Most patients’ complaints to the GMC are about a doctor’s professionalism. But the problem is that professionalism is subjective and difficult to define and measure. We think we have overcome at least part of this problem by developing a tool that monitors conscientiousness, an important part of professionalism. The tool, called the Conscientiousness Index’ (CI) was developed in Durham University and lead by Prof John McLachlan. It consists of points scored by students throughout the year for completion of simple, objective tasks, tasks that a conscientious person would carry out such as handing in assignments on time, attending compulsory session, completing evaluation forms. Our work stems from research carried out in States in the ‘90s that showed that simple administrative tasks such as not handing in a passport photo in the first week at medical school correlated with the likelihood of disciplinary action later on their career as a practising doctor. The CI has been validated against staff and students’ views of the Year 1 and 2 medical undergraduate students’ professionalism and correlates strongly with academic and clinical skills performance. The CI is now part of the summative assessment of professionalism in Phase 1 Medicine, Durham. The CI has been extended to other medical schools (Cork, Ireland) and in the postgraduate health care arena (anaesthetists and paramedics).

Dr Marina Sawdon, Durham University

References

M. A. Sawdon, K. Whitehouse, G. M. Finn, J. C. McLachlan, D. Murray. Relating professionalism and conscientiousness to develop an objective, scalar, proxy measure of professionalism in anaesthetic trainees. BMC Medical Education. 17:49.

Kelly M, O’Flynn S, McLachlan J, Sawdon M. The Clinical Conscientiousness Index: a valid tool to explore professionalism in the clinical undergraduate setting. Academic Medicine 2012.

McLachlan J Measuring conscientiousness and professionalism in undergraduate medical students. The Clinical Teacher 2010; 7: 37-40.

Finn, G., Garner, J. & Sawdon, M. “You’re judged all the time!” Students’ views on professionalism: A multi-centre study. Medical Education 2010; 44(8):814-25.

Finn, G., Sawdon, M., Clipsham, L. & McLachlan J. Peer estimates of low professionalism correlate with low Conscientiousness Index scores. Medical Education 2009; 43(9): 960-967.

McLachlan J, Finn G, McNaughton RJ The Conscientiousness Index: an objective scalar measure of conscientiousness correlates to staff expert judgements on students’ professionalism. Academic Medicine 2009; 84: 559-65.

Chaytor A, Spencer J, Armstrong A, McLachlan J. Do students learn to be more conscientious at medical school? BMC Medical Education 2012; 12:54

We’re pleased to announce that the following projects have been funded in the latest ERDP Development Grant call.

Meeting the needs of patients with disabilities – how can we better prepare the new dental graduate?

Dr Kathy Wilson & Richard Holmes, School of Dental Sciences, Dr Laura Delgaty, School of Medical Education and Kate Bird (Fifth Year Dental Student)

Teaching the teachers to draw: Observational drawing in as an educational approach.

Dr Iain Keenan, School of Medical Education

Focus group study of the influences of teachers on medical students’ consideration of future career choice.

Dr Hugh Alberti, School of Medical Education

Evaluating resilience for academic study sessions.

Dr Helen St Clair-Thompson, School of Psychology, Michael Atkinson, School of Medical Education & Professor John Whitworth, Dental Sciences

Laura Delgaty (School of Medical Education) is this year’s winner of the ASME Educator Innovator Award.

This national teaching award is in recognition of her research, funded by the Faculty Unit for Educational Research Development and Practice (ERDP) around the use of multimedia research digistories as online educational resources for our Medical Education Master’s  students.  The original funding application was submitted by a team that Laura led and included Erika Gavillet (library) and Marc Bennett (NUIT).  In an effort to make the ‘tacit’ and complex research process more explicit to students, and aware of time pressures to academics, Laura created digistories using archived materials.

As part of the award Laura will be presenting her research at the next ASME conference in July 2017,  ‘If story telling is central to human meaning, why, in the research world, is there not more storytelling?’

Please click here (allowing a minute to load) to view a RDS example created in SWAY: https://goo.gl/L3EYYF

A Leeds Institute for Teaching Excellence colloquium exploring University strategy and practice in relation to curriculum design, with a focus on the idea of the ‘Civic Curriculum’.

University of Leeds, Friday, June 9th 2017
We invite papers (20 minutes) which interrogate and reflect on ideas of engaged learning, community-facing programme design and curricula that establish links with regional politics, culture and business. We are especially interested in exploring the idea of ‘civic’ belonging, exchange and responsibility as ways of understanding the University’s role in relation to society.

Colloquium themes:

• Designing modules and programmes that engage students with regional communities, culture and business
• Heightening student awareness of, and loyalty to, the city or region
• Nurturing a student’s ability to understand and critique regional questions of power, politics and identity
• What ‘civic’ identity, responsibility and belonging could mean for University students and staff
• Thinking afresh about the idea and role of the University in relation to its surrounding region
• Taking risks with educational and learning spaces: the benefits and challenges of extending boundaries and sites of learning
• University strategy and the role of ‘the civic curriculum’ (or similar concepts) in institutional policy, marketing, identityThe colloquium will run from 10.00 to 17.00, is free to attend and will include lunch and refreshments

Proposals: please send a 200 summary of your proposed paper to Dr Raphael Hallett at r.hallett@leeds.ac.uk
Attendance: register with Rekha Parmar at r.e.parmar@leeds.ac.uk
Venue: The Great Hall & Parkinson Court, University of Leeds

In higher education there is increasing concern about students’ resilience. In recent research I have employed a theoretical framework of resilience, known as the model of mental toughness. This predicts a range of outcomes, including attainment, adjustment to university, and psychological wellbeing. This academic year I have therefore been working with some collaborators, including Michael Atkinson in the School of Medical Education and John Whitworth in the School of Dental Sciences, to offer students the opportunity to attend “resilience for academic study” sessions.

Prior to attending the first session students completed measures of mental toughness and perceived stress. Appropriate clearance was sought from the university ethics committee. In the first session students were then provided with their mental toughness profile and encouraged to reflect upon their scores. Students were then introduced to a range of tools which may enhance mental toughness, including mindfulness, positive thinking, and goal setting. Workshop sessions have since been offered on the topics of mindfulness and building confidence.

Later this year I will ask students to fill in a questionnaire in order to evaluate the perceived usefulness of the sessions, and also to complete the mental toughness and perceived stress scales again so that I can explore several aspects of the data. This is being supported by a grant from the Faculty Unit for Educational Research, Development and Practice. I look forward to a future opportunity to disseminate the findings of the project.

Helen St Clair-Thompson, School of Psychology

In the Spring 2016 round of ERDP Development Grants, Drs Steve Jones and Hugh Alberti were funded to carry out a study visit to Harvard medical school to inform the new Newcastle medical school curriculum on longitudinal integrated medical student placements.

Here is the report of their visit.
Aims

The aim of the visit was to observe first-hand the longitudinal integrated medical student placements (LICs) at Harvard Medical School and in particular to review the practical implications and challenges of implementation.   Harvard’s model of “longitudinal integrated clerkship” is a transformative redesign of clinical, largely community-based education involving up to weekly clinics in various specialities.  Grounded in the principle of “educational continuity”, students develop a “panel” of longitudinal patients over time in order to observe the patient journey, largely in the community setting but also following patients in and out of hospital.  Students also see the patient in the context of their “lived-lives” and develop relationships with them that are grounded in responsibility, commitment and duty.   Other key elements of the programme are regular “Bursts” of in-patient duties including on-call time and weekly student-led tutorials.  The other key aspect of educational continuity is through a longitudinal relationship with a clinical teacher or “preceptor” in each of the six disciplines. Students join the preceptor in out-patient clinics every week and have a meaningful role in caring for the patients. This would include clerking, presenting and recording in the patient’s notes, following up the patient at subsequent visits and  hospital appointments, calling the patient and or visiting them at home.

The Visit

We visited the Cambridge Health Alliance (CHA) over three days: This is associated with Harvard Medical School and is roughly the equivalent of a small base unit in which a group of 12 3rd year students are placed for a LIC for the whole of the academic year.  CHA is a cluster of small hospitals with around 150 in-patient beds allied to a number of community “polyclinics.”  We were able to observe teaching taking place on the wards, in the polyclinic and a student-led classroom based tutorial. We held discussions with:  Preceptors (clinical teachers) from a range of specialties, various faculty staff, students individually and as a larger group, administrators, course directors and both co-founders of the programme and the hospital chief.

Take home messages

Our key take-home messages are; Students have a meaningful, longitudinal role in patient care; Students matter to their preceptors; Students need sufficient white time; Students are responsible for the majority of their learning; The panel of longitudinal cases is key; Admin and IT have an important role to play; Students develop a range of generic and professionalism skills; The hospital reports seeing an increase in the number of residents (junior doctors) applying to work there; Experienced teachers can adapt easily to this model; Specialisation of clinicians may be a challenge but is not insurmountable; An electronic portfolio / log book is essential; Students are better prepared for graduate level learning; Students have the same outcomes / assessments but at different times.

Based on the visit, a number of proposals have been outlined that are being considered by the MBBS Curriculum Review Group.  In summary these are an amalgamated LIC model in semester 2 year 4 for all students and a more comprehensive 1 or 2 semester LIC in year 3 for a smaller number of students.

Steve Jones and Hugh Alberti, October 2016

Approaching the end of another year is often a time for reflection but also looking forward.

As we look back over this last semester we have had an outstanding workshop and seminar from Pauline Kneale from Plymouth talking about the very successful Pedagogic Research Institute and Observatory that she established some years ago and which has been a driver for change and innovation in learning and teaching in Plymouth since its inception.  Pauline also talked about the place of pedagogic research in the Institute.  While in some ways unique the example of Plymouth does provide a model for the sector as the platform within an institution to influence policy and practice in learning and teaching.  Our new Head of School in Education, Communication and Language Sciences gave us a stimulating seminar on the role of pedagogic caring in the creation of environments in which can more effectively take place.  Our Journal Club, now run by Luisa Wakeling, continues to provide opportunities to discuss issues of learning and teaching within our areas of interest through the discussion of papers.  Jane Stewart’s “What I mean when I say” fora are proving to be fruitful opportunities for free-ranging debate and discussion on a range of educational issues that impact upon us.  Please can I encourage you to attend these events?  They are designed to provide us all with a chance to engage in professional discussions about our learning and teaching and always give rise to wide-ranging discussion and debate.

In this issue of the newsletter we hear about progress on some of the ERDP-funded projects.  The projects that are featured in this issue are very diverse in their aims and contribute to learning in teaching through admissions, induction and by developing the curriculum. I pleased to note that a key feature of some is involving the public in our processes.  The current call for applications has just closed but there will be two further calls for funding bids in 2017 during the current academic year.  Our events programme will continue with further Journal Club sessions, seminars and “What I mean when I say”.  There will be a second Learning and Teaching Forum also.

So, all that remains is to wish you all and very Happy Christmas and New Year and a restful break after what seems to have been a very busy semester.

Prof Steve McHanwell, Director, FMS Unit for ERDP

Congratulations to Prof Roger Barton who is now recognised as a Principal Fellow of the Higher Education Academy. Principal Fellowship is an achievement that recognises, at the highest level, an academic’s commitment and contribution to student learning as well as their strategic leadership in teaching.

Commenting on his award Roger said “I’m pleased to gain the recognition, as I think it reflects really well on the Faculty, University and the Trust. They have all been very supportive of taking the educational agenda forward, and I’d like to think that they have seen the benefits of this. We have really witnessed the professionalisation of medical education in the last 20 years in the UK, and it is not over yet. There are so many opportunities now open to individuals who take that seriously.”

“I’d urge academics and clinicians to gain both experience and academic qualifications as early as possible – the Masters in Clinical Education was another tremendously valuable time for me, but I probably left it too late for it to have maximum benefit for myself. A lot of the success has been due to working with others, alongside colleagues, and in supporting younger clinicians and academics to explore and experiment. Variety has definitely been the spice!”

Roger is Provost & CEO of Newcastle University Medicine Malaysia. His fellowship is in recognition of activity at University and national level.  He has held two key leadership roles in the Faculty; Director of Studies for the MB.BS programme and then Dean of International Medical Education. During that time he successfully set up a clinical base unit, implemented the now widely emulated Teaching and Research/Education fellowship scheme and championed staff development at all levels.

At a national level he is a Team Leader in the Quality of Medical Education for the General Medical Council.  He is also clinical lead and facilitator for the Royal College of Physicians national and international Doctors as Educators series of workshops, being accorded Associate Director (Education). As Chair of the Joint Advisory Group for Gastrointestinal Endoscopy, and Education Advisor to the NHS Endoscopy Programme, working with other key individuals he brought about key changes to the training, teaching and accreditation of endoscopists and endoscopy units across the UK and further afield.

Congratulations to Michael Atkinson (School of Medical Education), who has been awarded Higher Education Academy Senior Fellow Status. An HEA fellowship is an international recognition of a commitment to professionalism in teaching and learning in higher education and demonstrates alignment of teaching practice with the UK Professional Standards Framework. Michael joined the Faculty in January 2012 as Teaching Fellow on the Masters in Medical Education programme, and is also the current lead for HEA applications on this programme. His current and past roles and responsibilities as a teacher educator, including former Faculty Programme Liaison Officer (FPLO) for the CASAP programme at the University, helped to support his claim for recognition.

Patient contact has a long tradition of benefit in medical education (1, 2).

However, while the ‘patient’s voice’ is increasingly emphasized in educational strategies, most involvement has been on ‘patient educators’ who have more formal educational roles. Students also benefit from contact with patients who have diverse health needs in the ‘real-world’ context, but less is known about how these ‘real-time’ patients feel about being involved in medical training or what steps could be taken to support ‘real-time’ patients to have an active part in the learning encounter.
This research was funded by the FMS Educational Research Development and Practice unit with the aim of identifying ways to enhance active participation of ‘real-time’ patients in medical students’ training.

We carried out a questionnaire survey of over 500 patients and held focus groups with patients from four GP surgeries across the North East. A focus group with medical students is planned.

Most patients (though not all) were willing for medical students to be part of their consultation. This tended to depend on the patients’ age, and sensitivity of the clinical problem.

Factors such as the doctors’ attitude, nature of the clinical problem, students’ gender and past experience may affect how patients view their active involvement in the learning process. Patients wanted more information about medical education, opportunity to give feedback to the students, and to be given feedback themselves about the impact of their involvement.

The research was presented at the Society for Academic Primary Care, and at the Future of Medical Education conference, organised by Health Education England.
In addition, these findings will be discussed with patient educators and clinical teachers at a workshop (PPI Seed Corn funding) to help generate recommendations for teaching practice changes that may help embed the ‘real-time’ patient in medical students’ training.

Doyin Alao, School of Medical Education (Adedoyin.alao@nhs.net)

Project team: Bryan Burford, Hugh Alberti, Susan Hrisos, David Kennedy, Elsa Randles, Gillian Vance, School of Medical Education

References

1. Towle A, Bainbridge L, Godolphin W, et al. Active patient involvement in the education of health professionals. Medical Education, 2010; 44: 64-74.
2. Lucas B, Pearson D. Patient perceptions of their role in undergraduate medical education within a primary care teaching practice. Education for Primary Care, 2012; 23: 277-85.