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Harden's Blog

September 2020 - 'Effect exams have on students'


In his latest blog Professor Harden discusses the effect examinations have on students' behaviour, the benefits of more immersive training for medical students, and more

Examinations change the student’s behaviour
A good assessment as highlighted in the Ottawa Consensus Statement by Norcini et al (2018) has a positive impact on the student’s approach to learning.

In Switzerland the national examination when the emphasis was on MCQs was found to encourage students to prepare themselves for the examination in a theoretical manner (Huwendiek et al 2020). When a clinical skills element was introduced students were more engaged in practical and communication skills.

The UK recently introduced national licensing examination promoted by the GMC, unfortunately the centrally set examination is in an MCQ format.

MacDougal et al (2020) noted “the contrast between the planned launch of a UK national licensing exam and the class of 2020 with many students graduating with a much reduced and changed examination diet and a reliance on in-course assessments”. In an earlier article MacDougal (2010) had pointed out “weighing a pig doesn’t make it heavier”.

Norcini, J., et al. 2018. 2018 Consensus framework for good assessment. Med Teach. 40(11). 1102-1109. www.tandfonline.com/doi/full/10.1080/0142159X.2018.1500016

Huwendiek, S., et al. 2020. The introduction of a standardised national licensing exam as a driver of change in medical education: A qualitative study from Switzerland. Med Teach. Epub ahead of print. https://www.tandfonline.com/doi/full/10.1080/0142159X.2020.1798911

MacDougall, C., et al. 2020. The impact of COVID-19 on Medical education and Medical Students. How and when can they return to placements? MedEdPublish. 9(1). https://www.mededpublish.org/manuscripts/3207

MacDougall, C.F. 2010. “Evaluation – the educational context”. Archives of Disease in Childhood-Education and Practice Edition. 95(1). 28-32. https://doi.org/10.1136/adc.2008.142240

More immersive training for medical students
There is an increase in student engagement in medical education. I was interested to read Alexander et al’s (2020) perceptions of the COVID-19 pandemic as students and the lessons to be learned for medical education. In their article All hands on deck: Early graduations of senior medical students in the COVID-19 pandemic, they had three important messages. First, there are important issues that need to be addressed when students are engaged in the clinical context. Second, the pandemic should not be a time for educational stasis. And third, they argued that in the future more emphasis should be placed in medical education on immersing students as part of a clinical team.

Sue Ross, who developed while working in the Centre for Medical Education in Dundee the DREEM tool for assessing the learning environment, shared with me recently a letter to the BMJ which highlighted the importance to students of intense periods of immersive hands-on clinical learning which may be associated with a range of competencies that should become part of the core curriculum.

Alexander, L., et al. 2020. All hands on deck: Early graduation of senior medical students in the COVID-19 pandemic. MedEdPublish. 9(1). https://www.mededpublish.org/manuscripts/3129

Conducting OSCEs in the COVID-19 environment
A number of papers published in MedEdPublish provide useful accounts of how the OSCE can be effectively organised in the present difficult circumstances. Conducting a high-stakes OSCE in a COVID-19 environment was one of the most downloaded papers, with more than 5000 pageviews.

Boursicot, K., et al. 2020. Conducting a high-stakes OSCE in a COVID-19 environment. MedEdPublish. 9(1). https://www.mededpublish.org/manuscripts/2939

AMEE 2020 Virtual Conference
We are in the final stages of preparation for the AMEE 2020 Virtual Conference. We have now more than 3800 participants registered from 93 countries. We have both a forward-looking format for the programme with a range of Best Practice sessions, invited presentations and Masterclasses. There is even a virtual Fringe. Participants can teleport themselves with their avatar to a session and join the discussion and question a speaker. They can meet and talk with other participants. A lot of work has gone into the Surgery Track, led by Sachdeva. This runs through the conference and should be a must-attend for all with an interest in surgery education.

Zombies in the academy
The prize for the oddest title for a publication must go to the book Zombies in the academy: Living death in higher education. Zombies are defined as a loss of individual control by teachers and contagion with the zombie metaphor used to produce different understandings of society. A spoof final chapter looks back from the future on a viral-Z outbreak with open-source working and collaboration. Does this have a message for where we are right now with the COVID-19 pandemic?

Whelan, A., Walker, R., Moore, C. 2013. Zombies in the Academy: Living death in higher education. Intellect Books, Bristol, UK.

Skype or Zoom
There appears to have been a move from the use of Skype to Zoom, with most of my time each day now spent on Zoom calls or meetings. I was surprised to read in Which? Computing, August 2020 that Skype rather than Zoom was recommended, Skype having a rating of 73% compared to a 59% for Zoom. Glitches in the video and poor audio were concerns with Zoom when the broadband communications connection is weak but this has not been my experience.

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