Reflective writing

It was 24th February, when I came to know that University of Lahore is going to conduct
an online certificate course on Health Profession Education (CHPE). That was an exciting news
for me, as I was waiting for quite a few months to get enrolled in CHPE. Some other institutions
were also offering CHPE but I enrolled myself in the university of Lahore because its reputation
was known to be the best among all. I am currently working as Associate Professor in the
department of Obstetrics and Gynaecology at Central Park Medical College. I am also member
of Curriculum, Assessment and Research Committee of my institute. I am engaged for quite
some time in formulating undergraduate curriculum of Obstetrics & Gynaecology. This is one of
the reasons to join this course as I wanted to fill gaps in my already existing knowledge and
practice in medical education. Most of my colleagues wanted to do this course to fulfill the
mandatory requirement to get promotion but my perspective was very different. Yes, fulfilling
the mandatory requirement was one of the reasons but not the sole reason to join the course.
My main aim was to equip myself with the continuously evolving trends in teaching, learning
and assessment methods in medical education and to become an effective teacher who can
produce an enthusiastic and lifelong learner. Not to exaggerate, but I would say that all my
expectations were almost fully met after completion of this course.
On the first day of course, my enthusiasm to learn new, to learn more, made me feel
very ecstatic. I was continually worried about losing the internet connection during the session.
This worriedness was not for the reason that I would be marked absent but for the reason that I
did not want to miss even a single minute of the course. Turns out that I was not worried
without a reason; I faced many connection issues during the session. The most embarrassing
moment was when I was just going to do presentation on behalf of my group and the WiFi
connection got interrupted. That was the day I realized that in order to attend an online session
one must have a backup device to remain connected.
I learned many things regarding curriculum. The SPICES model of planning educational
strategies was new to me. When we think about curriculum we must realize that curriculum is
not a static thing but it needs to be evolving to cope with the change and demand. If we go
through the history of the curriculum reforms in North America, we will come to know that they
continuously made efforts to reform their curriculum for better learning of the medical
graduates. If I talk about my institution we are currently following the traditional curriculum
and trying to stepping up on the ladder of integration. This course was a great help to identify
our needs and steps to be taken to move towards integration. If we say that curriculum is a live
thing that’s mean it may get diseased. For that reason it needs continuous evaluation. The
curricular diseases were very well explained by Dr Khadija. Learning outcomes are a very
important component of the curriculum. They give us the direction to move. Without a
direction, the journey is purposeless. Learning objectives should be SMART. Bloom’s taxonomy
is helpful to formulate learning outcomes. To make sessions interactive innovative methods of
teaching need to be introduced. Dr Tayyaba introduced online teaching and learning tools. It is
well known that traditional lectures cause students to lose attention. An attention span is 20
minutes. Keeping this in mind, some innovative tools can be used to maintain the interest of
the students such as throwing an online poll using kahoot or socrative during lectures. An
innovative teacher should be well versed with organizing online sessions as the need can be
aroused at any time. Dr Tayyaba explained us how to start a zoom meeting, generate a pole
during a meeting, and to generate break out rooms for group activities. All these things were
new to me.
I still remember the days of the Covid-19 pandemic, when suddenly all learning was
shifted online. I faced many problems in conducting online sessions. I felt as there was no
connection between me and the students and that I am talking to myself. After taking this
session of Dr Tayyaba on using online methods of teaching it helped me a lot in generating a
zoom meeting. But I think I need to work more on this issue. Although it is important to
introduce new learning situations, but traditional lectures cannot be altogether replaced. To
make lectures effective, the power point presentations should be very attractive and eye
catching. Dr Kainat taught us some tips on how to make a good power point presentation. All
the participants were given an opportunity to make a presentation and 10 minutes were
allocated to each participant. After that activity, a constructive feedback was given to each
participant to rectify the common mistakes while preparing the slides. Gagne’s nine event of
instruction should be kept in mind while conducting any learning activity. We learned the
different aspects of a good presentation from each other.
Dr Ummara introduced Anatomy 3D Atlas to demonstrate bony features. It was a good
application especially for distant learning. As in case of Covid-19 pandemic when students were
away and we were connected through online teaching. This technique would be helpful for
students’ understanding of bony features. At the end of the first module, we were given an
assignment on reflective writing and making learning outcomes. The first module ended but my
urge to become an innovative teacher started.
The second module was expected three months after the end of first module. But due to
some reason it got postponed to about a month later. The second module was about
assessment. Assessment is an integral part of learning as Ian Lang once said, “I believe that
teaching without testing is like cooking without tasting”. The first topic, by Dr. Usman, was on
assessment of competency and types of assessment. We discussed the Miller’s pyramid and
how different levels of competencies can be assessed. I was already familiar with the terms of
formative and summative assessments. Assessment for learning is more important than
assessment of learning as it has a strong impact on achieving learning outcomes. The concepts
of low stake and high stake assessments were new to me. MCQs are a very common method of
assessment and it is very easy to conduct too because it takes less time for conduction and
checking is also easy. But constructing an MCQ at analysis and application level can be really
hard sometimes. It needs lot of effort and training. During the session, we were given an
assignment to find any previous MCQ with a flaw, get it corrected and present both; the one
with a flaw and the corrected one. When I started looking at my MCQ pool, I could hardly find
any MCQ that was flawless. Dr Kainat gave a very detailed explanation on MCQ construction
and the common flaws in MCQs. The MCQ quality can be checked by doing analysis like
difficulty index, discrimination index and distractor analysis. By doing these analyses we can
generate an effective MCQ pool by rejecting, revising or accepting the already existing MCQs.
Table of specification and blue printing helps us to give more weightage to important topics.
There was a session on work placed based (WPB) assessment & assessing
professionalism by Dr Masood. It was a very interesting topic. We talked about different
methods for assessing clinical competence such as Mini CEX, OSCE, and DOPS, short & long
cases. It is vital to choose the right method of assessment for a particular skill. It was interesting
to note the difference between short case and OSCE. The short case is not structured, time
bound or uniform among different candidates. While OSCE is structured. The reliability of OSCE
can be further increased by appointing more than one assessor at each station. However
organization of OSCE is challenging as it requires more man power, equipment, resources and
structured well organized stations. Mini-CEX is a good tool to assess history and examination
skills. It gives the advantage of on the spot feedback to the candidate. But taking Mini –CEX
requires dedication both on the part of the examiner and the assesse as it is difficult to make
time during the busy running clinical setting. Multi-source feedback is an important part of
work place assessment. Integrity is an important aspect of being professional. It is best
evaluated by 360° feedback.
Dr Rehan’s session was on “open book examination”.  A person who does not know the
exact methodology of this particular assessment might consider it an easy task to do. My
perception was the same before this session. But as the session proceeded, I realized that it is
not a piece of cake. It is difficult at both ends. The construction of a high quality open book
exam question is a demanding job for the assessor. As the question should be assessing the
critical thinking of the student and put him in a challenging situation that he find it difficult to
answer even by referring to his notes and reference books.
At the end of the second module we were given a heavy assignment. At first I thought it
was an impossible task. I took me a lot of effort and hard work to complete the assignment.
These 6 months were very enjoyable for me. My group mates were very co-operative
and my facilitators were very knowledgeable. The most exciting part of the whole course was
group activity. The topics that we covered with a task done in groups were the most easily
understood and retained. I decided to bring innovation in my sessions with the introduction of
flipped classroom activity, online quizzes through kahoot and by making sessions more student-
centered. I acquired that the learning outcomes should be very clear and realistic; the
assessment should be aligned with the learning outcomes; and the assessment method should
actually assess what it meant to be. I decided to create an effective pool of MCQs for my
undergraduate students by doing post item analysis. I decided to take formative assessments
more frequently as timely feedback is more constructive and gives the opportunity of
assessment for learning. To become a good medical teacher, it is important to become a good
leader, a mentor and attain high emotional intelligence. This is a very common thought that
leaders are born. Yes, to some extent it is right but one can always polish himself and make
continuous effort to create leadership traits in himself. I also realized that I need to struggle to
improve my emotional intelligence.
This is the end of CHPE and start of my journey of becoming a good teacher, mentor and
leader to create more leaders by introducing innovative teaching and learning methodologies in
undergraduate and postgraduate medical education.