Students Staff

9 May 2014

More similarities than differences: Delivering a three-day training session to medical educators in Kurdistan.

In November 2013, Anne Corrin, Senior Lecturer in the School of Health and Human Sciences, and Dr Teshk Shawis, Consultant Geriatrician at Colchester General Hospital, collaborated on the design and delivery of a training programme for clinical educators at the University of Sulaimani in Kurdistan. [1]    Here, they talk to In Practice about their experiences.

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[1] The full team included Dr Hero Khoshnaw, Consultant Physician, Royal Surry Hospital, and was delivered at the University of Sulaimani’s School of Medicine, Kurdistan, Iraq.

IP:   How did this project come about?

TS:   The development of medical education is something that has been evolving in the UK for the last ten years but it is still quite new in Kurdistan. Because I come from that part of the world, and because of my involvement in the training of medical educators here, I saw an opportunity. I felt I needed an academic involved. I had met Anne previously when we both attended a conference in Kurdistan and thought that she was the right person. I contacted her and she was kind enough to agree.

IP:   What were your primary objectives?

TS:  Our aim was to train the trainers; in this case, the doctors who teach medical students in a clinical setting on a daily basis. We wanted to show them the scientific way of teaching, that is to say, the evidence behind good practice.

AC:   They are all experienced teachers, so the idea was to give them a taster of alternative approaches.

IP:   How easy was it to adapt the kind of theories and approaches we’re familiar with in the UK to the local educational culture in Kurdistan?

AC:   Although teaching is affected by the cultural context, the principles are the same. The local differences were of a more practical nature. For example, they don’t work from nine to five like us. After one o’clock, they are not in the college. Equally, they wanted us to run the sessions on Sunday, Monday and Tuesday, whereas in the UK we would never run a session on a Sunday. We adjusted our schedule to suit them. That is one of the reasons it worked, I think.

TS:   We could tell from their reaction that some of them were already doing the kind of things we were discussing, but they hadn’t considered the science behind it; why it should be that way and not another. About seventy-five percent of the course was workshops, so they were able to see how their colleagues were doing things, and to reflect and discuss.

AC:   It was important to take a collaborative approach so that it would be relevant for the participants. We got to know them on a day-to-day basis. We would have lunch with them so that was a good opportunity to talk about how it was going and get some feedback. There were also some senior people on the course. The Dean, Dr Ari Sami Hussain Nadhim, was there which sent a very strong message. I think that was important for the other lecturers.

IP:   What kind of feedback did you receive from participants?

AC:   It was very positive. “I’ve changed the way I view teaching”, that sort of thing. Somebody said, “I’m now taking into account what the students think. It’s about them, not just about me.” I was very taken with that level of honesty. They really wanted to make things better. They were very receptive, very optimistic.

TS:   You have to understand this in the context of the recent history of Kurdistan; what they’ve been through.

AC:   The changes are immense. The situation is rapidly developing and improving. It was lovely to be there and experience that positive energy.

IP:   Did you have any apprehensions before you went, Anne?

TS:   Boy, did she! I did as well because I worried about Anne, but she did much better than both of us!

AC:   It took me out of my comfort zone. I worried that I would be too far removed from their day-to-day experiences. In fact, there were more similarities than differences. They were discussing things like Botox and cosmetic surgery, and the treatment of asthma. I was listening and thinking, “I could be anywhere in the world”. I think it also helped that I had been to Kurdistan before, to a conference, so I realised that it wasn’t so difficult to be there as a woman. I felt comfortable in the culture.  It was very liberal.

IP:   What about the participants? In what ways were they taken out of their comfort zone, do you think?

TS:   We asked them to write reflections. This was probably their first experience of writing a reflective account.

AC:   Some of them were very thoughtful. There was one that was absolutely superb. But it’s not what they are used to, at all.

TS:   One of the questions we asked in the evaluation was, “What did you think was the most difficult part of this three day course?” A few of them said the reflective writing. They couldn’t grasp the concept of what it meant to write that way because, for them, an assessment is a question with a right or wrong answer. We were asking them to reflect on something they had done and reveal the thinking and the ideas behind it.

AC:   But people in this country also find that hard.

IP:    Anne, how would you describe the benefits of collaborating with Teshk?

AC:   Teshk is very can-do. He has a clear vision of where he’s going. Obstacles are there to be overcome. On my own, I probably couldn’t have pushed it through. Teshk has a great network which he utilised very, very well. It was interesting for me to see the amazing things you can achieve when you do that.

IP:   Teshk, what did you learn from collaborating with Anne?

TS:   I could see the overall framework of the project, but it was Anne who made it more presentable and exciting. It’s the little things which make a difference. For example, Anne was clear that we should include scenarios about students with difficulties. She was also very flexible and that kept me going throughout the whole trip. She said that whatever went wrong, we could always salvage something.

IP:   Clearly, the aim of the project was to share experience gained in the UK with colleagues in Kurdistan, but did you observe anything about their approach that you would like to bring back.

AC:   I was impressed by their enthusiasm. What they do is already good but they are so open to improving.

TS:   It was interesting to see that, whilst some of the older generation were inclined to say, “This is the way we’ve always done it,” the younger generation were very accepting of change. Ultimately, they are training doctors to treat patients so they are committed to improving the health-care system overall. If we were as productive here we could make a huge difference. Unfortunately, I think we end up doing things because we are pushed to do it rather than because we really want to.

AC:   I think there is less hierarchy in Kurdistan. If you have a good idea and you’re willing to put in a bit of work, you can make it happen, and that’s a nice working environment. Here, you can get tied up with the bureaucracy.

IP:   How would you advise a colleague who was presented with a similar opportunity but had reservations?

AC:   I would say that working collaboratively is fundamental. I could not have done this on my own. In this project we had different kinds of experience, we came from different angles; as a lecturer, I came with experience in education, Teshk and Hero had the medical and cultural experience. When we brought that together it gave us the confidence to push the whole thing forward. It energises you to work with people outside your normal team. It helps you not to get stuck in your ways.

TS:   It can also lead to further collaborations and exchange between the institutions involved. One of our participants was interested in the post-graduate course in medical education at the University of Essex because we had talked about it whilst we were there.

AC:   We are in a global world now. I was worried about the differences but in fact they were minimal compared to the shared learning that took place.

TS:   It’s a life experience.

Anne Corrin

School of Health and Human Sciences

University of Essex



Teshk Shawis

Consultant Geriatrician

Colchester General Hospital




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