Summary: With the current developments in global politics, Professor Harden addresses the rise of "post-truth" discourse and its effect on different aspects of medical education, including a former student attempting to sue his alma mater on the basis of their tuition resulting in him not earning a first-class degree. Description: “Post-truth” is a key-word for 2016. It is a belief that facts no longer matter and as described by Andrew Campbell in his recent blog (http://www.cea-ace.ca/blog/andrew-campbell/2016/11/4/teaching-and-learning) “what is proven is not relevant and what really matters are the emotional reactions to information, not whether the information is true”. He argues that “there’s considerable evidence that, contrary to conventional wisdom, people do not naturally seek truth. Rather than gathering facts and forming opinions based on evidence, most people form opinions and then accept or reject facts based on whether they confirm their beliefs”. In a study reported in Psychological Bulletin, Albarracín and co-workers (Feeling Validated Versus Being Correct: A Meta-Analysis of Selective Exposure to Information, Psychological Bulletin, 135(4)) asked participants about their views on a given topic and then allowed them to choose whether they wanted to view or read information supporting their own or an opposing point of view. They found that people are about twice as likely to select information that supports their own point of view. What was interesting was that people who have little confidence in their own beliefs are less likely to expose themselves to contrary views than people are very confident in their own ideas. What is worrying, as described by Campbell, is that website algorithms on search engines selectively guess what information a user would like to see based on information about the user, creating “filter bubbles” which separate the user from information which disagrees with their viewpoints. Eli Pariser in the Daily Dish (October 10th 2010) described experience relating to the “filter bubble” with two friends who googled “BP”. One of them got a set of links that was about investment opportunities in BP. The other one got information about the oil spill. It is argued that we need to ensure that students gain a better understanding about the digital world and that they need to be aware about the role algorithms play in what they read on their screens. Campbell argues that the Brexit decision and the election of Donald Trump highlight the implications of “post-truth” decision making.

I am currently working on my presentation for the 14th APMEC in Singapore in January. The theme of the meeting - From Globalization of Education to Global Healthcare - is timely. Brian Hodges and co-workers had argued previously in Medical Teacher (Hodges et al 2009, 31, pp910-7) “Globalisation is not a theoretical consideration in medical education- it is a process that is dramatically transforming who medical students are and what medical schools do across the globe”. There is no doubt that in medical education we are seeing greater collaboration. This is illustrated by the contributors to the preconference workshops and symposia sessions accepted for AMEE 2017 in Helsinki. 19 sessions had contributors from just one country, while 12 had contributors from two countries and 22 had contributors from three or more countries. Much of the attention in terms of internationalisation and globalisation in medical education has been on the curriculum, on students and on the business implications. In my own APMEC presentation “The Roles of the Teacher in Global Education and Global Healthcare – What would happen if the teacher were not there?” I am exploring the implications of internationalisation for the role of the medical teacher.

Featured in the news this week was the case of a graduate from Oxford who is suing the university for one million pounds, claiming “appalling and boring tuition cost him a high-flying career”. He claimed that his failure to get a first-class degree was due to negligent teaching and this denied him a career as an international commercial lawyer and that he deserved compensation for loss of earnings. The university did acknowledge problems with the teaching but is asking for the case to be dismissed on the grounds of time. I suspect that in the future universities and medical schools will be held much more to account for the quality of their graduates. In one court case in England where a nurse was on trial for her lack of professional behaviour, the judge in coming to a guilty verdict, also attached some blame to the nursing school who had graduated the nurse.

Anu Atluru (2016) a resident physician in emergency medicine at Massachusetts General Hospital and Harvard Medical School, argues in StatNews(http://www.statnews.com/2016/09/16/medical-schools-licensing-exam-competition/) that with the importance for career prospects attributed to the student’s performance in the United States Medical Licensing Exam and with the rapid expansion of knowledge, learning and retaining medical knowledge is a greater challenge for students today than ever before. Medical students it is reported, frustrated by the inconsistency of faculty delivered curricula, are adopting commercially available products that “teach to the test”, not only as study aids but in many cases as substitutes for textbooks, class lectures and notes. It is argued that the more that students rely on third-party materials, the more medical schools are at risk of becoming symbolic – rather than substantive – educators.

I wish all readers of the blog a happy festive season.