leicester medical school handbook for clinical teachers
TRANSCRIPT
Leicester Medical School Handbook for Clinical Teachers
2015/16
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Contents
Page
1. Welcome Letter………………………………………………………………………………………………………………....4
2. Your Role as a Clinical Teacher……………………………………………………………………………………………5
3. Medical School Contacts…………………………………………………………………………………………………….5
4. LMS Standards for Clinical Teachers……………………………………………………………………………………6
5. Current and New Curriculum at Leicester…………………………………………………………………………..7
6. Current and New Assessment at Leicester………………………………………………………………………….8
7. Tips for Teaching in the Clinical Setting………………………………………………………………………………9
8. Teaching in Groups…………………………………………………………………………………………………………..10
9. Providing Feedback – General Principles…………………………………………………………………………..11
10. Raising Concerns about Student Professionalism……………………………………………………………13
11. Support for Clinical Teachers………………………………………………………………………………………….14
12. Support for Students………………………………………………………………………………………………………15
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1. Welcome Letter
Dear Colleague,
On behalf of Leicester Medical School, I thank you for engaging in the education of our students as they prepare for professional practice. A positive and appropriate teaching process for medical students is of vital importance and can provide an invaluable experience for both the teacher and the student.
This handbook is designed to inform clinicians on the fundamentals of effective teaching that apply to a wide range of situations and settings. It also aims to provide an overview of the Medical School's curriculum and assessment programme. As this is a new initiative we would value any feedback or comments as to what additional information to include.
I encourage you to read through the handbook and use it as a continuing resource during your time as a clinical teacher.
The Medical School and clinical faculty are available to answer any queries you may have about the course or the student's clinical experience, and please feel free to contact the placement coordinator, if needed.
Thank you again for being an important part of our education team.
Kind regards
Dr David Heney Director of Undergraduate Medical Education Leicester Medical School
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2. Your Role as a Clinical Teacher
One of your key tasks as a clinical teacher is to support students in their professional development. This will include helping students to obtain knowledge and clinical skills, and develop appropriate professional attitudes. To do this successfully, you will need to use a range of teaching and facilitation skills and utilise them within a sound knowledge and understanding of the programmes of study in which your students are engaged.
3. Medical School Contacts
Key members of staff at the Medical School are listed Below:
Member of Staff Duties Contact Details Prof NJM London Head of Department and Associate Dean
Dr David Heney Director of Undergraduate Medical Education
Overall responsibility for the MBChB Course
Dr Judith West Deputy Director of Undergraduate Medical Education & Support Lead
Assists the Director of Undergraduate Medical Education and responsible for Student and Clinical Teacher Staff Support
Dr Laura Mongan Deputy Director of Undergraduate Medical Education & Phase 1 Lead
Assists the Director of Undergraduate Medical Education and responsible for Phase 1 of the curriculum
Dr Adrian Stanley Co-Lead for Curriculum and Phase 2 Lead
Responsible for Phase 2 of the curriculum Chair of Clinical Education Evaluation Group
Dr Sophie Parkinson Pastoral Support Lead
Head of Pastoral Support Unit [email protected]
Dr Rachel Westacott Dr John Dormer Assessment Leads
Responsible for MBChB Assessment
[email protected] [email protected]
Ms Kerry Glover Academic Administrator - Phase II [email protected] MrMitesh Vaghela Academic Administrator - Phase I [email protected] Ms Stephanie Maksimovic Assessment Administrator [email protected] Ms Sarah Bulman Assessment Administrator [email protected]
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4. LMS Standards for Clinical Teachers 1. Preparing to Teach
• Has made efforts to find out the expected learning outcomes of the clinical placement • Has reviewed student and staff handbooks where these are available
2. Delivery of Teaching
• Actively supports the delivery of the teaching programme • Encourages curiosity and independent thinking about clinical medicine • Is able to explain key concepts appropriate to student level • Relates the clinical teaching to previous theoretical learning • Provides student feedback where appropriate
3. Teacher Conduct
• Actively engages students in learning • Create a safe and positive environment to encourage effective learning • Treats students professionally and with respect • Demonstrates commitment to teaching by adequate preparation and making time for
students 4. Supporting Activities
• Within the parameters of the role is available to provide students with support and assistance
• Identifies and addresses any concerns regarding students they are responsible for • Encourages feedback on their teaching • Can signpost the student to appropriate support agencies at the University i.e. (Pastoral
Support Unit at the Medical School or the University Services such as Health and Wellbeing, Student Counselling, Student Welfare, AccessAbility or the University Chaplaincy)
5. Training in Clinical Teaching
• All newly appointed clinical teachers should attend a formal induction to their undergraduate teaching role
• All clinical teachers should attend at least a half day relevant refresher course on clinical teaching every three years e.g. clinical teaching skills, giving student feedback, learning styles
6. Acknowledging and Developing Skills
Teaching activity in appraisal should be judged as satisfactory based on:
• Student evaluation of the teaching delivered • Evidence that they have contributed to the teaching from those organising the programme
and evaluation of this contribution • Observation of teaching by someone qualified to observe at least once every five years
(consistent with validation requirements)
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5. Current and New Curriculum at Leicester
New Curriculum
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6. Current and New Assessment at Leicester
Current Assessment Structure
New Assessment Structure
Year 1 Year 2 Year 3 Year 4 Year 5
End of Semester
Assessments Written Paper
ESA 1 & 2 24 SAQs 100 SBAs Practical
Year 1 OSCE with ESA2
End of Semester
Assessments Written Paper
ESA 1 & 2 24 SAQs 100 SBAs
No Practical
Primary Professional Examination
Written Paper
15 SAQs 100 SBAs
Practical PPE OSCE 20 Grades
Intermediate Professional Examination
Written Paper
15 SAQs 100 SBAs
Practical IPE OSCE
20 Grades
Final Professional Examination
Written Paper
15 SAQs 100 SBAs
Practical FPE OSCE 28 Grades
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7. Tips for Teaching in the Clinical Setting
Learning environment
The Student Consultation Sandwich Think of the teaching session as a sandwich, with conversation with the student at the beginning and end and the learning experience in the middle. When you have a student learning with you in your consulting room or on the ward, start with establishing what their learning needs are. Most students will be able to tell you what they need to focus on, based on feedback from previous teaching sessions. Talking with them briefly at the start will help you to agree what the learning objectives are for that session.
Having established the learning needs of your student, give as much opportunity for practise as possible. Our students tell us that they benefit from taking many consultations under supervision. If time is short or you are running late, perhaps ask them to participate in those parts of the consultation they have identified as being the most important to improve in e.g. you take the history but they examine the patient or deliver the management plan. Junior students may need help after just a few minutes of history taking but more senior students need to be given opportunity to run consultations without interruption – after all this is what they will need to do once qualified.
Do you remember your medical student days? Did you ever have the experience of turning up on a ward where no-one expected you, everyone was too busy to help and the planned teaching did not happen? Teaching in the clinical setting starts with developing a good learning environment. The students will need an accurate timetable, the staff need to know that they are expected and the patients should be made aware and give their consent.
All of the other members of staff at Station Road Surgery were very friendly and made me feel like a member of their team
Do not feel you need to teach on every topic that comes up. Encourage students to take ownership of their own learning by keeping notes of topics to read about during private study time. At the end, provide specific feedback, focussing on the areas agreed on at the beginning of the session. Encourage the student to tell you what they have learned from the session and what they plan to do next e.g. further reading or practise. You may also wish to ask the student to give you feedback on how the session has run. Did they feel involved? Was the feedback you gave helpful? How could future sessions be improved? This not only provides you with useful feedback but also models reflective learning to the student.
I had numerous opportunities right from the beginning to take histories and perform examinations and was always given constructive feedback to improve.
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8. Teaching in Groups
Learning involves a series of phases
• Preparing to tackle the course material • Acquiring necessary information • Relating the information to previous knowledge • Transforming it into personally meaningful frameworks • Applying this understanding in new contexts • The most important part of any teaching session is the beginning. Establish the aims and
objectives for the teacher and also the groups’ ideas, concerns and expectations (ICE=the group’s aims). Make sure that you introduce yourself and also that you know the group members names.
For teaching to be student centred the following categories are required:
Orientation for teaching
Select content appropriate for the learners and time allocated Select appropriate teaching material Set the scene-ensure the physical environment is suitable and equipment is functioning Explain what is required
Motivating
Explain the relevance of the subject Make practical application apparent Use personal style effectively Show respect for learners Use encouragement to stimulate deeper thinking Respond appropriately to individual and group needs
Presenting
The teacher should introduce new concepts within a clear structure Summarise at appropriate intervals Enhance discussion by using open questions Clarifying
Explain with examples Provide remedial support
Elaborating
Introduce additional material to enhance understanding
Consolidating
Provide opportunities to develop and test personal understanding
Confirming
Check the groups understanding by asking them to summarise the main teaching points Summarise the main points yourself at the end and any key features Ensure that the groups’ ICE have been addressed
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9. Providing Feedback – General Principles Feedback is a valuable part of education and training programs. It can be used to help learners understand areas of strength and areas for improvement. It can help to identify actions needed to improve performance, and help to maximise a learner’s potential at each stage of their training. Good feedback models and encourages the process of reflection for a learner. This process can help the learner to critically evaluate their own and other’s performance, and help them to identify and address their own learning needs. Creating the right atmosphere
• Check the person is OK before you start • Be open, accepting genuine • Remind the learner that this is about learning and development • Clarify with the learner the areas to be covered • Be primarily positive especially in the early stages • Present the feedback as a means rather than an end • Signposting for more difficult feedback • Feedback should be given privately wherever possible
Key features of effective feedback
• Suited to purpose – relevant to the learner and their learning goals. • Personal – geared to the individual learner • Immediate/timely – should take place soon after the observed performance • Descriptive and non-judgmental – based on description not interpretation • Directed towards behaviour/performance not personality • Specific rather than general • Generalisable. Able to be transferred to other situations • Problem solving/solution orientated – provides positive alternatives • Concise. Don’t overload – identify 2 or 3 key messages
Purpose / Outcomes
• Discuss and agree with the learner the purpose of the feedback and areas the feedback will cover. Consider doing this before the learning event.
• Keep the feedback specific to the agreed purpose, and relevant to the learners needs.
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Methods / Tools
Pendleton’s Rules • Learner performs activity & clarifying questions can be asked • Learner says what they thought went well • Tutor says what they thought went well • Learner says what didn’t go so well & could be improved upon • Tutor says what didn’t go so well and suggests ways it could be
improved • Action plan for improvement agreed
ALOBA Agenda Led, Outcome Based Analysis
SET GO
• what I Saw • what Else did you see • what did you Think • what Goal would we like to achieve • any Offers on how we should get there
PI
• Point • Illustrate
PEE
• Point • Explain • Example
Descriptive Non-judgemental
Receiving Feedback
• Listen to the feedback rather than immediately arguing with it or rejecting it. • Accept it positively (for consideration) rather than dismissively (for self-protection) • Assume it is constructive until proven otherwise. Then consider and use those elements that
are constructive. • Be clear about what is being said. Ask for clarification and examples if statements are
unclear or unsupported • Triangulate. Check it out with others to see if the feedback is consistent. • Ask for the feedback that you want but don’t get • Consider the purpose of the feedback – what do you want it to achieve – affirmation that
what you are doing is OK or opportunity to develop / change? • Ask for suggestions of ways you might modify or change your behaviour
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10. Raising Concerns about Student Professionalism Teaching of Professionalism in Leicester Medical School Medical professionalism underpins public trust in doctors. While medical students do model their behaviour from respected role models, the need for formal teaching of professionalism and assessment of competencies, supported by personal and group reflection is now recognised and endorsed by Leicester Medical School. The professionalism curriculum in Leicester covers the four domains of the Good Medical Practice Framework. Knowledge, skills and performance Safety and quality Communication, partnership and teamwork Maintaining trust
The professionalism curriculum is led by Dr Leyshon Griffiths [[email protected]]. Dr Griffiths and Dr Judith West [[email protected]] are members of the UK Council for Teachers of Professionalism. The core underlying theme is patient safety. Personal professionalism development features throughout the course, interlinks with Ethics and Inter-Professional learning and is responsive to events such as the Francis Report. Student Professionalism referrals Students receive guidance on raising concerns about the behaviour of fellow students, members of the teaching staff, qualified doctors and other health professionals if this behaviour puts patients or themselves at risk published on the School of Medicine website under Professionalism – Raising Concerns http://www2.le.ac.uk/departments/medicine/regulations. Students are encouraged to seek advice concerning professionalism issues by contacting the Medical School Student Liaison officer or can self-present to the Professionalism Support team using the Professionalism Support website and resources on Blackboard. Concerns about a student behaving unprofessionally If a Clinical Teacher has a concern about unprofessional behaviour of a medical student, the Medical School would encourage the teacher, with support from the block lead, to discuss the concern with the student and consider a referral to the Professional Support Unit. Students may also self-refer. The primary role of the Professionalism Support team is supportive and not disciplinary; to work with students to improve their professionalism. The Professionalism Support team is led by Dr Judith West [[email protected]] and supported by 4 senior clinical faculty members at Leicester Medical School. The team can make use of all of the various support mechanisms available in the University and Medical School including pastoral support. Students who do not recognise that their behaviour is unprofessional or who do not engage with support and/or remediation can be referred to the Health and Conduct Committee, through to the Fitness to Practise Committee by the Professionalism Support team. The Code of Practice for the Professionalism Support Unit and referral form is on the School of Medicine website under Professionalism and Forms respectively http://www2.le.ac.uk/departments/medicine/regulations.
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11. Support for Clinical Teachers General Advice & Support in Trusts and Academy Teaching Practices Your Undergraduate Block lead or Academy GP Educator will be happy to provide advice concerning Block organisation, curriculum content and assessment. He/she can support you in managing a struggling student. All Leicester Medical School support services including pastoral, academic and professionalism support are available to students by self-referral or by members of Medical School teaching staff using either the Academic Support request form or Professionalism Support request form. Your NHS Appraisal Clinical Teachers are expected to undergo an annual NHS appraisal during which their educational roles are reviewed, developed and supported. The Director of Medical Education at your Trust, a nominated Deputy or your appraiser can provide further advice and guidance. NHS Clinical Teachers may wish to achieve recognition of their teaching through the recognised professional designations of MAcadMEd (Member of the Academy of Medical Educators or FAcadMEd (Fellow of the Academy of Medical Educators) signifying that they have successfully met appropriate professional standards for medical education practice and are committed to continuing professional development http://www.medicaleducators.org/index.cfm/membership/joining/ Local Teaching Development courses Your Trust or local GP Academy will offer “Teach the Teacher” sessions for new and established Clinical Teachers, medical trainees, nursing and PAM colleagues who teach medical students. Please contact your undergraduate coordinator for further information. New Clinical Teacher orientation and update workshops will be offered annually in each Trust comprising Leicester Medical School processes and curriculum structure, undergraduate teaching skill development, and priority areas identified through training needs analysis eg. Managing struggling students and giving feedback Recognition of Teaching The Director of Medical Education at your Trust or a nominated Deputy can provide advice and support regarding recognition of your Clinical Teacher role in job planning. Leicester Medical School recognises excellence in clinical teaching through Star Tutor and Outstanding Clinical Teacher awards based on student feedback and nominations. Medical School Resources 1. Leicester Medical School Clinical Teacher Web-pages (in development) 2. Leicester Medical School Clinical Teacher Guide (January 2016) 3. Lecture and seminar programme supported by the Leicester Medical School Research &
Scholarship Unit showcases new developments and research in teaching [Sharon Hague e: [email protected]]
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12. Support for Students In Phase 1 pastoral support of students is provided through a Personal Tutor System. Each student is allocated to a named member of staff whom they can contact for support and advice.
In Phase 2 students spend the majority of their time on clinical placements, often out of Leicester. When they are on clinical placement, they are encouraged to talk to their consultant, block lead, or programme administrator, if they have any problems.
If you encounter a student experiencing difficulties, whether personal or educational, if appropriate, please offer advice about what further action they may need to take. This may involve suggesting that they see their personal tutor, a member of the Pastoral Support Unit, Academic Support Unit, or a Medical School staff member such as Dr Adrian Stanley (Phase 2 Lead), Dr David Heney (Director of Undergraduate Medical Education, or Kerry Glover (Academic Administrator – Phase II). Contact details can be found at the front of the handbook.
The Medical School is in the early stages of developing a new Clinical Mentoring Programme, which aims to strengthen the support currently available to Phase 2 students. Pastoral Support Unit The Medical School wants students at Leicester to have easy access to pastoral support, to enable them to deal with issues that are affecting their life and studies. In order to provide this, the Medical School has a dedicated Pastoral Support Unit.
The Unit aims to:-
• provide pastoral support to students throughout their time at Leicester • signpost students to appropriate sources of help for specific problems that they may
encounter • maintain confidentiality whenever possible
Core Members of the Unit:
• Dr Sophie Parkinson is head of the unit. She is a GP and has been supporting medical students since 2002. She is a graduate of Leicester Medical School and also works in the Emergency Department at UHL
• Mrs Christina Oppenheimer is a consultant Obstetrician who has been delivering student support for over 10 years, focussing mainly on Phase 2 students. She has an additional interest in students with specific learning difficulties (e.g. dyslexia) and is the Accessibility tutor for Phase 2.
• Dr Erik Van Diepen is a consultant Psychiatrist and one of the leads for the Mental Health Block in Phase 2. He spends half a day a month in student support acting mainly as a resource for the other members of the team.
• Mrs Sheila Preston provides administrative support. She will make appointments, direct students appropriately and be the first point of contact for most students. She has been involved with student support for many years.