Reflections on the MERU Conference 2020
National Heart and Lung Institute
How are doctors taught? This is an interesting question, one that I with my fundamental science background was not sure I know the answer to. So, seeking more answers I recently attend the sixth annual Medical Education Research Unit (MERU) Conference.
The conference was an interesting afternoon and it broadened my knowledge of medical education and delved into active areas of research aiming to assess and improve delivery and outcomes. The key note seminar was entitled: Making TiMEtoTeach: Empowering a diverse and inclusive “universal” faculty by Cait Dennis (University of Leeds, ASPIRE awardee). This talk really focused on seeing medical education with a more holistic environmental focus. All of the interactions that training medical students have with Doctors, other students, nurses, specialists, allied professionals, to even receptionists contribute to their experience and help to shape them, their interactions and their future careers.
A key element of this talk was that patients also contribute to the education of medical students, and that this has been massively underappreciated. Cait’s project tries to educate all stake holders to obtain better medical outcomes and better medical doctors. She highlighted a major issue that medical students experience: that of training in such diverse, non-standard settings, in many different locations from different hospitals, trusts, primary/secondary care, to even prison locations.
Through the use of a Kern needs analysis model Cait and her team identified the key stake holders. Next, they developed a model to identify all the different knowledge exchange scenarios as teaching. They then encouraged participants to see these interactions as teaching, and that this was not just allowed but actively encouraged. Through expanding their network and the development of a brand they recruited enthusiastic champions to intern train and recruit more volunteers across diverse faculties. They established breakfast clubs and peer teaching to promote improved skills such as effective feedback, assessment of skills, bedside teaching etc. Many of these programs were seeded with simple room bookings and biscuits and advertised by ‘piggy-backing’ on other meetings. The TiMEtoTeach program has been supported by the University of Leeds and its ideas transferred to the wider organisation through a people, process, technology framework and has won several awards. I particularly liked Cait’s comment about different people playing a role in medical education. For instance this program has led to more Chaplains actively sharing their thoughts and experiences about end of life/terminal patients. This highlights the role that different people can play in medical education and how low funded programs can improve learning outcomes for all stakeholders.
I particularly enjoyed the short talk by Kay Leedham-Green (Imperial College London): Supporting diversity in the clinical academic career pathway. This focused on the ‘leaky pipeline’ and how women are lost from the medical/university ranks which is abundantly clear especially at the most senior levels. By doing a systematic review using a qualitative approach, Kay and her team have identified and collated many of the factors. They effectively demonstrated that this approach was deep and wide ranging, which for me was interesting as I am a much more a numbers focused person (the published article can be found here). I completely agree that it is a multifactorial picture and that we need to educate and self-reflect on why these differences are present. This is especially true as whilst some drivers that limit women’s equality are right in your face for example direct discrimination, others are much more unconscious or almost invisible. An example Kay used was that some forms of bias are only observed by other males whilst the women experiencing it do not realise they are treated differently. One point that did not resonate with me was the suggestion that more money for individuals could be part of the answer. I disagree with this as many medical practitioners get paid quite well and far about the average wage and above what most scientists with a PhD earn (which also takes a considerable amount of training time). However, I think something that was missed from the talk was the working hours of medicine. I partially understand the pressures and financial restraints of the system but from on outsider’s perspective it seems shocking that many medical roles have 12 hour shifts as common place and that engrained frameworks like this disproportionally affect women (which raises the question of why as well). I look forward to seeing the outcomes and further research stemming from this work.
‘Through others I examined myself’ was the central theme of Ana Baptista talk entitled: The transformative nature of Faculty development on self and others: some reflections. This talk was focused on self-assessment in education using a human factors framework and had an arts/philosophy focused delivery designed to stimulate further thinking. An interesting take on reflection from different viewpoints (we/I/us). Changing culture and practice can be a difficult task. Here a key message was that we spend so much time just reacting, rather than reflecting and talking action to improve education processes.
The next talk I attended was delivered by two Imperial medical students Arwa Hagana and Noura Houbby. This talk was centred about peer learning and how it has significant advantages for both the tutee but also the skill development and knowledge retention for the tutor. They additionally touched on drivers for why students get involved with such programs. Having experienced PEER learning myself, I completely agree that it is a great delivery mode for teaching.
The talk by Telak Ghosh focused on online meetings and pros/cons. This talk stimulated some interesting discussion and I completely agree that they are useful, timesaving and here to stay.
Linda Sonesson presented a case study about the development of complex scenarios for civilian/military trauma medical education and preparedness. I was particularly struck by the complexities required for these scenarios to be effective training tools for multi-team units.
In a very ‘Ready Player One’ vein Adam Misky talk discussed an application of virtual reality headsets and their potential future role in medical education. Many boundaries still need to be ironed out but new technology offers fantastic capabilities for learning and assessment.
Overall from the MERU conference I think the take away message was on REFLECTION on education and on our interactions with others. We all have a role to play in our environment and we, each individual, can make it a better place which fosters better learning outcomes.