Monthly Archives: December 2017

The internet doesn’t take annual leave

-which is nice when you have a bit of holiday time to browse. In the middle of the festive season I came across references on Twitter to two interesting medical teaching and learning resources.  They involve two different media, are in different disciplines and are directed at different audiences.  As I noted early on in this blog, I try to link to relevant and useful articles etc to pursue and peruse rather than assume I am an expert in all these different areas and for me these topics are also different in terms of my own comfort zone.  The first is designed for undergraduates and the second for hospital doctors but in both cases there is also relevance for learning in general practice.  The first resource is a collection of thirteen videos in pre-hospital treatment in Emergency Medicine and the second is a document on Care of the Elderly (COTE in the UK and both are from the UK context).  In fact, GPs often have to adapt their learning from other specialised contexts.  The different content of the two resources also lends itself to different approaches to teaching and learning.

I must admit a conflict of interest with the first one as the videos have been done by Dr Luke Regan to whom I am related! They are part of the Inverness Undergraduate Prehospital Care Course.  Emergency Medicine is something in which I have become rather de-skilled over the years but if you are a GP Educator who supervises GP registrars and medical students I think these very short videos have useful content and could be a starter for discussion, particularly in rural settings

Of course, I’m sure there are also some Australia- specific ones if you are working in that context. They were a good reminder to me of some basic principles. After the intro videos the topics include: upper limb injuries, respiratory, interosseous insertion, traumatic cardiac arrest, thoracostomy, analgesia, traction splinting, airways, pelvic stabilisation, paediatrics.  What I like about them (apart from the appropriate outdoor setting) is that they are short (generally 3-5 minutes), nicely paced with a clear delivery and highlighted take-home messages.  Despite recent opinions about our inability to multi-channel as we learn (in relation to bullet points on Powerpoints) I am actually a fan of sub-titles (even on TV movies at times) and I guess if the presenter had been talking in a broad Scottish accent I would have appreciated them even more!  For me they reinforced the message.  If the videos are not exactly what you want they could be used as a stimulus for something you produce yourself on your i-phone (these were shot on an i-phone).

The second resource is in an area that has been an ongoing interest of mine (clinical practice and teaching in the area of geriatrics / aged care) and was the focus of my PhD research.  It is in the form of a thirteen page PDF document that lists some important and succinct take home messages when dealing with older patients. 

The topics addressed include: confusion, delirium, dementia, frailty, medication review, UTIs, falls, and advanced care planning and when to investigate. This is quite a different collection of problems compared to the pre-hospital trauma topics. It includes a couple of eye-catching headings such as “end PJ paralysis” and “acopia is not a diagnosis”.  They are set out in an engaging format (arresting headings, do’s and don’t’s lists) that sets out fairly didactic (almost dogmatic) principles which may come as a surprise in some instances. What I liked about it is that it is a concise summary of a huge (and hugely important) topic, it highlighted some important issues and was presented in a readable format.

Both these resources

  1. can be used as learning resources (and as teaching resources)
  2. are good starters for discussion on the various sub-topics
  3. can be adapted to different contexts

For the second one, I agree that there are some important take home messages in this very readable document which is obviously very relevant for those working in hospital.  For those in GP Terms I think there needs to be some attention to context. I would change the emphasis and make a few important caveats (particularly to do with prevalence in community practice).  I have previously posted on the topics of teaching about Multimorbidity (X3)   and Care of the Ageing   but I might look briefly at some of the component topics (in relation to learning in general practice) over the next month – in between saunters along the beach..


To everything there is a season

I have always liked that quote (from Ecclesiastes 3:1 in case you were wondering), probably reinforced by the fact that it was turned into a song in the 60s (and a hit by the Byrds – who remembers them?) in my impressionable youth.  

There is a time for being serious and academic and evidence based in medicine and medical education -and that is probably most of the time – but thank goodness the BMJ has a seasonal xmas edition with lots of light heartedness.  One of my favourites this year was “Does Peppa Pig encourage inappropriate use of primary care resources?”  which was apparently taken as a serious suggestion in some quarters.

In medical education there are also times to be serious and occasions on which to be more light hearted, though generally it is within the overall context of imparting a learning experience. Sometimes it’s just for the purpose of enhancing the  interpersonal part of education which is in decline in current programs.  A Christmas quiz in a workshop setting can always include answers such as “Christmas disease” and questions about red noses and liver function tests.  Of course one can’t guarantee this method will be appreciated by all participants.  Some years ago I included a lunchtime “trivia” quiz at a workshop.  All the exam-style questions focussed on topics presented during the workshop day and four out of five were serious.  Twenty per cent were real trivia.  For example there were questions on respiratory disease and then some where the answer might be a rock band with a song title about “air’ or “breath” etc.  Out of a few dozen feedback sheets there was one comment that a trivia quiz was “unprofessional”.  They obviously felt it wasn’t the right season and maybe it’s all about the framing and expectations.

There have been many seasons in medical education. There was a long era of lectures and a shorter epoch of small groups.  There has been an evolution of overhead presentation technologies and we have entered the age of performance in the TED (technology, entertainment, design) talk template.   My daughter is a stand-up comedian and I observe similarity between the preparation for a six minute comedy set and a six minute Pecha Kucha.  There have been other more innovative approaches and, for the researcher and presenter there have been books, libraries, index medicus, online journals and, praise be, Google.  In terms of seasons, it is probably Spring heading into Summer for the use of various aspects of social media in medical education.

If we go far enough back there have also been dire warnings, at a society level, about TV replacing radio and cinema, screens replacing books and too much time spent on video games or social media. So it goes on. Perhaps the main issue is the end point – informed and reflective individuals – and there are stimuli aplenty to thinking and reflection in the whole range of media.  Afficionados of one approach to education are very much inclined to bag other approaches but perhaps there is wisdom in the quote that started this post and which still resonates with me after all these years.  “To everything there is a season and a time to every purpose under heaven”.   It all depends on appropriateness (and there is professional judgment in that) and that may depend on purpose and context (in its broadest sense).

Take some time over the Christmas season to take in a good (or bad) film, an interesting book, concert, gallery, magazine or blog and exchange views on social media or in person. I hope we can all find some time to relax, reflect and relate (and start the new year revived).