Evaluation of a multidisciplinary faculty to support learning in surgical practice.

The Theatre Faculty Project was a programme of education seminars, personal study and workplace educational activities for surgeons, operating theatre staff and surgical trainees at a hospital in north-west England. Its aim was to create a multidisciplinary faculty with an understanding of implicit aspects of surgical practice, of how these enter clinical thinking and professional judgement and are used to enhance the learning, teaching and assessment of surgeons. A qualitative evaluation of the faculty project showed improved educational understanding and multidisciplinary awareness among its participants. Refinements of the programme were identified to help those (surgeons in particular) having difficulty conceptually or practically with clinical reflective writing and with portfolio building. However, the support of Trust management at the host hospital will be vital in extending the programme beyond its initial group of volunteers and in integrating the multidisciplinary faculty into its organizational structures.

Placing learning needs in context: distance learning for clinical officers in Tanzania.

BACKGROUND: Poor public health indicators in Tanzania have led to the upgrading of nursing and clinical personnel who currently have just core training. Clinical officers (COs) have 3 years training in basic and applied medicine and are responsible for healthcare of large and dispersed rural populations. AIMS: UNESCO-Wales has funded colleagues in Wales (UK) to assist the upgrade of COs. An inquiry into their learning needs and the Tanzanian context has produced a framework for design of a module for COs on sexually transmissible infections and HIV & AIDS by distance learning. METHODS: Face-to-face discussions were held with the Ministry of Health, healthcare workers, educators and administrators in Tanzania; a review of training documents was carried out; and a follow-up questionnaire issued to COs. RESULTS: The discussions and review highlighted teacher-centred approaches, and management, infrastructure and resources obstacles to curriculum change. Principal learning needs of COs around STIs were: counselling, syndromic management, drugs management, laboratory diagnosis, health education, resources, staffing and service morale. CONCLUSIONS: Placing learning needs in context in dialogue with Tanzanian colleagues was an advance on simple transfer of educational technologies and expertise. The inquiry resulted in a draft study guide and resources pack that were positively reviewed by Tanzanian tutors. Management and resources issues raised problems of sustainability in the module implementation.

Counting quality because quality counts: differing standards in master's in medical education programmes.

BACKGROUND: In the United Kingdom the medical teacher role is being formalized. One result is that Masters level programmes in medical education are proliferating; however little or no attempt has been made to capture any differences in quality offered by them. A small scale project (Allery et al. 2006) set out to rectify this omission. AIM: Drawing on data from that study, this paper considers the variation in standards across programmes. Specifically research methods training provided in MMEd courses and levels of support for researchers is investigated. METHOD: A secondary analysis of the data generated by the evaluative study and gathered via review of programme web sites, semi structured interviews with MSc course directors and case studies in two sites, identified from purposive sampling. RESULTS: Variations in both taught and research elements were identified. The quality of the research experience was compromised for some students many of whom were poorly prepared to undertake educational research and the question of standards raised in respect of those institutions where the examination process lacked real academic rigour. CONCLUSIONS: The variance in research methods training and support raises a number of issues in relation to quality standards. The medical education community needs to engage in open and critical dialogue around the whole constellation of paradigms, methods and activities that pertain in educational research. Unless or until we address these deeper concerns, research into medical education will suffer through a lack of design flair, implementation and rigour.

Making a difference: researching master's and doctoral research programmes in medical education.

CONTEXT: The Association for the Study of Medical Education states that its aim is to improve the quality of medical education. As a consequence, it commissioned through its Education Research Group a small-scale project to explore the quality of the research methods elements in currently available UK master's and doctoral programmes. OBJECTIVE: This study aimed to explore the breadth, depth and diversity of the research methods provision of those programmes currently available to course participants. METHODS: The study comprised a 3-phase approach which utilised: a web-based search of curricula format and content; semi-structured interviews with key informants, and case studies and site visits to conduct documentary analysis of dissertations and in-depth interviews with core personnel. RESULTS: The study revealed wide variation across taught programmes. These discrepancies applied to length of course, requirements for the dissertation in terms of both length and time allowed to complete the study and, crucially, a wide variance in the quality and quantity of the levels of supervision provided for students during this research phase. DISCUSSION: This study raises concerns about the aims and functions of courses offering qualifications in medical education. It identifies a number of obstacles to the development of educational researchers who are skilled in the philosophical underpinnings of research activity or equipped to undertake educational research that is of a quality sufficient to withstand the scrutiny of the authors' scientific and clinical counterparts. We argue that if research into medical education is to thrive, it requires the full commitment of all those who are engaged in teaching the topic and supporting researchers.

Hospital doctors' views of their CPD and its relationship to learning in the organization.

Continuing professional development (CPD) has traditionally been an autonomous, professional concern of doctors in the UK. In a changing educational and service climate, can individualized approaches to CPD be reconciled with adult learning principles and learning that is practice-based and multidisciplinary? A survey of the CPD of consultant and non-consultant career grade staff in Wales (UK) has provided some clues on how doctors perceive their learning needs in relation to those of Trust hospitals. It indicated that these doctors pursued traditional forms of continuing education (reading, lectures and meetings), gained clinical knowledge and changed their practice as a result. The majority saw themselves as accountable for CPD to their college and specialty. Trusts had yet to promote CPD as a clinical governance priority but respondents felt that appraisal helped to mediate individual and organizational perspectives of CPD. Most career-grade doctors believed their CPD activities met the needs of their employing organizations and felt satisfied with a 'traditional' approach to CPD. Doctors and service organizations may need to confront preconceptions regarding education and respective roles in the negotiation of CPD if team-based learning in practice is to become established.

Thinking about the SHO curriculum.

This discussion of the reform of senior house officer (SHO) training draws on important evidence from the evaluation of a pilot curriculum for basic surgical education. Variations and anomalies in SHO teaching and learning were detected, many related to the service context. They highlight the need for explicit curriculum frameworks that build on, and are consonant with, current best practice in SHO education.

The educational evaluation of General Professional Practice of Surgery (GPPS).

The authors conclude that GPPS presents the possibility of enhanced learning from limited opportunities, but only if all parties are fully able to embrace the educational aims of GPPS and follow through its structured and coherent design for learning.