Medical Education In UK Research Articles

Ethical reflection for medical electives.

Fortypercent of UK medical students undertake their elective in a developing country. Although these opportunities are often rewarding, students encounter ethical questions, both in preparation and undertaking these projects. The British Medical Association highlights three key ethical considerations for elective students: clinical challenges, cultural challenges and impact on the host institution. This report reflects on these considerations in the context of a 4-week medical elective conducted by UK medical students in the Solomon Islands. Daily interviews were conducted with a focus group of six medical students in the Solomon Islands over a 4-week elective period. Descriptive analysis identified key themes. Students were aware of guidelines stating that they must act within their competency, but found it difficult to assess their own skills and capacities in unfamiliar non-UK settings. Culturally different societal and medical norms proved particularly challenging. The impact of the student elective on the host hospital was also larger than anticipated. In UK medical education, formal assessment sets the benchmark for competency. Assessments cannot cover every situation encountered on elective, and so students must therefore develop an alternative benchmark to measure their ability. The lack of research into the impact of electives on host institutions makes assessing the ethical nature of electives challenging. The British Medical Association highlights three key ethical considerations for elective students CONCLUSION: Prospective elective students would benefit from pre-departure training on self-assessment of competency and cultural awareness. UK medical schools have an ethical duty to encourage students to consider the impact of their elective placements on host institutions.

UK Medical Education Database: an issue of assumed consent

Editor – There are some significant misconceptions in the letter on UKMED by Best et al .1 UKMED is a partnership between data providers from across the health and education sectors to evaluate medical career progression. This will help to raise education standards by enabling us to assess the

Health informatics in UK Medical Education: an online survey of current practice.

ObjectiveHealth informatics has growing importance in clinical practice with successive General Medical Council recommendations. However, prior data suggest that undergraduate medical education largely neglects this area. An up-to-date, UK-wide view of health informatics training in medical schools is required.DesignAn online survey was developed using current guidance and recommendations of UK professional bodies.Participants and SettingSenior academic staff and health informatics educators at all 34 UK medical schools were invited to complete the survey.Main outcome measuresQuantitative and qualitative data regarding health informatics in the undergraduate medical curriculum.ResultsA total of 26/34 (76%) of UK medical schools responded and 23 provided full information. Aspects most frequently mentioned were literature searching and research governance. Seventeen per cent of respondents felt there was little or no HI training, although clinical record keeping was addressed by all medical schools. Pedagogies used to teach health informatics were self-directed learning (78%) to lecture based (70%), seminars (70%), informal teaching in clinical settings (57%) and problem-based learning (22%). Health informatics was usually integrated vertically and horizontally across the curriculum (76%). Assessment and updates of the health informatics curriculum are limited (57 and 41%, respectively). Thirty-two per cent of respondents reported a low level of confidence among students to use health informatics as doctors. In the most up-to-date survey of health informatics teaching in UK medical schools, there are three major findings. First, the proportion of health informatics in the medical undergraduate curriculum is low. Second, there was variation in content, pedagogy and timing across medical schools. Third, health informatics is rarely assessed and course content is not regularly updated.ConclusionsThere is a role for national guidelines and further research in this area of the curriculum which is rapidly gaining in prominence.

UK Medical Education Database: an issue of assumed consent

On discussion with current medical students and recent medical graduates (n=23 and n=21, respectively), few were aware of the large scale UK initiative to collate data on medical students and junior doctors into a single database: the UK Medical Education Database (UKMED).[1][1] The UKMED

The state of UK medical education and practice

The General Medical Council recently published its sixth annual report on the state of medical education and practice.1 Here are five things the report told us

Do personality traits assessed on medical school admission predict exit performance? A UK-wide longitudinal cohort study

Traditional methods of assessing personality traits in medical school selection have been heavily criticised. To address this at the point of selection, “non-cognitive” tests were included in the UK Clinical Aptitude Test, the most widely-used aptitude test in UK medical education (UKCAT: http://www.ukcat.ac.uk/). We examined the predictive validity of these non-cognitive traits with performance during and on exit from medical school. We sampled all students graduating in 2013 from the 30 UKCAT consortium medical schools. Analysis included: candidate demographics, UKCAT non-cognitive scores, medical school performance data—the Educational Performance Measure (EPM) and national exit situational judgement test (SJT) outcomes. We examined the relationships between these variables and SJT and EPM scores. Multilevel modelling was used to assess the relationships adjusting for confounders. The 3343 students who had taken the UKCAT non-cognitive tests and had both EPM and SJT data were entered into the analysis. There were four types of non-cognitive test: (1) libertariancommunitarian, (2) NACE—narcissism, aloofness, confidence and empathy, (3) MEARS—self-esteem, optimism, control, self-discipline, emotional-nondefensiveness (END) and faking, (4) an abridged version of 1 and 2 combined. Multilevel regression showed that, after correcting for demographic factors, END predicted SJT and EPM decile. Aloofness and empathy in NACE were predictive of SJT score. This is the first large-scale study examining the relationship between performance on non-cognitive selection tests and medical school exit assessments. The predictive validity of these tests was limited, and the relationships revealed do not fit neatly with theoretical expectations. This study does not support their use in selection.

Does the UKCAT predict performance on exit from medical school? A national cohort study.

ObjectivesMost UK medical programmes use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the UK Clinical Aptitude Test (UKCAT: http://www.ukcat.ac.uk), and 4 of its subscales, along with individual and contextual socioeconomic background factors, as predictors of performance during, and on exit from, medical school.MethodsThis was an observational study of 6294 medical students from 30 UK medical programmes who took the UKCAT from 2006 to 2008, for whom selection data from the UK Foundation Programme (UKFPO), the next stage of UK medical education training, were available in 2013. We included candidate demographics, UKCAT (cognitive domains; total scores), UKFPO Educational Performance Measure (EPM) and national exit situational judgement test (SJT). Multilevel modelling was used to assess relationships between variables, adjusting for confounders.ResultsThe UKCAT—as a total score and in terms of the subtest scores—has significant predictive validity for performance on the UKFPO EPM and SJT. UKFPO performance was also affected positively by female gender, maturity, white ethnicity and coming from a higher social class area at the time of application to medical school An inverse pattern was seen for a contextual measure of school, with those attending fee-paying schools performing significantly more weakly on the EPM decile, the EPM total and the total UKFPO score, but not the SJT, than those attending other types of school.ConclusionsThis large-scale study, the first to link 2 national databases—UKCAT and UKFPO, has shown that UKCAT is a predictor of medical school outcome. The data provide modest supportive evidence for the UKCAT's role in student selection. The conflicting relationships of socioeconomic contextual measures (area and school) with outcome adds to wider debates about the limitations of these measures, and indicates the need for further research.

Medical Student Views of Acceptable Professional Behavior: A Survey

Professionalism is a concept at the heart of good medical practice. Ensuring that medical students develop and display professional behavior is crucial, both to ensure that their early encounters with patients are safe and appropriate, and to help guard against difficulties in their future practice. As part of its role as the UK's medical regulator, the General Medical Council (GMC) sets the standards that doctors need to follow as well as overseeing UK medical education and training. This includes providing guidance on student professional values and fitness to practice, which it does in partnership with the UK Medical Schools Council (MSC). To inform policy development in this area, the GMC carried out a survey of student professional values between December 2014 and January 2015. This article expands on and discusses a report about the survey, produced and published on the General Medical Council (GMC) website in 2015.1 The results of the survey are presented here. A total of 2,501 students responded to the survey, giving their views on the level of acceptability of 16 different scenarios. These results were analyzed by gender, year of study and entry route to medical school. While medical students responded overall in ways that indicate an understanding of professionalism, the results have highlighted some areas to focus improvements on, and differences between groups of students may be helpful to medical schools in planning how and when to teach certain aspects of professionalism.

Commentary: Clinical skills teaching in UK medical education as exemplified by the BM5 curriculum, Faculty of Medicine, University of Southampton.

This commentary seeks to enable comparisons about clinical skills teaching in Germany and the UK. It outlines the British regulatory environment and its impact on programme design. Through the example of the University of Southampton we show how clinical skills teaching is integrated both vertically and horizontally.

Exploring stakeholders' views of medical education research priorities: a national survey.

Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These priority areas are in harmony with a range of current drivers in UK medical education. They provide a platform of evidence on which to base decisions about MER programmes in Scotland and beyond.

The future of UK medical education curriculum – what type of medical graduates do we need?

Many of the issues faced by undergraduate medical students and those planning their curriculum are not new. William Osler, Abraham Flexner and the General Medical Council have in turn made significant contributions to shaping today's UK undergraduate medical curriculum. It is anticipated that the reports from Robert Francis, Don Berwick and the Future Hospitals Commission about patient safety and quality of care will inform future planning. An increasing curriculum challenge is the achievement of an appropriate balance between biomedical and behavioural sciences in the context of progressive advances in basic and clinical science and increasing professional scrutiny. This requires agreement about the clinical knowledge and skills necessary at the time of registration, and true recognition of the continuum of learning from medical school to the time of retirement. The GMC's Tomorrow's Doctors defines outcomes from undergraduate medical training; this paper identifies 10 principles for curriculum planning to link theoretical educational concepts to practical clinical implementation. Such principles recognise the importance of reducing the burden of learning for an undergraduate student while reinforcing the relevance of generic clinical skills for competent and safe practice.

Nutrition in medical education: reflections from an initiative at the University of Cambridge.

Landmark reports have confirmed that it is within the core responsibilities of doctors to address nutrition in patient care. There are ongoing concerns that doctors receive insufficient nutrition education during medical training. This paper provides an overview of a medical nutrition education initiative at the University of Cambridge, School of Clinical Medicine, including 1) the approach to medical nutrition education, 2) evaluation of the medical nutrition education initiative, and 3) areas identified for future improvement. The initiative utilizes a vertical, spiral approach during the clinically focused years of the Cambridge undergraduate and graduate medical degrees. It is facilitated by the Nutrition Education Review Group, a group associated with the UK Need for Nutrition Education/Innovation Programme, and informed by the experiences of their previous nutrition education interventions. Three factors were identified as contributing to the success of the nutrition education initiative including the leadership and advocacy skills of the nutrition academic team, the variety of teaching modes, and the multidisciplinary approach to teaching. Opportunities for continuing improvement to the medical nutrition education initiative included a review of evaluation tools, inclusion of nutrition in assessment items, and further alignment of the Cambridge curriculum with the recommended UK medical nutrition education curriculum. This paper is intended to inform other institutions in ongoing efforts in medical nutrition education.

Evaluating leadership development in postgraduate medical education

Purpose – Medical leadership has attracted significant attention over the recent years as one of the factors that could potentially improve quality in healthcare. In response, various stakeholders in UK medical education have been looking into the most efficient ways of developing leadership among trainee doctors and invested in various courses and programmes. This paper aims to briefly set the theoretical basis for evaluating leadership development in postgraduate medical education. Design/methodology/approach – Critical review of available theoretical and empirical literature and review of the content of a number of leadership and management development programmes available to postgraduate trainee doctors in the UK. Findings – This review suggests that programme evaluation can be approached through four different “frames”: their pedagogical content, the conceptualisation and achievement of leadership, the contribution in quality improvement and the consideration of practical aspects that increase engagement and participation. On this basis empirical methodologies of evaluation can be developed. Originality/value – The evaluation of leadership initiatives for medical trainees is an important task that has not been adequately addressed in the literature. This paper provides a theoretical approach to developing more robust methodologies of evaluation.

Practical Experience of the Mini-CEX in Undergraduate Trainees

Mini-clinical evaluation exercise in UK medical education has grown in recent years. We conducted Mini-CEX as a clinical evaluation method to assess its’ feasibility and students’ acceptance in undergraduate trainees. They were assessed by valid and reliable rating scale.Then, their satisfaction and experiences were assessed. Trainees’ satisfaction of mini-CEX was 76.8±12.5 (of 100). They mentioned that this method could improve their motivation, but it was time-consuming. The results implicate that undergraduate students were satisfied with mini-CEX outcome. But they worried about its’ long process. We recommend shortening its’ process by dividing it into some parts in order to use mini-CEX as a lifelong learning.

Current medical education in UK and inspiration

This paper discussed on current medical education situation in UK through introducing the concept,method and system.Medical education in UK takes students as the center of education,emphasizes humanistic education and cultivates medical students' eloquence,clinical skills and scientific research.Medical education in UK sheds light on how to mobilize students' subjective initiative,improve communication skills and clinical skills,which medical education in china can draw lessons from. Key words: Medical education; UK; Inspiration

Learning the law: practical proposals for UK medical education

Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by...

Widening access to UK medical education for under-represented socioeconomic groups: modelling the impact of the UKCAT in the 2009 cohort

Widening access to UK medical education for under-represented socioeconomic groups: modelling the impact of the UKCAT in the 2009 cohort

Changes to medical education over the past 20 years

Kylie Lewington outlines the substantial changes that have occurred in UK medical education over the past two decades

Widening access to UK medical education for under-represented socioeconomic groups: modelling the impact of the UKCAT in the 2009 cohort

Objective To determine whether the use of the UK clinical aptitude test (UKCAT) in the medical schools admissions process reduces the relative disadvantage encountered by certain sociodemographic groups.Design Prospective cohort...

The Significance of Scientific Capital in UK Medical Education

For decades, debates over medical curriculum reform have centred on the role of science in medical education, but the meaning of ‘science’ in this domain is vague and the persistence of the debate has not been explained. Following Bourdieu, this paper examines struggles over legitimate knowledge and the forms of capital associated with science in contemporary UK medical education. Data are presented from a study of two UK medical schools, one with a traditional, science-oriented curriculum, another with an integrated curriculum. Constructions of legitimate knowledge were explored at both schools through six months participant observation, interviews with faculty members (n=15) and students (n=37) and documentary analysis. Findings show that medical schools compete for both scientific and clinical capital, but ultimately science has greater legitimacy. ‘Science’ is defined in accordance with the structure of the traditional curriculum and has become a symbolic resource – a mark of distinction for both medical schools and medical students – which is equated with clinical competence. The significance of science is circumscribed by the medical education field, yet the struggles for scientific capital there have ramifications beyond medical education itself. It is argued that Bourdieu’s concepts are particularly useful tools for studying the meanings that science takes on outside of the scientific field.