01.20 The newsletter of the Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine, Autumn 2009

Issues and news on learning and teaching in medicine, dentistry and veterinary medicine

Print: ISSN 1740-8768

Online: ISSN 1479-523X

IN THIS ISSUE:

• Postgraduate medicine and approaches to staff development
• Using installation and performance art to communicate ideas about medicine
• Interactive voting systems in teaching and symposia

01 is published three times a year by the Subject Centre for Medicine,Dentistry and Veterinary Medicine (MEDEV), part of the Subject Network of the Higher Education Academy. We are a publicly funded service, providing UK-wide support and services for higher education in medicine, dentistry and veterinary medicine. Details of our activities are available on our website: www.medev.ac.uk

As well as updates on MEDEV work, 01 features a wide range of articles on topics relating to medicine, dentistry and veterinary medicine. We welcome contributions. If you would like to submit an article (of between 500-1000 words), propose a book review or respond in a letter to an article published in 01, please contact the editor, Suzanne Hardy (suzanne@medev.ac.uk).

Views expressed in 01 are those of the author and do not necessarily represent those of MEDEV.

Website links are active at the time of going to press.

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Contents

• The hybrid learning model – a framework for teaching and learning
  Dr Vilinda Ross, Dr Alan Masson, Áine MacNeill, Colette Murphy, CETL(NI) Institutional eLearning Services, University of Ulster
• NICE eLearning resources in evidence-based decision making
  Dr Kieran Walsh, BMJ Learning; Dr Kamran Siddiqi, National Institute of Health and Clinical Excellence
• Book review: How to succeed at medical school: An essential guide to learning
  Amy-Jo Farrow, 4th Year Medical Student, Newcastle University
• Preparing for specialist training interviews: A focus group of successful applicants
  Dr Henry Jefferson, Dr Richard Thomson, Royal Liverpool University Hospital; David Brigden, Bangor University and University of Bolton
• CETL update: CEIPE, the broad brush stroke of interprofessional education – developments in research informed practice
  Dr Sue Morison, Director; Hazel Cuene-Grandidier, Dr Joanna Purdy, Anne Montgomery, Centre for Excellence in Interprofessional Education, Queen’s University Belfast
• Developing a staff development session formedical teachers
  Susie Schofield, University of Dundee; Dilip Nathwani, Ninewells Hospital, Fiona Anderson, NHS Education for Scotland, Professor Margery H Davis, University of Dundee
• From traditional dental lectures and conferences tomore interactivemethods: The Manchester experience
  Dr Ziad Al-Ani , Dr Ray Richmond, Professor Iain Mackie, Dr Nick Grey, University of Manchester
• MEDEV student essay 2009 competition winners
  Gillian Brown, Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine
• Suggest feedback methods and explain how they would help you progress on your course
  Richard Timms, Swansea University
• Staff development for health professions’ education
  Dr David Levy, Tameside Acute NHS Trust
• Creative communication formedical students: Using installation and performance art to communicate ideas about medicine
  Anna Dumitriu, Brighton and Sussex Medical School
• Supporting medicine, dentistry and veterinary studies: Striving to deliver high quality resources to the UK academic and research community BrianMitchell, JISC Collections
• Developing students’ Internet research skills: A new direction for the Intute Virtual Training Suite
  Jackie Wickham, Laurian Williamson, Intute: Health and Life Sciences, University of Nottingham
• Enhancing clinical learning in the workplace
  Professor Stephen May, DrMatthew Pead, Dr Vicki Dale, Royal Veterinary College, University of London; Dr Richard Hammond, Dr Sarah Freeman, Elizabeth Mossop, School of Veterinary Medicine and Science; Roger Murphy, Dr Ruolan Wang, School of Education; Professor Claire Anderson, School of Pharmacy, University of Nottingham
• Conference report: The teacher in obstetrics and gynaecology, May 2009
  Nigel Purcell, Senior Advisor (Education), Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine
• Conference report: The second national conference on student evaluation. Embedding evaluation: Working with students to close the loop, February 2009, UCL
  Dr Ann Griffin, Barts and The London School of Medicine and Dentistry; Dr Anita Berlin, University College London; Jerry Booth, Hull York Medical School
• Workshop programme

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The hybrid learning model - a framework for teaching and learning

Dr Vilinda Ross, Dr Alan Masson, Áine MacNeill and Colette Murphy, CETL(NI) Institutional eLearning Services, University of Ulster

The Hybrid Learning Model (HLM), developed by CIES (CETL (NI) Institutional ELearning Services), is a novel method of capturing and communicating teaching practice where teachers and students interactions and roles are clearly defined at each stage within a learning situation. The Model is based on the University of Liège LabSet project’s ‘8 Learning Events Model’ (8LEM)¹ and is enriched with a vocabulary of generic ‘learning activity’ verbs derived and adapted from.²

The HLMallows practitioners to describe, record and communicate their practice in understandable terms. Practitioners are provided with a set of flash cards which visually depict the 8 learning events and related learning verbs.

Using a lesson plan as a reference point they select an appropriate sequence of learning events to describe a chosen learning activity. The practitioner selects the verbs that accurately convey both their own activities and that of their learners within each individual learning event, and records this on a HLMmapping grid alongside supporting contextual information. This process allows complex learning activities to be broken down into a simple structured format in plain English.

HLM in practice

Evaluation to date indicates that the HLM enables practitioners to articulate their practice and analyse their role and that of the learners in an explicit and efficient manner. Feedback has suggested that HLM can provide practitioners with a pedagogical framework that encourages teachers to incorporate a variety of tasks and interactional styles encouraging themto introduce students to a richer learning experience. Studies with University of Ulster staff have shown that use of the HLM has been helpful in appreciating the learner perspective or as one practitioner commented it made them “look at the learner perspective with fresh eyes”.

Recent work with year one students usingmodelled activities, developed in conjunction with lecturers using the HLM, were presented to different student cohorts to assess how this impacted on student’s understanding of and participation in new learning activities.

Evidence to date with different student cohorts suggests that HLM ‘helps students adapt to the expectation of what is going on’. Studies have included modelling a range of different learning scenarios. These have included completion of a portfolio, and, a module with students from the Ulster Business School (UBS), 1st year experiments with Engineering students, software development with Computing students and completion of a reflective journal with 2nd year Career students. In each instance, students were presented in class with a HLM modelled walk through animation and a complementary textual mapping grid. Student feedback was elicited through immediate impact questions after the introduction of the model and an end of semester survey.

In general, studies have received positive feedback.

“Something like this would be a positive help... especially the terminology and being able to focus your learning differently.”

“It puts all the information into simple terms, and it is easier to understand as a new student.”

“I think it will be useful as it explained in simpler terms what is expected ofme to do throughout the semester.”

“It addresses the key concepts that need to happen for the learning process to be successful between the student and the teacher. This is easy to understand and take on board.”

First year undergraduate UBS students

A tagcloud was created at www.wordle.net of open response comments from a cohort of UBS students in response to how they thought the modelled activity would be useful in preparation for a portfolio based assignment. Students were clearer of what was expected of them, they found the task easier to understand and they considered the model a useful guide to help them complete the task at hand.

Conclusions

The HLM modelled activities offer a simple mechanism to help students scaffold their learning in a variety of different learning situations. The HLM has assisted teachers to guide the student to a better understanding of what is expected of them and has provided students with a simple framework and checklist to support independent learning. These teacher generated models have been successfully used in different learning situations and across different disciplines. The process is easy to use, easy to understand and offers ameans of introducing students to new learning situations in both practice based scenarios and in the classroom.

The project team are interested in exploring how this approach can assist learners to adapt to clinical learning scenarios.

References

1. Verpoorten D, Poumay M, Leclercq D. The 8 learning events model: a pedagogic conceptual tool supporting diversification of learning methods TENCompetence conference. 2006: Sept 12. dspace.learningnetworks.org (accessed 5 August 2009)
2. Bennett S. University of Wollongong. 2005. www.learningdesigns.uow.edu.au (accessed 4 August 2009)

For more information contact elearning@cetl.ulster.ac.uk

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NICE eLearning resources in evidence based decision making

Dr Kieran Walsh, Editor, BMJ Learning; Dr Kamran Siddiqi, Education Adviser, National Institute of Health and Clinical Excellence The National Institute for Health and Clinical Excellence

The National Institute for Health and Clinical Excellence (NICE) is collaborating with BMJ Learning to produce learning resources that will help medical students and other health professionals to learn about evidence-based decision making in health and healthcare.

NICE is best known for producing clinical and public health guidance for doctors and other health professionals. But what is less well known is the work that NICE has been doing to help health professionals at the coal face put this guidance into practice. To help with the implementation of its guidance, NICE has developed awide ranging strategy – it includes everything from providing individuals and institutions versions of its guidance in PowerPoint slides to helping local champions convince their peers to start implementing NICE guidelines.

Part of this strategy is education – if health professionals don’t know about NICE guidelines then they are unlikely to be able to implement them. To this end NICE has partnered with eLearning providers to produce a number of interactive and multimedia learning resources on its clinical guidelines. These have been used on continuous professional development resources aimed at fully qualified health professionals.

But what of the needs of medical students? And what about health professionals who wish to understand the principles and values that underpins NICE guidance?

NICE is working with relevant higher educational institutions to ensure that medical students (and thus eventually junior doctors) and other health professionals acquire the understanding of the underlying principles and skills to put NICE guidance into practice. This would enable them to influence their own practice and that of their colleagues to provide the best possible healthcare within a system that has limited resources.

To help achieve this, NICE in collaboration with BMJ Learning, has produced a medical student eLearning package which includes the following topics:

• evidence based medicine and following guidance - how to do it www.medev.ac.uk/dinky?dinky_id=950
• making decisions - how to do it in an evidence based and fair way www.medev.ac.uk/dinky?dinky_id=949
• changing practice - how to understand, identify, and overcome barriers to change www.medev.ac.uk/dinky?dinky_id=948
• health promotion and audit and feedback - how to do it www.medev.ac.uk/dinky?dinky_id=947

The package is currently being piloted in University of London, Leeds Medical School and St George’s University of London. The pilot is not just about seeing how the medical students get on with the package but also about how the medical schools succeed in integrating it into the curriculum. Interim results suggest that an overwhelming proportion of students in the two medical schools have used these resources and found them very helpful. Following on from this pilot phase, NICE would like to offer this package as a free resource to other medical schools in the UK. The package was officially launched in July 2009 at the ASME conference in Edinburgh. You can visit the pilot on learning.bmj.com/learning/viewchannel. html?channel=nice and let us know your thoughts and suggestions.

You can find the NICE education strategy through: www.nice.org.uk/usingguidance/education/Education.jsp

For more information contact kmwalsh@bmjgroup.com

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Book review: How to Succeed at Medical School: An essential guide to learning

Amy-Jo Farrow, 4th Year Medical Student, Newcastle University

‘How to Succeed at Medical School’¹ seeks to enlighten prospective and new medical students with an understanding of learning as an active process, in which they are the primary focus, encouraging an early consideration of learning for life. It aims to teach students how to learn effectively by applying evidence and experience-based techniques to challenges specific to medical school and beyond, in an attempt to discourage ‘do just enough to get by’ attitudes.

On first glance the paperback is small, thin and suitably looks like an effortless read. The chapters are routinely divided into an overview, introduction, suggestion boxes, students’ points of view, summary, references, further reading and frequently asked questions (FAQs). Within this, the body of the text is delivered in a ‘why do it/how to do it’ fashion, interspersed with experience based examples which lend themselves readily to practical application. Readers are also encouraged to actively participate in the ‘exercises’which are simple and provoke effective introspection, a skill medical schools hope that students will have mastered by graduation. Whilst this may sound disjointed, the informal delivery and anecdotes provided by the authors result in an interesting and engaging read.

With chapters such as ‘what kind of learner are you?’ and ‘portfolios and reflection,’ techniques for studying smarter² in ways specific to medical training circumstances are addressed. Whilst covering how to learn knowledge, clinical skills and clinical communication skills through delivering suitable tried and tested methods and an original model, the guide also reinforces the importance of proficiency in these for the future. Important messages about professionalism and careers are not given dedicated chapters but are present throughout the book. Thinking long-term, the chapters on revision and exam technique come after the chapter for life-work balance; which mirrors the subtext of the whole book.

A major strength is the way the authors cover learning theory using considered evidence, whilst always relating back to their experience with students and as trainees personally. A particularly good example of this is in relation to one of the authors as a student unsuccessfully trying to anticipate examquestions based on suspected patterns in past papers. In this way it not only suggests useful techniques but highlights fruitless methods from a student, examiner and doctor’s perspective. The book makes an attempt to identify and compensate for its limitations; the suggested reading and links to other potentially useful sources atone for gaps in the content, for example, how to tell if information sources are reliable. In this way the book can be used as a compass for other learning resources.

Although many weaknesses are identified there are a few things that could be improved. Alongside the odd grammatical and punctuation error, cross referencing between chapters and tables occasionally does not correspond with the content referred to, and, in spite of this there is still much inter-chapter repetition. The end of the book lets it down slightly. There was no epilogue, final word of reassurance or positive note to end on, which the writing style would have permitted, and the index could be more comprehensive. However, on balance the strengths are innumerable and offset the mild limitations.

Studying medicine is realistically presented in this book as a marathon and the need for students to teach themselves how to train to be doctors is the key message. Although written primarily for the benefit of medical students the metacognitive methods detailed in the guide are clearly also applicable to other vocational subjects and stages of training. Using the skills identified in the chapters, the student should be able to recognise their own learning needs, weaknesses and methods for resolution. Indeed when writing this review I used many of the techniques described in the ‘developing your academic writing skills’ chapter.

References

1. Evans D, Brown J. How to succeed at medical school: An essential guide to learning. BMJ Books. 2009:ISBN 978-1-4501-5139-9
2. Paul K. Study smarter, not harder 2nd revised edition (self-counsel business series). Self Counsel Press. 2007:ISBN 1551807416

For more information contact a.j.farrow@ncl.ac.uk

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Preparing for specialist training interviews: A focus group of successful applicants

Dr Henry Jefferson and Dr Richard Thomson, F1 Doctors, Royal Liverpool University Hospital; Professor David Brigden, Director of Learning and Teaching, The School of Medical Sciences, Bangor University, North Wales and Professor of Professional Development and Life long Learning, University of Bolton

As the number of applicants for foundation and specialist training posts increases the need to prepare for interview has never been greater. This study sampled opinions and advice from successful F2 applicants to highlight preparation for the interview.

Introduction

The specialist training interview is one of the most feared institutions on the road to becoming a specialist trainee. The 30 minutes or so spent in the interview room are ultimately more important than anything that has come before. How you present yourself will differentiate you from your counterparts and reveal your strengths and weaknesses.

With Modernising Medical Careers (MMC)¹ being introduced in 2003 there instituted a reform of the selection criteria for entry into foundation and specialist training. Entry into specialist training is competitive, drawing on evidence derived from the candidate’s past performance, as recorded by a portfolio, allowing ranking of candidates for interview.² However, the ability to differentiate candidates on their paper applications is difficult. This is especially true in general practice training posts where candidates are offered an interview only if they pass an exam.Many trusts have also abolished the house officer interview, resulting in a decrease in interview experience.

Evidence has emerged that the traditional ‘one panel interview’ is not reliable³ and a new process of multiple mini, or OSCE interview has been adopted in some trusts, comprising several ‘stations,’ each with a different interviewer, which test different aspects of the candidate’s knowledge and ability.⁴ An increase in the number of stations, limited only by the trust’s imagination and resources, increases the reliability of the interview and reduces potential sources of bias.⁵ The result is a fairer but more drawn out interview process which has received positive feedback from both candidates and interviewers.⁶

Aim

Our aim was to establish how to prepare for specialist training interviews based on the opinions of recently successful candidates.

Methods

We invited 15 F2 doctors, all of whom had secured specialist training posts, to attend a focus group. Each doctor was asked about their preparation, what structure their interview took, what guidance they received prior to interview and any changes they would make were they to repeat the process. The group then set out guidelines (Table 1) and recommendations (Table 2) for prospective foundation candidates applying to specialist training.

Results

Of the 15 doctors invited, ten attended the focus group. Of the ten present, give were successful applicants to surgical ST posts, four were successful GP applicants and one was a successful obstetrics and gynaecology applicant.

Table 1: What candidate did to prepare

Preparation

Speak to previous and current candidates:

• types of questions asked;
• format in particular Deaneries;
• sharing of recent research topics;
• ideas for audit and research;
• common questions;

Familiarised with portfolio and CV:

• built over the 2 years;
• CBD /miniCEX / reflection;
• ‘re-shuffled’ ensuring everything was in place and annotated for quick reference when questioned.

Studied:

• recent changes to practice in area of speciality and training;
• what was involved in the programme applied for;
• recent research in area of speciality;
• Identify, if possible, the type of interview and familiarise with the process.

DOPS for surgery.

Speciality logbooks e.g. surgical logbook for theatre time.

Audit in area of interest.

Participated in research or publications in speciality or area of interest.

Presente at educational meetings.

Teaching involvement.

Attended relevant courses e.g. ATLS, basic surgical skills, CRISP.

Covered as many areas of the person specification as possible.

Discussion/conclusions

Whether a foundation doctor applying for higher specialist training or an SpR applying for a consultant post there were several basic generic principles that applied when preparing for interview.⁷, ⁸

Differences in preparation for an OSCE style vs. a traditional panel interview were not clear at the end of the focus group. While the format had changed, the overall content and aims of the interview remained the same, and therefore so did the preparation.

Preparation for interview began on the first day of F1. Building of the portfolio and CV was the gateway to interview, but the ability to discuss and reflect what had been achieved in a critical manner was paramount. The ability to do this came from being familiar with the CV and portfolio, allowing the interviewee to guide questioning onto topics which they were familiar with and discuss important areas of their CV, which they felt was relevant to the job.

Mock interviews were viewed as an important step, but the best ‘practice’ was the interview itself.Many of the successful applicants had had previous unsuccessful interviews fromwhich they were able to draw experience. Even well prepared candidates had little idea what to expect in their interviews. Deaneries should train foundation doctors better to prepare.

Ultimately a candidate is selling themself as someone who has to work closely within a team. It is important to come across as professional and enthusiastic about your chosen area, and a good way to demonstrate this is being abreast of key areas of recent research.

Table 2. Recommendations from recently successful candidates

Recommendations

• Apply to as many posts as possible – the more interviews you attend, themore confident you will become.
• Start preparing early – portfolio and CV preparation takes longer than you think, and it is important that the first time you see your CV in three months is not in the interview room.
• Try not to plan other commitments around the time of interview e.g. exams.
• Start preparation for interview at the beginning of F1.
• Increase the number of mock interviews.
• Answer the question put to you.
• Be able to guide the interview onto topics you want to talk about.
• Have questions for the interviewers.
• Keep your answers succinct.
• Present yourself in a professional manner.

Limitations

The number of participants in the focus group was a limiting factor on the outcomes, with not all specialities being represented within the group, most notably core medical training applicants.

Preparation for interview following these simple principles remains as vital today as it was before the advent of MMC.

Table 3. Mock interviews were important

Mock interviews

• With friends/colleagues.
• With tutors and seniors.
• Who has provided guidance to you about the interviews you would face?
• Consultants.
• Seniors.
• Recently successful peers.

References

1. www.mmc.nhs.uk (accessed 4 August 2009)
2. Department of Health. Modernising medical careers: the next steps. The future shape of foundation specialist and general practice training programmes. London: Department of Health.
3. Elam CL, Andrykowksi MA. Admission interview ratings: relationship to applicant academic and demographic variables and interviewer characteristics. Acad Med. 1991:66(Suppl),13-5.
4. Eva KW, Rosenfeld J, Reiter HI, Norman GR. An admissions OSCE: the multiple mini-interview. Med Educ. 2004:38(3),314-26.
5. Harasym PH,Woloschuk W,Mandin H, Brundin-Mather R. Reliability and validity of interviewers judgements ofmedical school candidates. Acad Med. 1996:71(Suppl),40-2.
6. Humphrey S, Dowson S,Wall D, Diwakar V, Goodyear HM.Multiple mini-interviews: opinions of candidates and Interviewers. Med Educ. 2008:42,207-13.
7. Reiter HI, Eva KW, Rosenfeld J, Norman GR. Multiple mini-interviews predict clerkship and licensing examination performance. Med Educ. 2007:41(4),378-84.
8. Westwood MA, Nunn LM, Redpath C, Mills P, Crake T. Applicants regard structured interviews as a fair method of selection: an audit of candidates. J R Soc Med. 2008:101(5),252-8.

For more information contact dnbrigden@btinternet.com

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CETL update: CEIPE, the broad brush stroke of interprofessional education: Developments in research informed practice

Dr Sue Morison, Director; Hazel Cuene-Grandidier, Research Fellow; Dr Joanna Purdy, Research Fellow; Anne Montgomery, Research Assistant, Centre for Excellence in Interprofessional Education, School of Dentistry, Queen’s University Belfast

The Centre for Excellence in Interprofessional Education (CEIPE) is one of three Centres for Excellence in Teaching and Learning at Queen’s University Belfast.

The aim of CEIPE is to develop research informed interprofessional learning opportunities, which will enhance undergraduate education and enable students to become competent practitioners. Through learning together it is expected that students will understand more about other professionals with whom they will work in the future.

The CEIPE team comprises academic and research staff from a range of schools within the university who collaborate to develop areas of the curriculum that would enable students to benefit from an interprofessional approach to teaching and learning. The main foci of the interprofessional programmes is to enhance students’ team work and communication skills, promote collaborative practice and increase role awareness to facilitate them to become competent practitioners.

Emerging findings

To date, analysis of the quantitative and qualitative data has revealed informative and interesting results.

Students have reported that interprofessional education is a valuable learning experience and have described benefits such as an increase in role awareness; improved clinical and interpersonal skills; greater confidence to interact (learn and work) with other professionals; greater insight into patient safety issues and relevance for application to future practice.

Reported challenges within undergraduate interprofessional education include interactional problems such as competitiveness, difficulty communicating with one another, disagreement between professions; lack of disciplinary specificity and limited awareness of each other’s roles.

Preliminary results fromthe CEIPE’s theoretical research suggest variation in the teaching-learning process across professions. Healthcare professionals have distinct ways of approaching teaching and learning and differ in how they engage with students, with implications for interprofessional education. This study has substantive promise in pointing to ways in which improvements could be achieved.

Conclusion

• Undergraduate interprofessional education provides an ideal opportunity to embed the principles of safe clinical practice.
• An interprofessional teaching and learning approach has the potential to improve quality and safety in healthcare.
• Advancing healthcare and information technology appears to be an effective tool in the delivery of interprofessional teaching and learning.
• There is an important role for interprofessional learning in enabling healthcare professionals to examine healthcare beyond the confines of the clinical team.
• Professional identity and profession-specific approaches to teaching and learning are important considerations for future interprofessional developments.
• Long termfollow-up remains an important development to help determine if short term benefits translate into improvements in the workplace.

For more information contact h.grandidier@qub.ac.uk

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Developing a staff development session for medical teachers

Susie Schofield, Lecturer in Medical Education, Centre for Medical Education, University of Dundee; Dilip Nathwani, Director for Undergraduate Teaching, Ninewells Hospital; Fiona Anderson, Training and Education Development Manager, NHS Education for Scotland, Postgraduate Office, Ninewells Medical School, Dundee; Professor Margery H Davis, Director, Centre for Medical Education, University of Dundee

The GMC in The Doctor as a Teacher¹ recognises that “teaching skills are not necessarily innate, but can be learned. Those who accept special responsibilities for teaching should take steps to ensure that they develop and maintain the skills”. To identify the needs of the medical consultant workforce in Tayside for their teaching responsibilities we carried out a questionnaire survey in 2006/07. The topics they identified were used to inform a half day training session that also provided an opportunity to meet other teachers and medical educationalists.

Background

Tayside has approximately 350 consultants, the majority of whom are involved in undergraduate and postgraduate training. In 2006/7 an anonymised survey of all NHS consultants in Scotland was performed to collect information on topics relating to their educational activities. A list of 24 topics for workshops was identified froma literature review and respondents asked to rate the usefulness of each on a 5-point Likert scale with 1&2 grouped as ‘not useful’, and 4&5 grouped as ‘useful’. The responses of Tayside consultants (identified by hospital) were extracted and used as a needs analysis for future courses within Tayside.

Results

The return rate for Tayside consultants was 72% of whom 88% were NHS-employed. 92% had a role in undergraduate teaching, 94% in postgraduate training and 63% in multiprofessional teaching. 54% spent more time teaching than was allocated in their job plans and 69% wanted more time allocated. Only 54% knew they had access to staff development for their educational role (for Scotland as a whole this dropped to 43%). 94% had no educational qualifications and nearly half had attended no workshops on education. 50% expressed preference for workshops to deliver education training.

Course construction

A half-day course was constructed based on the questionnaire results, and invitations went out via email and internal post to all Tayside consultants. The invitation detailed the aims of the event, and attendance entitled participants to three internal continuing professional development (CPD) points.

Response to invitation

Response was high. Due to the small group rotating nature of the training, numbers were limited to 32 per workshop, and 126 consultants have so far attended.

Feedback

Feedback forms were handed out to participants and collected at the end of the afternoon. The main additional comment from the first event was that the sessions should have been longer. Subsequent events had a reduced lunch and slot for asking questions, and rotating sessions were increased to 25 minutes. All sessions were rated useful by the majority of the group, and themix of workshops and presentations was felt to be balanced. Sessions rated ‘not useful’ by aminority were rated as ‘highly useful’ by others so all sessions were retained.

Recommendations

• Do a needs analysis of the target group – paper or electronic questionnaire.
• Award CPD points.
• Ask for and take notice of feedback fromyour presenters.
• Present a mixture of talks and small group activities.
• If limited on numbers, make it very clear on the invitation.
• Send out invitations in plenty of time before the event – in the UK consultants need at least six weeks to reorganise clinics, but six months is better.
• Make sure there’s good catering and plenty of time and room for your participants to meet and talk to other participants – this is a rare opportunity for them to discuss their educational role with others.
• Send a polite reminder to presenters and participants two weeks before the event.
• Don’t give out certificates until participants have handed in their feedback forms.

Follow-up

• Consultants – a second course based on the needs analysis is being developed.
• Other grades – another needs analysis should be done. Don’t assume uniform needs across different job grades. An identical survey of Associate Specialists’ top 10 courses has shown no correlation with the consultant top 10.

References

1. General Medical Council. The Doctor as a Teacher. 1999. Available from www.gmc-uk.org/education/ postgraduate/archive/ doctor_as_teacher.asp (accessed 13 Jan 2009).

For more information contact s.j.schofield@dun.ac.uk

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From traditional dental lectures and conferences to more interactive methods: The Manchester experience

Dr Ziad Al-Ani, Clinical Teaching Fellow in Restorative Dentistry; Dr Ray Richmond, Teaching Fellow in Restorative Dentistry; Professor Iain Mackie, Professorial Teaching Fellow; Dr Nick Grey, Senior Clinical Teaching Fellow in Restorative Dentistry, School of Dentistry, University of Manchester

Learning is a dynamic process and those who are actively involved in learning activity may learn more than passive recipients of knowledge. Interactive symposia could provoke thought and enhance clinical thinking by arousing students’ curiosity, motivating them to learn, and guiding them into creative thinking.¹ This may increase the effectiveness of information delivery,², ³ by creating a positive, memorable learning experience.

Interactive symposia

Traditional lectures are used to convey to teachers information to large audiences but fail to provide feedback about student learning. Students are often passive recipients of information, without engagement in the learning process, and a short attention span. Lectures seem unsuited for teaching higher orders of thinking, instructing skills or influencing students’ attitudes.^4-6

The lecture presupposes the audience has the same learning needs.⁷ Processing of pre-understanding and student activity (which are important factors for learning) are hard to stimulate in the lecture theatre, and the lecture as a teaching form has been questioned and discussed.^1,8,9

Lectures often summarise course content. The same content is often required in assessment.⁷ Students actively search for clues about the content for the subsequent examination based on the actions of the lecturer, ‘cue seeking’.¹⁰ This seems to result in a surface approach and memorisation of facts rather than deeper understanding.⁷

Conventional lectures could be replaced by ‘structured interactive sessions’,². which give teachers feedback on students’ needs, on how information has been assimilated, and on future learning directions, while students receive feedback on their performance. Interactive lecturing benefits fromsmall group learning in a large group format.^2,6

Interactive lectures using an electronic voting system(interactive presenter)

Interactive lectures may align notions of knowledge and learning in problem-based learning (PBL), where students actively participate and process knowledge, and take an active part in contextualising content, directing session focus towards more challenging areas. The interactive lecture is an example of how knowledge about meaningful learning can be implemented.⁷

Interactive presenter is one of a range of tools offering a multiple choice question (MCQ) to an audience where up to 10 alternative response options are displayed. Small handsets are distributed to each audience member, allowing everyone to contribute anonymously. After a specified time, aggregated results are displayed. Everybody sees the consensus or spread of opinion, and knows how their answers relate to everyone else whilst remaining anonymous.

Games and quizzes

Students who are engaged with teaching can have a more successful learning outcome in terms of recall and knowledge base. Games and quizzes are interactive methods and contain additional elements of fun and distinctiveness.¹¹

Who wants to be a prosthodontist?

This game (based on the TV show Who wants to be a millionaire?) was developed to assimilate academic and clinical knowledge in prosthetic dentistry and to make symposia more enjoyable, stimulating and productive. One student responded to a series of 15 questions of increasing difficulty, selecting an answer from four responses, with the possibility of 3 lifelines:

• poll the audience;
• ask one colleague (‘phone a friend’);
• have 2 answers eliminated (50/50).

The lecturer discussed each question in detail and the group was allowed to ask questions before moving on.

Dental conferences

Medical and dental (typically passive) conferences provide amajor avenue for continuing education, maintenance of professional standards and professional development. Lectures or presentations rarely incorporate audience interaction, and have consistently failed to alter dentists and doctors behaviour, improve clinical performance or change patient outcome,^12-15 leading some to surmise that conferences are generally ineffective in changing health workers behaviour.¹³ Systematic meta-analyses indicate that conferences delivering interactive sessions, designed to enhance participation, are effective,^12-14 and therefore we should shift from traditional didactic or passive teaching at conferences tomore effective methods of learning that require audience participation and engagement.¹⁶

Evaluation of interaction

An evaluation questionnaire was used to assess the effectiveness of interactive sessions in an academic setting.

When asked about their general opinion, most of the participants valued interactive symposia and thought the organisation and application of the technique was successful.

Seventy-eight percent rated the lecture successful.When students were asked to rate how useful each component of the interactive lecture was for their learning, only 2% of student responses were negative.

Positive student feedback showed that the interactive symposia adopted in the School of Dentistry were effective in meaningful learning in a large group session. Student feedback demonstrated that the interactive philosophy of learning was successful, interactive and enjoyable. It was more motivating and retained attention throughout the symposium. These findings reinforced the idea that using interactive techniques in symposia may minimise many of the weaknesses of traditional lectures.

There were 78 fourth year 2007 undergraduate students exposed to Who wants to be a prosthodontist? game.

Feedback forms returned after the teaching session revealed that the students enjoyed the game-playing.

Students responded positively to the questionnaire used to assess this tool and a sample feedback from those who played the classroom version of this game was offered.

Some feedback from the students involved:

“Brilliant idea! Such a simple thing, but yet so helpful” “Excellent idea which makes learning [ ] easier”

“I found it a very useful learning aid, it makes you think and participate in seminars, it was also good fun”

“An extremely helpful and interesting way of learning. Made the seminars much more enjoyable, as well as providing the opportunity to be interactive – fab”

“Amazing idea, I look forward to the same thing for other subjects”

Participants at the BATCD (British Association of the Study of Conservative Dentistry) BDA (British Dental Association) and BADT (British Association of Dental Therapists) conferences responses were very positive with the rate of 98%, 96% and 97% respectively.

Feedback from students and conference audiences clearly indicated that they welcomed the interactive approach and themore direct input they had to the learning process. Most of the comments mentioning the interactive lecture were positive. Clearly, for most of the participants this was an enjoyable and rewarding experience.

References

1. Brown G,Manogue M. AMEE Medical Education Guide No. 22: Refreshing Lecturing: a guide for lecturers. Med Teach. 2001:23(3),231-244.
2. Steinert Y, Snell L. Interactive lecturing: strategies for increasing participation in large group presentations. Med Teach. 1999:21(1),37-42.
3. Stunkel KR. The lecture: a powerful tool for intellectual liberation. Med Teach. 1999:21,424-5.
4. Bonwell CC. New directions for teaching and learning enhancing the lecture: revitalizing a traditional format. San Francisco, CA: Jossey-Bass Publishers. 1996.
5. Keyser MW. Active learning and cooperative learning: understanding the difference and using both styles effectively. Research Strategies. 2000:17,35-44.
6. Kumar S. An innovative method to enhance interaction during lecture sessions. Adv Physiol Educ. 2003:27(1-4),20-5.
7. Fyrenius A, Bergdahl B, Silen C. Lectures in problem-based learning – why, when and how? An example of interactive lecturing that stimulates meaningful learning. Med Teach. 2005:27(1),61-5.
8. Gibbs G, Jenkins A. Break up your lectures: or christaller sliced up. J Geog in High Educ. 1984:8,27.
9. McKeachie WJ. Student ratings. The validity of use. Am Psychol. 1997:52,1218-25.
10. Miller C, Parlett M. Up to the mark. A study of the examination game Society for Research In Higher Education London. 1994.
11. Selby G,Walker V, Diwakar V. A comparison of teaching methods: interactive lecture versus game playing. Med Teach. 2007:29(9),972-4.
12. Davis D, Thomson MA, Oxman AD and Haynes RB. Changing physician performance: a systematic review of the effect of continuingmedical education strategies. J Am Med Assoc. 1995:274,700-5.
13. Davis D, O’Brien MAT, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A. Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behaviour or health care outcomes? J Am Med Assoc. 1999:282,867-874.
14. O’Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard- Jensen J, Kristoffersen DT, et al. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2007(4):CD000409.
15. Weller J,Harrison M. Continuing education and New Zealand anaesthetists. Anaesth Intensive Care. 2004:32,59-65.
16. Ting J. A shift from passive teaching at medical conferences to more interactive methods improves physician learning. Med Teach. 2007:29(2-3),285.

For more information contact nicholas.grey@manchester.ac.uk

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MEDEV student essay 2009 competition winners

Gillian Brown, Advisor (Education), Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine

Congratulations to the winner and runners up of the 2009 MEDEV student essay competition.

Richard Timms, Medical Sciences with Humanities student, Swansea University, who won an iPod Touch and attendance at the Higher Education Academy Annual Conference.

There were 3 runners up who each received a £20 book token:

• Abubakar Mohammed, Imperial College;
• Dipender Gill, Queen’s College, Oxford;
• Vengee Lim, University of Edinburgh.

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Suggest feedback methods and explain how they would help you progress on your course

Richard Timms, Swansea University

Beans on toast for tea has led me to contemplate the issue of feedback. The clue is in the word ‘feedback’. Just as starving students are perpetually in search of sufficient nutrition, we require mental satiation in the form of constructive comments on our work without which we cannot grow and develop as scholars and future professionals. And just as we can survive on a basic diet of toast and baked beans, yes, we can survive intellectually on basic grades or cursory comments on our performance. However, we are eternally grateful when a kindly relative treats us to a slap-up meal, and similarly a hearty portion of really constructive feedback is more than welcome.

To continue with the nutrition metaphor, a varied diet and equally varied forms of feedback will help us thrive. So grades, pencil scratchings in the margin, fulsome assignment sheets where our achievements and failings are detailed, verbal comments and tutorial discussions are all to be welcomed. Whatever the form it takes, feedback needs to identify the rationale for our particular grade or assessment and give pointers to how we can improve in future.

However, as students preparing to work in the ‘real world’, we realise that beyond the confines of academia overt feedback will be rare. Instead it will take covert forms. If our performance is poor we might only obtain clues from tight-lipped supervisors, grumpy customers, disenchanted patients or the binning of our letters and reports. Therefore, it is important to develop our capacity to evaluate our own performance, in effect giving ourselves feedback.

Because of this I am advancing a proposal for some, although probably not all, exams or written assignments.

To explain, after being evaluated by tutors, our work would be returned with a grade. At the same time, a model answer would be made available. We would then be required to submit a supplement to our original assignment which would be a critique of the assignment, demonstrating our understanding of how our work fell short of the model answer. The final grade would be the original assignment mark combined with one given for the evaluation.

This has several advantages. First, this would distinguish those students who have greater understanding from those who have less. There is a considerable difference in ability between the student who can understand why a lower mark has been awarded and those who cannot. Therefore two students may achieve a C or 55% for an assignment. But the one who has sufficient understanding to appreciate the deficits in their assignment, “Oh, I see that’s where I went wrong” has far more ability than their fellow scholar who insists their essay was perfectly okay and cannot see what was amiss with their work.

This system, in terms of the second advantage, would avoid the tragedy of students who write wonderful assignments which fail because they did not answer the question set. There are instances of very able students whose ability is not reflected in their marks because they did not appreciate that they were misinterpreting the question set or were becoming overly absorbed by irrelevant material. Such able students would be able to rectify the situation and gain at least some acknowledgement of their hard work through their self-evaluation.

To give a numerical illustration, normally able Student A misinterprets some exam questions resulting in a dismal score of 30%. More limited Student B does the same and also achieves 30%. In their feedback, while Student A writes a fulsome and accurate evaluation of his or her exam shortcomings and is rewarded with 80%, giving an overall 55%, Student B shows only the faintest glimmer of understanding and manages 40% resulting in only a slight overall elevation ofmark to 35%. The original 30% mark which both received did not reflect their differing abilities, whereas the final mark does somore accurately.

Thirdly, talking to student friends from a range of British universities there is the suspicion that some tutors have a cap on the highest marks they would ever give. Essays are returned with fulsome praise extolling the excellence of our work yet the mark is only 75% or A-, so where has the additional 25% gone? Where are the marks lost when almost no deficits in our assignment are highlighted? This system would require tutors to identify what a perfect answer looks like and mark assignments in comparison to the model.

It would, fourthly, give a double portion of feedback. Returning to the nutritional analogy, students would be served a main course and a pud. When the final assignment is returned there would be the tutor’s comments on both the original essay, project or examand the subsequent self-evaluation.

The fifth advantage is that it should develop our ability to appraise our own work and performance. As mentioned, in the real world although there is some provision for formal feedback from supervisors, and customer or patient satisfaction surveys, most of the time we have to rely on ourselves to determine the standard of our writing or performance. Self-appraisal is a vital skill and could be enhanced by this double-feedback method.

Although the focus of this essay has been on written exams and assignments, the proposal could be adapted for practical skills. Often a model is naturally provided by senior clinicians or experienced staff, we could therefore be required to evaluate our own performance in relation to interventions and behaviours modelled by them.

Turning to practical logistics, it is recognised that this proposal would demand a greater time commitment by academic staff. However, remember how grateful we are for an occasional slap-up meal and how necessary such largesse is to our hungry bodies. Similarly, this mealsized portion of feedback might not be part of the regular intellectual diet but would be very welcome as an occasional treat.

To conclude, variety of feedback adds spice to students’ endeavours. However, forms of feedback requiring self evaluation have a particular appeal and value. Now where have I put the can opener?

For more information contact gillian@medev.ac.uk

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Staff development for health professions’ education

Dr David Levy, Director of Medical Education, Consultant Paediatrician, Tameside Acute NHS Trust

There are several principles of quality assurance in medical education, including principles of accountability, self-evaluation and external peer review. Friedman et al.¹ relates to a comprehensive review at the University of North Carolina School of Medicine.

The process described in the paper highlights the accountability of North Carolina’s School of Medicine because:

• it clearly describes the medical education governance processes and the various committee structures;
• it involves stakeholders in the faculty-student group;
• evidence is sought through the development of standardised questionnaires;
• interviews are held with course directors and evaluations are compared over time;
• the process is subjected to public review;
• action plans are implemented from summary statements.

A similar but more extensive revolution in medical education has occurred in the UK through implementation of both Modernising Medical Careers (MMC) ‘run-through’ training² and of Postgraduate Medical Education and Training Board (PMETB) Generic Standards For Training.³ There are clear lines of accountability with the Deanery acting on behalf of PMETB to ensure standards are being applied, monitored and evaluated at local Trust level through monitoring visits and written evidence.

At Tameside Acute NHS Trust, a district general hospital, we have established clear medical education governance structures demonstrating lines of accountability, mapping with those designed by ¹ in the context of motivation and staff development within the Trust.

It became apparent that we needed to develop more robust processes in order to achieve the standards laid down by PMETB, the “Gold Guide”,⁴ National Association of Clinical Tutors (NACT) recommendations⁵ and other requirements. We have established a specific policy on medical education which underpins medical education governance, including:

• a vision andmission statement;
• the medical governance systems (internal and external);
• roles and responsibilities;
• management of the foundation and specialty programmes;
• quality control processes;
• monitoring and regulation of the educational supervisory process;
• career management;
• managing doctors in difficulty.

Accountability

Our Medical Education Committee (MEC) has become the focal point of the internal medical governance structure. It meets monthly and has been expanded to encompass more stakeholders including a lay person, a Deanery representative, GP tutor, career grades, HR, finance, the career lead, the librarian, multiprofessional services and an increasing number of trainees to represent each of the various training schemes (foundation and speciality, including GP). It reports directly to the Trust Executive Group (TEG) with the Director of Medical Education (DME) and Foundation Leads providing a biannual report to the CEO of the Trust and the Postgraduate Dean. Standing items on the MEC agenda include:

• foundation issues;
• speciality issues;
• European working time directive compliance and 2009 action plans;
• trainee issues;
• library and resources.

In the past the roles and responsibilities of the individuals involved in medical education has been a little haphazard. Our medical education policy clearly demonstrates each individual’s accountabilities including the CEO, Medical Director, Director of HR, DME, Foundation Leads, Royal College/Programme Tutors (RCT), Clinical Leads, Clinical Supervisors, Educational Supervisors and the Medical Education Manager.

It is planned that under the heading of specialty training the College/Programme Tutors will report biannually to the MEC on compliance with PMETB standards of their programmes using a structured proforma that is adapted from NACT. External reports will be disseminated (e.g. PMETB survey, Deanery visiting reports) and action plans developed according to recommendations in the reports.

An enhanced proposal for the monitoring and regulation of the educational supervisory process is contained in the medical education policy. Key clinical staff responsible for delivering training are educationally appraised annually. The process is made more robust by:

• introduction of specific training and education appraisal forms (adapted from Deanery);
• clear personal development plans (PDPs) in training and education being established;
• consultant PDPs in medical education being audited with targeted training established for identified gaps;
• the information to inform job planning has clearer reflection.

Each trainer is responsible for identifying and managing doctors in difficulty. A clear structure with practical advice is summarised in the policy on medical education with reference to Managing Trainees in Difficulty (NACT, Jan 2008)⁶, Guidelines for Managing Under-Performing Pre- Registration House Officers (Dept of Postgraduate Medicine & Dentistry, University of Manchester 2003)⁷ and the Trust Medical Conduct Policy.⁸

Self evaluation

This occurs in several areas including:

• teaching, learning and assessment;
• trainee support and guidance;
• learning resources;
• student progression and achievement.

We have implemented the Postgraduate Hospital Environmental Evaluation Measure (PHEEM) validated questionnaire. This has been introduced to foundation trainees and, following successful data collection and actions, has been extended to speciality trainees. Quality and improvement can only occur if weak areas are identified and rectified. A great advantage of this questionnaire is that further analysis also allows the breakdown scores for each item so that each department can obtain a clear idea about their own strengths and weaknesses. The reports are sent to each RCT together with a letter of explanation, who is asked to produce action plans using the template enclosed. Implementation of these action plans with subsequent regular, repetition of the PHEEM will hopefully demonstrate improvement and maintenance of quality of the training.

We carry out regular audits on a random selection of trainees in each speciality to include aspects highlighted by PMETB and not included in PHEEM (e.g. 4 hours of protected teaching, receiving timely, robust work-based assessments, having 3-monthly appraisals, good clinical experience and appropriate sessions in theatres, outpatients etc.). Results from these audits are used to cross-reference and triangulate the information from the RCT reports.

We have introduced more robust feedback forms for lecture/training sessions, and are now installing systems to:

• ensure more complete feedback (aiming for at least 80% of attendees);
• provide analysis of the results;
• send a timely summary of the feedback to the trainer which they can include in their portfolio.

We will evaluate trainee progression using a variety of methods, including the:

• success of our foundation trainees in completing the foundation programme and entry into specialty training;
• application numbers of qualified medical students to our local foundation programme;
• application numbers of trainees to our local GP specialty training scheme;
• recording of the success rates in postgraduate exam;
• regular auditing of study leave.

Staff development

Medical educators must be fit for purpose. This includes training so that they are able to take up the roles and responsibilities outlined in the medical education policy. Examples include:

• equality and diversity training;
• training in giving feedback;
• mentoring;
• work-based assessments;
• ePortfolio;
• delivering structured reports;
• managing and supporting doctors in difficulty;
• managing appraisal;
• understanding educational theory;
• advice about access to career management;
• supporting delivery of the educational contract.

This is an ongoing process and involves:

• the establishment of databases;
• reports of staff development of consultants by RCTs to the MEC in their biannual report;
• auditing of the annual appraisal of consultants on the aspects of medical education to see if there are training needs that can be delivered jointly by the Trust and Deanery. We are looking to utilise the same appraisal forms as the Deanery uses for their own team.

Teaching and training also forms a significant aspect of consultant application for Clinical Excellence Awards (CEA). Demonstration of excellence in this domain will help achieve monetary gain. This is currently aided by trainers receiving feedback on their teaching sessions but it is envisioned that:

• introducing a teaching dossier as described in the module will help inform consultants in their annual appraisal and in application for CEAs;
• introducing an award system similar to that described⁹ will help motivate trainers firstly by gaining recognition and also by being able to put such an achievement on the CEA application forms.

When educators have clear roles and responsibilities, they are able to recognise what is required. They can understand their own gaps in knowledge, skills or attitude and with robust appraisals can develop personal development plans which include specific study leave time and budget allocation. The Trust can monitor the needs of the staff and help target training to relevant needs.

In summary, academic accountability motivates consultants to improve their teaching and training skills. They know what is expected and have a clear idea of appropriate standards. Continuous monitoring, evaluation, action planning and rewarding are key areas that all need to be addressed in order to make staff development successful within my institution.

References

1. Friedman CP et al. Improving the curriculum through continuous evaluation. Acad Med. 1991:66(5);257-8.
2. www.mmc.nhs.uk/default.aspx?page=318 (accessed 4 August 2009)
3. www.pmetb.org.uk/index.php?id=gst (accessed 4 August 2009)
4. www.medev.ac.uk/dinky?dinky_id=943 (accessed 4 August 2009)
5. www.medev.ac.uk/dinky?dinky_id=944 (accessed 4 August 2009)
6. www.medev.ac.uk/dinky?dinky_id=945 (accessed 4 August 2009)
7. Document not available online, Please contact author.
8. Document not available online, Please contact author.
9. Posluns E et al. Rewardingmedical teaching excellence in a major Canadian teaching hospital. Med Teach. 12(1);13-22

For more information contact david.levy@tgh.nhs.uk

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Creative communication for medical students: Using installation and performance art to communicate ideas about medicine

Anna Dumitriu, Visiting Lecturer, Brighton and Sussex Medical School

Nowadays arts and humanities based subjects are increasingly being taught as optional but accredited courses in medical schools across the country. These classes enable students to broaden their experience and offer time to reflect during their intense medical training.

Anna Dumitriu’s Creative Communication course at Brighton and Sussex Medical School (BSMS) focuses on the use of performance and installation art as a means of communicating ideas around the practice of medicine. Many of the student outputs highlight design issues, such as problems of privacy and the emotional impact of hospitalisation, whilst other works communicate biomedical technologies in accessible ways. The course brings together philosophical, scientific and artistic methodologies to develop student-led ideas, creating a space to reflect on the process of medical training and also to look outwards to the impact of medicine on the wider world.

The course is structured into eight two-hour sessions. In the first half of the session the author describes her own art practice. She is a visual artist whose highly experimental work is involved with the nature of transdisciplinary practice-based research. She regularly collaborates with scientists and often tends to go very deeply into her chosen area of research, taking on, or attempting to take on, the role of scientist in an almost performative sense, raising paradigmatic questions in her work. Her installations, interventions and performances use a range of digital, biological and traditional media including video projections, mobile phones and embroidery, working with diverse audiences often in nontraditional settings.

The second half of that first session consists of a game called Is it Art or is it Science which the students play competitively. They are given a pile of cards showing images that were created for either artistic or scientific purposes and asked to divide the images into two new piles depending on whether they believe the images were created for artistic or scientific purposes. This leads the students to question their own assumptions about the two disciplines and recognise the similarities, whilst becoming strongly aware of the intellectual and aesthetic clues they have used in making their decisions. The author also uses the game to inform the students about interesting contemporary artworks, which take science as their inspiration. The game is a great icebreaker, students enjoy the competition without feeling the usual constant pressure to do well and it enables them to look at images in a new way.

Session two is a steep learning curve, students are taught a few simple performance exercises and asked to give a three minute improvised talk on some aspect of medicine that interests them. Their colleagues are invited to ask questions and comment on the speaker’s performance. Based on this talk students are invited to create a new artwork using a selection of found objects and materials. It sounds like it might be a difficult task considering that many of the students have no artistic background but the nature of the course so far has provided them with many good tools to pull it off. In this short workshop students have previously created impressive installations, sculptures, performances and video works. A big issue in teaching art is what can be known as ‘white paper syndrome’, where students feel intimidated and do not know how to start making a work of art, but this immediate, intense, but highly informal method enables the students to jump straight in to creating art and enjoy the process.

Over the next sessions with lots of one to one support, students can develop their own major artwork using whatever medium they choose. Dumitriu feels this progress is integral to her own socially engaged practice and describes the making process as a dialogue. The student’s progress, ideas and reflections are mapped in a sketchbook, which forms a significant part of the final assessment for the course.

Part way through the course students take a break from the process of making art and have a reading week which looks at theory in relation to art/science practice and issues of public engagement in science. Students then present back the papers they have read and enjoy an (often heated) discussion. Developing their own opinions about the role of combining art and medicine in the process.

Finally, students present the work they have created, and their colleagues discuss and critique it with them. This final peer critique session is important and often changes are made to the artworks before its final submission. An important aspect of the course is an opportunity to show the final work in an annual exhibition, the first of which took place during The Brighton Festival (England’s largest arts festival) in May 2009, which has a tradition of artists’ open houses. The BSMS teaching building was turned into an open house exhibition for a whole weekend and students were able to meet members of the public, talk about their work, screen video works and show their performances. By showing the work in this way the students gain confidence and develop a deeper understanding about making and showing art.

Examples of work on show in this years BSMS Open House, entitled Art and Medicine included a participatory reflection on perception of the word ‘medical’, which included an animated film/sound work and a live performance and a work created on an old hospital gown embroidered with the items that one usually craves when ill, but are not permitted access to when in hospital, for instance ones favorite armchair or a hot water bottle.

Dumitriu is currently Artist in Residence at The Centre for Computational Neuroscience and Robotics and a Visiting Research Fellow in the Dept of Informatics at Sussex University, participating in the prestigious e-MobiLArt project (European Mobile Lab for Interactive Artists) and researching her practice- based Fine Art PhD part-time at the University of Brighton. She looks forward to working withmore medical students on this innovative course as well as her additional new collaborative course Microbiology and Art which combines hands on practical microbiology and art making.

For more information contact annadumitriu@hotmail.com

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Supporting medicine, dentistry and veterinary studies: Striving to deliver high quality resources to the UK academic and research community

Brian Mitchell, JISC Collections, Lancaster Place, London

To help teaching staff, researchers and students enjoy the full benefits of eLearning and e-research, JISC Collections licences an extensive collection of high-quality online resources. JISC Collections mission is to support UK education and research by delivering affordable, relevant and sustainable online content.

A JISC-funded service, JISC Collections provides universities, colleges and research councils with a catalogue¹ of free and subscription-based online resources such as journals, e-books, full text databases, digital images, historical records, online film, reference resources and geospatial data. Many of these resources are available through your institutional library/learning resource centre. All JISC Collections agreements are based on the JISCModel Licences² which allow students and staff to make effective use of online resources for learning, teaching and research.

Portfolio of resources available for medicine, dentistry and veterinary studies: Widening access to essential content

The JISC Collections UK National Academic Archive³ includes an expanding range of specially selected archive resources which are available in perpetuity to UK higher and further education institutions, and research councils. This important programme is part of JISC Collections’ ongoing commitment to widening access to essential material across the subject spectrum.

The cost of acquiring archive resources is beyond the means of the majority of institutions. JISC Collections’ purchasing role at a national level makes it possible for all institutions to provide access to a wealth of high quality online resources. The majority of these archives are available completely free of charge to institutions. The following archives will be of interest to those teaching and researching in medicine, dentistry and veterinary studies.

• American Chemical Society – this includes over 464,000 articles fromjournals published between 1879 and 1995. The archive is available free of charge to subscribing institutions.
• Oxford Journals Archive – JISC’s purchase of the content on behalf of the UK academic community means that institutions can benefit from free access until at least July 2011, via the publisher’s server. The Medicine and the Science archives will be of most interest.
• Web of Science Backfiles – JISC has purchased the following Web of Science backfiles: Science Citation Index Expanded 1970-1980; Social Sciences Citation Index 1970-1980; and Arts & Humanities Citation Index 1975-1980. These are available at no extra charge to all institutions that subscribe to the Web of Science agreement.

Other free-of-charge online resources

JISC and JISC Collections funds other agreements which are available free of charge to the JISC community.

• BioMed Experts – this is a free literature-based social networking that connects biomedical researchers to each other.
• Film & Sound Online – this database contains hundreds of hours of film and sound material. The Wellcome Film Collection, the Sheffield University Learning Media Unit Collection; Healthcare Productions and the St George’s University of London Collection will be of most interest.
• Jorum – this is a free online repository service for teaching and support staff in UK further and higher education to build a community for the sharing, reuse and repurposing of learning and teaching materials.
• Medical Journal Backfiles – as a result of the Medical Journals Backfiles project, a collaboration between the Wellcome Trust, JISC (through its Digitisation Programme) and the US National Library of Medicine NLM), the entire archives of a number of historically significant medical journals are now freely available on PubMed Central.
• The ScientificWorldJOURNAL – available free of charge to UK higher and further education institutions and research councils.

Subscription-based online resources

Here is a list of some of the relevant resources which JISC Collections has licensed on behalf of the UK academic community.

• Academic OneFile – a journal database designed to fit the needs of academic libraries by providing students, academic staff and researchers with mostly peer-reviewed, full-text articles with minimal embargo periods.
• ALPSP Learned Journals Collection – a collection of 544 e-journals covering a range of science subjects, including 71 titles in medicine.
• BioOne – this resource aggregates 155 high-impact bioscience research journals.
• Collexis Expert Profiling – ideal for institutions conducting biomedical research, Collexis Expert Profiling is designed to enable users to quickly identify colleagues with the right expertise to integrate into a project team.
• Embase – this is a biomedical and pharmacological resource that gives users access to the most up-to-date information about medical and drug-related subjects.
• JSTOR – this is a digital archive collection of over 1000 core multidisciplinary and discipline specific scholarly journals, some of which date back as far as the 17th century.
• Oxford Reference Online – the Premium Collection combines rich and scholarly resources offered by acclaimed titles in the Oxford Companions series.
• Oxford Scholarship Online – this is a cross-searchable library containing the full text of over 2,700 Oxford books, including titles on neuroscience.
• PathCAL – 140 web-based tutorials (with more in development) on a variety of subjects designed to help students understand the basic pathological principles of disease.
• Scran – this extensive educational image archive contains over 360,000 high quality images, video clips, sound files and over 3,000 packs to support research, learning and teaching across the curriculum.
• Scopus – this resource is an abstract and citation database of research literature and quality web sources.
• Taylor & Francis Online eBook Library – the Library includes some 22,000 titles from the Taylor & Francis book publishing programme.
• Web of Science – this resource provides access to current and retrospective information in science from high-impact research journals and other literature such as conference proceedings.
• Wiley InterScience OnlineBooks^TM – this e-book collection offers perpetual access to e-books in health, life, medicine and veterinary sciences at title or subject level.

Online journal agreements - NESLi2

NESLi2⁴ is the UK’s national initiative for facilitating access to online journals on behalf of the higher and further education and research communities. Through NESLi2 negotiations and agreements, over 7,000 online journals are now available, which are published by leading commercial and society publishers, and university presses. The following NESLi2 agreements for 2009 will be of interest:

• AAAS Science, Annual Reviews, Australian Academic Press, BMJ Group, Cambridge University Press, Elsevier, Expert Reviews, Future Medicine Publishing, IOS Press, Karger, Multi-Science Publishing, Nature Publishing Group, New England Journal ofMedicine, Oxford University Press, the Royal Society of Medicine, SAGE Publications, Springer-Science and Business Media and Wiley-Blackwell.

Copyright essentials: Free interactive copyright tools

JISC Collections commissioned copyright tools designed to help staff at institutions and schools understand copyright issues in the use of online resources: JISC CASPER.⁵

Call for feedback

JISC Collections is always keen to get feedback from the academic and research community on their experiences of using the online resources which we licence (whether good or bad), and how they are being embedded in teaching, learning and research. This feedback will be used to generate support materials such as case studies, podcasts, vidcasts, showreels and testimonials.

How to find out more

Formore information on JISC Collections, the resources which we license or any of the issues raised in this article, please visit www.jisc-collections.ac.uk, or email collections@jisc.ac.uk with any specific enquiries.

References

1. www.jisc-collections.ac.uk/catalogue (accessed 4 August 2009)
2. www.jisc-collections.ac.uk/model_licence (accessed 4 August 2009)
3. www.jisc-collections.ac.uk/archives (accessed 4 August 2009)
4. www.nesli2.ac.uk (accessed 4 August 2009)
5. jisc-casper.org (accessed 4 August 2009)

For more information contact +44(0)20 3006 6004 or b.mitchell@jisc.ac.uk

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Developing students’ Internet research skills: A new direction for the Intute Virtual Training Suite

Jackie Wickham, Service Manager; Laurian Williamson, Content Coordinator, Intute: Health and Life Sciences, University of Nottingham

Students may be savvy with new technologies, but they still need advice and guidance on using the Web for their university studies. Do these statements ring true for your students?

• They rely too heavily on Google, Wikipedia and the open Web for their research, and avoid key academic information sources.
• They don’t critically evaluate the information they find on the Web, and degrade the quality of their work by citing inappropriate sources.
• They struggle to navigate the information landscape for scholarly work.

Intute is a national Internet service from JISC that aims to help students to make more discerning use of the Internet for their university coursework. This summer (2009) we launched 31 new Internet tutorials in the Virtual Training Suite (VTS), which focus on academic Web resources online, and stress the importance of critically evaluating material found on the Web. They are launched as part of a wider programme of improvements to the Intute website, and all the new Intute services are freely available to university staff to use with their students from www.intute.ac.uk

What’s new?

The VTS offers free online training in Internet research skills, with tutorials for most degree subjects, all written and reviewed by a national team of lecturers and librarians from universities across the UK. This year we have completely overhauled the content and design of 50% of our 62 tutorials, and new tutorials of relevance to the MEDEV community include the following freely available from the Virtual Training Suite www.vts.intute.ac.uk

• Internet for medicine
• Internet for veterinary medicine
• Internet for dentistry and oral health
• Internet for microbiology

We have been producing and updating Internet tutorials since 2000, and so last year we decided it was time to take stock and review our direction.

Intute website

The updated Intute: Virtual Training Suite is part of a wider programme of improvements to the Intute website. During 2008, Intute commissioned market research followed by extensive user feedback (analysis of over 5,000 online feedback forms and survey). The quality of the resources contained within the Intute site was perceived as first rate, and VTS is one of the most highly used parts of the Intute service. However, people also said that we needed to be clearer about what the service offered and to who. As a result, the website has been redesigned and we have focused the design, tone and structure to appeal to our target audience of students in higher education. The home page now lists 19 top level subjects which are more closely aligned to university courses. The search box is still central but increased prominence is given to the Intute: Virtual Training Suite, the MyIntute personalised workspace and more dynamic content such as the blog.

The tutorial content and design have been completely overhauled in light of Internet developments, in particulary Web 2.0 technologies and academic Web trends (changes in online academic publishing).We have re-written the tutorial content each with four main sections.

• Tour – focuses on the academic information landscape on the Internet and aims to create a mental map for students of the key scholarly sources for their subject.
• Discover – offers updated guidance on how to find scholarly information online; choosing the right search tool and looks at the importance of developing a search strategy.
• Judge – discusses how critical thinking can improve the quality of online research and provides guidance on how to judge which Internet resources are appropriate for University work.
• Success – provides practical examples of students using the Internet for research (successfully and unsuccessfully), so that students can learn by example as well as from the mistakes of others.

The format of our online tutorials continued to be popular,with high levels of uptake and use in university courses, but we have now introduced a brand new design to make tutorials shorter, easier to read online,with more graphics and exercises. Interactive features of each tutorial include quizzes, practical exercises, and a ‘links basket’ functionality which allows the user to keep a record of all website URLs mentioned in the tutorial. These features have proven popular with students in evaluation studies. Each tutorial takes a student around one hour to complete (in their own time and pace).

The feedback received indicated that teaching students about peer-review was evenmore important in a Web 2.0 world of user-created content, and that there is a growing recognition of the need to teach Internet research skills to university students.

Feedback from university staff suggests that they find it useful to point students to the tutorials from course handbooks, VLEs and library web pages. There is also evidence that VTS are being used to support courses in research methods, study skills and information literacy.

All the tutorials have an online feedback formand we welcome feedback on the new approach.

What’s new?

• Clearer navigation to subject pages and throughout the site.
• Hot topics published regularly on all subjects.
• MyIntute simplified with all the functionality on one page. Your personal space allows you to easily set up alerts for your subject by email or RSS and to export bookmarks to social bookmarking sites.
• New look and feel, new help text for improved readability.
• Clearer messages about the aim of the service, who it’s for and who creates the content.

Further information is available at www.vts.intute.ac.uk or email Jackie Wickham on jacqueline.wickham@nott.ac.uk

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Enhancing clinical learning in the workplace

Professor Stephen May, Dr Matthew Pead, Dr Vicki Dale, Royal Veterinary College, University of London; Dr Richard Hammond, Dr Sarah Freeman, Elizabeth Mossop, School of Veterinary Medicine and Science, Professor Roger Murphy, Dr Ruolan Wang, School of Education, Professor Claire Anderson, School of Pharmacy, University of Nottingham

The Enhancing Clinical Learning in the Workplace (ECLW) project¹ was funded as a benchmark award as part of the National Teaching Fellowship Scheme in 2008,² and represents a major investment in developing the future of veterinary education in the UK. It is a collaborative venture between the Royal Veterinary College and the University of Nottingham.

Our aim is to identify best practice in the clinical workplace and to disseminate that information among educators and professional bodies in the healthcare sector. The ECLW project will provide evidence regarding the value of components of clinical workplace learning, from delivery through to assessment in a variety of contexts.

Our goal of producing graduates within a modern competency framework, fit to practise veterinary medicine in the UK,³ coupled with the variety of methods of workplace learning at the two veterinary schools involved, offers unique opportunity for ground breaking educational research and development, aimed at the critical issues in professional workplace learning.

This project is primarily set in the context of the veterinary workplace but explores concepts applicable across the education of vocational professionals.

• How does workplace learning facilitate the students’ development towards becoming a successful clinician?
• How may workplace learning best support lifelong learning?
• How does prior experience, personality and learning style influence workplace learning?

New to the team

Dr Ruolan Wang
Ruolan joined the team in January 2009, having obtained a PhD in Education from the University of Exeter. With an interest in generating an evidence-base for undergraduate and postgraduate provision and, particularly assessing the impact of technological interventions with an educational component, her main responsibilities are to conduct research fieldwork in a range of locations, using a variety of data collection techniques and to identify best practice in the use of the clinical workplace as a learning environment. Recently, she has been working on a case study of veterinary reproduction teaching, to try to determine how different teaching methods in this part of the course contribute towards the development of Day One Competencies, examining the role of case-based teaching and types of visual technologies used, using a mainly ethnographic approach comprising observations of teaching and interviews with teachers and students about their experiences.

Kirsty Magnier
Kirsty is based at the Royal Veterinary College’s LIVE (Lifelong and Independent Learning in Veterinary Education) CETL. She will be conducting documentary analyses, questionnaires, focus groups and interviews and analysing her findings in partnership with Ruolan to draw comparisons between the two veterinary schools. Kirsty has a specific interest in experiential learning environments, having worked at the Experiential Learning CETL at the University of Plymouth. She is also particularly interested in exploring the role of educational technologies such as wikis, blogs and mobile learning devices in helping to prepare students for the workplace, aswell as investigating the more traditional methods of hands-on clinical training.

Seeking collaborators

We would like to work with students and qualified professionals across a spectrum of clinical disciplines to assist with this investigation. We are inviting fellow professionals to become part of this venture.

References

1. www.live.ac.uk/eclw/index.html (accessed 4 August 2009)
2. www.heacademy.ac.uk/ourwork/professional/ntfs (accessed 4 August 2009)
3. www.medev.ac.uk/dinky?dinky_id=946 (accessed 4 August 2009)

Further details can be found at www.eclw.ac.uk or contact vdale@rvc.ac.uk or ruolan.wang@nott.ac.uk

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Conference report: The teacher in obstetrics and gynaecology

May 2009, Royal College of Obstetricians and Gynaecologists

Nigel Purcell, Senior Advisor (Education), Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine

The aim of this meeting was to provide an overview of the current state of undergraduate education in the UK with particular reference to obstetrics and gynaecology.

The day was opened by Jenny Higham, Professor of Medical Education, Director of the Centre for Medical Education Research and Head of Undergraduate Medicine at Imperial College, London. The first keynote was given by Dr Sue Smith, Head of Examinations and Assessment at Imperial College who explored the vital issues relating to widening participation. She was followed by Eleanor Barry, a final year medical student at Imperial College who took time out from an intensive revision schedule to give us a user perspective on widening participation initiatives! Both presentations gave much food for thought and were an excellent start to the day.

The second session was on ‘curriculum Issues’ and began with a presentation by Mary-Anne Lumsden, Professor of Medical Education and Gynaecology at the University of Glasgow. Mary-Anne outlined work that had been done on developing recommendations for a national undergraduate Gynaecology curriculum. Dr Colin Duncan, Clinical Senior Lecturer at the University of Edinburgh then gave a talk on the issues around standard setting for assessment. The two presentations were followed by an opportunity for discussion and led to a lively debate.

After the coffee break we saw a fascinating presentation on the potential role of haptic simulations given by Dr Sarah Baillie, Senior Lecturer in Veterinary Education at the Royal Veterinary College. Sarah is also advising on the development of a haptic human and drew on her extensive experience with haptic animals. A demonstration haptic simulator was available during the day and I certainly enjoyed my very first experience of inserting my arm into a cow’s rear end! The sense of touch felt extraordinarily representative. Fortunately the simulator only simulates touch, so the realism of other aspects of the experience was mercifully limited! Nonetheless, the cow did give out a loud ‘moo’, when I applied excessive pressure.

Sarah’s talk was followed by Dr Naomi Low-Beer, Clinical Lecturer at the Centre for Medical Education Research at Imperial College who outlined the progress on a project to develop a haptic human. Clearly this has considerable potential uses in the gynaecology domain.

We moved into breakout sessions at which we had four options to choose from ranging from ‘Using gynaecology teaching associates’ to an introduction to an example of... A brand new course’ and this was followed by lunch.

Anne Keen MP, Honorary Professor of Nursing at Thames Valley University, and Parliamentary Under-Secretary, Department of Health explained the governments current thinking on widening participation and this was followed by a series of five short presentations on the topic of ‘getting yourself educated’.

The topics covered included examples of short courses, certificates/masters programmes, distance education programmes and a masters in surgical education. The final slot explored the national perspective with a particular focus on gaining recognition for teaching through the Higher Education Academy professional recognition scheme. This session was followed by a panel discussion and the day concluded with a very entertaining closing speech by Professor James Drife, Consultant in Obstetrics and Gynaecology at Leeds University.

Overall the day provided an excellent forum for participants to share ideas and practice together and to explore the issues around undergraduate education in relation to obstetrics and gynaecology.

For more information contact nigel@medev.ac.uk

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Conference report: The second national conference on student evaluation. Embedding evaluation: Working with students to close the loop

February 2009, UCL

Dr Ann Griffin, Senior Clinical Lecturer in Community-Based Medical Education, Barts and The London School of Medicine and Dentistry; Dr Anita Berlin, Sub Dean Quality and Senior Lecturer in Primary Care, University College London; Jerry Booth, Quality Assurance Officer, Hull York Medical School.

The second national conference on student evaluation welcomed over 50 delegates from all over the United Kingdom to this one day event including academics, quality officers and students predominantly but not from health related subjects.

This year’s conference widened its collaborative network to include Hull York Medical School (HYMS), and built on a well-established working partnership between Barts and The London School of Medicine and Dentistry and University College London (UCL). It received financial support from the MEDEV Subject Centre.

The opening plenary sessions highlighted the central and expanding role of the student in evaluating and contributing to educational quality within Higher Education. Our first keynote speaker, Lord Young of Norwood Green, Minister for Students (Department for Innovations and Universities and Skills), told us about the advances being made in hearing directly from students and amplifying their voice within government. He talked of the Student Listening Programme and other developments which facilitate contact with the ‘grass roots’. Aaron Porter, Vice President (Higher Education) National Union of Students (NUS), spoke next about the union’s work to empower students to co-author their educational experience and the implications of greater involvement for Students Unions. The afternoon plenary had representatives fromthe GeneralMedical Council, (KirstyWhite, Head of Quality Assurance and Tom Foley, student visitor) and The Quality Assurance Agency (Derfel Owen, Developments Officer). All three speakers discussed the philosophy behind embedding students in pivotal evaluations of educational quality (including Institutional Audit and programme reviews). They gave realistic tips on how we could support robust direct student involvement at our own institutions.

The workshops provided practical and interactive opportunities to build on the theme of the day. Professor Murdoch-Eaton presented her research around students’ perceptions of feedback, highlighting that students often did not recognise when they were being given feedback or being asked to provide it and she facilitated a discussion around how we can raise students’ awareness. Dr Berlin’s workshop debated the notion of greater involvement of students within the academy. Using a case study her workshop highlighted the tensions inherent in democratising the quality arena. Jerry Booth’s workshop focused on the innovative work done at Hull York by which students generate evaluation reports about clinical placements. Students work together in groups to write a collectively agreed letter to their tutors about their teaching. PeteWalker, Ann Griffin and Lynne Magorrian ran a workshop to look at the complex choices involved in making meaningful reports and demonstrated the features of the Bristol On Line Survey tool that could help in this process.

The conference fostered animated debate and discussion, and extremely good feedback. The key message from the conference was:

“If evaluation systems are to be effective at gathering data and prompting change there needs to be enhanced communication between the academy and students about the purposes, design and impact of such systems.”

Three main conclusions were identified.

• Involving students in external and internal review panels offers significant added value.
• Reviewing and redefining the role of student representatives may allow them to make a more robust contribution to quality enhancement.
• Providing timely, accessible information to students on how to give feedback, how their feedback has been used and why it sometimes is not or cannot be heeded may strengthen their confidence and involvement in the process.

Thank you to everybody who contributed to this event and the support of Ann Glasser, Tom Olney, and the MEDEV Subject Centre team.

For more information and access to many of the conference materials see the conference webpage: www.ucl.ac.uk/medicalschool/quality/student-evaluation/ or email a.e.griffin@qmul.ac.uk

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Workshop programme

Workshops are open to anyone involved in learning and teaching in undergraduate medicine, dentistry and veterinary medicine.They attract CPD points and there is currently no charge for attendance. The programme of workshops is designed and delivered by members of our constituency and thus reflect current concerns in the field.

Details of the workshops are available on the website and we place new ones on the site as soon as dates and venues have been finalised, so keep checking to see if there is something of interest to you. We also send email notification of each workshop to everyone on our mailing list as soon as it is finalised. If you are not on our contact list and would like to receive information about our workshops as well as our regular monthly update on current issues, funding opportunities etc then please go to www.jiscmail.ac.uk/lists/medev.html or email enquiries@medev.ac.uk To find out more or book your place on any workshop go to: www.medev.ac.uk/resources/meetings/workshops/

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Online: ISSN1479-523X

The Higher Education Academy
Subject Centre for Medicine, Dentistry and Veterinary Medicine
School of Medical Education Development
Faculty of Medical Sciences
Newcastle University
Newcastle upon Tyne
NE2 4HH
United Kingdom

T: +44 (0)191 2225888
F: +44 (0)191 2225016

enquiries@medev.ac.uk
www.medev.ac.uk

Our mission is to work with institutions, discipline groups and individual staff to provide the best possible learning experience for all students - postgraduate as well as undergraduate. We also work with the governments of the UK and their funding bodies to create the best policy environment to enable this to happen. We provide an authoritative and independent voice on policies that influence the student learning experience.

Discipline-based support is provided through the Academy’s Subject Network of 24 Subject Centres. These are a mix of single-site and consortium-based centres located within relevant subject departments and hosted by higher education institutions.

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