April 23rd, 2010 | 
Author: Thanks to everyone who made the effort to come along to the revision lecture on Wednesday – I appreciate that the week before the exams is a precious time, and two hours of me waving my arms about at the front of the class, being grumpy about hypoxic drive might not be your first choice of entertainment for Wednesday.
I have been told I was a little bit *too* grumpy, which is probably a fair piece of feedback – I was disappointed that the issues of Respiratory Failure, CO2 retention, and oxygen therapy remain the biggest stumbling blocks for you all, despite me having put in a lot of personal effort to explain these concepts to you all during the respiratory block.
After the lecture I taught a small group of 4th years on arterial blood gas analysis and respiratory failure. A small number of 2nd years tagged along (This is hugely rewarding for me, that 2nd years want to join in with 4th year teaching, so thanks) and it was during this session that I think I’m expecting too much regarding the respiratory failure, hypoxic drive issues: the 4th years have no more grasp of the concepts than the 2nd years. These *are* difficult concepts, and it is likely that the lack of understanding is due to poor teaching, rather than a global misunderstanding on the students part.
This has made me think about how I have been teaching these concepts. i have posted on DC1 and DC3.0 the definitions and explanations of the concepts of both CO2 retention in hypoventilatory states, the concepts of V/Q mismatch, and respiratory failure a couple of times, and each time I’ve tried to make them more understandable, and more straightfoward. I have had little feedback from the students regarding these posts. The videos are helpful, I’m sure, but the students are not getting it.
We have opportunities for students to do fellowships, SSCs, 4th year projects, and extra curricular work developing new learning materials, if anyone is interested.
So the revision lecture on Wednesday? My initial thoughts were of disappointment, and a small amount of despair. When I heard the feedback from a student that I was grumpy during the session, it has made me think more about not just the lecture, but how we teach these difficult concepts. Now? I’m hopeful that someone out there is encouraged enough to come to see me with an idea for a way to teach these topics in a more engaging way.
And I’m allowed to be grumpy occasionally – 365 days a year of manic enthusiasm takes it out on a person, even me!
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Hi, I know this isn’t a solution or even an explanation on understanding the reasons why we don’t understand the concepts but I know that for me, the reason I thought hypoxic drive was an important issue in COPD was because of it being in a physiology lecture: one of the first respiratory lectures we got and I think it just stuck because it was the first teaching(even if it was only one slide) that we got on it. Of course this might just be me but I think that it is sometimes that other lecturers teach things differently: eg. the maintaing oxygenation lecture had a lot about percentages of masks and nothing about O2 sats. For me I think I just get easily confused and don’t know what to learn when it’s contradicting someone else.
I do think that wednesdays lecture was helpful in clarifying though. 🙂
I’m starting to realise that this is a bigger issue than just me! Other people continue to teach the hypoxic drive theory, because that’s what they were taught 25 years ago. I had hoped that my bit of teaching on oxygen, and the revision session straight after the block, and the blog posts, would have put the concepts straight.
Next year I need to make sure the other lecturers talk about V/Q mismatch, as well as the theory of hypoxic drive….
Thanks for commenting, as you know, I *truly* appreciate any and all feedback.
I would tend to agree with Sarah on this one, DC. I do remember that you taught us about VQ mismatch and I did find the video of this helpful. However, there was still a huge emphasis on hypoxic drive during the chest block. I think if you hit next years bunch early with the idea of VQ mismatch and have it glaring at them from every direction, they might pick it up earlier and avoid unnecessary confusion!
It’s a cliche but I find things so much easier to understand when put into practice. I remember lots of respiratory medicine as a result of my respiratory based SSC. Encourage everyone to see a patient with COPD (Most will for RoCE)! Ask them to pay particular attention to the SEWS chart, and look at the sats and oxygen given really carefully!
Alternatively, Mr Dundeebones ran ‘patient presentation’ sessions this year and I think others would agree these were particularly successful. During these sessions we had a talk on the relevant anatomy and physiology, primary care, patient perspective and secondary care. Again, it is fairly likely that folks will retain a lot more when they can put the theory in context!
Just a few suggestions!
Laura
@Laura – I will have a look through the other chest block lectures to make sure the lecturers aren’t putting too much emphasis on the hypoxic drive theory, and try to redress the balance for next year.
Of the questions asked, one was about type 2 failure (already answered on the blog 5 days before), one was asking what the difference between pleural effusions and pulmonary oedema (answered on the blog 2 weeks before), CO2 retention in Type 2 respiratory failure (answered on the blog numerous times)…. You’re getting my drift, I’m sure.
The regular users seem to be getting lots from the site, but I’m not sure how to get the others to look on the site and see the information I’ve put up there….
Work in progress, I suppose.
I think looking at whats been achieved as opposed to a consolidation lecture, where your mood was at a tangent (as happens to the best of us), really puts matters into perspective. Taking the broader picture… You have established an extremely successful tool (PRN) by encouraging and giving students the opportunity to do so, and this will be used for many years to come I feel.
I think you’ve realised that students like to give the utmost feedback and I dont really blame you for losing ‘some steam’. It can seem like a downwards spiral.
The problem is getting us to give feedback because we often don’t feel that our voices are heard. This includes certain areas of the course, *cough* DPaC, where we are asked every year to provide constructive criticsm to help ‘improve’ the course, when nothing is really done.
You’ve broken that boundary- go and take a look at the DundeePRN and see that mother of a post- 46 comments?! Thats alot of feedback and you’ve actually managed to get us talking- which is an amazing feat. We usually give feedback for the sake of giving feedback, because we are cornered into doing so, but you have gotten us talking out of our own will and interest. I respect your enthusiasm and look forward to next year, knowing that what I, and others, say will most certainly be reflected upon and put into practice. There’s nothing more frustrating than giving direction when teachers ask for it, and nothing is done about it. You are proving to be the exception, I salute you