Share and choose

Working in a small team can be tricky at times. One of the first issues to arise is task allocation. The most intuitive approach understood by most people was codified by Hywell Dda in the laws of Wales and is known to most people as the principle of "one to share, the other to choose".

If you have never come across this approach, it's a treat and is particularly useful if you have children. Here's the deal: the first party allocates the tasks into two groups (or cuts the cake into two bits...); the second party then choses which group of tasks they want to do (or which slice of cake they want: bigger, more smarties on top etc).

This splitting puts a natural fairness control into the process. If the first party splits the work unfairly, they get lumbered with the worst / most work.

If there are more than two parties, then the work is allocated between groups in a iterative process until individuals are choosing.

Bags of fun.

International students: the future

So, looks like after 2010, international students in our state will be at the mercy of the ballot / merit system, if, and it's a big if, the state decides that it needs more interns that can be provided in the shape of local grads.

I think it will take a lot of arm-twisting by the universities to get the state govt to do this: even though our uni in particular brings in A$20m+ pa (my back of an envelope estimate which may be very wrong), I don't that that's enough to sway their current position.

Although I have been wrong before. Not least in hepatology tutorials.

All done

Assignments all done for this term. I have to say I'm beginning to run out of reflections and TurnItIn is starting to get a bit suspicious.

Hope to get back to posting a bit more... just have to worry about this term's exam now.

Return from a break

Apologies to the 100 people or so who have looked at this site for the gaps in posting. First off it was exams, then a break which meant that I wasn't so busy and was living up to the aphorism of "if you want something doing give it to a busy person". Not that I haven't been busy being Daddy Daycare, but it isn't the same.

Results came out a bit ago and so time to reflect... all for the benefit of my portfolio because I will have forgotten this by next year.

My prep for these exams was much patchier than for those I took in the UK. I managed three or four days proper study between child and partner care (I have to cook a lot, which is tricky due to my immediate family being vegetarians) which wasn't sufficient. I managed to get the flashcards going and a mini whiteboard was handy so I'll keep that approach to the rest of the exams. I think I'll have to annotate as the term progresses from now on: making notes took up too much time and left precious little for proper revision.

The outcome was pretty good. Although the exam was much vaguer than the UK one, which was a bit of a trivial pursuit exam at times (esp. the spotter), I manged to up my % a bit. Some of the questions were tricky indeed: the only way I knew one of the answers was because I'd done it before. It hadn't been taught to us here. That was probably the only prior knowledge that came in handy!

Kids on this course being, I think, brighter (or at least better at exams) than at my old med school, I dropped a couple of centiles from my ranking but still did well enough should grades determine internships (more of that later...) I'd like a Top 10 finish: perhaps with the experience of this format I'll manage to hop up a couple of spots when this differential between 1st and 2nd years become leveled out (we take the same exams). I'd be interested to see how I performed cf my own year rather than year 1 and 2.

Hmm... I'll probably fail the next exam after writing all that. Serve me right.

Pig Ignorant Students

I've posted before on the phenomena of students playing flash games on their laptops, passing the computers between one another in group of six or so. Irritating, rude and hard to understand. Why not stay at home and play, or go down the pub?

My theory: this minority of students are such a bunch of repressed swots that they would feel guilty if they didn't attend each and every lecture. Most of my fellow students are the product of educational hothousing both at school and at home and would probably feel the need to birch themselves should they not attend (physically, if not mentally). I'm getting tired of listening to fellow students conversations: the background level of hubub is unlike anything I've ever experienced during any of my previous degrees (been to uni too often) either in the UK (which was a med school) or in Australis (which wasn't).

I can normally put up with this, but today I had to say something. The irony of ignoring and carrying on a loud conversation whilst an aboriginal lecturer asks for attention and highlights how people's attitudes to indiginous populations need to change seemed lost on the young Australian students in front of me. The fact that the lecturer was effecting a welcome to aboriginal land to all students from where ever they came and was managing to strike a perfectly balanced tone did not help my mood.

However, I let that ride, and said nothing hoping that the students would engage as the lectuer progressed. Bear in mind here that the vast majority of the audience paid respectful attention. This did not include another student in front of me who was taking the opportunity to complete his individual assignment (why do this in a lecture? why not stay at home, you arse?)

Next up, I heard a sniggered comment from behind me when the lecturer informed the auditorium that many aboriginal people lived in Sydney and in particular in a suburb called Blacktown. I looked around to see what the deal was, but couldn't see what was going on or who was having such fund.

So far, so poor.

However, when, during the lecturer's discussion on the intervention, which contained real insights, the girl in front of me picked up her friend's iPhone and started playing some kind of bar tender game. This being the last straw for me, I leaned over:

"Perhaps you might like to listen to what's being said rather than playing a game on your friend' little phone".

The girl at least had the decency to realise that her behaviour was perhaps inappropriate and at least feigned rapt attention for the remaining five minutes.

It's going to take a while before I regain my faith in my fellow students, and the poor behaviour comes from a particular sub-population. Apologies for the lack of proof reading, but I'm a bit angry at the moment.

More on feedback

Following up from the crap sandwich discussion, I had a vague recollection of being taught something about peer feedback and how to make negative feedback as palatable as possible.

And... after spending far too much time going through old lecture notes and searching using Google, I found this* short document based on published work. This document gives guidance on how the nature of feedback affects motivation and also recommends not beating about the bush when it comes to providing feedback - so no crap sangers, please.

I particularly like the "Recognition Grid" which has stuck in my mind since I first came across it almost ten years ago:

Type of feedback / Effect on motivation (in what seems to be arbitrary units)
Generalised positive +100
Specific positive +50
Specific negative –200
Generalised negative –1,000

The point here being that generalised feedback applies to character traits, behaviours and other impossible to change aspects of an individual whereas specific relates to a particular action taken by that individual.

Thus, "I like working with you" is great to hear: I must be a stand-up guy! Compared with "You are terrible to work with"... what is it, do I have bad breath or something and if I do how do I change that?

Final point: negative feedback is remembered for much longer than positive... the taste of crap kinda lingers, a much more potent flavour than sliced white bread.

Reference: Carlopio, J., Andrewartha, G. & Armstrong, H. 2005. Developing management skills: a comprehensive guide for leaders. 3rd edn. Longmans, Australia. 409–410.


*For some reason Blogger is attaching some extraneous text in front of the ANU link. Remove the clearly wrong text if you want to see the file.

First Aid: UK vs Australia

UK First Aid student requirement: two hours of CPR, Nellie the Elephant and all that. Sign in, sit there, and then you're good to go.

Australian First Aid student requirement: two full days covering CPR, bandaging, breaks, burns, poisoning, hypoglycaemia, hyperglycaemia and, of course, all of the bites and stings you can enjoy here whilst swimming, walking or breathing the wrong way. Final exam with an 80% pass mark requirement with a regular refresher course requirement to keep your certification which current plus an obligation to assist once certified.

I feel I've had my money's worth on this one, although I'm buggered if I can remember every bite which needs warm water and which needs cold.

Crap sandwiches

Thinking through the last post, I realised I'd put up some received wisdom on the good old hamburger approach to providing feedback without backing it up with facts. In the spirit of evidence based medicine, to discover whether the crap sandwich is as crap as I thought, or not, I did a quick scout around to see what the world's great thinkers in feedback provision are saying. Caveat: very quick scout about.

A group called Success Strategies, who look like they are a group of management consultants of some kind, post an interesting discussion on the method. Their key issues are that:

(i) most people know about this method, brace themselves for the crap in the middle and discount / ignore the rest, and
(ii) it only takes a couple of rides on the crap sandwich rollercoaster to learn exactly how it works and react as for (i).

This page also provides an alternate method which avoids direct criticism and instead kicks the discussion off with suggestions of how to deal with the situation which went awry. Interesting.

Although this approach is grounded in NLP, which some consider pseudoscience (it says here - although it seems to work for Derren Brown), this group have worked with some creditable organisations which provides a degree of weight to their work.

A literature search brings up little on the subject... perhaps a fruitful research topic for someone, who knows. The search did, however, bring up an excellent article from a US Obs&Gynae educational committee of some sort describing in detail how the US is approaching the provision of feedback to medical undergrads. They outline a quite structured, complex process which necessitates a dialogue and a lot of preparation with no input from peers... quite the opposite to what Australian med schools seem be recommending. Given the lack of outcome evidence (from what I can see), who knows which approach is best.

The reference for this, should anyone be interested, is: American Journal of Obstetrics and Gynecology (2007). 196 (6). 508 -513. I think it may be available if you register, but it's an Elsevier journal so perhaps not.

On balance, I would still say the crap sandwich is on the nose. Avoid.

Med Student peer review

As part of a new phalanx of insight-laden medical students, full of reflective goodness, we receive a lot of feedback from our betters / tutors / call them what you will on a broad range of elements of performance.

Further, given all the reflective bits and bobs, we are at the pointy end of plenty of feedback from ourselves too.

All of this is assessed, and, presumably, if it looks like we're lacking in insight or something, steps will be taken remedy matters before graduation.

On top of this, joy of joys, we are subject to feedback from our peers. We are monitored to make sure that we're not too soft on one another, presumably to avoid an eBay-feedbackesque situation where everyone is nice to avoid tit-for-tat retributions and so to ensure that the feedback is honest and, therefore, valuable.

This all sounds fair enough: most jobs in the real world require an annual or semi-annual appraisal which may or may not be 360 degrees in nature. However, normally the blow of receiving this feedback is softened by (i) the medium of delivery and (ii) who is providing the feedback. And perhaps you'll get a pay rise or a promo if the review goes well.

To address the second issue first, it's going to be interesting to see how the feedback from fellow students evolves over the rest of the course given that to date for most people I've spoken to it's been somewhat lacking in positive, actionable steps.

This isn't a huge surprise given that my peers don't have a lot of experience here and have only been taught the largely discredited "crap sandwich" approach to feedback (start with something good about you, then get the meat of the feedback with something crap about you, then finish off with what to do to improve). Still, some of the stuff is useful so I suck it in and take what I can from what I'm given.

The main issue is the first: the medium of delivery. In my colourful pre-med career I received diverse feedback from diverse people in diverse situations. I've had good reviews from balls-out US investment bankers in the backs of a taxis (mental image unintended), terrible pay news from nervous European bankers over telephone lines and woolly, "what was that conversation all about" feedback from fuddled academics in labs who weren't at all keen on this type of thing. I've also had to use a number of electronic systems having nominated a number of colleagues all of whom, and this is important, have been trained in using these systems the output of which is numerical.

However, what I haven't had is an online posting system where you log in and read feedback. I'm not sure about this route to provide feedback to happy recipients: there's not a lot of room for discussion / clarification with the feedbacker, there isn't space for emotional or intonational nuances to be provided: it's rather like getting a very personal SMS from someone you barely know.

Let's see how things progress.