Title: Prescribing is "complex, effective and potentially dangerous": What should we do to increase medication safety?
Associate Professor Claire Harrison
Abstract: Medications and the environments in which they are used are complex. Medication errors continue to occur causing patient harm and significant health expenditure. There is evidence that a significant number of our medical graduates may not be ready to prescribe safely. This is despite regulatory support for competence in prescribing, in addition to its focus as a national and international health priority. In response to such concerns, the Prescribing Skills Assessment (PSA) has been developed. This is an online teaching and assessment tool in medication safety. It has been implemented in the Australasian region since 2015. Thirteen schools across Australia, Malaysia and New Zealand are scheduled to participate in 2019. This keynote presentation will describe the Australasian journey of the PSA, with a focus on how Monash students are currently performing and how results are influencing curricular enhancement. Opportunities for future educational innovations, research and interprofessional collaboration will also be discussed.
Title: Learning and working in a dignified environment: Challenges, consequences and cultural change
Professor Lynn Monrouxe
Abstract: Dignity has a number of facets including the recognition that individuals have a sense of inner worth that can be upheld, or lost, as a result of social dynamics and moral behaviours. Everyone has the right to experience dignity as part of their daily lives: dignity at work, dignity whilst learning and dignity whilst seeking professional assistance in a moment of need. Specifically, within the clinical environment, every medical practitioner, trainee and student have the responsibility to treat others – and be treated themselves – with dignity. However, such dignity is often compromised – sometimes knowingly, sometimes under duress from others and other times due to lack of understanding exactly how best to maintain others’ dignity, often when those others comprise minority groups or those from a different social or professional group to our own. Such dignity breaches cause personal harm, threaten people’s health, erode organisational values and deplete organisational resources, resulting in: employees decreasing their work effort, performance, job satisfaction and organisational loyalty. In her talk Lynn will draw on current research to highlight the range of dignity breaches faced by medical professionals and learners within the clinical workplace, the consequences of these breaches alongside possible ways forward for cultural change. She will provide opportunities to discuss how this might apply to medical education at Monash in both Australia and Malaysia.
Parallel 2: Workshop I:
Title: Implementing digital tools for in-course assessment in the medicine course
Background: Use of digital resources to facilitate work-based learning and assessment tasks has become an increasing priority for implementation of curricula in clinical workplaces. The Faculty of Medicine, Nursing and Health Sciences have provided PebblePad as a tool that can be used for these purposes. PebblePad is a digital learning space that can be used by students to store learning resources and assessment rubrics. This year PebblePad has been adopted for completion of logbooks and in-semester assessments in Year 3B of the Medicine course. Introduction of this technology has shown some challenges but also benefits in terms of monitoring and recording student performance of assessment tasks.
In this workshop, we hope to:
- Present and discuss the features of PebblePad as a platform for recording in-course, work based assessment
- Discuss the challenges and advantages that may be encountered using digital technology for recording work-based assessments
- Explore ways in which the data gathered from digital repositories could be used in educational research and for quality improvement purposes, as well as for student learning
Structure of the workshop: This workshop will include a short presentation, small group discussions and presentations/feedback to the large group.
Who should attend: Students, tutors, academics and professional staff interested in the use of digital and e-resources for learning and assessment.
Level: Introductory/Intermediate (This workshop is suitable for anyone who has used or will be using PebblePad or similar digital platforms and has an interest in exploring the use digital technology for in-semester assessment).
Maximum number of participants: 40
Parallel 3: Workshop II:
Title: “Are we producing clinically competent interns?” Revised aspirations of a continuous clinical skills curriculum
Background: The Monash MED course, if we are to believe the anecdotal reports from health services, produces good and competent graduates. The Medical Schools Outcomes Database (MSOD) suggests, too, that the vast majority of our students are well satisfied with their training. Before we simply rest on our laurels, how sure are we that our training produces clinically competent interns? How clearly have we defined the performance standards for these skills? How robust are these standards? How consistently are they implemented across multiple sites? How well do we monitor skills development and their attenuation over time? Is a clinical standard, as provided by a qualified medical graduate, a sufficient basis for judging clinical competency in our students? Is direct observation essential for judging performance and is this implementable at scale? To systematically address these questions, we have recently reviewed and revised our clinical skills curriculum as a continuum across all years of the MED course. We have revised the list of requisite skills and developed written performance standards and standardised assessment instruments for both clinical and procedural skills using agreed formats. We have also defined proficiency levels and pathways that make explicit what degree of proficiency is required at each stage of this continuum and adopted an overriding competency framework that is embedded in the unit structure of the course.
In this workshop we hope to:
- Elicit the experiences of students, recent graduates and teachers as participants in our clinical training program throughout the medical course
- Present and discuss the revised continuous clinical skills curriculum, in general, and our embedded approach to clinical skills teaching and assessment, in particular
- Interrogate the likely contribution of this curriculum to answering the leading question (are we producing clinically competent interns?) confidently in the affirmative
Structure of the workshop: This workshop will include small group discussions, short formal presentations, and focused large group deliberation on emerging issues.
Who should attend? Students, tutors and academics with an interest in clinical skills education.
Level: Intermediate (this workshop is tailored for all clinical tutors and medical students in the clinical years of the Monash MED program who are either assessing or being assessed for clinical competency).
Maximum number of participants: 40
Parallel 4: Workshop III
Title: “What do you do when your best friend and your worst enemy are conjoined twins?” Problematic Internet use: When online learning is threatened by online distraction
Facilitators: Eugene Moore representing The Student Advocacy and Support Officers of the Monash Student Association, Kavya Raj (Monash BrainPark) and Manoj Arachige (Third year Undergraduate Medical Student)
Background: A growing body of research indicates that university students may be at higher risk for problematic Internet use than the general population. Poor sleep, low mood, and decreased productivity are just a few of the problems associated with excessive Internet use. While problematic Internet use can be an issue for students studying any subject, it is particularly vital that students preparing to be healthcare professionals are able to experience minimal disruption to their studies. The unique situation in which the instrument of study is also the instrument of distraction, and which can contribute to students sacrificing their academic progress, calls for creative responses based on neuroscience. To this end, the MSA and the Monash BrainPark (an initiative of the Monash Institute of Cognitive and Clinical Neurosciences [MICCN] and Monash Biomedical Imaging) have cooperated to address this issue not only for the sake of the Monash student body, but also in order to contribute to a better understanding of the complex nature of the problem and its solution, in a world that is becoming increasingly connected 24/7. As well, since it is apparent that problematic Internet use can result in physical and mental health problems related to depression, social anxiety, sleep deprivation, OCD and other maladies, this is an area that must be understood by anyone entering fields of healthcare. Because overuse is ubiquitous and normalised in our society, patients often present with symptoms that they themselves do not associate with overuse. Therefore clinicians must be able to understand the complex nature of the problem in order to identify patients who need to address their Internet use.
In this workshop we hope to:
- Encourage discussion and action to address the unique nature of Internet overuse for students who must increasingly be online in order to study
- Present research and experience indicating the extent and impact of internet overuse on student academic progress and some instances of academic misconduct, and on physical and mental health in the general population
- Present and discuss the underlying brain/mind dynamics (neuroscience) that can contribute to the problem, but can also contribute to the solution
- Present real-life experiences of students and others who face this obstacle, as well as the experiences of those who help people overcome compulsive overuse
Structure of the workshop: This workshop will include formal presentations, panel discussion, small group discussions and focused large group deliberation on emerging issues.
Who should attend? Students, tutors, academics, clinical staff and professional staff.
Level: Introductory. This is an introductory workshop so does not require any prior knowledge.
Maximum number of participants: 40
Parallel 6: Workshop IV:
Title: Transition from lecture delivery to active learning using a concept and consolidation core learning approach in a large transnational medical student cohort: A workshop
Background: Active learning is a type of education delivery where large groups of students divide into multiple small groups in order to respond to problems or triggers and participate in activities designed to enhance learning rather than receiving pre-digested content similar to that delivered in some tutorials and lectures. In the context of a university-wide approach to transform education delivery away from lectures and towards a more active learning approach, the preclinical Monash Medicine program sought to understand the perceptions, barriers and enablers, as well as impact of active learning introduction in the Monash Preclinical medicine cohort in Rural, metropolitan Victoria and Malaysia. The delivery of identical learning outcomes with synchronous delivery of curriculum and assessment formed the basis to compare learner responses to content delivered in this new format. This workshop will outline the study we have conducted and our preliminary results, and will discuss the learnings from introducing this transnationally.
Structure of the workshop: This workshop will begin with a presentation of findings from this study and then explore examples of effective active learning approaches for medical students with some discussion of useful approaches and tips from academics experienced in active learning delivery. Student experience of active learning and triggers that have been effective will also be incorporated into the workshop.
By the end of this workshop, you will:
- Understand the rationale for active learning
- Describe the benefits of active learning over lecture approaches
- Understand approaches to design active learning tasks
Who should attend? Educators, unit co-ordinators, students and educational researchers.
Maximum number of participants: 40
Parallel 7: Workshop V
Title: To attend or not to attend: is that the question?
Background: Encouraging participation and attendance in medical school should positively relate to academic and clinical performance. While we know that classroom attendance is variable in medical programs, less is known about participation and attendance in clinical workplace learning. Research has explored student motivations for attending (e.g. raising attainment levels, opportunities to ask questions) and also barriers to attendance (e.g. lack of interest, perceptions of poor quality learning, scheduling constraints). Bloomfield et al. (2003) found that the amounts of time on learning activities by medical students were typically evenly spread over teaching, study and self-directed patient contact and observing patient care, but that examination preparation interfered with learning activities involving patients. In this workshop, we will consider the extent to which student attendance and participation in both classroom and workplace learning within the Medicine program is important from the perspectives of multiple stakeholders (e.g. students, academics, clinical teachers, professional staff, etc.)
By the end of this workshop, participants should:
- Have a better understanding of attendance from the research literature, in terms of why attendance matters, plus the enablers and barriers to student attendance and participation in classroom and workplace learning
- Understand current linkages in the Monash Medicine program between attendance and assessment (“attendance hurdles”), and be aware of (or propose) alternative models
- Have a better understanding of attendance from the perspectives of key Monash Medicine stakeholders (e.g. educators, academics, students, professional staff and employers)
- Determine a range of strategies (and the best strategy) for tackling attendance (and non-attendance) in the pre-clinical and clinical years of the Monash Medicine program
Structure of the workshop: This workshop will begin with a brief presentation of the research literature, followed by a panel discussion about the importance of attendance, plus the enablers and barriers from the perspectives of multiple stakeholders. It will also include small group learning activities plus feedback to the main group to develop strategies for tackling attendance (and non-attendance) within the Monash Medicine program.
Who should attend? This workshop should be attended with different stakeholders including students, academics, clinical teachers, directors of clinical teaching, and professional staff.
Level: This is an introductory workshop so is open to anyone interested in attendance and participation in classroom and workplace learning.
Maximum number of participants: 40
Parallel 8: Workshop VI:
Title: Assessment of collaborative practice: Too hard or part of usual business?
Background: At Monash University, the Faculty of Medicine, Nursing and Health Sciences and the Faculty of Pharmacy and Pharmaceutical Sciences have established a framework, set of learning outcomes and educational content for a Collaborative Care Curriculum. With interprofessional curricula now in place, assessment of collaborative competence is required. In recent years, the educational literature has explored multiple methods for embedding the assessment of interprofessional competence into the curriculum. A programmatic approach to assessment of collaborative competence is the ultimate target, which requires a shared vision and opportunistic integration across the levels of study, to embed valid assessment into existing processes and tools.
This workshop will:
- Discuss a programmatic approach to the formative and summative assessment of collaborative competence
- Concept map how interprofessional assessment can demonstrate competency in each of the dimensions and stages of the framework
- Propose strategies for the introduction and/or revision of assessment tasks to support the assessment of collaborative competence
Structure of the workshop: The recent literature on interprofessional assessment will be summarised, followed by several guided small group activities working with existing assessment tools, to propose a strategy for progressing the assessment of interprofessional competence at Monash University.
Who should attend? Academic and clinical staff with assessment responsibilities.
Level: The workshop is open to any staff and is pitched at an introductory level.
Maximum number of participants: 30