Harden's Blog

May 2020 - 'Magnolias and change'

In my March blog I featured camelias which symbolise understanding, patience, and collaboration, attributes much needed at this difficult time. I had hoped to spend longer in my garden while working at home but Zoom conferences have been almost non-stop. Magnolias are just coming into full bloom. Magnolias signify stability. They are thought to be one of the first flowering plants to evolve on Earth. According to the San Francisco Botanical Garden Society, fossils remain that show magnolias were around 100 million years ago. They have continued to evolve and there are now more than 200 species. For each species to survive and flourish, however, there is a need for the right conditions and environment. The same is true of the different developments we see in medical education. Each new innovation, whether it is the Flipped Classroom or Team-based Learning or Virtual Reality needs attention paid to their implementation if the benefits are to be achieved. Magnolias, interestingly, are the state flower of Mississippi, and also Korea’s national flower. The magnolia, a sweet smelling southern belle, was made famous via the iconic Edna Ferber novel and musical Showboat.

Education responses to COVID-19
Audrey Hepburn once said, “To plant a garden is to believe in tomorrow”. At this time we certainly need to look to the future. To do nothing is not an option and we can use the fulcrum of the present situation to bring about change. The response to the current challenge to medical education has been impressive. In the last three days we received more than 40 new manuscripts submitted to Medical Teacher. We are publishing an initial set of papers in the July issue and later hope to publish a series of more reflective pieces. In the meantime, MedEdPublish offers the advantage of rapid publication and there are already published a number of excellent articles describing innovative responses to the COVID-19 pandemic.

What do we expect our students to learn?
Reading the April 2020 issue of the Quarterly Journal of Medicine I was struck by the gaps in my knowledge. Articles reported conditions and clinical signs about which I was unaware – I had either never learned about them or had forgotten what I had learned. Described were the Yin-Yang sign, the Rosary sign, Roth’s spots, the Parker-Webber, the DeWinter syndrome, Morgagnian cataract, psychogenic pseudosyncopy, and phaeohyphomycosis. This started me wondering again about how we decide what it is we expect our students to learn. As noted in our book The Eight Roles of the Teacher, perhaps there are aspects of medicine about which students should be aware but not expected to understand the details.

Webinars
Trevor Gibbs has led a series of AMEE Webinars featuring aspects of the educational response to the COVID-19 pandemic. Recordings are available through the AMEE Website and will be regularly updated on the newsletter. A different subject was addressed in another webinar – the social accountability of medical schools. If you are uncertain about this I strongly recommend you listen to the webinar by Bob Woollard from 25th April, Advancing Social Accountability: the role of the ASPIRE Award and accreditation.

Avatars and a virtual conference
It was with regret that we had to postpone the AMEE 2020 Conference scheduled for Glasgow in September. Plans are now well advanced, however, for an AMEE 2020 Virtual Conference, which retains many of the attractions of the face-to-face conference while at the same time offering additional advantages. Conference participants will have their own avatars and will be able to talk with other participants. We had received more than 3000 abstracts for the Glasgow Conference and have now selected the most appropriate ones for short communications, e-posters, and other sessions in the virtual conference. I found, as always, reading the submissions, all of which having been read by three reviewers, fascinating. I look forward to hearing more, for example, about the use of the secret shopper approach for the assessment of the practicing doctor, and of how laparoscopic surgery and trauma care can be taught at home. The escape room approach is attracting a lot of attention and there were a number of papers on the subject. The best practice and short communication sessions on learning from failure will be interesting, as will the sessions on empathy and sustainability. The Surgery Track working group led by Sachdeva is planning interesting sessions through the virtual conference and believes that many surgeons who would be unable to come to the face-to-face conference in Glasgow will be able to join the Virtual Conference.

Responses to these difficult times
Chris Skinner sent to me a great video clip made by first year medical students at the University of Notre Dame, Australia, thanking the school of medicine for their efforts and support during the transition to online learning due to the COVID-19 pandemic. Well worth looking at.

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