Lecture attendance and use of digital recordings in medical training

The education of medical students and trainees increasingly involves technology. Learners expect to use technology as part of their studies;1 yet teachers can struggle with this change in learning behaviour. Although digital resources can improve learning, we have insufficient understanding of learners’ experiences2 or choices about using them to supplement or replace traditional teaching methods. Our research aimed to explore medical students’ decisions about using digital resources in order to better tailor our educational approaches.

We conducted mixed methods research using student questionnaires about lecture attendance and use of digital resources, and learning analytics to assess how digital resources were used. The research was conducted with final stage students undertaking their paediatric term at Sydney Medical School from October to November 2014 and from March to May 2015 (with approval from the University of Sydney Human Research Ethics Committee). Here, we report the questionnaire results on lecture attendance and use of digital recordings.

In total, 105/129 (81.4%) students completed the questionnaire (Box). The majority of students attended all or most lectures (89/103) and also listened to recordings (89/101). The most common reasons for lecture attendance were to show professionalism and respect for the lecturer (70/105), and the lecturer’s reputation as a teacher (62/105). Students’ most common reasons for not attending lectures were to listen to recordings at their own pace (61/101) and to improve productivity (52/101). Students valued using recordings to listen to segments that they struggled to understand (65/100) and to pause recordings to look up information (63/100). If recordings replaced lectures, students mostly used the time saved to study other material (56/99) and to exercise (41/99).

When deciding on lecture attendance, students appeared to weigh up the benefits for learning and demonstration of respect and professionalism against the perceived inefficiency of attending in person. Students generally desired to be actively involved in learning while at the hospital. Listening to lecture recordings improved productivity by allowing students to fast forward through familiar sections and avoid lecture days with long breaks. It also enabled students to improve learning effectiveness by reviewing segments that they misunderstood and pausing to look up information or take notes.

Revised teaching methods are required to assist digitally oriented learning and facilitate students’ preparedness for a technology-rich clinical environment.3 A flipped classroom approach, whereby students use digital learning resources to prepare for interactive teaching sessions based on case discussions, combines flexible and active learning.4 Understanding the learning habits and expectations of medical students and trainees is important for adopting targeted, effective teaching strategies.5

There were limitations in our study and, although we believe the results are generalisable, we recommend that further research be conducted with more participants in different settings using a validated questionnaire. Additionally, the impact of contemporary learning habits and digitally oriented learning on clinical proficiency requires evaluation.

Box –
Student responses to questions assessing reasons for lecture attendance and use of audio recordings

Reason	No. of students

Most important reason for attending live lectures (n = 105)
To show professionalism and respect for the lecturer	70
Lecturer’s reputation	62
To talk with classmates	56
To actively participate and/or feel involved	44
I learn better live	37
Not motivated to listen to the audio recording on my own	35
Most important reason for not attending live lectures (n = 101)
To listen to lectures at my own pace	61
To listen to lectures at any time of day/structure my day to improve my productivity	52
So I can use learning methods that work better for me	49
So I can set my own learning priorities	33
To set my own priorities	24
So I can study around family commitments	19
Most important reason for using audio lecture recordings (n = 100)
To listen to lecture segments I didn’t understand or missed	65
To pause to look up information	63
To revise for exams	61
To pause to take notes	60
To save time (more efficient)	56
To focus better	46
Most important activity enabled by replacing live lectures with audio recordings (n = 99)
Study other material	56
Exercise	41
General relaxation	24
Spend time with friends or family	24

[Comment] Offline: The uses of disease

Health is good. Disease is bad. So we are taught. The panoply of a doctor’s education and training, indeed the whole hypertrophied industry of medicine, is founded on these two assumptions. But perhaps we should also view disease as an ally, a state to be explored, even cultivated. I do not mean we should tolerate pain or distress. Yet maybe disease creates possibilities for life that might otherwise be denied to us. In his Journals (July 25, 1930), André Gide wrote: “I believe that illnesses are the keys that can open certain doors for us.

Labor’s antifreeze policy puts heat on Coalition

Main points

Labor promises to resume Medicare rebate indexation
Policy to cost $12.2 billion over 10 years
Welcomed by AMA as a win for patients

Labor has pledged to resume indexation of the Medicare patient rebate from 1 January next year if it wins the Federal Election, in a $12 billion commitment hailed as a big win for patients.

Seeking to outflank the Coalition on health, Opposition leader Bill Shorten has announced that a Labor Government would lift the Medicare rebate freeze and reinstate indexation, at a cost of $2.4 billion over four years and $12.2 billion over a decade.

The announcement came just days after the AMA launched a national campaign against the freeze, warning it would force many GPs to abandon bulk billing and begin charging patients up to $20 or more per visit.

“Nobody wants to head down the same path as America when it comes to our health system,” Mr Shorten said. “We will reverse Mr Turnbull’s cuts, which will reduce bulk billing and hit Australian families every time they visit the doctor.”

AMA President Professor Brian Owler said Labor’s announcement established a “real difference” between the major parties on health policy.

“Labor’s promise to lift the Medicare rebate freeze will be welcomed by doctors – GPs and other specialists – and patients across the country,” Professor Owler said. “Patients are the big winners from this announcement, especially working families with a few kids, the elderly, the chronically ill, and the most vulnerable in the community.”

In its Budget unveiled earlier this month, the Government announced that it would save $925 million by extending the Medicare rebate freeze, already in place from 2014 to 2018, through to 2020.

Medicare rebates were first frozen by Labor in November 2013 for eight months, but they have since been extended twice by the Coalition Government after failing in its attempts to introduce a patient co-payment.

Professor Owler said the freeze amounted to a “co-payment by stealth” by forcing medical practices to dump bulk billing and begin charging patients if they were to remain financially viable.

He said that for years GPs have done their best to shelter patients from the impact of the freeze, but the decision to extend it to 2020 would push many medical practices over the edge.

“Many GPs are now at a tipping point. With the freeze stretching out for seven years, they have no choice but to pass on the increased costs of running their practices to patients,” the AMA President said. “The Medicare rebate freeze is bad policy, and it should be scrapped.”

Bulk billing climbs

Last week, Health Minister Sussan Ley trumpeted official figures showing the GP bulk billing rate climbed to 84.8 per cent between July last year and March this year to argue that the Government was investing heavily in Medicare.

But Professor Owler said that the Government’s Budget decision to hold Medicare rebates down for a further two years was causing medical practices across the country to reconsider their finances and billing arrangements.

“The extension of the freeze for another two years under the last Budget has prompted many doctors now to contact the AMA requesting our help to transition them from bulk billing practices to ones that charge a fee,” he told Sky News. “Unless the freeze is lifted, I think we are going to see more costs being passed on to patients and so that’s why Labour’s announcement today is indeed very welcome by GPs but I think also by patients around the country.”

Labor’s promise has been costed by the Parliamentary Budget Office, and Opposition said it would be paid for by scrapping the $1000 bonus for single-income families with a child younger than one year, (saving $1.4 billion over 10 years), capping vocational education loans at $8000 ($6 billion over 10 years) and axing business tax cuts, saving more than $4.7 billion over four years (Labor would retain some relief for businesses with a turnover of less than $2 million).

The funding arrangement means Labor will be able to campaign on the claim that it is putting access to primary health care before tax cuts for business.

“This is about choices,” Shaodw Helath Minster Catherine King said on ABC Radio. “People get sick. We want people to go to what is in fact, the cheapest and most efficient part of our system, your GP, to stay well, to manage your chronic conditions, manage episodic illness, because if we don’t do that, people end up in the more expensive part of the system, the acute system where we are again, facing increasing demand.”

Ms King said that by reducing the barriers to people seeing their GP, the policy would help contain the growth in health costs.

“What we want to be able to do is actually have as many people going to your general practitioner because it is our cheapest part of the system, frankly. It’s the most efficient part of the system,” she said. “We want people to go for prevention. We want people to go and get advice about how do you manage obesity, if you find that you’ve got heart disease in the family, we want them to go and use the Medicare system to stay well and that is how you contain costs in the more expensive part of the system, our hospital system, by actually keeping people well.”

But Labor has so far resisted calls to reinstate bulk billing incentives for pathology and diagnostic imaging services.

Adrian Rollins

A campaign to improve the mental health of medical students

Australian medical students responded swiftly and effectively to the increased burden of mental illness in the medical profession, which was highlighted by the 2013 beyondblue National Mental Health Survey.1 In 2012, medical student representatives from Australia’s 20 medical schools passed a health and wellbeing policy,2 then in 2013, voted student mental health as a top advocacy priority for the Australian Medical Students’ Association (AMSA), choosing to advocate for the mental health of all tertiary students through development of the AMSA Mental Health campaign.

The four key aims of the campaign were to: (i) decrease stigma and increase awareness and mental health literacy among students; (ii) promote preventive measures to improve coping strategies and resilience; (iii) enable and empower students to look out for their peers and take positive action; and (iv) facilitate improved access to and uptake of mental health services.

Our advocacy strategy targeted the general public through broadcast and print media, the medical community through medical literature and conferences, and students through social media and on-campus events.

University campuses are geographical foci for at-risk young people and are therefore ideal sites for implementing effective preventative and early intervention strategies.

A “National Vice-Chancellor Tour” involved meetings of AMSA representatives with Vice-Chancellors (or their nominated representatives) from 12 of the 20 Australian universities housing a medical school. The purpose of these meetings was to explore the experiences and attitudes of the universities towards mental health. University mental health strategies varied greatly in their scope, complexity, student consultation, evidence base, and investment.

Blue Week, a grassroots component of the campaign, aimed to destigmatise and catalyse conversations about mental illness by engaging students on university campuses and in hospitals with blue-themed events and activities. In 2014, Blue Week ran at 17 medical schools, and over 5000 students participated. Activities varied, and included comedy, yoga, meditation classes, massages, guest speakers, and blue-themed parties. Although events were held throughout the year, a national online Blue Week was held during Mental Health Week (6–12 October). During this week we shared and distributed infographics, such as the poster shown in the Box, and over 200 people shared personal experiences and advice on social media. The online Blue Week reached over 90 000 people and engaged over 11 000 in at least one of its components.

AMSA also produced the second edition of the medical student wellbeing guide, Keeping your grass greener;3 coordinated the AMSA Mentor Network; ran Academy of the Mind, an online short course available to medical students internationally; and ran numerous student mental health workshops nationally and at conferences internationally.

The AMSA Mental Health website (mentalhealth.amsa.org.au/) and social media are ongoing focal points for students to access existing resources and information, blog articles,4 relevant news, and a comprehensive database of mental health services.

Although evaluation is difficult due to limited resources, the AMSA Mental Health campaign has engaged thousands of students and medical professionals in Australia and around the world. The campaign continues to grow and evolve, building momentum in the interests of student mental health.

Box –
An infographic distributed to participants during Mental Health Week

Benchmarking in Australia using the International Foundations of Medicine Clinical Science Examination

Demonstration of consistent standards in medical education is an important response to the increasing mobility of the workforce and the propagation of new medical schools around the world.1,2 Five Australian medical schools (at the universities of Adelaide, Melbourne, Sydney, Queensland and Western Australia) collaborated to perform a comparison across the subdisciplines included on the 2014 International Foundations of Medicine Clinical Science Examination (IFOM CSE).3

In 2014, a total of 1425 (of 1448) students in the final year of their primary medical degree at the participating Australian institutions took the examination. All schools used this examination as a formative assessment, although participation was compulsory at three schools. The lowest participation rate was 93% (155/167). The tests were delivered at different times of the academic year, with various administration conditions, including mode of delivery (electronic and paper-based).

The IFOM CSE consists of 160 multiple-choice questions created from items drawn from the United States Medical Licensing Examination (USMLE), which is produced by the US National Board of Medical Examiners (NBME). Results were collated into 18 profile scores, and the overall mean score at the five schools ranged from 502 to 549 (SD, 54–76). Eight students were excluded from analysis on the basis of a non-serious attempt, with a scale score ≤ 308 reflecting less than 30% of answers correct and guessing behaviour.

The NBME provides two comparisons to assist score interpretation — the mean and standard deviation for the International Comparison Group (ICG), which is made up of all participants in the test worldwide, and the equivalent passing score for Step 2 Clinical Knowledge (CK) of the USMLE, an extremely high-stakes examination in the US.4 While all Australian schools had a higher mean IFOM CSE score than the ICG, only 22% of students (311/1425) met the standard of competence equivalent to Step 2 CK of the USMLE. This result may be attributable to the difference in stakes between the two examinations, as well as differences in health systems and disease prevalence between the US and Australia.

As the collaboration shared de-identified data to protect the anonymity of schools, individual school rates for reaching the USMLE standard could not be assessed. There were too many differences in methods and timing of test administration to make substantive claims with aggregated de-identified data. The students from one school performed significantly lower (Z = − 3.34, P < 0.01) and those from another performed significantly higher (Z = 2.49, P < 0.01) than the overall mean score, despite fewer students in the higher performing school reaching the Step 2 CK standard. Both these schools had non-compulsory participation in the IFOM CSE.

To ensure that comparisons by subdiscipline across the medical schools reflected curriculum effects rather than student abilities, the scores were anchored to the overall mean score for the five schools (ie, 528). The adjusted subscores by subdiscipline showed very little variation between the five schools.

Longitudinal data obtained over time will reveal whether our results reflect stable curriculum effects. The Australian medical schools that have participated in the IFOM CSE have found it useful and informative.5 By sharing our results to conduct these comparisons, we have identified further how these data may inform curriculum decisions. For example, if the school that performed better than expected on the preventive medicine and health maintenance section is shown to consistently do so, course content could be shared to allow improvements in medical programs for all involved in the collaboration.

[Correspondence] Iran and science publishing in the post-sanctions era

After Iran and a group of six other countries signed a landmark nuclear agreement in July, 2015, with the aim of lifting sanctions imposed on Iran for a decade, the future of science research in Iran has become a major topic of interest among academics and policy makers worldwide. It will now be interesting to explore and understand what can be expected of scientific development in Iran now that the sanctions have been lifted. Although the sanctions might have led to national advancements in some specific research fields, they have also had serious side-effects on higher education in Iran.

[Editorial] Transforming primary care

Last week saw two important publications on primary care in the UK. The General Practice Forward View, published by NHS England and developed in partnership with the Royal College of General Practitioners and Health Education England, sets out a plan to transform general practice over the next 5 years. Backed by an extra £2·4 billion a year, the plan outlines steps to increase the number of general practitioners (GPs) and co-workers, as well as measures to reduce workload stresses, develop infrastructure, and support care redesign to enable increased access to GPs.

[Correspondence] The GAS trial

This letter represents a consensus response study from the Safe Anesthesia For Every Tot (SAFETOTS) initiative which addresses the need for teaching, training, education, supervision, and research inot the safe conduct of paediatric anaesthesia.1

News briefs

Gender differences in pre-hospital care

A Swedish study published in BMC Emergency Medicine has found that female trauma patients were less likely to be given the highest pre-hospital priority, the highest pre-hospital competence level, and direct transport to the designated trauma centre compared with male trauma patients. A retrospective observational study based on local trauma registries and hospital and ambulance records in Stockholm County, Sweden, was conducted. A total of 383 trauma patients (279 males and 104 females) over 15 years of age with an Injury Severity Score (ISS) of more than 15 transported to emergency care hospitals in the Stockholm area were included. Male patients had a 2.75 higher odds ratio (95 % CI, 1.2–6.2) for receiving the highest pre-hospital priority compared with females on controlling for injury mechanism and vital signs on scene. “We found differences in trauma mechanism between genders, namely, that the second most common trauma mechanism for females was a low-energy fall (26.9 %) … Perhaps this might be one of the reasons why females, despite severe injury, are not recognised at scene as potential severe trauma patients since the trauma mechanism is considered to be of low energy. Recognising gender differences with educational efforts and in pre-hospital trauma management protocols may expedite the trauma care of female patients.”

Bad hair day in space for some astronauts

Research published in PLOS One has found that spaceflight alters human hair follicle gene expression, leading to a possible “inhibition of hair growth in space”, particularly among male astronauts. “We found that FGF18 expression in the hair follicle changed during spaceflight. Hair follicle growth during anagen is strongly suppressed by the local delivery of FGF18 protein. Epithelial FGF18 signaling and reduction of expression in the milieu of hair stem cells are crucial for the maintenance of resting and growth phases,” the authors wrote. They also found that “FGF18 expression is known to decrease in growing hair follicles; the increase in FGF18 expression in several astronauts during flight potentially reflects a temporary arrest in the hair growth cycle; FGF18 expression appears to be very sensitive to whether an astronaut is in space or earth-bound; FGF18 easily recovered to baseline levels after returning to Earth”. Gender also has its effect, they found. “Although there are many differences such as hormone levels or functions between males and females, female astronauts appear to have a better response against the features of the space environment, as one example, FGF18 expression in females was more stable in space than in males.”

FDA clears experimental Zika blood test for use

The US Food and Drug Administration (FDA) has announced that it will allow the use of an experimental test to screen blood donations for contamination with the Zika virus, the New York Times reports. Puerto Rico, who had halted local blood donations and had imported almost 6000 units of blood from the US, will therefore be able to resume local collection. Zika poses a special challenge to blood banks, the report said, because roughly 80% of people who are infected do not have symptoms. “A handful of cases of Zika infection via blood transfusion have been reported in Brazil. During the 2013 French Polynesian outbreak, researchers found roughly 3% of asymptomatic blood donors actually tested positive for Zika infection, which they deemed unexpectedly high. It is not yet known how commonly recipients of Zika-contaminated blood end up infected, or how they fare.”

ASR hip replacement case settles for $250 million

Hundreds of Australians implanted with a defective hip device will be eligible for a share of $250 million in compensation following the conditional settlement of a long-running class action, the ABC reports. A worldwide recall of DePuy ASR devices in 2010 involved around 100 000 patients worldwide and 5500 in Australia, with approximately 1700 of those patients eligible for a share in the settlement. The settlement was negotiated after 17 weeks in court, but has yet to be approved by the Federal Court. A lawyer speaking on behalf of those bringing the class action said hundreds of Australian patients had yet to have revision surgery and they were welcome to join the class action which will remain open for a period. “There was no admission of liability by the makers of the ASR DePuy hip replacements as a part of the settlement.”

Aileen Joy Plant

Professor Aileen Plant (1948–2007) was a renowned medical epidemiologist and an outstanding global public health leader

In mid-March 2003, hurrying through Perth Airport on her way to a World Health Organization assignment, Professor Aileen Plant paused to write out her will. She asked the airline staff to witness it before boarding a plane for Hanoi. Her task was to lead a team trying to bring Vietnam out of its sudden nightmare of the deadly disease of severe acute respiratory syndrome (SARS), an illness that no one knew the cause of, nor how it spread. The person she was replacing, Dr Carlo Urbani — who had identified the new syndrome — lay sickened by it in a hospital in Bangkok.

Aileen knew that speed was essential. The effectiveness of the tasks of early detection and prevention of transmission would require a cohesive and willing team, which in turn would require the trust of the Vietnamese Ministry and the Vietnamese health care workers. This, she achieved.

On 29 March, Dr Carlo Urbani died. Dr Katrin Leitmeyer, virologist, recalls how Aileen rallied everyone, “gluing extreme characters from all around the world together under difficult psychological circumstances”.

The 3-week mission became 11 weeks. Vietnam had 69 cases of SARS and five deaths, mostly in staff and patients of the Hanoi French Hospital. During this time, Aileen’s sister, Kaye, became gravely ill in Perth. Aileen was desperate to be with her but knew that, even if she did return to Australia, she would not be allowed into any hospital.

Under her leadership, the Hanoi team characterised the clinical features of the disease, its incubation period and possible routes of transmission, and made important observations about the effectiveness of case isolation and infection control in halting transmission. On 28 April, Vietnam was declared SARS-free, the first country to eradicate the disease. The Vietnamese government awarded Professor Plant its highest award, the National Medal of Honour.

Aileen said of her experience that two things stood out. The first was that the Vietnamese government agreed that external help should be sought — an extraordinary admission in communist Vietnam at that time. The second was the dedication of the Vietnamese staff, who quarantined themselves in the hospital and worked with little in the way of modern technology or resources. Aileen thought they should have been awarded the Medal, rather than her. Her own keen sense of family no doubt contributed to her great respect for the grief and isolation of any individual. Finally, in June, Aileen was able to return home to her recovering sister.

Other WHO assignments in which Aileen was involved included investigating an HIV outbreak in children in Libya, childhood dermal fibromatosis in Vietnam, yellow fever outbreaks in Africa, tuberculosis trends in Indonesia and the emergence of avian influenza in Asia. She also began seminal work with the WHO on the International Health Regulations (IHR), to frame the relationship between countries and the WHO in regard to preparation and response for public health events of international concern, and continued work on the Global Outbreak and Alert Response Network (GOARN), which she had helped establish in 2000. Both are key tools in global biosecurity today.

Aileen came from a large family and left school at the age of 15 to work on her parents’ farm in Denmark, Western Australia. She became interested in infectious diseases, telling her father that an animal had died of eastern equine encephalitis. This became a family joke, as the animal in question was a cow. She took up work as a bank teller for 5 years but became determined to study medicine, putting herself though technical school and gaining entrance to the University of Western Australia.

Her early years as a resident doctor in the Northern Territory sparked her interest in Aboriginal health. She became firm in her belief that it was essential for the overall health of humanity to understand and care for vulnerable populations. Already evident to her colleagues by this time were her razor-sharp “bullshit detector”, her interest in all matters and her keen sense of humour.

Professor Aileen Plant with Professor Lance Jennings on a World Health Organization mission to investigate a cluster of H5N1 influenza cases in Vietnam in 2005.

Aileen went on to study at the London School of Hygiene and Tropical Medicine. On returning to Australia, she obtained a Master of Public Health at the University of Sydney, eventually joining the faculty as a lecturer, while also working with the New South Wales Department of Health.

In 1989, Aileen took up the position of Chief Health Officer in the NT. Although frustrated by politics, she kept her focus on Aboriginal health, pointing out the flaws in census methods and analysing a decade of data demonstrating health trends and causes of premature mortality in Aboriginal communities.1,2 Her 1995 report called for a whole-of-community and government approach to the poor health trends in Aboriginal and Torres Strait Islander populations.1

Among Aileen’s gifts was the ability to see the truth, or the way to the truth, in science, diplomacy and politics. Science was her bedrock, and diplomacy she saw as an everyday necessity from which wonderful friendships could grow. Bad science and politics tired her, perhaps due to the famous bullshit detector constantly being triggered.

In 1992, Aileen took up the position of Director of the Master of Applied Epidemiology (MAE) Program at the Australian National University, a program she had played a key role in initiating and developing. During her 3 years there, she completed her own PhD, guided many masters and doctoral students, and worked with her colleagues to develop a program on Indigenous health and in attracting Indigenous students. She convinced a colleague in the NT, Dr Mahomed Patel, to join her, developing pathways for international students and obtaining overseas placements for Australian trainees, including deployments with the WHO and establishing MAE-like programs in India, China, Malaysia and Vietnam.

The MAE Program has served the world exceedingly well, with many of its students, staff and graduates contributing to the control of SARS, avian influenza and other public health emergencies. Many of Aileen’s students are now leaders in public health, nationally and internationally.

In 1995, Aileen moved back to Perth to be with her much loved extended family. She worked initially as a senior lecturer at the University of Western Australia before becoming professor of international health at Curtin University in 2000. Together with Professor John Mackenzie, a world-renowned virologist, she compiled an ambitious bid to establish a cooperative research centre (CRC) with a focus on emerging infectious diseases. After two arduous attempts, their bid was successful. The Australian Biosecurity CRC for Emerging Infectious Disease was established in 2003, bringing animal, human and environmental disciplines together in research. Over 7 years, the CRC had many high-impact achievements, including extensive research into the ecology of disease emergence, the development and application of diagnostic tools and systems, and important work on Hendra virus, coronaviruses and influenza viruses. Translational research — taking research into action and policy — was a centrepiece. The CRC awarded over 60 postgraduate scholarships to students in Australia and South-East Asia.

During this time, Aileen continued to assist the Australian Government Department of Health and Ageing, including in emergencies such as the Asian tsunami, where her ability to see the path forward encompassed areas beyond public health. In 2008, the Department named its new crisis response centre the Aileen Plant National Incident Room.

Aileen’s comments usually went to the heart of the matter. Radio host Phillip Adams, interviewing Aileen on ABC RN Late Night Live, asked her whether authoritarian or democratic governments would be better at handling outbreaks. She replied that it depended on the characteristics of the disease and its transmission mode. Diseases like SARS, she noted, are shown to be well handled by authoritarian governments if backed up by a good public health system, but something like HIV–AIDS, which requires behavioural change, is better handled by democracies. She repeated the point, “Wherever they are, infectious diseases always make poor people poorer”.3

Aileen continued to work with the WHO on finalising the IHR, which were endorsed in 2005 and are now signed by over 190 countries. Many of the articles of the IHR reflect the cooperation and information exchange exemplified by Aileen’s time in Vietnam.

Professor Aileen Plant with Professors John Mackenzie (Curtin University), Mal Nairn (Charles Darwin University) and Charles Watson (Curtin University) at the opening of the Queensland node of the Australian Biosecurity Cooperative Research Centre in 2004.

In addition to 90 scientific articles and numerous book contributions, Aileen co-authored a book on the impact of SARS and another on the approach to communicable diseases.4,5 Aileen’s delight was to do projects with her friends and family, and their interests were hers, be they research projects, scientific books, teaching friends’ children to swim, writing creative fiction or designing tree farms.

Aileen died suddenly at Jakarta Airport on 27 March 2007, while travelling home from a WHO meeting, where she had helped to bring about consensus on the issues of sharing avian influenza viruses and access to influenza vaccine for developing countries.

Her spirit and values live on in her colleagues and her students. The Australian Science Communicators honoured Professor Plant as the 2007 Unsung Hero of Australian Science. The University of NSW introduced the yearly Aileen Plant Memorial Prize in Infectious Diseases Epidemiology, an honour for emerging researchers. The Public Health Association of Australia, together with three other peak public health bodies, awards the Aileen Plant Medal for Contributions to Population Health at every Population Health Congress (4-yearly), and Curtin University grants Aileen Plant Memorial Scholarships for Indigenous students and conducts an annual oration, the Aileen Plant Memorial Lecture.

Aileen’s sister Teen, arriving at Jakarta Airport in 2007, remarked, “This is where Aileen died”. Another sister, Caro, replied, “No, she was in departures”. Even in their deep sorrow, they both laughed, as they realised how much Aileen would have liked that quip.

Editor’s note: We hope you are enjoying our series on remarkable and talented Australian medical women. We would love to hear your suggestions about subjects for future articles. Please email your ideas to us at mja@mja.com.au.