Transcript for episode 66

This transcript is made by autogenerated text tool, and some manual editing by Papers Podcast team. Read more under “Acknowledgment”.

Jason Frank, Lara Varpio, Linda Snell, Jonathan Sherbino.

Start

[music]

Jason: Hey, welcome back to the Papers podcast. We scan the health professions, education, literature to find cool papers to enhance your practice. Well, three of us do, but John has a paper today. We’re gonna go back to him in a second. So welcome, Lara.

Lara: Hi everybody!

Welcome, Linda. You have to unmute. It’s technology, Linda.

Linda: How are y ‘all?

Jason: Fantastic. Jon, I’m already picking on you. You just got back from a beautiful Algonquin park where you’re getting dad points for conduing down the Mississippi River through polar bear breeding dens and giant pterodactysl, whatever it was out in the nature there. How was that trip?

Jon: It was great. There was no pterodactyls. Jason, we’re gonna give you a little bit of an instruction on the Neolithic and the Mesolithic periods. We did see moose or mesas. I’m not sure what the term is. We saw some bald eagles, but the most… No, there’s no chocolate. That’d be delicious though. Linda, I did have a concession to civilization. I did bring wine, but it was boxed wine. So, But…

Linda: Sorry, where the mousse, chocolate mousse?

Jon: No, that’s not chocolate.

Linda: Aaw.

Jon: That would be delicious, though. Oh, Linda, I did have a confession to civilisation, I did bring wine, but it was box wine, so uuh. But, for all of you who are outdoor enthusiasts, there is nothing like paddling out into the middle of a lake late, late at night where there’s zero light pollution and seeing the Milky Way. It is something spectacular. For those of you in the Southern Hemisphere, you have a very different kind of set of constellations to look at here in the North. It was just fantastic. It’s highly worth doing it, even for all the effort, even for all the boxed wine.

Jason: Boxed wine, fantastic. All right, John, you got a paper. It’s a long one. I’ve already griped about it, but I have more gripes to come. Take it away.

Jon: Alright, so I’ve entitled our episode today as Assessing without “distressing”, factors Influencing assessors in low and middle income countries. this is one of my favourite topics, assessment. You know that this is where I like to spend my reading time, I like to debate ideas, and I’m hoping we’re not going to get into too fine a debate that distracts from a more general conversation. But it also has a second favourite and perhaps parallel topic for me, which is challenging the assumptions about the global north. And so here’s the set up. We’re in this era of CBME. One of the strong critiques of this competency -based medical education movement is the operational cost, the expense in both time and dashboards or logistics in operating programmatic assessment. Multiple assessment from multiple people, longitudinally aggregated together for a summative decision. That’s programmatic assessment.

So to complete all these assessments, to collate them, and then to confer by bringing together a committee or a series of people to try to provide a general gestalt of what all the data points require, that’s a lot of technological and human resources cost. In the global north, where resources are probably less constrained than in the global south, there has been ongoing and legitimate concern about that ability to take the theory and translate it into practice.

So imagine when you move into a more resource constrained context, like low and middle income countries, what’s the issue? So we’re going to tackle a paper. It’s by Sims et al. The official title is “Factors influencing clinician educators assessment practice in varied Southern contexts, a health behavior theory perspective. And it’s published in Advances in Health Sciences Education. All the cool kids call it AZ. It came out in May of this year. Now, before we jump into the paper.

Laura, Linda, Jason, I’d love to hear your experience been with programmatic assessment? Is it working? Is it have opportunities for challenge? What do you think?

Lara: So first I’m going to say that all the cool kids call it Advances, not AZ. But that’s…

Jonathan: Personal friend with the founding editor. I’m go with AZ as my answer.

Lara: Personal friend with the current editor says Advances. But anyway, I actually, you know, yeah. Okay. AZ advances, whatever you call it. Great journal. Happy. So glad you picked an article from there because I really am a fan of the journal. When it comes to programmatic assessment. You know, it like in most things in life, I’m an extrovert. So I’m going to think a crowd is better than being alone. Cause that’s kind of my, my, my sweet spot of life.

But when it comes to programmatic assessment, I believe that even more so because, you know, our collaboration and our evaluation teams are full of different personalities, different perspectives, different priorities. We might all be looking for a marker of excellence, but we’re all going to be looking for signs and signals of that in different ways. And we need those different perspectives, for me too, I also believe that there’s a hawk dove phenomenon. You know, some of us are a little harsher as evaluators and some of us are a little softer.

And I think that’s, you know, that’s part of the reason we have multiple evaluators on many different fronts so that we can try to balance hawks and doves. So I think it’s going to be really hard for any one person to hold all that variety, all of those hawk and dove orientations. So yeah, I’m in favor of a crowd.

Jonathan: I love it. You’re foreshadowing maybe a punchline from this paper. All right, Linda, what do you think?

Linda: I agree with you, Lara. I’ll say as a past clerkship director that even before CBME and I’d say as a past residency program director too, those who were the directors of assessment always went out to actually get opinions from different people, whether it be written opinions or hallway conversations or whatever, to get that diverse perspective. So if the question is, do you think a crowd is superior to a loner? The answer is yes, but there’s a but to it. And the but is that those, crowd members, the individuals in the crowd have to be educated individuals who A, actually see the learner so they can assess them and B, do it in some sort of an authentic way without bias.

Jonathan: All right, I like that. Jason, you’ve built a lot of programmatic assessment systems. Is that even appropriate for UGME?

Jason: Sure, yeah. It’s just a principle, right? Just an approach that has some theoretical basis to it. So I live, like many of you, in a resource -intensive, well -developed, highly structured system where programmatic assessment’s been used for a number of years, and it works. I see it around me every day, and I’m pretty happy to be in that environment. I also work around the world in a variety of settings where programmatic assessment is something talked about. Sometimes it’s something that people are working to implement and they run up against two themes. One of them is resource constraints, just people and systems. And then the other is like infrastructure. There are lots of places that don’t have infrastructure that can do programmatic assessment. And maybe that’s apropos to your paper too.

Jonathan: Okay, so if you’re following along at home, here’s the setup. We have this era of competency -based medical education, which has one of its tiers or pillars, the idea of programmatic assessment. Short hand for that is multiple assessors. Now let’s contextualize it into the global South, into low and middle income countries, where end of clerkship rotations are often supervised and with somewhat of assessment performed by dun dun dun, a single assessor. So what is the weight? What are the consequences when you move from a crowd to the lone wolf? Here’s the purpose as spoken by the authors, which probably sounds a lot better than my short hand back of the envelope version.

Our research question was what factors influenced the assessment practice of individual clerkship conveners in exit level medical programs in diverse Southern settings? Okay.

Here’s the methods. It was a qualitative study which adopted a constructivist paradigm with a model of health behavior developed by the senior author serving as a theoretical lens. So they’re going to do a qualitative study. Their informing framework, their theory, their lens that gives them the ability to see their data and to interpret it is using a model that the senior author has produced. Now, health behavior theories include a whole bundle so it’s not just one thing. There examples would be theory of planned behavior, trans theoretical model of change. We’ve talked before about social cognitive theory, self -determination theory, et cetera, et cetera.

Interestingly, health behavior theories, HBT’s describe the behavior of an individual in relation to how they seek health and how they maintain their health. But in this context, they’ve pivoted and to try to say, okay, there is a strong parallel or strong correlation with how an assessor who is in charge of assessment program, what are their educational behaviors? So they’re taking a theory and applying it in a different context. And it’s a theory that they have their own unique theory built by their senior author. So I’ll describe the model very briefly, but I’m going to direct the listener to paperspodcast .com where you can find the abstract where we have taken all the important bits and put it there for you. So if you’re like, “hey, I’m having a hard time in my working memory holding all these ideas together.” You can go see it. You can see the figure. You can dig into it. You can spin it around and say, okay, now I see how they’re trying to interpret and what’s the lens through which they’re looking at their data. So this is the model by Cillier and he has a number or she, I’m not sure if it’s he or she, has a number of factors, but I’m to break it down in a very simple sentence.

Your intention to perform an action is shaped by your personal factors, things like your attitude towards the task or your self -efficacy, whether you have the ability or the perception of ability, as well as contextual influences. What are the interpersonal dynamics? Who is part of your team? What is the leadership overseeing what you’re doing? And environmental conditions. What does the system look like? What are the roadblocks? What are the resources available or unavailable to you? And so informing an intention to action does not guarantee that action. The move really depends on your skills and your opportunities or constraints in your context. So best intentions are not sufficient. What they did is they did semi -structured interviews last anywhere from three quarters to an hour with a convenient sampling of three centers. Two of them were public universities in South Africa. And the third was a private nonprofit Mexico university.

And interviews were conducted in the language of choice for the participants. So there wasn’t a gap in terms of understanding and articulation of perception and experience. And they asked them three questions. They’re pretty straightforward. I’ll read them for you. How do assessment in your clerkship? What personal factors influence your assessment practice? What contextual factors influence your assessment practice? Getting back to the model of Cilliers. I think they did. They don’t actually say it out loud.

So I’m going to stretch a bit and squint a little bit to try to make sense of it. I think they did a generic thematic analysis. And then once they completed, they had an independent review of the findings was conducted by the Mexican author so that there could be a comparison in terms of the analysis as completed by the two South African authors. So let me pause there. What do you think of the methods?

Let’s turn off the podcast and continue with our drive or a run. Or are there things that you might want to, in a perfect world, critique and improve slightly? Jason, Linda, Lara.

Jason: So first of all, thank you for that summary, Jon, because for readers, this is not a paper for the light of heart. This is like take a weekend. It’s a long paper. It’s very detailed. actually thought it was very well written. It’s very detailed. The model of health behaviors theory got 25 elements. For an ER doc, my hippocampus was completely offline after that page.

And I couldn’t remember all those moving parts. But your three -part thing, that makes sense. That’s a lot of theories that we have. The individual, the context, and the infrastructure or the environment or whatever. And then everything’s a sub-bullet underneath that. But that was fine. I thought their methods were fine. I didn’t have major problems with them. I actually thought this was pretty well-written.

Linda: So yeah, it was pretty well written, although I didn’t find it that accessible. I was busy trying to get with their, they labeled parts of it using numbers and letters and I got totally confused in there. So as Jason said, not for the faint of heart. A couple of things. First of all, the research question, what factors influence the assessment practice of clerkship conveners? That’s…

not necessarily a question that’s solely for the global south. I mean you could ask the same question of others and I think a nice question might have been a comparator. The second thing is these diverse southern contexts are really maybe not so diverse. It’s two countries. I would not call them low-income. They’re probably middle -income countries. I’m not sure about the South African universities but the Mexican one, Tecnológico, is pretty high end when it comes to teaching and assessment and curriculum. I’m not sure it’s a representative thing of the global South. Methods, I think, were fine. There was an interesting reflexivity statement which really describes where people are coming from.

I’m not sure it really helps with understanding their perspective though on things. And finally, I’ll say, as Jason alluded to, adopting this theory, which is for individuals and their health behaviors into health professions, education, assessor behaviors, I don’t really see that there’s a link. They haven’t made that link for me.

Jonathan: Okay, Laura, before you jump in, think I can be friendly to all those critiques. I would say that this is the whole reason for the podcast. This paper is 28 pages, and what we’re trying to do is summarize it into 30 minutes. And so, hey, dear listener, look at all the work we’ve done for you. We’ve saved you hours of your time. Jason took a weekend to read 28 pages, so if you figure out that, Jason can essentially read one page every three hours.

We’re gonna work on that. We’re gonna get your crayons out. We’re gonna help you a little bit on

Lara: I have two points that I want to make about the methods. One critique and one compliment. So I’m going to start with a critique and it’s not really a critique as much as a consequence because when the authors don’t tell us what methodology they’re using, and as John noted, it kind of looks like thematic analysis, but I don’t know which form because remember thematic analysis is a bit of an umbrella concept under which a number of different approaches to thematic analysis can sit. And also looking at the methods, I could imagine that it could also classified as a form of content analysis or maybe a constructivist grounded theory orientation. And the reason that has a consequence, if you don’t tell me what it is and I’m left to figure it out, each one of those methodologies is aiming for a different outcome. And the challenge becomes for me as a reader is I’m trying to figure out which outcome you were aiming for and did your work achieve that goal.

So I agree with you, John. I do think they’re doing thematic analysis and the purpose of thematic analysis. Your end point is the generation of themes. And I think they achieve that. So I think it’s fine. But, you know, a word of caution to our listeners, always try to be really explicit and label what you’re doing so that your reader isn’t making decisions and guessing and doing those sorts of things. Always better to direct me than to leave me to just go down a rabbit hole.

Speaking of rabbit holes though, and just to pick up on something that Linda said, I read the statement and there were a few words in there I had never seen before and that led me to a gold mine paper. So the authors had this little phrase and in their reflexivity section it says, “reflexive preparation for data collection took place, blah, blah, blah”, through these different activities. I have never heard of reflexive preparation. So they had a citation, you know, I went and read the citation and I’m so glad I did because the citation was to a paper entitled “Reimagining reflexivity through a critical theoryfFramework”. And the first author is Danica Sims, who’s the first author of this paper. And this citation is all about engaging in reflexivity to recognize the position that you as a researcher have taken when conducting a study. And this paper describes how auto -ethnography, and I know that’s a long word, Jason, but you know, just deal with it. How auto -ethnography narratives can be harnessed to help the researcher think about their personal position of power. So your identity and how your positions of privilege are part of that intersectional set of identities. And also about your epistemological position of power. So the way you do research, the way you think about knowledge that reflects assumptions and ideologies. So for personal reflexivity, this paper, this one that they cited, suggests using theories of intersectionality and for epistemological reflexivity. And it uses deep coloniality theories and southern theories. Anyway, all this to say, friends, yes, the paper they cited is dense. So if you thought this one was thick, the other one’s thicker. But please, take the time, take the weekend, one day to pull it out if the only thing you do is pull out table one from that additional paper and you pin that on your electronic desk because that table has incredibly useful questions to help you write your reflexivity section of your paper. So for me now, I have table one from this paper from Sims and I have the Olmos-Vega guide on reflexivity as my two go -tos.

And so I really do want to encourage you to go to the article and dig it up because it’s gorge and so relevant for this study that’s taking a critical view on assessment, examining how it’s different in the global South. Total gush worthy. I can’t say enough great things about it. Congratulations to Sims for writing it. Just thank you.

[chicken sound]

Jason: I just want to introduce a new feature to the podcast.

Lara:
What the flying flip was that?

Jason: This was suggested to me from our listener, Ben Kinnear, friend of the podcast,

Lara: He gave you a duck?

Jason: A chicken. This is the multi -syllabic chicken, and it’s kind of an alarm that goes off when Lara uses too many big words in a single paragraph. You’re allowed big words, you can spread them around, but too many big words in a single paragraph, you get a multi -syllabic chicken alarm. Thank you, Ben.

Jonathan: So we have the two ends of the spectrum. have Uber nerd and we have four year old boy. So welcome back to the podcast.

[chicken sound]

Lara: Because you know, it resonates, doesn’t it? I don’t mind being an uber nerd, unless I’m the four year old boy, but anyway.

Jonathan: Let’s, let’s jump into the results. They interviewed 31 Kirk ship conveners in a different context. That’d be the Kirk ship rotation director.

Jonathan: And although they use a convenient sampling, there was a diversity of gender, career stage, clinical discipline, and social and cultural context. In brief, I’m to summarize it and I’m let all of you tackle a portion of the results. Here’s my big summary.

An intention to act is informed by personal contextual factors. If the intention is negative as a function of impaired personal or contextual factors, then inaction happens. The opposite is true if a positive intention is adopted by the assessor. But these interplay of factors between the environment and the individual are very contextual and very complex. So I’ll give you just a highlight of big level factors and let you dig in after this. What’s your personal attitude towards the assessment practice? What are the consequences or the impact on you or your students, whether you perform or do not perform the assessment? What’s the opportunity cost? How much work is going to be required or not?

And then what’s your self -efficacy? Do you feel prepared or able to do this? So that’s the personal factors. The contextual factors are interpersonal. Do you have strong leadership that’s inspiring what you can do or inhibiting it? What’s the organizational environment? Are there resources or rules or policies that promote or inhibit? What’s your training in it? Have you been prepared or adequately developed as a faculty member to complete what is expected of you in this role? What’s the outlying assessment expertise? Can you draw on others to help inform or change or modify or improve your practice? And what’s the socio cultural influence? What’s the historical context? What is the expectation from the health sciences community, from the larger community on terms of what should be expected? So what say you, Linda, Lara, Jason.

Linda: So I was looking at the mediators of assessment practices and thinking about them and thinking if they were the same or different than the kind of mediators we have. And they talk about personal competency, whether the assessors, these individual assessors felt that they actually were competent to assess, and also the environmental constraints, which is really context, which may come up on a, which will come up in another paper that’s coming up soon on Papers Podcast. And these environmental constraints include things that we’re all familiar with, clinical workload, education workload, class size, that’s maybe something that’s more significant in an LMIC, where class sizes, I suspect, tend to be quite a bit larger. Help.

HR help, so we say human resources help from assessors, but also from patients. And the big one, of course, is financial. Are these different from what we face? No. Are they different in relative amounts? Yes, I would say.

Lara: I want to highlight one of the contextual factors, the identity, the authors identified, and it has to do with the influence of social, historical, economic and political forces that the individual evaluator feels. And this is an area of particular like this is a topic, a way of thinking that’s personally important. And I’m just going to highlight the data that came out of the South Africa context today for the sake of time. And the paper knows that South Africa’s post-colonial and post-apartheid context imposed a pressure on these assessors. And there was a, and I’m going to quote here, “a perceived pressure to pass to maintain a throughput of historically excluded students, despite personal assessment beliefs as pass rates were linked to public institutions receiving funding subsidies from the government” end quotation. knowing that and then getting the data, the excerpts from the participants, you really start to hear how a country’s history and their political ideas and social factors are landing on the shoulders of individuals in individual moments trying to do something. Just a little bit, I want to share just a few excerpts. One participant says, if they fail a significant portion of students, they, institutions, are financially embarrassed.

Another participant talked about passing students to deal with a growing student population. Again, quote, “you can’t fail 20 students. Only 10 are allowed to fail or no more than five are allowed to fail. And it’s not about color or the language of the students in this case. It is about volume. What do you do when you suddenly have minus 20 or plus 20 in the next year? That political pressure is greater than the social political pressures of color and language.” if you, if you listen to these words of these participants, you can hear this history of all kinds of economic and social and cultural pressures on their shoulders, having to make these decisions about protecting a whole bunch of different things. How do you navigate a path that respects all these contextual considerations and do what you feel is the best thing for everybody involved in the moment? Talk about needing some serious policies, right? Like these are pressures and responsibilities that that assessor is feeling. So I really appreciate this paper because it demands that we look broadly when we think about specific actions that individuals take, it is really easy to say that we need immediate guidance for assessors because they do. Because these kinds of pressures, these social political pressures that land on the assessors, we can’t affect change at the individual level. One person is not enough. We need lots of people doing lots of choices so that we protect patient safety, we protect the profession.

We do the work of uplift. We do the work of social change, but asking one person to bear the brunt of all of that is just a lot.

Jason: I agree that I think that’s what makes this paper actually delicious to read It I’m really I do gripe about this my clinician educator lands on but how dense this paper is But it is so rich it is filled with lots and lots of quotes So what I’ll just highlight is how relatable I found elements of this educational ecosystem Are to the context I live in so at some point not too long ago in the Canadian system I live in.

There were individual assessors making individual rotation decisions that had enormous, magnified impact across people’s careers. And they did it with very little training, support, policy, infrastructure. And, that relates to this paper, the things that these people are dealing with still resonate today in almost any setting. And many of them resonate with a setting that existed when I was a medical student.

I could always live in this paper through some of the quotes. So here’s an example. Somebody saying, you know, that like this is you have to make an assessment tool that’s really light. Otherwise you give up part of your life to, to Mark all everything. It’s too elaborate. Somebody else said it was griping about their colleagues who just everybody that they rate is born a 10. So it’s not discriminating. It’s not useful to this poor clerkship director who’s trying to, have a useful assessment system. So there’s lots of really, really yummy elements in here.

I encourage you to it, actually go through it, because you’ll find so many things that you could use for your future assessment papers.

Jonathan: I wish we’d had this conversation before I’d come up with a title.

Linda: Could I just say I agree with Jason and with Lara, but you probably can ignore the front part of the paper where they do this lit review which takes up a good half of the paper. I think that’s what overwhelmed me, found, I started to get sort of negative feelings because I didn’t find that part accessible.

Lara: Yeah, if you’re looking for a tidbit for practice, I think you have a good point there. But Linda, the Cilliers theory, Francois Cilliers theory, and the framework and the way it’s mapped out, like from my perspective, I loved it. I was there every step of the way. In fact, I’m thinking, okay, people I know who work in assessment, those sorts of things, maybe this is a take home. Maybe for them, the figure in there that breaks it down, maybe that’s a thing.

Jason: Okay, so it’s a PhD thesis. John, what’s a better title?

Jonathan: Well, I was struck with the metaphor of the weight on the shoulder of the individual, which is the counterfactual to what a programmatic assessment is trying to do is saying, can we distribute that weight in a different way? And so I think that’s a better metaphor than this idea of I need to assess or I’m in distress.

Lara: And whose metaphor was that? Just question, huh?

[inaudible]

Jonathan: Well, every now and then even a blind squirrel gets a nut. So we’ll go with that. All right. Let’s go to our conclusion from the authors. Let them the last word and then we’ll go to our round of votes. Personal competencies and conducive environments support intention to action. While previous research has typically explored factors in isolation, human behavior theory framing enabled a systematic and coherent account of assessor behavior. These findings added particular contextual perspectives to understanding assessment practice.

It also resonate with and extend existing work that predominantly emanates from high income context in the global north. These findings foundation for the planning of assessment change initiatives. I do have a small little paper clip, it gets back to the debate that Linda and Lara having, which is this is a great example of where there is not a word count. And so advances, thank you, Rachel, Az, thank you, Jeff, doesn’t have a word count for authors. Now they require you to be very parsimonious and to have clarity in your writing. And I think the authors really did a good work here. I think if you are typical, or if you are more practiced in reading the medical education literature, you might find that the long introduction is not typical of what you see. But if you read social sciences and humanities, a big introduction that dumps all of the literature in upfront is much more typical with a very short discussion. I think that’s kind of what we see.

Jonathan: Let’s go to our round of votes. One to five in terms of methods. We’ll go Linda, Jason, Lara.

Linda: So I’m going to give this a three plus. The plus is for, as Lara would say, we have the paradigm upfront. So it gets an extra point for that. It’s reasonably good. As you mentioned, we had to struggle to figure out what kind of analysis was done. So three is middle of the road, solid average.

Jonathan: I don’t know; this is a tour de force paper. it’s missing some parts, like we just alluded to. We assume it did thematic analysis. And it’s a bit dense. I actually think it’s a four. It’s an amazing paper.

Lara: So I’m giving it a four as well. The fact that they don’t signal explicitly their methodology, that really is a problem for me, but they signal their paradigmatic orientation and like the goldmine paper they shared. So yeah, four.

Jonathan: They did a ton of work. The only critique is it’s not clear what their analysis is, what the guidelines are, what are the boundaries for their analysis, so it gets a four from me.

Now let’s do reverse order in terms of educational impact, one to five.

Lara: So I’m going to give this paper a five. I think the findings are so important and so vital for us to think about it. So yeah, it’s a five.

Jason: I can’t give it a five because of the accessibility issue, because it’s not going to, not enough people are going to pick up this paper, but I am going to endorse that more people should. If you write about assessment, I think that this is a cool paper to pull quotes from and talk about themes, talk about how there are parallels and what the implications are, despite the differences in setting and ecosystem. So I’m to give it a four.

Linda: I too am going to give it a four, similar reasons to Jason. The results are useful and I can see people who are trying to develop a programmatic assessment system and haven’t quite got there using it to make the life of those solo assessors a lot easier by knowing what’s going on here.

Jonathan: I’m going to give this a five. Complex problems lead to complex results. I think too long in the assessment game, we focused on the tool. I’m going to make my scale better. I’m going to make my tool better. Or we think about the system. I’m going to make my dashboard better. Or I’m going to make my incentives better. And we forget that really it comes down to human judgment on some kind of piece of data. And this paper unpacks it in ways that are really broad. And although they situate it in an LMIC, I think the takes on it really can transfer to the global north. So I think that’s a five. So there you have it. Listeners, we’d love to hear from you. What’d you think of the paper? Is this something you’re in line with? Are you intimidated by 28 pages or can you read faster than one page every three hours? We’d love to hear from you at our website where you can download the abstract. Everything is compartmentalized and abbreviated for you at Papers Podcast.com or you can send us an email at thepaperspodcast@gmail.com. Thanks for listening.

Lara: Talk to you later.

Linda: Bye bye.

Lara: Jason, say take care everybody. I’ll say it for him. Take care, everybody.

Jason: Take care everybody.

Lara: I sound so much like you!

Jonathan: I like Lara’s better.

Jason: True. That was good. That’s good.

All right. I also want to say a big thanks to our friend Merchior who is in Mexico City. He’s a giant of medical education in Mexico and I saw him at AMEE and he had all of these anecdotes from papers. He didn’t just listen to us he’s got little quotes. Interestingly, they had quotes from Lara, quotes from Linda, quotes from me, and then he stopped there. He’s like, yeah, lots of good quotes.

Jonathan: But he’s a giant, and he and I think very similarly. And so he’s learning from you, but he and I are simpatico and see the world in very similar ways, because we’re both giants.

[inaudible]

Jonathan: Honestly, it was it was all from the three of you. He didn’t mention me at all I don’t much even knows I’m on it actually

Jason: you’ve been listening to the Papers Podcast, we hope we made you just slightly smarter. The podcast is a production of the Unit for Teaching and Learning at the Karolinska Institutet. The executive producer today was my friend, Teresa Sörö. The technical producer today was Samuel Lundberg. You can learn more about the Papers Podcast and contact us at www .thepaperspodcast .com. Thank you for listening everybody and thank you for all you do. Take care.

Radio microphone and paper with text.

Acknowledgment

This transcript was generated using machine transcription technology, followed by manual editing for accuracy and clarity. While we strive for precision, there may be minor discrepancies between the spoken content and the text. We appreciate your understanding and encourage you to refer to the original podcast for the most accurate context.


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