Curriculum reform : the more things change, the more they stay the same?

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Getting off the carousel : Exploring the wicked problem of curriculum reform

Acknowledgements The authors wish to thank all participants in this study. Our thanks to the School of Medicine where this study was undertaken for supporting LH’s doctoral research program. Our thanks to Alan Bleakley for his advice and guidance when planning the interview component of this study.Peer reviewedPublisher PD

A Culture of Control?

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'I feel like I sleep here' : how space and place influence medical student experiences

Acknowledgements the authors thank the College of Life Sciences and Medicine of the University of Aberdeen for its support of LH's doctoral research programme.Peer reviewedPostprin

Resilient practical assessment- Looking forward following a sociomaterial case study of a disrupted high stakes clinical assessment held during the COVID-19 pandemic.

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Disembodied, dehumanised but safe and feasible : the social-spatial flow of a pandemic OSCE

Acknowledgements The authors wish to thank all those who took part in the OSCE under study and who contributed their time to be interviewed.Peer reviewedPublisher PD

Scratching beneath the surface : how organisational culture influences curricular reform

Funding information: This work was supported by the Royal College of Surgeons of Edinburgh [Grant number RG-15026]. ACKNOWLEDGEMENTS We would like to thank Graham Haddock, Satheesh Yalamarthi and Mark Vella for their assistance with participant recruitment, and all the surgical trainees and trainers who took part in the study.Peer reviewedPublisher PD

It's making me think outside the box at times : a qualitative study of dynamic capabilities in surgical training.

Acknowledgements The authors would like to thank Graham Haddock, Satheesh Yalamarthi, and Mark Vella for their assistance with participant recruitment. Funding Information: This work was supported by the Royal College of Surgeons of Edinburgh [Grant number RG-15026].Peer reviewedPublisher PD

Scotland's Improving Surgical Training (IST) pilot: a tale of two cultural webs

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Integrating simulation into surgical training: a qualitative case study of a national programme

Abstract Background Applying simulation-based education (SBE) into surgical curricula is challenging and exacerbated by the absence of guidance on implementation processes. Empirical studies evaluating implementation of SBE interventions focus primarily on outcomes. However, understanding the processes involved in organising, planning, and delivering SBE adds knowledge on how best to develop, implement, and sustain surgical SBE. This study used a reform of early years surgical training to explore the implementation of a new SBE programme in Scotland. It aimed to understand the processes that are involved in the relative success (or failure) when implementing surgical SBE interventions. Methods This qualitative case study, underpinned by social constructionism, used publicly available documents and the relevant surgical SBE literature to inform the research focus and contextualise data obtained from semi-structured interviews with core surgical trainees (n = 46), consultant surgeons (n = 25), and key leaders with roles in surgical training governance in Scotland (n = 7). Initial data coding and analysis were inductive. Secondary data analysis was then undertaken using Normalisation Process Theory (NPT). NPTs’ four constructs (coherence, cognitive participation, collective action, reflexive monitoring) provided an explanatory framework for scrutinising how interventions are implemented, embedded, and integrated into practice, i.e. the “normalisation” process. Results Distributed leadership (individual SBE initiatives assigned to faculty but overall programme overseen by a single leader) and the quality improvement practise of iterative refinement were identified as key novel processes promoting successful normalisation of the new SBE programme. Other processes widely described in the literature were also identified: stakeholder collaboration, personal contacts/relational processes, effective communication, faculty development, effective leadership, and tight programme management. The study also identified that learners valued SBE activities in group- or team-based social environments over isolated deliberate practice. Conclusions SBE is most effective when designed as a comprehensive programme aligned to the curriculum. Programmes incorporating both group-based and isolated SBE activities promote deliberate practice. Distributed leadership amongst faculty attracts wide engagement integral to SBE programme implementation, while iterative programme refinement through regular evaluation and action on feedback encourages integration into practice. The knowledge contributed by critically analysing SBE programme implementation processes can support development of much needed guidance in this area