Clinical Education [Re-release] (3 April 2024)

SPEAKER_00 0:00

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SPEAKER_02 0:28

Hello everyone and welcome to this episode brought to you by the Trainees Numbers Committee from the Royal College of Physicians of Edinburgh. My name is Dr. Jonathan Bridgett, and I'm a TMC member, and today I am delighted to be talking with Dr. Jill Aitken, who is the programme director for the Clinical Education Masters and Postgraduate Diploma and Certificates in the University of Edinburgh. Welcome, Jill.

SPEAKER_03 0:49

Thank you very much, Johnny. Thanks for asking me along. It's a pleasure to come and speak to you and talk a bit about my pet topic of education.

SPEAKER_02 0:56

No, it's a pleasure to have you. And really what I'd like to start by asking Jill is why are we talking about clinical education and why is it so important to medical trainees?

SPEAKER_03 1:06

Okay, well, it's obviously something that I talk about a lot, and I would like to put the emphasis on the clinical. When the master's was first established, it was a master's in medical education, but some of my predecessors quite smartly realize because healthcare is undertaken by teams in the wider multidisciplinary staff group that really education should be delivered likewise. So the program is very much about learning with and from other people. While obviously undergraduate education is very much uniprofessional, I think there is a quite a wide acceptance that postgraduate education, so education of professional groups should occur in multidisciplinary groups. So I think that's why it should be a focus on clinical as opposed to medical education. I mean, clearly there's you know some technical skills that will be relatable to one sort of individual group or even specialty within a profession. But I think education and for me, postgraduate education is very much about widening someone's focus when we're talking about education.

SPEAKER_02 2:19

That's a really good introduction to hopefully what we're going to be able to chat about is a fascinating area of education in general. What I'd like to really bring it back to is talking about the knowledge and the skills and attitudes that trainees and healthcare workers develop. How can we help our listeners today that are listening to this podcast improve their awareness of what it is that clinical education is and how they can develop their interest in this?

SPEAKER_03 2:43

So, in terms of opportunities to get involved, most well, every health professional will be involved in teaching in some capacity, whether they think of it as formal teaching or it's just an informal conversation with a colleague, a junior member of staff, or a student on a ward or in a clinic. So we all teach. I don't think we can avoid that. Whether we have a formal interest in teaching, you know, that may or may not be the case. In terms of getting involved, there's lots of opportunities no matter where you are based. Your local medical school will want to encourage you if you express even half an interest. You'll probably find out that you are encouraged to and snapped up to get involved in some form of teaching or assessment. You can access faculty development opportunities, which are generally run by medical schools, but also other sources of information are available. So within South East Scotland, we have the Clinical Educator programme, and some people may want to go on and undertake more formal programmes of education, like our own postgraduate qualification at Edinburgh, but certainly Dundee and Aberdeen and actually Glasgow run similar programmes. So there's lots of opportunity to think about teaching in a more structured way, but actually you can do it yourself. I think most people who teach and think about teaching do it almost in an unconscious way where you think about how a session's gone, what you might do differently next time. So there's a lot of that that goes on, and that sort of unconscious of reflection is what we try to tap into. Certainly on the master's programme, there's a lot of conversation about that, and trying to think about how we can learn from that sort of practical experience and how can we look at what we're doing and try to improve what we're doing. Something that I'm really struck about every single year with new cohorts of students. I think every student I've come across, and this is specifically related to medical trainees, it's of in every profession. Most people say, Oh well, I decided to teach the things that I found really hard when I was a student, which is fair enough because you've got to start from somewhere. But equally, there's nothing that says something that you found hard as a student will be what the people that you're teaching found hard themselves. So there's something there I think about widening your focus when you think about education and trying not to replicate what has gone before. I think there's a bit of an unwritten expectation that because you're qualified in whatever profession you're qualified, that you're inherently a teacher. And I totally accept that, but I think there's ways in which one can become better at teaching. Sorry, that was a bit of a ramble.

SPEAKER_02 5:35

Not a ramble, but more I'm just listening in awe of all the things that you've touched on there, Jill. And I guess one of the things that I've realized through my experience in teaching is that I find it easier to teach things that I'm passionate about. What would your thoughts on that be?

SPEAKER_03 5:48

I think that's right. You know, when you're when you're in a in the it when you're listening to someone, if you're on the receiving end, if so if you're a student or you know you're just even in the audience of someone's talking, there's that really awful, oh my, they're not very good. It's that sort of anxiety, isn't there? If someone's anxious and nervous or not really confident in what they're talking about, it's quite stressful as a learner, I think. And you know, you can't really focus on what they're saying because they're stumbling through whatever is they're talking about. So certainly you're right, you know, your own knowledge and your own enthusiasm, I think, shines through. So I think that's really important, and what also is useful with your own expertise is that you have been through the process that the people that you're teaching are going through themselves, so you have that understanding of the process. You don't understand their individual experience, but you can understand the general to say the J-word, but the journey that they're on. So that gives you insight into the process, but the only way you can actually identify their specific needs is to ask what it is that they want to learn and where they're going, where they're at, and what they find tricky. So it comes back to this of don't assume what you found tricky will be tricky for everybody.

SPEAKER_02 7:10

Yeah, and I think another thing that's coming through is this journey that you're talking about and the experiences that both learners and teachers share. And really what I'd like to ask you about is what your thoughts are on what it is to be a teacher and what it means for you as a teacher, Jill, and then being able to place yourself in that learner's perspective as well about what it means to be a learner and how you can learn to be a learner because it's quite difficult to know how to learn as well as teach. Is that fair to say?

SPEAKER_03 7:40

I'll try and unpick that. What it means to me to be a teacher is it's a complete joy, I have to say. Sometimes I pinch myself that I'm paid to do the job that I am. The fact that you get to talk to people to try to understand their context and where they're coming from, where they're trying to get to, I think that's an unbelievable privilege. So for me, teaching is a privilege. In terms of how people become effective learners, that's a tricky question to answer because we'll all have come across lots of different ways in which supposedly one can measure the learning styles of our students. So I'm thinking of things like Honey and Mumford, things like the VARK, sort of visual, audio, kinesthetic learners, Myersbergs. There's lots of these sort of inventories which somehow try to classify people's approaches to learning, and to overly rely on such things would be a mistake. There is actually no evidence for the efficacy of any of these inventories. If I was being kind, I would say that there is a role for them in that if one thinks about potential ways that people learn, it would encourage you to design your teaching in different ways with different tasks, so they can be effective in that regard. But I would say, in terms of how best to encourage people to learn effectively, you have to understand their motivations and it's about design, I think. It's really very much about trying to come up with appropriate learning opportunities. And I think in terms of the sort of the learning the teacher, I think there isn't a hard and fast um barrier between the learner or the teacher. I think you have to accept that the teacher is just a bit further along than the learner, and the teacher is evolving as well. You know, the teacher is evolving as a teacher, but they're still learning, and the student is still developing along the process. So there isn't a hard and fast gap between the two, I don't think.

SPEAKER_02 9:53

Yeah, that's really insightful just to get an insight into the journey, as you said, about how the learner becomes the teacher or being able to flip rules between the two. And it kind of touches on the mastery idea of learning a procedure and then becoming a master of that procedure. What I'd like to discuss now is learning theory and what your thoughts on that are and how we use that in our teaching within healthcare.

SPEAKER_03 10:18

So by learning theories, you're talking about the ways in which people have tried to describe the somewhat messy, complicated, unmeasurable process of learning. There are various theories out there, and most of us who are involved in teaching that haven't really studied any formal educational programmes will be proceeding quite blissfully unaware of most of these. It's a massive topic. I would say that it's helpful to understand some of the theoretical underpinning, and certainly when we teach these types of things on the master's programme, there's always that kind of ah, so that's why that works. And generally it relates to when we talk about the more social theories of learning, so social cultural theory, primarily when we talk about the work of Lave and Wenger, who talk about communities of practice, and really it's the moving from the focus on the individual, so moving away from the sort of more behavioural, sort of Pavlovian approach to education. You do this, you get it right, I reward you, so that's what you do all the time, which is fine. I mean, there's still that aspect within clinical education when one's learning various skills and sort of more technical aspects, but the move away to how we actually practice healthcare in the current environment, people don't usually practice in isolation, so it's very much a sort of team approach. So it's that wider social aspect of learning and the idea that we practice within communities, and our learners are very much junior members or sort of lurking on the sort of periphery of our communities, and how do we actually facilitate their development as full members of the community of practice? So that would primarily be through techniques. Some people may have encountered the term scaffolding with regard to education. So, this idea that the more knowledgeable other within the community develops learning opportunities that will support the learner and gradually takes you know parts of the scaffolding away as the learner becomes more intimately within the centre of the learning community. So that's one example of a learning theory. I won't bore you with more details, but if anybody's really interested, I can give you more information. But that's a bit of a sort of is that enough of a sketch?

SPEAKER_02 12:53

No, that's great. And I guess it's just making me think back about my own experience in undergraduate and postgraduate education. And I think back about, well, more than 10 years ago now when I was at university, and I was thinking about how my day would go when I would attend lectures, and then I would have some small group work tutorials, and then I would go on to maybe do some practical work in a larger group within that. And then you would go home and study and you would do your own self-directed learning. And like it just makes me think about how you have different environments within learning and those within those communities of practice. It just made me feel a bit nostalgic about my own experience and how now my learning is very much self-directed by and large, and that's not just because of pandemic, but just as an adult learner. What are your thoughts on the shift from those communities of practice to more of an online-based learning or uh a self-directed learning?

SPEAKER_03 13:45

So my thought is it's all learning, and I think there certainly is a lot just now, isn't there, for people that are sort of keep up with the sort of educational literature. That there's almost this hard binary between online or in person. And actually, I don't think it's as simple as that. I don't think you can separate one from the other. If you know you talk about the the sort of slight nostalgia for when you went to lectures, but that that was still technical, you know, there was still technology involved there, whether there was a PowerPoint presentation or whether you were making notes. I mean, I suspect you were using a paper and pen back in the day, but students now will, you know, they'll whip out their laptops. It's still technology is still mediated in that process, much the same as when you run an online program, you still have, albeit technically mediated, face-to-face conversations. So I don't know that it's necessarily the difference between online or face-to-face. I think it's about interaction, I think it's about communication, and I think it's about people coming together and having a space to discuss. And I think that's one of the issues that I would identify that really needs to be seriously looked at within undergraduate curricula, is space. The curriculum is so jam-packed that it's very difficult to have this space, and it's built in in sort of earlier years with things like problem-based learning, but it's a space for conversation. And I think what most of us have done in the pandemic is we've looked for our own ways to engage with our peers. So whether that's study groups or whether we've, you know, like journal clubs or just informal conversations with peers, we're in inherently social beings, aren't we? And I think we will find ways to interact. So I think this idea that all undergraduates or whatever percentage of undergraduates are having a terrible time because of online learning, I that's a very simplistic view, isn't it? They're having a terrible time, yeah, they're having a terrible time because it's the middle of a pandemic and we're all having a terrible time. They're stuck in their flats, they're not meeting anybody. Yes, online learning isn't helping, but it's not as black and white as that, I think. And I think there's a definite need for more thoughtful research within this area.

SPEAKER_02 15:56

I very much agree. It's it's an amalgamation, it's an accumulation of all those experiences. And I guess when you say face-to-face, I'm also thinking about the clinical environment, just those daily informal interactions that you might not perceive as teaching, but are really lessons in themselves.

SPEAKER_03 16:10

Definitely, for sure. And I think you know, we haven't really talked about this up until now, but when one is working as a health professional, one is a role model of that profession. You know, what you're doing is I think modelling good practice or should be modelling in practice, and that's all the time, isn't it? So you want your students to or your juniors to be sort of this is how it is to be, not some kind of oh my god, this is really awful. You know, I this is not necessarily where I want to see myself in 10, 20 years' time. It's about what we can do as professionals. We can think about what worked for us and what didn't work for us, and that experience will help us in how we engage with people, but it's about that sort of positive, engaging, welcoming. You know, when you think about education, you tend to think about it's about delivering a PowerPoint or whatever it is, or it's running a tutorial. I'm teaching between 11 and 12 on Wednesday, I can forget about it the rest of the time. That's far too simplistic, isn't it? I mean, teaching, yes, it is about that actual transmission of information, but it's much more about that. It's about the things that you know that the ideas, oh I must that's a really interesting case. Um I can use that in my next session, or that's a really interesting way of thinking about something. I'll make a note of that and keep that idea and use that next time. So it's all that sort of preparation stuff that you don't actually, I think it's subconscious a lot of it, but it will come out. I find it always helpful to make a note of things because I always think I'll remember that, and I never do. So I just make notes to myself, and then I've got that in my booklet that I use when I'm preparing actual sessions. So I think we need to probably widen out what we conceive of as teaching.

SPEAKER_02 17:56

Yeah, and I I think a lot of that is ringing true with my reflections on case-based learning and you know, seeing patients and then reflecting on them, thinking back about what you could then elaborate on further if you were going to discuss that with one of your mentors. There's just so much to talk about. And I'd like to get your ideas on mentorship specifically and how you model your behaviours and your learning on mentorship within the clinical environment, Jill.

SPEAKER_03 18:19

That's a hard question, but in a way it's an easy question, isn't it? I mean, it's just do as you would be done by, I think. And there's so much positive behaviour and so much goodwill. It's difficult, I think, with time. So I would try to have some protected time if at all possible, but be honest about what you can manage in terms of time. I'm obviously not working in the clinical environment currently, but I manage 17 people just now, and that's been really challenging with everything else that goes on. I think it's about attitude, isn't it? That's an open door knowing that you are available should it be necessary for whatever reason. So it's a reciprocal process. I think a conversation at the start of the relationship is important to just have a few ground rules, but understanding that sometimes more will be required than other times. So there will be the sort of general ticking over maintenance type conversations to get whatever paperwork needs to be sorted out of the way. But equally, sometimes there will be bigger things that need to be sorted, and it's finding time for that. So it should be a privilege, I think, to be involved in supporting junior colleagues.

SPEAKER_02 19:36

That's great. And just on that, I'd like to get your thoughts into how you can actually tap into the learners' sort of needs. You know, how do you identify how their development is going and whether they need any guidance in their journey? Is there anything that you could you could help um the listeners with that?

SPEAKER_03 19:54

Well, you could ask them. That's a bit simplistic. But generally, I think it comes back to communication, doesn't it? In any sort of teaching relationship, if you have good lines of communication that are open, you will know if there's an issue prior to it becoming an issue. So it's trying to nip these things in the bud. I mean, each individual will be very different in how they want to manage that. But I think as an educator, if you're authentic, if you share of yourself with your students that they understand you as an individual, not someone who necessarily knows everything because nobody knows if well, maybe you do, Johnny, I don't know, but I don't know everything, and it's being this person who is a person, you know, you're maybe a more senior colleague, but you're still meeting as individuals, and if you have that honest, open conversation, then the learner should feel comfortable in sharing any specific problems that they may be having. There are other things that you can do, but I I would say that that would be the main thing, just have that open communication channel.

SPEAKER_02 21:03

That's really helpful, and I guess it is it is quite obvious, but sometimes in the busy lives that we have, that just that simplistic approach can be overlooked. Just touching on that, is there anything that you can help the listeners with when you're wondering whether one of your students might not be coping with the clinical experience, maybe they're struggling a bit with their work. Is there anything that you can help with and give any tips on that?

SPEAKER_03 21:25

Yeah, that's tricky because it's a balance, isn't it, between you want the student to feel supported, but equally you don't want them to feel in any way picked out or victimized as someone who is struggling or is in some way different to their colleagues. My advice would be to perhaps look for some sort of one-to-one session. You know, if if you noticed a problem in, say, for example, a wardround, then maybe just take them aside and or I'm doing this session on such and such. So, under the guise of some additional session, then there could be some. Informal conversation. It's tricky, but you know, there's obviously support available within the medical schools with the student support services have been increased dramatically in recent years. So there is formal support. I would always sort of try and tackle things in an informal, relaxed session just to get a sense of whether you know it could be something that's quite easily fixed, some kind of sort of deficit in knowledge, but equally there may be wider issues that require more specialist support.

SPEAKER_02 22:30

That's really helpful. I'd like to move on now and touch on what it is to learn a curriculum because trainees in all healthcare professions will or should have a curriculum to work from and to base their learning upon. Well, what is a curriculum and how is a curriculum designed?

SPEAKER_03 22:46

So a curriculum, I think it comes from the Latin for the way or the track. I think for you know, when they used to sort of charge round, I always think of the thing in Ben Hur when they're on their horses charging round in the forum. So that's kind of where it comes from, and it's basically a description of any program of study. So it's a fairly high-level document. You're right to say that they exist for every program, professional and academic program. They're quite often difficult to track down, and they usually exist in some sort of I was thinking some sort of dusty library somewhere, but now it's probably on some server backed up in some dingy room. It's well worth the effort of tracking down the curriculum document of any program of study because it will give you a very good overview of what's intended for the learners within that program. What most curriculum developers will follow is something called constructive alignment, which is an idea that basically you describe what your learner should be able to do after completing the program of study, and that will be through a number of learning outcomes. So you'll have thinned them. So if you think about the learning outcomes as one point on a triangle, the second point will be the method of assessment. So how are you going to assess that the learning outcomes have been achieved? And then the third point will be the actual process, so the tasks that will be involved, so the actual teaching. So that will be whether it is all going to be based on I don't know, it might be online or it might be on award, or it might be small groups, it may be entirely self-directed, but it should give you an idea of the number of hours involved, and there should be some consideration of the level of study of the programme. Needless to say, there's a massive amount of information about how to write curriculum documentation. We've maybe come across things called Bloom's Taxonomy, which is a useful way of describing the complexity of the learning outcomes. So obviously, if someone's involved in doctoral level study, the level that you're writing the learning outcomes at would be very different from a first-year undergraduate degree course. So basically, it's the instruction manual for an academic program, is the curriculum.

SPEAKER_02 25:17

That's really helpful. And the reason why I ask about the curriculum specifically is because if we're teaching healthcare professionals, we need to have an awareness of the curriculum. Is that fair to say?

SPEAKER_03 25:27

That's really interesting. We have a course in the first year of the master's programme called the curriculum. And as part of that, we ask the students to identify where the educational session that they're planning is based, the curriculum that it's based in. And I would say every year about 50% of the students on that course cannot find the curriculum within which their teaching sits. And I'm sure that quite a high number of people listening to this would be like, oh, I've got no idea where the curriculum is. It's actually quite hard to find the curriculum for the undergraduate medicine programme at the University of Edinburgh, and I'm sure that's the same for other medical schools. So is it helpful? Yes, it's helpful. Can you still deliver a good session not knowing what the curriculum says? Yes, you can. I think it's helpful if you're doing a lot of teaching to sort of understand the wider context because there is that whole issue, isn't there, that students will go to something and they'll think, oh, that's really good, and then they go to something else and then they get the same but slightly different from somewhere else. So I get that it's very challenging within the clinical environment when you're just doing your one bit and your one session on ophthalmology or whatever to know what is going on in the wider sphere, but it is all mapped out, it's just quite tricky to find.

SPEAKER_02 26:43

And really, I'd I'd like to sort of overlay that with what you said earlier about the descriptors of the ability to perform within the curriculum that we're talking about at the basic level about understanding or being able to recall facts going up to the analysis or the synthesis of knowledge and then making clinical or critical appraisal of evidence. Um how would you advise our listeners to to create a teaching session that can help cover those areas within the clinical environment? Is there an easy way or is there a helpful tool that you would recommend to help our clinical educators cover those range of abilities?

SPEAKER_03 27:25

That's quite tricky because I think it depends what the session is about. If it's a practical session in learning a skill or type of examination or something, then that's very different to some kind of coming to a diagnosis or something. That like the skills are quite different. I think in terms of tips on how to design a teaching session, if people are are struggling, I would suggest that they go to some kind of faculty development event, but you know, that that would be available to them that do have these kind of how to have the skills of running small group, how to teach a large group effectively. But I think for me the key things are what is it you're trying to do? So if you understand what it is you're trying to do, you explain that to your students at the start. This is what my aims are. I want to by the end of this, I want you all to be competent in doing whatever. Then I think competence loaded, isn't it? Because competent in what regard? Competent to do it with me watching you, competent for you to do it independently. It's being clear what it is that you're trying to achieve, and then to get an idea from the students whether that is something that they feel is within their range, because the most stressful learning opportunities for both the student and the teacher are when those two things are not aligned, and you either assume that they have knowledge that they don't have, or equally that they've been doing this since for like 18 months or something. So it's about trying to understand what it is that you're trying to do. The second thing I would say that's important is having the willingness and the flexibility in your teaching to let things go. So you may have designed the most fancy Dan session on whatever it is, but if your students already know that, then you've got this session. So what can you then do? So I think then it's this sort of well, what is it that you do want to learn? And if that's within your abilities, develop the session in that way. So I think to come back to the curriculum, that's actually quite helpful in a way if you don't understand the wider curriculum because you can just adapt the session to the learner's needs. And I would say that that's the big development that I see in people as they become more secure as teachers or educators. When you start off, it's very much focused on what you are doing as a teacher. Your preparation is all about to make sure that you're secure in your knowledge and your understanding and having that ability to answer any question. As you proceed in your development as an educator, I think your focus widens to think more about what your students are doing, and then it opens out further to think about the sort of wider environment, and that's the sort of curriculum, the more social aspects, the sort of political, wider context within which healthcare education resides. So I think there's you need to have the knowledge to then have the confidence to let it go. Sorry, that's a bit of a long-winded answer.

SPEAKER_02 30:26

Again, it's just making me remember so many different aspects of my teaching experience. And it's that uh window of what you unconsciously don't know and then what you consciously do know, really, just to say about the experience. It's been really helpful to get an insight into how you design and create your teaching sessions. Before we wrap things up, I'd like to just ask for your your tips on reflection. We've talked a lot about the experience of being a teacher and being a learner, and reflective practice is so core to that. How would you advise our listeners on how to improve how they reflect on teaching that they have delivered or that they've experienced?

SPEAKER_03 31:04

Yeah, so I think you can't not reflect as an educator. That said, I am slightly concerned about the way reflection is used within medical education as a almost performative tool. Personally, I think reflection is something that is best done individually. I make notes, as I've mentioned earlier, and that is the primary way that I reflect. For me, the most useful way and the most helpful insights that I get after an event are when I'm out walking the dog or running or whatever, I find the sort of motion quite helpful. So it's a sort of solitary thing, but then I discuss that with colleagues. I think it's good while reflection is an individual thing. I think it's good to have a group of peers that you trust that you can talk about things like teaching with.

SPEAKER_02 31:59

Are there any tools I'm thinking of like Gibbs um reflection cycle that learners can use?

SPEAKER_03 32:05

Yeah, there's plenty of models of reflection that you can access. And if you're not a natural reflector, they can be helpful. I think we probably need to widen out as a group how we think about reflection because I think models of reflection can they can be helpful, but they can be unhelpful in that they can sort of encourage you to think in ways that don't really work for you. I think people that are listening to this will be very well versed in educational practice, you know, probably the elite of exam-taking individuals having passed so many exams to get to where you all are. And there's something about backing the way that you think, I think, and not necessarily r relying on what other models that other people tell you to think in the way that they think. So I think it should be personal. Have a support group that you can speak to about such things, and if possible, try and make sure that you have some objective evidence on which to base your reflections. So by that I mean try and get feedback at the end of a session. It can be just very informal, it could be sort of hands up or post-it notes or whatever mode that is available to you, but try to get some feedback because inevitably most of us will focus on the things that we feel didn't go well. But try to be honest in your reflections. If you can, try to get someone that you trust to observe your teaching. Certainly within the Clinical Educator program, there's the opportunity to have your teaching sessions observed. So try to have a mix of your own thoughts but also objective feedback on your own teaching practice. It's helpful just to keep a note of how things are going. If you then decide at some stage that you want to do some formal programme of study within education, or if you want to get accreditation from the Academy of Medical Educators or the Higher Education Academy, which is now advanced HE, you will need to have detailed notes about the teaching that you've been involved in. So if you have that sort of running log of stuff that you can refer back to, it will make your life easier if you decide that you want to get more of formal accreditation of your teaching.

SPEAKER_02 34:28

That's really helpful, and it's been an absolute pleasure to talk about so much about clinical education with you today, Dr. Aiken. We've talked about what it means to be a teacher, what it means to be a learner, we've touched on learning theory and mentorship reflection, the curriculum, and just general hints and tips. Do you have any key messages for our listeners about what we've learnt today and talked about today? Is there anything that you would impart in terms of pearls and wisdom for our listeners?

SPEAKER_03 34:56

So hopefully that these messages have come out so far, but I would say always never assume. Sorry, that's a bit of a strangled uh way of putting it, but never assume any pre-knowledge from your learners. Always try to find out where they are within their own learning. So don't just assume on your own experiences what you think individuals will need to know. And the second thing I would say is just have the confidence to let your lesson plan go if you feel that it's not going well. So things can always be retrieved. Where possible, try and give the information prior to the sort of face-to-face session, like a flipped classroom approach where the information can be provided beforehand, and then the actual contact session can be used for conversation to clarify any points of confusion. So, yeah, back yourself is really what I would say.

SPEAKER_02 35:54

Great stuff. That's perfect way to end it. And thank you so much for your time today. And I'd like to say thank you for listening. Once again, Dr. Dillake, and thank you for talking about clinical education with me today for the Royal College of Physicians Edinburgh. Thank you.

SPEAKER_03 36:10

Thanks, Johnny. It's been an absolute pleasure.

SPEAKER_01 36:25

We wish to recommend our Demystifying PACES podcast series on career conversations. As some of you may know, in late 2023, MRCP UK updated the PACE's exam format, so we developed this new series to support PACE's candidates. Episodes cover exam organization, calibration, every PACE station, including key changes and candidate perspectives.