MBBS PHASE 2 Review 2009 Working Party 3: Creative Teaching and Learning Strategies Convenors: Professor Jane Dacre & Professor Irving Taylor

Meeting 9 September 2009 Irving Taylor Jane Dacre Pauline Leonard Joe Rosenthal Shakeel Saeed Dan Swerdlow Tim Cook

Group’s Terms of Reference To look at current teaching and learning strategies, identify their strengths and any weaknesses and consider the scope for innovation

Current teaching and learning strategies Current learning and teaching strategies in Phase 2 generally work well, and many should be retained and built upon. However our approach is largely based on traditional service models and teaching approaches. We need to adapt and develop in response to changing patterns of healthcare and evidence based innovations in medical education

Drivers for change Changing patterns of healthcare delivery Plans for local service recongfiguration Increased specialisation EWTD Reduced inpatient time Services moving to community Extended roles of nurses/AHPs Funding changes (NHS and University) Innovations and evidence in learning and teaching Lead in to Foundation Programmes Tomorrow’s Doctors

Integration Student choice (10%) Experiential learning Use of simulation Workplace based assessment Patient contact in all years

Creative Learning & Teaching Strategies 1.Problem Based Learning 2.eLearning 3.Use of ‘expert’ patients 4.Simulation in teaching clinical skills 5.Outpatient & Community based teaching 6.Mentorship and role modelling

1. Problem Based Learning (PBL) A student-centered instructional strategy in which students collaboratively solve problems and reflect on their experiences (Wikipaedia) PBL is any learning environment in which the problem drives the learning (Don Woods, McMaster)

Advantages of PBL Promotes skills in: Independent learning Sourcing information Organising and sharing knowledge Teamwork Problem solving

Disadvantages of PBL Demanding in terms of tutor time and numbers Tends to rely on virtual patients - ? at expense of real patient exposure Large numbers of students using resources at same time Weaker students may not thrive May deprive students of access to inspirational teachers

How about Patient Centred Learning (PCL)? Aiming to exploit the benefits of PBL but applying them to real patients, integrating basic science, clinical knowledge/skills and opportunities for professional development, working with multidisciplinary team wherever possible

2. e-Learning Has already become an important aspect of student learning Needs to be embedded more formally in the curriculum Complements but does not substitute for patient contact Large amount of UG and PG material exists but needs local and possibly national coordination Potential new methods of formative and summative on-line assessment

3. Expert Patients · Build on experience using actors/role players GTA Programme already running successfully Clinical Skills Centres have patient databases Patient groups eg diabetes, rheumatoid arthritis Voluntary groups in the community

4. Simulation Clinical Skills Centres very successful Considerable experience with models, actors/role players Scope for further development using new technologies Teamwork simulations (ward, theatre, emergency) Potential link to Trusts simulation centres

5. Outpatient, Outreach & Community Based Teaching Essential settings for learning as in-patient time reduces and services move nearer to patients Acute Trusts must recognise need for space and time in clinics ?dedicated teaching clinics in teaching hospitals Primary Care Trusts must support GP/PHCT role in undergraduate education Encourage whole-team support of outpatient/community based teaching, reducing dependence on individual enthusiasts Learning opportunities in new service models eg polyclinics, walk-in centres, OOH services Transparency of teaching funding ? role of independent sector providers

6. Mentorship, role modelling, & recognition for teaching Encourage, train and support teachers within both medical school and NHS Identify named teaching lead in every clinical teaching unit Plan and protect time for teaching Recognise roles of ‘Clinical Tutors’ and ‘Support Tutors’ Formalise out of hours teaching (?OOH tutors) Consider greater use of clinical teaching fellowship programmes Recognise and reward teaching in job planning and promotion Maintain appropriate system for award of honorary contracts

Next Steps Keep informed of changes in local service configuration and push for education to be on agenda in all negotiations Seek guidance from ACME on evidence base for benefits of different teaching and learning methods available Develop idea of Patient Centred Learning Explore local and national developments in eLearning (UG & PG) Discuss new opportunities for simulation and expert patients with Clinical Skills Centres and Trusts Coordinate with Education Deanery and other working parties in Phase 2 review