The SCOMEdy August 2011

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The SCOMEdy

The Standing Committee on Medical Education Newsletter AM11 1st edition


The SCOMEdy / 1st Edition

CONTENTS: 4

Editorial

5

The future of M.E.

6 SCOME vision, mission and values 8 SCOME in the EMR: Potential, Developments and Challanges IFMSA

The mission of IFMSA

was founded in May 1951 and is run by medical students, for medical students, on a non-profit basis. IFMSA is officially recognised as a nongovernmental organisation within the United Nations’ system and has official relations with the World Health Organisation. It is the international forum for medical students, and one of the largest student organisations in the world.

is to offer future physicians a comprehensive introduction to global health issues. Through our programs and opportunities, we develop culturally sensitive students of medicine, intent on influencing the transnational inequalities that shape the health of our planet.

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medical students worldwide

10 In our way to improve medical education. SCOME - The journey so

Imprint Editor in Chief Ioana Goganau, Romania

far in Africa

Text Editors Mohamed Meshref, Egypt Ioana Goganau, Romania

12 Assessment in Medical Education: An overview 14 Geriatrics without mysteries

Design/Layout Ioana Goganau, Romania Proofreading Omar Safa, Egypt Helena Chapman, Dominican Republic Caitlyn o’Fallon, New Zeeland Publisher International Federation of Medical Students’ Associations General Secretariat: IFMSA c/o WMA B.P. 63 01212 Ferney-Voltaire, France Phone: +33 450 404 759 Fax: +33 450 405 937 Email: gs@ifmsa.org Homepage: www.ifmsa.org

14 Laparoscopy workshops 15 Doctors and death - confronting with dying patients 16 The AMEE experience 21 SCOME agenda AM11 23 SCOME International Team 2010-2011

Contacts scomed@ifmsa.org Printed in Romania

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

EDITORIAL

The future of M.E. Dear reader, We have come a long way from the beginnings of our organization, 60 years ago, and communication has become easier and easier along the years. The technology today grants us possibilities our predecessors would never have thought of. Instant communication, chats, tweets, groups, websites, all these bring us closer and closer and allow us endless opportunities for collaboration, not only during the meetings, but also between meetings. My first message would be to take advantage of the opportunities we have today to improve communication and collaboration. However one thing remains the same in communication: you have to want it and actively engage in it. If people want, they can communicate even with smoke signals, and if they don’t, all the technoGA, Amsterdam 1968 SCOME session logical wonders are useless. So, my second message is this: be active, opened, listen and share. None the less, printed word continues to be a powerful tool. Thus it is with great pleasure that I present to you the first printed edition of The SCOMEdy. Medical education is a challenge itself for each of us. But we all work towards the same goals. We have in the lines of this publication, examples of work in medical education improvement around the world, inspiring stories and great perspectives. It has been a pleasure to work on it and read the articles as I am sure it will also be for you. I would like to thank all the contributors of this magazine for their work and efforts. Enjoy reading! Ioana Goganau SCOME Director, 2010-2011

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From the moment you can talk people start asking you what you would like to become when you grow up. Although it’s a silly question – how is a primary school child supposed to oversee such a life changing decision? – the answers are usually worth asking. My brother for example changed his mind every other week. And although he was very convincing when he told us he wanted to be an archaeologist, the subject at school he hated most was history. Nice match. When you grow older people will continue to ask you the same question. Even though it’s supposed to get easier with age, there’re many students that still don’t have a clue. For medical students it’s supposed to be different. You’re studying medicine and therefore you will become a specialist. Or...will you? The biggest challenge of medical education in the 21st Century is improving the alignment between the education of health workers and population health needs. A gap has been developed between the graduates of medical schools and what healthcare systems believe they need. Education has become more outcome-based and the main aim seems to be the production of brilliant medical specialists. These systems don’t take into account health system’s performance and people’s health status, while in fact, the outcomes of medical education should vary globally, because of the differences in healthcare needs in different parts of the world. In order to address this call for change within medical education, different organizations are currently working on this issue. The World Federation for Medical Education (WFME) for example, launched a project called the ‘Global Role of the Doctor’. They believe that the development of outcome-based education mainly depends on the definition of the role of doctor, because understanding of that role is essential for the development of assessment measures for the identified outcomes. Medical graduates should be able to

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work within a specific healthcare system and they will have to meet the needs of the communities they serve. The only way to achieve this is to adapt the outcomes of medical education to the healthcare system and population health needs. One specific focus point within this project is the social role of doctors, also referred to as social accountability. This year, the Global Consensus on Social Accountability has been published and it should be seen as a landmark for future medical education worldwide. It addresses ten strategic directions for medical schools to become socially accountable, including responding to current and future health needs and challenges in society, reorienting education and research accordingly and strengthening governance and partnerships with all stakeholders involved. In order to achieve this, networks and organizations concerning medical education should collaborate to move this consensus into action at global level. Also the World Health Organization contributes to this issue, with their initiative called ‘Transformative scale up of health professional education’. It aims to increase the quantity, quality and relevance of health professionals to strengthen their impact on population health. Therefore, educational institutions need to reform their curricula and improve the quality and the social accountability of graduates. Medical students can and should play an active role in this change within medical education. They should advocate to being educated as socially accountable healthcare professionals. They should be aware of the population health needs and the health care systems they will work in. And only when that will be included in their education they will be able to make a well informed decision on what they want to become after graduation. Margot Weggemans Medical student, Utrecht, The Netherlands SCOMED - 2009-2010 LOMEi - 2010-2011

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OUR

SCOME vision, mission and values vision is that medical students attain an optimal professional and personal development to reach their full potential as future doctors for better health care worldwide.

mission is to be the frame in which medical students worldwide contribute to the development of medical education. Students convene in SCOME to share and learn about medical education in order to improve it as well as benefit the most from it on a personal and professional basis. We support active involvement in education on a individual level encouraging students to take the initiative and responsibility for their education both curricular and extracurricular, through: seeking educational experiences and opportunities for further development, participating in extracurricular activities that simultaneously enrich them and benefit their peers or the community, collaborating with the faculties by forming and expressing informed opinions and providing appropriate feedback in an effort to elicit necessary change, as well as with national and international bodies in order to contribute to global improvement of medical education. We organize projects that promote and provide opportunities and tools for medical students to improve their knowledge and pursue their goals, provide information to students about relevant issues in their education, centralize students’ opinions, facilitate communication with the faculties or other institutions. We seek to promote best evidence medical education practices for efficient delivery, advocate for improvements in faculties, national medical education systems or international guidelines. Through all our joint efforts we work to create sustainable changes around the world, for ourselves as medical students, for the generations to come and for our future patients and our communities who are in fact the final beneficiaries of our education.

...more on vision, mission, values

Vision

Why do we do it? 2. What do we strive for? 3. How do we envision the future? The Vision outlines what an organization/ structure wants to be, or how it wants the world in which it operates to be. It concentrates on the future. It is a source of inspiration. It provides clear decisionmaking criteria. As an example of decision-making based on vision - most students would be happier with easier exams, but in the context in which we have the responsibility towards our future patients to provide them with quality healthcare we must realize we also have to have standards and quality assurance in medical education. We have to look for what provides us with the best professional development, and not decide on other criteria, like what is easier. Of course, if we can integrate other benefits for us in our decisions it is even better, but keeping in mind our priorities.

Mission

What do we do? 2. How do we do it? 3. For whom do we do it? The Mission defines the fundamental purpose of an organization or an enterprise, succinctly describing why it exists and what it does to achieve its Vision. As a simple explanation we exist to develop medical education in a way that fits and fulfils our vision. We do that in various ways from individual to global level as described more in detail in the mission.

values Responsibility - We take responsibility for our actions and education and act towards improving it.

Values

What principles do we base on our work, decision making, contribution, and interpersonal interaction?

Communication - We exchange experience, knowledge and opinions, and carry out our activities with complete transparency.

Collaboration - We work together towards common goals as medical students and also with other stakeholders.

Engagement - We involve and welcome all medical students in our actions.

Empowerment - We aim to motivate as well as provide the knowledge and skills needed to facilitate the efforts and drive change.

The Values are a set of beliefs that are shared among the stakeholders of an organization. Values drive an organization’s culture and priorities and provide a framework in which decisions are made. In this context, decision making refers to the procedure. There are two different sides of the decision making and to generalize, any other activity: the content/topic of the issue and the procedure to do it/decide on it etc. The organizational culture means all the internal procedures and unwritten traditions. Basically in SCOME it can be resumed to: we work together, we are innovative and we welcome others to join us. For example on international level we take the decisions as a group. Those with common interests should collaborate, but to identify common interests we have first to communicate. We are involved in our education and try to engage and empower others as well, since we all should be responsible for our education.

Creativity - We constantly look for new

Ioana Goganau, Romania, SCOMED 2010-2011

solutions and innovative ideas.

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

SCOME in the EMR: Potential, Developments and Challenges The Eastern Mediterranean Region (EMR) has been faced with great challenges for a long time. This region has always had a volatile temperament, often related to our status as a portal between the East and the West. Accordingly, many conflicts arise, such as those presently in the media. As medical students, we have learned to cope with these challenges, as actors in the theater say, “The show must go on!”. Medical school is a nonstop freight train whose destination can be elusive to many, especially since local and global opportunities may be scarce. Despite everything, the EMR SCOMEdians work to make their classmates’ experiences in medicine worthwhile. EMR SCOMEdians feel that it is their responsibility to stand up for their classmates. For those individuals who approach this altruism with skepticism, trust that we are capable due to the nature of our chosen profession. The present time calls for medical students to rise to the challenge, where we need to be armed with our knowledge and the qualities of a great physician and human being. However, great intentions do not always directly translate to great actions. Problems may arise, projects may be stalled, and sometimes we may find ourselves at a roadblock. This is natural and happens to all SCOMEdians around the world. The key is to find the right people to help. Our EMR’s biggest challenge is productive

communication. Noted as a major problem in the past, EMR SCOMEdians meet during regional meetings and general assemblies, interact superbly and promise to maintain contact, but subsequent months prove the absence of communication strategies. The good news is that we are working on reviving communication among EMR SCOMEdians with new friendships and shared experiences. We are collaborating in national trainings and general assemblies. For example, IFMSA-Saudi Arabia asked for input from their friends and regional assistants when advertising their national general assembly (NGA) in their region. As one of these described regional assistants, I was also asked to provide an update about the SCOME sessions at the IFMSA-SA NGA:

“SCOMEdians gathered from all parts of the country… Creative, intelligent ideas were shared and discussed in the SCOME sessions and workshops. Our slogan was: ‘Educate, Communicate, Improve.” In fact, ‘Educate, Communicate, Improve’ are three important tasks that SCOMEdians undertake. In the EMR, we constantly strive for the best in our countless projects aimed at improving the “life and livelihood” of our fellow medical students. This motto was taken from a SCOME project from LeMSIC Lebanon called the Orientation Initiative. Finally, I would like to reiterate an important message that I mentioned in the SCOME article recently published in the EMR Newsletter: “Join SCOME, Pay It Forward.” While helping elicit change in your faculty may or may not directly benefit you, it will bring about stronger physicians for your country. Imagine this impact on society as a whole! The practice of Medicine is characterized by the altruism of physicians. By participating in SCOME projects, you are truly exemplifying this value in your professional and personal life. This is why we can firmly say that SCOME is characterized by the altruism of the SCOMEdians. If any SCOMEdian is interested in learning more about the EMR projects, please read the EMR regional presentation given during the SCOME sessions and the minutes of the SCOME SWG in the Regional meeting at MM11. Please feel free to contact me for further information at ra.scome.emr@gmail.com.

Wajiha Jurdi Kheir, Lebanon SCOME Regional Assistant for Eastern Mediterranean Region, 2010-2011

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

In our way to improve medical education SCOME – The journey so far in Africa Medical education and health: Emerging of new philosophies for the concept of health denotes that the wheel of development in the health sector is still rocking, although it’s slow, with a lot of disparity and inequity when we take it from a global scope. Considering the fact that: ‘’Health is inter-sectoral’’ as one of these new philosophies, medical education remains the cornerstone sector in the infrastructure of any health care system. Where do we stand in Africa? Observational facts: Africa is known to be a part of those worlds that still suffer from severe shortage in the number of healthcare professionals and sequentially in the providence of even the basic health care services , because the whole situation including ‘’the medical education’’ is between the gravel of conflicts and the anvil of poverty. However some African countries are starting to cope with the international standards of health. Most of the African medical students carry the idea of either winning a university scholarship or completing their higher education in of the developed countries e.g. North America and Europe, convinced by the fact that the medical education they have received is not good enough, although most of the African countries offers the medical students a unique opportunity for more interactive clinical training in regard to the direct contact with patients. Furthermore they think that the current healthcare systems in their countries are not working effectively. Which contribute in creation of new problems as migration of the African healthcare professionals to other regions, to have their residency, while their countries are in extreme need of them. In our way to improve medical education in Africa - The international lobby World Federation of Medical Education (WFME) - In the last Africa regional meeting (ARM) in Nigeria –December 2010, we tried to contact the Association of Medical Schools in Africa (AMSA), which is the regional branch of the (WFME), through our SCOME Liaison officer Margot Weggemens. We asked them to www.ifmsa.org

come to the ARM to present in SCOME sessions about the WFME global standards of medical education with a future plan of lobbying with them, but unfortunately their contact person didn’t respond. But we will keep trying to approach them again. Federation for Advancement of International Medical Education (FAIMER) - The Foundation for Advancement of International Medical Education (FAIMER), is working mainly on the Educational opportunities, research, and data resources that inform health care policies and create sustained improvements in health outcomes. Africa regional institute is in South Africa (SAFRI) is a two-year fellowship program for health professions faculty who have the potential to improve medical education at their schools. Approximately 16 fellowships are offered each year. The fellowship is designed to teach education methods, scholarship, and leadership skills, and to develop an active, supportive professional network among educators. SAFRI (South African FAIMER Institute Fellows)is sponsored by FAIMER, and was established as a voluntary association in 2008 by 11 contributors. Fellows receive full funding for accommodations, meals, and program costs. International travel costs to and from the residential sessions are not included. By working to advance health professions education in Southern Africa, SAFRI supports FAIMER’s mission of improving global health by improving education. We didn’t established any contact with SAFRI yet, but we intend to lobby with them in the future days, after coordination with SCOME LO and SCOME D. SCOME Africa - the challenge is still ours As African medical students, we believe that improving the healthcare systems is basically in the hands of qualified future doctors, so our vision is’’ to be those who we should be; to face this challenge’’. In another words “how can we improve our medical education; to be qualified enough; to improve our career as well as our healthcare systems”. In hope to get their vision right, the African medical students started to raise their advocacy through different means e.g. forming local student’s unions, group work,

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academic associations, personal approaches, etc. Here SCOME entered the African pitch with its aim “to achieve excellence in medical education’’ ,this aim matches our African dream, though no doubt that SCOME will be our magical stick; to achieve this (SCOME aim/African dream). So, what’s the situation of SCOME in Africa? The mere facts Although I settled in the priority of my plan as SCOME regional assistant for Africa for this term; to have a view on the real status of SCOME in the region; to start the work, but unfortunately having a regional database for the African NMOs status regarding SCOME is a difficult job; because there is a huge gap in communications with the NOMEs even their NMOs, meanwhile I approach them through their official as well as personal contacts and I get no enough responses. The problem of communication was made mainly by the lack of internet access in most of the African countries. So knowing the situation depends mainly on the official reporting, which depends in turn on the NMO participation in the IFMSA general assemblies and Africa regional meetings(ARM) ,which itself is irregular ,and in some occasions upon the contact with the respondents (NOMEs and NMO presidents). Toward a better situation SCOME international team made a great effort by designing SCOME survey, and the new reporting system, which intends to reveal the situation of SCOME in the NMOs, the spectra of activities they have and the help we can offer to them. This was crucial for Africa; as it can gives us a more clear view on SCOME Africa and although there is responses, but we are still processing the results. According to the IFMSA’s official report of the last August meeting 2010 in Canada, there is 7 NMOs that submitted their report and SCOME is active in all of them. Those are: 1 -Burkina Faso – AEM 2 - Burundi – ABEM 3 - Ghana – FGMSA 4 - Nigeria – NiMSA 5 - Rwanda – MEDSAR 6 – South Africa –SAMSA 7 – Sudan – MedSIN-Sudan This is by far indicating that many African NMOs are working in SCOME, but there is a problem in sharing their work; due to lack of the reporting system and communication.

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SCOME Africa successful stories Some African NMOs represent a SCOME successful story ,taking SCOME MedSIN-Sudan as an example, they work on all types of activities of SCOME (project- based and curriculum based) and even more they have their own SCOME manual , and are involved in the transnational projects as ISSH and work on their own national projects e.g. SCOME training center … etc. Also SCOME FGMSA adopted ‘’ breaking the silence’’ an official IFSMA project and started to work on it nationally. And am sure there are more stories to be told.

SCOME Africa’s road map In SCOME sessions of the ARM 2009 in Sudan, we started to work on a development kit for SCOME Africa and the facilitator was Margot Weggemens (SCOME director at that time and the current SCOME LO), where we discussed the problems facing SCOMEdians in initiating and promoting SCOME in their NMOs. The last ARM 2010 in Nigeria we continued the discussions and now we are evaluating the progress of the proposed solutions, starting with the problems of reporting, communication and flow of information, which is the key point for the all upcoming actions. From the last ARM 2010, 2 new NMOs joined SCOME Africa family, they are Sera Lion and Ethiopia, and we have given them the support and the required knowledge and materials they need to establish SCOME. SCOME journey so far in Africa, despite the obstacles we face, will continue in a new era of enthusiasm and we will keep the advocacy for a better future of health and life in this old, great, rich land of Africa, through the IFMSA and SCOME in particular. Aymen Abbas Badri, Sudan SCOME Regional Assistant for Africa 2010-2011

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

Stakeholders and their questions regarding assessment

Assessment in Medical Education: An Overview “Assessment Drives Learning” This classic statement by George E. Miller (1919-1998) encapsulates in a single phrase the central role of assessment in any form of education. Particularly in medical education where the stakes are high, it is impossible to overstate the importance of assessment. Yet, medical schools are some of the most conservative in their choice of assessment methods, eschewing the new and embracing the tried and “tested” instead. Traditionally, assessment is viewed as a “necessary evil” in the curriculum — an act that we carry out because we have to. We posit that assessment, properly planned and implemented, has a powerful positive steering effect on learning and the curriculum. It conveys what we value as important and acts as the most cogent motivator of student learning. All faculties involved in assessing and teaching students must be aware of the profound influence they have on the education of their charges. It is not the marks they give the students that matter but their choice of assessment methods, implementation, monitoring, and, above all, the effort they put into the process that truly determines the outcome of our educational system. It is the duty of academics involved in assessments to be fully cognizant of the instruments available to them as well as the strengths and shortcomings of each. This Practical Guide seeks to give the faculty a better understanding of the principles of assessment, as well as an overview of the assessment methods available. Purpose Driven Assessment Assessment, if conducted properly, serves multiple purposes. Some of the purposes of medical student assessment are: • To determine whether the learning objectives that are set a priori are met • Support of student learning • Certification and judgment of competency • Development and evaluation of teaching programs • Understanding of the learning process • Predicting future performance (Amin & Khoo, 2004; Newble, 1998) Multiple purposes lead to wide ranging implications. One of these implications is that many stakeholders become interested in the results or data generated from the assessment. The areas of interest among the stakeholders also vary. What is at stake? In designing and planning assessments, it is critical to keep in mind the stakes of the assessment. The purpose of the assessment will determine the stakes. Generally, formative assessments tend to be low stake, continuous assessments of low or medium stake, and summative assessments of medium to high stake. The higher the stake is, the greater will be the consequences of the outcome of the assessment. Thus, there is a stronger need to ensure that the assessment is fair, reliable, valid, and properly conducted. www.ifmsa.org

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Assessment types and their characteristics

Examples of useful assessment instruments in low stakes examination include long essay questions and “traditional” long case examination. However, their use in high stakes examination is undesirable, as they tend to lack a high degree of reliability and are inherently prone to marking errors. A better strategy for high stakes examinations would be to replace those with more objective assessment instruments such as multiple short answer questions (in place of long essay questions) and objective structured clinical examination (in place of the traditional long case).

Mohamed Meshref, 2nd year medical student, Tanta university, Egypt Omar Safa, 5th year medical student, Tanta university, Egypt References and Further Reading Assessment drives learning, McGuire, C. (1999) George E Miller, MD, 1919-1998, Med. Edu. 33: 312-314. Purpose driven assessment AMIN, Z. & KHOO, H.E. (2003) Overview of Assessment and Evaluation. In: Basics in Medical Education, 251-260 (World Scientific Publishing Company, Singapore). NEWBLE, D. (1998) Assessment. In: Jolly, B. & Rees, L. (eds.) Medical Education in the Millennium, 131142 (Oxford University Press, Oxford, UK). What is at stake? SHEPARD, E. & GODWIN, J. (2004) Assessments through the learning process, Question mark White Paper. Question mark Corporation. Web address: http://questionmark.com/us/home.htm

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

Geriatrics without Mysteries

Disregarding financial issues, our simulators are capable of performing the same tasks and exercises requiring manual skills. Doctors and students with experience in field of laparoscopy field are invited to be lecturers and instructors during our workshops. Our workshops starts multimedia presentation describing the equipment used during laparoscopic surgeries, explains all the possibilities, presents most popular operation (cholecystectomy) in single step by step way. There will be also place for introduction of the future of laparoscopy and its variations like SILS, NOTES, da Vinci, Zeus, Aesop. After theoretical part we would like to continue with practical exercises during which we will present basic equipment e.g. graspers and scissors, familiarize stuAlicja Przywózka dents with its usage and basic maneuvers. Then participants will be allowed to pracMedicall student tice on training simulators in order to complete several tasks like peg transfer, pattern IFMSA Poland, Warsaw cutting, placement of ligating loop and suturing. We have no intention to teach how alicja.przywozka@gmail.com to perform specific procedures step by step but to develop students’ orientation and precision in action. If you decide that laparoscopy may be the idea created just for you, do not hesitate: there is nothing much more simple than becoming a surgeon – you just have to make one small step!

We live in an aging population and the numbers are ruthless. The “Look with eyes and hear with ears of an old person” number of elderly people has tripled over the last 50 years. It is predicted that by the year 2050, more than 1 in every 5 people throughout the world will be 60 or more. Healthcare system should be prepared to handle this situation so as medical students and future doctors it is our responsibility to manage this problem in the future. Geriatrics- what is the first association with this word? Boredom…? Nothing much wrong! Local Committee Warsaw of IFMSA-Poland with Geriatric Clinic will try to convince You that teaching geriatrics can be also a great fun! ,,Geriatrics without Mysteries” are innovative workshops that consist of PBL (Problem Based Learning) correlated with specific medical cases concerning geriatric issues, diagnosing step by step, discussion and brainstorm. We would like to present the differences between examining older and younger person and what’s more- main problems that occur in communication between doctor and old patient. It is important to get acknowledged how age influences people’s beliefs, opinions and emotions. The most attractive part of the workshops is a practical part ,,Look with eyes and hear with ears of an old person”. Every participant will be able to become older and see for oneself how it’s like to be. For that part we have prepared glasses with several diopters. While wearing them student has to read a text, for example medical prescription and ascertain how it’s difficult for short- sighted to read. Then we have stoppers to (not) hear and crutches to move. All of these suppose to help us to feel and understand everyday problems of elderly. Then students will have the opportunity to meet with a patient from hospital or retirement house, interview and examine him, suggest diagnostics and treatment. It is a great opportunity the use gained knowledge. After that students will meet with the president of polish association ,,Pensioner”- unbelievably active person who will show that being old doesn’t always create limitations to a person. The last part of the workshops is quiz with handbook prize. Medical student don’t always realize how important is to learn the differences while dealing with elderly patients. These workshops create completely fresh view on teaching geriatrics. We hope that every student will feel more confident and prove that learning geriatrics could bring many satisfaction!

Laparoscopy workshops

Rapid development of technology as well as non-invasive diagnostic and operative techniques One more step to becoming a surgeon gives laparoscopy the status of a ,,golden standard” and gradually replace old, invasive procedures. This is why we have decided to organize ,,Laparoscopy workshops”. This project aims to introduce all medical students to basic information and abilities in a field of laparoscopy, regardless of their future medical specialization. The workshops are scheduled to take place during next academic year in Local Committee Warsaw of IFMSA-Poland. There are several reasons why we have decided to organize this workshops. First of all, the need to obtain knowledge about the latest technology and basic surgical techniques is inevitable and it is every student’s obligation to be accustomed with latest methods before starting doctor’s career. We do think that it is beneficial for young doctor to be allowed to familiarize himself with laparoscopy during workshops, training on simulators rather than during real surgical procedure as it often takes place during one’s career. Additionally laparoscopy courses are expensive and limited to active doctors only. Workshops are aimed at medical students who want to introduce themselves to laparoscopy or widen their knowledge, gain several skills or perhaps discover their hidden talents. We would like to offer this workshops to students that are members of Student Scientific Associations with surgical profile such as general surgery, thoracic surgery, pediatric surgery, gynecology and urology. Moreover, we would like to encourage other students, especially those without any career plans to participate and learn about options in operative specialties. Professional training simulators offered by companies are extremely expensive and not all medical universities can afford them. Additionally, borrowing one for the purpose of training students is in most cases impossible. It is the main reason why we have decided to construct – with low financial expense and minimum effort – a simple training simulators which have the same features as the professional ones. www.ifmsa.org

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Doctors and Death – confronted by dying patients

Death is omnipresent. Even in times of transplantation, chemotherapy and open-heart surgery, there are diseases we can not cure. As future physicians, we will encounter many patients suffering from chronic diseases and eventually, all of them are going to die. But how do we deal with dying patients? How do we bear ourselves when faced with the boundaries of modern medicine? And how do cope with losing a patient whose live was placed into our hands? Questions like these may have crossed the minds of medical students all around the world. They evoke fear or even doubt about our capability to survive as doctors. But even though these questions are essential, they are never addressed in our education. For that reason we, four medical students from the University of Bern in Switzerland, founded the project Doctors and Death in 2010. Our goal is not to present solutions to the questions above but to address them. In November of 2010, we organized a series of workshops on a Saturday afternoon, open to medical students of all levels. During the four workshops we had tutors from different vocational fields telling us about their experience with dying patients. Among the tutors were doctors from a palliative center and hospital pastor. He showed us that according to studies from the US, 80% of the patients prefer to talk about spiritual questions with their doctor instead of with a priest. We also got a lot of practical tips on how to communicate with dying patients and how to discern what topics are of importance to them. A psychologist from the Swiss cancer league talked to us about dealing with the family members of those patients. In the end, we concentrated on our own relationship with death and on how we can cope with the death of a patient personally. Following the afternoon of workshops, the participants also had the opportunity to take a practical training in a palliative station in order to practise their communication skills and get an insight into this important branch of modern medicine. The second field of action of our project is at University level where we fight to make palliative care and communication with dying patients a firm component of the curriculum of our University, so that maybe some day our workshops will not be needed anymore. Until then, we go on, the next workshop is planned for November 2011. Rebekka Reber 5th year medical student at the University of Berne, Switzerland rebekka.reber@bluewin.ch

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The SCOMEdy / 1st Edition

The

A M E E

Photo: AMEE Conference, Malaga, Spain, 2009

experience

The SCOMEdy / 1st Edition

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The AMEE conference is the highlight of medical education. It usually takes place at the beginning of September each year, marking somehow the beginning of a new academic year. It brings together more than 2000 professionals and experts in medical and health related education, including teachers, educationists, researchers, administrators. It also brings together a incredible group of students for a great experience and memories that last a life time. The Student Taskforce consists of 25 students from all parts of the world. The IFMSA Liaison Officer for Medical Education issues, together with the IFMSA and EMSA Medical Ecucation Directors make a selection of all applications received. In the last five years, the Student Taskforce has assisted session facilitators and participants during the conferences and has been helping out with practical issues and logistics. At the same time, the students get the chance to participate in sessions, contribute as partners and learn a lot of things to take back home. In addition, students have proven to bring essential contribution to the sessions and medical education. They are the experts of their own education and their opinion and input has been very much appreciated. All in all, the Student Taskforce has become a constant part of the conference. There is also a growing number of students representing their universities coming to the AMEE conferences. They are going back to report what they have learned and bring innovations for their own educational systems. Students also present abstracts and posters on medical education. Since there is hardly a phrase in this conference that does not relate to medical students becoming the doctors of tomorrow, learning, being taught, being evaluated, selected, oriented, mentored, being active, even teaching, it is the most natural thing that the students are also present and well represented at the AMEE conference. Through the exchange of information, the intense discussions, critical analysis of the current situation and the networking, the AMEE conference fosters improvements and leads change in medical education worldwide. It covers a wide range of topics, some with a strong tradition like ESME courses (Essential Skills in Medical Education) and other that investigate the most recent trends. Very important in the headlines of last year’s conference, AMEE 2010, Glasgow, were topics like progressive curricula, perspectives in education of future doctors, professionalism, e-learning, integrative curricula and interprofessional learning. In Glasgow, medical students participated in different symposia and presented abstracts on students-run medical education workshops (MEDIK-Ts), on policy statement on the Bologna Declaration, even facilitated full workshops. They chaired and facilitated sessions throughout the conference, and in the end, our past Liaison Officer on Medical Education issues, Robbert Duvivier, presented the students’ view on the conference. The AMEE Conference is undoubtedly one of the most “educating” and delightful experiences. Through this article we would like to share the AMEE student experience by a series of interviews. www.ifmsa.org

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General Impressions The AMEE Conference inspires you from the first moment. From the beginning you have the feeling of being part of a great community that for a few days gets to debate, work, talk and half fun with the only purpose of achieving a better future for tomorrow´s doctors. You get to fill as if every moment counts for your future, that the things that you are learning there will change your daily practice as a student as a physician in the future. You are able to get in contact and discuss with the people that actually make change real in Medical Education. Even more, you get to understand that you, yourself can make a difference. What did you like most? The workshops and discussions are really practical and allow you to participate with absolute freedom and interact with the world experts on different topics. The range of different topics you´re able to learn from is really impressive: from quality assurance to continuos professional development, AMEE conference enables medical students to see that empowering change in Medical Schools is as easy as having the opportunity to have a greater vision of the medical practice. And being part of the student taskforce also allows you to discuss all the things you learn by day with “student experts” from all the world. The whole idea of a conference is to exchange your point of view and learn together with others. Working there with such a great time of students is indeed one

Photo: AMEE Conference, Malaga, Spain, 2009

of the main factors that keeps you wanting more. How did you use the experience you gained? I would say that the first thing that I gained was a whole new vision on what working on Medical Education means. You would say that being the workshops so specific, the only application you would find to an AMEE conference is a to see how you can use them back home. But I think that is not the point of the AMEE Conference. AMEE Conference has given my the first skills and knowledges that have allowed me to continue my work in Medical Education. The discussions opened in the AMEE, and the experience learnt there must be the first step towards working home in a more practical way. I encourage people to learn all they can there, but most important of all to look for new tools and topics to get them back home and explore them. In my case, I would speak of some really specific topics I have been trying to work back home: -The need of a continuos feedback for every personal/professional project that you embrace yourself on. -Life long learning as a need for future physicians, and the different models of continuos professional development we are able to find all over the world (CanMEDS, USA). -Bologna process implications and its implementation in different countries

Photo: AMEE Conference, Glasgow, UK, 2010

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

Thanks to my attendance to the AMEE Conference I´ve been able to discuss this topics with my School board, in my School Council and with National Council, achieving new (and great) results. For me, it was a really huge experience, and I hope that others in the future are able to learn and enjoy as much as I did. Thank you student taskforce 2009 ;) Iñigo Noriega, Spain Student taskforce 2009

General Impressions In few words: a swiss-watch precision in organizing the conference, so many open-minded scientists that have the ability to inspire others, performance, excellence, but warm atmosphere. What did you like most? The opportunity to find out the latest information in Medical Education. After all AMEE is the largest Medical Education Conference in the world. How did you use the experience you gained? I prepared scientific studies, based upon things heard at the Conference. One was awarded First Prize at an International Medical Student Congress. Flaviu Bodea, Romania Student taskforce 2010

General Impressions Great atmosphere, great people. I met doctors and teachers coming from all other the world to speak about their experiences and to learn a lot from themselves and from the trainers. Everybody really open minded, ready to talk, listen and learn. What did you like most? ESME courses and the pre-conference workshops. How did you use the experience you gained? I used the suggestions and the ideas in new project and proposals. THE experience to make! Andrea Scicolone, Italy Student taskforce 2009

General Impressions “INSPIRATION” is one word that can summarize the impact that AMEE had on me especially when I attended it as an AMEE student taskforce member. It is both inspiring and rewarding to have the unique chance of being exposed, only in the matter of days, to a wide variety of disciplines in medical education. It is also thought-provoking to learn, from medical education experts, about the status quo of and the challenges facing medical education in different parts of the world. I think the real power that underlies AMEE is its ability

many other scientifici medical fields, the number of students’ present and the activities students’ organised for conference participants allowed me to grow my network and to enjoy high level academic content, charismatic speakers and people whom infected me with more enthusiasm for the field of medical education. What did you like most? Various great speakers, Social programme organised by students for all conference participants wishing to attend. How did you use the experience you gained? It’s the AMEE conference in 2005 in which I was a student member of the Local Organising committee, together with the 2005 IFMSA/EMSA Bologna Process workshop, that launched me from being a locally active student into being an internationally active student. Right after the AMEE conference, I became a Medical Education Director for EMSA (The European Medical Students’ Association). From this point on my activities sky-rocketted. With what I learned at the AMEE conference, I created the idea for the first international leadership Summer and with the inspiration I got from here and my knowledge of medical education, I created a Summer School on Parkinson’s Disease for healthcare students and young professionals. I also created an elective course on “Teamwork” and I started development of a “Train the Trainer”-elective course in which we would train medical students to be trainers in “soft skills”. Paul de Roos, The Netherlands Student taskforces 2005, 2006, 2007

Photo: AMEE Conference, Glasgow, UK, 2010

to draw people from all over the world, create a unique atmosphere that is conducive to learning and exchanging experiences and finally translating this exchange into meaningful change that is implemented on a local level. What did you like most? I liked most about the very beneficial workshops, ESME courses, and the global networking. How did you use the experience you gained? Attending AMEE highly motivated me to pursue my

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contribution to medical education even beyond SCOME. That is why I enrolled for a more professional position in my medical school to help restructure our curriculum. Since then, the workshops I attend in AMEE help me prepare and implement proposals for improvement in my medical school. Fatima Ghaddar, Lebanon Student taskforce, 2009

General Impressions A conference open and welcoming to new people. Unlike in

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General Impressions To be a part of student task force was one of the best experiences of my life. In AMEE I learnt what is Medical Education and what role can student have in its’ development. I exchanged my ideas with other persons from diferents countries and understood what they want to improve and what difficulties they have to surpass. Since there I’ve constantly tried to improve medical education in my country. What did you like most? For me the most important thing was the possibility of exchange ideas with different persons from all over the world. I would point out the strong spirit of unity that existed among the students from all over the world during the five days of intensive work and all the learning that we had the privilege to have. How did you use the experience you gained? My experience in the AMEE allowed me to develop some activities at local level, but also at national level. Since AMEE 2009, I started some projects and I would like to mention two of them. “Dia de Educação Médica” - Medical Education’s Day, which consist in a small congress that I started in my School. In first edition in 2010 we made a contest of works of medical education for national students, researchers and doctors. On this day we also had 3 sessions, one about stress in medical students, other about simulated clinical situations and another one about master’s thesis. In the second edition, in 2011, we organized two long sessons. One about medical curriculum, and another one about medical carrer.

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This small congress had as basis for the sessions themes that I had see in the AMEE 2009, but also in the AMEE 2010 that I attended on-line. The other activity that I would like to talk about is “Tutorias”, which consists in a group of voluntary older students thats are responsable for recevied the new students of my school. The objective is to reduce the stress of the new students by entering in a new world, higher education. Therefore, since AMEE 2009, I started to be more involved in medical education in Portugal and I became a member of the group working in medical education in Portuguese medical student association. José Pedro Águeda, Portugal Student taskforce 2009

General Impressions An AMEE Conference is a tremendous experience! It is very empowering, may you want to become a teacher yourself, or want to make any change today in your university, bringing back home what your leant from the outside world education. What did you like most? The diversity of the topics dealt with, in parallel. Everyone can find something they will be interested in ! Often it is hard to decide between two sessions, the one you will attend. How did you use the experience you gained? Education experience gained can help in any IFMSA training, at our level. You also learn a lot about how other countries deal with the medical education issues (getting into the university, exams) and hence have a much broader insight to any topic you will be dealing in your NMO or University. Moulin Maxime, France Student taskforces 2009. 2010

General Impressions I think that the AMEE conference was incredibly inspiring. It is easy to take much of medical education for granted. However, when you are hearing talks about the newest cutting edge ideas, it is inspiring and make you want to take what you have learned back to the local level. What did you like most? I feel that AMEE had two incredibly strong points. First, it allows you to interact with students from around the world in a professional setting. It is one thing to meet students at IFMSA events, but it is an entirely different and deeper experience to hear them present on their research. Second, you are hearing from some of the world leaders in medical education. How did you use the experience you gained? I feel that I have gained international colleagues that I can collaborate with. I think that the conference also gives you a great “in”, not only in meeting some of the biggest thinkers in med ed, but gives you some credibility when going back to your local level. John Brockman Student taskforce 2010

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

General Impressions Overall, the experience was mindblowing. It was my first international event, as well, which probably helped in giving a good impression. What did you like most? The chance to meet experts from all around the globe that most of the time are possibly “people you read on Journals”. Apart from that, plenary speeches were really inspiring (and, of course, the rest of the students of the taskforce). How did you use the experience you gained? I used it (both the experience and stimulus) for diverse positions related to medical education (both NMO and student representative) On the next NGA (October 2009), I applied for a position as Liaison Officer for the Spanish Medical Education Society, and Student representative. Then, next year (now), I applied for NOME. This year, we tried to arrange a similar model (a student taskforce) for the SEDEM (Spanish Medical Education Society), but, finally, t is not going to be organized, at least by IFMSA-Spain. I think that the AMEE09 experience was an inflection point in me, and changed my life for the last two years. No joking. Ignacio Morrás, Spain Student taskforce, 2009

General Impressions The AMEE conference was one of the most eye-opening and inspiring experiences I’ve had in medical education. The conference is full of educators of all levels from around the world, looking for ways to shape the future of medicine.

What did you like most? The fringe sessions are amazing! They are so fascinating and often hilarious, but highlight effective ways to engage and educate physicians-in-training. However, the best part of AMEE is being surrounded by like-minded faculty and students who are excited to propel medical education forward in new ways. How did you use the experience you gained? The experience inspired me not only to learn more about medical education but to think creatively about education. The AMEE conference helped me to think outside the box anytime I’ve tried to learn or teach new concepts. Matt Stull, USA Student taskforces 2009, 2010

These testimonials speak for themselves. AMEE conference is one of the most wondeful experiences in medical education, helping us as students to gain knowledge, to become more motivated and capable to be active partners and contributors to medical education improvement worldwide. As IFMSA and SCOME it is a great addition and support to the resources we have in the organization as our greatest assets are the motivation, experience and joint efforts of our members. We welcome all of you to take part in it and get your own personal and wonderfull experience!

Interview by: Ioana Goganau, Romania SCOME-D 2010-2011

SCOME Agenda

60th IFMSA August Meeting, Copenhagen, Denmark August 2nd - 9:00-12:30

9:00-9:20

Check-in - Ioana & Margot Brief introduction to SCOME Icebreaker, expectations Ground rules

9:20-10:30 SCOME overview - Ioana SCOME around the world, highlights of activities in NMOs, reports Regional Updates - RAs SCOME policy statements - Margot

10:30-11:00 External session - Stefan Lindgren – World Federation for Medical Education President 11:00-12:15 Project presentations 12:15-12:30 Check-out, day evaluation

August 3rd - 9:00-13:00 9:00-9:15 Check-in, energizer 9:15-11:45 Setting up a SCOME activity/ project – parallel session *Common then split then join again 1)Newcomers - Basic principles, types, basic planning and strategies 2)Experienced – work on specific cases Exercises and group activities 11:45-12:00 IFMSA official projects - Nick (PSDD) 12:00-12:15 External session - Nick Shocky – Director, Right to Research Coalition 12:15-12:45 SWG set up, brainstorming, choosing SWG and facilitators 12:45-12:30 Check-out Day evaluation

Photo: AMEE Conference, Glasgow, UK, 2010

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www.ifmsa.org

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The SCOMEdy / 1st Edition

The SCOMEdy / 1st Edition

August 4th - 16:30-18:30 - SWGs time - SWG facilitators August 5th - 9:00-12:30 Check-in, energizer

9:10-9:30 External Updates - Margot WFME, AMEE, AMEE Conference 9:30-10:00 Presentation of candidates for SCOME-D, LOMEi for term ‘11-’12 Candidate debate and discussions 10:00-12:30 External session joint with SCOPH and SCORP 1)Sir Michael Marmot 2)World Health Organization representative 3) International Council of Nurses Topics: social determinants of health, healthcare access, neces sary interventions in medical education, interprofessionalism.

August 6th - 9:00-13:00

Ioana Goganau Director on Medical Education scomed@ifmsa.org

Margot Weggemans Liaison Officer on Medical Education issues lme@ifmsa.org

9:00-9:10 Check-in, energizer 9:10-11:30 Training - Advocacy 11:30-12:40 Outcomes and plans Presentation and discussion of SWG results SWG facilitators Follow-up plans Large group discussion 12:40-13:00 Check-out - Ioana Final evaluation Group photo

Aymen Abbas Badri Regional Assistant Africa ra.scome.africa@gmail.com

Fatia Masriati Regional Assistant Asia-Pacific ra.scome.asiapacific@gmail.com

Wajiha Jurdi Kheir Regional Assistant EMR ra.scome.emr@gmail.com www.ifmsa.org

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Ian Pereira Regional Assistant Americas ra.scome.pamsa@gmail.com

Deyan Popov Regional Assistant Europe ra.scome.europe@gmail.com

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SCOME international team 2010-2011

9:00-9:10

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Algeria (Le Souk) Argentina (IFMSA-Argentina) Armenia (AMSP) Australia (AMSA) Austria (AMSA) Azerbaijan (AzerMDS) Bahrain (IFMSA-BH) Bangladesh (BMSS) Bolivia (IFMSA Bolivia) Bosnia and Herzegovina (BoHeMSA) Bosnia and Herzegovina - Rep. of Srpska (SaMSIC) Brazil (DENEM) Brazil (IFMSA Brazil) Bulgaria (AMSB) Burkina Faso (AEM) Burundi (ABEM) Canada (CFMS) Canada-Quebec (IFMSA-Quebec) Catalonia - Spain (AECS) Chile (IFMSA-Chile) China (IFMSA-China) Colombia (ASCEMCOL) Costa Rica (ACEM) Croatia (CroMSIC) Czech Republic (IFMSA CZ) Denmark (IMCC) Ecuador (IFMSA-Ecuador) Egypt (EMSA) Egypt (IFMSA-Egypt) El Salvador (IFMSA El Salvador) Estonia (EstMSA) Ethiopia (EMSA) Finland (FiMSIC) France (ANEMF) Georgia (GYMU) Germany (BVMD) Ghana (FGMSA) Greece (HelMSIC) Grenada (IFMSA-Grenada) Hong Kong (AMSAHK) Hungary (HuMSIRC) Iceland (IMSIC) Indonesia (CIMSA-ISMKI) Iran (IFMSA-Iran) Israel (FIMS) Italy (SISM) Jamaica (JAMSA) Japan (IFMSA-Japan) Jordan (IFMSA-Jo) Kenya (MSAKE) Korea (KMSA) Kurdistan - Iraq (IFMSA-Kurdistan/Iraq)

Kuwait (KuMSA) Kyrgyzstan (MSPA Kyrgyzstan) Latvia (LaMSA Latvia) Lebanon (LeMSIC) Libya (LMSA) Lithuania (LiMSA) Luxembourg (ALEM) Malaysia (SMAMMS) Malta (MMSA) Mexico (IFMSA-Mexico) Mongolia (MMLA) Montenegro (MoMSIC Montenegro) Mozambique (IFMSA-Mozambique) Nepal (NMSS) New Zealand (NZMSA) Nigeria (NiMSA) Norway (NMSA) Oman (SQU-MSG) Pakistan (IFMSA-Pakistan) Palestine (IFMSA-Palestine) Panama (IFMSA-Panama) Paraguay (IFMSA-Paraguay) Peru (APEMH) Peru (IFMSA Peru) Philippines (AMSA-Philippines) Poland (IFMSA-Poland) Portugal (PorMSIC) Romania (FASMR) Russian Federation (HCCM) Rwanda (MEDSAR) Saudi Arabia (IFMSA-Saudi Arabia) Serbia (IFMSA-Serbia) Slovakia (SloMSA) Slovenia (SloMSIC) South Africa (SAMSA) Spain (IFMSA-Spain) Sudan (MedSIN-Sudan) Sweden (IFMSA-Sweden) Switzerland (SwiMSA) Taiwan (IFMSA-Taiwan) Tatarstan-Russia (TaMSA-Tatarstan) Thailand (IFMSA-Thailand) The former Yugoslav Republic of Macedonia (MMSA-Macedonia) The Netherlands (IFMSA-The Netherlands) Tunisia (ASSOCIA-MED) Turkey (TurkMSIC) Uganda (FUMSA) United Arab Emirates (EMSS) United Kingdom of Great Britain and Northern Ireland (Medsin-UK) United States of America (AMSA-USA) Venezuela (FEVESOCEM)

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