“Assessment drives learning” raises wry smiles (and occasional heckles) whenever it is mentioned. However it’s unfortunately the case that ‘encouragement’ to understand and learn comes from the need to demonstrate that new knowledge in some form of test. In Post Graduate Medical Education these tests are specialist exams which are required in order to progress to more senior stages of training. The scope of information needed is huge (and often the exams split into various sections to make them manageable!). The curriculum describing the knowledge similarly large and there is great heart ache as you scroll through 50+ pages of bullet points each starting, “the trainee will be required to know…”.
By necessity curriculum are bland but what has become increasingly apparent to me is the large blocks of ‘grey’ knowledge that appear to be missing from them. I say ‘them’, I can only really speak for Paediatrics, but I am given confidence in this assertion by the ever increasing momentum of the #FOAMed movement. Chris Nickson has previously eloquently explained why #FOAMed itself doesn’t need a curriculum. However while assessment drives learning, so does experience. It’s quite clear from the huge amount of materials posted daily on a variety of clinical topics there is a thirst for information that is not readily available by common reference sources. I’ll use the #SMACCGold conference to demonstrate this point.
Lets take the section on statistics in Royal College of Paediatrics and Child Health (RCPCH) emergency medicine curriculum.
To be fair this is clear, practical knowledge that is needed by clinicians. How does this translate into actual practice though? How will we use this to provide better patient care? What will convert these concepts into something clinicians can practically deliver? I think the answer comes from Prof. Simon Carley’s two excellent lectures at #SMACCgold. One on what to believe and when to change and one on risk factors in ED
As another example Paediatricians are involved in extremely challenging situations in resuscitating seriously ill children and sometimes need to make decisions about when that resuscitation should end. Is there a curriculum that defines and aids this process? It appears not but certainly Cliff Reid’s talk at SMACC is a great example of how this topic could be approached.
Finally I scanned through the College of Emergency Medicine curriculum for “chronic pain” and struggled to find anything. However with over 1000 views so far this probably fits the bill:
It would be harsh to say that those writing curricula have been lax in their tasks, it’s more that some topics are not easily encapsulated. They are often hidden, or camouflaged, in between more clear cut points.
This is where #FOAMed has come to the rescue. A variety of brilliant minds around the world have been able to recognise knowledge they needed to know but just wasn’t currently available ( a recent talk is entitled #paedstips you won’t find in books!). Ultimately #SMACCgold stands as a testament to revealing this camouflaged curriculum content (and I am sure more will be revealed at #SMACC2015). It may well be the case that assessment drives learning, but perhaps those in charge of medical education may want to use #FOAMed to drive curricula…