Kristina Sundberg

An educational leadership responsibility in primary care: ensuring the physical space for learning aligns with the educational mission.

WHAT IS ALREADY KNOWN IN THIS AREA ⦁ Physical learning spaces (the hardware) are seldom aligned with the curricula (the software) – this is true both for health professions’ education in general as well as for education in primary care specifically. ⦁ Without an alignment between the hardware and software the quality of learning in primary care education will be jeopardised with implications for patient safety. This situation poses a true challenge for educational leaders.

Aligning physical learning spaces with the curriculum: AMEE Guide No. 107.

Abstract This Guide explores emerging issues on the alignment of learning spaces with the changing curriculum in medical education. As technology and new teaching methods have altered the nature of learning in medical education, it is necessary to re-think how physical learning spaces are aligned with the curriculum. The better alignment of learning spaces with the curriculum depends on more directly engaged leadership from faculty and the community of medical education for briefing the requirements for the design of all kinds of learning spaces. However, there is a lack of precedent and well-established processes as to how new kinds of learning spaces should be programmed. Such programmes are essential aspects of optimizing the intended experience of the curriculum. Faculty and the learning community need better tools and instruments to support their leadership role in briefing and programming. A Guide to critical concepts for exploring the alignment of curriculum and learning spaces is provided. The idea of a networked learning landscape is introduced as a way of assessing and evaluating the alignment of physical spaces to the emerging curriculum. The concept is used to explore how technology has widened the range of spaces and places in which learning happens as well as enabling new styles of learning. The networked learning landscaped is explored through four different scales within which learning is accommodated: the classroom, the building, the campus, and the city. High-level guidance on the process of briefing for the networked learning landscape is provided, to take into account the wider scale of learning spaces and the impact of technology. Key to a successful measurement process is argued to be the involvement of relevant academic stakeholders who can identify the strategic direction and purpose for the design of the learning environments in relation to the emerging demands of the curriculum.

The Swedish duty hour enigma

BackgroundThe Swedish resident duty hour limit is regulated by Swedish and European legal frameworks. With a maximum average of 40 working hours per week, the Swedish duty hour regulation is one of the most restrictive in the world. At the same time, the effects of resident duty hour limits have been neither debated nor researched in the Swedish context. As a result, little is known about the Swedish conceptual framework for resident duty hours, their restriction, or their outcomes: we call this “the Swedish duty hour enigma.” This situation poses a further question: How do Swedish residents themselves construct a conceptual framework for duty hour restrictions?MethodsA case study was conducted at Karolinska University Hospital, Stockholm – an urban, research-intensive hospital setting. Semi-structured interviews were carried out with 34 residents currently in training in 6 specialties. The empirical data analysis relied on theoretical propositions and was conducted thematically using a pattern-matching technique. The interview guide was based on four main topics: the perceived effect of duty hour restrictions on (1) patient care, (2) resident education, (3) resident well-being, and (4) research.ResultsThe residents did not perceive the volume of duty hours to be the main determinant of success or failure in the four contextual domains of patient care, resident education, resident well-being, and research. Instead, they emphasized resident well-being and a desire for flexibility.ConclusionsAccording to Swedish residents’ conceptual framework on duty hours, the amount of time spent on duty is not a proxy for the quality of resident training. Instead, flexibility, organization, and scheduling of duty hours are considered to be the factors that have the greatest influence on resident well-being, quality of learning, and opportunities to attain the competence needed for independent practice.

Future learning environments: the advent of a “spatial turn”?

This supplement addresses the issue on how space impacts on learning in professional and interprofessional education. We previously have claimed that the ‘‘software’’ (curricula) development in health professions education is not aligned with the hardware (physical learning spaces) development and that we hence to some degree are working in ‘‘living museums’’ representing a past era of thinking about health professions education (Nordquist, Kitto, & Reeves, 2013). In this commentary, we synthesise findings from the included papers in this supplement as well as reflect and further elaborate on positions taken within the field of learning environments and interprofessional education.

Power and resistance: leading change in medical education

A key role for educational leaders within undergraduate medical education is to continually improve the quality of education; global quality health care is the goal. This paper reports the findings from a study employing a power model to highlight how educational leaders influence the development of undergraduate medical curricula and the resistance they encounter related to this activity. Sixteen educational leaders at a medical university in Northern Europe were purposefully sampled and interviewed through semi-structured interviews. The results indicate that the educational leaders are feeling powerless when it comes to engaging their colleagues in the process of developing medical education. As a result, these leaders appear having to create a ‘vicarious legitimacy’; legitimacy connected to other areas than education, such as research or clinic. Research results from this study can be used to develop faculty development programs for health education leaders on national and international levels.

Institutional needs and faculty development for simulation.

This review focuses on simulation in anaesthesiology as an educational intervention from a learning perspective. Simulation-based education in anaesthesiology has implications for both faculty development and institutional needs. However, in order to find evidence for the implications of these areas, it is necessary to turn to the literature on anaesthesiology simulations, health-care simulations and also the medical education and pedagogical literature. The most important factor for successful simulation-based education on an institutional level is curriculum integration of simulation, closely connected with defined learning outcomes. The corresponding factor concerning faculty development in simulation-based education is feedback. These three factors are closely interrelated, and to understand them and how to design high-quality simulation interventions from a learning perspective, it is important to look not only to the simulation literature but also to the pedagogical literature.

May I see your ID, please? An explorative study of the professional identity of undergraduate medical education leaders

BackgroundThe mission of undergraduate medical education leaders is to strive towards the enhancement of quality of medical education and health care. The aim of this qualitative study is, with the help of critical perspectives, to contribute to the research area of undergraduate medical education leaders and their identity formation; how can the identity of undergraduate medical education leaders be defined and further explored from a power perspective?MethodsIn this explorative study, 14 educational leaders at a medical programme in Scandinavia were interviewed through semi-structured interviews. The data was analysed through Moustakas’ structured, phenomenological analysis approach and then pattern matched with Gee’s power-based identity model.ResultsEducational leaders identify themselves more as mediators than leaders and do not feel to any larger extent that their professional identity is authorised by the university. These factors potentially create difficulties when trying to communicate with medical teachers, often also with a weaker sense of professional identity, about medical education.ConclusionsThe perceptions of the professional identity of undergraduate medical education leaders provide us with important notions on the complexities on executing their important mission to develop medical education: their perceptions of ambiguity towards the process of trying to lead teachers toward educational development and a perceived lack of authorisation of their work from the university level. These are important flaws to observe and correct when improving the context in which undergraduate medical education leaders are trying to develop and improve undergraduate medical programmes. A practical outcome of the results of this study is the facilitation of design of faculty development programmes for educational leaders in undergraduate medial education.

Interactive Patient Cases in Occupational Therapy: How to Succeed

This chapter introduces an opportunity to learn more about the benefits of using interactive patient cases in occupational therapy education. Why, how and when should you introduce interactive patient cases and how do you write a case and facilitate a case seminar? This chapter brings insight to these questions, as well as presents a historical background to the usage and an overview of what type of learning interactive cases can stimulate.