Facilitating reflection in an undergraduate medical curriculum

A reflective practitioner is one of the desired outcomes of medical education. This paper describes the introduction of a reflective assignment in the first year of a medical curriculum. Students completed written reflective assignments for which individual and group feedback was provided. Tutors reflected on their roles throughout the development and implementation of this new assignment. The majority of students completed the assignments and while some students became highly involved in the task others worked at a surface level. Tutors found the process time consuming and less enjoyable than working directly with students who need to be supported in the development of skills necessary for reflective practice.     

Planning and implementing an undergraduate medical curriculum: the lessons learned

In 1995 Dundee medical school introduced an integrated, systems-based spiral curriculum with a number of innovative features. The medical school has now had eight years' experience of the curriculum. This paper describes the changes that have taken place in the curriculum over the eight years. Evidence from internal and external reviews and student examination data are used to identify the lessons learned from implementing the curriculum. The Dundee experience, the approaches to the curriculum described and the conclusions reached are relevant to all with an interest in medical education.     

How we developed a bioethics theme in an undergraduate medical curriculum

The 5-year undergraduate medical curriculum at Aga Khan University integrates basic sciences with clinical and community health sciences. Multimodal strategies of teaching and learning, with an emphasis on problem-based learning, are utilized to equip students with knowledge, skills, behaviours, attitudes and values necessary for a high-calibre medical graduate. Bioethics teaching was introduced in the medical curriculum in 1988 and has since undergone several changes. In 2009, a multidisciplinary voluntary group began review of undergraduate bioethics teaching and invested over 350 man-hours in curricular revision. This involved formulating terminal objectives, delineating specific objectives and identifying instructional methodologies and assessment strategies appropriate for the contents of each objective. Innovative strategies were specially devised to work within the time constraints of the existing medical curriculum and importantly, to increase student interest and engagement. The new bioethics curriculum is designed to be comprehensive and robust, and strives to develop graduates who, in addition to being technically skilled and competent, are well-versed in the history and philosophy of ethics and bioethics and are ethical in their thinking and practice, especially in the context of a developing country like Pakistan where health indicators are among the worst in the region, and clinical practices are not effectively regulated to ensure quality of care.     

Student-selected components in the undergraduate medical curriculum: a multi-institutional consensus on purpose

Student-selected components (SSCs) are an established part of undergraduate medical curricula in the UK. Implementation has been against a background of differing educational approaches to curricular change, together with a lack of clarity about their purpose, relationship with the core curriculum and contribution to overall assessment. This has resulted in a diversity of programmes with perceived differing importance between medical schools. This paper documents the approach used by a consortium of medical schools with diverse curricula to develop consensus on the educational purpose and learning outcomes of SSCs. Agreement on common purposes and outcomes was achieved, and consensus documents are reported. These may be valuable for other medical schools implementing any form of student-selected project work. This work will now be the starting point for further work on producing recommendations for assessment of SSCs, which will be applicable across different medical schools.     

Task-based learning (TBL) in undergraduate medical education

Problem-based learning (PBL) is a proven method to learn medicine during the first years of studies. In the clinical phase the active, self-directive student may experience difficulties in adapting to the life of professionals in health care units, where students usually have to attend and work according to preplanned timetables. Task-based learning (TBL) can serve as an intermediary in the meeting of these two cultures. Here we describe a TBL study module for fourth-year medical students and experiences of implementing it at the University of Tampere in Finland. Eighty-five students participated in this study in 1998 and 1999. Our results show that this method works and that it leads to learning. Students evaluate their skills connected with the general practitioner's work in a health centre hospital as better after the study module than at the onset.     

Rapid change in Japanese medical education

Change in Japanese medical education has been accelerating over the last 10 years. Historically, clinical departments in each medical school played a crucial role, but reports in the mass media tried to refute the feudal 'ikyoku-koza' system with a number of malpractice cases, inappropriate patient-doctor communication, etc. At that time policies by the Ministries of Education and Health (rationalized in 2001) independently became more influential in medical education. In particular the network of governmental medical schools has been restructured, merged and privatized since 2001. In the 1990s several private medical schools developed distinctive curricula including problem-based learning (PBL), the objective structured clinical examination (OSCE) and introduction to clinical medicine (ICM). The curriculum for clinical medicine is still a critical issue and will be a major challenge for the management of each medical school. The effectiveness of the National Model Curriculum consisting of more than 1200 objectives might be questionable but the National Common Achievement Test (CAT) will make a strong impact on the preclinical curriculum. In the future each medical school should adopt an outcome-based education system to close the loop of curriculum development. An evaluation system based on the entire medical school or curriculum will be the key to successful education.     

Status of portfolios in undergraduate medical education in the LCME accredited US medical school

Aim: We sought to investigate the number of US medical schools utilizing portfolios, the format of portfolios, information technology (IT) innovations, purpose of portfolios and their ability to engage faculty and students.

Methods: A 21-question survey regarding portfolios was sent to the 141 LCME-accredited, US medical schools. The response rate was 50% (71/141); 47% of respondents (33/71) reported that their medical school used portfolios in some form. Of those, 7% reported the use of paper-based portfolios and 76% use electronic portfolios. Forty-five percent reported portfolio use for formative evaluation only; 48% for both formative and summative evaluation, and 3% for summative evaluation alone.

Results: Seventy-two percent developed a longitudinal, competency-based portfolio. The most common feature of portfolios was reflective writing (79%). Seventy-three percent allow access to the portfolio off-campus, 58% allow usage of tablets and mobile devices, and 9% involve social media within the portfolio. Eighty percent and 69% agreed that the portfolio engaged students and faculty, respectively. Ninety-seven percent reported that the portfolios used at their institution have room for improvement.

Conclusion: While there is significant variation in the purpose and structure of portfolios in the medical schools surveyed, most schools using portfolios reported a high level of engagement with students and faculty.     

Integrating professionalism teaching into undergraduate medical education in the UK setting

This paper examines how professionalism teaching might be integrated into undergraduate medical education in the United Kingdom setting. It advocates adopting an outcome-based approach to curriculum planning, using the Scottish Deans' Medical Curriculum Group's (SDMCG) outcomes as a starting point. In discussing the curricular content, potential learning methods and strategies, theoretical considerations are explored. Student selection, assessment and strategies for optimising the educational environment are also considered.     

Twelve tips for crossborder curriculum partnerships in medical education

Abstract

Crossborder curriculum partnerships are a relatively new and fast-growing form of internationalization in which the curriculum that has been developed by one institution (the home institution) crosses borders and is implemented in another institution (the host institution). These partnerships aim to provide comparable learning experiences to the students in both institutions and are driven by a variety of motives, such as strengthening international networks, increasing financial gains, and stimulating research spinoffs. Although popular, crossborder curriculum partnerships are also criticized for their potentially low educational quality, failing to address fundamental differences in teaching and learning between the home and host institutions, and not addressing the educational needs of the host country’s health care system. Our aim is to provide guidance to those considering or engaged in designing, developing, managing, and reviewing a crossborder curriculum partnership or other forms of international educational partnerships in medical education. Drawing from research, personal, and institutional experiences in this area, we listed twelve tips categorized into four themes, which contribute to the establishment of sustainable partnerships that can withstand the aforementioned criticism.