Author: Chris Walsh / Editor: Nikki Abela / Codes: SLO9 / Published: 11/06/2018


The content you’re about to read or listen to is at least two years old, which means evidence and guidelines may have changed since it was originally published. This content item won’t be edited but there will be a newer version published if warranted. Check the new publications and curriculum map for updates

Editor’s note:

RCEMLearning’s head of e-learning, Chris Walsh, spoke to EM educators at the EMEC about RCEMLearning. Chris is one of the big brains behind the site and how we function, and you may be surprised to find out that a lot of what we do is based on educational philosophies and theories, largely driven by Chris and a team of people with a passion to continue doing what we do. We are openly reflecting on this in the hope that you can learn from us too, and  feedback any thoughts or ideas.

I was honoured to be invited to talk about RCEMLearning @the_emec today in Birmingham. My objective for the talk was to provide an overview of how the site delivers and complements educational activities for increasingly busy, stressed and multidisciplinary ED teams.

This is a compressed version of the talk that will focus on three core components:

  • Our educational philosophy
  • How people are using the site
  • The challenges we face (and some challenges for our learners)
Our Educational Philosophy

This could fill a whole series of blogs, as anyone who’s had the misfortune of listenting to me bang on about this stuff will attest, but these philosophies make a vital contribution to what RCEMLearning’s all about. For the purposes of the talk I focused on three aspects of our philosophy: the postdigital, dialogic education, and transformative learning.

Don’t be put off by the prefix as the post-digital is something we need to give serious thought to. There’s a growing body of literature about it, but at heart it’s a school of thought that looks into how education is impacted by the increasing (and perhaps irreversible) incorporation of technology into our cultural, social and educational lives. Perhaps there’s nothing new here for many of you, but I certainly feel jaded when having to justify digital learning, explain its relevance or make crude differentiations between demographic usage (digital natives vs. digital immigrants etc.). So as Cramer (2015) identifies, it might suck as a term but its presence affords lots of opportunities for productive formal and informal learning.

Another significant influence is dialogic education. I’ve found this a really persuasive theory as it looks at how digital education contemporizes rather than replaces many conventional aspects of deep or successful learning.

Dialogic education stresses the importance of discursive practices to sharpen criticality, and those conversations or dialogues could be internal and individualised, or conducted across departments, learning networks or social media platforms. Just channel your inner Partridge here: good learning is like entering the chat o’sphere. And of course to be truly effective it has to be inclusive, and inclusivity is a core element of educational programmes within EM.

Pretty much everyone using RCEMLearning is a highly accomplished adult learner, operating at sophisticated metacognitive levels in challenging local contexts. You’re all adult learners who need to continually learn and re-evaluate your assumptions and knowledge. However you also work in environments which regularly challenge your approach to things and your interpretations of them.

Learning within EM adheres to Jack Mezirow’s theories of transformative learning, especially what he terms disorienting dilemmas, ‘wherein adults are challenged to examine their assumptions and beliefs that have guided meaning-making in the past, but now are no longer adequate’ (Merriam, 2018, p. 86). We hope that our resources equip our learners to deal with a range of clinical presentations, but also to re-frame their understanding when they encounter disorienting dilemmas.

How people use the site

We’ve looked at the theory, so now I want to showcase how a single content item that simultaneously demonstrates all three philosophies can be put into practice. The resource in question is our recent podcast on aortic dissection. This differed from our usual podcasts as it was about a specific clinical issue, as opposed to discussing new evidence, literature and guidelines. Here’s how it evidenced the three aspects of our educational philosophy:

  • Podcasts are an accessible postdigital resource that can be easily embedded into shopfloor teaching (see the Tweets below).
  • It increased the range and inclusivity of our dialogic components by including patient perspectives.
  • The broad dialogue also presented a disorienting dilemma not just for EM but also for some radiologists, who made an additional contribution following the initial podcast. The multi-disciplnarity is also something we’re increasingly keen to promote.

The challenges

There’s always more work to be done and ways to improve. As part of my preparation for the talk I once again channelled some Partridge and used Alan’s digital Dictaphone (things have moved on to Twitter since Alan’s days) to ask what we could do better.

Some of the examples are shown below. We need to get better at engaging with specific groups, especially around key times of year (such as exam times). A really interesting thing that also came up was how we could perhaps collaborate or consolidate some of the other excellent FOAMed and digital learning resources (including St Emlyn’s and The Resus Room, although there are many more of course), into something more cohesive. This is a sign of FOAMed and digital learning’s increasing centrality to EM education, although it’s very, very early days here, and we need to give lots of thought to what this would look like and how it would work.

We also need you to continue to be our “Alan’s Dictaphone”. We’re always grateful to receive submissions, feedback and comments on what we do, and we need those to ensure we keep delivering resources that are relevant and credible. Everyone in the EM community is responsible for continuing the dialogue.

The EMEC team had the brilliant Aoife Abbey producing digital summaries from the talks of the day. Here is the one for this talk:


  1. Cramer, F. (2015). What is ‘post-digital’? In D. M. Berry & M. Dieter (Eds.), Postdigital aesthetics: Art, computation and design (pp. 12–26). New York, NY: Palgrave Macmillan.
  2. Merriam, S.B. (2018). ‘Adult learning theory: Evolution and future directions.’ In Contemporary Theories of Learning. Learning Theorists … In Their Own Words(2nded.) Illeris, K. (ed). Abingdon: Routledge.
  3. Selwyn, N. (2016). Is technology good for education? Cambridge: Polity Press.