Saturday, 10 November 2012

ASPiH 2012 annual conference: the "good"

The recent ASPiH conference in Oxford (6th-8th November) was my third. It has improved year on year. The keynote speeches were a highlight.

The two excellent keynote speeches by K. Anders Ericsson and Donald Clark were bracketed by less impressive, but still thought-provoking, presentations by Jonathan Wyatt and Tom Reader.

Jonathan Wyatt's presentation style was original; mixing vignettes about his travels and encounters, with a more traditional presentation. Jonathan had obviously put a lot of work and thought into this keynote so there was certainly not a lack of preparation. Where it fell short, however, was in its applicability and relevance to the audience of the entire conference. An excellent speech for an interested minority became an unsuitable performance (with its incorporation of Gilles Deleuze and post-structural theory) to the plenary.
I did like his comment on how, at times, we go to a lecture or presentation in order to switch off. We disparage the orator for his use of powerpoint slides while at the same time praying that he/she does not make the session interactive.

Tom Reader had the misfortune of using a powerpoint-based, behind-the-lectern-standing presentation which had been mocked by Donald Clark earlier that day. However, Tom's idea that psychologists need to get involved in the building of scenarios and looking at outcomes is well-informed. Tom's challenge to us that the holy grail of simulation, showing that what we do improves morbidity and mortality across the board, may be unachievable (or wrong) was a good one. Tom also mentioned the ceiling effect of the simulator, that people may at one stage not improve despite further simulator sessions. This was relevant to Dr Ericsson's talk.

K. Anders Ericsson discussed expertise and the lessons which may be learned from expert chess players and musicians. Malcolm Gladwell's 10,000 hours to become an expert was referred to and supported. However Anders reinforced the idea of deliberate practice. As a guitar student I know exactly where he's coming from: repeatedly putting your fingers in the wrong position for a given chord means you become very good at playing the chord badly.

Anders also showed that "older/more experienced" is not necessarily "better". If we fail to continue to carry out deliberate practice then our skills deteriorate. This may be one reason for the fear of senior doctors to come to the simulation centre: those whom we would expect to be most experienced (and best) in a scenario may disappoint us and, much more importantly, themselves. This makes the creation of a safe learning environment with an understanding faculty an essential foundation of good simulation-based medical education.

Donald Clark provided the most thought-provoking and challenging keynote. Why do we continue to use lectures to provide information? Why are we paying traditional universities thousands of pounds so that students can sit in lecture theatres to hear a one-off talk from a person behind a podium? Can we use adaptive learning in simulation? Should we be embrace "failure" in the simulator? Donald gave me the kick up the backside I needed to look at how we can communicate better and smarter. This blog is a small first step.

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