a complex error type, for example because diagnostic errors often do not result from a single source but from the interaction of physicians, their patients and the context. The field of medical education has in the past extensively explored the cognitive sources of error within a single physicians mind, while the patient safety movement was heavily investigating enabling factors in the health care system. Meanwhile, clinical medicine has identified several diseases, chief complaints and groups of patients likely to be misdiagnosed.

However, these lines of inquiry have remained somewhat isolated from each other and strategies to introduce diagnostic error, error prevention and error communication at all levels of medical education remain the exception rather than the norm.

The symposium brings together researchers from diverse backgrounds, all with a unique perspective on the multiple facets of diagnostic error, in an attempt to broaden the debate on clinical reasoning and diagnostic error within medical education and to ultimately strengthen the quality of our and our learners diagnoses.

Who should participate in the symposium?  Everyone with an interest in clinical reasoning, the teaching and assessment of the diagnostic process as well as colleagues with an interest in patient safety. 

What will they gain from participating?  We will provide participants with different perspectives on diagnostic error through an interactive discussion. Participants will learn how diagnostic error and the diagnostic process are conceptualized in different fields such as medical education, human factors research and automated diagnostic decision support among others. The symposium is specifically intended to widen the perspective on diagnostic error from a focus on clinical reasoning to a more holistic perspective.
Furthermore, participants will be introduced to the development of a consensus curriculum on diagnostic error for health professionals at the postgraduate level, an initiative currently underway in the United States.
 

 

Session 8: Tuesday 29 August - 1400-1530

8A - Playing Devil’s Advocate: Research that challenges how we think about Clinical Supervision

Presenters:

  1. Lorelei Lingard, Western University, Canada
  2. Chris Watling, Western University, Canada
  3. Mark Goldszmidt, Western University, Canada
  4. James Brown, Eastern Victoria GP Training & Monash University, Australia
  5. Tavis Apramian, Western University, Canada
  6. Olle ten Cate, Utrecht University, Netherlands

Summary:  Clinical supervision is widely recognized as a linchpin of work-based medical education. However, the last systematic review of clinical supervision concluded, almost two decades ago, that supervisory practice in medicine has very little empirical or theoretical basis, and the authors called for more robust empirical research into supervision in practice settings (Kilminster & Jolly, Med Educ. 2000 Oct;34(10):827-40). The 2007 AMEE Guide ( Kilminster et al, Med Teach. 2007 Feb;29(1):2-19) offered a framework for clinical supervision, but acknowledged that much remained unknown including the influence of context, the variability of supervisory relationships, the implications of teams, the role of judgment, and the practice of observation. This symposium asks: a decade after the AMEE Guide, what are the big new insights and ideas about clinical supervision from empirical research?

This symposium will present highlights from research into clinical supervision in the past decade, and discuss their implications for medical education. Speakers have been selected to represent research into clinical supervision in a range of medical contexts (e.g., internal medicine, general practice, surgery), supervisory situations (e.g., inpatient teaching team, ambulatory clinic, operating room) and learner levels (e.g., medical students, residents, fellows); their work also represents a range of theoretical perspectives.  Using a TEDTalk style of presentation, each speaker will offer ONE BIG IDEA from their empirical research that elaborates or challenges our current way of thinking about clinical supervision:

  1. What we see is not real: the impossibility of authentic observation (Chris Watling)
  2. What we struggle with is not ‘students these days’, but ‘systems these days’ (Mark Goldszmidt)
  3. What we assess is not independent: the challenge of coupled performance (Lorelei Lingard)
  4. What we judge as ‘competent’ is a reflection of individual supervisor preferences (Tavis Apramian)
  5. How we supervise compromises, rather than supports, trainee identity formation (James Brown)
  6. Discussant to play devil’s advocate, asking the implications of these BIG IDEAS (Olle ten Cate)

Each presenter will draw out ONE BIG IMPLICATION of their idea for current concerns in medical education, such as competency-based training, entrustment, coaching, and performance assessment. The discussant’s role is both to try to apply these ideas but also  to play devil’s advocate, challenging the speakers to explain how their idea helps us understand (or completely rethink) a common clinical supervision scenario. We intend to use at least one clinical supervision scenario on video to engage the audience and apply the ‘BIG IDEAs’ to it, to get into dynamic debate with the audience about both the affordances and the drawbacks of these research insights for our approach to clinical supervision.

Who should participate in the symposium?  This symposium will be of interest to clinical teachers, medical learners, educational leaders and researchers studying clinical teaching and learning.

What will they gain from participating?  Participants will participate in a provocative discussion intended to challenge our assumptions and advance our understanding of a fundamental practice in medical education: clinical supervision. They will take away knowledge from new research regarding clinical supervision, and be able to critically reflect on how these ‘big ideas’ might cast their own clinical supervisory practices in new light. They will also come away with a sense of what remains to be explored regarding the nature and implications of clinical supervision in medical education.

 

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8B - Developing consensus-based guidelines and education for Emergency Medical Teams for limb injuries in disasters and conflicts

Presenters:

  1. Ian Norton, WHO
  2. Elhanan Bar-On, Sheba Medical Center
  3. Jane Wiedler, AOEI
  4. Stefanie Hautz, AOEI
  5. Harald Veen, WHO

Summary:  Project Goal - What:  The main goal of this project was to improve outcomes for patients suffering limb injuries during disasters and complex emergencies. To ensure this, we provide the first open access training material platform for Emergency Medical Teams (EMT) to train EMT´s for limb injuries in disaster situations. All material is based on a competency-based curriculum. On this platform, EMT´s cannot only find a downloadable specific field guide, but also topic-related learning videos, and a collection of available resources.

Outline - Why: As medical science improves and trauma rates decrease in high-income countries, well-intentioned surgical teams can find themselves unprepared for the realities of austere settings.  To develop a limb surgery educational curriculum for global medical disaster responders' support and endorsement was granted by the AO Foundation, Switzerland.  The project is run in collaboration with the AO Foundation, the Sheba Medical Center and the WHO, with input from other partners and representatives of humanitarian response agencies, academic institutions, and surgical experts from low and middle-income countries (LIMC).

Process - How: To realize this project, an expert meeting with 30 international participants was held in December 2015 in Davos, Switzerland. Also,  a core group consisting of surgeons as well as Sheba Medical Center, WHO, and AOEI staff from different backgrounds and different parts of the world was created to work constantly on content, look and feel of the physical field guide and the contents of the Website. After a period of one year, the constant iterations resulted in the launch of the first consented field guide on this topic on December 16, 2016. Based on the topics defined during the consensus meetings, educationalists, surgeons and other disciplines drafted and developed a competency-based curriculum for disaster limb injuries to go with the filed guide.The possibility to present such a product is due to the effort of many international world experts, working as volunteers together with the Sheba Medical Center, WHO and AOEI.

Symposium Topics: This symposium will present key lessons learned, demonstrate examples of the newly defined content adapted to the austere environment, and promote the exchange of opinion between panelists and participants.

  1. Good intentions are not enough: why responding to disaster and conflict situations demands specific training.
  2. Capturing best practice in an "evidence-free zone": building consensus among disaster and conflict opinion leaders to update guidance on the management of limb injuries in disasters and conflicts.
  3. Developing EMT training materials that are up-to-date, accessible and attractive to the new generation of responders, especially national EMTs in disaster-prone countries.

Who should participate in the symposium?  Whoever is interested in the methodology of a consensus process of large bodies and across countries and/or with an interest in developing shared results such as guidelines or even curricula.

What will they gain from participating?   Participants will learn more about how the process of how a consensus can be reached on a topic affecting all parts of the world, various interests and opinions.

8C - Stimulating medical education and medical education research: the dean’s perspective

Presenters:

  1. Norman Beauchamp (Michigan State University, East-Lansing (MI), USA)
  2. Richard Hays (University of Tasmania, Australia)
  3. Vishna Devi Nadarajah (International Medical University, Kuala Lumpur, Malaysia)
  4. Albert Scherpbier (Maastricht University, Maastricht, the Netherlands)
  5. Monica van de Ridder (Michigan State University, Grand Rapids (MI), USA)

Summary:  Over time, the tasks of Deans have changed and have become more complex. (1) Deans do not only deal with educational challenges, such as curriculum management, interprofessional education and funding the educational mission, they also deal with challenges related to clinical care (e.g. health care reform, programmatic development), administration (e.g. space management, strategic planning, financial operations), and research (incentivizing research, funding new research initiatives). (2) The working environment is complex: research, clinical care and education have often-competing missions. (1)  Many faculty in medical schools don’t feel acknowledged. They are of the idea that the Dean’s office does not know how hard they are working; they feel invisible and not listened to. Furthermore, they feel the attention mostly goes to departments that bring in high amounts of research money, which is not so much the case in medical education.  The many developments taking place in medical education which require greater collaboration and the engagement of a wider arrange of stakeholders including students, might have led to a gap between perception and understanding between deans and staff.  The goal of this symposium is to explore and discuss with the audience and the panel a) the gap in perception and understanding between deans and faculty, and b) solutions and best practices how medical education and medical education research can be stimulated and made more visible. The topics for discussion will be derived from a questionnaire sent out to the audience prior to the conference.
1. Rich EC, Magrane D, Kirch DG. Qualities of the medical school dean: insights from the literature. Academic medicine : journal of the Association of American Medical Colleges. 2008;83(5):483-7.  2. Buckley PF. The medical school dean: leadership and workforce development. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2014;38(1):82-5.

Who should participate in the symposium?  Both the leadership (associate deans, department chairs), and faculty, staff and students who are interested in how to make medical education and medical education research more visible in medical schools.  To match the international audience of AMEE, the deans invited to participate on the panel are from Asia, Australia, Europe and Northern-America.

What will they gain from participating?  After a short introduction of the topic and the outcomes of the questionnaire (10’), the deans will give a seven-minute introduction about themselves, their medical school, and a best practice of how they stimulate medical education and medical education research (30’). This will be followed by a discussion with the audience and panel (40’). The best practices to stimulate medical education and medical education research will be summarized at the end of the meeting (10’).  The outcomes of the discussion should be:

  1. A better understanding of the gap between deans and medical school faculty and staff;
  2. Examples of best practices provided by the deans, that can be used in other medical schools.

Session 9: Tuesday 28 August - 1600-1730

9A - Managing the Tension -- From Innovation to Application

Organiser:  Ara Tekian, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA

Presenters:

  1. Ronald Harden, Dundee, UK
  2. David Cook, Mayo Clinic, Rochester, USA
  3. John Norcini, FAIMER, Philadelphia, USA
  4. Dan Hunt, LCME/AAMC, USA
  5. Yvonne Steinert, McGill University, Montreal, Canada

Summary:  The demand for better teaching and assessment of health care professionals has led to a number of educational innovations which provide detailed guidance on improving practice. Recent decades have seen the rise of competency-based medical education, milestones, entrustable professional activities, team-based learning, and so on. However, these innovations have come at a price. Resources are not available to accomplish all that is recommended, nor does the research offer much insight into the absolute effectiveness of the various options facing educators.  The symposium will describe some of these tensions as they relate to curriculum, instruction, assessment, evaluation, and faculty development. Strategies for balancing these innovations against one another and in the context of constrained resources will be discussed.

Who should participate in the symposium?  This symposium might interest all the participants of the AMEE meeting, since every educator from any profession or specialty faces some problems in adjusting the magnification and attention to details of innovations in curriculum, instruction, assessment, and evaluation.  This will be of interest for people working both at the undergraduate and postgraduate levels.

What will they gain from participating?  The participants will have first-hand opportunity to hear from experts how they are dealing with tensions created by innovations in curriculum, instruction, assessment and evaluation when research does not offer much insight into the absolute effectiveness and resources might not be available.  Additionally, they will know about some strategies to balance these innovations against one another.

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9B - Learners as Educators - Realizing Potential, Sharing Best Practices

Organised by the AMEE Postgraduate Committee

Presenters:

  1. Rille Pihlak, European Junior Doctors, University of Manchester, UK
  2. Matthew J. Stull, MD, Case Western Reserve University School of Medicine, USA
  3. Simon Gregory, Health Education England, UK

Summary:  Docere, the latin word from which our professional name is derived, quite literally means to teach. Physicians are expected to teach each day, from their clinical practice to the trainee in the classroom. While this expectation tends to be ubiquitous it is rare that educator skills taught throughout the formal medical education continuum. This symposium will review the opportunities and challenges in building teacher training into postgraduate training and other ways to support young educator development around the world.

The session will introduce attendees to the need for such programs and outline initiatives from a number of continents to better incorporate this important skill set into training. Following a discussion of the “why and how,” the major challenges of such programs will be discussed in a plenary (discussant) format by presenters.  Challenges discussed will include the the motivation underlying both deans and trainees interest in building such programs, sustainability efforts of trainee-driven efforts, where these lessons can fit into already crowded curricula, and what the most meaningful outcomes of such programs should be. Finally, the session aims to show how these programs can stimulate postgraduate medical education and research and what the postgraduate community around the globe could do to develop the next generation of clinician educators.

Who should participate in the symposium?  Trainees of all levels, supervisors, programme heads, policy makers, stakeholders and all AMEE delegates interested in this topic and postgraduate education and training in general.

What will they gain from participating?  For learners stimulation to develop as educators and empowerment to do so whilst in training.  For learners and educators examples of good practice to support transfer of learning from “teacher programs” globally, with discussion of challenges, solutions and opportunities.  All participants are invited to share their personal perspectives and challenges on this topic to learn from each other.

9C - Are medical schools selecting students with the appropriate values for 21st century medicine?


Panel :

  1. Katrina Dima (IFMSA)
  2. Professor Harm Peters (Germany)
  3. Professor Sharon Peters (Canada)
  4. Professor Trudie Roberts  (UK)

Chairs:  Professor Val Wass and Professor Peter Dieter
 
Summary:  Trudie Roberts raised the question at the 2017 AMSE/AMEE symposium of whether doctors will exist in the future? - Almost certainly they will. But future doctors may well need a different skills mix. We face increasing challenges through globalisation, shifts in population needs, social determinants and health inequity. Arguably the current medical workforce is failing to meet these. Other health workers and robotic technology development may increasingly subsume current responsibilities.

This symposium will explore this question from an international perspective. The views of European medical schools will be aligned with the increasingly international participant input offered by AMEE. Why are we currently focused on academic success as an entry criterion for medicine? Has this resulted in the current mismatch between medical school output and the deficit in specialties such as family medicine, psychiatry, emergency medicine? Can we foresee the future challenges doctors will need to address? If individuals with a different, more resilient and flexible skills mix were selected might we avoid the current burn out experienced by some of the clinical workforce?
A panel will be selected to offer a full international stakeholder perspective to support audience debate and identify whether these questions are valid and how they might be addressed.

Who should participate in the symposium? The symposium will be designed to maximise audience discussion fully embracing the international perspective. Each speaker will be limited to 10 minutes offering 30-40 minutes of discussion. This will be chaired by Trudie Roberts (AMEE) and an AMSE executive.

The audience (and Panel) will share views to reach a consensus of whether selection into medical schools should change from the current focus on academic ability and examination performance to embrace a different skills mix. The symposium will offer debate and conclude on what this should be.

Session 10: Wednesday 29 August - 0830-1015

10A - Assessing Social and Behavioural Sciences in Medical Education: Square Peg in a Round Hole

Presenters:

  1. Dr Jeni Harden (chair)
  2. Dr Tracey Collett (Plymouth University, UK)
  3. Dr Dan Hunt (AAMC, USA)
  4. Dr Ellie Hothershall (University of Dundee, UK)
  5. Dr Kathy Kendall (University of Southhampton, UK)
  6. Dr Hiroshi Nishigori (Kyoto University, Japan)
  7. Prof Madalena Patricio ( University of Lisbon, Portugal)

Summary:   Attention has turned in recent years to the broader inclusion of social and behavioural sciences (SBS) in medical curricula. However, there is as yet only limited evidence about how best to assess these subjects. This is very pertinent given that SBS questions have recently been included in the MCAT exam in the USA (in MCQ format) and are likely also to be included in the proposed UK Medical Licensing Assessment. This symposium will discuss key issues including: whether and how SBS is included in assessment blueprinting; what is being assessed (knowledge, skills, competencies); and whether, and on what basis, tools used for assessing SBS are considered to be ‘fit for purpose’. We will hear from speakers representing a range of educational contexts. Each speaker will identify a key challenge which we will then open for discussion among the panel. Those attending the symposium will be invited to participate with questions and comments in the traditional manner and via Padlet (an online collaborative space). Although focussed on SBS, the symposium is of wider relevance to medical educators interested in assessment.

Format:  Short presentations by a maximum of 4 speakers followed by a discussion of the key challenges identified. The panel (speakers and a discussant) will respond to questions and comments from the symposium participants. We would prefer to make this interactive so we plan to encourage discussion via Padlet, the online collaborative wall which participants can access during and after the session. 

Who should participate in the symposium?  The primary group attending this session is likely to be those with an interest in SBS. We have demonstrated in our AMEE sessions (workshops and a symposium) over the last three years that there is a strong interest in this area. However, this session will also appeal to those with interests in assessment more generally including those with interests in other areas that are often regarded as more challenging to assess such as humanities and professionalism.

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10B - Undergraduate National Medical Licensing Exams from an international perspective: lessons learned and future directions

Presenters:

1.      Sören Huwendiek, Institute of Medical Education, Bern, Switzerland (Moderation)
2.      Raphael Bonvin, Medical Education Unit, Fribourg, Switzerland (Overview National Licensing approaches)
3.      Brian Clauser, National Board of Medical Examiners, Philadelphia, USA (American perspective)
4.      Ingrid de Vries, Medical Council of Canada, Ottawa, Canada (Canadian perspective)
5.      Mi Kyoung Yim, Korea Health Personnel Licensing Examination Institute, Seoul, Korea (Korean perspective)
6.      Marc Braun, conseil scientifique du CNCI, Nancy, France (French perspective)

Summary:  A national licensing exam (NLE) represents a very special type of high stakes exam. It is typically a large-scale “one shot” exam that assesses several years of training. The licensing role of those exams require them to be highly defensible. With all these constrains, NLEs can assess certain competencies and use specific methods. This symposium will offer an insight into the assessed competencies and the assessment methods used from the perspective of four countries running such exams (Canada, USA, France and Switzerland) and discuss the lessons learned and future directions among the presenters and with the audience. As deeper insights in these important issues concerning NLEs are usually not easily accessible we decided to establish this symposium.

Who should participate in the symposium?  All who are interested in high stakes assessment and want to get more insights on the lessons learned and future directions drawn from NLEs.

What will they gain from participating?  Participants will get an insight into the National Licensing Exams of four countries. In particular, they will learn about following aspects:

  1. Main experiences and lessons learned from countries with established NLEs concerning the competencies assessed and methodological approaches used.
  2. Visions and future directions for NLEs from an international perspective.

Further, participants will be invited to reflect on how to transfer these reflections to the exams they are involved with.

10C - Glocalisation of Medical Education and the Teacher’s Role

Presenters:

  1. Dujeepa Samarasekera, National University of Singapore, Singapore
  2. Lambert Schuwirth, Flinders University, Australia
  3. Lee Shuh Shing, National University of Singapore, Singapore
  4. Matthew Gwee Choon Eng, National University of Singapore, Singapore
  5. Yvonne Steinert, McGill University, Canada

Summary:  Educational discourse in recent years has increasingly centred on the ‘twenty-first century skills’ that aim to prepare students to meet the challenges and demands of the society.  There is also a trend in adopting and adapting curricula, teaching-learning methods /materials and assessment formats conceptualised and operationalised in different countries/settings to one's own. Most times, educational philosophies, cultural and contextual issues have been ignored when operationalising these educational activities. This has led to ground level challenges where the teachers and students have been struggling to cope. Consequently, many misconceptions have colored the actual discourse leading to conflict and negative impact to international collaboration in medical/health professions education. However, Clifford (1988, p. 76) mentioned that “We come to understand our own culture by trying to understand others”. In this symposium, instead of highlighting the differences between cultures and educational philosophies, we would like to discuss some of the best practices in incorporating and contextualising such educational activities with different philosophies in order for the medical/health professionals to acquire skills required for the 21st century.  Clifford, J. (1988). The Predicament of Culture: Twentieth Century Ethnography,Literature, and Art. Cambridge, Massachusetts: Harvard University Press.

Who should participate in the symposium?   The symposium is suitable for teachers, academic heads, curricular leads of undergraduate and post graduate medical education, program directors and mentors of health professionals.

What will they gain from participating?  After attending this workshop, participants will gain understanding of:

  1. glocalisation in different settings or context
  2. contextualisation of different educational activities adopted or/and adapted in different countries
  3. roles of teaches in incorporating cultures and educational philosophies in adopting or/and adapting different educational activities.

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