Dr S J Lockey sarah.lockey@anglia.ac.uk Diversity and Drugs Dr S J Lockey sarah.lockey@anglia.ac.uk

Challenges Faced in Pharmacology Teaching Annually more medications come to market Polypharmacy in the elderly Patient Safety always a key factor NHS Budget reductions The prescription of drugs is an expected task of a doctor But it is a complex process that involves a sound knowledge of the drugs being prescribed, judgement and skill to manage a patient and their illness. Each year more medicines are produced, each with complex pharmacology, We have an aging population and as patients become older poly pharmacy is more likely. Patient safety is a key issue and every effort should be made to reduce medication errors With reductions in nhs budgets there is an ever greater need for cost effective use of resources, drugs being a key area of expense. The British pharmacological society reports that, A number of reports have highlighted that junior doctors and medical students feel there is insufficient emphasis on the practical aspects of prescribing in the undergraduate curriculum To be a safe prescriber outcomes for graduates states: Newly qualified doctors must be able to prescribe medications safely, appropriately, effectively and economically and be aware of the common causes and consequences of prescribing errors.

Achieving Those Outcomes In Medicine Prime positioning as a new medical school Vertical theme integrated into horizontal blocks of learning Spiral Curriculum The challenge for medical schools will now be to achieve those required outcomes. As a new medical school we are in a prime position to establish a medical curriculum in which clinical pharmacology is a curriculum thread with learning predominantly integrated as a recurrent theme in horizontal blocks of learning with organ‐based specialties.  This learning will take place across different modules of learning and over several years using horizontal and vertical teaching strands and therefore must be signposted to the students so they are aware of when this content is being delivered. Initially the focus in the early curriculum should be on understanding where and how drugs act, with a later emphasis on more clinical aspects, such as how they are prescribed. Students are expected to learn the mechanism of action, indications for use, contraindications and adverse effects of medicines as detailed in the British National Formularly. It is a content heavy subject that requires support from teachers and peers to be learned effectively

Possibility of Flexible Learning In Medicine? Higher Education Academy believes that learning is about empowering students by offering them choices in how, what, when and where they learn: the pace, place and mode of delivery. The learning outcomes can be achieved in a variety of teaching and learning styles these range from traditional didactic lecture based session to small group seminars, or indeed TBL. However, these methods it could be argued are although pedagogically sound don’t allow students the freedom to integrate their content easily I want to create a community of practice amongst my students where elements of the curriculum can be co-developed and students can engage in some flexible modes of teaching and learning and share their best practice as part of a community. This started by recognizing the styles of learning that students preferred. Higher Education Academy believes that learning strategies are about empowering students by offering them choices in how, what, when and where they learn: the pace, place and mode of delivery. Students were asked to vote on a couple of styles of learning that could be delivered in the following learning environment Lecture theatre Small group work GP consultation in practice

The Response: Over whelming the students chose active learning styles at the start of the programme However, now they are switching to more traditionally passive learning styles Are we creating this?

What’s Required? This flexibility in learning requires a balance of power between institutions and students, and seeks to find ways in which choice can be provided that is economically viable and appropriately manageable for institutions and students alike.

To encourage this active learning Create communities of practice Where do we go from here? To encourage this active learning Create communities of practice both staff and students Share resources and experience across Faculty/ University/ Nationally Once students are on clinical attachments, there are many opportunities for using ward or clinic based examples of drug use. But before this opportunity for active learning must be encouraged Health care professionals join as communities to share practice and further knowledge skills and professionalism, often students join these communities when they are on placements and work from being a peripheral member to a more central role with increasing experience. We should model these communities of practice in education By engaging our students to contribute to our educational practice in more ways than giving feedback at the end of a module after completing a prescribed block of learning What this means for pharmacology teaching within the medical school? Students are encouraged to contribute content and ideas for content development I have developed online resources and google classrooms with activities Canvas quizzes to generate cases with integrated questions from across discipline within medicine. What we are lacking in the theme through my lack of experience is the allied healthcare perspective. The students need to learn about the whole process of prescribing, particularly the role of other healthcare professionals.  Safe and effective medication use involves collaboration between healthcare professions. Therefore joint teaching of medical students with students of the allied health specialties is key. These days simply providing a link between drugs and clinical conditions is insufficient to develop an appreciation of the complex considerations that surround the decision to write a prescription to treat or manage a patient.