Dr. Prof. Adrian Freeman is an expert in medical education and president of the European Board of Medical Assessors (EBMA), an organization that audited the Practicum Script simulator a year ago. As a university professor, he has worked for many years at the undergraduate and postgraduate levels, and is mainly interested in assessments in education. His conversation with Practicum Script suggests that timing and international vocation are the tool’s main credits.

“Clinical reasoning is about having an understanding of the mechanisms that we use as doctors to reach certain conclusions”

“Assessments should not be only of learning but also for learning; the assessment should provide feedback to students about where they are, how they are progressing, and ways in which they can identify gaps in knowledge and, particularly, in clinical reasoning skills.” These are words by Dr. Prof. Adrian Freeman, who recently organized a conference on continuing medical education at the University of Exeter. With that conference in mind, and knowing of his involvement as the president of EBMA during an audit of Practicum Script conducted by Carlos F. Collares in November 2017, we spoke with him to understand his opinion on the strategic use of evaluation for significant learning.”

According to the English doctor, who is also an examiner of the Royal College of General Practitioners, we must be more flexible with our assessments as well as more sensitive to the needs of current and future physicians. “Clinical reasoning is about having an understanding of the mechanisms that we use as doctors to reach certain conclusions.” In his opinion, “sometimes relying on intuition and experience might not be useful; we would have a considerable challenge with complex medicine due to comorbidities.” In these situations, Dr. Prof. Freeman argues that decisions must be based on evidence, but “that doesn’t mean that we have to be rigid with algorithms.” As doctors, “our strength should be in an education that allows us to adapt these algorithms if necessary.”

Immediate challenges
The main challenge lies in the accelerated times. “Things move really very quickly; if before medical knowledge doubled in 2 years, this will soon happen in 2 months,” the expert suggests. He supports his thesis that “we have advances in artificial intelligence, technology, and genomics” and, among other things, it is difficult to reconcile this revolution with a 5-year-curriculum followed by a final exam. There, in view of the rapidity with which changes occur in the health area, lies the importance of constantly updating our medical skills. And that is precisely the need covered by Practicum Script.

Dr. Prof. Freeman has experience in the development of training programs and assessments abroad, and his work in a dozen countries, from China to Canada, helped him understand that the highest standards of medical excellence come from what others are doing well. “About 80% of medical knowledge is common across different cultures, countries, and healthcare systems, while only 20% is local. Therefore, if we think globally, we must commit ourselves globally to education. “In his opinion, innovation must cross borders, and EBMA and Practicum work together towards this goal. In fact, both institutions are finalizing a protocol to incorporate the simulator into the graduation cycle in universities associated with the EBMA.


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