All posts by Eleanor

Students of Today

Last week I tweeted a link to a clip to this video: A Video of Students Today, from anthropologist Michael Wesch at a conference on the future of medical education. The speaker was presenting his work on live tweeting in lectures, and some of the delegates expressed their concerns. I’m not ashamed to say that my first reaction was very parental. I wanted to scream at the students to put their devices down and take notice of what was happening around them. Watching the video for a second time, after having reflected on my own practice for TMA02, I realised that this is the world now. Online, offline…the line is fine and permeable. And that’s OK. The students in this video had an awareness of world issues that I don’t think my generation really until 1984, when Michael Beurk reported on the Ethiopian famine. And that was delivered to us, in our living rooms via television. Before that it was books.

There’s a point in the video where you find yourself making a judgement – what the students are saying about their study is either great, innovative, exciting or it’s disgracefully disrespectful of traditional academia. The first minute sets out that there’s a divide between the old and the new, both equally alien in the other’s worlds. But you could say that about anything, you only have to watch an episode of Horrible Histories to see that (my favourite has to be Queen Elizabeth I and the “wrist clock”).

But as the video progresses, Wesch shows us what the world of study looks like through the eyes of typical undergraduate students. You could be pedantic and argue that these were typical undergraduate anthropology students but if Dahlstrom et al (2013) are correct then they are pretty much representative. In fact, the presentation that I referred to at the start of this post into undergraduate medical students confirmed to me that it is very representative.

So when Wesch asks “Can technology save us?” my answer is yes, it always has. Technology is a manifestation of the ingenuity of the human mind, the reason why humans adapt to every challenge the world has thrown our way – mountains, oceans, deserts, space. The internet is overcoming physical barriers, allowing us to communicate with distant friends, families and tutors. It’s making remote working and studying possible, providing the potential to create socio-political change more rapidly than ever before. It’s giving us the opportunity to lots of things, but how we choose to use it is up to us. Perhaps, therefore, a more pertinent response to the question “Can technology save us?” might be “From what?”

Victoria Hewitt

Module Leader

Flexible e-learning: How flexible is it?

Pete

Content and activities that you can access on a tablet or a phone, courses you can do from anywhere… Is it really so flexible…?

Stranded in Kathmandu.

April 2010 and the Iceland ash cloud grounded flights into Europe. I’d squeezed in a short Easter climbing trip in Nepal and now I was stuck in Kathmandu with teaching commitments pending and no quick way of getting home. The one little glimmer of hope was that much of the student support stuff for the Research Methods module and the Dissertation modules was by e-learning, and you are supposed to be able to do that sort of thing from anywhere… aren’t you..?

So a backpackers hotel at $8 a night that had an internet café on the ground floor, and a block booking on the nice-quiet-machine-in-the-corner-please.

– Contacted the University Line Managers – they went “REALLY…???…” and laughed.

– Contacted the PGT course co-ordinators… they went “OMG…!!!.”.. and laughed.

– Contacted the University IT guys saying I’d be accessing stuff (very) remotely… they said “yeah, whatever…”

So how did it work:

The students though it was “cool” (their words). No change in support ‘though a few did comment that its supposed to be the students that bunk-off in a backpacker dive on the hippy trail, not the staff.

IT was fine. As support is mostly text based (mostly email) it was seamless; the resources really do what they are supposed to.

What did it cost..? Eating in the Thamel district and $8 a night for the best room in the place was actually cheaper than being at home. I kept all the receipts for internet access; little paper flimsies, stamped and triple-signed for an average of 200 Nepali rupees a day (about £2) which made a better souvenir than an expenses claim. Only really expensive bit was the jewellery. With the delay I’d missed my wife’s birthday…. and out wedding anniversary …. Q: Have you any idea how much a really BIG Topaz costs…?

Modern distance learning is seriously flexible – its all the other bits of life that  are still in the slow lane.

What’s it really like to study online?

We run an entirely online MSc for healthcare professionals in Oncology and Palliative Care, but I have never actually studied via e-learning…until now! I have just started studying an MSc course which is delivered entirely online and I just wanted to share my experience of e-learning from a student perspective.

At first I was apprehensive, after spending so long supporting my own students and saying things like “online learning is the future”…what if I couldn’t hack studying online? What if I wasn’t motivated enough?

So how is it going you ask?  Well I am thoroughly enjoying it, I can’t deny that it is a completely different experience to any previous learning but I have found that there is far more support than on my face-to-face undergraduate degree.   The best element, I find, is the online discussion boards and online tutorials, these let you know that you are on the right track, that the other people are “real” and they are facing with the same issues as you. Grappling with technology when you are on your own can be daunting but there is always someone to help you, via email, phone or discussion board and if you ask the group via discussion, someone has probably already had that issue and worked it out, all you need to do is ask!

I have found the key to a successful week is getting a really good routine, at the start of the week making a list of everything that needs to be done for that topic and then making a plan for the week. My approach has been to do a bit of work every evening, and then it doesn’t feel like it is taking up ALL of your time.

So what are the negative aspects…Of course it does take up quite a bit of time and the housework is certainly falling by the wayside and I am also boring people to tears by telling them ALL about the things I have learnt that week, but they are yet to tell me to shut up (there is still time!)

Cake and Tea
Studying Essentials

It is so convenient to be able to study from anywhere with an internet connection, no need to leave the house when it’s raining and blowing a gale. Just open your laptop, get a comfy chair and a cup of tea (and may be some cake) and you are good to go! The take home message…. I still think e-learning is great and now I have first-hand experience! Give it a go!

Ellie

 

Anxiety, blind panic and doing a Masters Dissertation

 
 
Dr Pete Middleton at Base Camp Everest
Pete  at Base Camp Everest

I’ve been supporting distance-learning students for over ten years as module lead for students completing research projects and writing up their Masters dissertations. The students are people well embedded in a career track in health care; research nurses, pharmacists, trial managers, doctors in their specialty training etc. As you can imagine they are an impressive bunch of people who are robust, adaptable and well used to the rigours of “further training”, yet for many they share a common concern… the pirate ship looming over the horizon that is…. The Masters Dissertation.

So what is it that makes this particular element of a masters degree such a source of anxiety…? Here is a sample of the collected concerns from the last decade, with comments:

I’ve never done any real research…. Are you sure? Most folk have to identify unknowns about their patients or work tasks on a daily basis. They use agreed or standard methods, apply standards to make decisions and have to relate the new facts to a wider experience in order to use the new information. That is the scientific process and for most healthcare workers it is also… the day job…!!!… they just didn’t realise it. The simple way to check that an individual can demonstrate that they understand the whole scientific process is to do the process from beginning to end… that’s why doing a research project figures so strongly in Masters degrees worldwide.

I don’t really understand all the IT stuff.  Me neither… we have geeks who do it for us… they give us how-to sheets that we follow… that you can also use (or ask your kids, or anyone under 19 yrs)…. We also have great IT support who are used to daft questions… even mine…

The regular modules are fine, but the dissertation seems scary. That is because in a knowledge-based module with an exam at the end you can hide-in-the-crowd to a certain extent, whereas a research project is individual and one-to-one with a supervisor or mentor. But one-to-one is a plus, you deal solely with YOUR issues/concerns/thoughts.

The writing scares me. That’s because you did science at school, science at University and you haven’t had to write a document bigger than a thank-you letter for 15 years…. This is common in folk on a science or healthcare career track but its not that you can’t, you just never got the practice… so here’s the opportunity… and its easier as its on a topic you know well…. and you even get help and support in “how-to-write”.

I don’t really understand stats. Q: did you play cards for pennies at University… ?…then yes you DO understand stats.. for the formal stuff we have great little modules in the courses and one-to-one support for “working” your own dataset.

It all seems a bit daunting. Aha..!… the crux issue. We are all good at working the day job, but the reality is that we are rarely the sole arbiter of what the bigger plan is that we contribute to… for a Masters dissertation you are the ring-master… you decide what advice to follow and what to ignore and to ensure that all the components come together, from study design to governance applications, from data accrual to doing the stats…. but it’s a learning curve with support, not a chucked-in-the-deep-end process. The module staff  help and guide you in this bigger process of project management and final assembly, just like the teachers did for the individual component subjects… its just another skill after all.

This capacity of being responsible for the whole plan is the quality that employers/appointment boards are expecting when they see someone has a Masters degree, which is why you see it so widely as a necessary qualification for senior staff, team leaders, senior administrators and those wanting the gateway to higher qualifications.

We all have holes in our skills set; things we didn’t master first time or wish we were better at, and much of the anxiety concerning a masters dissertation seems to centre on our own personal gaps… so a Masters dissertation is an effective way to plug the gaps as part of professional development…. just not what you were expecting when you thought you’d like a gap year. (?).

 

Dr Pete Middleton.

Module Lead Dissertation Module.

Oncology and Palliative Care Masters programme.

Clinical Research Masters Programme.

 

In Praise of Postgraduate Study Supporters

 

Chatting to the VC at a Newcastle Graduation
Chatting to the VC at a Newcastle Graduation

Although I am a tutor on this course, I also know what it is like being on the other side of the text books or laptop screen.  Not just with my own studies, but also as a family supporter of a postgraduate student – in my case my husband.  In fact, I’m writing this the day after his graduation ceremony, so forgive me if I become sentimental and reach for the tissues.  You have been warned!

As an undergraduate you take for granted that the people who love you – mainly your parents – will make sure you’re fed, watered, clothed and generally cared for.  But as a postgrad you quickly realise how much those who share their lives with you have to sacrifice to help you on your journey.  Sunday afternoons out, school plays, trips to the cinema, weekends away… they seem like a distant memory, suspended on a promise of better things to come.  The loss of a housework-friendly spouse to the inner sanctum of the study was a one  I particularly grieved over.

But it’s not just the physical, hands-on help your non-studying supporter will have taken on for you.  It’s the emotional protection they give you that is so often overlooked yet demands the most.  Even just listening to your loved one ventilating about unrealistic assignment deadlines, tight timetables and unintelligible coursework takes its toll – especially when you’re facing a full laundry basket, a heart-broken teenager and an eleventh-hour school project.  Alone.

Or so it seems.  But when you see your spouse or parent, partner, child, sibling or friend in cap and gown, walking up to receive their handshake and certificate… when you listen to the rousing valedictorian speech… even when you’re sipping champagne at your celebratory cocktail party (if you’re lucky)… then you know it’s all been worth it.

At my postgraduate congregation all the graduates turned to face the audience and applauded their friends and family supporters, in a gesture of gratitude that seemed too

Family and friends there to celebrate
Family and friends there to celebrate

small.  I’m welling up with tears just remembering that moment, and it was 6 years ago, such is the power of that simple, heart-felt act (well, I did warn you).  I saw a sea of proud faces – smiling, waving, cheering, clapping – each one had travelled every step of the journey with us.  We just hadn’t really noticed that they were there until that moment.

So when you finally finish your studies and are realising the fruits of your labours, turn to the ones that were with you and say thanks.  One day, if you’re lucky, you may have the opportunity to return the favour.

Dr Vicky Hewitt- Module Leader and Personal Tutor

No more Mr NICE guy… Can we continue to afford new cancer medicines?

By Steve Williamson, Consultant Cancer Pharmacist, National CDF Panel Member and Module Leader.

My Module, Cancer Drugs and Technologies looks at pricing and market access to cancer medicines amongst other things.  This is an area that is never far from the news headlines. Last week saw the announcement of changes to the Cancer Drug Fund (CDF), which provides funding for high cost cancer medicines for patients in England.  The fund which was £200million has been increased to £280million for this year and next… just as well, as the fund overspent last year by nearly £50Million.  It also highlighted some important changes to the ways the CDF will work, more of that later.

The CDF was seen as the great solution to accessing high cost cancer medicines, extra money specifically to fund drugs too expensive for the UK’s  Health Technology Assessment body, NICE.  It’s fair to say that the CDF has worked and improved access and its first three years and funded many new treatments that get turned down by NICE.  But one of the great weakness of the CDF is it hasn’t taken account of cost, until now.  You can speculate that this has led to manufacturers being less concerned at keeping their UK pricing down as the CDF will fund it anyway.  Look at the row between Roche and the NHS over its new breast cancer drug, Kadcyla.  See the coverage on the BBC http://www.bbc.co.uk/news/health-28688311.  In summary, NICE have said no and patients are disappointed, NICE were not able to agree an acceptable discount with Roche, but the drug is available at full price on the CDF.

NICE said they were unable to say yes as the company were not working with them on pricing. Their chief executive Sir Andrew Dillon said: “We are really disappointed that Roche were not able to demonstrate more flexibility…The company is well aware that we could not have recommended Kadcyla at the price it proposed.” This is really strong language for NICE who usually do not comment when they say no.  Roche then went on the counter offensive with Roche Senior figures quoted: “We’re very disappointed with this decision and, frankly, not just for patients”, “NICE’s rejection of Kadcyla demonstrates quite simply that their current system is broken, not fit for purpose”, strong words.

Now it just happens that this row was between NICE and Roche, but in truth given the global pricing trends it could have been any manufacturer with a new expensive cancer drug.

But what are the facts behind the headlines?  Kadcyla, is new version of an existing drug trastuzumab (herceptin) that offers benefit after patients disease has progressed on trastuzumab.  It is the original trastuzumab molecule a biological targeted agent combined with a traditional cytotoxic agent, which is then ‘delivered’ directly to the tumour, clever stuff.

But Kadcyla is not a curative drug, its used (for the moment) in patients with advanced breast cancer.  The trials show it extends median overall survival by 6 months, that is patients will on average live 6 months longer.  Its costs £90,000 for a 14.5 months course of treatment, equivalent to £75,000 a year.  This compares to trastuzumab at £21,000 per year.  So why is it so much more expensive than the original molecule?  The Pharmaceutical industry often quotes drugs development costs to justify high prices, but have development costs increased so much in 10 years?.  Development costs are often driven by need to test many molecules that don’t prove to be successful in search for a winner.  In this case you could argue that there were none of these costs as the drug combined existing drugs. Only Roche have answers to this. My view is that it is overpriced and the high price is driven by recent high prices in other cancer drugs, it seems that as soon as the next ’most expensive’ cancer drug price is accepted, this resets the pricing benchmark and prices just keep spiralling higher.

So coming back to the CDF (still with me?) you could speculate that manufacturers will be less keen to try and seek agreement on discount price with NICE if the can have their drug funded in England by the Cancer Drug Fund.  The NICE rejection has not hurt Roche’s sales in England as the CDF continues to pay the full price, reaching agreement with NICE could be seen as counter intuitive for Roche as soon as NICE say yes at a discount the CDF will stop paying full price.   The CDF panel has recognised this and part of the changes announced recently mean that they will look more closely at prices of drugs it has approved and will be trying to support NICE in its efforts to encourage more realistic pricing for the UK.  There is going to be some interesting discussion at the next CDF panel meeting, that’s for sure!

 

All opinions expressed in our Blog are those of the author and not of Newcastle University.

Hello from the Outer Hebrides of Scotland

Tablet close up

Hi, my name is Christine and I am going to tell you a few things about myself and how I found being an e-learning MSc student.

I live and work in the Outer Hebrides of Scotland which makes attending any ‘face to face’ training difficult both in time and cost. Having a small population means we have a small hospice(!) but still have to satisfy the national standards for a specialist palliative care service. These standards state that the lead palliative nurse should be educated to MSc level, hence my decision to undertake the course. A colleague had already started the MSc in Palliative Care with Newcastle and recommended the quality of teaching material and accessibility to me. I have been fortunate to be funded by my employer, along with some tuition fee grants from Help the Hospice. My employer also granted me three paid study leave days for each module.

It took me a few modules to get into the swing of e-learning and time management, or, being honest, to discipline myself to work steadily rather than panic and cram into last few weeks. It’s amazing how interesting the ironing and hoover become when an assignment is due….! I found that when I needed to concentrate and when working on assignments that I achieved more by coming in to the small library that we have at work and treating the time as ‘work’.

E-learning is definitely about getting out what you put in. The tutors are mostly helpful but don’t have a crystal ball or mind reading capacities so we students have to be proactive in contacting them. Discussion boards are interesting and as you progress you often find that others are following the same path as you and you develop a ‘virtual bond’.

It’s hard work juggling full time work, family and study but now I am, hopefully, finished I can say it’s worth it. Mind you two months ago, when in the midst of dissertation angst, I was saying to my colleagues, “Don’t ever let me say I’m going to study something again!” However, much to my surprise, I am already missing the learning so might be looking for something else to study sooner than I envisaged.

I can’t decide whether to attend the graduation. It would be great to meet those I’ve got to know virtually in the flesh but time, distance and expense might outweigh other considerations.

If you are dithering about starting and reading this to help you decide I can say it has been a positive learning experience even the modules I felt were way beyond me, like Genetics. I find that I have retained more than I expected and able to apply the learning in lots of aspects of my work. Try and persuade a colleague to do it with you, it was definitely beneficial to be able to talk coursework through with others.

Christine- MSc Palliative Care Student (soon to be graduate!)

 

Studying From All The Way Down Under

The essentials for studying via e-learning.
The essentials for studying via e-learning.

Hi, my name is Jeanie and I’m a clinical pharmacist from Perth, Australia. After finishing my postgraduate studies in pharmacy I realised that oncology was still a big mystery to me. Working in a teaching hospital where many weird and wonderful things happen on a daily basis only exemplified that! I attended an introductory course on oncology and realised that I wanted to know more – a lot more. After a long search of cancer related courses on the internet, I thought Newcastle sounded like a good course – it was online, covered many different aspects of oncology (more than what a pharmacist would learn) and the Programme Team answered my emails very quickly!

Prior to starting the course, I hadn’t studied via e-learning. I was a little worried that I would find it difficult to be self- motivated, but having the discussion board for each subject really helps. I’ve ‘met’ so many people from around the world and also found others studying close by! Seeing how things are done differently in other countries has made me open to new ideas and possibilities. The module leaders are also very encouraging and helpful if you encounter problems along the way.

Studying via e-learning is also very handy for learning on-the-go. I’ve read articles and module notes on my phone or tablet while on public transport and on aeroplanes! It’s really portable and the iPad app for Blackboard is easy to use. The course is also very up to date – you can watch videos and look at very recent news articles. You can also print anything you want if you prefer.

I’ve found it fairly easy to study part-time while working full time – one or two units per semester. The hardest thing I’ve found is that the UK semesters run Spring to Autumn in Australia, so sometimes staying inside during beautiful weather can be difficult! I usually set aside time on the weekend to studying at the dining room table with a cup of tea (or three) to work through the topic with my ‘supervisors’ (my budgie and cockatiel).

I think the MSc Oncology course has been really beneficial so far – I’ve developed confidence and knowledge, which I am passing along to younger pharmacists and I understand the roles of others in the oncology team. Studying has also helped me to obtain a specialty pharmacist position – thanks Newcastle!

The origin of species – or at least of this course!

Dr Charles Kelly- Deputy Degree Programme Director
Dr Charles Kelly- Deputy Degree Programme Director

 This group of MSc s is still the only one available anywhere in the world completely online.
Its origins go back into the mists of time or at least to the mid to late 1990s. The educational environment was very different then. Most distance learning was still carried out using a text based correspondence course model, and even the Open University, Britain’s leading pioneer in distance learning had most of its courses using this model with students being sent a box full of textbooks and notes when they initially signed up to a course.
MOOCs, of course had not even been thought of, and to be honest most computers were used as glorified typewriters or for playing games by adolescent youths.
Oncology did have formal postgraduate courses and there were several MScs in oncology across the country, based at some of the larger oncology centres but they tended to have small numbers of students, were primarily aimed at medical graduates, and did not fit in awfully well with the model of medical postgraduate education, which at that time and still is through vocationally based Royal College diploma courses ending up with a completed certificate of training.
These regional MScs associated with universities also suffer from problems with capacity and demand with some years there being very few students wishing to do the course and other years a lot more, making future planning difficult.

A few years after taking up appointment in Newcastle, I was asked to look at the possibility of setting up a Newcastle MSc, but rather than using the model in place at the time, I and some colleagues explored the possibility of an online course which should to some extent reduce the capacity and demand problem, be scalable and accessible to a greater number of students throughout the UK and indeed the world.
Another consideration which we took very seriously, was the realisation that the great majority of students taking these courses would be in either part-time or full-time employment, and they would appreciate the benefits of online learning which they could do, fitting in with their employment and family life and not taking them away from their place of work. We were also very keen to have multi-professional access to the course, to a much greater extent than other oncology MScs
So as a small group we moved on to developing the MScs as a solo project and, by this time, Dr Graham Dark, , had joined the consultant body at, as was then Northern Centre for Cancer Treatment, Newcastle General Hospital.
Looking back, I think, in the beginning, we were incredibly naive (and to be truthful, naïvely stupid, in a good way) and this actually helped us. I think if we’d sat down and thought about all the potential obstructions and challenges, the courses would never have got off the ground. We did have a certain “Bob the builder” attitude – can we do it, yes we can!

The courses are now flourishing and developing further streams, and we have a great team, and I think it would be fair to say happy team, which is important to us
Maybe in years to come, a University archaeologist will dig deep into the paperwork in my office (notoriously overstuffed and disorganised) and find the documentation from the very start of the course, the “big bang” moment.

My experience of the course, has been both enjoyable and very fulfilling. I particularly enjoy when our students come in person for graduation in Newcastle, knowing this is the only time they have actually been in Newcastle, and that they are here voluntarily, because the course has given them the flexibility of completing it from wherever they live and work, and they’re coming to Newcastle to mark, I hope, one of the red letter days in their lives.
I suppose the only advice I can give from the course is that if you think you have a good idea, hold onto the naive stupidity and go for it, thinking why not do this rather than listening to all the naysayers telling you the 17 reasons why it won’t work.

Continue to enjoy the courses!
Dr Charles Kelly