General Medical Council Grant success

Congratulations to Dr Gillian Vance, Dr Bryan Burford, Dr Charlotte Rothwell (SME) and Fiona Beyer and Dr Louise Tanner (IHS) who have been  commissioned by the General Medical Council to carry out a project to identify ‘Best Practice in Assessing Competence’.

What the project will do, and why it matters.
The GMC is the independent regulator of all doctors in the UK, and has various roles in relation to assessment, including one-off summative assessments. In this study, we will conduct a systematic literature review, supplemented by a number of case studies, to explore and synthesise evidence for good practice approaches to the summative assessment of doctors’ professionalism, ethical and safe practice, and use of simulated environments to assess clinical and professional competence.

The project’s outputs will support the GMC’s roles in assessment, and inform the regulator’s wider assessment strategy, including development of the new ‘Medical Licensing Assessment (MLA)’. The MLA is anticipated to complement the current quality assurance arrangements for undergraduate education and to replace the current ‘PLAB’ test for International Medical Graduates seeking to practise in the UK.

Talking about this commission Gill Vance, PI said:

“We are delighted that our research can help shape this significant development in the regulation of medical education in the UK.”

Fostering Engagement with Feedback: from ‘barely perused’ to ‘proactively used’

On Wednesday 8th of November Dr Naomi Winstone, Lecturer in Cognitive and Educational Psychology & Associate Dean, Learning and Teaching at the University of Surrey, visited Newcastle to deliver a talk as part of the ERDP seminar series.  The focus of the session was Naomi’s recent work looking at student engagement with feedback.

Her work is embedded in the context of recent efforts by many educators to respond to the student voice calling for “better” feedback but seeks to address why, despite these efforts, many departments still face NSS results that indicate persistent student dissatisfaction.  Naomi and her collaborators have sought to understand this phenomenon in terms of student engagement with feedback.

In experimental situations Naomi and her colleagues have shown that students are more likely to remember evaluative rather than instructive comments which suggests that students are not as good at recalling the parts of their feedback that they might feed-forward into future pieces of work.  Naomi argued that findings such as these indicate the need to foster skills in students that allow them to become ‘proactive recipients’ of feedback not only as essential abilities for their educational journeys but also beyond.

Naomi presented The Developing Engagement with Feedback Toolkit that she has developed alongside Dr Rob Nash for the HEA which provides educators with resources developed in collaboration with students to facilitate their proactive engagement with feedback.

The audience was very receptive to Naomi’s work and whilst voicing some thoughts about how the experimental findings would be replicated in real assessment settings there was a strong consensus about the need to understand feedback as dialogue rather than unidirectional and to ensure educators and students spoke the same “feedback language”. On the back of this seminar session the School of Psychology’s Educational Research in Psychology (ERiP) group has instigated a number of research collaborations with Naomi to start in the new year.

Dr Amy Fielden, School of Psychology

ERDP Development Grant: Meeting the needs of patients with disabilities. How can we better prepare the new dental graduate?

Background: Over a billion people, 15% of the world’s population, live with a disability (WHO, 2016). People with disabilities have poor oral health, high levels of unmet need and often limited access to oral health care facilities (Coyle et al., 2004; Ahmad et al., 2015). The dental profession has a social responsibility to provide equitable oral health care for all and this is recognised in the General Dental Council  document ‘Preparing for Practice’, which states “ registrants must be able to recognise the needs of all patients, including those with special care requirements”. This raises the question, are we adequately preparing future dental professionals to fulfil their obligations.

Understanding how students view the phenomena from an educational and social perspective, considering the interplay between these factors during their professional development as they prepare for clinical practice, led to the specific research questions.

Aim: To explore final year dental students’ insight into issues of disability, in order to inform the undergraduate Special Care Dentistry programme.

Research Questions
1. What are students’ perceptions of their preparedness to meet the needs of patients with disabilities?

2. What has influenced this sense of preparedness?

Method: Using a broadly phenomenological approach, two focus groups were employed to address the research questions. Sixteen final year dental students, attending Newcastle School of Dental Sciences participated. The recorded discussions were transcribed and analysed using thematic analysis, as described by Braun and Clark (2006).

Results:
In relation to the research questions, there was a noticeable variation in students’ perceptions relating to their preparedness. This variation appeared to be related to several influencing factors which can be linked to the emergent themes from the focus group discussions, namely; ‘Perceptions about disability’, ‘Experience of Disability’, ‘Patient Management’ and ‘Teaching and Learning’. These themes are not independent of each other; elements of each will be drawn upon and woven together during the formative years from undergraduate to practicing clinician, influencing the extent of self-efficacy beliefs and how prepared students feel about meeting the needs of those with disabilities. For example, perceptions will be influenced by experience, both from a social context and clinical and educational perspective. Clinical experience itself will be related to patient management and the teaching and learning element of their undergraduate education.

Conclusion:
The results of the study resonate with the majority of the literature, in that students reported different levels of experience and knowledge of disability and varying degrees of preparedness and self-efficacy in meeting patients’ needs. Closely aligned to Banduras theory of Self-efficacy (Bandura, 1994) which considers ‘mastery experience’ to be the most powerful influence of efficacy beliefs, students who had encountered people with disabilities at a social level, through volunteering, family or friends, had a strong sense of self-efficacy; added to this, if clinical exposure was reported, students again felt more comfortable dealing with this patient group. All agreed that the benefits of social and or clinical interaction with the disabled community would greatly enhance their professional development.

Drawing on the literature and outcomes of the study, as emphasised by Goss (2007), there is a need to nurture positive attitudes towards those with disabilities to reduce social factors contributing to health inequalities. It is therefore imperative the dental profession focus on providing appropriate education, including exposure to people with disabilities, at undergraduate and post-graduate level.

Project team: Dr Kathy Wilson (Dept of Sedation), Dr Richard Holmes (Dental Public Health), Miss Kate Bird (5th Year BDS), Dr Laura Delgaty (SME)

References
Ahmad, M.S., Razak, I.A. and Borromeo, G.L. (2015) ‘Special needs dentistry: perception, attitudes and educational experience of Malaysian dental students’, Eur J Dent Educ, 19(1), pp. 44-52.

Bandura, A. (1994) Self Efficacy. Available at: www.uky.edu/~eushe2/Bandura/Banency.html.

Braun, V. and Clarke, V. (2006) ‘Using thematic analysis in psychology’, Qualitative Research Psychology, 3, pp. 77-101.

Coyle, C., Saunderson, W. and Freeman, R. (2004) ‘Dental students, social policy students and learning disability: do differing attitudes exist?’, Eur J Dent Educ, 8(3), pp. 133-9.

Goss, N. (2007) ‘What do we mean by disability and equality in oral health? Editorial’, Journal of Disability and Oral Health, 8(3).

WHO (2016) 10 Facts on Disability. Available at: http://www.who.int/features/factfiles/disability/facts/en/{Accessed

 

ERDP Development Grant: Developing student resilience and compassion?

The MBBS programme is currently undergoing the first major curriculum review for 18 years. A major part of this is to enhance the professional development of medical students with a major focus on developing resilience and maintaining compassion and empathy. We are keen to develop this, and other themes, using an evidence based approach through developing and adapting effective strategies that are being used in other institutions.

To this end, we held a symposium on resilience in February in which the evidence was explored and “tasters” in specific techniques were demonstrated. We were particularly keen to explore how the medical school in Cardiff have developed this strand in their curriculum both in terms of a deeper understanding of the principles but also in terms of their practical implementation. Cardiff was a particularly appropriate model for us to develop as they are leading thinkers in this area and are a medical school of similar size and reputation to Newcastle.

The ERDP Development Grant proposal was for a small team from the MBBS programme to visit Cardiff University at the invitation of Professor Debbie Cohen in order to understand the pedagogy and the practicalities of adapting their model to our own curriculum. In addition provisional thoughts about collaborative pedagogic research in this area, to include internationalisation through NUMed would be developed.

Key principles taken from the visit. 

Colleagues at Cardiff identified the importance of badging issues around resilience smartly in order to improve student engagement, for example instead of resilience, they use the word emotional intelligence, and for reflection, they used the word “change story”.   They also emphasized the need to find exciting ways to make some of these concepts more real and to strive for authenticity in the teaching.   They use near peer experiences to engage the students, for example, they used foundation year and core trainees for teaching notions of resilience to third year students.

Another key theme that Cardiff emphasise is the need to focus on positive emotions and focus on achievements and the positive attributes that protect against some of the stresses of being a medical student and a foundation year doctor.   There was mutual recognition from colleagues in  Cardiff and the visitors from Newcastle, that work environment is key and that understanding and having had experience of working within the environments in which students train and junior doctors work is central to supporting well-being.

In terms of Cardiff’s approach to resilience teaching and training, they did not feel that it should be mandatory but if it was, it would be more appropriate towards the end of the course in preparing the students for entry into the workplace.   With regard to measurements of resilience, the consensus was that these needed to be multiple in order to be robust  and that various tools were available,  however the overriding imperative was to decide what one  wanted to get out of the particular tool that you chose and why.

Embedding resilience into the new curriculum

In year 1 the team identified the need to develop a didactic session entitled ‘Becoming a doctor’ which introduced notions of professional identity formation, the hidden curriculum and resilience. Linked to the didactic session would be a seminar looking at self-awareness, one’s  values and possible clashes with the values of the profession  through the use of interactive  activities designed to engage the students and to  open their perspective around who they are and their journey to being doctors. Embedding notions of self-care within the academic mentorship role was also identified as another achievable outcome.  The establishment of mental health first aid training was proposed, possibly linking this with a tool kit in dealing with the stress of sitting a first OSCE type examination.

In terms of year 2 linking teaching of the neurobiology of stress to notions of resilience was discussed, possibly with a linked seminar to explore this further.   Also within year 2, the end of year transition course in the new curriculum could be developed to improve notions of listening and dealing with emotions prior to the student becoming more embedded in the clinical environment.

In year 3 staff development around mentoring,  role modelling,  and using key aspects of Schwartz and Balint style approaches were thought to be important. The use of a weekly seminar session in semester 1 to provide a space for reflection was seen as a key area to use some of these skills.  Also identified in year 3 for was the scope for integrated days in semester 2 where generic issues across rotations could be discussed.   Adolescent health has been suggested as a potential topic and this would both be a useful learning tool around their development as doctors but would also resonate in terms of their own self-care.

In year 4 the emphasis would be on inter and intra- professionalism and getting along with others, with looking to develop skills in dealing with conflict and managing uncertainty.  Also in year 4 there are plans to use longitudinal clinical placements, the evidence suggests that this would reduce empathy erosion and through embedding students in teams does much to support professional identify and improve resilience.

Year 5 would revisit some of the notions that were introduced in year 1 such as the hidden curriculum and role models. Considering both these concepts though areas such as human factors and the use of simulation would allow student  develop a better understanding of how these issues could affect both one personally and be related to patient safety.  In addition, educational supervision in year 5 would review reflections within a portfolio.  Revisiting self-care and resilience through near-peer experiences would be appropriate.  This is to some extent this is already been developed within the current PDS 6 course.

Finally with  regard to research,  the team concluded that getting some baseline data using a mix methodology approach comparing notions of resilience though different cultural perspectives and what constitutes good role models across cultures would be a good starting point.

Dr Stephen Jones, Director of Studies
Dr Dominic Johnson, Professionalism Lead
Dr David Kennedy, Degree programme Director

Director update: Winter 2017

Dear Colleagues,

Welcome to this the last issue of the ERDP Newsletter for 2017.

In this issue of the newsletter we have articles from colleagues on projects and periods of study leave that have been supported by the ERDP small grant scheme.  As ever the projects themselves are diverse reflecting the wide range of educational interests within the Faculty.  The extent of that diversity can also be seen in the range and scope of education publications so do take a look at that as well.  An innovation for the newsletter is a Think Piece.  I am often asked about publication in HE Journals and following a recent article in Higher Education Research and Development I have written a short item on publishing in education journal.  I would like to see more of this kind of article in the newsletter so please feel free to submit articles on any topic that you think would interest other readers.

Next year looks to be a busy one in our events programme with seminars and workshops focussed around aspects of the university education strategy and a number of national meetings being held in Newcastle alongside our own Learning and Teaching conference and the Three Rivers Conference.  In January we have Dave Lewis from Leeds speaking on final year projects while in March Stella-Devitt Jones will deliver a seminar and workshop on Uses and Abuses of Student Voice and Gavin Knight will be speaking about assessment.  The Newcastle Learning and Teaching Conference date has been announced and there has been a call for submissions to deliver hands on workshops, presentations, lightning talks and posters.  The keynote speaker is Camille Kandiko Howson who will be talking on learning gain which is an especially hot topic at the moment.  There is also a call for submissions to the Three Rivers Conference.

Please consider submitting a proposal to one or both of these conferences as they provide a good opportunity to speak to colleagues locally or wider in the region.  With two national meetings being held in Newcastle there are plenty of opportunities to talk about your work or simply to attend to hear what is going on.  As if this was not enough our newly-arrived Pharmacy School is hosting a conference in July and having seen the provisional list of speakers this promises to be of interest to many and not just those in Pharmacy education.  Make sure you save those dates in the diary.

All that remains now is to wish you all and very Happy Christmas and New Year and a restful break after what is always a very busy semester.

Prof Steve McHanwell, Director, FMS Unit for ERDP

 

FMS Education Journal Club Semester 1

It has been a great start to the year for the journal club. We have heard from our very own Steve McHanwell presenting Elwick, A & Cannizzaro, S (2017) Happiness in Higher Education. Higher Education Quarterly 71:2, 204–219.  This sparked much discussion on the definition of happiness in higher education and in life! We asked the questions “Are our students happy being in higher education and what do they get from it that would make them ‘happy’?”, “What can we do as an institution to support a student to be happy?” and “Can we even achieve this?”

Sue Thorpe gave us a good amount of thought provoking material to see us through November delivering Fox, C (2016) ‘I Find That Offensive’. Biteback Publishing Ltd, London prologue ix-xxii & part one 3-53. An account explaining the complexity of free speech and how many students, these days, are perhaps too easily offended to allow them to engage in proper debate.

Ellen Tullo then brought us into the world of Peer Teaching as seen by Ten Cate, O & Durning, S (2007). Dimensions and psychology of peer teaching in medical education. Medical Teacher 29(6):546-52. We discussed our own experiences of peer teaching within our courses and the possible benefits and disadvantages that could crop up. An interesting aspect of this is to consider advising students to review their learning material as if they were going to teach it!

Lastly, I would like to welcome School of Pharmacy to the group! It has been great having new input and a boost to the audience. We have our very first Pharmacy presenter after Christmas, Hamde Nazar and we will certainly look forward to discussing aspects of education from a Pharmacy perspective.

Seasons greetings,

Luisa Wakeling

All links to articles and up and coming speakers can be found at the Journal Club’s webpage https://internal.ncl.ac.uk/medical/teaching/events/journal.htm.

New ERDP Development Grants

We’re pleased to announce that the following projects have been funded by the ERDP.

A proposal to host a regional one-day Anatomy Symposium: Technology enhanced learning in Anatomy

Deborah Patten

The dark side of technology conference
Laura Delgaty

Medical Students’ perceptions of General Practice: a multi-centre, mixed methods study

Kim Banner and Hugh Alberti

An antipodean perspective on Sport and Exercise Science graduate destinations

Brook Galna

ERDP Development Grant: An antipodean perspective on Sport and Exercise Science graduate destinations

Earlier this year, we welcomed the very first cohort of Sport and Exercise Science students to the FMS here at Newcastle University. With their arrival, so came pertinent questions about how they will contribute to society once they graduate. And so despite the threat of man-eating sharks, spiders as big as your hand and the odd drop-bear, I ventured to the East coast of Australia on a fact finding mission: namely, to explore the career pathways of Australian Sport and Exercise Science graduates. This is because Australian universities have an excellent reputation for producing high-quality Sport and Exercise Science graduates who work in clinically-based contexts.

My first stop saw me present at the International Society of Biomechanics World Congress in Brisbane. The presentation focussed on some collaborative work (a big thanks to Naomi Oosman-Watts from the Careers Service) on graduate destinations of UK Sport and Exercise Science graduates over the past decade.  The questions and conversations that followed highlighted that universities worldwide are facing the same increasing pressures as we are to help students find meaningful employment, although there exists a wide variety of potential solutions with varying degrees of success.

The second part of my trip Down Under included visits to several key figures at leading universities, sporting institutes and the national industry body, Exercise & Sport Science Australia. The most striking difference between the Australian system and most of the world (including the UK) is the clear pathway Australian graduates have into clinical-based practice, particularly for graduates working as registered Exercise Physiologists within the national healthcare system. The regulatory framework that allows this to occur took over a decade to be established but now provides a huge benefit to graduates because they have well-defined pathways to employment and the focus on clinical-based destinations addresses a well-defined need within the community with respect to rehabilitative and preventative medicine. However, associated changes to the university curriculum so students can become registered for clinical-based work has led to fewer students obtaining the knowledge and skills to contribute to the high performance sport industry, much to the chagrin of sporting academies and institutes.

I thank the ERDP for helping fund these visits following the conference because they yielded valuable insights will help us guide and provide appropriate careers advice and opportunities to our Sport and Exercise Science students. Yet questions often beget more questions: Should we focus on Sporting or Clinical graduate destinations for our students here at Newcastle? And if we adopt an Australian-style curriculum so that our students contribute to the rehabilitative and preventative medicine needs of our community – will the NHS and other regulatory bodies be ready for them?

Dr Brook Galna
DPD of the Sport and Exercise Science Programme

Faculty Publications Winter 2017

Congratulations to everyone in the Faculty who has published their research this quarter.

B Abdulmohsen, I Gharib, S McHanwell (2017).  Exploring active learning approaches to increasing student engagement through assessment and feedback”, HEA Transforming Assessment in Higher Education Case Study Series 2017- Enhancing student engagement through assessment. Case Study 12, Page 75-79. https://www.heacademy.ac.uk/knowledge-hub/transforming-assessment-higher-education.

Alberti H, Atkinson J (2017), Twelve tips for the recruitment and retention of general practitioners as teachers of medical students. Medical Teacher. URL https://doi.org/10.1080/0142159X.2017.1370082

Alberti H, Delgaty L (2017), From the UK ‘with love’:Transferring a medical curriculum to Malaysia. SEAJME (Southeast Asia Journal of Medical Education).

Bailie J, Delgaty L (2017), A systematic review of qualitative research addressing learner and educator perceptions of valuable e-learning in medical education.. AMEE.

Baqir W, Rathbone AP, Stocker A, Campbell D (2017), Foundation pharmacists in GP Practice: exploring experiences of future workforce development. Clinical Pharmacy Congress 2017.

Burford B, Medford W, Carter M, Tiffin P, Vance G, Corbett S, Shapiro E, Guilding C, Illing J (2017), The Health Education Quality Framework and National Education and Training Survey: Evidence, Evaluation and Pilot. .

Burford B, Rosenthal-Stott HES (2017), First and second year medical students identify and self-stereotype more as doctors than as students: a questionnaire study. BMC Medical Education. URL https://doi.org/10.1186/s12909-017-1049-2

Carter M, Rothwell C, Medford W, Kehoe A, Illing J (2017), Newcastle University MBBS curriculum renewal: Report on stakeholder views. .

Delgaty L (2017), Redefining practice: challenging academic and institutional traditions with distance learning. (EJEL) Electronic Journal of E-learning.

Field J, Stone S, Orsini C, Hussain A, Vital S, Crothers A, Walsmely D (2017), Curriculum content and assessment of pre-clinical dental skills: A survey of undergraduate dental education in Europe. European Journal of Dental Education.

Hardisty J, O’Neil H, O’Connell J, Hancock R, Lucas R, Parkin L (2017) Simulating complexity: providing undergraduate students with exposure in early clinical training to the multidisciplinary management of frail older people. The Association for Simulated Practice in Healthcare  http://stel.bmj.com/. 

Holmes RD (2017), No evidence to support or refute the benefits of school dental screening. Evidence-Based Dentistry. URL https://doi.org/10.1038/sj.ebd.6401264

Holmes RD, Kowolik JE, Schrader SM, Waterhouse PJ (2017), The Newcastle-Indiana Experience: A Transatlantic Educational Initiative for Dental Students. IADR/AADR/CADR General Session. URL http://www.iadr.com

Keenan ID, Slater JD, Matthan JM (2017), Social media: Where are we now? Current educator usage and perceptions in higher education.

Moxham B, McHanwell S and Berkovitz B (2017).   The development of a core syllabus or oral anatomy, histology and embryology to dental students via an international Delphi panel.  Clinical Anatomy    https://doi.org/10.1002/ca.23002 .

Nazar H, Akhter N, Husband A (2017), Evaluation of a blended learning approach to teach pharmacy law. Pharmacy Education Symposium.

Nazar M, Husband A, Nazar H (2017), Medical education in the press: Read all about it!. Pharmacy Education Symposium.

Beat M. Riederer, Jean-Pierre Spinosa, Veronica Macchi, Andrea Porzionato, Raffaele De Caro, Stephen McHanwell and Bernard Moxham. (2018).   Clinically-Orientated Anatomy:  Five exemplars to portray the concept.  European Journal of Anatomy (in  press)

Rothwell C, Carter M, Medford W, Kehoe A, Illing J (2017), Newcastle University MBBS Curriculum Renewal 2017 Report for Newcastle Medical School.

Scally K, Wilson K, Linsley M, Girdler NM (2017), Formative assessment as a tool to enhance knowledge, skills and student experience in undergraduate sedation teaching. Journal of Disability and Oral Health.

St Clair-Thompson H, Graham A, Marsham S (2017), Exploring the Reading Practices of Undergraduate Students. Education Inquiry. URL https://doi.org/10.1080/20004508.2017.1380487

Teodorczuk A, Thomson R, Chan K, Rogers GD (2017), When I say … resilience. Medical Education. URL https://doi.org/10.1111/medu.13368

Young TJ, Tullo ES, Schartner A (2017), How transculturally appropriate is person-centred communication in the care people living with dementia? Perspectives of medical students in the UK and Malaysia.. The 67th Annual Conference of the International Communication Association (ICA 2017). URL https://www.icahdq.org/page/Conference

 

 

 

 

ERDP Development Grant: Engaging Distance Learners with No Economic Background in an Online Health Economics Course?

In July 2017 I attended a teaching health economics workshop which was part of the biannual conference of the International Health Economics Association in Boston, USA. This was funded via an ERDP Development Grant.

At the conference I presented some findings around ‘Engaging Distance Learners with No Economic Background in an Online Health Economics Course’ from an online module that I teach ONC8021 which is part of the MSc in Oncology and Palliative Care.

Below is a brief summary of the presentation:

Background: Many students who decide to undertake a distance learning course need to balance their learning with jobs and other commitments.  This impacts on when and how they engage with online materials.

Aims: This presentation will outline two methods for engaging health professionals with no previous economics experience enrolled in an online health economics module as part of a Master’s programme in Oncology and Palliative Care.

Methods: Many of the students would access the material in chunks to fit around their busy schedules rather than on a weekly basis as per the layout of the course.  This meant that discussion boards were not a useful tool to foster engagement.  To create a collaborative learning environment that fit in with the needs of the students, I developed a wiki exercise and sequential group work.

Results: The economic evaluation wiki exercise allowed students to contribute to completing a basic example of an economic evaluation of comparing four different methods for screening for colon cancer when their schedule permitted.  The health care market group work gave each individual two weeks to complete their part in identifying market failure in the market for health and offering solutions to overcome these failures.  Students were able to engage with their classmates by discussing the material and submitting an assignment at the end of the 6 week group exercise whilst still having a flexible timeframe for their learning.

Conclusion: Alternative methods of engagement to discussion boards are successful for health care professionals taking an online health economics module.

Practice Points:

  • Different engagement strategies are required for distant learners
  • Effective engagement using alternative methods for online students improved student performance and feedback
  • All material and methods for group work cannot necessarily be transferred directly from a classroom to an online environment

From this presentation I have become involved in the Teaching Health Economics Special Interest Group which is part of the International Health Economics Association.  The aim of this group is to provide a mechanism for developing a global community of health economics educators that would collaborate to promote quality health economics training and to support one another in this endeavor.

Thanks to this ERDP funding I was able to help network at an international level and become a part of a community promoting best practice at the global level.

Dr Heather Brown, IHS