2. The changing trends of medical education SACORE 5-9-2011 Livingstone Zambia Parveen Kumar Professor of Medicine and Education

3. Factors influencing how we should train doctors Demographic changes –Population health –Percent GPD spent on health –Legislature –Role of doctor Societal attitudes- patient expectations So where does this leave research?

4. MEDICINE Basic Sciences Pathology Communication Clinical Skills PatternRecognition Research

5. Tomorrow’s Doctors, 1993 factual overloadReduction in factual overload learning (PBL)Increase in learning through curiosity (PBL) clinical skills /communication skillsEmphasis on clinical skills /communication skills Research technologyUnderstanding of Research technology Development of the skills and attitudes that befit a doctor

6. Core Competencies GMC Good Medical Practice Additional skills Teachers Researchers Managers Leaders

7. Population health Complex factors: Age Genetic profile Lifestyle – alcohol, smoking, obesity, exercise Environment – pollution Socio-economic conditions - poverty Effectiveness of health service

8. Changing face of disease and disease management

9. Peptic Ulcers THEN…….. Bed restBed rest AntacidsAntacids Prev- milk dripsPrev- milk drips ………Operate………OperateNOW….. Helicobacter pylori !

10. Myocardial Infarction THEN… Bed rest – 3 weeksBed rest – 3 weeks Mobilisation-3 weeksMobilisation-3 weeks Off work 3-6 monthsOff work 3-6 monthsNOW… ThrombolysisThrombolysis Angioplasty/stentingAngioplasty/stenting MedicationMedication Life style changesLife style changes

11. Educational strategies in medical education SStudent-centred learning Problem-based learning IIntegrated teaching CCommunity-based education EElectives ( core curriculum+) SSystematic introduction to skills and competences Harden et al 1984

12. Teaching Methods Small groups Interactive Integrated with the curriculum Educational resource – real patients – standardised patients – models – video

13. Self-Directed Learning (SDL) 100 traits associated with self direction… curiosity creativity and motivation persistence and responsibility confidence and competence reflectiveness and self awareness (Candy 1991)

14. Experiential learning and clinical skills Apprenticeship is not dead! Mentoring Clinical Supervision On the job training Clinics

15. Summary message from learning theories The learner is an active contributorThe learner is an active contributor The learning environment is importantThe learning environment is important Learning is related to the solution of real life problemsLearning is related to the solution of real life problems Learners are capable of self- regulationLearners are capable of self- regulation The ability to reflect on practice is critical and needs encouragementThe ability to reflect on practice is critical and needs encouragement

16. MB,BS CURRICULUM PLAN Year 1Year 2Year 3Year 4Year 5 A spiral curriculum revisits themes CARDIORESPIRATORY METABOLISM LOCOMOTOR BRAIN & BEHAV. HUMAN DEV. FUN MEDFUN MED FY1 PREPFY1 PREP THE WHOLE PERSON E

17. How do you learn? PBL tutorials Self-directed study Learning Landscape and Clinical Skills lab Lectures E learning

18. The Objective, Structured Clinical Examination (OSCE ) A circuit of stationsA circuit of stations Students perform standardised tasksStudents perform standardised tasks Structured rating formsStructured rating forms FlexibleFlexible Valid, reliable, practicalValid, reliable, practical (Harden and Gleeson 1979)

19. Basic Applied Translational Practice Hypothesis driven NHS Solving problems MRC NIHR new board Includes animals patient & people based

20. Consultation 2005

21. Academic careers (Walport) Academic Careers Subcommittee of the UKCRC and Modernising Medical Careers

22. Why do research? Enquiring mind - rigorous analysis of problems. Unchartered waters Can be basic science or clinical (both) Academic pathways established Improves quality of care to patients International collaboration/friends Highs and lows FUN

23. Research (making discoveries) is a creative activity, not a standard process that can be prescribed, scored and audited like the accounts of a company.

24. In a research and teaching environment we need to cultivate: Flair Inspiration Creativity Achievement

26. CETL learning Available tutorials