Department of Medicine, Faculty of Medicine
Divisions of Clinical Epidemiology and Internal Medicine, McGill University Health Centre
What are some of the strategies that you use in your courses to engage students?
I teach a 600-level course on research methods in clinical medicine together with Nikki Pai, an Assistant Professor at McGill (Clinical Epidemiology, EPI 600). There are about 50 students, mostly medical and surgical trainees. We use an interactive approach and a lot of group work. For example, in the first sessions, the students will get an abstract, and they’ll try to figure out the design of the study. They’ll then give their analysis and we’ll have a discussion. They may be asked to design a study based on a research question. Knowing what they know clinically and searching the literature even just within the course, they’ll come up with a study design and share it with the rest of the class. There are also usually one or two debates on the merits of a research paper using the framework we have to analyze that particular study type. They’ll present it to the class, and the class will provide input.
How do you evaluate your students’ learning? What kind of assessment strategies do you use?
We listen carefully. We get to know most of the students in the class fairly quickly and have a sense of which students have really done the reading, synthesis and analysis based on their presentations or the nature of the questions they ask. The groups also provide written work on which they are evaluated. Group members provide an assessment of one another. The vast majority will finish with an A grade, but they know they have to work hard. We have a class participation grade of roughly 10% because they’re all clinicians and in the health profession, you have to be able to talk.
They have a final exam during which they are provided with a couple of short papers or abstracts and then we ask them, “What was the study design? Do you think the design elements were addressed properly from what you see in the results? There are potential sources of different types of bias in studies. Do these apply here?” They may be asked for a few computations to show that they’ve understood. There’s usually a question worth 20-25% in which we ask them to design a study using a choice of research questions. The vast majority of our students will be life-long consumers of medical literature, and they’ll need to go beyond the conclusion of a study and look at the methods, deciding if they can have faith in the answer that’s being presented and in the interpretation of that answer.
What is the most important thing students in your discipline learn when taking a course with you? How about students from outside your discipline?
That it’s reasonable to question and be skeptical but also to say, “Given the potential biases, do I have faith in what is put forward? To what degree can I really accept this? Will this change my practice? Am I better to go with the status quo or is it reasonable to try this option?” I think students at that level are quite excited about this because all along, they’ve been reading papers and now they have refined their tools for reading and assessing. You see people you’ve pointed in the right direction take it to a whole different level. We had a presentation this year about a much publicized therapy for people with Multiple Sclerosis. The group of students went to the original studies, which were quite biased with very selective patient populations, and the students demonstrated all of the flaws in the studies. There’s a whole back story that was quite disturbing. The students presented how the evidence was not enough to even justify a trial, let alone a therapy. So they really pieced together the whole story. And these are people who are clinicians; this is maybe the only research methods course they’ve taken in their training. That to me is a great experience.
How do you help your students understand what research and/or scholarship is in your discipline (including findings, methodologies, etc.)?
My co-teacher Nikki Pai and I are both physician scientists. At the beginning of the course, we give the students an idea of the research we do. We show the challenges and discuss the projects we’re doing. Eight weeks a year I look at patients in the hospital and work with the students in residence. One day a week I treat patients with diabetes and then I have a research program around management of diabetes. Nikki Pai is an internationally known HIV-researcher. She describes her very large research program and the different methods she’s used in her personal history. I talk about my clinical trials examining behavioural nutrition and physical activity interventions in diabetes and gestational diabetes. We also invite other clinician scientists, especially during the last two weeks, to come and talk about their work and how they integrate research into clinical practice and teaching, where the nexus is. The students get the role modeling examples as well as the discussions of the course content.
What are your recommendations to new faculty members to help them develop in their teaching role?
Teaching is like anything: the better tools you have, the more refined it is. I would say if you’re going to design and teach a course, take advantage of all the resources that Teaching and Learning Services is offering. Be open to different ways. Another piece of advice is to ask students early on how they’re finding things. The feedback is important, but be prepared that you’ll get a whole range of answers. And I think the students realize, “Well, they’re asking, so if I didn’t voice anything, how could I expect it to be different?” We try to respond to it and see how it works. The other thing that I enjoy is the co-teaching with Nikki Pai in the active learning classroom. We’re able to effectively teach 50 students. You can still have quality in numbers if you have the right people and the right type of classroom. I would encourage new faculty to use the active learning classrooms.
What advice do you have for undergraduate students about how to get the most out of your courses?
Do the background reading and reflection and engage actively in the exercises and in the discussions. I think if they do that, they’ll get everything they need. For undergrads, I think they shouldn’t be shy about interacting, asking questions, doing the readings, applying themselves. One of the things we have at McGill is leaders in their field with knowledge in many areas. So if you have a professor who is a certain way, don’t limit yourself by getting upset and complaining. Just say, “Well, what can I get out of his or her course and reading the materials?” Ask the right questions. The other thing would be to take advantage of the wonderful library services we have. I think our library services are unparalleled, bar none.
Why do you teach?
I can say personally, that it allows me to amplify my effect. If I see patients in my office—which I do and enjoy doing—I have a certain effect. If I teach, I expand that effect because my students will see patients. If I do research, I potentially change practice, which expands my effect, but if I teach people how to do clinical research, then that’s a whole other level. It allows for an amplification of one’s capacities and contributions. And it’s definitely not a one-way street: I always learn from my students. Their questions make me look at things differently, and my methodology or understanding becomes stronger.