{"id":23675,"date":"2013-01-10T12:45:36","date_gmt":"2013-01-10T11:45:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=23675"},"modified":"2013-01-10T12:45:36","modified_gmt":"2013-01-10T11:45:36","slug":"kieran-walsh-should-we-be-more-short-term-in-our-thinking-about-medical-education","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/10\/kieran-walsh-should-we-be-more-short-term-in-our-thinking-about-medical-education\/","title":{"rendered":"Kieran Walsh: Should we be more short term in our thinking about medical education?"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/09\/21\/kieran-walsh-free-medical-education-would-deliver-savings-in-the-long-term\/kieran_walsh\/\" rel=\"attachment wp-att-20671\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-20671\" alt=\"\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2012\/09\/kieran_walsh.jpg\" width=\"160\" height=\"110\" \/><\/a>Putting the horse before the cart always seems like a sensible idea. And so it is with funding initiatives\u2014it seems sensible to invest in starting up sustainable projects that will have long term positive outcomes. This is largely the received wisdom in investing in healthcare professionals\u2019 education\u2014invest in the undergraduate education of healthcare professionals in poorer countries and in a few years time you will have a bigger, better, and more productive workforce. Although sound in theory this doesn\u2019t always work in practice. Trainee health professionals drop out or emigrate to richer countries or the funding is invested in the production of professionals who follow a Western model and that does not always meet the needs of the local population. Production of tertiary care specialists in countries that need primary care professionals is not likely to be a helpful outcome. Healthcare professionals\u2019 education is also by its nature a long term process\u2014it takes ten years to produce a family doctor from scratch\u2014by which time people have moved on, the agenda has moved on and funders have often moved on also. It seems like heresy to even ask the question, but is there something that we can do that would be short term, that would have immediate positive outcomes, and that would have high take up amongst healthcare professionals? <!--more--><\/p>\n<p>George Miller famously said in the context of medical education that, \u201cassessment drives learning,\u201d and Richard Hays in a different take on the same subject said, \u201cif assessment drives learning, then let\u2019s ensure that it drives learning in the right direction.\u201d Both quotes emphasise the importance of assessment in medical education. Medical students and doctors in training are driven by the need to pass exams. By and large they will only study what will come up in exams. So if we can change the agenda of the exam then we can change the agenda of healthcare professionals\u2019 education\u2014in a far more fundamental and effective way then we can by adding another new item to an already bloated curriculum. How can we change exams? Its easier than you might think. Medical education bodies often struggle to get material (test items) for their exams. If you supply them with test items, then they will take them up and use them in their exams. Students will then study towards the test. If you supply lots of test items in communication skills, then that is what students will study. If you supply test items in shared decision making, then that is what students will study. The same goes for clinical subjects.<\/p>\n<p>It\u2019s putting the cart before the horse, but it may be an effective strategy and its surprising that it hasn\u2019t been tried more often.<\/p>\n<p><em><strong>Kieran Walsh<\/strong> is clinical director of BMJ Learning\u2014the education service of the BMJ Group. He is responsible for the editorial direction of BMJ Online Learning, BMJ Masterclasses, and BMJ onExamination. He has written two books\u2014the first on cost and value in medical education and the second a dictionary of medical education quotations. He has worked in the past as a hospital doctor &#8211; specialising in care of the elderly medicine and neurology.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Putting the horse before the cart always seems like a sensible idea. And so it is with funding initiatives\u2014it seems sensible to invest in starting up sustainable projects that will [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/10\/kieran-walsh-should-we-be-more-short-term-in-our-thinking-about-medical-education\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5732],"tags":[],"class_list":["post-23675","post","type-post","status-publish","format-standard","hentry","category-kieran-walsh"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Kieran Walsh: Should we be more short term in our thinking about medical education?  - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/10\/kieran-walsh-should-we-be-more-short-term-in-our-thinking-about-medical-education\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Kieran Walsh: Should we be more short term in our thinking about medical education?  - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Putting the horse before the cart always seems like a sensible idea. 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