By Nicole Lim
Assistant Director, Communications & External Relations
It’s hard to imagine, but barely a year ago, LKCMedicine’s newly restored heritage headquarters was devoid of the hustle and bustle of student life. Instead, the stately exterior belied the anxious excitement felt by the faculty and staff within, who were busy putting the finishing touches to the curriculum, facilities and the technology-support systems.
Looking back at June 2013, Executive Vice-Dean for Administration Professor Lionel Lee said, “There were high expectations of us to succeed. We had to be world-class. So there was no room for failure; we simply had to succeed.”
Vice-Dean for Education Associate Professor Naomi Low-Beer added, “We definitely had the eyes of Singapore on us. There was some anxiety but also a lot of excitement to see these empty buildings filled. Everyone felt under pressure, but we had been through lots of dry runs which gave us confidence.”
A year on, the overall success of the first year is evident in the decision to increase the second cohort to 78 students from 54. “If what we are delivering had fallen short of our promise, then we wouldn’t have been asked to take on more students,” said Assistant Dean for Phase One Professor Michael Ferenczi.
Introducing technology-enabled TBL to undergraduate medical students
Benefitting from a unique opportunity, LKCMedicine assembled the best evidence-based teaching practices from around the world and built customised facilities and support systems to implement its pedagogy.
But the technology-enabled Team-Based Learning (TBL) approach was unfamiliar to many of the clinicians involved in teaching students. “Many of us didn’t understand TBL and how it worked. But I have to say, we were pleasantly surprised by the effectiveness of this teaching method,” said Vice-Dean for Clinical Affairs Associate Professor Pang Weng Sun.
“Teaching TBL was an eye-opening and very enriching experience for many of us who had been used to teaching the traditional lecture model,” added Assistant Dean for Phase Two and Three Associate Professor Tham Kum Ying.
The other uncertainty lay in how the students would take to this new teaching method which is rarely used with undergraduate medical students. But very quickly, the students became vocal and participated actively in the sessions.
In addition, the School opted for a paperless and completely mobile learning framework. Drawing on existing software and customising new ideas led to the creation of the Technology-Enhanced Resources Activities Support and Assessment framework, or TERASA in short. What’s more, TERASA can support up to 2,000 users simultaneously.
“We did something that no one else in the world has done,” said E-Learning & IT Services Director Mr Paul Gagnon. “We looked around the world for e-learning systems and software that could support our vision of a paperless, mobile pedagogy; and that’s what we delivered.”
Apart from the final year exams, the students have not had to revert to paper. Having a completely mobile learning system has also helped overcome the challenge of the School’s dual campus. With books, lectures and other resources on their iPads, the students can work anywhere, anytime.
Focusing on applied medicine
Moving away from the traditional structure of medical curricula, LKCMedicine has built its learning journey around the patient and the application of medical knowledge.
“We geared the curriculum so that come the clinical years, the students will be familiar with the practice of medicine and the technology that is being used,” said Assoc Prof Pang.
Basic science is taught in context with its clinical implications. For example, LKCMedicine has adopted a team-based teaching style for anatomy lessons, where students are taught by clinicians as well as anatomy professors. During these lessons, students rotate between different stations – gross anatomy, histology, and clinical imaging, which uses technologies such as x-rays and ultrasound.
“Using ultrasound in particular has proven to be such an enriching experience that one of the other medical schools in Singapore is now also looking to introduce this technology into their curriculum,” said Assoc Prof Tham.
This approach has also led the School to introduce patient contact early on, another unique feature that has paid dividends. Taking existing modules from Imperial – the long-term patient project and the integrated clinical practicals – and adding the clinical encounters modules, the LKCMedicine team decided to introduce them right from the get-go.
Focusing on the patient experience of the healthcare system, these projects require no prior medical knowledge, but aim to inculcate an appreciation of the patient’s perspective in students.
“I was worried about introducing students to patients so early on,” said Assistant Dean for Family Medicine Associate Professor Wong Teck Yee. “But they proved me completely wrong. Both projects the students did for Hospital and Polyclinic Week showed that they had taken on what we wanted them to learn.”
For Hospital Week, which was held as early as the second month of the first year, the other learning objective was for students to spend one shift observing the nurses at work and building relationships with other healthcare professionals, in particular junior doctors.
“Alongside the School’s proper House system, we wanted to start an informal mentoring programme between students and residents where the age gap is smaller. Both our students and the residents have taken the programme and run with it. We hope that through it, we can nurture a paying-it-forward mentality in our students so that even after they graduate, they continue to look after their juniors in medical school,” said Assoc Prof Tham.
Review, revise, refine
Despite the first year’s success, faculty and staff are busy adjusting and fine-tuning the curriculum, the technology and the facilities to make the second year even better.
The seminar room and clinical skills lab at Research Techno Plaza are being reconfigured to accommodate the larger first year cohort; the e-learning team is working on extending the School’s learning apps to other types of tablet computers; while the curriculum team is busy fine-tuning some of the content.
For example, ensuring that the pre-prepared materials from Imperial and the application exercises prepared here are fully aligned is one area that is being refined for the benefit of both first and second year students.
“LKCMedicine is unique in that we are the result of a true international collaboration, where teachers from Imperial and LKCMedicine have to work together to deliver a lesson,” said Assoc Prof Low-Beer. “While this means we get the best of both worlds, delivering it seamlessly is an area we can do better still.”
Through student feedback, other areas for improvement have also been identified. For example, the curriculum team in London will be working on standardising the length of pre-recorded material, so that for each TBL session, there is enough discussion time after the individual and team assessments have been completed.
Individual and team readiness assessment (iRA and tRA) questions are also being revised to better test for the desired learning objectives.
TERASA will also play “her” part in the review process, by collecting analytics on student behaviour when they are going through the online materials. It can track how long students stay on a particular page or how long they watch a video lecture. This can then be matched against their individual readiness assessment scores. “This gives us information on whether the material provided is too easy or complex or maybe the learning outcome is not clearly enough signposted,” said Mr Gagnon.
Nurturing a close spirit in a growing school
Despite not having a senior year for guidance, LKCMedicine’s House system has taken strong roots. “What we really hadn’t anticipated was the anxiety felt by our inaugural cohort,” said Assoc Prof Low-Beer.
The dedicated House tutors who offer advice, support and mentorship have, therefore, become an important source of reassurance.
Designed to nurture greater bonding between student groups, the House system will grow in importance as the student numbers at LKCMedicine grow. “Especially as we increase in size, the House system will continue to provide a sense of cohesion and bring seniors and juniors together,” said Prof Ferenczi.
“It will also act as an important liaison between faculty and students as the School continues to grow,” added Assoc Prof Wong. Together with the official student feedback system, this will help to ensure that students continue to play a key part in fine-tuning the curriculum.
“When we started, we had a unique opportunity to build something special, drawing on the best evidence in medical education and assembling a world-class curriculum to meet the demands of 21st century doctors,” said Prof Lee.
To continue delivering a first-class education, the School will have to sustain its meticulous planning so that new challenges are thought out before they arise, especially with the increasing number of students who will come through its doors.
“What has made this first year so exceptional is the dedication, commitment and enthusiasm of not just the faculty and staff, but also the students,” said Assoc Prof Low-Beer.
But to continue to attract the best and the brightest, LKCMedicine also needs to invest in research, so that the latest medical and scientific knowledge can be shared with the students by the best experts.
The School’s Vice-Dean for Research Professor Philip Ingham FRS said, “We have brought together world-renowned experts in the fields of metabolic diseases, neurological and psychiatric disorders, dermatology, infection, immunity and public health, all of whom are pushing the boundaries of medical research. Focusing on the prevention as well as the treatment of disease, their work will shape how our graduates practise medicine in the years to come.”
Collaborating with the School’s primary clinical partner, the National Healthcare Group (NHG) as well as leaders in business, bioengineering, science and technology such as the A*STAR research institutes, and the different Schools at NTU and Imperial, LKCMedicine is following a bench-to-bed as well as bed-to-bench research strategy. Prof Ingham, who is also Toh Kian Chui Distinguished Professor, added, “Together with our various partners, we aim to elucidate the pathways leading to disease, allowing us to develop the best new preventive and therapeutic options for the local population.”
Building a legacy
With everyone from students to faculty and staff fully committed to making the first year a success, the next challenge lies in maintaining this level of commitment.
LKCMedicine Dean and Dean of the Faculty of Medicine at Imperial College London Professor Dermot Kelleher is pleased with the School’s progress. He said, “In the past year, we achieved significant milestones in collaboration with colleagues from NTU, Imperial, NHG and other healthcare partners. The School is well set to not only nurture doctors with the competencies that match the challenges of modern medicine but also to become a centre of great scientific ideas, generator of innovative technologies that enhance public health, and a focal point for the creation of novel solutions for problems that have been challenging our best scientific instincts for decades.
“The next big step for us is to make these attributes synonymous with LKCMedicine globally. In pursuit of this goal, I hope to see faculty, students and staff to continue to go the extra mile in everything they do.”