1. “Tomorrow’s Doctors” Implementation Workshop
University of Edinburgh Medical School
Professor Allan Cumming

2. MANY CHALLENGES
Focus on two
Outcome-based education and assessment
The Student Assistantship

3. GMC QABME, University of Edinburgh 2008/9
“Review and simplify the curriculum structure …….”
“Rationalise the vertical themes running through the curriculum……”

4. Outcome-based education and assessment

5. Curriculum model (Edinburgh)
Spiral *****
Core and options *****
Integrated ****
Systems-based *****
Discipline-based ****
Problem-based **
Case-based ***
Task-based **
Outcome-based **
Student-centred ****
Self-directed ****
Multi-professional **
Community-centred ****
Curriculum model (Edinburgh)

6. Curriculum outcomes
= preparedness for practice
What to learn - content
How to learn – educational strategy teaching and learning tools
Assessment
Educational environment
Student

7. What are we doing?
Edinburgh curriculum is being structured and described in terms of twelve Curriculum Outcomes
The assessment strategy is being aligned with these outcomes
“Tomorrow’s Doctors 2009” outcomes are the primary basis of the new structure - with appropriate additions to reflect the character of the Edinburgh graduate

8. EDINBURGH MBChB OUTCOMES OVERARCHING OUTCOME
GMC TOMORROW’S DOCTORS 2009
OVERARCHING OUTCOME
An Edinburgh medical graduate will be a caring, competent, confident, ethical and reflective practitioner, equipped for high personal and professional achievement, able to provide leadership and to analyse complex and uncertain situations.
GMC 7. Medical graduates are tomorrow’s doctors. In accordance with Good Medical Practice, graduates will make the care of patients their first concern, applying their knowledge and skills in a competent and ethical manner and using their ability to provide leadership and to analyse complex and uncertain situations.
THE DOCTOR AS SCHOLAR AND SCIENTIST Ability to apply to medical practice:
1. BIOMEDICAL AND CLINICAL SCIENCES
GMC 8. Apply to medical practice the biomedical scientific principles, method and knowledge relating to: anatomy, biochemistry, cell biology, genetics, immunology, microbiology, molecular biology, nutrition, pathology, pharmacology and physiology.
2. PSYCHOLOGICAL ASPECTS OF MEDICINE
GMC 9. Apply psychological principles, method and knowledge to medical practice.
3. SOCIAL SCIENCES AND PUBLIC HEALTH
GMC 10. Apply psychological principles, method and knowledge to medical practice.
GMC 11. Apply to medical practice the principles, method and knowledge of population health and the improvement of health and health care.
4. EVIDENCE-BASED MEDICINE AND RESEARCH
GMC 12. Apply scientific method and approaches to medical research.

9. THE DOCTOR AS PRACTITIONER
Ability to:
5. Carry out a CONSULTATION WITH A PATIENT
GMC 13. Carry out a consultation with a patient.
6. DIAGNOSE AND MANAGE CLINICAL PRESENTATIONS
GMC 14. Diagnose and manage clinical presentations.
7. Undertake CLINICAL COMMUNICATION
GMC 15. Communicate effectively with patients and colleagues in a medical context.
8. Carry out EMERGENCY CARE, FIRST AID, RESUSCITATION AND PRACTICAL PROCEDURES
GMC 16. Provide immediate care in medical emergencies.
GMC 18. Carry out practical procedures safely and effectively.
9. Apply principles and knowledge of PHARMACOLOGY AND THERAPEUTICS, including prescribing.
GMC 17. Prescribe drugs safely, effectively and economically.
10. Apply principles and knowledge of MEDICAL INFORMATICS
GMC 19. Use information effectively in a medical context.
THE DOCTOR AS PROFESSIONAL
11. Apply principles and knowledge of MEDICAL ETHICS, LEGAL AND PROFESSIONAL RESPONSIBILITIES
GMC 20. Behave according to ethical and legal principles.
12. Demonstrate PERSONAL AND PROFESSIONAL DEVELOPMENT
GMC 21. Reflect, learn and teach others.
GMC 22. Learn and work effectively within a multi-professional team.
GMC 23. Protect patients and improve care.

10. OUTCOMES – END PRODUCT OF THEMES
Each Outcome supported by an Outcome Theme (OT)
Each OT has a Theme Head and team
Curriculum content and assessments related to each OT planned and tracked electronically

11. The Edinburgh MBChB curriculum
“a caring, competent, confident, ethical and reflective practitioner, equipped for high achievement, able to provide leadership and analyse complex and uncertain situations”
12 CURRICULUM OUTCOMES
12 THEMES
The Edinburgh MBChB curriculum
PRIOR LEARNING

12. OUTCOMES PLUS equipped for high personal and professional achievement
RESEARCH
RECOGNITION OF EXCELLENCE
STUDENT CHOICE
MOBILITY
caring, competent, confident, ethical and reflective practitioner
EXTRA-CURRICULAR
HUMANITIES
12 CURRICULUM OUTCOMES
12 THEMES
SAFE PATIENT CARE
SAFE PATIENT CARE
PRIOR LEARNING

13. Examples
“the Edinburgh graduate will be…”
“Scientist/scholar; Practitioner; Professional
“Ability to apply principles and knowledge of pharmacology and therapeutics, including prescribing”
“Provide a safe and legal prescription”
“Describe the adverse effects of warfarin”
Levels of outcome in the Edinburgh MBChB degree programme. “Course” refers to any subdivision of the curriculum such as a module or clinical attachment.

14. Outcome-base assessment and compensation
Tomorrow’s Doctors 2009, Para 117
“Medical schools must have appropriate methods for setting standards in assessments to decide whether students have achieved the ‘outcomes for graduates’. There must be no compensatory mechanism which would allow students to graduate without having demonstrated competence in all the outcomes.”
Most ‘integrated’ assessment systems have some degree of compensation as an integral feature of their design. Ensuring that each of the outcomes has been passed by every student will require investment in resources and time to alter systems of assessment, data gathering and remediation.

15. BLUEPRINTING Tracking Assessment of Outcomes

16. Student Assistantship (StA) – some questions
Could the StA be considered an approach to teaching and learning lasting throughout final year?
If the StA is a discrete period of time within final year, how long should it last?
Even within a StA, students may not undertake activities that require provisional registration. This is interpreted in a variety of ways by clinical staff and NHS management. ? Is there guidance on how students should gain real-life experience in, for example:
Prescribing drugs and fluids
Injecting drugs into patients
Injecting drugs into bags of fluids for IV infusion
Accessing IT systems in hospitals and practices