01.14 The newsletter of the Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine, Summer 2007
Issues and news on learning and teaching in medicine, dentistry and veterinary medicine
Print: ISSN 1740-8768
Online: ISSN 1479-523X
IN THIS ISSUE:
- Conference Call: ePortfolios, identity and personalised learning
- The virtual farm
- Student essay competition winners www.jisc.ac.uk
Other publication formats
This issue is also available as a low resolution PDF document suitable for printing.
Welcome!
The fourteeth issue of 01 sees the usual intriguing plethora of articles from you about the burning issues in learning and teaching in medicine, dentistry and veterinary medicine.The Subject Centre has been busy making plans for a forthcoming conference, here in Newcastle upon Tyne, centered on ePortfolios, identity and personalised learning.We are grateful to the Joint Information Systems Committee (JISC) for the funding enabling us to run the event, in February 2008 at no cost to participants and attendees.The one day conference promises to be an exciting event with presentations, posters and excellent networking opportunities in a grand Georgian building in the heart of the City Centre.We very much look forward to seeing you there. Dont forget that we love to get articles for the newsletter! Perhaps you recently presented a poster at one of the many great medical education conferences that we are privy to attend - you might consider turning that into a short 500 word article for 01. Do send your ideas to newsletter@medev.ac.uk, or give me a call to discuss on 0191 222 5888.
Suzanne Hardy
Senior Information Advisor
Contents
- CETL update:Transforming placement learning in health and social care
Susan J Lea, Director/Professor of Applied Social Psychology, Centre for Excellence in Professional Placement Learning, University of Plymouth - Student essay competition 2007 winner
Clare Mitchell,Medical student, University of Bristol - Workshop report: Professional development for medical and healthcare teachers: Meeting the national agendas for change
Clare Morris,Associate Dean; Judy McKimm,Associate Dean and Visiting Professor, Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire - CETL report: Centre for excellence in professional development through education research and technology (The ExPERT Centre)
Lesley-Jane Eales-Reynolds, Professor of Immunology, University of Portsmouth - VETNET lifelong learning network - challenges and opportunities
Sarah Field,National Co-ordinator; John Butcher, Eastern Region Manager,VETNET Lifelong Learning Network (LLN) - Mentoring as a means of encouraging personal development in dentistry
David N Bridgen, Professor of Health Sciences Education, University of Chester & Advisor for Postgraduate Medical and Dental Education, Mersey Deanery, University of Liverpool; Brian Grieveson, Postgraduate Dental Dean, Mersey Deanery, University of Liverpool - **Integrated Children’s Services in Higher Education (ICS-HE): Preparing tomorrow’s professionals**
- The virtual farm
Michael Begg, Learning Technology Section, College of Medicine and Veterinary Medicine, University of Edinburgh - ePortfolios, personalised learning and identity in healthcare education
- Congratulations to 2007 National Teaching Fellows in healthcare related subjects
- GMC/Gateways disability project
Suzanne Hardy, Senior Information Advisor, Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine - Conference report: Anatomy teaching - the cruellest cut of all?
Diana J Lawrence-Watt, Professor of Human Anatomy, Brighton and Sussex Medical School Stephen McHanwell, Professor of Anatomical Sciences, Newcastle University - The learning disability open meeting - Service users, carers, inter-professional partnerships improving leadership, practice, education and service delivery
Jim Blair, Senior Lecturer Learning Disabilities, Kingston University and St.George’s, University of London - Using blended learning to accommodate different learning styles
Eddie Gulc, Senior Adviser, Higher Education Academy - Forthcoming educational events and conferences
- Workshop programme
- Educational funding opportunities
Student essay competition 2007: What advice would you give to students starting your course?
We would like to congratulate the winner and runners up to the Subject Centre for Medicine, Dentistry and Veterinary Medicine annual student essay competition 2007.
Winner: Clare Michell, University of Bristol.
Runners up: Niamh Fogarty (Veterinary Medicine), Glasgow University; Rhianydd Williams (Medicine) Brighton and Sussex Medical School; Viren Bharkhada (Medicine) Birmingham University.
The winner went forward to the national competition, and attended the Higher Academy Conference 2007, at Harrogate, where the overall winner was announced. The runners up all received book tokens and both winner and runners up were awarded certificates from the Higher Education Academy. The reviewers commented that the standard of essays was excellent, and the entrants provided a set of unique and insightful commentaries on their experiences, with useful and practical advice to new students starting out on programmes of study in Medicine, Dentistry and Veterinary Medicine. Here we are pleased to print the winning essay which represented this Subject Centre at the national competition.
Winning essay: Clare Michell, Medical student, University of Bristol
Medical school: a plunge into the deep unknown?
At school you were all big-fish-in-asmall- pond; now-you-are-simplytadpoles- in-a-reservoir!
These were some of the first words I heard on my arrival at medical school. At the time I didn t really understand what the Clinical Dean meant by them. However; five years later I realise how true they were. It is not that medical school is particularly intimidating; but it is a very different environment from that of school, and I think it is important that young people starting their medical training are aware of that. It is certainly an exciting time. You arrive having survived the stress of A levels; had three months of complete freedom; and are now embarking on a training programme that most aspiring medical students have been dreaming about for years. Nonetheless, the first few months at any university can be daunting, and so any advice that more senior students can offer to our younger colleagues is a bonus. For this reason I want to suggest a few handy tips to surviving medical school based on my own experiences.
*Tip 1: Enjoy your first year; but don’t forget those exams!*
I recall my first year at university with immense fondness. I had friends from a wide variety of different courses and I thoroughly enjoyed my new found independence. In fact it continues to amaze me how much stamina we all had. We were out most evenings but still managed to be up for the 9am lecture the next day! Words of warning however; do not lose sight of the real reason why you are at university. I got a little carried away with the all the fun I was having and to my despair failed one of my 1st year exams. I couldn t believe it! I had never failed an academic exam in my life, and yet there I was standing in front of the notice-board and staring at my candidate number on the referred list. I went to see the Pre-clinical Dean the next day and came away from our meeting feeling even more desolate than I had the day before. I would have to re-take the exam in August, but what really upset me was how impersonal the whole state of affairs seemed. Unlike school where the teachers knew me well, I felt I had been relegated to a simple number and had no-one to turn to for support. This is, unfortunately, a relatively common feeling amongst my peers. Our large number has made the personal tutor scheme a logistical nightmare and has resulted in us having very little contact with staff. However; things improve as you progress up through the medical school as you gradually build up your own relationships with professionals. It is also reassuring to note that the issue of pastoral care during the pre-clinical years has recently been re-addressed and improved. With the benefit of hindsight; although horrible at the time, the episode was probably for the best. It gave me such a fright that I have worked hard for exams ever since and consequently done reasonably well. I would just suggest to any young students that it is probably best avoided!
Tip 2: Continue any extra-curricular activities.
Studying medicine requires a balance between academia and leisure. I have continued to play sport at university level throughout my training and have thoroughly enjoyed it. It has offered a welcome change to the hospital corridors and provided an opportunity to meet undergraduates of all ages studying different disciplines.
Tip 3: Intercalate if you can.
Not all medical schools offer the opportunity to take a year out of medicine to study for a BSc, but I would certainly recommend it. I decided on Physiology and have not regretted my decision. It was hard work, but the close contact I had with my personal tutor was excellent. He gave me a lot of useful feedback regarding my critical writing skills which has become invaluable in the latter years of the course.
Tip 4: Enthusiasm and patience go a long way.
During the clinical years you find yourself spending a lot of time hanging around. I have always found this frustrating, and it can dampen your dedication. However; whilst busy people, the majority of doctors enjoy teaching as long as you show an interest. It is also important to respect the nurses and reception staff. They are more often the experts and not you, and they can certainly make life a great deal easier if you develop a good relationship with them.
Tip 5: Practice makes perfect.
The most effective way to learn clinical skills is to do it yourself, and for this reason I would encourage students to volunteer as often as possible. Certainly my anaesthetic placement was one of my favourites. This was not because I particularly want to do it as a career, but because I was urged to try things on my own. I clearly remember being asked to mix up some antibiotics. It sounds simple enough doesn t it? Yet I still managed to push the liquid so hard into the enclosed container that it exploded all over the theatre floor! At least I did it then and not as a qualified doctor... that really would be embarrassing!
Tip 6: Learn as you go along.
Medical training can be academically demanding, especially because of the large volume of material one is expected to learn. Over the years I have discovered that a good technique is to learn topics as you come across them in clinical practice. Associating things with certain patients seems to facilitate the learning process. Through the above suggestions I hope to have highlighted issues that I think are most pertinent to those embarking on a medical course at university. My intention is to demonstrate that, as long as you are prepared to be enthusiastic and to work hard, medicine can be enormous fun and highly rewarding. In the light of the current uncertainty surrounding the new Modernising Medical Careers scheme, this is of particular importance. It is distressing to see so many junior doctors so disheartened by the system, but I have confidence that the situation will improve with time, and therefore it is important to continue to encourage young people into the profession. For details of next year’s competition, contact enquiries@medev.ac.uk or go to: www.medev.ac.uk/resources/proposals/competitions/
Workshop report: Professional development for medical and healthcare teachers: Meeting the national agendas for change
Clare Morris,Associate Dean; Judy McKimm,Associate Dean and Visiting Professor, Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire
This workshop aimed to explore the needs of staff/educational developers. Most participants worked in Higher Education Institutions, with representation from medical Royal Colleges and the NHS.The day was facilitated by the authors and Nigel Purcell from the Subject Centre.
Aims
To provide a forum for:
- Comparing practice and identifying potential resources available.
2. Exploring the educational and professional development needs of those designing and delivering healthcare education.
3. Discussion of identified core topics of interest, such as course design, assessment, eLearning, meeting the needs of clinical teachers, reflective practice, widening participation and interprofessional learning.
Activity: Mapping exercise
Mapping involvement in educational development revealed two distinct cohorts
- Those with specific educational development roles, e.g. those running teaching the teachers activities and/or Masters or Doctoral level programmes in clinical education.
2. Those who had an interest in identifying (and /or addressing) educational development needs of those engaged in UG/PG education and training.
Three key areas were identified where delegates could share expertise:
1. eLearning.
2. Interprofessional education.
3. Medical education development.
Presentation and discussion: Context setting - exploring the national agendas for change
The session focused on changing agendas in UG and PG education and training including:
- Increasing student numbers across dispersed sites.
- Impact of national strategies e.g. HEFCE e-learning strategy, widening participation agenda.
- Emergence of national standards for HE teachers.
- PgCerts in Learning and Teaching in over 90% of UK HEIs, mainly for new lecturing staff.
- Educational/staff development often delivered by standalone units in HEIs.
- Divide between educational/staff development.
- Rapid ongoing reform of medical education and training.
- Increasing ‘professionalisation’ of teaching in the context of medicine at all levels of education and training.
- Explicit career pathways in academic medicine/medical education.
- Proliferation of M level programmes in Medical/Healthcare Education.
Delegates were asked what was missing. Dual agendas and competing demands on HE and NHS based teachers (e.g. tensions between research & teaching or service & teaching) were noted along with concerns arising from the changing face of healthcare and impact on opportunities for workplace learning. This included the reform of medical education and training; capacity issues due to increasing undergraduate places; the increase in international graduates; the interprofessional agenda and the emergence of new professional roles in medicine and health. Capacity issues were identified in relation to new contracts, specifically to financial implications for engaging in education & training and levels of NHS activity. The potential impact on training places with the emergence of more non-NHS providers and a concern for Foundation Trusts opting out of education/training roles was discussed along with CETLs and their potential impact within and across institutions.
Activity: Soap box debates
Delegates focussed explicitly on educational development issues, and were assigned groups to work up soap box debates, arguing the case for and against three aspects:
1. Discipline specific educational development
For: As education and training happen in specific contexts, educational development activity should reflect them and use situated examples.
Against: There are common learning principles across subject areas and within one professional group there are disciplinary/contextual differences that can only be addressed by a learner centred approach. The importance of providing opportunities to engage with others working in other contexts/specialities.
2. Shared educational development
For: As teachers work together in service settings, it is important to provide opportunities for shared educational development, modelling the interprofessional agenda. Such approaches are resource efficient, providing opportunities to share knowledge, methods and expertise and enabling the development of new methods of working. By bringing teachers together across professional boundaries there is the potential for increased ‘lobbying’ to improve facilities and resourcing.
Against: The need to safeguard professional identities and agendas. Issues of status, power differentials, professional qualities and priorities may have a negative impact on group dynamics and fail to address specific professional needs, best addressed in profession specific groups.
3. Compulsory educational development for NHS/HE teachers
For: Subject mastery does not equal teaching mastery. Developing appropriate teaching knowledge, skills and attitudes requires a formalised educational process. With increased self-funding, students have a right to expect properly trained teachers in HE/NHS settings.
Against: Compulsion should be avoided. Not all teachers want to avail themselves of opportunities. Rather than looking at a threshold competence for all teachers, efforts and resources should target enthusiastic/potentially gifted teachers who elect to be there.
Facilitated discussion:What are the unmet development needs of educational developers?
A number of key issues were agreed:
- Keeping up with the literature.
- Opportunities to discuss/develop ideas from the literature.
- Developing the pool of educational developers.
- Mapping commonalities/differences and being aware of changes and developments.
- Support educational developers as change agents and educational leaders/managers - recognising skills deficit and finding ways to support the development of self and others.
- The need to network, exchange ideas, share resources, team teach, mentor.
- Raising awareness of engagement in research by mapping what is happening/interests, identifying collaborative partners.
- The need to develop as a reflective practitioner - and enable others to be reflective/reflexive.
- Seek international perspective, develop networks and contacts overseas.
- A directory of interests/expertise.
Break out activity
The emphasis then shifted to consider specific ways in which educational developers’ needs might be met by the possible formation of a network and to discuss what support such a group might need. This session aimed to identify the purposes of a network, the methods and practices it might use and the support required.
- Purposes of the network:
- counteract isolation and loneliness
- share practice, innovations and experiences and raise standards
- networking
- identify ‘experts’ in the field
- forum for developing, swapping and evaluating resources
- a means of establishing or determining direction in staff/educational development, of offering professional leadership and support, of influencing policy and lobbying
- peer review
- career paths and development
- raising the profile of staff development
- developing theory.
- web based database of individuals
- mailing list with contact details, phone numbers etc
- face to face meetings - develop relationships with others - a mix of local/regional/national meetings
- buddy system/team teaching
- publications
- bid writing
- research database
- journal clubs
- structured discussions and email list
- chatrooms/weblogs
- lobbying power and direct action
- shadowing/visits to other colleagues
- ideas club
- question of the week.
- Support needed:
- good leadership - co-ordinator/commissioner
- funding
- IT resources
- think tank
- online facilitator
- website
- regular updates
- venues to meet in attractive locations
- links to influential people and institutions, access to power, links to ASME/AMEE/GMC/GDC/HNC/SEDA etc
- conferences/streams
- time for CPD.
Plenary
It was agreed that it would be helpful to:
- Form a network for education developers in healthcare education.
- Discussions should be held in relation to the Resource Archive for Teacher Trainers (RAFTT) project, because it would be more effective to link any new network with RAFTT.
- A steering group should establish aims and purposes, inform other individuals and organisations that have shared interests, set up events and discussion groups and develop a web-based directory of interests.
- Events could be held at different schools, for example those with examples of good practice or who have CETLs, and could be structured around a tour of the facilities and activities coupled with a meeting around specific topics with expert speakers.
It is planned to hold a second meeting for staff and educational developers in Autumn 2007 with a focus on leadership. For more information please contact nigel@medev.ac.uk
CETL report: Centre for excellence in professional research and technology (The ExPERT Centre)
Lesley-Jane Eales-Reynolds, Professor of Immunology, University of Portsmouth
The ExPERT Centre (Excellence in Professional development through Education, Research & Technology) is a Centre of Excellence in Teaching and Learning instituted by the Higher Education Funding Council of England in 2005.
Its mission statement is:
To facilitate the adoption of new approaches to learning and teaching, and the performance of research to underpin the pedagogic knowledge base. By encouraging scholarship in learning and teaching, we shall enhance the student experience and support the professional development of staff and students in the healthrelated sciences.
The Centre aims to support staff in developing scholarship in learning and teaching and has a strong focus on pedagogic research and knowledge transfer in order to enhance the student learning experience. The students concerned include those in biomedical sciences, psychology, radiography, social work, professions allied to medicine and dental professions and students will play a central role in our activities.
The Centre is also designed to act as a resource for the local dental and medical communities for continuing professional development and continuing medical/dental education. We are working towards a highly integrated approach that will benefit both professionals in the local community as well as our students at the University of Portsmouth through providing wider interprofessional educational opportunities that would otherwise be unavailable.
Research
Research in the ExPERT Centre is undertaken with reference to the leading educational theories of adult learning. A special interest within the Centre is Variation Theory and how that may explain the outcomes of blended learning approaches to teaching and learning. Three key research areas emerge from this centralised theme, which are underpinned by the expertise of the Research Team within the Centre. The streams are:
- The value of simulation in blended learning (including clinical, computer-based and scenario simulation).
- The use/role of virtual learning environments in blended learning.
- Creativity in blended learning.
In support of these themes we have a research committee who overseas and quality ensures our research programme. In addition we have two postdoctoral researchers and, currently, four PhD students. The Centre also supports a number of annual small research awards particularly aimed at staff new to HE or to scholarship in teaching and learning.
Current and pending research activities:
- Development of presentational tools to support learning activities within a VLE.
- Developing effective use of simulation in the health-related sciences.
- Development of appropriate assessment in complex learning activities.
- Academic identity.
- Development of interprofessional role play as a learning environment for professional skills.
- Developing the autonomous student in non-traditional doctoral students.
Facilities
The ExPERT centre has state-of-theart facilities for developing tomorrow’s health-related scientist. Many of the teaching activities that take place within the centre are intimately linked with sound pedagogic research into the effectiveness of blended learning as a means to encourage deeper learning and to foster self-confidence in skills acquisition.
Main facilities:
- Simulation suites with human patient simulators.
- Laboratory simulation suite.
- Flexible teaching space accommodating 20-40 students complete with computers.
- Usability hardware.
- Audience response voting systems.
- Recording equipment.
- Meeting/interview rooms.
We have two simulation centres, one comprising four beds with human patient simulators, the other containing a high fidelity patient simulator. The rooms and equipment can be arranged to simulate particular clinical scenarios and the realistic simulators enable students to experience clinical situations in a safe and supportive environment.
Audio and visual recording of the simulators is used for teaching purposes and may be simultaneously streamed into the two, twenty-seat flexible teaching spaces. These rooms are fully equipped with easily moveable furniture, each desk having its own computer and video-editing set-up. This allows students to critically appraise the activity in the clinical simulation centres.
We also have a laboratory simulation room where students who will be working in clinical laboratories can learn how to log and process samples as well as record and report results - key skills for clinical scientists.
Other facilities in the Centre include small meeting rooms with visual and/or audio recording equipment, a resources room containing a range of equipment including usability hardware (for assessing how a subject interacts with material on a computer screen), audience response voting systems, CD copying and labelling equipment and MP3/WAV portable digital recorders.
Simulation team
The ExPERT simulation team is a group of staff and colleagues from the local health services and professions who are designing and developing scenarios that will support the professional development and practical skills acquisition of students and staff in the health related sciences.
We have established an interprofessional simulation team who are developing guides and standards. This is in order to ensure that the incorporation of simulation into various programmes is of appropriate quality and fit for purpose. The team comprises of individuals from practice, a biomedical scientist, a radiographer, a psychologist, a sports scientist, a creative technologist, a pharmacologist, an educationalist and an educational technologist.
In addition to establishing the physical environments, the team are identifying learning outcomes in various curricula that are common to a range of students. They are then performing the required quality assurance procedures to gain validation for their altered units.
The team are developing scenarios on this inter-professional basis with colleagues contributing scripts, guidance materials for students and staff running the scenarios, debriefing documentation and assessment regimes.
For more information please contact expert.centre@port.ac.uk or visit the website www.port.ac.uk/expertcentre
VETNET lifelong learning network - challenges and opportunities
Sarah Field,National Co-ordinator;
John Butcher, Eastern Region Manager,VETNET Lifelong Learning Network (LLN)
- **How do we get more students to move-on from vocational courses at college in to higher education?
- How do we get a more diverse veterinary and animal science profession?
- How do we get more people who are already in our areas of work to take part in continuing professional development?**
These are just some of the key questions that are being addressed by the recently established VETNET Lifelong Learning Network (LLN).
This three-year project has been awarded £3.74 million by HEFCE to develop and promote progression to higher education by vocational learners. The network, which launched officially in April 2007, is specifically concerned with developing progression routes in the veterinary and animal related sectors. As well as encouraging progression from Further to Higher Education, the Network will also promote entry to HE from the workplace. VETNET LLN will also work to develop further opportunities for continuing professional development as part of its lifelong learning agenda.
Background and locations
The project was initially proposed by the Royal Veterinary College in response to concerns within the veterinary sector about the long term sustainability of some branches of the profession in light of an applicant profile that is predominantly white, middle class and female. The RVC and the veterinary schools at Cambridge, Liverpool and Bristol universities, along with a number of universities and colleges delivering curricula in related fields, have come together to establish the VETNET LLN. The network will seek to diversify the student intake to both veterinary and broader animal-related programmes by opening up new progression routes from vocational FE programmes such as BTEC Nationals and NVQs into Higher Education.
VETNET LLN will function at both a national and regional level. To ensure a full geographical coverage of England, and to bring the network closer to the students who will benefit from it, six regional centres have been established. These are based at the Royal Veterinary College (London and the South East), University of Bristol (South West), University of Cambridge (East), University of Liverpool (North West), Nottingham Trent University (Central) and Newcastle University (North East and Yorkshire). These institutions were selected as either having existing veterinary schools or a substantial track record in animal related sciences. The objectives of the partnership will be delivered through collaboration between institutions within each region but also through co-ordination of activity at a national level via the small national team based in Bletchley, near Milton Keynes.
Planned activity and the challenges ahead VETNET LLN will develop and encourage progression for vocational learners through three major activities. These are:
- Qualification mapping activities
- Curriculum development, and
- Formalising progression routes via progression accords.
Of these, curriculum development presents potentially the biggest challenge but also will bring the greatest opportunities.
Veterinary degrees have always been extremely demanding so high levels of performance - good grades - in academic science subjects at A level have been used as a predictor of success. Progression to veterinary based courses from vocational FE has been non-existent and vocational courses rarely provide a sufficiently rigorous training in the sciences to allow students to tackle the demands of the veterinary curriculum. One of the Network’s biggest challenges will be to help institutions devise curricula to bridge this gap. Much good work is already going on through programmes such as the Gateway programme at the Royal Veterinary College and the development of a number of Foundation Degrees across the country that bridge the divide between vocational and academic study. To extend these activities, and to embed the vocational progression philosophy more generally, will demand extensive curriculum re-engineering at both FE and HE level.
Vocational learners from animal related FE courses hold a valuable skills set. They have already developed a core of specialist subject knowledge as well as a good range of practical animal handling and management skills. In addition, vocational awards place emphasis on the development and acquisition of key employability skills such as communication, problem solving and team work. However their learning at FE level has often been structured around relatively small group sizes, practical learning opportunities and well developed academic support networks. As a result their ability to cope and learn successfully in the rather different environment of large groups and lecture halls may be impaired. If progression for vocational learners into veterinary and related provision is to be a reality, the curriculum of both the providing and receiving institutions will need attention.
Providers of vocational Further Education awards will need to work with HEIs to establish the baseline requirements in terms of scientific knowledge that will allow their learners to access the HE curriculum. There are also issues surrounding the preparation of vocational learners to face the demands of the selecting institutions which will allow them to compete effectively with candidates from the more established academic progression routes. Higher Education institutions will need to work with FECs to gain a clearer understanding of vocational learners and their preferred learning methods. It is anticipated that a number of bridging courses and additional study activities will need to be developed to underpin progression accords formed as part of VETNET LLN’s work in this area. However revisions to first year curricula to accommodate a broader range of learning styles will also be necessary which would potentially enrich the provision for all learners regardless of entry route. This is surely one of VETNET LLN’s greatest opportunities. What next?
This is a project that demands collaboration - amongst the whole spectrum of education providers and within the veterinary and allied professions. Not only must the project succeed here, it must also work to get it right with the young learners who are thinking about a lifetime in the sector and it must keep getting it right with those already employed and working within the veterinary and allied professions. With only three years of funding, VETNET LLN is already gearing-up to move at a challenging pace.
For more information about this project please contact sfield@vetnetlln.ac.uk
Mentoring as a means of encouraging personal development in dentistry
David N Bridgen, Professor of Health Sciences Education, University of Chester & Advisor for Postgraduate Medical and Dental Education;
Brian Grieveson, Postgraduate Dental Dean, Mersey Deanery, University of Liverpool
Mentoring is a process to help people achieve what they need to achieve in their lives by use of a mentor and structured mentoring programme.Aims need to be established and the role of the mentor is to guide the mentee through the reflective process until they can develop solutions themselves.This article gives an example of a structured mentoring programme which describes the various stages that may be utilised in the mentee/mentor interaction and relationship.
The length and content of any coachmentoring relationship can vary considerably. It is defined by an agreement between the person being mentored and the coach-mentor, and will be influenced by the needs of the mentee, the time and resources of both parties, its aims and the content in which it takes place.
Within dentistry, the opportunities to develop a good and productive mentoring relationship may occur in a number of situations. For example; The new graduate in the first two years of their career may need help in deciding a career pathway and a mentor may be the ideal helper.
Also, the newly appointed consultant who faced with different working patterns and new levels of bureaucracy and internal politics may benefit for the support and help of a mentor to allow them to share their concerns and develop confidence in a confidential manner.
Dentists facing threat of action from PCTs, the GDC or their own PASS Committee may want to discuss their problems with a mentor and though the mechanism of mentoring and the opportunity to reflect, colleagues may be able to work their future action plan.
Although every relationship will be different and tailored to individual needs, this is a new development process that usually incorporates stages as detailed below:
- Initial meeting to clarify purpose and process.
- Preparing for the end at the beginning.
- Starting to build the relationship.
- Following through the Coach- Mentor Relationship.
- Identifying where the mentee is now and where he/she would like to be.
- Clarifying the possibilities and options for progress, deciding and planning a course of action.
- Following through that plan.
- Reviewing Progress.
- At the end of each session.
- At designated points within the period of the relationship.
- At the end of each relationship.
Initiating the relationship
The main aim of the initial meeting is to clarify what the mentee is hoping to achieve and to assess whether coach-mentoring is the best way to address this. Recognition of a problem may be difficult to identify, as the underlying real issues may need discussion and thought to identify them.
However, not all situations are suitable for mentoring and there may be the situation where referral to a trained colleague for counselling or even psychiatric help may be the most appropriate course of action.
However long the programme, it is important to have an end in sight right from the start of the relationship. This is a way of creating greater focus and encouragement for the mentee to achieve the goals or objectives he/she needs to within a particular time frame. It is also a way of reducing the risk of a dependency mind set, as the relationship is created in the knowledge that it is of a temporary nature.
Each session must also be time limited and started as such so as to maximise use of time and focus thinking.
Staring to build the relationship
It is important to remember that any coach-mentoring relationship will stand or fall on the quality of the relationship between the individuals involved. Mutual respect and acceptance, honesty, reliability, openness and trust are essential.
A mentoring relationship can not be developed if the mentor is in anyway involved with the mentees’ professional assessment, line management or day to day supervision.
The mentee will need absolute trust in the mentor for the successful outcome to become achievable.
As a mentee, although we maintain responsibility for ourselves and our decisions, we come to the coachmentoring environment expecting a safe place in which to;
- Self assess ( i.e. examine our mistakes as well as our successes)
- Take risks by saying what we really think and feel
- Experiment with ideas about what we could do
That places the coach-mentor in a position of power. The implication of this is a requirement for the coachmentor to act in a professional manner, not abuse his/her power and to act within the area of competence.
Following through the relationship
If the coach-mentoring sessions are being used to support the development of an individual, then we need detailed information about what the mentee has done so far as a baseline for future developments.
The contact and depth of what should be explored will depend on the focus of the coach-mentoring relationship, the degree of comfort of the mentee and coach-mentor, and their available time.
In sample form the model may be in terms of organisational change:
- Where am I now?
- Where do I want to be?
- How can I achieve that?
- What has to change to make that happen?
In a Dentist in Difficulty scenario, a similar model may be:
- What is/was the problem?
- How did it originate?
- Looking back, what could I have done differently?
- How could I deal with this now and in the future?
As a general rule, a broader understanding of the interface of different experiences and an exploration of the characteristics, impact and significance placed on these by the mentee are valuable for a number of reasons:
- People often have insufficient time to reflect on the range and depth of their achievements and they often forget the personal qualities they have drawn on and the skills they have applied.
- Rediscovering these helps the mentee realise the resources they have to draw on, as well as improving their self-esteem and efficacy, which in turn can enhance performance.
- The mentee may also get in touch with things he/she has really enjoyed or gained satisfaction from doing.
- By considering actions over a period of time, patterns may emerge, both positive and negative, identifying consequences to built on and directions to avoid.
If the coach-mentoring programme is specifically related to helping the mentee respond to organisational change or to learn or develop a specific skill, the gathering of information on past and current experiences and skills will be less general and instead will be orientated towards the target change or skill.
Clarifying the options for progress, planning - a course of action
At this stage the mentee gets support to consider options and to work out a plan of action. Within this process, they will draw on options that have been generated through the previous stages and consider how others can be developed.
For specific skills training, these options may be clearly defined. Where the mentee has broad developmental needs or complex issues, options may not be immediately obvious and further approaches may be needed to generate them, for example, through meeting, shadowing and talking to other people, or by using more creative techniques.
Where the coach-mentoring programme relates to a particular organisational issue or to a specific skill development there may be externally required targets that will influence which options are selected and prioritised.
Once options have been selected, they need to be drawn together in the form of a development plan, this should have a section for each goal, which described the target goal in simple but SMART terms (specific, measurable, achievable, realistic and time based), and the steps in terms of action and activities needed to achieve it.
Following through the plan
The title of this part of the process sounds simple, but it is here where the mainstay of the coach-mentoring process occurs, that is to say the coach-mentor supports the mentee to work on and achieve his/her goals over a number of sessions.
The personal development plan (PDP) is the important summary of the mentoring process in terms of outcomes.
If possible specific targets with specific dates for completion should be observed and also an agreed time to review the PDP.
In many cases the mentor can help guide mentees into being reflective and analyse themselves and their actions. This helps mentees clarify their thoughts and become clearer on achieving their goals.
However, each stage of the process will need to be completed before moving on and some mentees may require more sessions that others.
Overall, mentoring has proved successful in personal and professional development of dentists of all ages and experience.
For further details on coachmentoring you may wish to read Coaching and Mentoring in Health and Social Care published by Radcliffe and available at www.radcliffe-oxford.com
Also recommended;
The Skills Helper seventh edition by Gerard Egan published by Thomson Learning, Brooks/Cole
For more information please contact david.brigden@merseydeanery.nhs.uk
Integrated Children’s Services in Higher Education (ICS-HE): Preparing tomorrow's professionals
A Higher Education Academy project, co-ordinated by SWAP, the Subject Centre for Social Work and Social Policy
Project rationale
The Every Child Matters agenda, bringing together health, child care, education, social work and youth justice to improve outcomes for children, young people and families has far-reaching consequences for higher education. These include curriculum review, joint working and new programmes, taking into account the Common Core of Skills and Knowledge for the Children’s Workforce and the Integrated Qualifications Framework being developed by the Children’s Workforce Network (CWN) and the Children’s Workforce Development Council (CWDC).
Project aims
This project aims to bring together relevant subject disciplines and sector bodies to:
- Provide an evidence-based approach to identify effective ways of developing inter-professional curricula and pedagogy for professional practice in children’s services;
- Scope existing initiatives and support the development of informed educational policy and practice for professionals who will be working in reconfigured children’s services;
- Facilitate a co-ordinated response across higher education to the Integrated Qualifications Framewok for the children’s workforce.
Project partners
Project co-ordinated by SWAP, the Higher Education Academy’s subject centre for Social Policy and Social Work in collaboration with the HEA’s subject centres for: Escalate (Education), Health Sciences and Practice, Medicine, Dentistry & Veterinary Medicine and Psychology. The Children’s Workforce Development Council (CWDC) and Children’s Workforce Network (CWN) are also project partners.
Work strands and contacts
Project activities
The project will work to:
Key outputs
- National conference Autumn 2007
- Report on both strands of work February 2008
Project reference group
A reference group will include project partners, regulatory and professional organisations (e.g. GSCC, GTC, GMC, NMC) academic co-ordinating bodies (e.g. the Universities Council for the Education of Teachers, the Councils of Deans and the Joint University Council- Social Work Education Committee) and employers. Joint Project Chairs are Jackie Rafferty .rafferty@soton.ac.uk and Hilary Burgess H.C.Burgess@bristol.ac.uk.
ICS-HE is funded through the Higher Education Academy (HEA) with a grant from HEFCE to strengthen employer engagement in HE and improve links with Sector Skills Councils.
Integrating children’s services in HE one day conference: 23 November 2007, EMCC Nottingham.
Contacts:
The virtual farm
Michael Begg, Learning Technology Section, College of Medicine and Veterinary Medicine,The University of Edinburgh
The often significant distances between teaching farms and the rest of the learning environment can lead to missed opportunities to make use of the valuable teaching and learning resources to be found on site.The University of Edinburgh s Virtual Farm has been developed to bring students closer to the day to day operations of the two main teaching farms.
Background
The two main teaching farms for the University of Edinburghs College of Medicine and Veterinary Medicine’s veterinary student community are located some 10 miles from the centre of the city. This, despite the presence of teaching and learning facilities at Easter Bush, places them at somewhat of a distance from the core of the students learning environment. This has previously led to under use of these highly valuable teaching resources.
A successful collaborative bid - from farm staff, RDSVS teaching staff and learning technologists from the College’s Learning Technology Section - to the Principal’s eLearning Fund has enabled the development of a Virtual Farm, which is accessible from and integrated with the Edinburgh Electronic Veterinary Curriculum (EEVeC); the managed virtual learning environment (VLE) supporting the BVM&S; curriculum.
The virtual farm
Many of the features of the Virtual Farm have been developed with the aim of allowing students to feel more directly engaged with the day-to-day activities of the farm - even if they are physically remote. There is a virtual tour of each of the farms, offering interactive maps, images and videos of the sites. Web Cams operate 24/7 to provide a direct and immediate window into what is going on right there and then, while an RSS newsfeed allows farm and teaching staff to keep students informed with up to the minute information regarding activities such as market rates, milk yields, vet visits, etc.
A discussion board allows staff and students to post threads on farm activities, and ask questions about data anomalies, report episodes witnessed on the web cams. For example, a student recently witnessed a fox scavenging in the calving shed on one of the web cams. The report of the fox led to a discussion board posting referring to the epidemiology of neospora and cross species transference of oocysts. Other examples of non curriculum specific learning opportunities include discussions on why a DAM and calf pair should be found to be on the same lactation, and the opportunity to pass comment and ask questions following the chance to watch an emergency Caesarean on the web cam.
Over time these discussions grow to provide an interactive diary of farm related activity over the full year. By providing access to previous academic sessions discussions this record becomes a richer source of data.
One of the most popular features of the Virtual Farm has been to pair students with individual sponsored sheep and cows. Customised information concerning a student’s allocated animals is drawn from the general herd dataset to provide a week by week report of the development, production and health of individual animals. Tailored information is delivered to the students including milk quality and yield, weight, and details any vet visits. This encourages the students not only to appreciate the rate of development of a farm animal, but leads them back into the herd data to assess how their own animal compares with the herd in general. It has become quite common to see students use the virtual farm discussion board as a kind of sparring ground as they compare the performance of their respective animals!
Although called the Virtual Farm, there are aspects of the project that remain very real. Herd and flock management software offers a flexible environment for data recording including animal weight, milk yield and quality and health and fertility events.
Calves and milking cows are issued with collar-based transponders holding a unique ID on a microchip. These tags automatically record, in the case of the calves, the weight of the animals when they use automated feeders, and how much feed they take at each sitting. In milking cows the transponder automatically identifies each animal as they enter the milking parlour. A similar tagging system also exists for the sheep stock. This data - as well as affording farm workers easily accessible information that may allow them to identify issues such as feeding problems with individual animals - can also be quickly exported and made available as full herd datasets to students. Local versions of the management software have been installed on University lab machines in order to allow students to interact directly with the data.
The University of Edinburgh’s Virtual Farm has brought an often distant study community closer to the immediacy of the farms. The dayto- day activities and processes can now be observed, recorded and can be interacted with in a variety of ways.
Following the initial success of the project, future developments will focus on directly embedding datasets, records and other materials generated by the Virtual Farm within the fabric of the curriculum. For more information please contact M.S.Cockram@ed.ac.uk
Congratulations to 2007 National Teaching Fellows in healthcare related subjects
Dr Elizabeth Anderson, University of Leicester Senior Lecturer in Shared Learning Nominated by the University of Leicester
Ms Julie Baldry Currens, University of East London Principal Lecturer - School of Health and Bioscience Nominated by the University of East London
Mr Tim Bilham, University of Bath Director, Education Research and Development Nominated by the University of Bath
Professor Susan Bloxham, St Martin’s College Head of Centre for Development of Learning and Teaching Nominated by St Martin’s College
Dr Elizabeth Boath, Staffordshire University Reader in Health Nominated by Staffordshire University
Dr Katharine Boursicot, Queen Mary, University of London Reader in Medical Education, Head of Assessment Nominated by Queen Mary, University of London
Dr Lynn Clouder, Coventry University Research Fellow and Director of the Centre for Interprofessional eLearning Nominated by Coventry University
Professor Gill Marshall, St Martin’s College Professor of Medical Imaging Education Nominated by St Martin’s College
Professor Stephen McHanwell, Professor of Anatomical Sciences, University of Newcastle, Senior Lecturer in Anatomy Nominated by the University of Newcastle
Professor Edward Peile, Professor of Medical Education, University of Warwick, Associate Dean (Teaching) and Head of Institute of Clinical Education Nominated by the University of Warwick
Dr Gaynor Sadlo, University of Brighton Head of Occupational Therapy Nominated by the University of Brighton
Dr Jill Taylor, Leeds Metropolitan University Director, Faculty of Health Learning Technology Unit Nominated by Leeds Metropolitan University
Professor Dominic Upton, University of Worcester Head of Psychology and Health Sciences Nominated by the University of Worcester
For a comprehensive list and further information please go to: www.heacademy.ac.uk/ourwork/professional/ntfs
GMC/Gateways disability project
Suzanne Hardy, Senior Information Advisor, Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine
The General Medical Council has joined with 11 medical schools to develop guidance encouraging people with disabilities into medicine.This project is match-funded by the (former) Department for Education and Skills scheme Gateways to the Professions.
The objective of this project is to develop advice for medical schools on supporting disabled students into medicine and retaining them within the profession. The participating medical schools are:
- St George’s University of London
- Newcastle University
- University of Leeds
- Hull York Medical School
- Brighton and Sussex Medical School
- University of Southampton
- University of East Anglia
- King’s College London
- University of Sheffield
- University of Glasgow
- Cambridge Medical School.
The commission to carry out the work awarded to a team led by Professor Janet Grant, of the Open University Centre for Education in Medicine and builds on the GMC discussion document by Anne Tynan, Today’s Disabled Students: Tomorrow’s Doctors (December 2006).
Background
Following Sir Alan Langlands Gateways to the professions report in 2005, the Government has clearly stated its wishes to encourage young people to consider professional careers and to overcome obstacles and low expectations that may stand in their way. This includes medical careers.
The former Department for Education and Skills (DfES) began an initiative entitled Gateways to the Professions. A £6 million development fund was established to provide financial support for projects designed to encourage young people who might otherwise not have pursued professional careers.
The GMC was successful in securing matched funding to take forward its interest in encouraging disabled people to study and practise medicine. With help from 11 medical schools, and its own resources, the project is now fully funded and the work well underway.
The GMC/Gateways project
There is already a great deal of practical advice for young disabled people, including the recently published Into Medicine (published by Skill: National Bureau for Students with Disabilities). However, there is a desire for some centrally produced specific guidance for medical schools, which can help them navigate the complex legal maze, fulfil their duties under the Disability Discrimination Acts (1995 and 2005), the Special Educational Needs and Disability Act (2001), the Medical Act (1983) and their obligations to protect the public.
This project is designed to provide advice to medical schools to encourage the entry of disabled people into medicine and to retain them in the profession.
The work involves developing guidance for medical schools, aimed at administrative and academic medical school staff (though the team recognises it will be read by a larger group) that will:
- Address specific myths and stereotypes, and challenge incorrect assumptions about disabled students and trainees.
- Give advice on equitable policies and procedures e.g. recruitment, selection, admissions and retention.
- Advise on the process to improve the career and education opportunities of disabled students in medical training.
- Consider the genuine and equitable attainment of curriculum outcomes and competencies.
- Identify an illustrative range of reasonable adjustments that could be made to medical school arrangements to meet the requirements of disabled students.
- Identify the legal requirements and strategies to eliminate disability discrimination in medical education practice.
- Advise on developing, with the involvement of disabled people, a strategic and sustainable disability equality scheme.
Additionally the team hopes to identify pathways and barriers to the retention in the profession of disabled people and develop appropriate guidance for medical schools, postgraduate deaneries and medical Royal Colleges.
These aims will be pursued against the responsibilities of the GMC to foster good medical practice, promote high standards of medical education and medical practice, offer clear and proportionate guidance, and ensure the safety of patients and the public.
The project team will review current arrangements at medical schools to see what can be learned about what works well to support disabled medical students and to identify the sort of unnecessary obstacles that they face.
Using that evidence, guidance will be drafted with open consultation.
The team hopes that the final guidance will be ready by March 2008, in order to meet the requirements laid down by the DfES. This will then be evaluated, although it is recognised that it will be difficult to provide more than indicative findings by the end of March 2008 when funding for the project ends.
To oversee the development of the guidance, a Project Board has been set up including representatives of:
- The GMC.
- The medical schools funding the project.
- Association of UK University Hospitals.
- Equality Challenge Unit for higher education.
- BMA Medical Students Committee.
- Office of Public Management (who were working with the DfES).
In addition a wider Expert Advisory Group has been set up - this group will act as a reference group, commenting on the development of the guidance.
The workplan
A recruited group of disabled people will participate actively in all parts of the work, which will have three stages:
1. Review of existing disability policy and practice
- Survey all medical schools with telephone interview follow up.
- Survey disabled medical students and trainees. Determine disability-related reasons for leaving medicine.
- Interview partner and stakeholder organisations.
- Review GMC and Medical School Council guidance.
- Review the legal position.
- Review the Disability Rights Commission Codes of Practice.
- Guidance from other professions and previous reports.
- Guidance from other countries - including USA, Canada, Europe and Australia.
2. Preparation of disability equality guidance
Guidance for medical schools, and a parallel version, if necessary, for Deaneries and Colleges, that is practical, straightforward and useable and addresses the context of disability equality in medical education and clinical practice. It will therefore present:
- Positive ideas to improve relevant policies and procedures - recruitment and selection, accessible education information and publications, website accessibility, making reasonable adjustment, genuine competence and assessment regimes.
- Accessible open days, fairs and interviews, reasonable adjustments and disability equality training for staff responsible for recruitment and selection.
- Positive action training for disabled applicants to attract and retain them, targeting disabled people’s organisations and schools/colleges.
- Making accessible the admissions, teaching, learning, assessment and support processes, meeting the requirements of disabled students, making reasonable adjustments to education content and method, understanding the University’s anticipatory duty and DED, providing disability equality training for admissions and teaching staff, links with Disability Equality Training for the NHS developed with the DRC.
- Responding to DDA part 2 duties especially in partnership with NHS and other employers offering clinical placement and the requirements of Qualifying Bodies to fairly register and assess disabled applicants and give support to disabled doctors in practice.
- Retaining doctors after qualification (Trusts, Deaneries) link with DRC Formal Investigation into Careers and revised GMC guidance Good Medical Practice.
3. Evaluation of guidance in practice
The evaluation Phase consists of two parts:
- An immediate evaluation of the process of developing the Guidelines, their distribution, immediate and potential impact.
- Plans for the longer term impact of the Guidelines on actual practice.
The Office of Public Management will be involved in evaluation of the medium-term impact. With its help the project teams hopes, in relation to medical schools, to:
- Elicit achieved and planned responses to the guidance.
- Identify changes in attitudes, policies and daily practice as a result of the guidance.
In relation to disabled students and disabled people who might consider a medical career, to determine whether the guidance helped schools to attract them, meet their requirements, educate them fairly and retain them.
How can you join in?
The team needs your help, in the first instance, to recruit a representative group of people to take part in the project: Disabled and non-disabled students and staff to take part in surveys, be interviewed, and make comment on the project plan. The team is anxious to make sure that the process if as transparent as possible, with as much stakeholder involvement as possible.
If you are interested in taking part, finding out more, recommending people or organisations to contact, the team would love to hear from you.
For further information please contact Professor Janet Grant, j.r.grant@open.ac.uk
References
- www.gmc-uk.org/educationqa/qabme/library/docs/Todays_ Disabled_Students_Tomorrows_Doctors.pdf Accessed 16 July 2007
- www.medev.ac.uk/dinky?dinky_id=278 Accessed 16 July 2007
- www.dfes.gov.uk/hegateway/hereform/gatewaystotheprofessions/ index.cfm Accessed 16 July 2007
- www.skill.org.uk/shop/shop_showProduct.asp?graphics=on& productID=3292359 Accessed 16 July 2007
Conference report:
Anatomy teaching - the cruellest cut of all?
Diana J Lawrence-Watt, Professor of Human Anatomy, Brighton and Sussex Medical School
Stephen McHanwell, Professor of Anatomical Sciences, Newcastle University
On 20 March 2007 the Royal College of Surgeons hosted a meeting to discuss the future of anatomy teaching in both the undergraduate and postgraduate medical curricula.The meeting was attended by some 200 delegates.There were many representatives of the anatomical and surgical communities as well as radiologists, physicians and medical educators alongside those with responsibilities for postgraduate surgical training. It was also very interesting to note that within the audience there were a substantial number of doctors in training.
The impetus for calling the meeting was the growing perception, coming from those training and examining surgical trainees, that qualified doctors entering surgical training are doing so with levels of anatomical knowledge far below that felt to be necessary (and well below that of ten years ago). However, though the initial impetus came from surgeons, as the day unfolded it became abundantly clear that these concerns were equally shared amongst the other groups represented. Not least of these were newlyqualified doctors who themselves expressed their view that they were not always adequately equipped with relevant anatomical knowledge to fully manage the conditions they were encountering in their F1 and F2 years.
Views of the GMC
The current edition of the Tomorrow’s Doctors document was published in 2003 and the GMC have recently entered a process of review of that document. Their Strategic Consultation papers summarising the process of consultation has so far highlighted a number of concerns relating to clinical knowledge. The GMC state that respondents to their document fell into two camps in relation to the balance to be struck between professional knowledge and skills, and clinical and basic scientific knowledge. However, they identified the fact that a large number of respondents identified particular subjects that should be protected in the curriculum including anatomy and physiology and pharmacology... One of their conclusions was that a revised Tomorrow’s Doctors could include more emphasis on basic science and clinical knowledge at the same time recognising of course that this could have an impact on already full curricula.
Present position
With the views expressed by surgeons, newly-qualified doctors and many respondents to the GMC consultation process the question which had to be posed was where are we going wrong. This was the major area for discussion in the early part of the meeting which then went on to suggest a number of actions to address the concerns.
At the meeting there was a very strong consensus expressed that the changes to medical curricula initiated since 1993 had been generally very positive. This was both in terms of linking basic science to clinical knowledge and skills and in equipping newly-qualified graduates with personal and professional skills, including those of communication. However, there was also consensus agreement that in some areas the pendulum had swung too far away from providing students with sufficient basic science foundations to support their clinical knowledge and skills. The evidence for this, in relation to anatomy, came from postgraduate trainers and examiners and from the newly-qualified doctors themselves. Anatomy is one of the key foundations of safe and effective medical practice and is no less important today than it was in the past. This is not least because increasingly sophisticated imaging techniques are becoming part of the standard diagnostic repertoire and require a thorough knowledge of the relevant anatomy for their interpretation. It has also been identified that surgical errors stemming from inadequate anatomical knowledge and leading to litigation are becoming increasingly commonplace and evidence has been presented that these can constitute up to 40% of claims for surgical negligence in some areas. Finally, we heard from a representative from a patient liaison group who expressed very eloquently the group’s view that doctors need a good knowledge of anatomy in order to be able to manage their patients safely.
The way forward
After the arguments had been heard three questions were posed to the delegates.
- In response to the question of whether there should be a core undergraduate syllabus in anatomy (defining content not the manner of its delivery, the latter being curriculum) the meeting was overwhelmingly in favour. However, it was well-recognised that at undergraduate level we are not setting out to train surgeons. Nevertheless all medical graduates need sufficient anatomical knowledge for examining the patient, interpreting standard diagnostic images and for the safe conduct of basic interventional procedures. Therefore, there is a need to train all medical undergraduates to that level prior to them entering their F1 year.
- Similarly all delegates were in favour of maintaining and extending the option for medical undergraduates to undertake special study modules in anatomy. At this point there was some discussion about the merits or otherwise of early specialisation but it was recognised that many medical undergraduates would wish to undertake such an option whatever their future career plans.
- Finally, to the question should we be facilitating all ST1 trainees to undertake a period of formal training in anatomy, again the delegates were overwhelmingly in favour recognising that a solid grounding in anatomy is a prerequisite for the safe practice of surgery. The traditional route to this training has been through a period of serving as a demonstrator teaching anatomy to medical undergraduates. Evidence shows that these demonstrator rotations have largely disappeared following the introduction of MMC. The meeting called for the reinstatement of such periods of rotation as a demonstrator. This will have two effects. It will train the surgical trainee to the required level of competence. It will also provide the necessary manpower to deliver on questions 1 and 2.
Summary
Anatomy, in common with other basic medical sciences, has suffered a detrimental reduction in content in medical undergraduate curricula. It is now time to redress this balance both for the benefit of newly-qualified doctors and those receiving their care. This redress must occur within the overall framework of an integrated curriculum so that anatomy is taught in a clinical context while at the same the many other benefits of recent curriculum innovations are not lost.
For more information please contact stephen.mchanwell@ncl.ac.uk
The learning disability open meeting - Service users, carers, inter-professional partnerships improving leadership, practice, education and service delivery.
Jim Blair, Senior Lecturer Learning Disabilities, Kingston University and St.George’s, University of London
Services for people with learning disabilities have undergone many changes. Recent governmental policies relating to people with learning disabilities aim to enhance quality of life and are based on a number of themes: empowerment, social inclusion, citizenship, choices and making decisions, the same opportunities and rights as other people (Department of Health 2001).This article describes a face to face meeting approach fostering communication and the impact it is having.
The meeting strives to encompass the evolving world of people with learning disabilities, their families, carers and professionals by providing an arena in which discourse between those that receive and provide services is fostered. The meeting promotes opportunities to build partnerships and to create and maintain networks within a practice focused educational environment.
Getting started
The first meeting was held in 2002 at which the main focus was to identify the aims, values and expectations of the participants. It was decided that we would meet 5 times a year, on Fridays from 2-4pm. Members and non-members would be approved to give talks on a variety of health, education and social care issues.
It is important to have protected time to undertake photocopying articles, room booking and creating advertising materials. Administrative support would assist with the running of the meetings. It is essential that time is set aside for sourcing resources from a variety of journals as well as promoting the event by email. The venue is a large room at the university in Kingston providing a neutral environment since it is not associated with any service.
The University funds refreshments, photocopying and pays speakers’ travel expenses. Recently the Royal College of Nursing’s Learning Disability Forum has provided funds to pay unwaged speakers with and without learning disabilities. Funding from other professional organisations is being sought. The benefit of having a professional group supporting the meeting is that it enhances its credibility.
Framework and function of the meeting
Each meeting follows a similar structure which helps to promote a feeling of confidence and a sense of ownership. Chairs are placed in a circle encouraging engagement and reducing the opportunity of a hierarchical structure to form.
The meeting is a forum where people share local and national issues and it provides mutual support. Also it promotes opportunities to network and breaks down professional barriers and enables exchanges of the latest practice initiatives, policy and theoretical materials.
Everyone who attends becomes a member. This provides ownership and fosters inclusion. People with learning disabilities, learning disability nurses, social workers, special school teachers, health and social care lecturers, people from a variety of voluntary services, speech and language therapists, occupational therapists, adult nurses, mental health nurses, physiotherapists, psychologists, doctors and students on a range of health and social care courses regularly attend. At the first meeting twelve people attended now between 35 and 55 people regularly come.
Although most participants come from further away including Southampton, Manchester and Norwich. Topics that have been covered include: drug and alcohol misuse, direct payments, spirituality, computers in special schools, employment, the role of the police and mental health. People with and without learning disabilities give the talks.
Evaluations and outcomes
There have been four evaluations and generally the feedback is that the meetings have led to improved relationships by sharing information, developing networks, enhancing leadership, delivering best practice and continuing professional development within all sectors. Service delivery has improved as a result of the educative nature of the meeting.
Those attending are content with the current structure and would like it to continue to reflect the concerns of members as well as local, national and international innovations and policies. A few said that they would like the meetings to be all-day events with more people with learning disabilities and unpaid carers attending (which would be challenging to coordinate and there are financial implications to consider if more people with learning disabilities and their unpaid carers were to attend, such as transport availability and costs as well as some carers having to pay for home support).
Barriers have been overcome as people communicate in a relaxed manner. For example, when a Metropolitan Police superintendent came to talk a woman with learning disabilities felt able to chat to him which she was pleased about.
Members have acted as consultants, providing feedback on new educational developments within the university. One member said: It is useful to have a forum that allows open discussion on current issues and responds to initiatives. Another appreciated the meeting’s free flowing nature as it means it can adapt (to address) current needs/issues/concerns. The flexibility, in terms of topics discussed, of the meeting is behind its growing success.
From discussions with members, the meeting has enhanced members’ leadership by:
- Translating and imparting knowledge.
- Creating partnerships on various levels.
- Confidence of participants to challenge and discuss issues.
The meeting’s increasing appeal demonstrates it is valued by members, while a mix of speakers, the advance notice emails and the opportunity to update practice are other attractions.
Conclusion
The meeting illustrates how boundaries can be broken down when a neutral non service-based organisation sets up an informal practice-focused educational meeting and as a member noted, it allows time for us to connect with others.
During 2005/6 I presented papers on the open meeting at a number of medical, health and social care conferences in the UK, Netherlands, Finland and Italy. As a result there is burgeoning interest from a range of professionals working with a variety of client groups in many European countries, Australia, USA, Iran, Iraq and Jordan. There are a number of universities and organisations planning to create open meetings in the near future.
Department of Health (2001), Valuing People: a new strategy for learning disability in the 21st Century. Department of Health: London
This article is adapted from Blair, J (2006), Altogether now: Learning disability open meetings Learning Disability Practice 9-6 July pp10-14.
For further information, please contact jblair@hscs.sgul.ac.uk
Using blended learning to accommodate different learning styles
Eddie Gulc, Senior Adviser, Higher Education Academy
The rapid growth in the use of learning technologies, particularly the use of the Internet and web-based communication, has provided teachers and tutors with many more opportunities to explore the most suitable mix of teaching and learning styles for a given task.
For some time now the Government has encouraged greater adoption of new education technologies, particularly networked technologies, in their drive to expand provision, widen participation and stimulate a greater acceptance of lifelong learning. Certainly Ufi/Learndirect has benefited from this commitment from Government, but mainstream education has also benefited from a huge investment in the infrastructure supporting networked learning.
These investments have been shown to benefit a wide variety of students studying across the full spectrum of provision. Many of the benefits, for example, are being felt by students who are:
- Remote from a traditional centre of learning like a university or college.
- Disabled or suffer some learning difficulty and who are supported with assistive technology.
- Non-traditional learners - workbased, parents with young children.
What Is blended learning?
Before proceeding any further it is vital to get an understanding of what blended learning is. A study carried out for the Higher Education Academy (Sharpe et al 2006) suggested the term blended learning was attributed in the 1980s to the Open University’s model of blending distance learning with face to face support. They do, however, point out that the term is now rather ill defined and that it can mean different things to different people/institutions/organisations.
The University of Hertfordshire’s, Blended Learning Unit (BLU) Centre for Excellence in Teaching and Learning (CETL), state that they aim to develop, promote and evaluate the combination of established ways of Learning and Teaching and the opportunities offered by technology in order to improve students’ learning and increase flexibility in how, when and where they study.
Significantly the British Educational Communications and Technology Agency (BECTa) describe it as a combination of face-to-face and on-line delivery, which they believe suits a wider range of learning styles.
Such a blend of eLearning and classbased learning combines the any time/pace/place advantages of online facilities and materials, often through a mix of media, with opportunities for tutor support.
The most effective learning has always involved the use of different strategies and techniques to maximise knowledge acquisition and skill development. For example, university programmes usually combine lectures, seminars, group projects and, quite often industrial visits and placements, to offer students a variety of different learning opportunities.
Many pedagogues have accepted that blended learning is about developing skills and knowledge by engaging and challenging the learner in different ways.
The traditional learning style requires massive investment in buildings and classrooms but does offer the learner face-to-face contact and support. At the other end of the spectrum we find online learning, which can be delivered anywhere, anytime (asynchronously), for example at the learner’s home or workplace, and offered at a time to suit them. Although the latter may be perceived to be less expensive for the provider of the online programme, learners may feel isolated and this may affect motivation and student retention. Blended learning offers some of the best of both worlds: face-to-face tutor support and contact with peers alongside the ability to work remotely, for example be sent and submit work electronically.
When developing a blended learning experience we need to populate the whole spectrum with learning opportunities that are appropriate to the learner and the situation. Contrary to perceptions, blended learning isn’t a cheap option as it requires substantial investment in the educational technology and support. In addition, as will be discussed later in the article, it does involve very careful planning and preparation for it to be successful.
The challenge to develop blended learning
As educationalists we are being challenged by the Department for Innovation, Universities and Skills (DIUS) and funding councils to see how we can integrate the use of learning technologies to develop blended learning experiences in the programmes we offer. Both the DfES and HEFCE eLearning strategies refer to blended learning.
Blended with traditional methods, replacing some of them, eLearning allows a new relationship with learners to develop. It takes them beyond the confines of the traditional classroom, extending collaboration and enabling teachers to bring new resources into their teaching, culled from a world of digital libraries.
Colleges and universities are experimenting with new blends of campus and distance learning, and different mixes of online and face-to-face methods to create more flexible learning and accreditation opportunities. DfES (2005)
HEFCE (2005) states that the early concentration on infrastructure has given way to a focus on pedagogy, and on connecting electronic communications with other processes, in a new blend of approaches to learning and teaching. Distance learning is now seen as one end of a continuum where eLearning offers opportunities across all programmes and all education sectors.
So why blended learning?
For many tutors the reason for providing blended learning is that it works, enabling them to support learning that focuses on the best learning style for each student.
It is in the tutor’s best interest to provide as many opportunities for the learner to access the educational content as possible, and in a way that the student can learn without finding the experience difficult or off-putting. Learners don’t just like one way to learn, so we should provide as many ways for them to receive their educational programme as possible. This is where eLearning blends come in.
We can all learn anywhere, anytime, anyplace as there are opportunities to learn all the time and all around us. We can learn in the home, workplace and even travelling (mobile or mLearning). Educational programmes can be tailored to the kinds of useful delivery media that are convenient, user-friendly, and (most importantly) serve the needs of the learner. TechDis - the JISC service to improve provision for disabled students through technology - argue that using blended learning can offer a great variety of presentation methods and can revisit materials covered previously in class and these materials can be more easily adapted to learners’ needs. So, for example, using e-mail discussion forums for group work can assist learners with communication barriers (TechDis 2003). Disabled learners can benefit greatly from eLearning as it not only allows for distance and flexible learning, but also enables them to use a range of assistive technology to access those resources which would otherwise present them with significant barriers.
Further benefits of blended learning: empowering learners and teachers
Using a blended learning approach can improve the quality of the learning experience, and in so doing, extend the scope of the tutor. This can be achieved through:
- Individualised learning experiences for all learners, including those who are disadvantaged, disabled, exceptionally gifted, have special curriculum or learning needs, or who are remote, or away from home/work.
- Personalised learning support - personalised information, advice, and guidance services help learners find a suitable course, with seamless transition to the next stage of their learning, which might include online applications/ enrolment as well as an e-portfolio to take with them.
- Collaborative learning - this offers a wide range of online environments to work with and learn from other individuals or groups of learners as well as tutors, and develop the cognitive and social skills of communicating and collaborating.
- Virtual learning environments (VLEs) - learners can take part in active and creative learning with others through simulations, roleplay, remote control of real-world tools and devices, online master classes, or collaboration with other schools or organisations.
- Flexible study, with learning on demand, anytime or anywhere, to meet learners’ needs wherever they want.
- Wide access to digital resources, shared tools and information systems.
In addition, the Sharpe et al (2006) study found that some universities see other benefits of blended learning, notably:
- The ability to support operating in a global context.
- Offering greater efficiencies, especially with increased student numbers/group sizes.
- The support it can offer professional/work-based skills developmen.
- Getting the Blend Right.
The blended learning mix will offer a variety of teaching and learning styles, course materials and learning technologies such as:
- Traditional classroom/lecture theatre/laboratory environment.
- CD-ROM/DVD.
- E-mail/SMS.
- E-books.
- VLEs, including message boards and chat rooms
- Asynchronous online delivery/tools, like wikis and blogs.
- Synchronous online delivery/tools, like instant messaging.
The best approach to developing a blended learning pedagogy is to evaluate the materials and practices you have already been using with your learners and see how your programmes can be improved or enhanced with technology.
The right solution for each programme, and indeed each learner, depends on the balance of learning provided within the blended learning mix. Success will only come from blended learning where a review of the learning programme enables it to be broken down into modules, and where the tutor can assess the best medium to deliver each of those modules to individual learners.
When developing the blend you need to be clear about the level of learner autonomy that you are seeking to build into the programme. If you require learners to take responsibility for their own learning and, in so doing, select how, when and where to learn, they must have the responsibility, skills and motivation to make those decisions for themselves.
The design of the blended learning mix needs to be built around the fundamental ways in which people learn. Individuals acquire knowledge and skills through a blend of many different experiences such as reading, observation, collaboration, trial and error, guided practice, application and experimentation. These same learning principles should be built upon to develop your blended learning programme. One learner may favour books and eLearning while another may prefer interactive activities such as discussion forums, workshops and virtual laboratories to cover the same learning. A holistic approach has to be taken to the development of blended learning programmes if they are to be successful. The various elements of learning should really be viewed together, as one solution, not broken up and treated as separate components. Meaningful connections between teaching, tutoring/ mentoring and eLearning content, will lead to a more robust programme which supports and maintains motivation.
Evaluating the blended learning mix
It isn’t easy to create a truly effective and balance blended learning mix, but by monitoring and improving your balance of teaching styles and methods, you will see the value of this approach and what works best. Learning programmes that effectively blend multiple learning strategies and styles represent the very best of traditional teaching methods and exemplars for the future. They do, however, require the tutor to be aware of the need for holistic programme development. This emphasis on overall programme design and development requires practitioners who understand the pedagogy of learning and who can maximise the potential of the learning technologies that are available to them.
Conclusions
The concept of blended learning has been with us for some time and really builds on the good practice of blending teaching and learning styles for the benefit of the learner. Tutors who adopt a variety of teaching styles are more likely to offer their learners a more rewarding and successful educational experience. This is as true when e-learning and online learning are added to the mix, as it would be for integration of practical work and industrial visits. The potential of new technologies can be maximised when you see how best to blend Learning with existing programmes to the benefit of learners.
eLearning is a valuable tool to have at our disposal when building and delivering our educational programmes and we should be using it wherever appropriate to enhance our provision and offer tailored learning to meet the needs of our learners.
One challenge for the future is to see how we can work with learners to add the growing use of social (Web2.0) tools and technologies into our blend, so that we can incorporate, for example, smart phones and iPods into our teaching and learning mix. However, the question might be, will our students let us, as these technologies are very personal to the individual and many students don’t want work mixed with leisure/pleasure.
Further reading/ information
If you are interested in knowing more about blended learning then read the review of UK literature and practice undertaken on the undergraduate experience of blended eLearning for the Higher Education Academy by Rhona Sharpe et al - see references below.
There is an annual blended learning conference organised by the BLU CETL, University of Hertfordshire, together with the Higher Education Academy. More information is available from the BLU website at: www.herts.ac.uk/blu
For more information please contact eddie.gulc@heacademy.ac.uk
References
British Educational Communications and Technology Agency www.becta.org.uk
DfES (2005) Harnessing Technology: Transforming learning and children’s services www.dfes.gov.uk/publications/e-strategy/
HEFCE (2005), HEFCE strategy for eLearning www.hefce.ac.uk/pubs/HEFCE/2005/05_12/
Sharpe R, et al (2006), The undergraduate experience of blended elearning: A review of UK literature and practice undertaken for the Higher Education Academy, www.heacademy.ac.uk/ourwork/research/ litreviews/2005_06
TechDis, JISC, Ferl (2003), Inclusive Learning and Teaching: ILT and Disabled Learners
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