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Interview with the ASME president

Prof Gallen: “The difficulty in medical education is the nature of translating knowledge into practice into work with patients”

According to Prof Gallen, evidence based practice and best practice are at the heart of ASME.

Professor Derek Gallen is the president of the Association for the Study of Medical Education (ASME), based in Edinburgh, Scotland (United Kingdom). He took over the position in 2017 and has been particularly devoted to increase its profile both in the UK and abroad. He has been the Postgraduate Dean for the Wales Deanery since 2006, facilitating the research around educational standards and introducing medical education to the curriculum of trainees. He is also the Director of the UK Foundation Programme and sits on the Education and Training Advisory Board at the General Medical Council. Here, he talks about medical CV, assesment and clinical simulation on the occasion of our institutional membership.

Exeter - February 21, 2019. Could you please explain us your role as president of ASME and the core components of the association itself? What are your goals in 2019?

As president my job is to be an ambassador for the organisation. ASME is a charitable organisation and its aims are “to meet the needs of educators, learners and policy makers by supporting scholarship, inquiry and research-informed best practice within medical education”. We have a number of special interest groups looking at specific aspects of medical education. Our main groups are the educational research group and the educational delivery group. They run events every year for our members (and non members) to attend and get the latest updates.

Over the coming year we are particularly trying to increase our profile and membership both in the UK and abroad. We are also looking to develop local champions in other countries to disseminate the work of ASME. We would be particularly keen to have representatives from your country and we can help with publicity materials to be given out at local events. Our website outlines the working groups we have and of course there is the journals medical education and medical teacher that form a large part of the dissemination of the quality in education we are firmly committed too.

We recently joined ASME, what kind of support and guidance can we expect from your side? Transformation and Innovation are the main topics of the Annual Scientific Meeting to be held in Glasgow, what can you anticipate about the congress?

We are firmly committed to supporting those members that are not in the UK and hope they are all recieving our updates and the journals. We are happy to receive any queries or requests for help within the medical education envelope. We would be delighted to have more attendance at the yearly annual scientific meeting and would welcome a delegation from Europe. We would also like events badged with the ASME logo and could help with organisation and content in your country going forward. Our conference this year is going to be well attended as the topic is of great interest to all moving forward in the educational domain. It is the highlight of the year for ASME and brings together excellent keynote speakers and a wealth of expertise from those presenting workshops and papers. The full programme will be available on our website soon.

As an expert in educational standards, what’s your opinion about tools not only designed to measure knowledge but also the way we learn? Are you pro assessment of learning or for learning?

This is an interesting question and not one that can be answered simply or in a few sentences, rather a conference subject! What is clear, I think, is that we need a blended approach to learning and assessment. We are fixed in formative and summative approaches but this is more dictated by institutional requirements than reality.  Reviews are important at the very least for the learner but we have too many artificial way points that drive the learning agenda in a direction that is not necessarily the best. The difficulty in medical education is the nature of translating knowledge into practice into work with patients. The public needs to be reassured that those delivery care have the knowledge, skills and attitudes to do this. Hence, we need to assess them. But are our tools yet totally fit for practice? It is an evolving iterative issue.

You’ve developed many new innovative training schemes for junior doctors in academic medicine and leadership, what are the main challenges in relation to medical competence and CV?

The main challenges with any new programme is buy in from those whom undertake it and credibility with the wider profession. Pilot programmes are a good way of getting new ideas off the ground and getting the necessary time required to prove (or not) their effectiveness. Change comes slowly in the modern NHS!

Doctors are very keen now on portfolio careers and are looking for other opportunities that present themselves. This is very positive for them but can at times deplete the available workforce. However the new skills and knowledge that they acquire are, on the long run, invaluable to the service.

Leadership skills are to the fore but many misunderstand the concepts of leadership. They think it is about a single person when in reality is for everyone to lead in their own area and work. We have to foster that approach and the responsibilities that come with it into all starting at medical school.

How can we train the future medical students to confront situations without categorical evidence?

Evidence based practice and best practice are at the heart of ASME. It beholds us to ensure that this is they way we practice in the workplace. We should promote this at every opportunity and in every lecture. However your question , I think, is more about dealing with uncertainty. No one can know everything about medicine, not even supra specialist in their own field. We need to be able to teach how to practice and dealing with uncertainty in a positive way so students and doctors understand it is a normal part of the day to day working. That patient safety is the goal and that you need to know who to go to for help or advice. The other issue is that if there is no evidence we need to find it. It is a great opportunity for research and pushing back the boundaries.

To what extent can online reasoning training benefit the future clinical physician?

Simulation is here to stay; all we are really discussing is when and how, as near reality as possible can we deliver it. It has major implications for real team work. It stops teams practicing on patients and allows them to develop technical skills, team communication and leadership in a controlled environment. New technologies are coming at a fast pace and we need to embrace them as an adjunct to face to face teaching and as a method of reducing time away from patients on didactic lectures.  We are presented with real life in real time training in simulation and this has to be good.

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