ANATOMY AND PROFESSIONALISM IN AN UNDERGRADUATE MEDICAL CURRICULUM

Name: Gabrielle Maria Finn Title of thesis: Anatomy and professionalism in an undergraduate medical curriculum Higher degree for which submitted: Doctor of Philosophy (PhD) Year of submission: 2010 This thesis describes two themes within the undergraduate medical curriculum; innovations in anatomy teaching, and the assessment of professionalism. Methodologies from both the quantitative and qualitative paradigms were utilised. The main findings were: 1) The Virtual Human Dissector™ (VHD) was shown to be equally as effective as cadaveric prosections as a tool for learning cross-sectional anatomy. 2) Body painting was demonstrated as being a highly motivating and engaging exercise for students. Students reported that the bold colours and kinaesthetic nature of body painting promotes retention of knowledge and informed their approach to future patients when painting was coupled with simultaneous peer-physical examination (PPE). 3) Contextual learning and simulation were shown to directly impact upon retention of knowledge through the use of clothing in anatomy education. This highlighted how when implementing simulation small and seemingly trivial details, such as clothing, are important. 4) The Conscientiousness Index (CI) has been demonstrated as an objective and scalar measure of one element of professionalism, conscientiousness. The CI identified students at the positive and negative end of the behavioural spectrum, and this correlated with peer and staff judgements on the professionalism exhibited by students at these extremes of behaviour. 5) Students were able to accurately assess the conscientiousness of their peers, however were unable to self-assess conscientiousness. The reliability of such peer assessments was improved when peers assessed only those in their tutor groups, with whom they had the majority of academic contact, compared to when assessing the entire cohort. This demonstrated the importance of assessor familiarity in assessments. 6) Critical incident reporting, of extremes in professionalism, was shown to promote reflection in students. Critical incident reports, as with the Conscientiousness Index, offers faculty a tool by which outlying students can be identified. 7) Students were unclear about the constituent elements of professionalism and the contexts in which professionalism was relevant. Three contexts were identified; the clinical, the academic (University), and the virtual (online) context. The impact of professionalism assessments and the scrutiny on students has led students to struggle with identity negotiation. This was with respect to their personal and professional identities and the expectations of different stake holders, such as faculty, the media and prospective patients

Responsibility with a Safety Net:Exploring the Medical Student to Junior Doctor Transition During COVID-19

INTRODUCTION: The Foundation Interim Year-one (FiY1) Programme was part of a UK strategy to increase the medical workforce in response to the COVID-19 pandemic. However, the strategy was introduced urgently without evidence. We sought to explore the transition experience of medical student to FiY1 to foundation doctor, with a view to inform future undergraduate education. METHODS: In this hermeneutic phenomenology study, semi-structured individual interviews were completed with nine foundation doctors who had experience of an FiY1 placement. A template analysis approach was taken, and themes reported. RESULTS: Participants reported that FiY1 tended to offer a positive experience of transition as a stepping stone to becoming a foundation doctor. Having a degree of clinical responsibility including the right to prescribe medication with supervision was highly valued, as was feeling a core member of the healthcare team. Participants perceived that FiY1 made them more prepared for the foundation transition, and more resilient to the challenges they faced during their first foundation job. DISCUSSION: The FiY1 fostered many opportunities for junior doctors to bridge the transition to foundation doctor. Aspects of the FiY1 programme, such as early licencing and increased team membership, should be considered for final-year students in the future

Learning clinical anatomy

SUMMARY This article places the student at the center of their own learning experience. It draws together research to enable us to put forward a theoretical framework of best practice for student learning of clinical anatomy in a modern medical curricula. Anatomical knowledge involves both propositional knowledge and non-technical knowledge. For knowledge to be gained it must be contextualized and the content matter engaged with in a way that creates meaning for the students. From a neuroanatomical basis, this involves memory processing at a synaptic level within the circuitry of the hippocampus. It is important to recognize learners as individuals with their own personality traits and spatial ability. Both of which have been shown to influence the learning of anatomy. Students can vary the way they go about learning, they may utilize a surface, deep and/or strategic learning approach. It is quite possible that each student’s approach will differ depending on their personal experience. Approach will also vary at different points of their learning journey, because in higher education, students are free to engage in a wide range of learning activities. At some point in the future students may need to relearn or reconfigured their knowledge because the initial route to understanding is superseded by either a greater need or a more sophisticated line of reasoning, for example, knowledge can be challenged via more complex clinical scenarios. Knowledge consolidation is the next stage for students/trainees and this involves embedding the restructured learning and using it in practice. This stage will vary in time depending on the content it may occur during education or many years later. Anatomy learning is a personalized journey for the individuals. However, it is the role of the educators to aid learners in the development of a education framework that makes their learning effective, meaningful and stimulating

Pedagogic research in anatomical sciences: a best practice guide

This article explores the background of anatomical educational research. It draws together research and our own personal experiences to propose a best practice piece for novice researchers in anatomical education. The article explores the domains of both qualitative, and quantitative methods as applied to anatomy pedagogy. It takes into consideration validity and what might be undertaken to increase validity and reliability. The article explores how both qualitative and quantitative data can be analysed and recommends top tips including: Identify your research questions and theoretical framework. Map out how you are going to answer your research questions. Consider collaborating with like-minded researchers in other countries: multi-centre studies have a better chance of getting published and carefully consider your target journal and suggestions for peer review, taking into consideration individuals expertise and potential conflicts of interests. This article is designed to be a guide to anyone starting anatomical research or experienced researchers looking for new methods and ideas

Care of the dying : a qualitative exploration of foundation year doctors’ experiences

Context Foundation Year doctors (FYs), who are newly qualified, are expected to provide care for dying patients. Experiences at this early mandatory stage of training may form the foundation for future encounters, but little is documented about what these experiences involve. The aim of this research was to explore the experiences of FYs in caring for the dying, using the recently published ‘Priorities for Care of the Dying Person’1 as a conceptual framework, to identify areas for improvement in education and clinical practice. Methods Semi-structured group and individual interviews were conducted to explore the experiences of FYs and how these relate to the five aspects of Priorities for Care of the Dying Person: ‘recognise’, ‘communicate’, ‘involve’, ‘support’ and ‘plan and do’. All FYs in the North Yorkshire and East Coast Foundation School (n=335) were invited to participate and 47 FYs were recruited from five sites through convenience sampling and snowballing. Recordings were transcribed verbatim and a framework analysis approach was used with the published Priorities for Care of the Dying Person guidelines as a conceptual framework. Results Five main themes and 13 subthemes emerged from the data. The five main themes, which mapped to the conceptual framework, were: recognition that the patient is dying; communication with the patient, family and other staff; involvement of the patient and family in their care; support for the dying person and their family; and planning and carrying out good care of the dying. Examples of when things are done poorly or done well were shared, giving context to experience.ConclusionsAreas for improvement were identified around all five main themes. These will be useful for informing those involved in undergraduate and foundation training on how to improve the experiences of Foundation Year doctors and thereby improve patient care

A narrative literature review considering the development and implementation of longitudinal integrated clerkships, including a practical guide for application.

Hailed by supporters as the answer to many challenges facing medical schools and the wider healthcare system, Longitudinal Integrated Clerkships (LICs) offer a practical and sustainable alternative to more traditional block rotational models. Given this, their popularity as a curricular measure is increasing, although such clerkships remain relatively novel within the United Kingdom (UK). This narrative literature review of international work provides a comprehensive introduction to developing and implementing LICs within medical education. This review generates a practical guide for medical educators with a focus upon the development and implementation of LICs within the United Kingdom (UK), on which there is little work. Using illustrated examples and with reference to contemporary literature, it outlines the rationale for considering an LIC within a curriculum, the different types of LIC, barriers and enabling factors to LIC implementation and considers the contemporary application of LIC models within the UK. The practical guide details key questions educators must consider when developing and implementing an LIC, particularly within the landscape of UK medical education

The Anatomical Society core embryology syllabus for undergraduate medicine

A modified Delphi methodology was used to develop a consensus regarding a series of learning outcome statements to act as the foundation of an undergraduate medical core embryology syllabus. A Delphi panel was formed by recruiting stakeholders with experience in leading undergraduate teaching of medical students. The panel (n = 18), including anatomists, embryologists and practising clinicians, were nominated by members of Council and/or the Education Committee of the Anatomical Society. Following development of an a priori set of learning outcome statements (n = 62) by the authors, panel members were asked in the first of a two‐stage process to ‘accept’, ‘reject’ or ‘modify’ each learning outcome, to propose additional outcomes if desired. In the second stage, the panel was asked to either accept or reject 16 statements which had either been modified, or had failed to reach consensus, during the first Delphi round. Overall, 61 of 62 learning outcome statements, each linked to examples of clinical conditions to provide context, achieved an 80% level of agreement following the modified Delphi process and were therefore deemed accepted for inclusion within the syllabus. The proposed syllabus allows for flexibility within individual curricula, while still prioritising and focusing on the core level of knowledge of embryological processes by presenting the essential elements to all newly qualified doctors, regardless of their subsequent chosen specialty