Transcript No Slide Title

“Tomorrow’s Doctors”
Implementation Workshop
University of Edinburgh Medical School
Professor Allan Cumming
MANY CHALLENGES
Focus on two
• Outcome-based education and
assessment
• The Student Assistantship
GMC QABME, University of
Edinburgh 2008/9
“Review and simplify the curriculum
structure …….”
“Rationalise the vertical themes running
through the curriculum……”
Outcome-based education and assessment
Curriculum
model
(Edinburgh)
• Spiral
• Core and options
• Integrated
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Systems-based
Discipline-based
Problem-based
Case-based
Task-based
Outcome-based
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Student-centred
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Self-directed
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Multi-professional **
Community-centred ****
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Curriculum outcomes
= preparedness for practice
What to learn - content
How to learn –
educational strategy
teaching and learning tools
Assessment
Educational environment
Student
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
EDINBURGH MBChB OUTCOMES
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.
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
Ability to:
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.
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
“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
OUTCOMES PLUS
equipped for high personal and professional achievement
RECOGNITION OF EXCELLENCE
RESEARCH
MOBILITY
STUDENT CHOICE
HUMANITIES
caring, competent,
confident, ethical and
reflective practitioner
EXTRA-CURRICULAR
12 CURRICULUM OUTCOMES
12 THEMES
SAFE PATIENT CARE
SAFE PATIENT CARE
PRIOR
LEARNING
Examples
Overarching Degree
outcome [1]
Role outcomes
[3]
Curriculum outcomes
[12]
Detailed Curriculum
outcomes [~60]
Course outcomes
[many]
1
2
3
4
5
“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.
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.
BLUEPRINTING
Tracking Assessment of Outcomes
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