Two initiatives, coordinated by AMEE and of considerable importance to the internalization of medical degree courses, are Best Evidence Medical Education (BEME), based on the inclusion of evidence in medical education and Essential Skills in Medical Education (ESME), which focuses on teaching skill. These interesting ventures are an addition to the MedEd World project, referred to in a previous issue (Familiari, 2013).
1) Best Evidence Medical Education
Best Evidence Medical Education (BEME) is defined as: “The implementation by teachers and educational bodies in their practice, of methods and approaches to education based on the best evidence available” (www.amee.org).
The aims of BEME are: to disseminate information capable of permitting teachers and stakeholders in the medical and health-care professions to make decisions informed by the best evidence available; to produce systematic reviews providing access to this kind of evidence; to cater for the needs of the user while promoting a BEME mind-set amongst individuals, institutions and national bodies (www.amee.org).
AMEE is a founder member of the BEME Collaboration organization which has members worldwide. The BEME Collaboration organization is an international group of individuals, universities and professional associations committed to the development of evidence-informed education in the medical and health professions.
BEME’s goal is to give visibility to the latest scientifically grounded educational research findings, thus enabling teachers and administrators to make informed decisions regarding the provision of evidence-based educational initiatives capable of boosting learner performance underpinned by measurable cognitive and clinical criteria.
BEME rejects the legacy of medical education whereby decisions were reached on the basis of pseudoscience, anecdotes, and flawed comparisons rather than on empirical evidence. The BEME approach argues that in no other scientific field is personal experience relied on when choosing policies, and that no other field is grounded on such limited research bases.
The definition of BEME reviews, as assessed by the AMEE Internet site (www.amee.org), is the following:
– A BEME review is a systematic, logical and explicit appraisal of available information to determine the best evidence relating to an issue within the field of professional health-care and medical education.
– A BEME review is designed to assist individual teachers, institutions and national bodies to reach informed decisions concerning educational practices and policies.
– A BEME review provides descriptions and evaluations of evidence pertinent to clearly formulated topics/questions availing of explicit scientific methodologies and methods aimed at the systematic identification and organisation of data and the critical analysis and summing up of information relevant to a review topic.
– A BEME review selects data from primary literature in a rigorous, transparent and reproducible way and analyses and synthesises them according to the rationale of the type of data (quantitative, qualitative and mixed) chosen. In any case, the methodology applied to analysis and synthesis must fit the purpose and be chosen from the broad range of secondary research methodologies available, e.g. realist synthesis, theory led analysis and synthesis, statistical meta-analysis, meta-ethnography.
– A BEME review should be reported in a systematic, transparent, scholarly and user-friendly manner and be capable of enabling the practitioner to judge and employ the evidence according to his or her individual criteria and context.
– All BEME reviews are registered with and approved by the BEME Collaboration organization and endorsed by a BEME Review team following accepted BEME review procedures.
– The BEME position relative to secondary research processes is one of inclusivity. We encourage reviewers to use a wide range of investigative methodologies appropriate to their review topics and aims.
2) Essential Skills in Medical Education Courses
The need for doctors, scientists and others involved in teaching in the healthcare professions, to be trained in teaching is widely recognized (Dornan et al, 2011; Gallo, 2011). The AMEE Essential Skills in Medical Education (ESME) courses have been designed to meet this need. A range of courses covering basic medical-education skills, assessment, simulation and technological research is available.
For the courses appraised by AMEE see www.amee.org; the courses address the basic skills required by health-care teachers and have the following unique features:
– The courses are organised around an important educational conference which includes a pre-conference workshop, recommended conference sessions and a post-conference workshop;
– The courses are led by international experts; personalised tutorial support is provided during the conference;
– The course format is interactive and challenging;
– A useful set of resource material is provided to support the course;
– There are opportunities for discussion with other course participants before, during and after the conference sessions;
– The ESME courses are accredited by AMEE and approved by an International Advisory Board. A certificate of attendance is provided and it is possible to work towards an ESME Certificate in Medical Education. The ESME Certificate is recognised as stage one of the International Association of Medical Science Educators (IAMSE) Fellowship Award;
– The courses are organised in different parts of the world;
– The courses have now been running for several years and are widely acclaimed by course participants.
There is increasing recognition of the knowledge, skills and attitudes that promote and favour quality in teaching and of the need for formal training in the area (Dornan et al, 2011; Gallo, 2011). The ESME courses are designed for teachers practicing within the medical and the healthcare areas, whether basic scientists or clinicians. They are intended both for those new to teaching and for teachers with years of experience who would like to gain a deeper grasp of the basic principles and update their knowledge of current best practice. The courses recognise that, with appropriate help, all, even those with considerable experience, can improve their teaching skills.
The ESME courses are also available on line, and offer those who sign on the undeniable advantage of being able to study from the work place, from home and at the time most convenient to them. The on-line courses are practical and simple and are underpinned by clear theoretical premises. The ideas are presented in such a way as to be easily applied to the day-to-day work of the teacher.
Briefly, in conclusion
These two highly interesting AMEE initiatives are centred on two of the fundamental issues relating to medical and health-care education upheld by AMEE, by the numerous international scholarly reviews devoted to the issue and by the SIPeM, the Italian Association of Medical Pedagogy.
The first of the two issues, BEME, refers to the fact that medical education needs to be “evidence-based” and correspond perfectly to practices grounded solidly on scholarly research. The numerous monographic BEME studies available in literature bear valid witness to this fact. One must always keep in mind that medical training needs to be seen as a complex process on a par with all other areas of scientific research (Dornan et al, 2011; Gallo, 2011).
The second issue, that regarding ASME, shows how unequivocally and keenly the importance of learning to teach is felt at international level, and how promptly AMEE responds to this need by providing both in-class and on-line courses aimed at improving teaching methods. No doubt surrounds the existence of first-rate medical scholars; what is at issue here, however, is whether they are capable of transferring their competence to students. What they need, when all comes to all, is to learn how to teach as the existence of AMEE, various important medical education institutions and SIPeM, the Italian Association of Medical Pedagogy demonstrates.
In Italy, at present, appraisal of the efficiency of didactic performance regards the overall performance of the universities on the whole and not that of single members of the teachning staff. This issue is one that needs to be addressed urgently, at least within the ambit of the medical training, where there is considerable evidence that correct teaching methods are mandatory, a fact to which the two examples provided here bear witness.
1) Familiari G. The international dimensions of medical education. Med. Chir. 57: 2537-2538, 2013.
2) Gallo G. Insegnare nei Corsi di Laurea in Medicina e Odontoiatria, Collana di Pedagogia Medica, SIPeM, ESPRESS Edizioni, Torino, 2011.
3) Dornan T, Mann K, Scherpbier A, Spencer J, Medical Education, Theory and Practice. Chrchill Livingstone, Elsevier, London, New York, 2011.
Familiari G., Consorti F., Best evidence medical education and essential medical teaching skills: two important keys to the internationalization of medical education, Medicina e Chirurgia, 59: 2662-2663, 2013. DOI: 10.4487/medchir2013-59-8