BY JAMIU BUSARI (@JOBUSAR)
Background
On the 4th of October 2023, 131 international scholars in health professions education (HPE) from 20 countries came together for two days to discuss current controversies and future trends in competency based education in the health professions. Initiated by the international competency based medical education collaborators and hosted by both he Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden, the MedEd on the Edge conference was the first of its kind to bring a select group of leading scholars in Health professions education together to debate contemporary controversies in (competency based) HPE. Although the representation from the different countries was unequal, the conference succeeded in having each continent represented by at least one country.
Five areas constituted the central focus of the meeting, which included
- the impact of HPE on health (outcomes)
- Equity in HPE
- Assessment in HPE
- Competence and continuing professional development
- HPE research.
Furthermore, the controversies around these themes were crafted into the following five questions, namely
- Does Health Professions Education Make a Difference to the Health of the Public?
- Can We Ever Achieve Equity in Health Professions Education?
- Has Assessment Ever Worked?
- Competence, Incompetence, and Continuing Professional Development?
- What is HPE Research For?
Unlike most mainstream HPE conferences, the ICBME collaborators’ MedEd on the Edge conference was limited to a maximum of 300 attendees and intentionally designed to attract voices and perspectives from multiple health professions and every continent. The sessions were diverse and designed to be dynamic, interactive, filled with debates, and consensus-forming. Participants were invited to come with some of their high-impact research works and emerging ideas. The objective was to generate cutting-edge insights from the highly interactive discussions in (“edge”) groups that two senior HPE scholars facilitated. There was also a mix of plenary presentations, (precon) workshops, and masterclasses.
Based on the feedback from the conference in Stockholm, the attendees felt a certain buzz around the design, content, and format novelty. There was unanimous consensus among the organizers and attendees of the conference that it should be organized again because of the richness of content, learning, and interaction it offered. To provide the reader with an insight into one of the controversial topics discussed at the meeting, Thirusha Naidu (Clinical Psychologist and Associate Professor at the University of KwaZulu-Natal) and Javeed Sukhera, (Chair/Chief of Psychiatry at the Institute of Living and Hartford Hospital in Connecticut, USA), offer a synthesis of the plenary session they delivered titled “Can we ever achieve equity in health professions education”?
The conversations
Dr Naidu’s presentation focused on what is needed to achieve equity and also uncovered some invisible barriers which inhibit this aim. Reflecting on specific social determinants that impact women of colour more, Dr Naidu discussed how attempts to achieve inequity were not new. Her talk emphasised various “iterations of equity as illustrated by the intergenerational work of activists like W.E.B. Du Bois, Franz Fanon, bell hooks and most recently Kimberley Crenshaw. Using examples of social activist movements like the civil rights movement, Black Lives Matter and other equity movements, Dr Naidu pointed out that the repeated need for such movements demonstrate there is still a long road to achieving equity due to preexisting inequitable structural and systemic forces in our societies. Global obstacles to achieving equity, she said, continue to include economic discontent, immigration and identity, fear of terrorism, political dissatisfaction, social media and online radicalization, and populist leadership. Finally, while she acknowledged that there was still much to do before equity in medical education could be attained, Dr Naidu identified some steps that could be taken to hasten that journey. These included promoting the understanding of epistemic Injustice impact on medical education and decolonizing the Curriculum by deconstructing the Eurocentrism at its core.
Dr. Sukhera’s presentation foregrounded his research exploring how health professionals grapple with feedback about their role in discriminatory harm. He shared deeply meaningful personal experiences of identity-based trauma, highlighting the importance of humanizing conversations about equity in HPE while validating the emotional labor of equity work for minoritized individuals. Dr Sukhera suggested that moving forward we (would) need to balance dialogue and disruption more as we work towards justice. He offered the participants a framework (sharedhumanity.ca) built on the pillars of sharing humanity, sharing trust, and sharing power, that can help to dismantle inequities in clinical learning environments.
Summary and conclusion
The two-day ICBME collaborators MedEd on the edge conference in Stockholm could be considered to be a success based on the cutting-edge plenary discussions that took place, intense group discussions and informal network conversations that generated new ideas and perspectives among the participants. In the plenary session on EDI in medical education, participants were offered new insights and ideas although many were left with more questions than answers. A major takeaway from the conference, however, was the need to re-gauge the emphasis on the “global North” ways of approaching health care and medical education and balance it out with the Global South’s ways of understanding and promoting healthcare education and research. Ultimately this should help in effectively addressing power imbalances in healthcare systems, promote new perspectives ion social justice in health professions education and research.