Exchange report - incoming teachers
Home university: University of Malawi
Study programme: Medicine
Exchange programme: Linnaeus-Palme
Semester: Autumn semester 2018/2019
Duration: 25
Name: Tamara Phiri
Email address: tamaraphiri@gmail.com

Accommendation

<div>The accommodation was organized before I arrived by the international coordination team.</div><div><br></div>I found the apartment clean and orderly. I also found it convenient as there were amenities for cooking present in the apartment and I&nbsp;was able to prepare my own meals and cut costs by not buying take-aways all the time.<div><br></div><div>The accommodation was also a short walking distance to both the bus station and tram station which made my movements easy.<br><div><br></div><div>I was warned beforehand that it was winter and that I needed to bring my own beddings as these were not provided for. I brought along plenty of warm beddings which came in handy as you sometimes could feel the cold even with the heating on in the room. I was comfortable and cozy throughout the stay.</div></div>

Language and Culture

Teaching was in English for all the sessions I taught or attended.<div><br></div><div>For all other interactions and just getting around, everyone spoke Swedish but would quickly change to English when they realized I didn't understand Swedish and many of the people spoke English fluently. It was easy to get around and get things or ask for directions, etc.</div><div><br></div><div>I found the Swedish people warm compared to other places I have been - which most of the Swedish people were surprised to hear when I said that to them as they thought of themselves as being reserved. I found the people were keen to help if you asked for help finding your way for example, and people generally seemed interested in what you were saying and accommodating you.&nbsp;</div>

Leisure time

There were many leisure activities arranged and a lot to do and see in Stockholm and it was not possible to see everything in a short time.<div><br></div><div>But I had an outstanding experience. My visit coincided with the Nobel week and the Nobel lectures took place at KI while I was there. Unfortunately, I was unable to physically attend the Nobel lecture from the winners in Medicine and Physiology because I was in the medical education course at that time. I had, however, a very rare experience of seeing and hearing the 2018 Nobel Peace Prize winner in person - Dr Dennis Mukwege- speak at a closed-door event for a small audience. He had just received the Nobel Peace Prize in Norway two days before and had been invited to speak in Stockholm. This was a very unique and memorable event. Among other social activities, while I was there, I was also invited to attend a concert and a&nbsp;week later was invited to attend a Christmas carol service - the music at both events was superb. I went to the Christmas Market and toured the oldest part of Stockholm - Gamla Stan - with a Swedish colleague who also taught me a lot about Swedish traditions and traditional Swedish food.&nbsp;</div><div><br></div><div><br></div>

Miscellaneous

I was very impressed with how Stockholm as a city is organised and their public transportation system is one of the most organized I have seen compared to all other places I have been. It is very easy to get around even if you have never been to Stockholm before as I was when I arrived.<div><br></div><div>My advice on getting around Stockholm for teachers coming on the exchange who have never been to Stockholm before: you will use public transportation a lot and I would encourage you to download the SL app beforehand - it shows all transportation routes and tells you exactly how to get to where you want to go using SL buses, trains and even boats I think. It will tell you for example which specific bus stand to find a particular bus - which Google won't do- and this came in very handy on my first morning when I knew which bus to take but did not know which one of the many bus stands in the bus station my bus would come to, I probably would have figured it out but it would have taken too much time. &nbsp;I was told about the SL website www.sl.se before I arrived but only discovered the app from a tourist in Stockholm. It was extremely handy on the go. I would also highly recommend using it hand-in-hand with Google Maps app as Google Maps gives you more detail on the physical infrastructure and distances to expect as you go around which the SL app will not.</div><div><br></div><div>Also get the electronic pdf version of the Stockholm rail network - you can download this on the SL website. It is very handy as you can easily pull it out on the go and be sure you are on the correct rail line, going the correct direction, how many stops to expect, where the various rail lines intersect, etc</div><div><br></div><div>Download Google Translate app - very handy as you will come across many things written or said in Swedish which you want to understand.</div><div><br></div><div>Lastly, things are more expensive in Stockholm than in most other cities, be prepared for that. Other than that it is a very beautiful and clean city with lovely people and plenty to see and do. &nbsp;</div>

Other activities

I attended a course on medical education which brought me in contact with other clinicians that have an interest in medical education like myself. It also brought me in touch with the course facilitator who also offered himself for further input should I have further questions or want help in setting up medical education programs in the future which was great.<div><br></div><div>Overall I built friendships with several colleagues in medicine with whom I hope to remain in touch.</div>

Preparation

I was informed&nbsp;about the Linnaeus-Palme&nbsp;teacher exchange program by a colleague&nbsp;from my university who had visited KI as part of the initial talks between the two institutions to set up such a program.<div><br></div><div>Before I left, I prepared lecture materials for the lectures that I was going to give to undergraduate and postgraduate students at KI</div><div><br></div><div>I had a big advantage in my preparation having met Swedish teachers from KI in Malawi just before I went to KI. They themselves had come as part of the same teaching exchange program. They were very helpful talking me through what to expect and even after I arrived, one of the teachers was very helpful helping me to settle in and also introducing me to a very good medical education course while I was there.</div>

Reflections

At the teaching exchange,&nbsp;I was exposed to a leading medical institution with hundreds of years of experience in delivering medical education. I was impressed with the attention to detail in creating a good learning environment and learning spaces that are conducive for both learners and teachers.<div><br></div><div>I also was exposed to different teaching methods. One method of teaching that stood out was the case discussion which I did jointly with KI students for undergraduate students. This was very well planned and well executed even though all four of us teachers had different backgrounds. Students were very engaged and seemed to have enjoyed this type of teaching. It certainly is one thing I will try with my students.</div><div><br></div><div>My methods of teaching will change as I have reflected more on having a learner-centred approach which actually benefits the students and trying to apply different teaching methods in the teaching sessions to avoid the teaching becoming monotonous. I spent quite some time learning about how to give feedback and I am keen to try these methods out.</div><div><br></div><div>Overall the visit was a very positive experience as it has expanded my view of the teaching, learning and medicine as a whole and the good impressions and insights I got will remain with me for a long time.</div>

Teaching

I had a variety of teaching sessions at KI. These included didactic lectures with the undergraduate and postgraduate students, a case based discussion with undergraduate students (done together with two members of the KI teaching staff and another Linnaeus-Palme exchange teacher from another country that was at KI at the same time I was), and a talk and discussions with infectious diseases residents and consultants.<div><br></div><div>There were differences in the teacher-student relationship that I observed at KI compared with my setting. The KI teachers were very careful not to put students on the spot by not asking them questions directly during learning. They were very cautious about appearing confrontational or offending/embarrassing the students. This is different from my setting where students are usually put on the spot and often have to defend their lines of thought before a fairly large and senior audience. Although this is nerve-wracking as a student, &nbsp;it begins to prepare our students at a very early stage to stand up and defend themselves - a scenario they will go through many times after training especially if they become the leader of a fairly large health facility and health program soon after completing internship which is not uncommon in my setting. Both methods certainly have their pros and cons and a combination of the two would be ideal. You don't want to create a negative learning experience for the student by making learning humiliating. On the other hand, if you are too protective of the students, you are not preparing the students for the many nerve-wracking real-life situations they will have as a doctor defending their position to their colleagues, members of other disciplines in medicine or a team of people they are leading if they assume leadership positions.</div><div><br></div><div>I also observed that students at KI seemed to have a lot more autonomy - during one session for example, a student asked if we could stop the session and take a break for coffee before continuing - which was right because a break was needed for them to keep on concentrating but many students in my setting would probably not be comfortable to raise their hand up and ask the teacher to stop for coffee. I am also not sure how other teachers in my setting would view that. Secondly, attendance to some of the undergraduate learning sessions seemed non-compulsory and only a few students attended which is different from my setting where most undergraduate lessons are compulsory.</div><div><br></div><div>Participation in the teaching activities was generally good as long as the students understood what the teacher was saying. Most students or audience members were engaged.</div><div><br></div><div>In managing patients in the hospital, there was a clear difference mainly because of the wide availability of resources and far larger staff numbers at KI compared to my institution. There were several senior doctors in the team managing the patients and the trainees had to be quite high up in the ranks before they could take on full responsibility&nbsp;or be left to perform certain tasks alone. In my setting trainees have to "mature" quite early and take on responsibilities early in their training which may be left to the very end of training or after training in other settings.&nbsp;</div>

Teaching hours

On average I spent 4 hours per week teaching. The smallest number of hours/week spent teaching was 2 hours in my second week and the largest number of hours spent teaching was 9 hours/week in my last week.<div><br></div><div>In total, I gave 2 seminars and 1 case discussion to undergraduate students, 1 seminar to masters students, 1 seminar to infectious diseases residents and consultants.</div><div><br></div><div>I attended a 3 full-day medical education course during my stay.</div><div><br></div><div>I spent 2 mornings observing outpatient clinics. I did not have bedside teaching sessions.</div><div><br></div><div>I spent 1 morning observing a simulation session with undergraduate students.</div><div><br></div><div>I had several meetings during my stay - some administrative and some informal - there were a few of these each week.</div><div><br></div><div>I also attended other lectures on various topics of interest while I was there.</div>