MEDEV

School of Medical Sciences Education Development

Introduction

The eCourse, a web-based learning management system from the Birmingham School of Dentistry,won the JISC sponsored award for Outstanding ICT Initiative of the Year at the Times Higher Awards in November 2007.

The eCourse was redesigned in 2006-7 to meet students' rather than teachers' aspirations. It is unashamedly fashionable, and has taken the bold step of allowing students the same rights as teachers to provide learning and teaching materials. It also allows participating students to be anonymous, avoiding personal identification when providing learning materials, asking questions, and giving feedback. This article gives an overview of its development.

The ecourse at Birmingham School of Dentistry was developed to complement existing learning opportunities within the school. Differing student learning styles are catered for in a variety of ways including lectures, tutorials, one-toone teaching, role-playing, problem solving scenarios and computer-based learning. The eCourse aimed to extend the range of available learning methods, providing another way for students to engage with the course.

The eCourse has distanced itself from traditional elearning methods, where modules are provided to cohorts of students at a specific time, with intensive on-line input required from the module teacher, and examinations being based on the online work. It is (in effect) a 24-hour library, where all 'courses' are open to all students, irrespective of their year. Use of the eCourse is entirely voluntary and not directly tested in summative assessments. Its survival depends entirely on how attractive it is to students.

What attracts young people to the Internet is not immediately apparent to an older generation of teachers, and the 'teacher knows best' model of education delivery is still commonplace (despite the 'doctor knows best' model of healthcare delivery now being discredited). Published guidelines on best practice in Internet based delivery of education tend to be out of date as soon as they are published because of the speed the web changes, and the ability to apply best practice is often limited by the inertia of institutional content delivery systems.

Before designing the new eCourse, we interviewed young people (not just dental students) about which web sites they enjoyed visiting, and why. We compiled a list of everything they liked, and everything they might like, regardless of whether it was technically possible. This list was presented as a questionnaire to the student body, for them to vote for features they would wish to have in an online learning environment.

It was perhaps no surprise that many web 2.0 features were very popular, like podcasts, (captioned) videos, gadgets, instant searching - where results appear as you type, file sharing, and the ability to create, share and edit content. Customising the appearance of their learning space was not considered important, but the ability to download any page as an editable word document was strongly supported. Compatibility with mobile devices was also very strongly requested, reinforcing the suspicion that the days of sitting in a computer cluster are numbered.

Other desires included anonymity when interacting with the eCourse (including providing content), a wish list (where students could post a wish and others could vote for it), and the ability to write (persistent) notes directly onto an eCourse page as one might write in the margin of a book. Students wanted a unique discussion board for every page, as well as a conventional forum, to ask teachers questions.

From a teacher's perspective, many of their desires were challenging. Giving control of educational web space to students, especially if they didn't have to identify themselves, might result in a whole series of problems, including abusive postings and providing poor quality information (or even disinformation).

It was decided to trial a new system that met the students' aspirations, and see if these fears were justified. The new Learning Management System (LMS) was written in-house, and was designed to be very easy for untrained people to create interactive materials. Our existing eLearning material was adapted to it. In eight months of use, there has been no abuse: This may be as a result of the 'professionalism' ethic that is instilled into dental students from their very first term.

Students have expressed appreciation at being able to provide course-work online: It becomes a worthwhile exercise that will be appreciated by future students, rather than an essay or presentation that attracts a mark and then gets forgotten. Additionally, students are now voluntarily providing reflective treatment diaries on how they have provided care for their patients, a variety of podcasts, and large teaching areas of theeCourse (such as orthodontics and evidence based dentistry) have been provided by students.

Students are encouraged to provide references to the evidence-base when they create material, and teachers check it for accuracy, modifying it as needed. A notice appears on studentauthored wiki pages indicating that they weren't written by teachers, and this helps students develop judgement about quality of information for their professional lives. Some teachers have found that it is much quicker to moderate and polish a student-created learning object than to write one from scratch themselves, which has greatly increased the knowledge base of the eCourse. A few have expressed their concern that the eCourse now appears to be the first place that our students go when seeking information; perhaps this is more of a sign of success than a signal for concern.

The pilot has been successful in more ways than we could initially imagine, and the new eCourse is now an established part of our education delivery model. This brings us on to the future. The eCourse team's personal desire is to make it a high-traffic international resource for dental workers and students everywhere. For such an interactive site, there would be issues of robustness and moderation. However, these are temporary problems.

The main lesson learnt is to listen to students' views and incorporate their leisure activity into their learning activity. Allowing students to guide their virtual learning space, contribute to it, and retain anonymity is the way forward. 

Introduction

The General Medical Council (GMC) joined with eleven medical schools to develop guidance on encouraging people with disabilities into medicine.The project was match-funded by the Department for Innovation, Universities and Skills (DIUS) scheme Gateways to the Professions, which is designed to encourage a wider range of young people to consider pursuing a professional career.

The objective of the project was to develop advice for medical schools on supporting disabled students into medicine and retaining them within the profession.

Advising Medical Schools: Encouraging Disabled Students emphasises that people with a wide range of disabilities can satisfy the requirements set for medical graduates. It is quite wrong to assume that disabled doctors pose a risk to patient safety. On the contrary, their perspective can help make health services appropriate and welcoming for all.

The guidance points out that ‘disability’ is not restricted to sensory and physical impairments and covers mental health and other hidden conditions. Also, impairments can change and develop so students should be encouraged to declare conditions throughout the course.

The guidance provides practical advice to medical schools for the various stages of a student’s journey:

• How can medical schools encourage disabled people to apply?
• How should they make sure that selection procedures are non-discriminatory?
• What adjustments can be made, so that disabled students are treated fairly? 100 specific examples are included in the guidance.
• What can be done to support disabled students after they graduate?

The guidance also sets out the legal framework, explaining terms like the anticipatory duty, the Disability Equality Duty, Disability Equality Schemes, reasonable adjustments and competence standards. The guidance is advisory and does not impose new requirements on medical schools.

The Project Board for the guidance brought together wide expertise and experience with representatives including the GMC, eleven medical schools, BMA Medical Students Committee, Skill: the National Bureau for Students with Disabilities, the Equality Challenge Unit for higher education, the Office for Public Management (as agents for DIUS) and the Association of UK University Hospitals (AUKUH). Dr Kathy McLean from AUKUH chaired the Project Board. The guidance was drafted by a team led by Professor Janet Grant from the Open University.

Hard copies of the guidance are available from the GMC, and electronic copies can be downloaded from the GMC website.

Key Suggestions to medical schools

The guidance includes more than 50 general suggestions to medical schools. These include:

• Set out entry and assessment criteria that are relevant and genuine, and linked to Tomorrow’s Doctors and Good Medical Practice.
• Ensure course information has positive images of disabled people in medicine.
• Encourage applicants to disclose impairments or health conditions.
• In selection interviews, avoid questions about an applicant’s impairment.
• Assess a disabled applicant as though reasonable adjustments had been made.
• Inform the Disability Officer that a disabled student has been offered a place, to start agreeing reasonable adjustments.
• Provide students with an ongoing confidential opportunity to disclose impairments.
• Conduct a risk and access audit of premises.
• Develop effective support systems, including committed personal tutors with disability equality training.
• Provide effective careers guidance for every medical student, in appropriate ways and using a range of communication formats.

For more information please visit: www.medev.ac.uk/dinky?dinky_id=836

Introduction

Medicine and healthcare face the problem that opportunities for student-patient contact, which is at the heart of clinical competency, is declining in most European member states.Training is hampered by two important factors: The healthcare budget constraints that increasingly limit clinical teaching, and the reduction in the time that patients stay in hospital.

Virtual Patients (VPs) are now recognised by the medical education community as very effective tools for developing clinical reasoning. However, VPs are time-consuming and expensive to produce, and even leading eLearning institutions cannot produce a sufficient number to give full coverage of the medical or healthcare curricula.

In 2005, several of the major European eLearning centres in medicine and healthcare formed a working group for the development of a pan-European collection of VPs. Together with MedBiquitous, the leading developer of healthcare standards, this group began to define a standard for the interoperable use of VPs across Europe.

This collaboration has now been supported with funding from the European Commission, under their eContentplus Programme, to further develop this activity over the next three years as part of this electronic Virtual Patient (eViP) programme.

This ongoing activity has now provided a unique opportunity. The large collection of VPs which already exists between the partners will be pooled, adapted to a common technical standard, and 300+ VPs repurposed for multicultural, multilingual access. Non-partner institutions will be able to repurpose these VPs for their own local and educational needs. The shared bank of VP resources will cover the entire range of specialisms required to support clinical training.

These shared resources can be used to maximise VP uptake by educators in both partner and non-partner countries to underpin and extend current teaching and learning, minimise inefficient practice, reduce costs, and improve the consistency and quality of clinical care and wellbeing of patients throughout the European Union.

eVIP partners

• St George’s University of London, UK (SGUL).
• Karolinska Institutet, Sweden.
• Ludwig-Maximilians-University, Munich, Germany.
• University of Warwick, UK. - Faculty of Medicine at Universiteit Maastricht, Netherlands.
• Faculty of Medicine at Heidelberg University, Germany.
• University of Medicine and Pharmacy Cluj-Napoca, Romania.
• Uniwersytet Jagiellonski, Poland.

eVIP objectives

The objective of this three-year programme is to create a shared bank of VPs for the improved quality and efficiency of healthcare education across the European Union. This will include the following steps:

• Implement common technical standards for all VPs by adopting the MedBiquitous VP standard for the existing partner VP software systems.
• Collate and select VPs from partners’ existing collections for repurposing to local educational needs.
• Promote the sharing of VPs between different healthcare disciplines such as medicine, nursing, physiotherapy and dentistry.
• Restructure content to standards-compliant structure, metadata including the culture and language metadata of the partners (English, German, Dutch, Swedish, Polish, Romanian) and content packaging; all to enable multi-lingual access.
• Further enrich the content of the repurposed VPs with the addition of supporting resources e.g. supporting basic and clinical science resources, clinical skills videos, owned by the partner or in the public domain, or available under creative commons licence.
• Share repurposed and enriched VPs with the wider EU community through an online referatory.
• Evaluate how the repurposed and enriched VPs meet the individual needs of the partners and the wider community.
• Share templates and tools within the EC community for the easier creation of new VPs.
• Disseminate best practice guidelines for repurposing, enriching and sharing VPs.
• Embed a sustainable model for the storage and retrieval of VPs beyond the lifetime of the 3-year initiative.

To assist with dissemination, SGUL, as the lead coordinator, have recently formed a partnership with MedBiquitous. MedBiq Europe is a collaboration to promote the adoption and implementation of MedBiquitous technical standards and specifications for healthcare education within Europe with a immediate focus on VPs.

The eVip programme plan

The eViP Programme plan is complex with the multiple interdependencies and for simplicity it is divided into 7 separate projects (each project is led by one partner institution but involves the input of all partners).

1. Start-up and pilot study (SGUL). The objective is to conduct a pilot study to test some of the early hypotheses by repurposing and enriching partners’ existing VPs to different contexts. In addition, the pilot study aims to explore the early implementation of an eViP VP application profile and VP repurposing and enrichment methods. This project aims to evaluate the pilot study and disseminate the findings.
2. Standards implementation (Karolinska). The objective is to test, implement, and evaluate the adoption of an eViP application profile within each of the partners’ VP authoring and playing systems. In the process, it is anticipated that this project will look at testing other third-party open-source tool to assist with interoperability. Another aim of this standards focused project is to develop a licensing and access model to assist with the sharing of the VPs.
3. VP repurposing and enrichment (Karolinska). This forms the bulk of the work in the eViP Programme. The objective of this project is to do the actual repurposing and enrichment work whilst conforming to the agreed application profile in project 2 (standards implementation) by involving a multitude of expertise (e.g. academics, students, subject matter experts, VP experts, learning technologists, technical developers, metadata experts, and legal experts). Another key aim of this project is to populate and update the eViP referatory over the course of the programme lifecycle in order to realise the benefits anticipated by the Programme.
4. Awareness and dissemination (Warwick). The objective is to publish a variety of outputs relating to the overall programme outcomes. In addition, a number of dissemination activities are planned at key conferences over the next few years including one major VP event at the end of the 3-year programme. The aim of this dissemination is to inform and engage with other like-minded institutions.
5. Assessment and evaluation (Maastricht). The objective is to evaluate the repurposing and enriching efforts of the programme from different perspectives (e.g. from the perspectives of students, staff, technical developers, and VP experts). This project will also aim to share a number of outputs including research articles based on the programme in line with Project 4 (awareness and dissemination), VP evaluation tools and instruments, case studies, and comparative studies based on use of VPs in different educational contexts.
6. Exit and sustainability (Munich). The objective of this project is to develop a suitable sustainability model for the eViP outputs, including the eViP referatory, beyond the life of the programme. This project will work closely with Project 2 (standards implementation) in order to implement appropriate digital rights frameworks for the content generated over the course of the programme.
7. Programme and project management (SGUL). Each project is managed by a project lead (as mentioned above). The overall programme is managed using the key governance themes, principles, and transformational flows from the Office of Government Commerce’s Managing Successful Programmes (MSP) framework. To ensure tight alignment to Programme objectives and outcomes, each project is managed using key principles from OGC’s PRINCE2 project management methodology.

Introduction

Medical students will be helped to understand what it is like to go under the knife thanks to a world-first project that brings together art and science.

A unique surgical gown, which recently went on international display in the USA, could improve understanding of where operation incisions are made, and what they mean to the patient, say its developers at Durham and Ulster Universities.

It is hoped the gown, which would be worn by medical students in the classroom, will supplement the traditional plastic models of the human body that are currently in global use as teaching aids. It will also help in explaining procedures to patients, according to the scientists. The gown has nine zips showing where surgeons make cuts in the body for various operations such as removal of the appendix and open heart surgery and its silk material is more like human tissue than the plastic of the traditional models. Medical students will wear the gown in the classroom whilst fellow students learn about surgical incisions using the zips. It will lead to a greater understanding of what it means to be the patient, say the developers.

Researchers say it will contribute to an improvement in teaching aids currently available. They say that, although the traditional plastic models can be used to show areas of the body and where incisions will roughly be made, they are not able to give medical students a sense of the feeling if they were the patient or show them the type of texture they will find once they have made an incision.

Leading developer Professor John McLachlan explains *Current anatomical teaching aids describe but they don’t evoke. They take no account of emotional involvement or the feel of the body. The way medical students distance themselves emotionally from the patient’s body has long been seen as a desirable outcome of current modes of medical training.*

But this desensitation also brings with it the risk of objectifying the body. The patient becomes the liver in bed four rather than Mrs Smith. We think we can use art to bring meaning back into medical teaching and we want to help students understand the significance of the body as well as its structure.

The operation gown, named Incisions, was funded by the Wellcome Trust as part of a wider project to explore teaching, learning and thinking about the body through a series of art works and artefacts. Incisions has been selected for inclusion in two major international exhibitions with the first one at the Museum of Science in Boston, USA opening in January 2008.

Artistic lead, Karen Fleming, Reader at Ulster University, said: The body and garments are common objects in art and design but collaboration with medical knowledge brings a new dimension. The challenge for us has been finding material metaphors for living matter that were aesthetically inviting rather than repulsive. We have combined some of the familiar features from hospital gowns with fashion detailing to make it appealing

The research team aims to feed the use of the gown into medical schools around the UK and beyond. It could form an integral part of the Personal and Professional Development strand of medical training in which students develop the ability to communicate effectively and sensitively with their patients.

Part 1: October 2007

On 17 September 2007 Peninsula Dental School opened its doors to the first cohort of 63 students. We all knew how important the day was. It wasn’t just the first day of the academic year and a new career for the students, it was the first day of the first new dental school in the UK for over 40 years. We had spent the previous year planning and building; constructing our team as well as the curriculum and teaching facilities.

Feeling like pioneers as those on the Mayflower who set sail not far from our Dental School, we nervously awaited the students’ arrival. The School was officially launched by Alison Seabeck MP after the first students enrolled.

The School offers a four year Bachelor of Dental Surgery Programme. The entry requirement is an honours degree in a biomedically-related subject or a qualification in a health care profession subject with relevant experience of working as a health care professional. The School is based in the far South West with the students spending time in Plymouth, Exeter and Truro, in the community, hospitals and dental practices.

With the patient at the heart of the programme, the students encountered their first dental patients within the first week of the programme. With the support of the local dental community, the students were able to spend time in dental practices.

The enquiry based learning (EBL) programme is centred around the human life cycle. The students begun by looking at a 6 month old baby and will move on to look at teenage, middle age and old age. Students will work in teams of eight and develop a sense of responsibility for their peers. Good communication and, when appropriate, leadership skills are important in EBL sessions and will be developed further in the clinic.

During the first two terms, the students will spend time a considerable amount of time practising their new dental skills in the brand new Phantom Head Laboratory. The Curriculum is supported further by sessions in the Life Science Resource Centre and the IT Suite. Plenaries supporting the EBL sessions are held throughout the week and are offered by Peninsula Dental School staff and external experts within their field.

Teeth are only one part of the patient and the patient lives within their socioeconomic setting. This is where a sound understanding of the biomedical basis of oral disease and holistic care comes in. The Devonport Regeneration Company has been a supporter of the School and the Devonport area is in need of improved dental care. The School’s flagship building is currently being built in this area and will provide dental care to the community.

The students will begin their work in this area in February when they undertake three Special Study Units. The students will visit nursery, primary and secondary schools and residential homes for the elderly, where they will provide oral healthcare advice.

In March, the students will progress to spending a day a week in a dental clinic in Exeter. This will be another momentous step for the students and the School, for all our steps are made hand-in-hand with our students. Having spent a year as a ‘virtual’ dental school we all wondered what our first cohort would be like. Would they be as enthusiastic as we had hoped? Would they share the educational ethos of the School? We feel very lucky, our first cohort sparkles with enthusiasm and inquisitiveness, and aspire to be great dentists. We have a four year journey ahead to graduation and it would be difficult to find a better group to share this journey with. Of course, this isn’t where the journey ends. For the newly qualified dentist and his/her patients, this will be just the beginning.

Part 2: January 2008

We now have a full term under our belts and systems feel less new and more routine. DentSoc held its first social event at Christmas and this marked another milestone for us all.

The programme of continuous formative and summative assessment is well underway. During Year 1 there are 14 procedures in which the student must demonstrate competency. S/he decides when they are ready to be assessed on their level of competency and book an assessment slot.

Students are continually assessed on their performance and contribution within the EBL sessions. Reflection on this and other assessments form part of their Regulation Portfolio Appraisal (RPA). Approximately every six weeks, each student meets with their Academic Tutor. Prior to and during this session the student reflects on their performance and plans remediation for any areas requiring improvement. This enables any difficulties to be identified at an early stage and corrected promptly. Once students begin their clinical work in March, this will also form part of the RPA.

In February the students sat their first Progress Test. This online test will be taken by all dental students twice a year and is set at the level expected of a newly qualified dentist. A similar process is used within medicine but the approach is completely innovative within dentistry. It has kept the local dental community well occupied as they have assisted with much of the question writing. During the first two years, the results of this test will be formative. The feedback it will provide to students and the School will be of enormous benefit.

At the end of the year, students will sit two MCQ tests. Questions within these papers will be associated with dental sciences and life sciences. Then we will undertake our first assessment panels and boards.

We have engaged the students in a fair amount of evaluation, both formal and informal. Feedback has been highly positive, with a few areas requiring some minor modification. With the students telling us how happy they felt and the DentSoc party, we all felt content to take a well deserved break over Christmas!

For more information please contact jo.pepperell@pds.ac.uk

Introduction

The term problem-based learning (PBL) is sometimes used to claim educational excellence for different approaches to education.These approaches may not be applied primarily or consistently throughout an educational programme.

Most of the claims in the literature for or against the acceptability, effectiveness and efficiency of PBL tend to focus on the acquisition of factual knowledge. Any mention of add on, transferable generic abilities and skills, tends not to be accompanied by explicit detail of how PBL was implemented to foster their development. Similarly, such papers tend not to describe other variables, such as those related to students’ and tutors’ level of familiarity with the application of PBL or to the curriculum design, including the validity of how students are assessed.

The ill-defined educational goals and lack of overt description of critical variables, as well as variable implementation, may lead to wholesale rejection of PBL as just another passing fashion in higher education2. Several schools have adopted a systems approach, intending that all curriculum elements complement the key principles of PBL itself and acknowledging the potential positive or negative impact that each may have on the success of PBL as an approach to learning and tutoring.

Guide as holistic application

A guide3 has been developed which is intended as a step towards a more holistic application of the principles of PBL for professional higher education with flexibility to accommodate changing requirements in this new century. This approach may permit a more robust evaluation of the quality of PBL, including its acceptability, effectiveness and efficiency. It sets out to describe the main variables, which may affect the success, or disappointment, when using PBL.

These variables can be used as criteria when planning a new course, when revising a curriculum or when evaluating acceptability of the experience (for the students and for the teachers), when reviewing the effectiveness of the learning outcomes and the efficiency of the course.

The approach may appeal to editors when they review papers concerned with claims and outcomes of PBL.

We hope that a clearer specification of the expected outcomes and the related educational construct and implementation may assist a more generally agreed understanding of what is intended through PBL in higher professional education.

In this specific context the guide is arranged as a sequence of thirteen questions which ought to be considered by those who set out to design, revise or research courses which claim to be based on the principles of PBL. These explore:

(i) The generic abilities and skills which PBL would aim to develop.

(ii) What PBL should enable students to experience and practise in relation to (i). These sections are followed by:

(iii) The design and content requirements related to (i) and (ii).

(iv) Section (iv) addresses the implementation of (iii) to achieve (i) and (ii). This is considered separately in relation to small group learning and work-based learning.

Subsequent sections explore the nature of variables related to assessment of students’ progress and achievement:

• The recruitment and selection of students;
• Students’ conception and perception of their PBL experience;
• The perception and reaction of non-clinical academics;
• Recruitment, induction, support of academics;
• The design, implementation, organisation of monitoring and evaluating the curriculum;
• The overall organisation of a curriculum for contextual, integrated, cumulative, active learning;
• And finally the requisites for the initiation and maintaining change from a traditional to an innovative curriculum.

Each Section is accompanied by related references to the literature.

Please Contribute

The guide has been conceived as a First Edition to be amended and improved through suggestions from colleagues from the three professions throughout the world.

Your input towards the next edition of the guide is sought, and you are invited to contact david.powis@newcastle.edu.au as the new editor of the guide, with suggestions for further refinements of the variables as they relate to your profession.

Acknowledgements

On behalf of my colleagues who so generously devoted their time and expertise to the assembly of the guide. The initial set of variables was developed at a workshop, supported by the Subject Centre for Medicine, Dentistry and Veterinary Medicine at the Liverpool Medical Institute, December 2004. Subsequent support by the Centre for Excellence in Enquiry Based Learning, University of Manchester is gratefully acknowledged.

Introduction

The School of Medicine at Imperial College has a long history of using broadcasting technologies to deliver clinical lectures. Since 1998, the broadcasting system has covered 15 teaching rooms in 10 different hospital/campus locations in West London. More recently, the sustainability of the system and of the teaching approach became less certain as changes in NHS clinical service delivery were impacting on where students will be.New educational drivers were required to bring learning and teaching into the 21st century.

Background

The technology of eLearning has progressed to the point where real opportunities now exist to improve radically some aspects of teaching and learning, moving away from the traditional lecture scenario.

The model of the eLecture programme developed uses interactive technologies, including Web 2.0 technology and eLearning tools, to assist learning and teaching in the clinical programme for 350 medical students during year 3. The technology used to deliver this programme is not new; however, the way this technology has been put together to deliver a clinical eLecture programme has proven to be innovative curriculum practice and a stimulating learning experience for the students.

The development of this programme has also helped identify common threads running across different years. This has led to the development of reusable eLearning materials in the area of diabetes, which have endorsed the concept of vertical integration across the curriculum.

eLecture programme

The eLecture programme was developed to provide a blend of face-toface sessions in the lecture theatre with access to interactive online learning materials available 24/7 via WebCT.

A series of face-to-face sessions is scheduled and delivered at the main lecture theatres, and intercalated with the online topics. During these face-toface sessions, the course leader reinforces the main issues raised during the online topics. Feedback is received from the students via personal response system (PRS) handsets or ‘clickers’.

A total of 30 eLectures is provided, offering a wide range of online learning materials in different formats: interactive eLectures, quizzes, podcasts and vodcasts, simulations, discussion groups and virtual patients, in eleven topics:

• Acute abdomen.
• Neurology.
• Angina.
• Antihypertensives.
• Diabetes.
• Infectious disease.
• Vascular disease.
• Respiratory.
• Lumps and bumps.
• Oncology.
• Renal.

Student feedback

Student focus groups and online feedback have indicated the new eLecture programme is an effective and popular way of learning. Students value the opportunity to have access to the eLectures from any location and review them at their own pace.

For example, these are some of the student comments received:

• I think the general programme so far has been excellent and very useful. The information provided in the eLectures has been brilliant and the self-assessments and quizzes have been very helpful in familiarising myself with the lecture topic concerned. I have gained a lot from the eLecture sessions, the main reason being that the eLectures can be done in your own time which means you have enough time to make notes at the same time.
• Being able to juggle lectures with own material, at my own convenience. The frequent quizzes and ability to pause the lectures were fantastic.
• We could access the lectures whenever we found it convenient, which meant we concentrated on the lecture content. We could still ask questions and get a written answer back through the forums.
• The availability of podcasts, online lectures, EMQs and the ability to print off handouts makes for a fantastic learning experience.

Conclusion

The approach taken in the development of this eLecture programme has been followed for other eLecture programmes delivered by the Faculty of Medicine. The Clinical Pharmacology and Therapeutics (CPT) eLecture programme has also been developed following this model.

This CPT programme brings together seven online topics with a total of 38 eLectures, which are also delivered using the wide range of online learning materials described.

These eLecture programmes have been delivered as envisaged in the original proposal. The objectives have been achieved using an approach that has proved practical and compatible with the current technology used by the students.

Introduction

The health service is changing.We are all required to be more accountable in the face of public demand. In addition,we need to be able to show the various authorities that we can do what we say we can.

The GMC, colleges, postgraduate deans and medical schools are all looking for evidence of achievement, attainment and competence. A portfolio is now a widely used means of assessing clinical competence and accomplishments at all stages of medical training from undergraduate medical students to consultants. It forms a core part of postgraduate assessment and appraisal. We are all being asked to keep, and at regular intervals produce, evidence to show we are achieving learning objectives, maintaining skills and standards at an appropriate level, and keeping up to date.

Whether it is for examination or certification purposes, or ultimately revalidation, all doctors are encouraged to log, record and reflect on what we do. We are all encouraged to become self directed learners, to focus learning strategies on our needs – either individual or service need – but it can be difficult to identify these needs, let alone devise a plan to meet them based on the reflective cycle proposed by Kolb1, allowing one to turn a subjective learning experience into a learning process.

The starting point is often a clinical experience or query raised through clinical practice. The critical element to this is to reflect on this new experience, putting it in the context of previous ones.

This allows one to test previously held ideas about areas of practice and identify gaps in knowledge and understanding. Finally, one can draw up a plan of how to remedy this gap or deficiency, often identified as a PDP, is a reminder that knowledge and experience will evolve with usage and that there are always changes to be made.

A portfolio can help to record the elements of thinking and reflection that ultimately lead to a PDP. As well as being a record of learning that has taken place it also provides a reflective record of professional development and enables the individual to document progress and if used correctively can act as a catalyst for learning. It provides evidence of achievements and presents a useful tool to assess readiness for the next stage of postgraduate training. But to do so, its structure and content must be clear enough to present the evidence in a systematic and accessible way.

So what should the portfolio include? There are no hard and fast rules. Overall, the portfolio should be seen as an active document that stems from and develops via a reflective process (Brigden and Purcell 20042). Keep in mind what it is for and when presenting the evidence, a number of questions will help to guide you:

• What are you wanting the evidence to show?
• Is the evidence relevant?
• Are you demonstrating competence in your field?
• What is missing? Identify gaps of knowledge.
• What is to come? How will you fill those gaps?

Not all these questions are applicable to every situation, but will help order the evidence you collect and keep it appropriate. It should also demonstrate reflective practice with positive and negative outcomes of learning. This balance will help assessors see the development of thinking and allow them to gauge to what extent you have taken an active part in your learning rather than being a passive recipient.

The kind of evidence that is often used in portfolios is highlighted in the list below and different pieces of evidence will be required at different stages of your career and may be given varying weight depending on how you are using your portfolio.

• Personal details.
• Examination certificates.
• Summary of rotations and placements.
• Courses and teaching sessions attended and thoughts on their value.
• Research experience and aspirations – student selected components, projects, audits.
• Publications.
• Case presentations and case based discussions.
• Practice skill competencies and clinical skills assessments (e.g. DOPS, Mini-CEX).
• Multi-disciplinary team assessments (e.g. M-PAT).
• Career intentions and current curriculum vitae.

A further way of organising your portfolio is to reflect the principles laid out in the GMC’s Good Medical Practice.3 The main principles relate to: good clinical care, maintaining good clinical practice, teaching and training, maintaining trust, working with colleagues, probity, honesty and health.

Portfolios can be time consuming to keep up to date. An increasing body of literature suggests that the move towards an electronic portfolio or ePortfolio, which is currently being used to assess doctors in the foundation program is the way forward. An ePortfolio, which can be accessed online, provides a more flexible means of keeping your portfolio up to date.4 Portfolio assessment often requires senior assessment in the form of case based discussions and appraisal of clinical skills (for example: history taking, physical examination skills, communication skills, clinical judgement, professionalism, organisational skills). ePortfolios can be accessed quickly in a hospital environment enabling swift assessment by time constrained clinicians. The individual is also able to evaluate performance. For example the online nature of the foundation program portfolio allows the individual to compare assessment scores nationwide with peers at the same level of training, thus facilitating best practice and highlighting areas for future improvement.

In summary, portfolios are here to stay and it is likely that the requirement to document and produce evidence will grow and develop in all areas of clinical practice.Getting into the portfolio habit as an undergraduate could certainly ease the pain in the long term.

Introduction

A recent initiative by JANET(UK) (formerly UKERNA) and the NHS Connecting for Health (CfH) builds upon the benefits of using a centrally managed and maintained Internet gateway to allow access to and from NHS and HE online resources.The gateway went live in its initial configuration in October 2007.

Academics and students who have a role within the NHS have long had problems accessing online content such as library resources, virtual learning environments and secure documents back at their host HE institution whilst within the network confines of the NHS. Various ways of overcoming this problem have been tried in the past ranging from sneakernet (shuffling data via floppy disks, CDs and lately, USB sticks) through to having two physical machines on a desk, one connected to the NHS network and one to a network provided by the institutions on the JANET network.

This situation was clearly unsustainable, and from a security point of view, untenable, and so the NHS-HE forum1, a group set up by Professor Roland Rosner of UCL to assist in the sharing of information between IT managers in HE and the NHS, started looking at ways in which this problem could be alleviated. The NHS was going through a major network upgrade at the time, moving from NHSNet to the new, N3 network, and a gateway was planned for connecting the general Internet to N3.

It became clear that pushing academic traffic through this gateway would not be ideal, so Mark Ferrar of CfH and Malcolm Teague lobbied for an additional gateway (that became the N3 JANET gateway) that would be a single point of entry and exit to the NHS from academic networks. There would be a host of benefits including; enhanced security, economies of scale, consolidated management of access to HE resources from NHS networks and better bandwidth provision, which could be increased as needed.

It was a chance encounter at an NHS-HE forum (1) held at Leeds in May 2006 that lead to CETL4HealthNE2 involvement. Mark and Malcolm gave a presentation on what the gateway hoped to achieve (2), which sounded suspiciously similar to the CETL4HealthNE network requirements to connect up partner sites in the north east of England. The gateway was in danger of floundering at the time due to NHS funding issues.

CETL4HealthNE was in the process of tendering for network equipment and to replace expensive and support better access to virtual learning environments and videoconferencing applications. and so the gateway idea was extremely appealing. After some reconfiguring of budgets and a lot of talking to partners to assure them the situation would be vastly improved, CETL4HealthNE made a contribution to the gateway, which when added to other sources of income, was enough to get the gateway off the ground.

Martin van Eker and colleagues at the University of Bristol had a similar idea to tie together the University of Bristol, the University of the West of England and six NHS Clinical Academies in the region using a combination of standard web traffic, CITRIX, video conferencing and video streaming. Once Martin saw the N3 JANET gateway was going ahead, he enthusiastically joined in, injecting a wealth of experience and ideas into the project, and along with the University of Birmingham, the three became the initial ‘early adopters’ of the service.

CETL4HealthNE provided H.323 videoconferencing between University and NHS sites through the JANET Videoconferencing System (JVCS) by funding the equipment as a contribution to the N3 JANET Gateway project. About 18 NHS videoconferencing equipment endpoints are currently envisaged at NHS Trust sites in north east England and it is expected that the use of the facility will be popular with other parts of the country elsewhere.

What's next?

• Expansion of the early adopter group to other institutions – particularly if the application will further the overall usefulness of the gateway
• Potential use of JANET Roaming (EDUROAM) on NHS sites as an access method for University services.
• Expansion of video-conferencing access through the JVCS.
• Video-streaming.
• Specialist applications for learning.
• Research databases.
• eJournals and knowledge bases.
• Possible Voice over IP applications (VOIP).

Introduction

The TechDis Accessibility Essentials Guide on Making the Most of PDFs has been designed to provide step-by-step information to enable anyone creating or using PDF documents to do so in a more accessible manner.These hints and tips will benefit those who create PDF documents using scanned materials or word processed documents, or receive a PDF version of publicity materials from a graphic designer.

Accessibility Essentials 4 is available online and in hard copy at no charge (a fee may be charged for bulk orders), and is supplemented by web-based guidance including hints and tips for screen reader users, best practice case studies and a comparison of some free PDF software.

The use of the techniques described here will aid people with a wide range of disabilities, needs and preferences to get more from written content by highlighting the potential benefits of PDF format and enabling documents to be created with these in mind. These techniques will have benefits (and possibly barriers) for different groups of learners and it is important to consider the needs of the specific learners and adapt the materials as necessary.

A few highlights are included here as an illustration of the full document.

Building accessibility into existing PDFs

Note - These functions are available in Adobe® Acrobat Professional but may not be available in all software.

The accessibility check

Navigate to Advanced > Accessibility > Full check. The dialogue box seen in Figure 1 will appear.

Make sure the Create Accessibility Report and Include repair hints in the Accessibility Report boxes are checked.

Select the appropriate range to be checked and click Start Checking.

This will produce a dialogue box giving a brief overview of any problems found. Clicking OK in this box will produce a full report giving links to any problem areas of the document and instructions for amending these areas.

Typically the accessibility check will find at least two problems; that the text lacks a language specification and that there is no reading order. Instructions on how to address these are given in Accessibility Essentials 4

Adding tags and structure to PDFs

If the source document has been properly created using styles and headings these will be carried over when the document is converted to PDF format. However if you do not have access to the source document or it was not well structured, it is possible to clear the existing structure and add the appropriate tags. This can be a lengthy process if you are working with a long document

Clearing the existing document structure

This may be necessary if the source document was not structured appropriately and an entirely new structure is needed. N.B. It is important to note that any existing tags will be erased, leaving a completely unstructured page.

Navigate to Advanced > Accessibility > TouchUp Reading Order.

Select Clear page structure.

A dialogue box will prompt you to check whether you want to clear all structure from the document. Click Yes.

Adding structure

Once the existing reading order has been cleared a new structure can be added. To define the new structure:

Navigate to Advanced > Accessibility > TouchUp Reading Order.

Using the mouse, select the area to be tagged.

Click on the appropriate button. For example to make the selected text into a main heading, click the Heading 1 button. This will tag the selection as a particular type of content.

Reading order is determined by the order in which the content is tagged, i.e. the first tagged item will be the first item in the reading order. Each item is labelled with a number corresponding to the reading order of the document.

Mistakes in the reading order can be rectified by dragging and dropping the numbers to the appropriate place.

User personalisation of Adobe Reader

This section covers techniques that the reader can use to amend the look and feel of a PDF document so that it is best suited to them. Please note that many of these functions are only available in Adobe® Reader; users will not necessarily be able to access the same functions when reading a PDF in a web browser or other PDF reader software.

• Personalised font and background colours: This section covers how users can change the background and font colours to suit their personal requirements.
• Enlarging the text size: This section covers the use of the zoom function to enlarge the text size of a document.
• Document navigation: This section covers using the Bookmark and Pages views to quickly navigate through a document. It also covers the Find and Search functions which allow users to search the current and other documents for particular information.

Alternative views - Adobe® Reader allows users to reflow text, enabling columns to be arranged into continuous text and magnified text to fit into the window without the need for horizontal scrolling, scroll through a document automatically and have specified sections, pages or a whole document read aloud. This section shows users how to make use of these alternative views.

Accessibility essentials 4

This is the fourth publication in the Accessibility Essentials Series, with other titles covering:

• Making electronic documents more readable.
• Writing accessible electronic documents with Microsoft® Word.
• Creating accessible presentations.

TechDis

TechDis supports the education sector in achieving greater accessibility and inclusion by stimulating innovation and providing expert advice and guidance on disability and technology. TechDis is a JISC-funded advisory service.

Introduction

Reflection upon several years of service on the UK Unrelated Transplants Regulatory Authority, the Local Research Ethics Committee, the Fitness to Practice and Investigation Committees of the GMC and co-teaching an elective module in Medical Ethics and Law for medical undergraduates(1) leads me to propose the SLICE - Structured Learning in Clinical Ethics - model for helping health professionals determine their own conscience positions (or moral compasses as Swenson and Rothstein(2) put it) while at the same time respecting the autonomy of their patients and families/carers in the areas of compliance, concurrence, conversation and conversion. I describe below how the SLICE model was applied to the teaching of Transplantation Ethics in the 21st Century as elective option in a Scottish medical school in early 2008.

Structured learning in clinical ethics (SLICE) for transplantation ethics in the 21st century

Conscience - evolving and recognising one’s own moral and ethical positions as clinical experience grows or as Bertrand Russell put it more than a hundred years ago: I should rather regard the true method of Ethics as inference from empirically ascertained facts, to be obtained in that moral laboratory which life offers to those whose eyes are open to it leading to principles that are all inferences from such immediate concrete moral experiences - albeit that these inferences are arrived at through particular religious or cultural belief systems.

Compliance - conforming with the laws, regulations and social conventions/consensus around a given issue or act. For example:

• UK Human Tissue Act (2004) and Human Tissue Act (Scotland) 2004.
• Laws on capacity to consent.

Assessment. Knowledge e.g. MCQs MEQs and competence testing: e.g. scenarios requiring application of the knowledge.

Concurrence – practising along side other people’s points of view, drawn from different cultural, religious and social contexts. For example:

• Being aware that no major religion forbids organ retrieval but all consider organ donation in life or death to be supererogatory and non-obligatory.
• Respecting patient autonomy in reaching ethical decisions different from one’s own.

Assessment. Knowledge of the range of view points; critical analysis of the philosophies involved; reflection on the values represented by each viewpoint e.g. by discursive oral discussion or debate, PowerPointTM or written essays evaluated for quality of information retrieval through literature search of e.g. Medline, critical analysis and synthesis with particular reference to ethical reasoning in clinical contexts.

Conversation - being able to dialogue with patients, carers, colleagues and the public about ethical and moral issues with respect for others’ viewpoints. For example:

• Having the communication skills of active listening etc. to be able to elicit family members’ (probably varying) views on organ donation.

Assessment. Interviewing skills; report writing on views expressed.

Conversion – negotiating acceptance of a particular view or course of action because of its clinical benefit while respecting the other person’s world view. For example:

• Having the communications skills to be able to put the case for organ retrieval to a grieving family without over-persuading individuals who might later suffer serious regret over the decision.
• Ability to educate patients and families to autonomous informed consent or refusal of organ donation.

Assessment. Communication skills relating to breaking bad news and negotiating the possibility of organ retrieval in emotionally charged situations.

How should health professionals be taught the following elements of ethical practice in relation to transplantation ethics for the 21st Century? Learning objectives

• To facilitate the development of the learner’s personal ‘moral compass/conscience’ in relation to the fast-moving developments in transplantation ethics in the domains of compliance, concurrence, conversation and conversion.
• To facilitate the skills required to perform appropriately in the field of clinical ethics in the domains of compliance, concurrence, conversation and conversion.
• To enhance generic skills such as oral presentations; written analysis and synthesis of discursive material; reflective philosophical thinking and writing skills; team working and collaborative skills; patient interviewing and communication skills; design and implementation of Medline searches; Vancouver-style citation; word processing skills.

Teaching and learning strategies

The course takes place over two weeks. The first two days are primarily information gathering with speakers such as a transplant clinician and transplant retrieval coordinator with frequent student interaction and discussions led by a course coordinator. The third day the students visit a Renal Dialysis Unit by agreement with the senior nurse and negotiate/conduct interviews with patients. The students then have 5 days of self-directed learning around the topics they have chosen to write on (1500-2000 words with full Vancouver citations) or to co-present with a nominated partner. They also prepare 500 word reflective essays on their patient interviews. On the final day of the course the group convene in plenary for presentations and discussion, and submission of the personal essays.

Curriculum content

The course centred on the following issues or ethical dilemmas, from which the students chose their personal essay topics and their paired presentation topics.

• Is informed consent more complex with living or dead donors?
• Should brain death be sufficient for organ retrieval?
• Do ‘Opt Out’ policies lead to increased donation? If so, under what conditions/circumstances?
• Should prisoners be encouraged to make live donations? If so, under what conditions/circumstances?
• Should prisoners be encouraged to make posthumous donations? If so, under what conditions/circumstances?
• Are expanded criteria for donation justified?
• Why do the Human Tissues Acts require psychological assessment of genetically related potential donors?
• Why do the Human Tissues Acts require psychiatric assessment of potential ‘altruistic/stranger’ donors?
• Should the market in live kidney donation be regulated? If so, how?
• How could donation be increased in the UK without resort to Opt Out?
• Could there be a ‘futures market’ for donation? How would it work?
• Under what circumstances should we allow minors to make living donations?

For more information please contact s.l.roff@dundee.ac.uk

Introduction

A one day interprofessional SimBaby workshop was held in Queen's University Belfast (QUB) in October 2007. The aims were to share experiences of designing, implementing and evaluating SimBaby teaching and learning within medical and nursing undergraduate curricula. In addition, the participants were given the opportunity to obtain practical experience in producing and using their own clinical scenarios to deliver interprofessional SimBaby teaching.

The workshop was organised by a team from the Centre for Excellence in Interprofessional Education (CEIPE) at QUB and was led by medical and nursing educators, supported by research and administration staff. MEDEV sponsored it and prepared delegate packs, and Laerdel were able to provide additional SimBabies to allow all participants access to the manikin in the practical sessions of the workshop.

High-fidelity simulation of critically ill children has been developed by the CEIPE team as an interprofessional learning tool for medical and nursing students at QUB. Fourth year medical students in their paediatric attachment work together with final year children’s nursing students to assess and manage a child with conditions such as bronchiolitis, meningitis or cardiac failure. Students rate these sessions very highly, often describing them as the most useful part of their module. The facilitators have observed significant improvements in interprofessional teamworking and communication skills during the two hour SimBaby session.

A barrier commonly acknowledged in interprofessional education is the issue of timetable incompatibility and, particularly where medicine and nursing are concerned, large numbers of students. The facilitators hoped to demonstrate that the interprofessional model they have developed can be used effectively for large numbers of students from different disciplines and that the development of an interprofessional simulation team is both desirable and relatively straightforward to achieve.

Participants in the (oversubscribed) workshop included 24 medical and nursing educators from tertiary and district general hospitals across Ireland. After an overview of the features of SimBaby and how to programme it, and a review of the implementation of IPE within the curriculum to date, the participants worked in interprofessional teams to write clinical scenarios suitable for undergraduate or postgraduate learners. These scenarios were tried out later in the workshop. Feedback was given on the realism of the simulation and whether it facilitated interprofessional learning.

The workshop received a very positive rating from the delegates with overall agreement that their main objectives in attending the workshop (gaining a broader insight into the learning environment created within the simulation sessions attended by students; learning about SimBaby and associated learning and networking opportunities) had been achieved. Delegates found the ‘hands on’ nature of the workshop very beneficial, in particular the afternoon session when they had the opportunity to write a scenario, programme the SimBaby and see their scenario played out. Workshop participants also highlighted interprofessional education and learning as one of the most useful aspects of the workshop.

Based on the success of this first workshop, there is the demand for further events such as this. As a direct outcome of the workshop, discussions regarding the acquisition of other SimBabies in locations across Northern Ireland to facilitate the expansion of interprofessional learning and workshop are already underway. The workshop facilitators are very grateful to the Subject Centre for their support in enabling us to take this successful project forward.

For more information please contact n.kennedy@qub.ac.uk

Introduction

As a new veterinary school (our first intake was September 2006), we are continually developing our curriculum and teaching resources, an exciting but demanding process. We are lucky enough to have a large and well equipped skills lab – but how do we put it to best use for students and staff?

The integration of clinical material from day one of our curriculum provides many opportunities for clinical skill teaching, but we are still learning how to do this to provide the best possible experience for students. We are also developing a wide range of assessment tools to measure our students’ abilities in the lab.

It was extremely generous of MEDEV to sponsor travel to Italy to take part in this clinical skills conference, which provided a wealth of information and many opportunities to discuss ideas with colleagues from around the world. You may ask what a veterinary educator is doing at a medical educator’s conference, but many ideas and practices can be easily transferred from the medical to the veterinary context. The establishment of a skills centre is a good example of the transfer of a sound, evidence-based educational principle between disciplines. This short report highlights some of the sessions I participated in.

The title of the conference was Teaching, learning and assessing clinical skills: Does one size fit all? Within this there were four themes:

• Practising safely and professionally.
• Developing competent skills for practice.
• Preparing health professionals for the world of work.
• Improving simulation for learning.

A pre-conference afternoon of workshops gave an opportunity to interact in a small group with experts in the field of clinical skills provision. The teaching and assessment of professionalism is an important issue for all providers of healthcare education, including veterinary surgeons. Malcolm Parker from the University of Queensland lead a workshop discussing some of the difficulties surrounding this issue, and it was a chance to discover that most educators share similar problems. A variety of approaches were discussed, the clear message being that this is not an easy problem to solve!

The title We’ve got a skills lab – what do we do now? seemed to fit perfectly with our needs, and this workshop lead by clinicians from Melbourne provided some useful tips and ideas for how to get the lab up and running. Some of the excellent commercially available medical models were also on show, which made me envious – there is very little available in the veterinary part task trainer world.

The conference began with keynote speakers discussing the transfer of skills from the lab situation into the real world, and the use of simulation in healthcare education. Medical simulation is at an advanced high fidelity stage, and it is interesting to see how communication and team working skills can benefit as much as clinical skills whilst interacting in a scenario. Although veterinary simulation is still in the embryonic development period, there is much that can be taught to students using relatively low fidelity simulation, without the need for a Sim-dog or Sim-horse!

The use of peer tutors was discussed in the clinical skills setting by two different presenters. Both studies showed that it is possible to set up effective peer assisted learning, with benefits to both learners and teachers. Peer assisted learning will be fully utilised in our integrated curriculum, and it was very useful to hear how it should be done in the clinical skills environment.

The experience of institutions such as the University of Sheffield is invaluable for those of us starting out on the road to a skills lab, and their workshop provided some excellent guidelines and help for setting up a clinical skills centre. A step by step guide helped to identify important issues such as key competencies to be taught by the centre, and the main stakeholders in the project. Although we are some way down this road – we already have a building and most equipment – it was very useful to bring a structure to the process, and help to consolidate some of our own ideas. This guidance is available on line at www.limbsandthings.com/uk/lib.php?d=csc

Several papers discussed the use of simulated patients to train healthcare students not just in communication skills, but also in clinical skills such as clinical examination. We are planning a heavy use of simulated patients (clients in the veterinary context) within our communication skills curriculum, and it was interesting to hear views of how these actors should be trained, and the skills they require. Our initial experiences of using medical actors have been very positive, and well received by our students. The evidence presented showed the value of training for actors used within a healthcare curriculum.

There was an incredible variety of presentations, from institutions around the world – my only complaint being that there was so much going on it was easy to miss a really good session.

I have returned from this conference full of new ideas to get the most from our skills centre. Although we only have two years of students at present, our centre is getting busier and busier, which is fantastic to observe. I would recommend this conference to anyone involved in clinical skill teaching whether in medical, dental or veterinary education.

For more information please contact liz.mossop@notts.ac.uk

Introduction

This workshop (November 2007) provided the opportunity for staff, curriculum and educational developers in medicine, dentistry, veterinary medicine and health professions to meet together as part of a special interest group (SIG).The day was facilitated by the authors and Nigel Purcell. Full details of the workshop, including resources and presentations, can be found on the MEDEV website1.

Background

At a meeting held on 8 June 2006 it was agreed to form the SIG with a remit to:

• Create a community of practice amongst educational/staff developers to address strategic issues.
• Provide a forum for discussion and debate on strategic and policy issues in healthcare education.
• Foster an educational development community response to the changing situation in healthcare education.
• Provide a mechanism for supporting and mentoring colleagues.
• Support the process of leadership and management in healthcare education.
• Provide opportunities for engagement with centres of innovation.

The SIG links to two other activities supported by MEDEV:

• the Resource Archive for Teachers Trainers (RAFTT) project2;
• and a JISC-funded mini-project led by Clare Morris and Judy McKimm Supporting a community of MEDEV professional developers3.

Workshop Report

The November workshop focussed on one of the SIG core themes: to support leadership and management development of participants through a focus on leading and facilitating educational change, and was framed around a collaborative leadership approach aimed at sharing ideas, challenges and educational practice. The specific aims of the workshop were to provide a forum for participants to:

• Enhance their understanding and awareness of key national policy agendas that impact on healthcare education and identify strategies for meeting these agendas.
• Further develop leadership knowledge and skills and consider their role as change agents.
• Participate in professional networking, planning of collaborative activities and the further development of the SIG’s activities.

Participants were involved in a number of interactive, small group activities and discussions, interspersed with presentations. Supporting documents on educational change and leadership and were provided prior to and during the workshop.

Key presentations were given as triggers for activities, discussion and dialogue.

Clare spoke about the JISC project and how this related to the SIG. She also gave a personal viewpoint on some of the current policy agendas and how these impacted on the development and delivery of a new masters’ in medical education programme at Bedfordshire and Hertfordshire Postgraduate Medical School.

Nigel spoke about the Higher Education Academy accreditation scheme and the Professional Standards Framework and highlighted some of the issues for staff and faculty developers involved in ensuring that programmes meet the Standards.

Judy and Faith led sessions on educational leadership and change management. Judy gave an outline of some leadership and change management theories with a focus on leading organisational change through collaborative leadership. Faith spoke about the experiences of establishing a faculty development programme (including leadership training) at the University of Southampton. She highlighted the advantages of working with key stakeholders to develop a local approach.

The workshop activities were framed around the COINNs model of professional development (McKimm, 20074):

Challenges

Opportunities

Ideas

Needs

Next Steps

This model enables individuals and groups to identify key issues that concern them around a structured framework, leading to generation of ideas and opportunities for further professional development. The following sections summarise the outputs of the group activities.

Challenges

The main challenges to staff and educational developers identified through a horizon-scanning activity were:

• Working within a rapidly changing NHS and workforce development context. Reorganisation of SHAs and Deaneries and subsequent changes in NHS personnel, funding and commissioning arrangements have had huge impact on course planning and delivery, causing confusion, setbacks and delays.
• Wider NHS changes in healthcare provision, community healthcare, integrated services, foundation trusts and global healthcare issues.
• Workforce changes such as interprofessional learning, changing roles of healthcare workers and changing student numbers.
• Balancing delivery of high quality programmes with increasing involvement of a wider range of stakeholders, coupled with a need to respond quickly to government recommendations within relatively inflexible HE structures.
• The mismatch between different government agendas, with varying responses needed to a large number of external QA and regulatory agencies and organisations.
• HEIs need to deliver multiple agendas e.g. widening participation and eLearning agendas.
• Clashes between HE and NHS IT systems make flexible learning involving clinical organisations more difficult.
• The impact of the RAE and a more businesslike focus from many HEIs leads to competition between HEIs and between departments that discourages collaborative endeavours and often feels like reinventing the wheel.

Opportunities

Next, we looked at how challenges can be reframed as opportunities. For example NHS reorganisation and change reveal new sources of funding such as Learning Development Agreements (LDAs). Increasing transparency and accountability with increasingly aligned external QA processes and other agendas (flexible learning, integrated services, interprofessonal learning, changing healthcare roles) offer levers for new collaborations, culture shifts, organisational development and curriculum innovations.

The SIG offers developmental, networking and collaborative opportunities and a source of information, sharing and generating ideas and support for isolated individuals. It offers opportunities for action research, generation of new knowledge, scholarship and raising the profile of education.

Sharing ideas about leadership devlopment

Participants worked in small groups on a thinking strategically activity.

They were asked to consider and share their own experiences and identify ideas for faculty leadership development. One strategic initiative was the Open University personal leadership programme involving all academic staff, incorporating senior champions and a support network which enables sustainability.

Other points raised were:

• The lack of time for strategic thinking and change management; no explicit definition of leadership as a skill/necessity; few formal mechanisms for spotting and using leadership potential and including this in professional development and succession planning.
• Ideas for developing organisational capacity and capabilities included appreciative enquiry; investing in people; ringfencing funding and joining up policies for education and training; providing protected time for development and teaching; identifying skills and talent; being transparent about vision, values, goals and strategy; being explicit about levels of leadership, communications and defining academic and clinical roles appropriately; providing training for leadership and ongoing mentoring and training and learning from other sectors.

Needs

In the final session, participants were invited to share their vision for the SIG and align this with their own personal/professional needs.

In summary the SIG should aim to provide members with opportunities for:

• Being part of a national dynamic community of developers that advise and inform around good practice and provide a unified voice for change in education.
• Making a difference and having a real impact.
• Face to face and virtual networking in a safe environment.
• Sharing up-to-date information, resources and expertise.
• Access to wider contexts, experts and innovative ideas.
• Accessing on-line resources on policy agendas and educational innovations.
• Developing and exchanging ideas about leadership and organisational and educational change.
• Cross-institution collaboration in staff/educational development, research, working, writing and scholarship, including educational leadership as an academic subject.
• Personal and professional development – to ‘credentialise’ expertise of faculty developers

Next steps - future activities

It was agreed to identify and agree a process for developing an on-line facility to support the SIG. This will link closely to the RAFTT project activities and enable SIG members to access and share a range of resources relevant to their role as well as provide a communication forum. It was also agreed to explore links with other staff/professional development organisations such as SEDA and to identify opportunities for SIG members to formalise their learning and development from meetings and other activities.

It is planned to hold two meetings for the SIG in 2008. The first was held at the University of Bedfordshire Bridges CETL on 15 May and the second is planned in conjunction with the ASME national conference at Leicester in September. The next meeting will establish the aims, purpose and a timetable of activities for the SIG as well as continue the focus on leadership development. One of the ideas that emerged from the workshop is to establish an on-line collaborative writing forum which will produce papers and ultimately an on-line journal. This idea will be further explored and developed at the May meeting.

Future meetings will offer masterclasses on topical issues for staff and educational developers. Meetings will be held in various locations with a view to enabling members to explore different educational and learning environments.

Education, curriculum and staff developers involved in medical, dental, veterinary medicine and healthcare education are encouraged to join the SIG.

Introduction

This National Conference on Student Evaluation welcomed 50 delegates from all over the United Kingdom to this one day event at University College, London in October 2007. It was a collaborative venture between Barts and The London School of Medicine and Dentistry and University College London (UCL) and was funded by two grants: one from UCL’s Executive Sub Committee on Innovations in Teaching Learning and Assessment (ESCILTA) and the other from the Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine.

The day started with a very enlightening keynote presentation by Professor John Richardson, from the Institute of Educational Technology at the Open University. He discussed research into the Course Experience Questionnaire and the National Student Survey and got us all thinking about what students’ evaluations tell us about academic quality. This was followed by a choice of two workshops both looking at evaluation tools. Sue Roff (from Dundee University Centre for Medical Education) shared with us the research behind the DREEM tool, a method to assess educational climate, which looks at five subsets of climate: students’ perceptions of learning; teachers; self perceptions; atmosphere and social perceptions. UCL’s clinical academic Dr Will Coppola’s workshop demonstrated the use of the web for collecting online student evaluations and he presented UCL’s considerable experience of using this technology.

The postprandial dip was superbly overcome by two presentations from the student perspective. Dr Andrew Wilson, Clinical President of UCL Medical Students Union, talked about why students might not take part in evaluation and what the academic body could do about it and Ms Hannah Pudner, Student Feedback Co-ordinator at National Union of Students, urged the audience towards greater collaboration with the student body. This was followed by two further workshops, which focused on the dilemmas that generating evaluation data can evoke. Dr Anita Berlin ran an interactive session about the ethical aspects of student evaluation data and how we should handle concerns about teaching quality. This produced a lively debate. Dr Ann Griffin, Ms Viv Cook, and Ms Tal Schechter, a medical student from Barts and The London School of Medicine and Dentistry, led a workshop entitled Acting on Evaluation which encouraged participants to share best practice and innovative ideas in how institutions could become more effective in closing the loop and act on students’ feedback. The participants’ ideas were constructive and a Twelve Tips paper, based on their discussions, has been accepted for publication in Medical Teacher.

The conference fostered animated debate and discussion, and extremely good feedback. The day was seen to be highly relevant to current issues in student evaluation and provided the attendees with valuable information and ideas to take away with them. The only significant criticism of the day resulted from the delegates having to choose from a variety of interesting workshops; many said ideally, they would have liked to be able to attend them all.

The positive reception for the conference has prompted discussion about making this an annual event and we are actively exploring this. Thank you to everybody who contributed to this event and the support of Ann Glasser, Tom Olney, Terri Charrier (UCL) and the Subject Centre team.

Introduction

This one day conference, was organised by the Subject Centre for Medicine, Dentistry and Veterinary Medicine, and funded by the Joint Information Systems Committee (JISC). It was held at The Assembly Rooms, Newcastle upon Tyne on 28 February 2008 and attracted 150 delegates from across the UK to be part of a packed day including 4 keynote speeches, 21 presentations over 4 streams of activities and 18 posters.

Congratulations to the winners of the favourite presentation and favourite poster prizes as voted for on the day.

The winning presentation was AM1(c) Johanna McMullan, Queen’s University Belfast, Interactive personal response, an innovative approach to teaching and learning.

The winning poster was PO17 Viktoria Sargent, Tom Holland, Gareth Frith, University of Leeds, Using mobile technologies to create ePortfolios and personalised learning environments for 16 health and social care professions.

The papers from both are included in Special Report 10 Conference Proceedings: ePortfolios identity and personalised learning in healthcare education which is now available both to order as paper copy (200 pages) or to download (1.9MB) as PDF. Please email enquiries@medev.ac.uk to order paper copies at no charge, or download from: www.medev.ac.uk/dinky?dinky_id=835

Keynotes and parallel session presentations from the conference are all available from: www.medev.ac.uk/workshop_resources/105/list_contents

Introduction

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