Introduced by Megan Quentin-Baxter, Deputy Director, David Dewhurst took us through the links between the ACETS conference, which had concluded that morning, linking it to the Breaking Boundaries event. Rachel Ellaway posed some questions and then Reg Jordan gave the keynote speech, his theme the changes that MEDEV (formerly LTSN-01) has gone through and the changes in medical, dental and veterinary education of the past and the coming decades. In the evening there was a webcast of a talk by John Halamka, Chief Information Officer at Harvard Medical School.
David Dewhurst: ACETS is a JISC-funded project under the JISC Exchange for Learning programme, standing for Assemble, Catalogue, Exemplify, Test and Share, investigating the use of Reusable Learning Objects. The project report may be downloaded here. David described the Edinburgh context, how their e-learning strategy enhances learning experience and allows them to exploit new markets in CPD and postgraduate support. He invoked (?Susan) Eisenbach who had apparently defined the ten Es of e-learning, though I can't locate the reference. They support a series of Web-CT based learning environments: EEMeC for medicine, EEVeC for the Royal Dick Veterinary School, EEPoP for postgraduates, EMSeC for a new programme, a BSc in Biomedical Sciences and EGrad for alumni. They use a thing called EROS (Edinburgh Reusable Object Sequencer) for authoring, delivery and tracking of RLOs.
He gave some examples, including a page on gluconeogenesis from the veterinary area, patient scenarios involving blood pressure measurement and PathCAL.
Their virtual patients were interesting, George, a patient with respiratory disease which gets worse in real time, Hannah, a woman going through a normal pregnancy, and best of all, the alcohol family who we meet at their wedding party.
They have a considerable research programme and a seemingly inexhaustible supply of acronyms to describe their projects, looking at alternatives to animals, DEVIL: (embedding library resources In) VLEs, and a follow up to DEVIL called : D +, RECAL for the re-aggregation of tools, and CHERRI-PIE on patient consent for clinical recordings
ACETS itself was a case study of reuse with a healthcare focus, particularly in anatomy and communication skills.
They had 21 teachers creating exemplars, who were given a baseline interview, kept reflective diaries, were given semi-structured interview and wrote learning design statement (they also developed materials)
Their chief findings are:
RLOs need to meet real curricular needs
educational creativity is much more important then technical skill
institutions need to think about ownership of intellectual property and how to reward creators of RLOs (those in the ACETS project created them entirely altruistically)
RLOs must be easy to find and use, the conditions of use must be clear
Rachel Ellaway then spoke, asking a series of more theoretical questions. I present these as questions as, from memory, I think that's how she did.
What do we lose by using virtual learning environments?
Are we teaching practice or transmitting knowledge?
Are these transient technologies (what is there life-span of a Virtual Learning Environment; planning is uncertain, there may be both unexpected benefits and perils)?
Is there a new discipline of healthcare education informatics?
She suggested that technology acts as a mirror to practice and that there was flux in more or less every aspect of education. We need to reflect on epistemology, status and confidence, creativity, constructive alignment, democracy, self-determination, accountability a and professionalism.
Reg Jordan, Director, then spoke: we've had the subject centres in one form or another for ten years, a period of considerable change in higher education and there's likely to be more. The LTSN's have now become the HEA centres, funded until 2010 by top-slicing. Medev now forms the Health network with the Health Sciences and Practice Centre.
The new centres have three tasks:
information and dissemination
building capacity and
brokerage.
He pointed to some successes. At Breaking Boundaries in 2003 in Manchester, there was a stronger technology theme and presentations on the eUniversity: UKeU, NHSUniversity and IVIMEDS; the last is the only one of these still in existence which means, he suggested, that top-down approaches don’t necessarily work. Continuing his then and now theme, he contrasted the drivers for change in the period 1990-2000 with those in the current decade: then the impetus for change came from the professions with curriculum reform, Tomorrow's Doctors, self-regulation cf. the RCVS) and curriculum reform, whereas now its service delivery modernisation, forced by public and political pressure, and the employability of health professionals
Describing threats and opportunities, he identified that there were more people, working differently, that public expectations and demands for accountability would increase, and that there would be more expansions. On this latter point he pointed to the current expansion of dentistry, the new veterinary school at Nottingham and the medical expansion, a further 1000 places in 2006 and 1000 in 2008, on top of the previous expansions which doubled student numbers. We should expect the professions to work differently, with an increased emphasis on the interface with public health, citing avian influenza as an example. Modernising Medical Careers, the Foundation Years, clinical academic career paths, professional and standards and service reconfiguration would all have an impact.
In the area of public expectation and accountability, the schools do both pre- and post-registration education, and graduates go into service delivery but the government is demanding change to increase employability and accountability. In medical education the Department of Health now provides more money than the higher education funding bodies. We should perhaps expect another round of curriculum reform.
In the NHS we can expect an April 2007 restructuring in England and Scotland, with devolution, Strategic Health Authorities coterminous with regional government, Primary Care Trusts who only commission, Foundation Trusts and the impact of Modernising Medical Careers; medical schools output will increasingly be linked to their patch workforce planning…
If this was not enough, we will also have to deal with new standards, a national licensing framework and QABME, a new emphasis on professionalism, FFP: lack of standardisation across schools, student registration on entry to medical school, accreditation/revalidation, preparing for the modern world (DH) patient centred education etc.: advisory,but will not be
But he thought political requirement for educational change provides chance for enhancement constructive alignment: opportunities there for taking we’re here for long term,politicians ephemeral but can’t be ignored . Finally he drew attention to the foundation at N Newcastle of the Centre for Excellence in Healthcare Professional Education (CETL4HealthNE).
Finally he drew our attention to an impressive list of sponsors of the event.
