Training

The Ottawa Conference 2002 - Dr. J Schofield
This is my 3rd. This time not only with Neil & Reed but also Peter Burrows who was presenting a paper on running simulated surgeries for PPDs.

The themes tend to be the same, Curriculum, Teaching methods, Assessment, OSCEs, New developments etc. This time I felt that there was an increased awareness of the new technology that is coming our way.

The importance of these meetings is both to give people an opportunity to present their ideas and work and also to meet others and get a feel of where things are going.

Developing Technology
I went to a few talks on this and probably present a biased view of its importance. The thing that is really going to make the difference is the PDA (personal digital assistant). I’m not sure yet which system will be adopted Palm or MS but Microsoft are spending a huge amount of money in this area and will be hard to stop.

Points relating to PDAs
- Central Data Bank – access to educational material
- Immediate feedback of knowledge and ability
- Decision making algorithms + Tips
- Dealing with sensitive information – telephone communication
- Push or Pull technology – should things be pushed at students?
- Electronic Personal Portfolio – Log Book

We are moving into a world of -
Just In Time Training - JITT
Just For You - JFY
Enhancement

The Customer
Even now some of the speakers did not seem to understand the concept of the customer and were only concerned about their students and not what the public needed of their future graduates.

Key questions were-
- How do we deal with the intermediate customer? - student
- What types of Drs do we need for the future? M/F ratios?
- How do lay assessors fit in the process?

I thought that Joan’s plan for teaching actual patients to train and assess Drs sounded very interesting. The advantage over actors seems to be that real patients are not temped to try and play Hamlet and have real emotion and body language.

Continuous Assessment
The technology gives the opportunity to change onto QA if wanted?
- MCQs etc – focused, reusable, cloned, available anytime, anywhere, CAT (Computer Adaptive Testing)
- Simulators – sophisticated, programmable
- Immediate feedback
- Personally structured programmes

Computer programmes for testing are moving to a more centred type where the student is probed for areas of poor knowledge and feedback given.

The need to Log and record what is done will become very important as legal challenges are made to examination systems.

Shared material
The Scottish Medical Schools in particular are moving to common resource material and a shared curriculum. This I feel sure will be the future with the following points-
- increasing complexity of the training
- cost of preparing good quality material
- shortage of teachers
- availability of broadband internet
- training of mature students – able to work from home
- pressure to constrain costs.

It would be nice to feel that some of this material would make its way to be freely available on the web as it could be reused around the world, in particular developing countries. I spoke with the lady who is working on this in Edinburgh and it is quite possible now to Tag material - RLOs (Reusable Learning Objects).

Learning Theory
They talked about Generalizability Theory – I don’t understand!
A few points that I picked up were-
- Pattern Recognition
- Schematic deduction
- Hypothetical Deduction

We have also the concepts of group learning and knowledge and the Group Portfolio. Much of the computer material seems best used in a group situation with a facilitator.

One session that I went to was interesting as it looked at different ways that a novice and an expert dealt with material – for instance a specialist dermatologist was confused by a verbal description and got a more accurate diagnosis by just looking. There must be some change in brain activity as your ability improves.

Poor performance
There was a good talk on this that I went to. They were splitting attributes into-
1. Knowledge
2. Skills
3. Attitudes
4. Relationships
It is interesting that they added ‘Relationships’ as this is very much at the heart of what goes wrong.

There was a discussion about Personal Health, Work Attitudes and one of the most insightful comments came from the floor. The suggestion was made that we should be able to make better use of Human Resource specialists who would tackle many of the aspects of PPDs such as working with others, poor work record, ill health etc.

The other phrase that I picked up was
- Recognise Achievable Objectives.

Neil and I went to a session on Linking Assessment to Learning.

The idea of this was that personal knowledge degrades both because of the period between the learning episode and its application and the ability of the brain to hold knowledge, and the rapidly changing knowledge base. Thus for any ability one has a varying level which needs to be topped up regularly or may otherwise fall below an acceptable level. This leads on the concept of either point assessment or longitudinal assessment and which is fair and reliable.

Conclusion
It was a very enjoyable trip and I think we picked up some ideas.