Hacking Medical Education

Today, Thursday 9th of July 2015, I have the opportunity to speak to Australia’s medical students at The AMSA National Convention Melbourne 2015 about ‘Hacking Medical Education’. This post contains the resources for the talk.

The talk is dedicated to the memory of Dr John Hinds, who tragically died last weekend. The simplest advice one can give to any medical student is “Be like that guy – Dr John Hinds“. Ride on, John.

What do I mean by Hacking Medical Education?

Hacking means many things – all of which apply to this talk to some extent (especially the latter):

  • “gaining unauthorised access to data in a system…”
  • “cut with rough or heavy blows”
  • “to modify or write… in a skillful or clever way”

By medical education, I don’t only mean getting through medical school, but also (and more importantly) our lifelong path of learning in medicine.

HACK #1 Learn from Osler!
  • Becoming an Oslerphile
  • The Master Work is Work (unfortunately there are no shortcuts to learning!)
  • “Medicine is learned at the bedside… the patient is our first, last and only true teacher” a lesson from Osler via The Breakfast Club‘s Tim Koelmeyer
  • The key to learning is work, the key to work is to love it – have fun, see the comedic side of life and cultivate your inner Egerton Y. Davis!
HACK #2 Discover the hidden curriculum!
  • There are three at least three ‘hidden curricula’:
    • the unintended things you learn from a course
    • the things you really need to know to pass the course (may be different from what is stated)
    • the ‘internal’ curriculum you need to develop to be the doctor you want to be and look after the patients in front of you
  • The Necessary Evil of Examinations (they are ‘rocks of offence’, however ‘assessment drives learning’)
  • FCICM Exam Preparation (preparation for an exam must be exam specific, this page outlines useful approaches for the Fellowship of the College of Intensive Care Medicine; however many of the suggestions and techniques are generalisable)
  • We don’t need no FOAM Curriculum (we need to develop our own ‘internal curricula’ that supplement those set for use by Universities and Colleges – FOAM resources can help here… see below!)
HACK #3 Apply cognitive science!
  • Effective learning techniques are not widely taught, are not widely known and are not widely performed
  • Cognitive science highlights some promising techniques, although definitive evidence of their effectiveness in the medical setting is generally lacking
  • We construct knowledge, it isn’t transferred
  • Use these techniques:
    • retrieval practice and take advantage of the ‘test effect’ (putting things into our brains isn’t that hard, being able to retrieve it at the right time can be – practice retrieval, ideally in the context in which you want to be able remember something)
    • spaced repetition (try to practice retrieval at just the time you are about to forget something to promote durable learning)
    • elaboration (channel your inner 3 year-old: ask ‘why?’ and explain things to yourself and others)
    • generation (test your knowledge of a topic before learning about it – ask yourself questions and try to predict what will be said before reading a section of a book or article)
    • reflection (reflect on your experience – combines retrieval practice and elaboration and is a way of giving feedback to yourself)
    • calibration (get objective feedback so you are not deluding yourself as a learning)
    • interleaved practice (mix up problem types and topics during practice to prepare you for the real world)
  • Learning by Spaced Repetition (I used software called Anki to help me remember key facts for exams)
  • Effective Learning Techniques Revealed (brief summary of the techniques given the thumbs by Dunlosky et al, 2013)
  • Dunlosky J, et al. Improving Students’ Learning With Effective Learning Techniques: Promising Directions From Cognitive and Educational Psychology. Psychological Science in the Public Interest, 2013; 14 (1): 4 (great review of the science of effective learning techniques)
  • Brown PC, Roedinger HL, McDaniel MA. Make It Stick. Harvard University Press, 14 Apr 2014 [Google Books] (excellent popularisation of the ‘new learning science’)
  • Education Theory for the #MedEd Clinician (key insights from Jonathan Sherbino, a master clinician educator)
HACK #4 Simulate!
  • good patient outcomes need more than individual competence, they need collective competence – team-based simulations can help achieve this
  • Hadfield, C. An Astronaut’s Guide to Life on Earth. Random House of Canada, 29 Oct 2013 [Google Books]
  • In situ simulation (simulation in the workplace, with real teams in the environment in which we work, rocks!)
  • Simulation-based learning helps develop essential non-technical skills: Crisis Resource ManagementCommunication in a crisis and Speaking up
HACK #5 Join the FOAM Party!
HACK #6 Be a Critical Thinker!
HACK #7 Work Smarter and Get Things Done!
FINAL WORDS
  • Learning medicine is hard work, learn to love it
  • Strive for mastery, not success

It is up to us to save the world

Peter Safar

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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