Bidirectional learning

Been thinking about how preparing for elective can facilitate bidirectional learning i.e. elective students teach and share knowledge with host students/doctors/staff/patients etc.

The UCL elective Booklet is filled with some excellent ideas on what to bring and how to prepare mentioning how students could contact the centre in advance and find out if they have any use for medical textbooks, BNFs etc.

In the context of electronic resources i had a thought. There are a number of excellent podcasts on International health issues: some discussing electives, global disease and treatments, health care policies, international aid and so on. Many are audio, some are in video.

These are easily linked to on a wiki resource, but i only thought of searching itunes for podcasts now, how many students would think of this before elective?

Moreover, podcasts can be downloaded to ipods or mp3 players. Almost every student has an mp3 player and no doubt takes that on elective. Lightweight, lighter than a bunch of textbooks, and with a cheap pair of speakers, easily presentable to a number of people. real potential for bidirectional learning. Not only that, it allows the student to study/refresh/learn about important things in the elective when they want to, when they might necessarily have more time to do so

lancet infectious Diseases Podcasts - burden of disease, research in public health ...

Lancet Student podcasts - electives, activism, diseases ....

CSIS Global Health Policy Podcasts - policies, interviews and articles on global health

Global Health & Development Podcasts - public radio International podcasts and videos of common diseases, health issues

There is a whole host more too.

Availabilty of resources

Electronic Resource for Students on Elective in Resource Poor Countries.

A fortnight into my research and I am certain that there is no easily accessible central resource for students going on electives. Sites do exist with small gems of information, but the majority of websites are orientated towards placing students on electives and the pragmatic approach to going on elective.

Sites like The Elective Network - from the MDU, Medicstravel and Medical Student Electives contain a wealth of hospital lists and contacts as well as information on travel advice, what to bring, health insurance and so on. But almost no content on what to expect, socio-cultural expectation, moral and ethical issues, how to prepare in a way that will ease transition, assist the host institution etc.

Within Dundee Medical school there appears to be almost no preparatory information provided or required to be sought by students before going on elective. The exceptions being the absolute requirement to read policies on infection control and HIV risk.

In Dundee, the elective is seen as a task to be completed by the individual: to take responsibility for planning, communication and personal development and has been assimilated into the 12 Outcomes of the Scottish Doctor. Rightly or wrongly, this has long been the tradition of the medical elective - presumably since its inception. The learning outcomes relate strongly to experience gained whilst on elective, but make no claims that the student should prepare beforehand.

Competent to offer advice in health promotion and disease prevention

• The most common health problems of the area/country: possible ways of improving health care.
• Statistical data relating to the country, the health services, the hospital and ability to offer health care service.
• Size and facilities of hospital: its staff (if abroad, how many of the staff are nationals/expatriates): service provided by the hospital: population it serves

Understanding of basic, clinical and social sciences and underlying principles

• Further knowledge of medicine: opportunities to gain clinical experience.
• List of diseases you saw and (if possible) numbers of patients presenting.
• Short vocabulary list (if elective overseas), i.e. words useful for students.
• Account and analysis of any research project undertaken.

Appropriate attitudes, ethical understanding and legal responsibilities

• At least two full case histories with comment on social and cultural back-grounds.
• Willingness of the staff to accept students for elective: teaching methods and standards.
• Appropriate decision making skills and clinical reasoning and judgement
• Critical analysis of information

Understanding of the role of the doctor within the health service

• A comparison of the doctor’s role within a different system of healthcare compared with that in the NHS.
• The contribution a student can make in the work of the hospital: the work you did and the level of responsibility given.

Aptitude for Personal Development

• The value of the elective within the final year curriculum: the academic value of your elective and its particular value for you personally.

Two key concerns are raised from these outcomes. Firstly, many of these outcomes are could be achievable before going on elective and would vastly improve the experience of students on elective. It is not unreasonable to ensure students have relevant knowledge of the diseases they will be encountering, before encountering them. Secondly, the outcomes of the elective are incredibly unidirectional and pertain in no degree to the benefit of the host institution or ethical considerations.

This may seem far removed from a student project in developing an online resource, but my observation is that the creation of such a resource is indicative of the current attitudes of Medical electives.

Somewhere in the region of 150 Students in Dundee will go on a 6 week elective at Dundee. A UK survey by Miranda et al (2002) found that around 40% of elective students go to poor countries, largely on unstructured electives. In Dundee, with a year-group in the realms of 150, that is at least 60: the cumulative equivalent of nearly 7 years experience in a resource poor country. As Dowell and Merrylees(2009) point out, thats an estimated 350 years of elective time spent in poor countries by UK students alone, and represents a substantial opportunity.

So far, a number of important issues have arisen and will need to be in my mind as I go on through this project:

• The system is flawed
  
• There is a disproportionate lack of information relating to electives in comparison to the enormity of the elective programme and Global health issues
• Students don't use elearning to its full potential and won't make full use of resources -
  
• 4th Year students are incredibly busy with exams and general 4th year business to worry about preparing properly for electives.

The task at hand therefore is to weave together a resource that encapsulates important aspects of global health and working as a student in resource poor countries in an attractive and relevant format with the potential to be developed by a community of students

Art of Crossing Cultures from INMED on Vimeo.

Elective Research Survery

If you have found this site, you have probably seen or completed the survey i have compiled entitled "Pre-elective Resource" on polldaddy.com

The aim of the survey is to establish opinions about what kind of electronic resource medical students could use as preparation for their elective in a resource poor country.

Hopefully the results of the study will assist in the creation of such a resource which will improve the prepared

I will post the background reasoning behind this shortly, but in the meantime it would be great if you could complete the survey and leave some comments