Dr Lisa Collins Dr Rebecca Farrington Manchester medical school Using Western Pedagogy to Teach Middle Eastern Students – does it work? Dr Lisa Collins Dr Rebecca Farrington Manchester medical school We would like to discuss our experiences of delivering small group teaching to a group of visiting Middle Eastern students. Each year, Year 3 and 5 students from Mansoura and Taibah have the opportunity to join the MB ChB (Medicine) programme for four weeks to experience the types of clinical placements our Manchester students undertake. We wanted to share our experiences and generate discussion with others about their experiences in delivering a course to students preparing to practice overseas, with a potential to collaborate in developing ideas.

Clinical Debrief Overview Small group learning Learning from real experiences Tutor as facilitator Minimally hierarchical Background CD Continuity of tutor over 12 weeks for Manchester students, this group 4 weeks. Focus group with experienced CD tutors to explore their experience, the positives, differences, barriers, what they might do differently next time.

Focus group results Value of knowledge Communication skills “They have slightly different types of placements there, very pressured about knowledge, we have more expectations our students will go and see patients and get more involved” “Most doctors in their countries wouldn’t do ICE as patients expect to be told what is wrong” Importance placed on the value of knowledge was high, with less importance given to a holistic approach to patients.

Teaching Methods Interactivity “I did the footsteps game and I got them outside, …they really responded fantastically to it…some of our [Manchester] students are quite used to novel teaching techniques, they seem a little bit jaded, it’s harder to surprise them” Used to a more didactic approach in a hierarchical environment

Clinical Reasoning Initial engagement Novel concept “Their programme didn’t seem to value the things we were teaching them, e.g. CR skills, I found it harder to get them to engage with the process” “They loved to break it all down. This was alien to them, they hadn’t come across the concept” CR core to MBChB programme

Clinical Supervision Wellbeing Self-care “I also talked about their wellbeing, and “HALT”. They had never gone through this stuff. Basic how to manage your own wellbeing” “There were some lightbulb moments ‘It’s important to look after yourself!’ “ Not discussed before.

Cultural sensibility Tension Safety “Big difference, in beginning quite a bit of tension between the student from Egypt and from Saudi. Various prejudice issues which slightly caught me off guard in the first session” “One of the students did not find CD a safe space. [They] sat in the corner. I asked [them] lots of questions to involve [them]” Potential issue, tension between the members of the group being reflected upon by several tutors.

Tutor satisfaction Connectedness Reach “It’s ace, it gives you that extra challenge, a fantastic global perspective, medicine is a global profession” “It was an opportunity to teach international students, innovative” Challenge Some real positives in delivering this; development as a tutor “Very much reflection in action as a tutor”

Student feedback One of most exciting bits of our learning.., talked about everything from debatable topics to playing games and speaking our minds in a very safe place …Emphasised the biopsychosocial model and the importance of looking at the patient as a whole We felt the change between our first and last session regarding analysing cases and thinking about the information we provided Despite coming from a very different background and experience of education and the clinical environment, students were very open to new approaches. Greater awareness of cultural sensitivity on our part and a development of content of the materials to better reflect their environment and experiences at home.

Conclusions Recommendations Tutor and student satisfaction was high Further exploration of teaching and integration of international students is needed Adapt sessions to allow reflection on different clinical and learning experiences Prepare tutors for the cultural and pedagogical differences