The Conference: Organization and Themes

From the 30th August to the 3rd September, the 2014 edition of AMEE Conference was held in the splendid context of the MiCo Congress Centre in Milan. It was organized by the International Association for Medical Education, in collaboration with the University of Milan, the Sapienza University of Rome, the Council of Directors of Italian Medical Curricula, the Council of Directors of Curricula of Italian Healthcare Allied Professions, the Council of Deans and Directors of Italian Medical Faculties and SIPeM, the Italian Society for Medical Education. The president of the AMEE executive Committee was Prof. Trudie Roberts, the General Secretary of the AMEE secretariat was Ronald M. Harden, the Chair of the AMEE 2014 Organising Committee was Fabrizio Consorti, President of SIPeM (Figs. 1, 2, 3).

An important contribution was made by the AMEE student taskforce which is a team of students from all over the world who worked side by side to help with the conference logistics and assist delegates. There were also local representatives: Tancredi Lo Presti, Felice Sperandeo, Eleonora Leopardi, Stefano Guicciardi, Matteo Dameri, Mario Staccioni, Ilaria Gambelli, Matteo Gavagnacchi, Andrea De Rosa, Roberto Barone, Giustino Morlino, Federica Balzarini, Emilia Tomarchio and others (Fig. 4).

The Milano congress provided an excellent occasion, as Ronald Harden pointed out, to:

– deliver an update on current best practice in education in the healthcare professions;

– provide information about trends and developments in education;

– share personal experiences and research;

– network with others from around the world with similar interests.

As is the tradition, this, like all the previous editions of the congress, turned out to be an imposing event due to the number of those taking part and the high quality of the contributions. There were 3,300 delegates from 93 nations, not only from the heavily industrialized countries (over 50 each from the United States, Canada, Brazil, Japan, Taiwan, Thailand, Singapore, Australia, the United Kingdom, Germany, Norway, the Netherlands, Sweden, Finland, Denmark), but also many from low-tech countries (5 or less each from Eritrea, Libya, Chad, Ghana, Cameroon, Uganda, Angola, Botswana). Every facet of the manifold field of medical educational excellence was represented including clinical training, general science, educational science, administrative issues, degree-courses, as well as Deans/Directors of Medical Curricula (288), Directors of Departments (552), Students (288). The representation of the Italian reality was substantial both in size and in quality on this occasion.

There were three Plenary sessions, 22 Symposia on a wide range of topics, 531 Short Communications, 37 Research Papers, 745 Posters, 209 e-Posters and 82 Conference Workshops.

The themes treated included curriculum planning, learning outcomes, teaching and learning, new technologies, assessment, selection, faculty development, education management, medical education research, postgraduate education, CPD and international issues.

This type of organisation, which did not contemplate plenary sessions alone (which in this instance were few in number and of the highest quality) but a consistent number of parallel symposia, short communications, posters, e-posters and workshops, provided a variety of settings capable of fostering interactivity among participants who were free to focus on the topics of greatest interest to them, although the high quality of the sessions offered make it difficult for some to choose between the myriad events on the daily agenda (Figs. 5, 6, 7).

Last but not least, we wish to mention the numerous Commercial, Not-for-Profit and Academic Exhibitors, whose stands made an excellent contribution by providing information concerning refresher and update opportunities. By way of example it suffices to mention Academic Exhibitors like the Harvard Macy Institute Professional Development Programs of Academic Leaders, and the University of Pavia’s stand.

The Italian Contribution

In the edition of the Congress held this year in Milan, the Italian presence was more numerous and incisive than in the past, a testimony to greater international integration.

The following events are worthy of mention:

SIPeM organized and ran a pre-congress workshop entitled “Cinema as a learning tool to promote reflection in healthcare. How to manage the personal impact of patients’ pain” (conducted by L. Montagna, V. Ferro Allodola, L. Fieschi and L. Garrino). In an international context a similarly sensitive issue represented a veritable challenge which the team managing the event faced and won. The workshop attracted an audience of 25 participants (i.e. the largest audience forseeable) from many different countries and the discussion following the educational activities proposed by the team, demonstrated that the language of cinema is capable of crossing borders and cultures and acting as a very valuable educational tool.

Of the symposia, that regarding the important Italian experience of the Progress Test, conducted by the Council of Directors of Medical Curricula proved of particular impact. The symposium held by Alfred Tenore on “Progress Testing In Italian Medical Schools: An 8 Year National experience”, compared the experiences of an Italian, a Dutch (L. Schuwirth – Maastricht) and a number of German (Z.M. Nouns – Charitè University, Berlin, Germany) Universities. The Progress Test is important when testing knowledge, a valuable tool for the students who avail of it to monitor their progress. Particular attention needs to be paid, however, to efforts being made to transforming it into an inter-university benchmarking tool. This highly sensitive issue was discussed in depth and is one to which Prof. Alfred Tenore intends dedicating a specific article. The general discussion and the data presented by Alfred Tenore show that the Italian experience is one of the most far-reaching data experiments regarding this theme carried out to date as far as numbers of participant universities and the quantity of data generated are concerned. The dimensions of the results obtained in Italy, compared to those of the Netherlands, where the Progress Test was actually drawn up, prove how up-to-date this practically mandatory procedure has become and how useful it is to students of medicine and surgery.

Another interesting symposium was the one organised by Fabrizio Consorti and dedicated to professionalism, Entitled “Variations on the theme of professionalism: Students’ experiences of professionalism dilemmas across culture”, it attracted the participation of a truly international audience which took active part in discussing experiences from all over the world (conducted by MJ Ho – Taiwan University, Taipei, Taiwan; L. Monrouxe – Cardiff University, Wales, UK; C. Rees – University of Dundee, Scotland, UK; M. Chandratilake – University of Kelaniya, Sri Lanka; F. Consorti – Sapienza University of Rome, Italy; S. Ginsburg – University of Toronto, Canada). The symposium was the outcome of three international research projects run at the National Taiwan University, the Cardiff University of Wales, the University of Dundee in Scotland, the University of Kelaniya in Sri Lanka, the University of Toronto in Canada and the Sapienza University of Rome. The goals of the symposium were to present different cultural contexts for researching dilemmas accruing to professionalism, to discuss cross-cultural similarities and differences in dilemmas regarding professionalism and to discuss how to conduct cross-cultural research. The core methodological concept was the idea of dilemma, a situation where two or more professional values clash. The use of standardized scenarios, written or represented through video clips, proved to be a powerful tool to foster the reflection of learners on the values and motives informing professional action in the presence of complex elements. The inter-cultural comparison of the results carried out, made it even more evident that the construct of professionalism is culturally mediated.

Besides communications presented by some Italian teachers and students, we wish to refer to the communication approved by the Council of Directors of Medical Curricula, entitled: “Selection of Medical Students and non-cognitive skills: A National, longitudinal written test validation” (C. Barbaranelli, G. Cavaggioni, M.G. Strepparava, A. Lenzi and G. Familiari). We wish to point out that, as far as undergraduate admission to university medical degree courses is concerned, three short communication sessions were held on the topic, as well as a poster session and an e-poster session, which shows how keen the international debate is concerning this issue of the greatest interest in our country at present too. In addition, SISM (Segretariato Italiano Studenti in Medicina – IFMSA Italy) students presented three posters, entitled: “LabMond, Laboratorio di Mondialità: An Informal Education project on Global Health issues. What is the impact in the core curricula of Italian Medical Students?” (S. Pegoraro, E. Giambelluca, M. Staccioni, B. Goletti and G. Perfetti), “Analysis on the knowledge of conflict of interest among medical students” (M. Dameri, A. Meleddu, G. Occhini, S. Bolchini and N. Pecora), “Nationwide Train the Trainer program for undergraduate in the field of Disaster Medicine” (E. Leopardi, L. Ragazzoni, S. Lo Baido, F. Maccapani, P.L. Ingrassia and F. Della Corte).

We also wish to mention that the prize for the best e-poster went to the colleagues from the Milano Bicocca University for “Personality differences in communication skills and attitudes in a sample of Italian medical students” (L. Tagliabue, D. Corrias, G.F.A. Rezzonico and M.G. Strepparava).

The Opening Lecture

Undoubtedly a very special mention goes to the opening lecture by Richard Horton, Editor-in-Chief di The Lancet, United Kingdom, entitled “Meanings of Medicine: the convergence and crises of civilisations”.

Of the utmost interest, this talk addressed the often complex and difficult relationships existing between professional health-care training and global shifts, which impact not only on epidemiological but also on international political issues.

Richard Horton concluded that “Education of health professionals is being threatened by rapid epidemiological and political shifts … It is not clear that medical education systems can meet the demand of fast changing health systems” … A new vision for transformative learning and interdependence for health equity could provide the framework for successful adaptation … But successful adaptation requires a radical reassessment of the role of the University … The forces shaping Universities today – especially market fundamentalism and perverse metrics – are eroding the public values of education and Scholarship … There is an opportunity to defeat these forces … the chief challenges facing societies in the C21st are sustainable and resilient civilisations and survival … The Physician can be an agent for advocacy, resistance, and transformational change, offering a global vision for the right to health, equity, and social justice”.

A brief conclusive summary

Being unable to sum up an event as complex and multifaceted as the AMEE 2014 Milan Conference in all its multiform aspects (for a detailed account of the contributions it is possible however to access the 906-page AMEE abstract book), we believe that the vital message launched by a personality of Richard Horton’s stature, represents an important prompt not only to the Council of Deans and Directors of Medical Faculties and the Council of Directors of Medical Curricula, but to all those responsible for medical and health-care education at national level for the organisation of the country’s national health service policies. If the Editor of The Lancet, one of the world’s most prestigious scientific medical journals, speaks of market fundamentalism and perverse metrics as threats capable of nullify the public values of education and Scholarship, we believe the moment has come to reflect seriously on his words.

The moment has come to reflect deeply on the social and ethical implications of how we teach and manage our professional medical and health-care courses. We are convinced that we must continue to pursue the virtuous route we have already begun, one capable of enhancing health, equity and social justice in this country too, although we believe that medical education in Italy measures up well by international standards and that our national health system is one of the world’s best. Much has been done by the Council of Deans and Directors of Medical Faculties, the Council of Directors of Medical Curricula and by SIPeM, the Italian Society for Medical Education, a lot more still needs to be done in the better interests of health, equity and social justice to which we dedicate our passionate energies, our lives and our work, daily.

The AMEE 2014 Conference programme and the abstract book are available at http://www.amee.org/conferences/amee-past-conferences/amee-2014

Familiari G, Consorti F., AMEE 2014 – International Conference, Milan, Italy.  Excellence in Education – The 21st Century Teacher. A brief Report, Medicina e Chirurgia, 64: 2901-2904, 2014. DOI:  10.4487/medchir2014-64-5