SAFRI 2011 (session 2) – day 1

A few days ago we began the second SAFRI* session of 2011, which will lead into the SAAHE conference** later in the week. Every day I take notes and will try to put them up as we go along bearing in mind that a lot of what we do is workshop-based. The notes are a combination of points given by presenters, and my own reflections that were sparked by something that someone said. My thoughts are in italics.

Achievement: changed the way I think about the world (word = clinical education)

Challenge: helping others to see the world the way I do

Never give up…or Give up often? Come up with lots of ideas, some will be good, some not so good, some terrible. Test them all (even if only mentally) and throw away the ones that don’t stand up to being tested. Analogy with digital cameras and taking loads of photos because the cost is zero and you can delete the poor ones.

Find the underlying principle that can be generalised to many contexts i.e. details aren’t necessarily important

Why did I miss the diagnosis? (Bordage, 1999) → “Less is better” i.e. foundations are good to build on

We tend to focus on student behaviour, instead of their learning e.g. “students must attend class and pay attention”…but if you’re not interesting, then why should they attend? What is it about their presence that somehow ensures that “learning happens”? If they’re not going to listen to you (and if they can pass the exam without attending), then why do we place so much emphasis on their presence?

Teach an approach to discovery, rather than a list of things

Dual processing theory (a universal model of diagnostic reasoning)

  • How do we reason through clinical problems?
  • Make observations and identify signs / variables
  • Query your existing database i.e. your pre-existing knowledge
  • Identify associations between the observed variables and your own database i.e. pattern recognition
  • If existing knowledge is insufficient, query an external database (e.g. patient / textbook)

If you go through the above process enough times, you “get experience” → add more patterns to your internal database

I’m sure the above process is more eloquently and comprehensively described elsewhere

Dancing naked in the mind field” – title of a book that perfectly describes why I blog…putting my thoughts, reflections and experiences out there and by doing so, exposing myself while sharing.

Having a diagnosis frees you from having to think. This has implications for when you’re tired / stressed / pushed for time, in that in those circumstances you can’t think and so latch onto a diagnosis. Students experience the same thing when they’re looking for answers. Having the answer means they don’t have to think because thinking is hard and places a high demand on system resources.

There’s a strong emotional response / association with diagnoses that are made intuitively i.e. without an analytical reasoning process

Talking out loud externalises a reasoning process that is often obscured and hidden from the student

“Diagnostic error and clinical reasoning” (Norman & Eva, Medical Education, 2010)

“construct referenced” as it relates to feedback?

Black , P. & William, D. (1998). Assessment and classroom learning, Assessment in Education, 5, pp. 7–75


  • “Classroom assessment techniques” (Angelo & Cross)
  • Rushton, A. (2005). Formative assessment : a key to deep learning ? Medical Teacher, 27(6), 509-513
  • Nofziger, A. C., Naumburg, E. H., Davis, B. J., Mooney, C. J., & Epstein, R. M. (2010). Impact of Peer Assessment on the Professional Development of Medical Students : A Qualitative Study. Academic Medicine, 85(1), 140-147

*SAFRI (Southern Africa FAIMER Regional Institute); FAIMER (Foundation for Advancement of International Medical Education and Research)

**SAAHE (South African Association of Health Educators)