On this episode of the Academic Medicine Podcast, Carrie Chen, MD, PhD, Terry Kind, MD, MPH, and Research in Medical Education (RIME) Committee members Cha-Chi Fung, PhD, and Daniele Ölveczky, MD, MS, join host Toni Gallo to discuss new research into faculty and student perceptions of unauthorized collaborations. They discuss several tensions in the preclinical learning environment that likely affect how faculty and students see unauthorized collaborations and the implications of those tensions for curriculum design and assessment.
This episode is now available through Apple Podcasts, Spotify, and anywhere else podcasts are available.
This episode is the second in this year’s 3-part series of discussions with RIME authors about their medical education research and its implications for the field. Check back next week for the next episode in this series.
A transcript is below.
Read the RIME article discussed in this episode:
- Chen HC, Brown K, Hernandez Y, et al. Faculty and student perceptions of unauthorized collaborations in the preclinical curriculum: Student or system failure? [published online ahead of print August 03, 2023]. Acad Med. DOI: 10.1097/ACM.0000000000005356.
Transcript
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Toni Gallo
Before we get into today’s episode, I’m really excited to announce that you can now claim CME credit for listening to this podcast. Academic Medicine is offering this service free of charge. There’s no cost to you. All you have to do is visit academicmedicineblog.org/cme, listen to the 8 episodes listed, then follow the instructions to claim your credit.
This is an annual activity so you can claim these credits once between now and next July. And annually we’ll be updating the list of included episodes and additional credits will be available. You can find more information at academicmedicineblog.org/cme or you can email academicmedicine@aamc.org with questions. As always, thanks so much for listening and here’s today’s episode.
Toni Gallo
Welcome to the Academic Medicine Podcast. I’m Toni Gallo. Every year Academic Medicine publishes the proceedings of the Annual Research in Medical Education, or RIME, sessions that take place at the AAMC’s Learn Serve Lead meeting. This year, the RIME papers, including the one we’ll be talking about today, will be presented throughout the Learn Serve Lead meeting, which is taking place in Seattle, Washington, in November.
The RIME papers are available now to read for free on academicmedicine.org. As in previous years, I’ll be talking to some of the RIME authors on this podcast about their medical education research and its implications for the field. On last week’s episode, I spoke to Dr. Tammy Shaw and RIME committee member Dr. Arianne Teherani about new research into medical student and resident perspectives on the learner handover process.
Today, for the second of this year’s RIME conversations, I’m joined by Dr. Carrie Chen and Dr. Terry Kind who authored the paper “Faculty and Student Perceptions of Unauthorized Collaborations in the Preclinical Curriculum: Student or System Failure?” Also joining us today for our conversation are RIME committee members Dr. Daniele Ölveczky and Dr. Cha-Chi Fung.
Carrie, Terry, and their coauthors interviewed faculty and students using a set of scenarios that depicted different unauthorized collaborations. They analyzed responses to these scenarios between and across student and faculty groups to identify themes related to student motivations and the impact of the learning environment. Today, we’ll be talking about tensions in that learning environment that might have affected how the students and faculty saw these scenarios and unauthorized collaborations in general. We’ll get into the implications of their findings for curriculum design and for assessment. So let’s get started today with introductions. Carrie, would you go first?
Carrie Chen
Sure. Hi, everyone. My name is Carrie Chen. I’m a professor of pediatrics and the senior associate dean for assessment and educational scholarship at Georgetown University in Washington, DC.
Terry Kind
Hi, I am Terry Kind. I’m associate dean for clinical education and a professor of pediatrics at George Washington University and Children’s National Hospital.
Cha-Chi Fung
Hi, I’m Cha-Chi Fung. I’m the assistant dean for research and scholarship in medical education at Keck School of Medicine of USC and I’m also one of the co-chairs for the incoming RIME Planning Committee.
Daniele Ölveczky
Hi, I’m Daniele Ölveczky. I am a geriatrician and a hospitalist at Beth Israel Deaconess Medical Center and I’m the faculty director of the Office of Diversity, Equity, and Inclusion.
Toni Gallo
Thank you all for being on the podcast today. I am looking forward to our discussion. Carrie and Terry, could you start us off with just a little bit of background on what is an unauthorized collaboration and maybe give our listeners an example if they’re not familiar with the term.
Carrie Chen
In the study, we defined it as essentially unauthorized provision or sharing of exam or assignment assistance or information with other learners.
Terry Kind
So an example would be, let’s say, a student shares information about the content of an OSCE with a classmate who hasn’t taken that OSCE yet or a senior student passing on small group case notes. But those happen to contain answers to a junior student. I’ll just round out with a third example. Let’s say there’s a group of students working together on a group assignment and then they decide to also work together on a pretest that’s supposed to be taken individually. And these are the kinds of examples that we fleshed out further into scenarios that we then used in this study.
Toni Gallo
So could you tell us a little bit about those scenarios and what you did for your study and maybe some high level or particularly interesting findings?
Terry Kind
So this was a qualitative study and, as you noted, we interviewed students and faculty in the preclinical curriculum. It was at 3 medical schools and the overall goal was to explore their perspectives on unauthorized collaboration in the preclinical curriculum. And so we had the participants reflect on these scenarios of unauthorized collaborations and then we prompted them in our questions to discuss their perceptions of the student’s intent or motivations in that scenario. What were some of the influences of either personal or environmental factors? Where do they see the boundaries of what’s acceptable and not? And then we also asked, what would be the appropriate consequences of some of these actions?
And then I just wanted to note in our study we did include students from each institution on the study team, and they were conducting the student interviews. They recruited from their own schools but then conducted interviews with students from a different school, and they were involved in the coding and the theme abstraction and writing and all. So that was when we did the inductive thematic analysis.
Carrie Chen
So what’s interesting in our findings was that we see variation among the faculty participants and how they felt, and we saw variation among the students, but in fact there was very little difference between faculty and students. So they were bringing up really the same issues. And what we found was they were talking about the same key tensions and so we ended up using those tensions as our themes.
And what we found was that there was (1) tension between faculty goals or curriculum goals and student goals, to the tension between what we might consider inherent character traits versus modifiable behavioral states. And then finally the tension between a student’s relationship with their peer group versus their relationship with the medical education system.
Toni Gallo
So I wonder if we can dig in to one of those tensions, thinking about the tension between faculty and curricular goals and student goals, both how it played out in your study and also these feels like something that happens in a lot of different ways in undergraduate medical education. So maybe we can start with your study and then also talk a little bit about how this theme might play out in other ways in UME.
Carrie Chen
In the study, it’s not like faculty only saw one set of goals and students saw the other. They all saw all of these different goals and it’s just that the faculty tended to put emphasis on different goals than the students. For instance, the faculty are much more focused on the process of learning and helping students achieve that long-term goal of being competent and being an excellent physician. And it’s not like students can’t see that. Students do realize that, but I think the students then have the pressure of the short-term goal of … long-term goals are fine and dandy but first they have to survive the course, they have to survive medical school, so they can’t help but then be pressured to look at that as well.
Terry Kind
We could think of similar pressures around things like the USMLE licensing exam. There might be the school or the faculty are saying students should focus on the school’s curriculum. That’s what we’re delivering on to help you become competent physicians. But then in a student’s reality, they are focused on passing the boards as individuals first.
Daniele Ölveczky
We thought this was also similar to a tension that we see at our medical school, at Harvard Medical School, which is students coming to class. Students do understand that they have to understand that in education to become physicians, but the way in which they get it or accept it or absorb it, they want to have some agency in how they choose to do so, which is an individual response. So then it’s hard for them to appreciate that they detract from the group experience when they’re not present. And then it’s also this long-term goal, which for them seems so far away. Then the immediate goal of, “I have an extra half an hour to study for this exam if I don’t go to class.” Versus “If I do go to class, I’m going to be further behind for this exam.” So I think it was beautiful in that it highlighted 3 tensions that are very much prevalent in many of the issues that we face in undergraduate medical education and going to class is just one of them.
Carrie Chen
Yeah, I think there’s always a tension between how we design the educational experience and then we tend to get frustrated when our learners don’t fall into line. But I think this has also helped to remember that … and when we see faculty do this too, we all do this. There are things that probably our institution or our mentors would love us to do, but then I’m sitting here, “I got to get through my day.” So I’m making different decisions than maybe what others would wish for me.
Toni Gallo
Given all of that, then, are there changes that you would make to curriculum design or delivery or … either Carrie and Terry, based on your study or just generally in your practice of medical education, things that you would do differently to help bridge this gap that you see or things you would tell medical students? What might be some ways to address this or mitigate this tension?
Terry Kind
Probably starting out that these tensions will follow people for the rest of their careers, like what Daniele and Carrie were just saying. And so to be upfront and open about that. Also in the curriculum to clarify expectations, that’s what came out in our study too as a recommendation to … what is acceptable and unacceptable, have more explicit instructions and reminders, and to the extent possible, a unified faculty approach in terms of describing or categorizing what can and can’t be shared. But that is probably hard to do in such a neat and clean way.
One thing that actually came out in some of our findings was the suggestion to actually use some of the scenarios like were in our study in curricular design or in orientations to help the students work through and wrestle with some of these things upfront in the curriculum. And think about the rationale for why collaboration would be encouraged in some instances but then not permitted in others and talk some of that through … the individual learning needs and then the professional goals as well.
Carrie Chen
And I think what might be helpful is to zoom out a little bit, because I know we’re digging into that first tension of faculty and curricular goals versus student goals, but I think the other 2 things that we found really pointed to the influence of the environment and issues around trust. So who do students align with? Are they aligning with their peers? Are they aligning with the medical education system? So I think the trust really becomes a big part of it.
So some of this is, as Terry was just saying, is “How do we build better alignment between the faculty and the curriculum with the students?” And how do we gain their trust in the curriculum? And some of that is being more explicit about, for instance, if we come up with something that the students have to wrestle with is saying that, “We designed it this way on purpose, we want you to wrestle with this because this is how you’ll learn something.” Versus students think that we didn’t put enough thought into it and they were just having to wrestle with it because we weren’t thoughtful and it’s just a waste of their time.
So I think it’s sometimes being very explicit about, “We designed it this way because we wanted you to get this out of it.” And then really thinking about moving from the stance of “We build the curriculum this way, you have to do it this way.” And having more empathy about, so what is going on with them? How do we work together? And how do we create little pop-off valves and understanding and support for when students bump up against issues so that they’re trusting the medical education system enough to support them through this rather than it being us versus them. And that the only people they can go to for support are their peers and then the way they help each other is to circumvent the system. So that’s not what we want, as we want them to come to the system and the system to be supportive of their success.
Cha-Chi Fung
So I think the issue of trust is such a fascinating phenomenon because we’re beginning to hear students say, “We want transparency. We want to know how you came up with these policies.” And all that. Now, it makes me wonder … it does feel like we’re always sitting around committees trying to think about ways to help students understand or come up with ways to put some parameters around these policies.
I wonder if trust building will come from having students sitting on those committees and having them come up with those policies because we’re always modifying policies and making it clear, and then eventually you become very long-winded. And really we are targeting just maybe the 5% or even 1% of students. So I wonder if you guys have any thoughts or you have uncovered any recommendations from both faculty and students along your interviews and stuff?
Terry Kind
Yeah, I think that’s so helpful. It’s actually analogous to us having the students on our study team, which was just such a win-win, helped us flesh out everything and stay authentic. I completely agree with having students on the committees where the discussions are happening. I think then that also might bring up another tension of then is the student representing their peers or are they speaking for themselves in a certain instance or they probably share some of that as well.
Carrie Chen
Yeah, and I think we certainly at Georgetown have students on all of our committees and we try very hard to remind them that they’re not just speaking for themselves, but they’re speaking for their classmates, and as much as possible, we would love them to check in with their classmates and then bring in various viewpoints to help us consider.
So this study was funded actually by a grant from the NEGEA. We had a little bit of money left over, so we asked for no cost extension to apply the money to faculty development for us to be able to do work with our faculty at our different institutions. But we recently had conversations about, wouldn’t it be great if we actually did workshops with students? And share the study results, share the scenarios, and engage them in thinking about, so what do you guys think about this? How should the school approach this? And also, this idea … so if a student stumbles, how do we address that and how do we have graded levels of response so that people are allowed to make a mistake and stumble and learn from it and having a severity of the consequence match what’s happening.
And I think what was interesting for us about this is that all of the participants, so all of the students and all of the faculty that were interviewed, had a lot of empathy for the students in the scenarios. And they really view this as very different from cheating for self and that they really saw this as a whole different animal and really did want us to think about approaching this differently.
Toni Gallo
I think that’s a good segue into another tension that came up in your paper, which was thinking about individual competence and students being able to demonstrate and you being able to assess individual competence, but then also the emphasis on teamwork and collaboration and how do you fit those 2 together and how do students perceive the tension between those 2 things. I wonder if you can tell us a little bit about that finding and then maybe we can discuss some of your recommendations or how this might play out in UME.
Terry Kind
In this study, it was clear students do recognize the need for individual accountability and that their individual competence will be assessed, but they also recognize that they are encouraged to work with each other and that throughout their careers they will be working with colleagues in the clinical settings and for the rest of their lives. That gets at some of the tension, and we create some of that tension in the curriculum because we foster students working together in small groups and we embrace them supporting each other and helping each other learn. Then that comes up against the individual demonstration of competence. Circling back to the need to be clear about when it’s one circumstance and when it’s then a different circumstance, in terms of that sharing.
Carrie Chen
Some of the faculty we interviewed were pretty eloquent in saying that, “We were the ones who did this to the students.” One of the schools where we did the study was the Uniformed Services University. And so they are very clear with students when they put them in groups like, “This is your team.” And if you think about the military, the culture is no one left behind. So now, you have your team, you’ve been told that this is your team and you’re responsible for each other. So what do you do when the team member is struggling?
We talked about in the study, you put students in the situation of they’re having to choose between altruism when helping a teammate and then integrity and adhering to whatever the school’s rules are. And I think this is why the ambivalence comes in as “how do you fault someone for choosing altruism?” When really their goal is try to help this teammate? And we told the students that, “Your team is important.”
It’s an interesting struggle for us … is how do we convey that? Yes, it is really important, the team is very important and in the real world we will be … It’s a shared competence as you progress in training, but at some points we do need to assess you for individual competence. But it does have me thinking about, are there certain things where we can assess for team competence as well? Where it doesn’t always have to be an assessment of individual competence.
Daniele Ölveczky
I think I have 2 quick things to add that Cha-Chi really beautifully brought up when we were having our discussion. I think that in the beginning of medical school, something I never heard, which Cha-Chi brought up, which I think is really important, is part of a team is owning your own individual performance, so you don’t compromise the position of your team members. And so I think that’s another message that we need to make clear that, of course we have bad days, unexpected life events, but when you have the choice of how to spend your time, part of when you’re looking at the effects of spending your time has to be, “How is this going to affect my team? Am I going to make them compromise their standards? Because they’re going to have to help me out because I didn’t do what I was supposed to do when I was supposed to do it.”
I think that’s something that we need to really help our students think through because, I’m very open in admitting in medical school, I didn’t think anything about that. I was just thinking, just trying to make those decisions one at a time with no long-term thought about what would happen next. I think that’s one thing.
And then the second thing I think that we should do better at is labeling when things are being assessed to individual competence versus group competence. Because I can tell you definitely as a nocturnist, you’re on your own sometimes and you need to perform on your own. You’re looking at that focus result on your own. Does the patient have tamponade or not? And you might be able to call the intensivist, but they’re going to take a little while to come, and you need to really be able to make that decision on your own. So same thing with many things.
So I think that’s the tension that there is a lot of it that is team-based, but there are some high-stakes moments when it is really based on your individual competency and somehow we need to make that clear.
Terry Kind
Yeah, I think you’re so clearly saying to be intentional about it, thinking through everything. Circling back to your first example is thinking about if a student doesn’t come prepared, then how does it impact themselves, the team, and so on. To make it even further challenging, if something gets in the way of that student being prepared that was like a life event or an accident, then the other students want to be helpful to that student who had something come up and want to help support that student in getting to the next step. But then sometimes that support is to the detriment of their individual learning or the group’s process. So yeah, it’s quite nuanced and important.
Daniele Ölveczky
I just want to jump in there with one quick thought, Terry. One thing I’m very interested in is moral distress and I feel that when we ask our teammates to compromise their moral values and their integrity, even though it’s towards the altruistic purpose of helping somebody else out, there is a longer-term penalty towards doing that, when we act in a way that is not consistent with our values. We know what the right thing is to do, but yet we do things that are not consistent with our values and our moral compass.
And that’s what I think about when we need to educate our learners and ourselves. That we’re doing this every single day of our lives still, that there is a real importance to thinking these things through and trying to align one’s behavior in such a manner that one doesn’t compromise one’s own integrity, values, puts one’s own self in a place of moral distress and definitely doesn’t drag others along with them.
Carrie Chen
I think, exactly. And that was why there was a lot of discussion about using these scenarios to really work with students. It’s not just telling them, “Don’t do this, don’t do that.” And as you brought up, Daniele, for the rest of their lives as professionals, this will come up. Wanting to advocate for your patient when the insurance company is saying, “You can’t do X, Y, or Z.” So how do you navigate all of that? And so is to really focus not on the, “This is behavior you can’t do.” But to say, “Here are these tensions.” And then moral distress that comes in. And how do you sit down and think it through? How do you think it through and make a thoughtful decision? So it’s not just a knee-jerk reaction that you might later regret.
Toni Gallo
Carrie, you mentioned that your research team included some students from the participating schools. How did these issues come up in your conversations with the research team? And how did the students feel about some of the recommendations or the themes that came up? Did it resonate with them? And I’m curious about the discussions you had as a research group.
Carrie Chen
Yeah, I think as individuals, we always bring in our own viewpoint. And so I think it was very eye opening for everybody to read the transcripts to realize that people had such different takes on it. And sometimes it was surprising. I was like, “Oh, this is how some people feel. I’ve never thought about it that way.” And so I think because the students were so engaged, they did all of the student interviews, so they were already seeing and experiencing the range of participant reactions.
And as I mentioned, the range was greater among the students and among the faculty than between the two. So then by the time we were then… And they were involved with coding, so they were coding the faculty transcripts as well, they were seeing that it was all the same themes. And we had multiple, multiple large group discussions among all team members to come up with the themes because we were seeing all these different things.
And I still remember it was… I think one major meeting we had on Zoom while I was in Los Angeles in July, we hit on this aha of like, “Oh, these are really about these tensions.” And it’s how these tensions come together. And it was really Tony Artino who brought up this idea of … This is really consistent with what we see with Bandura’s theory and really about the impact of the environment and how the environment is shaping like behaviors. And really thinking about the environment and not necessarily just blaming the individual.
Toni Gallo
You’ve mentioned this now that there were more differences among students than between the students and faculty participants. I wonder if you have any theories about maybe why that was? Or any discussions that came up in your research meetings about why the data showed that?
Carrie Chen
Again, I think that there are just such individual differences. I’ll mention that, when we asked students what might be leading to this behavior, some participants were reading into that basically a question of, “Whose fault is it?” I just remember one transcript where a student basically said, “It was the school’s fault.” So if the schools don’t put enough safeguards in place to prevent cheating, then they should expect that it’s going to happen. It’s like, “Well, it’s your own fault for not locking your front door that you got robbed.” It’s that perspective. And that was a minority perspective. I think most students didn’t feel that way, but then a similar thing might come up with a faculty saying, “Well, it’s our fault for not doing this.”
So I think what we’re seeing is that the range of perspectives was quite wide, and it was wide in both groups. And it’s always like when we map out height, for instance, between different populations is you might see that the average height is a little different between the two populations. But if you look at the spread, the two graphs overlap quite a bit and I view that as what we’re seeing is that the range of responses were pretty much the same, but the slight emphasis were a little different in the two groups.
Terry Kind
And maybe if we think about it as .. this was about the unauthorized collaborations, so the type of “cheating” that it would be amongst a group or interpersonally rather than individual cheating. These scenarios were viewed as less dishonest than an individual taking a cheating action than what we’ve talked about helping others along. It was also interesting the positive motivations or the positive intent that our faculty and students could see in why these behaviors were happening. So both faculty and students saw that.
Carrie Chen
Yeah, and I remember one faculty participant even said, “Isn’t this the type of doctor that we want, the one that really cares about their fellow human being?”
Cha-Chi Fung
As I read your paper, it’s really fascinating. What I’m trying to grapple with is, in a situation where unauthorized collaborations happen, there are truly two parties: the one providing the help and the one either intentionally or unintentionally seeking the help. But it seems like for your study, you guys focus just on the helper, the person providing the information. And the scenario seems to say that it wasn’t really solicited. It was really just like they saw an opportunity they wanted to help.
So I wonder would there be any … focusing more on the relationship with the peer group, between the helper and the seeker, should we explore that relationship further? Because we’re always focusing on the people providing the information, like faulting them for doing that, but should we also look into those who were asking for help, whether or not they know it was unauthorized. I’m just curious about your thoughts in this process because that’s what I’m seeing is like, “Oh, we’re focusing on the person giving the information.” Whether or not it was solicited and we’re focusing on their rationale for thinking through this process. Is there any merit for looking at those who are asking for that help?
Carrie Chen
That’s such a great point. And I think when we designed the scenarios, we hadn’t thought about that, but it’s interesting that, in the interviews, they came up a little bit, where people would say, “Well, if a classmate had asked for help because of X, Y, or Z, they really should be going to the course director or going to the deans.” And again, like you said, Cha-Chi, it’s focusing on the response of the person who’s being asked. Yeah I’ll have to think about this some more. I don’t know if, Terry, if you have any thoughts about focusing on the person who is asking.
Terry Kind
It’s a great question and it makes me also think about those relationships amongst the students and trust and all that. So “why would they be asking me for this information?” is one approach or “Oh, I’m glad they reached out and asked for this kind of…” they would say “help” not “this kind of unauthorized collaboration.” But it does make me think of those group dynamics and relationships amongst the students. And then there’s of course the larger point about the students and school relationship or student and faculty relationships as well.
Daniele Ölveczky
That’s what worried me. And I think Cha-Chi’s point is so important is … I think every school and definitely our school prides itself on having avenues where students who are struggling or may have fallen behind for any life event could go for help. So the fact that these, the seekers, as Cha-Chi beautifully described them, aren’t going to access these systems, isn’t that pointing towards a problem in our system, or it could just be the lack of trust. But again, why is that?
For example, I just did a brief teaching on this, on microaggressions and reporting them in the environment, and part of what I did in that session was I actually went to the dean to ask, “How many had been reported?” Went to the students, “How many did they report?” Asked the students, “How did it go for you?” And anonymously, it was really reassuring that there were no reports of students being gaslit for reporting these instances. There were no reports that the students were in any way hassled for reporting this.
And I think that we need to keep doing these double checking of the systems as much as we can, as much as the students will be honest and be vulnerable to tell us, to make sure we can really make sure that the safeguards that we are expending a lot of energy into putting into place are actually serving their purpose. Because you might ask that perhaps this is showing us that these safeguards aren’t working and we should really be investing our time, our energy, our money into something else.
Carrie Chen
Absolutely. I think we can put in safeguards, and we can say we can always ask but if the students don’t trust that we’re going to respond in a positive way, if they don’t trust that this somehow won’t be a mark against them in their record, then they won’t come and ask for help. Last night we had a curriculum committee about giving students an ability to opt out of a session that was very sensitive in case it recreates trauma for the learner, but the system to opt out outs the student as having been someone who experienced this challenge and the students may want to be very private about that. So we think we’ve created a safeguard, but we’ve created a safeguard that’s not very safe actually for the students to use. And so I think we just need to be paying attention to those things.
Toni Gallo
So maybe Carrie and Terry, you can tell us a little bit about where, whether it’s your research team, you had mentioned some faculty development work, but any kind of next steps or other research questions that came out of this study? We’ve had some really interesting conversation here, so I imagine that you all did too and have some good ideas for where to take this.
Carrie Chen
Well, as I mentioned, our three institutions have committed to doing work internally to share our results with our community and to engage our community in thinking through strategies and problem solving. Even though our participants had offered up some potential strategies and so forth, that was just done in the moment. And so, as we acknowledge in the paper, we don’t actually know whether any of those strategies will work. And so that is something in terms of future studies and future work is actually digging into some of those strategies and see if they would work, if certain strategies have more impact than others, et cetera.
Toni Gallo
I want to give you each a chance, if you have any final thoughts that you want to share with listeners or anything that we haven’t covered yet in our conversation, we’ll just go around, and anybody is welcome to share their final words. Carrie, you want to start?
Carrie Chen
I think the biggest thing for me is always for us as medical educators and as faculty to take a step back when something isn’t working and try to be careful about always just pointing the finger at the learner and saying, “There’s something wrong with them” because they’re not doing what we expect them to do. But instead, really think about what’s happening in the system and the environment and the situation that we’ve put students in and think about what we’re doing that’s leading to these behaviors.
Terry Kind
Among the nuances and tensions we’ve discussed, I’ll just circle back to teamwork and helping is so important in this field that we’re in and the health care professionals we’re developing as is demonstrating individual competence or being able to perform individually. So things to think about as we try to be clear in our expectations but also explore some of the challenges that are inherent in some of our curricular systems and our interpersonal relationships.
Daniele Ölveczky
I think this has been just a wonderful opportunity to reflect on a really moving piece of research that really centers us in the learner’s experience. And I would just hope our listeners take away from this paper that there’s a need for this mirror image of double checking in everything that we do and that’s what we call intentionality … is that we need to really double check that the systems that we’re putting into place are really having the desired consequences. And if they’re not, making sure that in as many ways as possible, we’re trying to understand why.
Cha-Chi Fung
Yeah, I think that’s a great thought. And reading this paper just cemented the idea of there’s never one side to the story. There are always multiple sides. This is a serious issue. If we just convert unauthorized collaboration into the word cheating, that is a huge issue, and we know it’s the undercurrent in our curriculum. Students are intentionally or unintentionally trying to get ahead.
And we as faculty tend to fall into the traps of pointing fingers saying, “There’s something wrong with the students. They’re dishonest.” But really this paper really shines light on … We need to look at everything, everything that the students are part of — the system, the faculty, their relationship, and even trying to understand the larger societal atmosphere that we’re under. I think what’s great about this paper is just really reminding us that there’s never really one side to the story. Always look for multiple contributor to the why.
Toni Gallo
Well, I want to thank you all for being on the podcast today. I really appreciate it. I encourage our listeners to look for the paper that we discussed today as well as the whole RIME supplement. And if you’ll be at the Learn Serve Lead meeting, we hope to see you at the RIME sessions. So thanks everyone.
Carrie Chen
Thank you so much.
Terry Kind
Thank you.
Daniele Ölveczky
Thank you.
Toni Gallo
Remember to visit academicmedicine.org to find the article we discussed today as well as the other RIME articles. Be sure to check back next week for the next episode in this year’s RIME series. I’ll be talking to the authors of a qualitative study of faculty experience responding to microaggressions targeting medical students.
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