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Harden's Blog > Harden's Blog - '2021'

May 2021 - Getting the endings right

In his latest blog Professor Harden discusses Getting the endings right, Escape Rooms - an educational tool, Taking responsibility for equity, and more.

In the ESME course, in the session on lectures, I emphasise the two most important parts of the lecture – the first and the last minute.

In a paper in Educational Leadership, April 2021, p80, Matthew Kay writes about a psychological theory and “getting the endings right”. He refers to the experiment described in Daniel Kahnemans’ book, Thinking Fast and Slow. The participants were asked to dip their hands into 14 degrees water which, according to the book, is painfully cold but not intolerable. They then had to hold their hands under for 60 seconds before receiving a warm towel. Seven minutes later, the experience was repeated – but this time the experimenter waited an additional 30 seconds before telling the subject to remove their hand. During this additional time he secretly turned a valve that let in a splash of warm water. Not a lot, just enough to increase the water temperature by one degree, which is just enough for the subject to detect the change, but crucially it still hurt. So in the second task the pain was lessened but prolonged.

Seven minutes later the participants were asked which of the two experiences they would most want to repeat. Incredibly, 80% of the participants chose the long version, even although it meant longer discomfort. Kahneman uses this experiment to support his “Peak/End” rule, which basically states that what we will most likely remember from an experience is its “emotional peak” and how it ends. There is a message here for education.

Escape Rooms, an educational tool
Escape rooms are attracting increasing attention as an educational tool as indicated by papers submitted to Medical Teacher and for the AMEE Annual Conference.

AMEE is very excited to be part of a project co-funded by the Erasmus+ programme that explores the potential role of Escape Rooms in healthcare curricula, bringing innovation to multi-professional education ( https://escape4health.eu ).

Escape rooms are settings where teams of participants solve puzzles and riddles in a closed space with a particular theme to achieve predetermined goals, in a limited amount of time. Like serious-game-based approaches, they put the focus on interactional dynamics outside of the work context with its grown interaction patterns. This provides valuable insights on how teams work together.

Trudie Roberts and Trevor Gibbs give further details of the initiative in the AMEE newsletter.

I find interesting the television programme, Dragon’s Den. entrepreneurs pitch for financial support in return for a financial stakeholding. This week one of the successful pitches was for an online escape room.

Taking responsibility for equity
Not everything that is faced can be changed: but nothing can be changed until it is faced”, this is a quote from an essay by James Baldwin, published in the New York Times Book Review, 14th January 1962. The quote is used as the basis for a theme of racism and equity in the March 2020 issue of ASCD’s Educational Leadership Journal. Racial equity, it is suggested, must be explicitly integrated into the education programme. Effective equity work, however, often creates a feeling of disequilibrium in schools because it threatens long-held systems and beliefs. Jamila Dugan (p35) writes “Equity isn’t a destination, but an unwavering commitment to a journey”.

Scholarship
The scholarship of teaching and learning is on today’s agenda in medical education. Jennifer Cleland led an AMEE Working Group which produced an excellent AMEE Guide (Guide 142) on the topic. The subject will be discussed at a joint AMEE-ANZHPE workshop at AMEE 2021. Following this it is intended that a policy statement on the subject will be made available.

Cleland, J., Jamieson, S., Kusurkar, R.A. et al. 2021. Redefining scholarship for health professions education: AMEE Guide No. 142. Med Teach. Epub ahead of print. https://www.tandfonline.com/doi/full/10.1080/0142159X.2021.1900555

Metric fixation
I am continually reminded of the problems associated with metric fixation, as described by Jerry Muller in his plenary presentation at AMEE 2020. He has highlighted his key messages in a paper “The Perils of Metric Fixation” in the June 2021 issue of Medical Teacher. This is available here.

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