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Perspectives 2018: Brian Hodges


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Why Measure Competence?

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Perspectives 2018: Brian Hodges

  1. 1. Dr. Brian Hodges University Health Network Plenary I: Why Measure Competence?
  2. 2. Why Measure Competence? Brian Hodges MD, PhD Professor, University of Toronto Executive Vice President Education UHN
  3. 3. @BDHodges1
  4. 4. Competence is a god term* • What is “competent” is determined by culture and history • It means nothing outside of the context in which it is used *Lorelei Lingard
  5. 5. ` Competence was Character Assessed with subjectivity 19th Century
  6. 6. ` Competence was Knowledge Assessed with written tests Early 20th Century
  7. 7. Competence was Performance Assessed with tests of performance Mid 20th Century
  8. 8. Late 20th Century Competence was a Set of Roles (derived from the needs of 20th C Canada) Assessed with a Roles x Tools Matrix Advocate Manager Collaborator Communicator Scholar Professional
  9. 9. Once upon a time… …won’t do for the future
  10. 10. `Knowledge, skills and roles from the past century are not adequate for competence in the future… (nor a sufficient basis for assessment)
  11. 11. ` In the 21st Century, a new question… What is Human Competence Needed For?
  12. 12. As we think about the future of professional education, what capabilities will be needed most… …that human professionals can bring Susskind and Susskind
  13. 13. Medical Education, January 2018 Medical Education 2018 Dorothy Vaughan 1910- 2008
  16. 16. Issue 1: Meta- cognition • Deep Learning - Artificial intelligence • Digitization of Humans • Cloud-based Information
  17. 17. Digitized Humans
  18. 18. The Robot Will See You Now: Artificial intelligence in medicine UofT News 2016
  19. 19. Esteva et al. Nature 2017 Gulshan et al JAMA 2016
  20. 20. Cognitive Competence for the Future • Knowledge will be largely held externally (cloud) • Excessive memorization wastes cognitive resource • Health professionals must invest in understanding the strengths & blind spots of human cognition
  21. 21. Curriculum Based on Metacognition? • Vanderbilt University College Colloquium – “meta-cognition as a foundation for professionalism and empathy” • Goals: – Understand one’s own habits and patterns of thinking and emotion – Gain humbling appreciation of fallibility of cognition – Appreciate complex interplay of cognition and emotion (Via Quentin Eichbaum) Fleming et al 2013
  22. 22. How can we assess as metacognition?
  24. 24. Human-Machine Interaction
  25. 25. Important Transformations in Skills • Human Augmentation • Robotics • Automation
  26. 26. Meet your new blood-drawing, needle-wielding robot phlebotomist John Hewitt, August 19, 2013
  27. 27. Human health professionals will collaborate with machines
  28. 28. AI for Radiation Therapy Treatment Planning at Princess Margaret Cancer Centre, Toronto: • From 3 hours to 4 minutes per patient
  29. 29. Human(e)-Machine Interaction • Ensuring empathy is conveyed (including by technologies) to patients and other staff • Emergent failures of human-computer communication – Tech rage – Etiquette
  30. 30. Tech Rage
  31. 31. “Voice assistants behind a generation of rude kids, artificial intelligence authorities say” Jennifer Dudley-Nicholson, News Corp Australia Network March 10, 2017
  32. 32. Curriculum Based on Human- Machine Collaboration? • The Human-Machine Interface • Melding human psychomotor skills with machine guidance • Emotional regulation (understanding machine function and failure) linked to patient safety & outcomes
  33. 33. How can we assess human-machine interaction?
  34. 34. C A R I N G a n d C O M P A S S I O N
  35. 35. D I A G N O S I C S K I L L TEC H N IC A L SK ILL
  36. 36. We are Digitizing Dehumanizing Humans
  37. 37. In the hands of TECHNOLOGY
  38. 38. Look in my eyes…be present for me
  39. 39. How can we assess HUMAN PRESENCE?
  40. 40. 21st Century Human Competence (That we should measure) Metacognition Ability to Collaborate with Automated Systems Critical Thinking & Advocacy for Humane Institutions Caring, Compassion & Human Presence (Including Machine-Human Relationships)
  41. 41. So why measure competence?
  42. 42. Why measure competence? Because now, we have competition 
  43. 43. A book about Technology and the Future of Healthcare Coming soon….
  44. 44. 2018 Perspectives Symposium January 22, 2018 #TSINPerspectives2018