Letting the Student Voice Drive Teaching Innovation - Dr. Athanasios Hassoulas, Director of the Master of Science Psychiatry Program Cardiff University and Winner of a 2022 Osmosis Raise the Line Faculty Award

Michael Carrese: Hi everybody, I'm Michael Carrese. In this special episode of Raise the Line, we'll be talking to one of the winners of the 2022 Osmosis Raise the Line Faculty Awards, who was chosen from over 1,000 nominations we received from 377 institutions around the world,

with students and colleagues submitting videos and testimonials telling us how they embody the six Osmosis core values. I'm here today with Dr. Athanasios Hassoulas, director of the Master of Science Psychiatry Program and Digital Education Lead at Cardiff University in Wales. Thanks very much for joining us and congratulations. 

Dr. Athanasios Hassoulas: Thank you very much and thank you for having me. 

Michael Carrese: So tell us about your background and how you got started on your path to a career in education? 

Dr. Athanasios Hassoulas: Well, so in terms of how it all started, I guess I won't go all the way back. I'll start at the PhD. I did my PhD in obsessive compulsive disorder. I always had a kind of an interest in neuroscience, behavioral science, and I think it was at that point when I was doing my PhD, I realized that I was drawn to teaching. I enjoyed the research, but I think I was drawn to the kind of more teaching focused side of things. My supervisor at the time, Professor McHugh, couldn't make a lecture that she was meant to deliver. I remember it was on research and stats and I was kind of thrown into the deep end a little bit. But looking back, I really appreciate that opportunity and it kind of confirmed that education was definitely the area I wanted to pursue.

I did a little bit of postdoctoral work after that in Greece and the UK until I got my first lecture job at Cardiff University in 2014, as a lecturer in psychiatry. Whilst Cardiff is an excellent research institution, the focus on teaching excellence was something that really appealed to me and it was from that very first post that I had the opportunity to explore my kind of, I'd say, hopefully budding teaching innovation and experiment a little bit with that. So yeah, I think I always knew this was the area that I wanted to pursue, but it was Cardiff University's emphasis on teaching excellence that kind of really did bring it out in me. 

Michael Carrese:  We'll get into some detail on that and your innovative approaches to teaching, but I also want to know before we go any further about psychiatry. What drew you to that field? 

Dr. Athanasios Hassoulas: So, my background is in experimental psychology, and I have a personal experience with OCD.I was diagnosed with obsessive compulsive disorder as a teenager and I guess that's where my interest came into it because there is only so much I think that medicine on its own can do,there's only so much psychology on its own can do, but when you bring the two together -- the biological and neurobiological and the kind of environmental behavioral factors -- I think that's when you start to understand conditions of a psychiatric nature a lot better.And in my instance, the kind of neurobiological basis of OCD made a lot of sense for me, but also environmental factors helped my understanding. That's something that I was drawn to in a research sense. So I think that's something that I found interesting. Also I had a very close family member take his own life when I was sixteen years old. I guess at that age, you don't quite understand suicide and you don’t understand what would make someone take their own life. I think for me, that was confirmation that this is an area that I'd like to understand a lot better and perhaps even dedicate my future career to kind of ensure that we do something to intervene at an earlier stage.

Michael Carrese: Well, that's certainly a deeply rooted interest. So, your teaching, as we came to know from all the nominations, has inspired a lot of young health professionals and we were wondering who inspired you to teach? 

Dr. Athanasios Hassoulas: That's a big question. To teach...I would say many colleagues at Cardiff University. First and foremost, I think those who gave me my first gig, my first break at Cardiff University, Professor James Walters and Dr. Liz Forty. The first post I held whilst it was lecturing in psychiatry was very much teaching focused and that's something that I wanted, which is why I applied for the post. I found working with them really, really great and that's why I decided to stay at Cardiff. I went for a lecturer in medical education position, which I got and got to meet amazing people like the now head of school, Professor Stephen Riley, Professor Marcus Coffey and many others. They served as mentors for me, perhaps unwillingly. I wouldn't say that I modeled what I did on them. I think I observed their practice, but I followed my own routes and I think what I aspired to was the kind of passion that they have for teaching, and that's kind of rubbed off on me.

Michael Carrese: I was talking to you before we started recording this about having Dr. Riley on the Raise the Line podcast this summer. It was wonderful to talk to him about what attracted him to Cardiff, which is the sense of citizenship and social accountability and how that's been woven into the curriculum in a lot of ways and provided opportunities for the health students to be engaged in the community in lots of different ways. So, that's all wonderful background for them. 

Now comes the point where we're going to embarrass you and share with you some of the things that the nominees said. You received many, many testimonials from students and colleagues, and we have a snapshot here that I'm going to read: 

“At the heart of Dr. Thanasi's teaching ethos is the student experience, and he is expert at incorporating student feedback into iterative adaptions of his practice to enhance and enable their learning activities. He has led the development of innovative teaching approaches and the development of a student-centered approach to digital and blended teaching. His teaching methods are not only innovative, but they are always developed with a big focus on inclusivity, and this inclusivity is not only regarding students, but staff as well.” 

So what's your reaction to all that? 

Dr. Athanasios Hassoulas: I mean, it's really moving. It's really touching that, you know, someone would come up with all of that, and yes, it really makes me feel good that my teaching practice is having that impact on students and colleagues. 

Michael Carrese: What are you proudest of in terms of the innovations that you bring to teaching, and are there moments when you really feel like centering that student voice is paying off? 

Dr. Athanasios Hassoulas: Yeah. I think what I'm proudest of is that I like bringing creativity into things. So, thinking a little bit out of the box. I think that's potentially what the students like as well. I think we have moved away from the traditional, purely didactic way of delivering teaching, which is good. This is something that obviously platforms such as Osmosis is amazing in spearheading that. That has been an inspiration to me as well, in all honesty, because the way in which you bring students into the learning as active participants is something that I've tried to do in my practice, and I think what I’m proudest of is that. 

A few years ago when I was lecturing in medical education, one of my first attempts to kind of pilot a new approach was to bring students as co-module leads into one of the modules I led on, which may seem a bit controversial at first to some colleagues, but I felt that was important for the students to have a voice in terms of curriculum design and development. Obviously students come in with a lot of blue-sky thinking. That's great, and sometimes we need to put the brakes on that a little bit. But I think sometimes we become a little bit too grounded as academics, as educators, and thinking outside of the box does help when you have students on your shoulder, kind of giving you their perspective of how things come across, you know, from the other side of the lectern. 

That has kind of driven over the years what I've tried to do now in developing our Cardiff University School of Medicine's digital education group. That was launched just over a year ago. We call it HIVE -- Hybrid and Interactive Virtual Environment -- and I'm really proud of that because I think what we've done is we've really embedded within the school the notion that students have to be active participants, whether that be on the physical campus or the virtual. 

People hear digital education and they think, “Okay, it's all online,” which is not necessarily true. I think we live in an era now with so many platforms, so many digital tools at our disposal. You can't just rely on the forty-five PowerPoint presentation anymore. There's so much we can do, and I'm really proud of the group that I've helped create and the enthusiasm that colleagues have shown to get involved. I feel proud when someone presents a lecture using something different, something new, and the student feedback is great. That makes me feel really good.

Michael Carrese: Give us an example of students impacting the curriculum?

Dr. Athanasios Hassoulas: Well, the first time I piloted this was with the undergraduate medical program, and it was actually a unit of study on a head trauma case. So, a year two neurology type of unit of study. I appealed for student volunteers from our senior student cohorts to come forward and identify where they, in hindsight, felt there may have been some gaps in the curriculum, at least in the first phase, in the preclinical years. And that was really good because, you know, we are aware of where most gaps are. It was a new curriculum at the time as well, the curriculum for the 21st century that Cardiff had launched in 2013 or 2014. So it was around ’14 or ‘15 that I launched this initiative and as the years went by, the students were really insightful. 

For example, suggesting that we could touch a little bit more on stroke, and that's something that we have embedded within the curriculum. E-learning is something that was purely their idea. So, I was always in favor of these innovative approaches and liked the fact that it came from the students. The students also said they wanted bite-sized chunks of information. I think in essence, what they were telling us is that they wanted something like Osmosis offers that was tailored also to the learning outcomes that we offer at Cardiff University. Something that kind of reaffirmed and confirmed what many of us felt was needed, which was this kind of supplementary -- and also sometimes not just supplementary, but actually some of it mandatory -- e-learning that further enhanced their understanding of key concepts and is also engaging and interactive as well. 

Michael Carrese: Yeah, it really does seem like we're in an era now where students are partners more in learning than just being the recipients of learning. Would you say that's true? 

Dr. Athanasios Hassoulas: Definitely, definitely. In the medial program, students will eventually become educators working clinically. They will be teaching medical students inevitably, and the fact that we have so many of them coming forward and expressing kind of an interest in teaching and pedagogy and things that we deal with on a day-to-day basis is really inspiring to see as well. I think that needs to be harnessed and looked after. Students who come forward and have a passion in working as partners with staff is definitely something that I personally find valuable. 

Michael Carrese: Yeah, absolutely. So as you know, Osmosis has six core values: start with the heart, spread joy, have each other's backs, imagine more, open your arms, and reach further. We're wondering if there's one of those that you feel you embody and tell us why. 

Dr. Athanasios Hassoulas:  I really like the analogy with the anatomy, the various organs. I think what did stand out for me was the heart, the joy, the care. I think care is kind of the philosophy that underpins what I do. I wouldn't feel good if I deliver a session that students don't feel went very well. I care about the student learning experience partly because of my OCD, I think, but also because I'm passionate about teaching. And that care, I think, drives me to be better at what I do and I think that propels the innovation that I try to work on as part of my day-to-day job and encourage others to do as well. I also think I try to at least care about my colleagues' experiences. 

I know that being a lecturer, a professor these days is more challenging perhaps. I don't want to speak out of turn, but I remember when I was a student, our professors were revered for being experts in their fields, but they didn't necessarily have all the teaching qualifications and the emphasis on pedagogy that there is today. I think lecturers these days need that and professors need that. It can be overwhelming at times for colleagues who have their day-to-day job to also undertake this extra training to be good teachers, to be good educators. I think it's important that we work together as a team. So, yeah, I do care that colleagues may be overwhelmed at times and helping where at least I can. I think even if I make a small difference, I want to say that's enough for me. I know me and my OCD would want more than that, but… (laughs)

Michael Carrese: (laughs) Well, and on top of the pedagogy that they need to learn, there's also that whole layer of digital technology and learning how to teach effectively in a virtual environment, which you are intimately involved in. So that is a lot. 

Dr. Athanasios Hassoulas: Definitely, and you could tell that people were overwhelmed, especially when the pandemic first struck. It wasn't so bad for programs that had quite a prominent e-learning component. A lot of our postgraduate programs are like that. But for instance, the undergraduate programs and the medical program -- which is massive...you have 1,500 students across five years, and that's predominantly face-to-face -- going overnight into lockdown was quite overwhelming for a lot of people and I think that's what also served as a catalyst for our group, which is now known as HIVE. 

What we did initially was provide a few workshops to help colleagues with starting off with things like Zoom, which was new to a lot of people. Starting off with Teams as well, and then going on to kind of the more advanced stuff. We offered workshops in how to use various platforms in designing effective e-learning, how to create an interactive pre-recorded lecture with embedded activities within those, and how to make your live webinars more interactive as well and we've sort of carried that on now, even post-lockdown, post-pandemic, spilling over into the virtual campus as well. We don't want to lose that emphasis on the digital because, I think, as you've said, it is here to stay and it's only going to get more advanced. I know that a lot of schools now are looking at virtual reality, augmented reality, so you don't want to miss the boat, I think. 

Michael Carrese: We're not even going to get into chatbots and AI and all of that. So when you look ahead and think about your teaching and your career, what do you think is next for you? Do you anticipate continuing to evolve? What are some thoughts about that?

Dr. Athanasios Hassoulas: I think what I'm most passionate about is seeing our new digital education group, HIVE, adapts to its new post-pandemic existence and era. The next step is to collaborate with a few national and international partners we've established relationships with to look at how what we develop could be of use to perhaps students elsewhere. 

One example is the University of Cape Town. I'm working with a colleague there who has identified certain gaps in their students' knowledge which we could fill and vice versa, that they could help us fill those gaps through joint e-learning creation. I think it's that kind of networking, those links that we're looking to establish. I'm quite excited by all of that, and also ensuring that our students at Cardiff University have a great learning experience through interactive learning, whether that is synchronous, asynchronous, on the physical campus, or on the virtual campus.

On a personal note as well, I'm keen to also explore further opportunities in postgraduate education and senior roles there because, I'll be honest, I think there are junior lecturers coming in behind me who obviously they've got skill sets that surpass mine when it comes to coding and the digital stuff. I'd be more than happy to hand over what I've started to them because I think that's the way something grows. It's not to hold onto it, but to pass it on to people who can take it to the next level. 

Michael Carrese: That's very wise. So as you know, obviously we're a teaching company and we love to fill knowledge gaps. I'm curious to know if there's a particular topic that you're very interested in where you would say to us, “You know, Osmosis, why don't you make a video about that?” What would that be? 

Dr. Athanasios Hassoulas: That's a difficult one because you've made a lot of videos. We've got an Osmosis subscription for our students and they love it. I was telling my wife about it, who is a pediatrician, and I asked her to give me any medical topic. She went through almost everything she could think of and there was an Osmosis video about it. I don't think there's a video that you haven't made, but my personal interest is the kind of neurobiology of psychiatric conditions. 

Psychosis, OCD specifically, is my area of interest. I think that that is an area of interest for me because there's a lot of misinformation in terms of many psychiatric conditions. The one that I focus on is OCD because people will take it as kind of quirky behavior or a little bit of eccentricity. For instance, people enjoy cleaning...things like that. Whereas the neurobiology underpinning the condition and the distress that that kind of dysregulation causes is sometimes overlooked - not purposefully -- and indirectly diminishes the experience of people with these conditions. There's a lot of misinformation, not just with OCD. 

I think challenging the stigma is a big one in psychiatry. People, for instance, with schizophrenia are frequently, at least in the media, equated with being violent and we know that most of the time, people with the psychotic disorder have been on the receiving end of violence. I wouldn't say that's something that you haven't developed, but I think that's an area that -- at least in terms of society in general and contributing to a better understanding of psychiatric conditions -- I think that's an area that we all could do more in terms of addressing. But I'll be honest, I think millennials -- Gen Z, I think they're called, the latest generation -- I think they're a lot better at challenging the stigma than our predecessors were, and that's really nice to see. 

Michael Carrese: Yeah, I would agree with you there. What's your go-to advice for students

who are heading out on a health career? 

Dr. Athanasios Hassoulas: What I would say is, be open about your experiences. If you're feeling overwhelmed working in the health sector as a medical professional there are rewarding experiences, but you will have really, really rough days. It's important to talk about that and not to sort of isolate yourself, not only from others but from your own experiences as well, because you don't want to burn out. I think sharing your experiences, obviously not oversharing, but being open about what you're going through is really important and working as a team is key as well. I think you can only work as a team when you're open about what you're going through, address each other's weaknesses and play to each other's strengths. Be part of a team and be true to yourself. 

Michael Carrese: That's wonderful advice. So, as we wrap up here, I wanted to give you an opportunity to thank anybody -- imagine yourself on the Oscar stage accepting the award or in your case, BAFTA awards or something -- but are there some folks you want to give a shout out to? 

Dr. Athanasios Hassoulas: Yeah, I'll try not to make a really long Oscar acceptance speech here, but I think- 

Michael Carrese: (laughs)And I won't start playing music if it goes too long.

Dr. Athanasios Hassoulas: (laughs)Okay, that’s good to know. Tomorrow would have been my late dad's birthday and I think he's probably the first person I would thank because my mom and dad noticed something wasn't going quite well when I was a teenager. I think it was their early intervention that really helped me at least go through school, having received the support I needed, go through college, university and get to where I am today. So, without their early intervention, I can honestly say I wouldn't be here speaking to you right now. 

My sister has also been there. Seven years ago, my wife came onto the scene and I think she's been a great support whenever I'm bouncing ideas off of her to do with creating this or that resource. She's always there with a smile on her face, even though I know sometimes she's dying inside listening to me rant on. But yeah, she's always been there for me. 

And then my colleagues as well. I mentioned Prof. Coffey and Prof. Riley. They've been inspirational. Dr. Andreia de Almeida who I think submitted that quote that you read out. She's a new lecturer in our Center for Medical Education and I just find her passion for teaching inspirational. Many colleagues including Professor Anne Taylor, who's given me the opportunity to develop my skills in post-grad. 

And then there’s students. To be honest with you, I've been teaching at Cardiff University for eight and a half years and I can remember students who stood out from the first year I started. I won't list all of them, but students like Alex Hackney and Thomas Beresford, they were the student co-leads for that unit of study I mentioned. And then some inspirational students who have just gone above and beyond their studies: Miray, Ravanth, Srinjay...so many of them. I didn't used to go above and beyond when I was a student. I'll be honest. It's something that I kind of have grown into. But just watching these students go above and beyond and have the passion that they do, I find it inspirational. My thanks to all of them for being my inspiration as well. 

Michael Carrese: That's wonderful. It sounds like you're in a great spot...a supportive, creative place to do teaching and learning. 

Dr. Athanasios Hassoulas: I would say so, yeah. We have a new Dean of Medical Education, Dr. Jamie Reid, and he's been really supportive of everything that we're trying to do in terms of pushing the envelope when it comes to teaching innovation. I would say the support that we receive is invaluable. 

Michael Carrese: Well, I'm going to have to stop it there, but I want to thank you very much for joining us today. Congratulations once again on receiving this award. It's obvious why you were nominated for it and were selected, and we're just wishing you the very best in the coming year. We want to thank you for helping to train the next generation of healthcare professionals. 

Dr. Athanasios Hassoulas: Thank you, and thank you for everything that you do as well. It is really, really inspirational for our students.

Michael Carrese: Well, we appreciate that. I'm Michael Carrese. Thanks for checking out this special episode of Raise the Line. If you would like to learn about the other faculty award winners from 2022, please check out Osmosis.org/faculty-awards. And as always, remember to do your part to raise the line and strengthen the healthcare system. We are all in this together.