AI & Medicine
All readers
⏱ 32 min
2026-08-05
AI arrived in Kenyan clinical practice ahead of any plan for teaching clinicians how to use it. A 2025 randomised trial found that physicians who had already completed twenty hours of AI-literacy training still deferred to deliberately erroneous model output — which means the obvious curriculum is the wrong curriculum. This is my blueprint for a permanent national institution that would train and certify the clinical AI competence of an entire country's health workforce: five professional tracks, five gated levels, assessment by simulation and workplace observation rather than attendance, seventy-one core posts specified by qualification, and outcomes published whether or not they flatter us. No such institution exists anywhere in the world.
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AI & Medicine
All readers — no teaching background assumed
Kirkpatrickprogramme evaluation
2026-08-17
The tenth of the Institute's ten pedagogical commitments is one sentence long: we measure at Kirkpatrick 3 and 4, or we admit we do not know. This is the fourth companion to the blueprint, and it unpacks that sentence completely — starting from zero, for a reader who has never planned a course in their life. What the four levels are and why almost every training programme stops at the second one. What 'behaviour' means when the behaviour in question is a habit of mind. How you would actually observe, audit and log a student-clinician at three and twelve months without fooling yourself. Why the independent-impression rule is my candidate for the fastest-decaying thing we teach, and what would refute that. What a stepped-wedge design buys you, what it costs, and what to do when you cannot run one. And a working catalogue of the other pedagogical instruments — Miller, entrustment, programmatic assessment, Angoff, retrospective pre-post, logic models, audit and feedback — with notes on how each would be used here.
⏱ 41 min
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AI & Medicine
Educators and assessment leads
standard settingAngoff
2026-08-12
One line on one slide of my Level 1 deck reads: Standard set by modified Angoff panel (No arbitrary 50% pass rate). It is the least glamorous sentence in the whole curriculum and possibly the most consequential. This post unpacks it completely — what a cut score actually is, why 50% is indefensible and norm-referencing is worse, who the borderline candidate is and how you build one, the mechanism step by step with a full worked panel whose arithmetic you can check, what 'modified' really means (the usual story is wrong), what the 2025 meta-analysis of 91 studies says about which variant to choose, and precisely where Angoff stops working.
⏱ 21 min
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Deep Learning
Complete beginners
backpropagationchain rule
2026-08-12
Backpropagation is the algorithm that lets a neural network learn, and it is usually taught either as a wall of subscripts or as a vague story about errors flowing backwards. It is neither. It is one idea — if I nudge this, how much does that move? — applied over and over. This post derives every piece from scratch, assuming no calculus at all, and works a complete network end to end with numbers you can check on paper. By the end you will have built backpropagation in a spreadsheet and confirmed each derivative against a nudge.
⏱ 26 min
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AI & Medicine
All readers
OSCEAI-OSCE
2026-08-11
The blueprint I published last week rests on an examination that does not yet exist. This post explains the machinery it borrows: what an OSCE is, the problem Harden was solving in Dundee when he built the first one, why a written paper can never certify a clinical skill, and what changes when the thing being examined is a doctor's judgement about a machine. Along the way: what conjunctive failure means and why some errors cannot be compensated, why a standardised patient is a trained professional and not a volunteer, and why the pass mark is never 50%.
⏱ 21 min
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AI & Medicine
All readers
AI fluencyclinical AI
2026-08-10
The competency framework underneath my clinical AI blueprint was not built for medicine. It came out of an art school in Sarasota and a business school in Cork, developed by a novelist-turned-AI-coordinator and an information systems professor. That provenance is not a curiosity — it is the reason the framework transfers to clinical work at all. A framework built for medicine would have hard-coded medicine into it. This is what Dakan and Feller built, what I kept, what I reframed, and the one thing I had to add because creative work does not kill anyone.
⏱ 11 min
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Deep Learning
Advanced
transformersbackpropagation
2026-08-03
Every explanation of a transformer eventually reaches a line like loss.backward() and stops. This is the one that does not. I take a complete decoder-only language model written in NumPy — no framework, no autograd, every gradient derived by hand and checked against finite differences — and walk the whole of it: byte-pair tokenisation, layer normalisation, causal multi-head attention, the residual stream, the backward pass through attention, Adam, nucleus sampling, and the formula that connects a 27,861-parameter toy to a 175-billion-parameter frontier model without changing a single line of the mathematics.
⏱ 45 min
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Engineering
Advanced
hardware hackingmedical devices
2026-08-02
A single ESP32-S3 board the size of a business card, running open-source firmware, will speak nearly every wired bus and radio protocol an embedded medical device uses. This is how I use an M5Stack Cardputer ADV with BitPirate as a portable protocol workbench — to map hardware, watch a device boot, sniff its buses and radios, and pull its firmware — worked all the way through with an infusion pump, plus a targeted probing plan. Authorised, isolated, off the patient. The legal and safety constraints are not an appendix here; they are the first tool you pick up.
⏱ 30 min
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AI & Medicine
All readers
medical softwareKenya
2026-08-01
A third of my care-home specification did not survive one question: under which country's law does this run? Kenya now has a health-specific digital statute, a certification regime for the software itself, and a 72-hour breach clock. This is the work I do — building clinical software for Kenyan care homes and small hospitals that is lawful to deploy, capable of certification, and still standing after contact with the night shift.
⏱ 22 min
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