MEDEV

School of Medical Sciences Education Development

Edited by John Sweet, Sharon Huttly & Ian Taylor. Published by Kogan Page for the ILTHE and the Times Higher Education Supplement.

This is the 4th in a series of Effective learning and teaching volumes commissioned by the Institute for Learning and Teaching in Higher Education (ILTHE), published in association with the Times Higher Education Supplement. According to Sally Brown's Foreword, these volumes are to play an important part in the ILTHE's mission to enhance the status of teaching, improve the experience of learning and support innovation in higher education, and to this end the book sets out to address generic issues in higher education (HE) from medical, dental and veterinary (MDV) perspectives.

A curate's egg

It is an interesting book, but there's a touch of the 'curate's egg' about it. Furthermore, although the intended audience is both new and experienced teachers in MDV education, I wonder whether in trying to be all things to all readers, the book fails to meet the needs of any particular group. For example, we are told that the new teacher will find themselves pointed in the direction of new sources of outside help, and ways to develop and assess student learning and their own teaching.

In my experience, new teachers, indeed most jobbing teachers, are busy, pragmatic people who want clear, succinct, no nonsense guidance and tips about teaching and learning methods.

As a potential source of such advice, I think the book might not quite match up. There are chapters that get near to fulfilling this function, for example those on communication skills, small group and large group teaching, but their approach and coverage is necessarily superficial, and there are many more appropriate and useful texts on the market.

Discussions

What is interesting, however, are the discussions, albeit usually brief ones, of the similarities and differences between the three disciplines, in terms of how they approach the particular topic, not only from an educational perspective (in the case of communication skills, for example, medical educators are way ahead of dental and veterinary educators in developing relevant teaching and assessment), but also in terms of those requirements of real-life practice that should guide curriculum development (taking communication skills again, dental and veterinary students differ from medics in that they need to develop specific skills early on because they actually treat patients during their training).

Most chapter authors have made a stab at drawing together common themes and differences between the three disciplines, inevitably focussing on their own disciplinary background. However, I feel a trick may have been missed in not delving deeper into these issues.

Although they may not be of much concern, and are certainly of little practical use to most teachers, these issues are of great interest and relevance to those involved in working across disciplines, for example through LTSN-01 or within their own institutions.

In fairness, Chapter Two does look at the commonalities of MDV education, highlighting three areas: repair, healing and care (and the social dimensions and ethical imperatives that prevail as a consequence); positivism and humanism (something the authors identify as perhaps the most important feature of MDV culture, not least the tension that exists between them, increasingly so in the research-driven environment of the contemporary university,); and transmission and imitation (as the predominant educational modes in MDV courses for centuries, with all their quirks and foibles). The authors argue forcefully how important it is for educators to understand the culture in which they operate, especially if they aspire to change it! They also discuss the value of collaborative learning to promote collegiality, which they claim to be one of the foundations of lifelong learning.

Use of jargon

Another issue that might deter the ordinary teacher from delving too far is the use of jargon. There is a smattering throughout the book, thankfully kept to minimum, of the kind that has crept into education-speak in the past few years, most of it from the business and management world - old friends like stakeholders, agendas and vision feature prominently, along with the odd horror such as performativity!

What about the meeting the needs of the experienced educator? As previously argued, the coverage of some topic areas is somewhat basic and superficial. The big picture chapters, such as Chapter Two described above and Chapter Three on curriculum do provide food for thought, but some of the other chapters do not really provide much in the way of new or interesting insights.

However, the final chapter - The way ahead for MDV education - rounds the book off nicely with some interesting ideas and speculation, focussed on three themes: integrated pedagogy for practice (essentially an argument for learner-centred approaches supported by a mixed menu of methods including communications and information technology - being wary of letting the technology drive the learning); professional practice (designing curricula that are appropriate to working in the real world).

Omissions

Inevitably in a book attempting to cover so much ground, there are lots of omissions and plenty of nits to pick. For example, I would challenge the throw-away statement on page 18 in Chapter Two that, despite the exhortations of official bodies such as the General Medical Council, there have not yet been radical changes in MDV education in Britain, nor in medical or dental education in the United States.

The authors don't tell us exactly what they mean by radical, but I would argue that there have been some positively dramatic developments over the past decade, albeit mostly in medical education: the breakdown of the pre-clinical/clinical divide; introduction of outcome-based approaches; greater student choice; graduate entry; problem-based learning; innovations in teaching and assessment methods; and increasing emphasis on personal and professional development.

In Chapter Nine, on student support, little is said about the challenges of continuing to provide comprehensive academic and pastoral support, because of increasing pressures and demands on academic staff, increased student numbers, and budget constraints. Pertinent to this, more might have been said about peer support and mentoring schemes, which many schools are developing.

Chapter 12, on reflection in clinical practice, explores the theory behind reflective practice, but there is not much about its assessment, which is surely one of the major challenges in health care education at this time. I was also surprised there was so little about inter-professional education (IPE), comprising only a couple of paragraphs buried towards the end of the final chapter.

Since this is currently a major policy issue, and most certainly flavour of the month, surely a discussion about the hoped-for benefits, the problems and challenges, and the evidence-base of IPE would have been useful and appropriate for such a volume. Similarly, there is virtually nothing about faculty development, which some would argue is absolutely crucial to successful curriculum development. 

Conclusion

.....the (sic) guide to surveying and understanding the key issues, best practices and new developments in medical, dental and veterinary education, as claimed on the cover, this book is not. However, despite its limitations, there is something in it for everyone, and a copy should find its way onto bookshelves in university libraries and educators' offices. It could, for example, be a useful resource for students undertaking higher professional qualifications in MDV education. At the very least it puts down a marker describing, albeit patchily, the state of the art of MDV education for future reference.