Teaching professionalism through virtual means.

OBJECTIVES: Virtual patients are used across a variety of clinical disciplines for both teaching and assessment, but are they an appropriate environment in which to develop professional skills? This study aimed to evaluate students' perceived effectiveness of an online interactive virtual patient developed to augment a personal professional development curriculum, and to identify factors that would maximise the associated educational benefits. METHODS: Student focus group discussions were conducted to explore students' views on the usefulness and acceptability of the virtual patient as an educational tool to teach professionalism, and to identify factors for improvement. A thematic content analysis was used to capture content and synthesise the range of opinions expressed. RESULTS: Overall there was a positive response to the virtual patient. The students recognised the need to teach and assess professionalism throughout their curriculum, and viewed the virtual patient as a potentially engaging and valuable addition to their curriculum. We identified factors for improvement to guide the development of future virtual patients. CONCLUSION: It is possible to improve approaches to teaching and learning professionalism by exploring students' views on innovative teaching developments designed to augment personal professional development curricula.

Preparing for an institutional self review using the WFME standards - an international medical school case study.

BACKGROUND: Curriculum reform poses significant challenges for medical schools across the globe. This paper describes the reforms that took place at the medical school of the Royal College of Surgeons in Ireland (RCSI) between 2005 and 2008 and the institutional self review process that accompanied these reforms. RESULTS: Although fully accredited with the Irish Medical Council the RCSI sought additional detailed review of all aspects of its undergraduate medical program. Five medical educationalists were invited to visit the College in 2005 and again in 2008 to act as 'critical friends' and guide the self review using the World Federation for Medical Education (WFME) standards which had recently been adopted in Ireland. CONCLUSION: The process of institutional self review (as opposed to more high stakes accreditation) can bring about significant reform, especially when supported by a panel of 'critical friends' working alongside faculty to help guide and support sustained curriculum reform. The WFME standards continue to provide a useful framework to consider all medical education activities within a medical school engaged in continuous renewal. Adequate preparation for such reviews is critical to the success of such an undertaking and should be supported by a comprehensive communication strategy and project plan.

Curriculum reform: a narrated journey.

OBJECTIVES: Curriculum reform poses significant challenges for medical schools across the globe. Understanding the medical educator's personal and lived experience of curriculum change is paramount. This paper illustrates the use of narrative inquiry as a means of exploring the author's own evolving professional identity as a medical educator engaged in planning and leading curriculum reform and in understanding the meanings she and other medical educators attribute to their roles as agents of change in a medical school. CONTEXT: In 2002 it was decided to radically reform a school of medicine's (SoM) traditional 6-year medical degree course (converting it to a 5-year, integrated, case-based programme). This followed a decade of adverse external reports by the national accreditation agency. The 2001 accreditation report was the most significant catalyst for change, and drew attention to the School's need for a 'collective will' to introduce a series of specific curriculum reforms. To support this reform, a new curriculum working group (NCWG) supported by a dedicated medical education unit (MEU) was established. In late 2002 the author joined the School as the director of that unit. METHODS: This paper draws on a 3-year study which captured the stories of the curriculum planning project between 2002 and 2005, as well as stories of curriculum reform from past deans of the same medical school dating back to 1965. Narrative inquiry is used as a means of probing the author's own lived experience as coordinator of the new curriculum project and the experiences of key members of the NCWG, including the dean, and of former deans from the same medical school over its 40-year history. CONCLUSIONS: Through a living, telling and retelling of the story of curriculum change, narrative inquiry has a role to play in both elucidating the individual lived experience of curriculum change and shaping the evolving professional identity of the medical educator as an agent of change.

'Lost in translation'? Developing assessment criteria that value rural practice.

INTRODUCTION: Rural workforce preparation is often discussed in terms of specific interventions such as rural placements. More technical discussions of education matters seem to belong in the realm of education experts. However, this issues article argues that a focus on quality assessment techniques is important to the rural health agenda. Making connections between the medical education literature and the broader education literature, it explores elements of a qualitative decision-making model as an alternative to narrow competency-based and norm-referenced approaches. In the process it explores assessment techniques that may help educators better translate their intentions to value rural practice into the learning of students. BACKGROUND: Research suggests that, in Australia at least, many university educators have different and conflicting understanding of assessment criteria. At the same time, the literature on the development of assessment criteria is relatively small in a context in which the medical education literature takes a quantitative, reliability-driven approach. This has important implications for how we ensure that rural practice is given enough emphasis at the level of education that most strongly drives student learning-assessment. METHODS: This article explores such matters by examining the steps needed to develop assessment criteria in undergraduate medical education courses. It draws on key writings from the past, as well as current debates, in the medical education and broader education literature. It focuses on the detail of assessment techniques to show how the intention to value rural practice can be 'lost in translation' with narrow norm-referenced and competency-based assessment models. CONCLUSIONS: Rural health has a stake in technical debates about education in health sciences courses. Like other knowledge and skills, the knowledge and skills important to rural practice cannot be valued at the coalface of student learning if our assessment techniques subvert intentions. Developing the quality of assessment techniques involves scrutiny of not only the medical education literature, but also the broader education literature, including writings about working models of criteria-and-standards-based assessment. This scrutiny suggests assessment techniques are not equal in terms of how well they translate intentions. More than that, it suggests the value to rural health education of shifting from narrow norm-referenced models to best practice in criteria-and-standards-based assessment.