01.7 The newsletter of the Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine, April 2005

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

Print: ISSN 1740-8768

Online: ISSN 1479-523X

In this issue

• Art: life drawing and ‘operating theatre’
• Clinical skills teaching: simulation and video
• Actively involving learners

Other publication formats

This issue is also available as a low resolution PDF document suitable for printing.

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Contents

• RAFTT project, The Resource Archive for Teacher Trainers Nigel Purcell, Subject Centre for Medicine,Dentistry and Veterinary Medicine
• Horus: An open source toolkit to manage learner-centred education Martin Brown, Horus Project Leader, University of Manchester
• Actively involving learners David Brigden, Mersey Deanery (University of Liverpool) Nigel Purcell, Subject Centre for Medicine, Dentistry and Veterinary Medicine
• Life drawing in Undergraduate Clinical Attachments Sarah Gull,Tutor, Cambridge Graduate Course,West Suffolk Hospital
• Mini-project update: Clinical skills online Charavanan Balasubramaniam, St George’s University of London
• Workshop report: Sheffield assessment in medical education workshop 2005 Sarah Rolland, University of Newcastle
• SSC in medical education: Patient safety and medical mistakes Craig Montgomery & Rob Milligan, University of Newcastle
• Workshop report: External examiners Nigel Purcell, Subject Centre for Medicine, Dentistry and Veterinary Medicine
• Scenario-based simulation for learning practical clinical skills Roger Kneebone, Imperial College London
• Conference report:ASME 2004 Susan Jamieson, University of Glasgow
• CETLs in medicine, dentistry and veterinary medicine
• Special focus: Operating theatre Dominic Slowie, University of Newcastle
• Workshop programme for 2005
• Meet Suzanne Hardy

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The Resource Archive for Teacher Trainers, RAFTT project

Nigel Purcell, Senior Educational Advisor, Subject Centre for Medicine,Dentistry and Veterinary Medicine

Are you engaged in delivering teacher education to doctors, dentists or vets? If so you may be interested in the Resource Archive for Teacher Trainers (RAFTT) project. The project aims to support staff developers engaged in teacher education by providing them with a high quality resource for use in their workshops and teacher training programmes.

The objectives of the project are to:

• create a bank of subject related learning and teaching resources to support the delivery of short courses on teaching skills and teaching certificate/diploma programmes to health care professionals
• foster an active community of practice to promote the creation, evaluation and evolution of the resources and to disseminate good practice in the field of teacher development

The Resources

The resource sourced from the sector will consist of a range of reusable learning objects (RLOs) including:

• sets of teaching and learning development activities for use by and with trainee teachers
• sets of audio-visual aids together with an explanation of how they can be used
• sets of formative and summative assessment activities
• plans suggesting how to combine the resources into teacher development sessions, workshops and programmes
• case studies of current practice in teacher development in medical, dental and veterinary education schools
• templates for session, course and programme planning
• plans and pro-formas for evaluating teacher development programmes

The resources will be classified using a metadata structure developed in accordance with the BIOME database protocols, and will be made available both through the Subject Centre website and through searches in the BIOME databases.

Developing the resources

The resources themselves will be generated by those who are engaged in the teacher training of medical, dental and veterinary teachers.

The subject centre will set up an online submission process to enable practitioners to enter examples of resources on the database.

The first round of resources will draw on our current workshop programme. Many of these workshops are highly suitable for replication in local contexts.

We will shortly be sending out an invitation to all medical, dental and veterinary schools to submit teacher development materials that they have found to be effective and which they would like to share with the teacher development community.

You will be welcome to submit resources using a set of word and PowerPoint templates for entering each type of materials onto the database.

We also envisage that we would have on-line web evaluation/feedback forms on our site for staff developers to give feedback on how they used a particular resource and on how well it worked.

The completed evaluations would be available on the site so potential users could see how highly a given resource had been rated and in what contexts it has been used.

Resources can then be modified, updated and adapted as appropriate. In this way the resources will be continuously evolving and developing.

Dissemination

We plan to run two workshops for staff developers which will provide an opportunity to examine and evaluate the materials and to work with them. Staff attending the workshops will be invited to join a network which will evaluate and work on the further development of the materials.

The network of practitioners will we hope in time become an active community of practice which is engaged with a continuous process of ‘collaborative action research’ in the area of teacher education.

For further information contact nigel.purcell@ncl.ac.uk

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Horus: An open source toolkit to manage learner-centred education

Martin Brown, Horus Project Leader, University of Manchester

The JISC e-learning tools programme (e-tools), which is part of the distributed learning programme, ended in March 2005 and aimed to develop a variety of tools for both learners and teachers.

Twenty-two projects were funded and a central requirement is for them to be released as open source and to support educational standards as described by CETIS and the e-Learning Framework (eLF).

The Horus project is a collaboration between the University of Manchester and Hope Hospital. The aim was to further develop the iSUS technology so that it can be configured, deployed and integrated by FE/HE institutions in their learning environments and is being released as open source software (on sourceforge.net) at the end of the project.

Project in brief

Horus is an e-tools project that builds on the research and experience of the iSUS system, and aims to develop functionality for supporting flexible, learner-centred education by gathering quality and competency feedback data that can be stored, analysed and disseminated for:

• Constructing a learner’s portfolio to aid reflection.
• Constructing feedback portfolios for events and teachers to provide peer review.
• Resource discovery where learners are directed towards relevant learning opportunities, based on their current portfolio and the event’s learning opportunities.
• Quality assurance of the education process by analysing year-on-year performance, identifying unusual performance by learners, groups of learners and teachers etc.

Educational applications

The primary objective in the Horus project is to take the key idea in iSUS of supporting learner-centred education by gathering and storing feedback on teaching and allowing flexible analysis and dissemination, and generalise it so that the following educational “feedback” scenarios can be supported:

• Learners providing quantitative feedback in terms of both hierarchical competency and quality attributes, about learning events they have undertaken.
• Learners providing qualitative, textual feedback about their learning experiences.
• Learner attendance at learning events.
• Teacher/peer quantitative assessment and qualitative remarks.

The Horus software tools allow multiple types of feedback data to be gathered, stored and analysed on the same server.

The tools were validated during March 2005 on two medical demonstrators that are being developed on the Horus project:

• Clinical Psychology at Wythenshawe Hospital
• Foundation Programme at Hope Hospital

In addition, a substantial requirements exercise was carried out to identify, and illustrate, typical learning processes that would benefit from this type of technology.

Development overview

The Horus project has developed a set of web services that can support the gathering, storage, analysis and dissemination of the educational feedback data.

The web services will allow platform and language independent integration with other learning software, and it is important to note that by itself it is not a complete learning environment.

The toolkit’s services store the information about competencies, quality attributes, textual questions etc and provide simple services for:

• Constructing a feedback form
• Storing feedback.
• Constructing a learner’s competency/skill profile.
• Displaying a learner’s (teacher’s/event’s) textual feedback portfolio.
• Calculating the relevance of a learning event etc.

The information is returned as either xml or html data for easy, “on-screen” integration.

In addition, open source tools such as Mondrian and JPivot are being used to provide flexible data analysis functionality.

Future plans

The Horus toolkit will form the basis for further collaboration between Manchester and Hope, as well as (hopefully) starting active open source user and development communities.

Our work will focus both on the deployment of these learning concepts to novel educational applications such as the Medical Foundation Programme as well as investigating novel data analysis techniques such as text mining for automated qualitative analysis and deviation detection for automatically identifying unusual patterns in the educational database.

Further information

• JISC e-tools programme, www.jisc.ac.uk/ elearning_tools_home.html Dornan,T. et al. How can medical students learn in a self-directed way in the clinical environment? Medical Education, 39;4, 356-364
• CETIS,www.cetis.ac.uk
• e-Learning Framework, www.elframework.org
• iSUS project, Leadbetter D.‘iSUS’ Using ICT to enhance quality in clinical placements, LTSN-01 Newsletter, October, 2004, 11-12
• Horus project www.csc.umist.ac.uk/horus

For further information about Horus contact Martin Brown, Horus project leader, University of Manchester martin.brown@manchester.ac.uk

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Actively involving learners

David Brigden, Adviser for Postgraduate Medical and Dental Education, Mersey Deanery (University of Liverpool), Professor in Professional Development, Faculty of Health Sciences, University of Cape Town and Nigel Purcell, Senior Educational Advisor, Subject Centre for Medicine, Dentistry and Veterinary Medicine

This short paper will be of particular interest to you if you have been involved in clinical teaching and learning facilitation at both undergraduate and postgraduate level.The principles expressed will serve as an aid to help support your role in training.

Approaches to Teaching

Historically, medicine has been taught didactically continuing the teacher-centred learning processes, common in primary and secondary levels of education, through university and into the years of clinical practice. This form of didactic teaching is comfortable for those learners who do not want to be challenged, and for those learners who believe knowledge is simply material to be memorised and retained.

It is also comfortable for teachers who were mainly taught in that way themselves. In the long term such didactic teaching, if relied on as the sole method of education, tends to lead to a state of dependency on the learner’s part, and it is not a good model for professional development.

An alternative to the didactic model is to adopt learner centred strategies. With this approach, instead of seeing the learners as receptacles for information they are encouraged to seek and reflect on new knowledge in the light of their own experience and to decide on the most effective way of integrating that knowledge into their own practice.

Research into learning in higher/professional education has demonstrated conclusively that when we are actively involved in our own learning we become more effective learners. The following illustrates this. We retain:

• 10% of what we read;
• 20% of what we hear;
• 30% of what we see;
• 50% of what we see and hear;
• 70% of what we say;
• 90% of what we say as we are doing something

(Montgomery 1993)

A more teacher-centred approach may be the most appropriate in the early phase of learning when the learner’s knowledge base is weak and skills are limited. Later, a more learner-centred approach should be adopted as experience builds.

There are a range of techniques which can be used in teaching, and part of the skill of the teacher is selecting the most appropriate techniques to teach a particular topic. The choice of technique will also be influenced by the type and range of your learners.

However, there should be one overriding reason in selecting a teaching technique – it should help and reinforce learners in their endeavour to become competent independent practitioners of lifelong learning.

The skill of the learner centred teacher lies in:

• identifying learning opportunities
• providing links and directions for the learner
• challenging the learners to reflect on both their own past experience and areas of new knowledge and practice skills
• acting as a resource for learners to test and discuss their new or revised knowledge and skills.

Actively Involving the Learners

So how can you be more learner centred in your teaching? There are a wide range of strategies available to you. Some examples are listed below, but you will find many more in the suggested readings at the end of this article. You can foster active learning by:

• Asking learners to teach the topic or skill they are learning. Learners learn most effectively when they are asked to teach another person. To be able to carry out this task effectively, they have to become fully involved in developing a clear understanding of a particular skill or body of knowledge. This encourages them to think critically about the material: to anticipate difficult questions; to spend time concentrating on particularly difficult or challenging elements of the skill or area of knowledge; and to decide on the most effective way of communication their new found knowledge and skills to others (including their teachers).
• Chunking formal teaching into periods of no more than ten minutes duration, allowing questions and uncertainties to be raised. Lengthy expositions are a challenge to concentration and tend to reduce the learner to a passive role. Try to break up your teaching and think of how to involve the learners in an activity after each of your brief formal teaching slots. For example, you could ask the audience to consider a particular matter with their neighbour for a few minutes, then two or three of the pairs could be invited to offer the answer or their opinion to the whole group.
• Setting up tutorials/supervised sessions. But limit your personal contributions to an introduction of the topic and lines of approach and then act as a resources person, steering the direction of the discussion as little as possible.
• Asking your learners to write a report. Your role is to act as a resource and only take responsibility for leading in the opening stages, offering minimal direction.
• Ask your learner(s) to present a clinical case to yourself or a group. This creates the opportunity to discuss patient management and treatment planning or problem-solving, as well to practice and develop presentation skills. This can be done by individual learners but you can also divide your learners into small groups and ask each group to look at a different case and then feed back in plenary. In this way multiple perspectives are brought to play and a number of cases can be covered perhaps linked to a particular theme or condition. Admission of ignorance should be encouraged and valued as a means for clarification and learning for others. Most explanations should be offered by group members rather than by the teacher.
• Inviting learners to present at team meetings. Trainees might be asked to investigate some point of uncertainty and provide feedback to the next meeting. This has the added advantage of grounding the learning directly in real professional practice.
• Setting up a journal club. Each member has a journal article to review and present to the group. Other members should be encouraged to read the same article and independently criticise the paper. This helps the learners to engage with the relevant literature for themselves rather than relying on the knowledge being filtered through the teacher.
• Employ active strategies in grand rounds and other large scale lectures. There are a number of practical strategies for breaking up a grand round into manageable chunks. For example you can set a short task based on a case study and invite the audience to form into ‘buzz groups’ of two or three and briefly discuss the issues raised. One or two of the groups could give feedback. Many lecture theatres now have facilities for electronic feedback from the audience so you can set questions and ask for responses. These have the added advantage of enabling you to check whether the audience have understood the information given. You should also aim to encourage, questions or clarification during the presentation.
• Encourage your learners to find out for themselves through guided self study. Your role is to help the learner plan their learning and to agree clear outcomes. You can also provide guidance and support to the learner as he/she undertakes the agreed learning tasks. Clear learning outcomes and plans provide a focus and motivation for self study and empower the learner to become increasingly self sufficient.
• Asking your learners to talk through practical tasks as they perform them. Using video recording and providing immediate constructive feedback is also an invaluable tool in developing skills. When giving feedback avoid sarcasm or highly negative remarks. Seek to identify any positive aspects of a performance but be honest and clear about how the skill can be improved. In this model of teaching, the teacher becomes an active facilitator of learning. The teacher works with the learner on a wide variety of learning opportunities (both formal and informal) to maximise the effectiveness of the learning process. Teaching and learning becomes a dynamic interactive process – a partnership between teacher and learner – where the teacher is learning at the same time as the learner.

Further Reading

Bayley, T. and Drury, M. (Eds) 1998, Teaching and Training Techniques for Hospital Doctors, Oxford. Radcliffe Medical Press.

Brookfield S. Understanding and facilitating adult learning, ISBN:0335152260.

Cryer, P. (Ed) 1992, Enabling Active Learning in Small Groups, CVCP Universities Staff Development and Training Unit, Sheffield.

Montgomery, D. (1993), Fostering Learner Managed Learning in Teaching Education, in Graves, N. (ed), Learner Managed Learning, HEC. Leeds.

Payton, J. W. R. (Ed) 1998, Teaching and Learning in Medical Practice, London, Manticore.

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Life drawing in Undergraduate Clinical Attachments

Sarah Gull,Tutor, Cambridge Graduate Course,West Suffolk Hospital

Background

The Cambridge Graduate Course took its first student intake in 2001, which is due to qualify this summer. During the initial curriculum design it was agreed to develop a strand in the humanities, which has provided the opportunity to consider the potential for various ways of learning. These have included a number of small-scale projects, including the introduction of Life Drawing during clinical attachments at The West Suffolk Hospital.

There is nothing new about drawing from life (or the cadaver) as a means of learning: the development of established knowledge of anatomy was based on this practice. Leornado da Vinci wrote: “Observe the body from birth to decrepitude. Describe the changes which the members, and particularly the joints, undergo. Notice which grow fat and which grow lean”. The GMC currently emphasises the scientific basis of medical practice, yet definitions of art and science are blurred. “Art” may involve observation, measurement and experiment, whilst “Science” involves interpretation and leaps of imagination. Visual imagery of the body also has the potential to address far more than observational skills, and the potential for this needed to be considered.

We were uncertain how acceptable life drawing would be to a diverse group of students with a first degree in any discipline, and whether this should be an optional or core activity. Neither were we sure whether we should be advertising any specific aims for the activity, as this might constrain learning. Most undergraduate activity is underpinned by assessment, but it was unclear how life drawing might fit into this context. These formed the research questions for a Mini-project funded by the Subject Centre in 2003.

What we did

With the help of an artist, Sarah Brownie, 3 Life Drawing workshops were held for different groups of students, each lasting 2-3 hours. These were advertised as optional activity for the first two and core activity for the third. The workshops were held within the educational facilities of the hospital using a male model twice and a female once. The students started with some short 10- 15 minute poses. They then had a break, where they were shown examples of work by well-known artists depicting the body. These were chosen to address particular themes related to physicality and to generate discussion. The students then carried out a final piece. Some of the final work was later presented as a computer installation.

Artists used to prompt discussion on physicality

Bouchet, Fragonard sexuality

Marc Quinn physical impairment

Rubens ethics of observation

Barbara Kruger embarrassment of being observed

Cindy Sherman body image, posing

Lucien Freud, Jenny Saville obesity

David Hockney old age

Kiki Smith bodily functions

Kahlo pain

Giacometti vulnerability

Methodology

The project was seen as an example of Action Research, as the two teachers were also the researchers. Data collection was mainly qualitative through participant observation, a diary of e-mails and a questionnaire, with some quantitative date from attendance records. Three research questions were considered:

• Should life drawing be core or optional?
• Could or should aims be identified?
• What is the role of assessment?

Results

Core or optional?

A total of 33/63 students attended the workshops. Numbers did not vary whether the sessions were advertised as optional or core. The students felt it should be optional, although one commented: “It is tempting to say it should be compulsory since I think everyone would end up getting something out of it”. Only 3 who did not attend the sessions returned a questionnaire, but reasons for not attendingincluded a dislike of drawing and “being too busy revising for exams”. All students who attended enjoyed the sessions and wanted life drawing included in the curriculum for the future, but as an optional activity.

Identifying aims

All students agreed that the exercise improved their observational skills. Other possibilities, tended to vary from session to session depending on how discussion developed. These included differences and similarities between art and science and analogies between the relationships between artist/model and doctor/ patient. Trying to force discussion around these issues in did not work easily and it was felt unnecessary to include these as aims for the future.

Role of assessment

It was agreed by the students that assessment was not appropriate for this type of learning. Several students did not want others to see their work, and self-assessment was enough. Others agreed to exhibit their work for peer-assessment and gave consent for any left-over work to be used in a computer installation. There was some evidence, however, that assessment in other subjects limited learning from life drawing: “would it be OK if I used Wednesday afternoon for revision time?”

Some conclusions and ideas for the future

• Overall the students who attended were positive about life drawing: “I came to do something different”, “a refreshing alternative”, “such activities should be strongly encouraged”. The use of artists’ images was also appreciated. It is planned to continue to offer this as an optional activity during clinical attachments. The concept of the humanities as a core strand within a curriculum could be addressed through a menu of options.
• If an aim is required then “To develop observational skills of the body” is a reasonable one. The use of visual images by artists also provoked discussion on many issues related to physicality, the doctor-patient relationship and the meaning of science or art in medicine.
• We have since tried other workshops looking at pathological processes using art processes.
• Inter-disciplinary involvement with an artist was valuable, and there is potential for involving interdisciplinary groups of students.
• There remains concern that the pressure students feel to prepare for formal examinations may constrain learning from activity of this kind.

For further information abut this project contact Sarah Gull, Tutor Cambridge Graduate Course, West Suffolk Hospital, Bury St Edmunds. sarah.gull@wsh.nhs.uk

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Mini-project update: Clinical skills online

Charavanan Balasubramaniam, St George’s University of London

In an era of widening participation, students from diverse backgrounds are strongly encouraged to enter a variety of medical and healthcare professions which are reliant on a skills component. Most students come in, at the introductory Higher Education levels, with a basic knowledge but are relatively unprepared for the skills being taught.

What is needed is some form of transitional support which introduces the student to the necessary skills training and helps ease their familiarity with this relatively new environment.

Cost and staffing constraints usually limit the amount of time dedicated to conventional skills teaching and individual tuition. So it is essential to maximise the learning experience within that time. A prefamiliarisation of the setting would benefit staff and students alike.

It is often difficult to convey relatively complex actions with the aid of traditional methods of delivery, such as text books and diagrammatic teaching guides. What the student needs to see is the actual performance of the skill in an appropriate setting. Video is an obvious medium to use in order to mirror the movement of a skill procedure; it is this movement which is the key to any clinical skill.

Currently there is a shortage of effective learning resources to support the classroom teaching of clinical skills. Video resources already exist but are often too long and complicated for a student coming in at the introductory level. There is also widespread concern over the quality control and copyright issues of these videos and whether they can be re-used easily.

With this in mind, the Educational Technology Unit at St. George’s University of London, in partnership with the Subject Centre, embarked on a pilot Miniproject, in July 2004, to develop supporting interactive video resources for clinical skills in such a way that they were free-to-all and adaptable to a number of courses (e.g. medicine, nursing, paramedics and physiotherapy)

St. George’s is committed to interprofessional education and a key issue at our institution is that of identifying and supporting resources so that they are suitable for use in all disciplines (i.e. ‘reusable learning objects’). The project team consists of clinical skills specialists from various medical and healthcare related courses. This multiprofessional working group was assembled in order to collaborate with each other and create one shareable asset that was relevant for all disciplines. Not only does this structure promote interprofessionalism but also highlights a content quality control mechanism which is in place.

These videos have been developed inhouse and their dissemination is via a website (Clinical Skills Online). Each short web streamed clip highlights a specific skill and is intertwined with relevant interactive ‘question and answer’ activities. This combination increases the student awareness of the significance of the skill and its importance in detecting different pathologies, thereby incorporating both ‘normal’ and ‘abnormal’. The project has reached its halfway mark and most of the videos have been produced. We are currently experimenting with different forms of interactivity to engage the student further.

As an interim measure, these videos have been released via Clinical Skills Online so that we are able to test and get some feedback on the resources. The initial anecdotal reaction from both staff and students has been extremely favourable.

Since the project started we have developed strong international bonds with other similar projects. We all share the same view to create a standard format for high quality interactive clinical skills videos that are free-to-all and relatively inexpensive to develop. Our focus is on re-purposing rather than recreating resources for clinical skills. We hope that more and more institutions will be able to use our resources so that we can all share materials, rather than re-inventing the wheel.

The resources are freely available: www.etu.sgul.ac.uk/cso/

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Workshop report: Sheffield assessment in medical education workshop 2005

Sarah Rolland, University of Newcastle

As the lucky winner of the competition to win a free place to the Sheffield Assessment in Medical Education Conference, I was both delighted and apprehensive…

The Sheffield Assessment in Medical Education conference is a well established course for all medical teachers involved in designing and implementing assessments and for those interested in acquiring skills relevant to the latest methods of assessment.

It provides a broad overview of current thinking in assessment strategies, alongside the opportunity to explore some areas of particular interest or relevance in more depth. The course was a blend of lectures and workshop style sessions. The lectures covered the basics of current strategies in medical assessment and “hot topics” in the assessment field. Workshop sessions complemented the lectures and provided a nonthreatening environment in which to tackle and discuss genuine issues regarding clinical and written assessments.

Three sessions covered a broad range of topics ranging from knowledge and experiential methods, assessing clinical competence to psychometrics. As a relative newcomer to the academic world, I was slightly concerned that the conference would be too complex or lack relevance to my work. However, I found this conference both stimulating and informative, the learning style flexible and amenable to the needs of participants. Assessment is constantly evolving and the importance of using appropriate assessment to drive learning cannot be underestimated.

The enthusiasm of the workshop leaders for assessment was highly evident and therefore I would recommend this conference to anyone who has an interest in assessment or anyone who is involved in assessment but not quite so interested!

For further information contact s.l.rolland@ncl.ac.uk

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SSC in medical education: Patient safety and medical mistakes

Craig Montgomery & Rob Milligan, University of Newcastle

Patient safety is currently a hot topic in the media and has become a subject which most doctors and health professionals are used to talking about. However, in the past there has been little formal teaching to medical students on the subject.

As two fourth year medical students at Newcastle University, currently undertaking a special study component in medical education, we were given the opportunity to develop a small group session on patient safety and medical mistakes for first year students as part of the Personal and Professional Development Strand of the undergraduate medical curriculum. Before we started to construct the session we defined learning outcomes, upon which we hoped would provide a framework for the seminar and a guide to the students. In order to suitably engage our students we thought it was appropriate to encourage them to think of mistakes of which they have been either the recipient or perpetrator. This is ultimately to help them empathise with patients who have been involved in adverse incidents.

Mini lecture

In collaboration with our module supervisor, Professor John Spencer, we designed a mini lecture, to be delivered in the seminar, to set the scene about just how commonly mistakes occur within the health care setting. This brief lecture includes information about how and why mistakes occur, and details of the scale of the problem. It also helps introduce the students to such seminal documents as ‘Organisation with a Memory’(1), and the ‘Seven steps to patient safety’(2).

We developed a number of clinical cases based upon real life mistakes, to help students understand how mistakes can occur and to emphasise that most mistakes are multifactorial and are not solely due to individual error. We adapted a Root Cause Analysis flowchart (3) to create a worksheet with which the students can break down these mistakes into their individual components. The students are then encouraged to think of possible ways to prevent a reoccurrence of the error or mistake.

Video clips

We produced two video clips of professional quality of a junior doctor apologising for making a mistake. The first clip is an example of how not to deal with a mistake, with the doctor not accepting full responsibility and not allaying the relative’s concerns. This clip ends with a very dissatisfied relative and the threat of further action. The second clip shows the same scenario, but highlights the importance of good communication skills and saying sorry, ending unacrimoniously with the relative’s ideas, concerns and expectations addressed.

As teaching is of paramount importance in all medical practice, we have decided to help deliver the seminar to the students ourselves. We feel that it will be a very good opportunity to improve our teaching skills and will stand us in good stead for the future, when we will undoubtedly be responsible for teaching both medical students and junior colleagues.

Evaluation

As this is a new part of the curriculum at Newcastle University, evaluating the session is vital, and will hopefully allow improvements to be made. The evaluation consists of a questionnaire, seeking views about the session (e.g. were the learning outcomes achieved for you?) using a six point Likert scale and further free text boxes. In addition we conducted a focus group with students several weeks after the seminar. We hope that this will introduce to the students the important issues that surround this subject of patient safety and that it will link in well further undergraduate training.

For further information contact C.D.Montgomery@newcastle.ac.uk

References:

1. www.doh.gov.uk/buildsafenhs
2. www.81.144.177.110/site/media/documents/499_sevensteps_overview(2).pdf
3. www.npsa.nhs.uk/ipsel/

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Workshop report: External examiners

Nigel Purcell, Senior Educational Advisor, Subject Centre for Medicine, Dentistry and Veterinary Medicine

The role of the external examiner of undergraduate health care programmes: a joint workshop run by the subject centres for Medicine, Dentistry and Veterinary Medicine and Health Sciences and Practice held in London in December 2004.

External examining is a current major issue for the health education sector as it is for all subject areas and there is a strong need to address the issues arising from the changing role and accountabilities of external examiners. In response to this need the subject centres for Medicine Dentistry and Veterinary Medicine and for Health Sciences and Practice held a joint workshop in December on the role of the external examiner in the health care context. The workshop was partially funded with a grant from the Academy External Examiners project.

Through the workshop we sought to draw on the work of that project as well as on the expertise of practitioners, in order to develop effective support for external examiners in the health care sector.

The event was aimed at newly appointed and experienced external examiners of undergraduate health care courses, senior curriculum managers seeking to improve their induction programmes for external examiners and staff developers who wished to provide training to prospective external examiners.

The model

The day began with an overview of the work that has been done on this issue and an outline of the input/process/output model for external examining developed as part of the project. This was then used as the basis for the first group activity in which the aim was to contextualize the model in the health care context. Three groups of approximately ten were formed and flip charts were used in combination with post-it notes to provide a structure for the feedback.

Each group was facilitated by one of the three speakers. The group work was stimulating and effective and was followed by a very constructive and valuable discussion in the plenary feedback session. We felt that real progress had been made in terms of applying the model to the health care context and that the model itself was a valuable heuristic tool. Of course in practice there was substantial overlap across the three stages of the model and it was clear that a rigid division was neither desirable nor possible.

Scenarios

In the afternoon the groups were each given a scenario based on situations drawn from the experience of external examiners. In the first scenario more than 60% of the first year students had failed a particular component of the course, the second concerned the issue of upgrading borderline students and the third related to what to do if the centre ignores an external examiners recommendations. The groups were invited to discuss the issues they felt arose from the case studies and to suggest how they would have responded. The session proved both stimulating and practical and gave delegates an opportunity to explore a range of typical problems that external examiners may have to face and to identify the underlying principles of effective practice in the role.

For the final session we used buzz groups combined with plenary feedback to outline and define the respective responsibilities of the institutions, course/programme leaders and external examiners’ themselves. In practice we found that there was substantial overlap between the institutional and team leader responsibilities.

Findings

All of the findings were written up for initial circulation to the group for comment and suggestions and we hope to produce a short guide to external examining contextualized to health care. Overall the evaluations of the day were very positive and there was a strong consensus that we had been able to make real progress in exploring the issue of the role of the external examiner in the health care education context. There was also real interest in continuing to engage with the issues through ongoing networking and further meetings as appropriate and we have now set up an ephorum to discuss these issues. This can be accessed at: www.health.heacademy.ac.uk/phorum/ ‘Health Education External Examiners Network’.

Resources

A full report on the workshop including the PowerPoint slides, summaries of the flip charts produced by the groups and the scenarios is available at www.medev.ac.uk/workshop_resources/30/list_contents

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Scenario-based simulation for learning practical clinical skills

Dr Roger Kneebone, Senior Lecturer in Surgical Education, Surgical Oncology and Technology, Imperial College London

The following account describes an innovative combination of simulated tissue models with Simulated Patients to create realistic scenarios for learning, teaching and assessing clinical skills.

Doctors are expected to be competent in a wide range of skills by the time they qualify, and practical clinical procedures are crucially important. It is widely accepted that knowledge, skills and attitudes underpin good practice. Although much emphasis is placed upon the acquisition and assessment of knowledge, acquisition of skills and attitudes receive much less attention.

However, these are key to professional competence and to demonstrating high levels of professionalism within workplacebased practice.

Most existing work on teaching and assessing specific technical skills has focused on the use of inanimate benchtop models, such as those for venepuncture or urinary catheterisation.

Such methods miss the wider context of practice, however, since performing practical procedures on conscious patients requires a holistic approach which combines interpersonal with technical skill. The patient’s perspective is crucial yet frequently overlooked.

Innovation

This innovation in clinical skills teaching uses models made from artificial tissue attached to Simulated Patients (professional actors who perform the part of patients).

Strategically placed drapes cover the joins between patient and model, heightening the illusion. Learners carry out a procedure in a quasiclinical scenario, where they have to interact with the ‘patient’ while performing a technical task. This simulated clinical environment allows learners to perform in realistic circumstances, while ensuring that patient safety is never jeopardised.

Expert observers use objective rating scales to provide a structured assessment of each performance. Technical rating is based on Objective Structured Assessment of Technical Skill (OSATS), which was developed in Toronto and has since been extensively validated.

Communication skills are rated using a two-fold approach, where the observer’s perspective uses a framework of desired behaviours and the patient’s perspective draws on the SP’s response while ‘undergoing’ the procedure.

This allows characteristics such as warmth, empathy, sensitivity and professionalism to be mapped alongside technical competence. Focused feedback from observers and SP provides learners with insight into their performance, and videorecording allows them to review their performance at a time of readiness to learn.

A portable digital recording device developed at Imperial (the Virtual Chaperone) allows the scenarios to be set up within clinical settings, thereby recreating many of the contextual cues of actual practice.

An inconspicuous pole-mounted video-camera, resembling a drip stand, feeds into a small portable computer display, and the technology allows simultaneous recording of technical detail (in close-up) and the overall consultation (wide-angle view). Immediate encryption onto digital disc assures confidentiality, while the digital format allows convenient storage and manipulation of data.

Evaluation

Evaluation with approximately 200 procedures (with medical students, nurses andother healthcare professionals) have shown this approach to be a powerful and innovative learning tool.

The combination of realistic quasiclinical scenarios and digital recording equipment can be used in a variety of settings, breaking down barriers between simulated and real environments.

By providing a framework for observation and constructive patientcentred feedback, procedural skills can be learned within their clinical context.

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Conference report:ASME 2004

Susan Jamieson, University of Glasgow

Having entered the ‘Rewarding Excellence in Learning & Teaching’ competition earlier this year, I was delighted to win a place at the ASME Annual Scientific Meeting 2004, held in Liverpool, from 1st to 3rd September.

Fitness to practise

The theme of the meeting was ‘Fitness to Practise’, and the Plenary speakers approached this from the viewpoint of assessment, with presentations on an adapted EBEL method to assess a PBL-based curriculum (Sue Fowell, Liverpool); inter-school variation in standards at OSCE stations (Katharine Boursicot; St. Bart’s, London); the Sheffield Peer Review Assessment Tool (SPRAT) for self- and peerassessment of paediatric SHO trainees (Julian Archer, Sheffield); and a keynote lecture from Professor Susan Case (Madison, USA), which placed particular emphasis on the need to address the reliability and validity of our assessment tools.

Broader aspects of ‘Fitness to Practise’ were addressed by the Chair of the GMC, Dr. Graeme Catto. Moreover, Dame Lesley Southgate (Academic Centre for Medical Education, London) reminded us that the concepts of ‘Fitness to Practise’ and ‘Professionalism’ have different meaning in different parts of the world.

She challenged us to consider our personal views of the sometimes fine line between fitting in with one’s peer group, and showing integrity.

International perspective

The conference programme included a mix of parallel papers and poster presentations on many themes, including ‘International Medical Education’, in which U. Choudhuri (Aberdeen) presented a study on medical students’ attitudes to learning, using a modified Perry scheme.

He found interesting differences in the learning attitudes of various student groups (home, mature, overseas); and also that learning attitudes did not correlate significantly with student performance on the Common Assessment Scale.

Student perspective

The Sir John Ellis Student Prizewinner, Kirsty Buchanan (Aberdeen), gave an excellent presentation, describing her design of a course aimed at enhancing the prescribing skills of medical graduates.

Arguing that new doctors have limited training in completing prescriptions, drug administration, drug dosages, etc., she presented a scheme for teaching and assessing these skills.

Personally, however, the most valuable sessions included the workshops, since these provided a real opportunity to share teaching experiences and learn from colleagues.

A major lesson from the workshop on ‘Reflective Learning in Undergraduate Medical Education’ (Andy Grant, Cardiff) was the extent to which current teaching and learning practice is (or is not) evidence-based; we each have a responsibility to read original literature critically.

Medical Education the Journal

The editorial staff of Medical Education held a well-attended workshop in which they described the reviewing process for articles submitted to that journal, and explained what they required of their reviewers. The session offered a valuable insight for those hoping to become authors with the journal, as well as those who were interested in reviewing.

Other personal highlights were presenting a parallel paper based on my competition entry; with the chance to receive constructive feedback from a vocal audience! Not to mention the social events at Sefton Park Palm House and Liverpool Town Hall, where I had brilliant conversations with some new, and hopefully lasting, friends.

Many thanks to the Subject Centre and to ASME for a wonderful opportunity.

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CETLs in medicine, dentistry and veterinary medicine

A selection of the relevant Centres for Excellence in Teaching and Learning that were established in 2005 with HEFCE and DEL. In some cases only the lead institution for each bid is shown.

Background

In January 2003 the government published its white paper ‘The Future of Higher Education’ and in July 2003 the Higher Education Funding Council for England (HEFCE) published their Strategic Plan 2003-08.This plan included proposals to establish Centres for Excellence in Teaching and Learning (CETLs) which were further developed into a policy consultation document and a call for proposals. HEFCE committed over £300 million to fund the establishment and operation of at least 70 CETLs over a five year period. Department for Employment and Learning NI, also ran a competition to establish CETL (NI).

CETL funding is intended to:

• reward practice that demonstrates excellent learning outcomes for students
• identify beacons of good teaching practice and encourage development of this practice so that the benefits are delivered more widely
• enable institutions to develop approaches to teaching and learning that encourage a deeper understanding within the sector of methods of addressing student learning needs
• encourage collaboration and sharing of good practice and so enhance the standard of teaching throughout the sector
• contribute to the information available to inform student choice.

Further information All information from HEFCE and DEL: www.hefce.ac.uk/learning/TInits/cetl/final/

4E CETL for Clinical and Communication Skills

Queen Mary, University of London and City University

This collaboration between two institutions in an established strategic alliance, will enhance communication and clinical skills in students from five healthcare disciplines. It has grown from a shared clinical skills facility where staff are recognised nationally and internationally for groundbreaking work in helping students acquire and continuously improve professional practice skills. It will now extend beyond this, offering new opportunities for students to learn and practise in a safe environment at their own pace. Rigorous, fair assessment and stronger links with the NHS, supported by the development of the mobile ‘Skills Bus’ will be additional benefits. The students' experience will encourage lifelong learning skills and reflection in practice, preparing them for careers as tomorrow's health care professionals.

Main Contact: Dr Maggie Nichol, CETL Director (m.j.nichol@city.ac.uk) or Dr Anne Cushing

LIVE! Centre for Excellence in Lifelong and Independent Veterinary Education

Royal Veterinary College

The LIVE! vision is a fundamental transformation of the veterinary and allied professions, ensuring future generations will be lifelong independent learners from induction to retirement. LIVE! is focused on successful completion by all students of the important switch from pedagogical to andragogical learning modes which is a feature of effective tertiary education. Through computeraided learning, new veterinary clinical skills laboratories, and communication skills courses, LIVE! will promote coherent, incremental professional skills acquisition. Targeted initially on veterinary students at the Royal Veterinary College and Liverpool University, the project will quickly extend to related degree programmes, including Veterinary Nursing and Veterinary Physiotherapy.

Main Contact: Professor Stephen May, Vice-Principal for Teaching (smay@rvc.ac.uk)

Centre for Excellence in Interdisciplinary Teaching and Learning in Mental Health

University of Birmingham

This CETL will develop a dynamic and collaborative partnership between six schools in the university and the mental health service user, practice and policy communities. Through this partnership it will enhance and expand the delivery and evaluation of innovative, interdisciplinary mental health programmes within higher education and the mental health sector. Service user and carer involvement as well as e-learning will be key features of programme development and evaluation. The CETL will contribute to the promotion of best practice in supporting students with mental health problems access and complete programmes of academic study.

Main Contact: Professor Ann Davis, Professor of Social Work (a.davis@bham.ac.uk)

The AIMS Centre (Applied and Integrated Medical Sciences)

University of Bristol

This CETL will integrate the teaching of medical sciences with clinical skills in an excellent learning environment. It will develop proven teaching approaches in anatomy, physiology and pharmacology to include state-of-the-art models, images and simulations of normal and diseased body structure and function. A major resource of webbased histology and pathology teaching material will also be created. Existing teaching space will be extended and enhanced to include a clinical anatomy and surgical training centre. New equipment and software, including computer-controlled human ‘manikins’, will be purchased and a number of staff appointments will be made.

Main Contact: Dr Judy Harris, CETL Director and Senior Lecturer, Department of Physiology (judy.harris@bristol.ac.uk)

Assessment and Learning in Practice Settings (ALPS)

University of Leeds

This CETL will ensure that students graduating from courses in Health and Social Care (H≻) are fully equipped to perform confidently and competently at the start of their professional careers. H≻ courses rely on the quality of students’ learning experiences in practice settings. The excellence already demonstrated by us within professions can be extended and disseminated across professions, providing the opportunity to learn in an interprofessional environment. Identifying generic and specific professional competences will allow us to develop work-based educators and practitioners who will confidently support students’ learning, and specifically assessment, in the workplace and across professional boundaries.

Main Contact: Professor Trudie Roberts, CETL Director, Professor of Medical Education (t.e.roberts@leeds.ac.uk)

Genetics Education - Networking of Innovation and Excellence (GENIE)

University of Leicester

This CETL builds on existing expertise and synergy between world-class science genetics education. We will lead the development of innovative approaches and establish a network of institutions engaged in teaching genetics, promoting the sharing of resources and experience. An internationally accessible database of these resources will also be assembled. Intrinsic to the philosophy is the embedding of generic skills and the application of generic approaches to broader fields, for example, biotechnology, medicine and law. Therefore the learning experience of students from a wide range of subjects will be enhanced, reflecting the broad impact of genetics on science and society.

Main contact: Dr Annette Cashmore, Sub Dean, Faculty of Medicine and Biological Sciences, and Head of Department of Genetics (amc19@le.ac.uk)

Centre for Excellence in Teaching and Learning in Developing Professionalism in Medical Students

University of Liverpool

Through this CETL, we will further develop in our students the professional attitudes which are increasingly important in the NHS in the 21st century, better preparing them for their future careers. We will do this by:

• developing robust mechanisms to assess attitudes and behaviour of medical students
• developing a careers advice service for medical students
• underpinning the changes by developing criteria to determine excellence in clinical teachers which we would aim to have accepted nationally.

The work will be appropriate for dissemination to all medical schools and to other professions - especially in health care.

Main Contact: Professor Anne Garden, Executive Director CETL, Head of School of Medical Education (a.s.garden@liv.ac.uk)

Centre for Excellence in Enquiry-Based Learning

University of Manchester

The CETL will capitalise on our excellence in Enquiry- Based Learning (EBL), with Medicine and Manchester Business School being leaders in problem-based and casebased learning, and a National Teaching Fellow pioneering these approaches in humanities.The CETL will extend EBL throughout the new university, aligned with our LTA strategy and working with students as partners. We will establish a university ‘hub’ facility for EBL linked to four faculty ‘spokes’. The hub will provide support and expertise, whilst each spoke will implement a major EBL project, reaching at least 5,000 further students overall. A programme of evaluation and research will support the CETL.

Main Contact: Professor Paul ONeill, CETL Director and Professor of Medical Education (p.a.o’neill@manchester.ac.uk:p.a.o’neill@manchester.ac.uk)

Centre for Excellence in Teaching and Learning in Mental Health and Social Work

Middlesex University

The centre will enhance teaching quality by:

• continuing to develop innovative programmes of learning for practice
• establishing a core capability-based curriculum, adaptable to mental health and social work, that allows workers to learn together and work together
• delivering that curriculum in the workplace via team teaching and mentoring
• devising strategies for student support that enhance retention and progression
• making sure that other learners beyond mental health and social work professionals are influenced by the CETL's teachers to raise their own thresholds of performance in academic work and in practice.

Main contact: Professor Peter Ryan, Professor of Mental Health (p.ryan@mdx.ac.uk)

Centre for Excellence in Healthcare Professional Education (CETL4HealthNE)

University of Newcastle

This CETL will work with a range of partners across the region to design and deliver innovative learning and teaching for future health professionals - in order to meet the changing expectations of patients. Increasingly, healthcare students will learn together in the workplace, with simulated and real patients (and communities), and will learn to involve patients to best manage their care. Students will learn professionalism, to be creative and to work with developing technologies as well as to value each other and their patients - to meet the needs of future healthcare.

Main Contact: Dr Geoff Hammond, CETL Director, Senior Lecturer and Head of School of Medical Education Development (g.r.hammond@ncl.ac.uk)

Centre for Excellence in Professional Development Through the Use of Relevant Technologies (the ExPERT Centre)

University of Portsmouth

The ExPERT Centre is designed to provide students in health-related sciences with exciting and innovative ways to learn and develop professionally. The centre will have state-of-the-art equipment to support the creative delivery of both academic and professional skills including dynamic media, computer-aided learning, telemedicine, laboratory and human patient simulation. Initially concentrating on students in health-related sciences, the ExPERT team will embed the use of blended learning and research how this impacts on the student experience. Through dissemination and collaboration with national and international partners, we will establish a community of practice to share our experience and expertise.

Main Contact: Professor Lesley-Jane Eales-Reynolds, CETL Director and Head of Institute, (Lesley.Reynolds@port.ac.uk)

Placement Learning in Health and Social Care

University of Plymouth

The CETL for Placement Learning in Health and Social Care aims to enhance health and social care students’ practice/placement learning. Strands of development work relating to placement learning and teaching are planned: preparing and training staff, supporting students with disabilities, evaluating learning assessment tools, evaluating interprofessional learning opportunities, auditing and enhancing the learning context, and the role of OSCEs. Building on existing excellence, the CETL also aims to develop new multi-professional placement opportunities at the cutting edge of service in the South West including working with refugees and asylum seekers, prisoners, homeless people and carers.

Main Contact: Dr Susan Lea, Associate Dean (Learning and Teaching) (susan.lea@plymouth.ac.uk)

Centre for Excellence in Interprofessional Education (NI):Curriculum and Assessment Development

Queen’s University, Belfast

The Centre for Excellence in Interprofessional Education (NI) will undertake educational research and develop programmes of interprofessional learning and assessment within the Faculty of Medicine and Health Sciences and throughout the University. The team will undertake exploratory research to identify subject areas that will benefit from an interprofessional approach and the implications of this for future curriculum and assessment development. The team will also investigate how greater understanding of students' and teachers' learning styles and learner-teacher interaction, can inform interprofessional curriculum and assessment developments. Appropriately for healthcare students and pertinent to other academic disciplines where work-based learning occurs, these issues will be examined in relation to classroom and workplace learning. Instruments will be developed, trialled and evaluated for this purpose. Similarly, the team will expand this approach to consider how better understanding of learning and teaching styles, and learner-teacher interaction might contribute to mass higher education. The team will work closely with key stakeholders including professional bodies, employers, students and other UK CETLs to ensure effective dissemination and sharing of expertise at all stages of development.

Main contact: Dr Sue Morison, CETL Director (s.morison@qub.ac.uk)

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Special focus: Operating theatre

Dominic Slowie, Senior Medical Tutor, University of Newcastle

Operating Theatre is based in the School of Population and Health Sciences, which is part of the Faculty of Medical Sciences at Newcastle University.

It was a project devised by Senior Medical Tutor Dr Dominic Slowie who has taught on the MB BS undergraduate curriculum for the last eight years and also has a clinical commitment as a local GP.

Dominic continues to chair the project and works closely with the writers and performers to develop plays and devise workshop and seminar material. Here he tells us about current developments in the project Operating Theatre.

Julia Darling

What is Operating Theatre?

Operating Theatre uses stories, drama and writing to assist learning in health care and medicine.The project particularly focuses on areas of health learning where there may be complex emotional issues or communication hurdles, e.g. how to deal with feelings of professional self doubt, the patient experience of talking to a doctor, how to describe symptoms and use metaphor to explore them further.

We write and produce professional drama that can be used as an educational tool in a variety of settings but that will stand up in its own right as first class theatre suitable for public performance.

We also create and deliver theatre workshops for small groups that explore more deeply the themes introduced in the plays. In these we use a range of creative writing and drama techniques in interactive work with the performers.We do not use role play or improvisation.

Operating Theatre’s purpose is to allow student audiences to connect with characters in situations that they are unlikely to have experienced personally, by engaging them with a performed story.

The value of this is that it allows students to feel the emotions of the characters in a real sense whilst knowing that the scenario is fictional. This naturally leads audience members to develop empathy for the characters, which can then be further explored in seminars, reflected upon and ultimately transferred into similar situations that they meet in their clinical work.

The project started as an experimental exploration into how drama might be usefully used in the education of health professionals and students, by running a series of workshops at Live Theatre on Newcastle’s quayside. From the outset the project was privileged to be able to work with professionally acclaimed writers Carol Clewlow (Keeping the Faith, A Woman’s Guide to Adultery) and Julia Darling (Crocodile Soup, The Taxi Driver’s Daughter). We have continued to work with both of them as well as a number of the region’s professional actors.

Core curriculum

Many ventures in the field of Medical Humanities are delivered at the level of Student Selected Components (SSC’s). Whilst Operating Theatre plans to deliver its first SSC project in May, from its conception the project wanted to aim at the core medical curriculum believing that a powerful and innovative learning method should not be restricted to an enthusiastic minority. Recently Operating Theatre realised its ambition of going mainstream with two live performances to full year groups of first year medical students at both Newcastle and Durham’s Stockton Campus. These performances were followed by new seminars for which the year groups were divided into smaller groups.

Live performance

The play performed in Newcastle was an adaptation of Julia Darling’s radio play Letters Home recently performed on Radio 4. It dealt with how a teenage girl with anorexia and her mother cope with their communication breakdown. They start to rebuild their relationship and come to some degree of mutual understanding by writing letters to each other. It was performed at the front of a lecture theatre with minimal staging and was embedded in the case launch lecture on adolescence as part of the ‘Life Cycle’ strand. The performance was funny and emotive and met with huge and sustained applause from the 220 strong first year student group. It was followed by a period of hot seating where the students are allowed to ask any of the characters, who remain in character, about their lives, their opinions and the things that influence them. This exercise itself is designed to help students develop deeper empathy for the characters and being fiction they are unrestricted as to what they can ask.

Empathetic reflection

In the seminar that followed, part of the Medicine in the Community course, further empathic reflection was encouraged through creative writing exercises and discussion. Tutors and students gave extremely positive feedback reflected by the following comment from first year medical student Lucy Holden: “It was gripping and very moving. It allowed us to get inside the minds of the characters and put a real life perspective on what we’re studying.”

A medical whodunnit

The play performed to the Durham medical students in Stockton A medical whodunnit was written by Carol Clewlow and dealt with a doctor being called into a hopeless situation to try and rescue a woman with end stage alcoholic liver disease. There are clues to stories in this woman's past but the doctor remains frustrated that he cannot put the pieces of the jigsaw together and begins to wonder if he may be to blame for not discovering her problems sooner. This play was delivered as part of the Personal and Professional Development course and focussed on issues of professional blame. It also allowed an opportunity for another new educational venture as the medical students were joined by their colleagues on the Masters Degree in Social Work, for the performance and the seminar that followed.

Both student groups and their tutors enthusiastically received the play, the hot seating and the seminar that followed. In the tutor feedback that took place immediately following the afternoon, discussion arose as to whether this approach gave additional benefits to introducing real patients and their stories during lectures.

At Operating Theatre we feel that the power of stories and fiction, whilst long recognised for its power for learning, is underutilised in medical education. When a student sees a piece of drama that is engaging, emotive and entertaining vivid images and learning points are likely to stay with that student for a very long time. Yann Martell, in his introduction to ‘Life of Pi’ explains the power of stories well when he explains that fiction is about the selective transformation of reality and that it is this twisting that can bring out the essence of reality. This is why we feel drama can offer something over and above the case presentation or clinical anecdote.

Feedback

“You can ask how using theatre is better than questioning a real patient,” says Dr Jane Macnaughton, director of the Centre for Arts and Humanities in Health and Medicine at the University of Durham.

“The answer is that drama creates a safe and circumscribed environment in which to explore very sensitive issues.You can also manipulate the situation with an actor so that particular teaching points can be made.”

Further information

If you would be interested to learn more about what Operating Theatre is doing, are interested in us writing and performing a piece for you or would like us to run a theatre workshop please see our website: www.operatingtheatre.org.uk e-mail: d.f.slowie@ncl.ac.uk or telephone Alison Etherington at the Medical School 0191 222 7382.

References

Martel, Y. (2001) Life of Pi Canongate Books, Edinburgh.

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Workshop programme for 2005

Our workshops are free and open to anyone involved in learning and teaching in undergraduate medicine, dentistry and veterinary medicine and all attract CPD points.

At present we have some 21 workshops in place or under development and these cover a range of themes of interest and value to medical, dental and veterinary education practitioners.

All of these workshops have been designed by members of our constituency and have been approved by our review panel.

Details are now available for a number of the workshops and more will be placed on the website as soon as dates and venues have been finalised, so keep an eye on our website 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, so watch your - doubtless crowded - inbox as well! 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 book your place on any of our workshops fill in a registration form online. www.medev.ac.uk/resources/meetings/workshops

Forthcoming workshops include:

The best of the web, finding and evaluating health and life science information on the internet

The Internet is awash with health and life science related websites, many of which may be inaccurate. Traditional search engines such as Google and Yahoo provide no quality control mechanisms or useful contextual information, often listing good quality materials alongside poor ones or yield many broken links. Busy students and practitioners can be overwhelmed by the sheer number of resources returned by even the most careful or detailed search.

BIOME overcomes the problems of finding high-quality information quickly on the Internet by providing UK students, teachers and researchers with a focused collection of high-quality Internet resources of direct relevance to their specific needs.

Aimed at academics and information professionals, this CPD training session will raise and address a range of issues in this area and provide participants with an overview of Web site evaluation issues as well as specifically touching on services to assist Internet resource discovery and teaching in medicine, dentistry and animal health such as the OMNI and VetGate Gateways and the RDN Virtual Training Suites.

Meetings of the communication skills leads of UK medical schools

An invited meeting designed to establish a network of medical undergraduate communication skills teachers in the UK, create an on-line forum and the lay down plans for future regular meetings. The first meeting took place on the 21st April 2005 at the School of Clinical Medicine, University of Cambridge; a second is planned!

The Patient Safety Curriculum; modular or integrated?

Patient safety is increasingly important in the daily medical practice and we need to address this topic in the medical curriculum. Medical schools are actively thinking about patient safety and how and where to incorporate it into their curricula and whether to adopt a modular or an integrated approach.

Patient safety also links with other important themes in modern medical education such as interprofressional education, professionalism and patient empowerment. This workshop will provide an opportunity to share ideas and good practice in a non-competitive forum.

The workshop will comprise a mixture of presentations and small group discussion with feedback to share experiences and good practice to address patient safety. Following an introduction and general discussion clarifying definitions and terms there will be a review of the overall intended learning outcomes for patient safety curriculum and how and where it sits in medical curricula. The Medical Protection Society (MPS) will present an overview of a series of seminars, which they have developed for a student centred component. The participants will then, in small groups, design teaching and learning activities with related assessment, which will be shared in a plenary discussion. These could include problem based learning scenarios, communication, clinical, and team skills and could incorporate interprofessional learning opportunities. The workshop will conclude with a final summary and evaluation.

Professional and Personal Development Portfolios in the Early Years of the Medical Curriculum

The purpose of the workshop will be to support those who are already delivering PPD portfolios or who are planning to do so, to students in the first years of their medical degree address through exchange of experiences.

This will be achieved through short presentations from three medical schools, that have each adopted different strategies for introducing PPD portfolios, two of which are paper based (Manchester and Glasgow) and one (Newcastle) is electronic. This will be followed by small group discussions, which directly address the issues raised above e.g. assessment, evaluation, development of single portfolios for the entire medical degree and beyond, training of mentors/tutors. The workshop will culminate in a plenary round up session in which discussion groups will report back.

Interprofessional online learning: sharing the experience

This series of three free workshops (two generic and one by invitation - especially aimed at dentists and PCD) will introduce participants to inter-professional learning (IPL), and how an online approach could provide a useful tool in its promotion. The workshop will provide information about current, national activities and the drivers that have put IPL and e-Learning on the agenda, and suggest how they may complement each other. Manchester Hope Hospital 6th July 2005 (open); University of Sheffield 13th July 2005 (open); and Queen Mary, University of London 21st September 2005 (invitation only).

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Meet Suzanne Hardy

Describe your role in the subject centre:

I have been with the Subject Centre almost since it started as back in 2000. Gosh is it really that long?! I was employed as Information Officer/C⁢ Manager, with quite a broad remit to provide marketing support to the centre, and to promote the use of C⁢ in learning and teaching in our subject disciplines.

My responsibilities include the management of all of our printed and online published materials, including our subject centre corporate identity. I look after the production and commissioning of materials for our newsletter, 01, and write the copy for nearly all of our other printed materials.

I work with Paul Hollands, our Web Development Officer, to ensure the constant development of our web services, constantly striving to improve them, make things easy to find and ensuring as far as we can that resources are updated regularly, news is current, and our constituency is kept well informed of learning and teaching related developments.

I also act as liaison point for many learning technology related projects in which the centre is involved, and also with disability related issues, though I don't pretend to be an expert in that field - I am learning lots!

What is your professional background?

After a degree in History of Modern Art, Design and Film, I worked in the arts, theatre, dance and performance as a marketing officer or project manager for over ten years in various places throughout the North of England. I decided on a career change and after getting a job to project manage a research project funded by the NHS at the Sowerby Centre for Health Informatics at Newcastle (SCHIN) I developed an interest in learning technology. It was quite a short step from there to the subject centre, where I have been ever since.

And your professional interests?

I am particularly interested in seeing the wide variety if applications of learning technologies in medical, dental and veterinary education - there are some highly creative people doing marvellously innovative things with technology in learning and teaching. I am interested in the effective dissemination of good practice and the methods we use to disseminate that good practice, including our face to face work as well as our printed and online presences.

Tell us about your personal interests:

Well, when I have spare time (I am trying to finish a MSc in Advanced Learning Technologies) I like to travel with friends, splash about in the sea, and knit. Preferably all at the same time... I also love cooking and eating and consequently try to find time to burn off all the calories I eat. I also enjoy yoga, being outdoors, reading, listening to music (which drives some of my lovely colleagues mad at times since my taste is, erm, eclectic - sorry guys) and films.