Yong Loo Lin School of Medicine Newer Competencies
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Yong Loo Lin School of Medicine Newer Competencies for Medical Teachers Zubair Amin Batch K 42; Dhaka Medical College Associate Professor; Dept of Pediatrics School of Medicine National University of Singapore Senior Consultant and Head; Dept of Neonatology National University of Singapore paeza@nus. edu. sg 1
Yong Loo Lin School of Medicine Newer Competencies • Developing content knowledge as an integral part of competencies as teacher • Importance of understanding the context of medical practice and applying those into teaching • Integrating education with the healthcare
Yong Loo Lin School of Medicine Timeline to Become a Specialist Basic Medical Degree + Internship Transition to PG Trainee Fellowship Learning in Practice 2023 2026 2030 2035
Yong Loo Lin School of Medicine What Do We Know will be Different in Future? • • • Changes in healthcare delivery Aging population Explosion of biomedical knowledge Emergence of new technologies Rising healthcare cost Emerging new diseases Increasing public and student expectation New learning technologies Challenges to ethics and professionalism New generation of learners
Yong Loo Lin School of Medicine Demographic Changes in Developing World Global Impact of Demographic Changes. IMF Working Paper. 2006. WP 06/9
Yong Loo Lin School of Medicine Planning an Evidence-Based Education
Yong Loo Lin School of Medicine Changes in Disease Patterns Ten projected leading cause of Disability Adjusted Life Years (DALYs) in Developing World by 2020. Murray and Lopez. Lancet 1997. 349: 1498 -1504.
Yong Loo Lin School of Medicine Traditional Model Upcoming Model • Medicine • Health and well-being • Surgery • Pathology • Radiology • Et cetra • Acute care • Chronic disease management • Elective procedures • Palliative care
Yong Loo Lin School of Medicine Future of Health Care
Yong Loo Lin School of Medicine Addressing the National Needs • Health and well being • Elderly and adolescent population • Mental health • Ethics and professionalism
Yong Loo Lin School of Medicine Learning Among Millennial Generation • Doing is more important than knowing – Knowledge is no longer perceived to be the ultimate goal (the half-life of information is so short). Results and actions are considered more important than accumulation of facts • Learning more closely resembles Nintendo that logic – Nintendo symbolizes a trial-and-error approach to solving problems; loosing is the fastest way to mastering a game because loosing represents learning. Millennials: Our Newest Generation in Higher Education. Northern Illinois University, Faculty Development and Instructional Design Center; www. niu. edu/facdev
Yong Loo Lin School of Medicine Learning Among Millennial Generation • There is a zero tolerance for delays – Millennials were raised in just-in-time, service-oriented culture. They expect and demand quick turn around in today’s 24 X 7 culture and do not easily accept delays. • Consumers and creators are blurring – In a file-sharing, cut-and-paste world, distinctions between creator, owner, and consumer of information are fading. The operative assumption is often that if something is digital, it is everyone property. Millennials: Our Newest Generation in Higher Education. Northern Illinois University, Faculty Development and Instructional Design Center; www. niu. edu/facdev
Yong Loo Lin School of Medicine Stress Among Medical Students Hamza Abdulghani. Stress and depression among medical students: A Cross Sectional Study at a medical college is Saudi Arabia. Pakistan J of Medical Sciences. 2008: 24(1).
Yong Loo Lin School of Medicine Hamza Abdulghani. Stress and depression among medical students: A Cross Sectional Study at a medical college is Saudi Arabia. Pakistan J of Medical Sciences. 2008: 24(1).
Yong Loo Lin School of Medicine Higher Education in Digital Age Economist. The Future of Universities: Digital Degree. June 28 th. 2004
Yong Loo Lin School of Medicine Higher Education in Digital Age • What can we offer to the students that online e -learning platform can not deliver? • How can we harness the power of technology? • Who would drive the education in the era of rapid development of technology?
Yong Loo Lin School of Medicine Newer Competencies Adding values to existing practice Broadening the range of competencies
Yong Loo Lin School of Medicine Scottish Doctor Learning Outcomes
Yong Loo Lin School of Medicine A Framework for Newer Competencies • What medical teachers are able to do • How medical teachers approach their teaching • Medical teachers as professionals
Yong Loo Lin School of Medicine A Framework for Newer Competencies • What medical teachers are able to do – Knowledge competencies – Skills competencies • How medical teachers approach their teaching – Scientific underpinning of teaching and learning – Understanding the context of practice • Medical teachers as professionals – Scholarship
Yong Loo Lin School of Medicine What a Medical Teacher Should be Able to Do Knowledge competencies Skills competencies
Yong Loo Lin School of Medicine Knowledge Competencies: Emerging Opportunities • • Health Aging Mental health Patient safety Preventive medicine Emerging infectious diseases Genetics, epigenetics, and genomics
Yong Loo Lin School of Medicine Examples: Aging • Biochemistry – Why do we age? – What are the biomolecular changes during aging? • Pathophysiology – What are the changes that take place in organ function during the aging? • Anatomy – What are the changes that take place in musculoskeletal systems during the aging? – What are the modifiable factors in aging?
Yong Loo Lin School of Medicine Examples: Aging • Pharmacology – How do drug-drug, drug-disease interactions affect elderly patients? – How does aging affect metabolism of drugs? • Preventive Medicine: – Why do people age differently? – How can be compress the period of morbidity? • Paediatrics – What are the similarities between approach to problems in paediatrics and elderly population? – What is the impact of death and disability of grandparents on a tri-generational family?
Yong Loo Lin School of Medicine Prerequisites • High level of integration • Continuous faculty development and updating of knowledge • Radical change in the educational planning and delivery
Yong Loo Lin School of Medicine Harden RM. Integration Ladder.
Yong Loo Lin School of Medicine Inter-professional collaboration Medical, nursing, allied health, pharmacy, medical students Interdisciplinary collaboration Science, engineering, public health, epidemiology Harden RM. Integration Ladder.
Yong Loo Lin School of Medicine Technical Competencies: Existing Paradigm • • Delivering an effective lecture Teaching at the bedside Using simulator/simulation to teach Providing effective feedback Facilitating a PBL Creating a contextual MCQ Conducting an OSCE Developing a module
Yong Loo Lin School of Medicine Rationale for Simulation Use • Safe environment, mistake forgiving • Trainee focused versus patient focused • Controlled, structured, and proactive patient exposure • Reproducible, standardized objectives • Opportunity for immediate feedback • Increase public trust in the profession Scalese, Issenberg 2005; Mc. Gaghie 2007
Yong Loo Lin School of Medicine Ethical Reason for Use of Simulation “The use of simulation wherever feasible conveys a critical educational and ethical message to all: patients are to be protected whenever possible and they are not commodities to be used as conveniences of training. ” Ziv A et al; Academic Medicine. 2003; 78: 783– 788.
Yong Loo Lin School of Medicine Putting the Patient First: Repeated Practice
Yong Loo Lin School of Medicine Putting the Patient First: Infrequent Clinical Situations
Yong Loo Lin School of Medicine Putting the Patient First: : Emergency Team Drills
Yong Loo Lin School of Medicine Putting the Patient First: Privacy and Comfort
Yong Loo Lin School of Medicine Putting the Patient First: Sharpening the Clinical Skills
Yong Loo Lin School of Medicine Curriculum Integration & Progressive Exposure Learning Outcomes Intubation Suture Available Options Video >> Simulator >> Real Patient (RP) Plastic model >> Animal tissue >> RP Heart sounds Audio, video >> self-learning modules >> Harvey >> RP Pelvic examination Anatomical model >> Standardized patients >> Anesthetized RP >> RP
Yong Loo Lin School of Medicine Technical Competencies are Insufficient • Technical competencies alone are not enough to meet the need for the future • Knowledge and skills in pedagogy are closely linked together • We should not repeat what others’ can do better
Yong Loo Lin School of Medicine Value Creation m a n p o w e r c o st c o m p l e x it y Low volume High complexity Moderate volume Moderate complexity High volume Low complexity Volume
Yong Loo Lin School of Medicine m a n p o w e r c o st c o m p l e x it y Integrated Seminar Expert Lectures Value. Creation TBL, PBL, Simulation, Tutorial Internet resources Study Guides Volume
Yong Loo Lin School of Medicine m a n p o w e r c o st c o m p l e x it y Low volume High complexity Critical thinking Creation Clinical. Value judgement Application of knowledge Problem-based learning Simulation Task based learning Moderate volume Moderate complexity Facts Basic concepts High volume Low complexity Volume
Yong Loo Lin School of Medicine "We must acknowledge again that the most important, indeed, the only, thing we have to offer our students is ourselves. Everything else they can read in a book or discover independently, usually with a better understanding than our efforts can convey. ” Daniel Tosteson. Dean, Harvard Medical School Learning in Medicine. NEJM. 1979: 301 (13): 690 -4.
Yong Loo Lin School of Medicine How Medical Teachers Approach Their Teaching Understanding the Context of Practice
Yong Loo Lin School of Medicine “The knowledge of the world is only to be acquired in the world, not in a closet. ” Lord Chesterfield, Letters to his son
Yong Loo Lin School of Medicine Green et all. The Ecology of Medical Care Revisited: NEJM. 2001; 344: 2021 -5
Yong Loo Lin School of Medicine Leading causes of preventable death worldwide Number of deaths resulting (millions per year) Cause Hypertension 7. 8 Smoking tobacco 5. 0 High cholesterol 3. 9 Malnutrition 3. 8 Sexually transmitted diseases 3. 0 Poor diet 2. 8 Overweight and obesity 2. 5 Physical inactivity 2. 0 Alcohol 1. 9 Indoor air pollution from solid fuels 1. 8 Unsafe water and poor sanitation 1. 6 WHO Global Burdon of Diseases
Yong Loo Lin School of Medicine Understanding the Context of Practice • Medical education needs to be firmly linked to the practice of healthcare • Integrating the teaching with the larger context of healthcare is paramount for value creation • The risk of ignoring the environment is akin to burying the your head in the sand during a sandstorm
Yong Loo Lin School of Medicine Medial Teachers as Professionals Scholarship in Education Faculty Development
Yong Loo Lin School of Medicine “Comprehensive faculty development, which is more important today than ever before, empowers faculty members to excel as educators and to create vibrant academic communities that value teaching and learning. ” Wilkerson and Irby, 1998. Acad Med 73: 387 -396
Yong Loo Lin School of Medicine First Who; Then What • Getting the right people on the team before vision, strategy, and tactics • Getting the right people on the bus, and getting the wrong people off the bus • Put your best people for the greatest opportunities, not for the biggest problem James C Collins. Good to Great. 2001
Yong Loo Lin School of Medicine Good Program Good Teacher Good Program Bad Teacher Bad Program Good Teacher Bad Program Bad Teacher
Yong Loo Lin School of Medicine Good Program Good Teacher Good Program Bad Teacher Bad Program Good Teacher Bad Program Bad Teacher
Yong Loo Lin School of Medicine Good to Great Transformation A good medical teacher of the present is someone with the requisite knowledge and skills to serve the students.
Yong Loo Lin School of Medicine Good to Great Transformation A great medical teacher of the future will incorporate the context of healthcare into her teaching, add values to her teaching, and be passionate about the advancing the educational scholarship.
Yong Loo Lin School of Medicine If you are planning for a year, sow rice; If you are planning for a decade, plant trees; If you are planning for a lifetime, educate people. Chinese Proverb If you are teaching for a year, teach the students; If you are teaching for a decade, hire teachers; If you are teaching for a lifetime, educate the teachers.
Yong Loo Lin School of Medicine “I touch the future, I teach. ” Christa Mc. Aullife; A Teacher in Space
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