Anne Stephenson

Teaching professional development in medical schools

Doctors must increasingly be aware of what they should be, as well as what they should know. Professionalism, including a value system that supports the compassionate care of patients, is a means of encapsulating and prioritising these competing responsibilities. Accordingly, in this article, we assume that professionalism is an essential aspect of medical practice that needs to be taught to those entering medicine. We first describe critiques of professionalism and current challenges to it, in practice and in medical education. We then assess the current efforts of curriculum reform to incorporate professionalism and the methods used to teach it. Adopting and assessing such approaches to ensure that they are effective is of central importance in the education of future clinicians.

The teaching of professional attitudes within UK medical schools: reported difficulties and good practice

Introduction  The demonstration of appropriate attitudinal behaviour is crucial in the professional development of doctors. This study explores the experiences of UK medical schools in developing and assessing the behaviour associated with the attitudes of undergraduate medical students.

Introducing peer observation of teaching to GP teachers: a questionnaire study

In medical education programmes which rely on clinical teachers spread across diverse sites, the application of peer observation of teaching offers the potential of both supporting teachers and maintaining quality. This paper reports on a questionnaire survey carried out with general practitioner (GP) teachers of medical undergraduate students from Kings College London School of Medicine at Guys, Kings College and St Thomas’ Hospitals. The aim of the study was to determine GP teachers’ views on a proposed programme of peer observation of their teaching. The majority of GP teachers identified benefits of the proposed scheme with 69% saying it would help improve the education of future doctors. However, despite seeing the benefits, less than half wished to take part in the programme. Two thirds cited time and paperwork as major disincentives to taking part and 62% said that they felt it would make them feel under scrutiny. No associations were found between measures of workload and willingness to take part. This suggests that a fundamental fear of scrutiny and criticism may be the main hurdle to be overcome in implementing the scheme. Imposing peer observation on GP teachers in the form proposed could create suspicion and distance between the university department and practice-based GP teachers and may even result in a loss of teachers. The introduction of peer observation is more likely to be successful if GPs’ apprehensions are addressed. Using peer observation to strengthen the process of quality assurance may undermine its role in the support and development of clinical teachers.

The emotional intelligence of medical students: An exploratory cross-sectional study

Background: Emotional intelligence (EI) may be related to student characteristics (such as conscientiousness and empathy), and performance at medical school, although few studies have so far been conducted. Aim: To investigate the association of EI with students’ age, sex, ethnicity and stage of study at a London medical school. Methods: All medical students were invited to complete an online EI instrument, the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) version 2, a 141-item measure of the ability to perceive, use, understand and manage emotions. An additional questionnaire to gather demographic data was linked to the MSCEIT. Results: We analysed 263 responses from a population of 2114 medical students after three reminders (12.3% response rate). Aggregated EI scores were similar through the curriculum. Age, sex and ethnicity explained 9.2% of the variance in aggregated EI scores. In terms of managing emotions, 6.7% of the variance was explained by the stage of study, with significantly higher scores for students in their final year compared to those in the first two years. Conclusion: This exploratory study provides preliminary data on EI scores for UK medical students identifies factors associated with higher and lower scores and suggests that aggregated EI scores remain stable during medical training.

Quality Assurance of Community Based Undergraduate Medical Curricula: A Cross-Sectional Survey

Because of the increasing contribution of university departments of general practice to the undergraduate curriculum in UK medical schools, involving large numbers of general practices and community based teachers, quality assurance of these ‘distributed’ curricula is essential. We have conducted a cross-sectional survey of all UK university departments of general practice to determine how they are approaching the task of quality assurance of their community based curricula. The response rate to our survey was over 85%. Most departments now contribute across all years of the undergraduate curriculum providing an average of 13% of total curriculum time. Over 85% of departments were confident that the teaching delivered in their community based programmes was consistent with the aims, Education for Primary Care (2008) 19: 135–42 # 2008 Radcliffe Publishing Limited

Medical students' perceptions of the factors influencing their academic performance: An exploratory interview study with high-achieving and re-sitting medical students

Background: Little is known about medical students’ perceptions of the factors that influence their academic performance. Aim: To detect factors medical students, in the final years of their undergraduate medical studies, believe affect their academic performance. Methods: We conducted semi-structured interviews with high-achieving and re-sitting students in the final two years of their studies in a London medical school. Interviews were recorded and transcribed. Thematic content analysis was conducted. Similarities and differences in factors perceived to affect the academic performance of high-achieving and re-sitting students were identified. Results: Eight re-sitting and ten high-achieving students were interviewed. Three core themes were identified: engagement with learning; reflections on learning methods and experiences and the application of learning to future practice. High-achieving students showed a greater awareness of what worked in terms of their approaches to learning and coping with difficulty than re-sitting students. There were also differences in the degree of positive engagement with peers, suggesting the positive contribution of socialising with other medical students. Conclusions: This exploratory qualitative study identified attitudes, behaviours and motivations that appeared to contribute to success or failure at medical school. Our findings suggest ways to improve appraisal, remediation and support mechanisms for students.

General Practice: The Future Teaching Environment: A report on undergraduate primary care education in London

Readers of The Back Pages may be interested to know that an important report on undergraduate primary care education has been produced by the Heads of Departments of General Practice and Primary Care at Londons five undergraduate medical schools; Barts and the London, Imperial College, Kings College London, St Georges and UCL. It is entitled General Practice: The Future Teaching Environment. The report is based on a study which included scrutiny of the relevant medical education research literature, analysis of faculty teaching material, and personal interviews with education leads from the five London medical schools. The study emerged from growing concern in medical school …

What motivates general practitioners to teach

The Australian general practitioner (GP) teaching workforce will need to expand in order to provide for the increasing number of medical students and doctors‐in‐training. Understanding factors that motivate GPs to become involved in teaching in their clinical practice environments is important for developing recruitment and retention strategies.

Reply to Dornan et al.’s ‘On evidence’

Editor – We would like to respond to Dornan et al.’s recent commentary, which touched on the nature of evidence in medical education research, the range of research methodologies that can be deployed, and the relationship between research quality and funding. Dornan and colleagues referred to our British Medical Journal paper, in which we reviewed the current state of published medical education research in a number of key journals. For the record, we did not advocate randomised controlled trials as the single gold standard for medical education research, but we did say that if they are going to be conducted, they should be conducted well. We did not advocate the use of quantitative research methods at the expense of qualitative or mixed-method approaches and, although we did find a suggestion that better-funded research may be more likely to be published in more highly regarded journals, we certainly did not say that unfunded research was necessarily inferior. Our message, in a nutshell, was that better funding is needed for medical education research, across the board, and that medical education research needs to aspire to the highest standards, irrespective of the methods used.

The future of medical education in the UK.

Medical education is always changing but the next 5 to 10 years are likely to see an increased pace of change as we face financial pressures in both educational and health systems. Every change and challenge presents an opportunity, and we must ensure that we use any forced changes to develop our aspirations for the future of medical education. Despite promises of protection of health funding, the financial constraints on the UK economy will affect the health service as health inflation outstrips resources. Higher education is already feeling the effects of funding reductions, and medical education is likely to be squeezed from both sides. It is crucial that medical educators demonstrate the quality and value of graduates, and show that 5 to 6?years of expensive education for young people in the highest academic bracket produces a workforce of considerable and unique value. There is a continuing move for more health care to be delivered in the community, requiring more qualified doctors working in that area. This will lead to an increase in the proportion of graduates training for general practice (planned for at least half of the medical workforce1) and a shift in the working pattern for secondary care specialists. We must ensure that we are training graduates to meet these needs. Although medical education tends to follow changes in clinical practice and NHS organisation, we must predict these more precisely to avoid too …