SAAHE conference, 2011 – day 1

Introduction by Dr. Lionel Green-Thompson

A country whose health is fragile

The future of health science education: 2020 vision by Prof. Athol Kent

“After an introduction like that I can’t wait to hear myself speak”

It’s not the strongest or fittest who survive but the ones who are most adaptable to change

  • Who will our students be?
  • How many of them will we need?
  • Who will their teachers be?
  • What will we teach them?
  • How will we teach them?

They will be smarter, better prepared, more IT literate, more women, more black students

We need far more than are currently graduated, more from rural areas, more mid-level workers, clinical assistants

“Innovation through diversity”

Why do health professionals leave? Political, security, working conditions, financial reasons

Makes reference to Freni, et al, Health Professionals for a new century, The Lancet

30% of all posts are unfilled

Need to increase intake & satellite campuses must evolve

All service posts should have a teaching component

Doctors who want part-time work (e.g. mothers) can be integrated as clinical teachers

Generalists who teach as opposed to specialists

Peer teaching should become a core, significant component of clinical teaching (“the mark you get will be the same mark your students get”)

Syllabus will change from curative to preventative → PHC, lifelong learning, less factual, more core and process orientated (“we can’t possibly teach all the facts”, “teach how to learn”)

“The world is flat” → information is everywhere

Move from university → centres → health/education system-based

Teach students HOW to learn

Move from assessment of learning → assessment for learning

“A lecture without a story is like an operation without an anaesthetic”

800 specialised language forms in O&G alone ← imagine what this must look like to a new clinical student

Is the gap between secondary education and health science education going to increase?

The content we give students today is based on work that was done 5 years ago. In 10 years time that content will be less valuable even than today. For all intents and purposes, the content is irrelevant. We need to give students the tools to identify gaps in their own knowledge, and the skills to find the answers to the questions that will help fill those gaps.


Evidence-based practice: how can we facilitate student learning? by Prof. Robin Watts

Practice = EBP is nothing if concepts are not implemented in clinical practice

Evidence-informed practice? More inclusive in that it implies that evidence isn’t the only factor in clinical decision-making, and that practice knowledge is an important component to take into account

Different language roots have an impact on how EBP is understood by people from different parts of the world

EBP steps:

  • Asking (Population, phenomenon of Interest, Context, Outcome)
  • Acquiring
  • Appraising (levels of evidence – hard for students to conduct appraisals of online sources)
  • Applying
  • Assessing

Is evidence derived from medical research directly generalisable to other health disciplines? Should be be modified? Avoid making assumptions of transferability

Springer, “7 pillars of information literacy”

Discrete subject (EBP separate from other modules), or integrated throughout and within other modules? Standalone courses appear to be less effective than integrated. Discrete modules found improvement in basic knowledge, but no impact on appraisal ability. It integrated into clinical practice, improvements occur throughout. Integration should be well-designed.

Content in EBP module should be sequenced, building on previous content / components

Benefits of EBP enhanced when modelled by clinicians

Integrating EBP into the curriculum requires a culture and mindset change

 

Morning POEMs (Patient Oriented Evidence that Matters) – Teaching Point-of-care, patient centred, evidence-based medicine by Dr. Eamon C. Armstrong

Patient presentation followed by real-time internet search for best available evidence → discussion of patient management using those sources

EBM triad:

  • good clinical expertise
  • best external evidence
  • patient values and expectations

POEM = valid:

  • information that patient will care about i.e. has positive patient outcomes
  • addresses a common problem
  • should require a change in practice

How do you brindge the growing knowledge “chasm”

Change the paradigm from “just-in-case” (learn everything in case it comes up) to “just-in-time” (learn what you need, when you need it)

Negotiate common ground around medical decision-making

Prior to the introduction of POEMs, use of electronic sources was scant (study done in US hospital)

Led to fundamental change in prevailing teaching and learning practice

 

The use of reflective journaling in the training of play therapy students by Isabella Jacobs

Reflection used to raise personal awareness, and integrate theory into practice

Students find that ideas become clearer when they write them down, they have to declare concepts in concrete form

Existential dialogue = ways of being, reflective journal may help to implement

Students must receive guidance regarding expectations for jounnaling i.e. must be structured

Role of the self in patient encounters

Journals not assessed, although a random selection of journals were analysed

Students not informed prior to journaling that the journals would be researched, so as not to influence their responses. Informed consent obtained from students after assignments were completed

Students initially reluctant to participate in journaling, but awareness of self began to emerge over time

“as we write conscious thoughts, useful associations and new ideas begin to emerge” (Miller, in Moon, 2006)

“regain my balance by losing my mind” (student quote)

“I do not want to be in unawareness anymore” (student quote)

Some students referred to the process as “a life changing experience”

 

Selective alignment as an applied education and research tool by Sophia Fourie

Assingment which served as an educational tool and research project

Students gained research experience, improved knowledge, and encountered principles of rational drug prescription

 

Do emergency medical care student’s perceptions of their educational environment predict academic performance? by Benjamin van Nugteren

Role of the academic environment in student success?

Identify areas of student dissatisfaction / satisfaction

Used the DREEM questionnaire: 50 statements based on 5 point Likert scale

Looked at:

  • perceptions of learning
  • perceptions of teachers
  • academic self-perception
  • atmosphere
  • social self-perception

Associated above outcomes with academic performance

Noticed a trend of decreasing satisfaction in all of the above components from 1st – 4th year medical students, even though overall satisfaction was reasonably high. What are the implications considering these students are going straight into clinical practice? Is burnout beginning already?

When the data is connected relative to final exams / other stressors might make a difference to student perceptions

 

Workshop: Concept maps and cognition by Dr. Stephen Walsh

Here’s the basic concept map I made during the short workshop: