Trend spotting: fashions in medical education

Quality and constructed knowledge: Truth, paradigms, and the state of the science

CONTEXT AND TRUTH

Education is a social science. Social science knowledge is related to its context of origin. The concept of global 'truth' in education is therefore of limited use when truth is tempered by context. The wider applicability of our knowledge can only be judged if we look at the context in which that knowledge was produced and the assumptions that underpin it. This calls into question the idea that educational research is a quest for global 'truth', although in relation to programme evaluation, truth tied to context is an aim. An analysis is presented of the effects of social construction on research and evaluation processes, on the selection of paradigms, reporting and interpreting findings, and on the ethics of all this.

QUALITY AND IMPROVEMENT

Quality improvement is based on information selected, constructed and interpreted by those who gather, analyse or use it. The strength, and not the weakness, of our knowledge is that it is socially constructed, contextual and of its time. Increasingly looking for our own truth about educational quality, and not importing the truth of others, is crucial to the state of the science. In terms of quality development, using others' findings must be based on informed local judgement. In social science, those judgements are linked to social context and their associated ideologies.

IMPLICATIONS FOR FUTURE WORK

The hallmark of social science is not a narrowing of focus and the search for one truth, but is a broadening of concepts, theories, paradigms, reported experience and method, and an intention for each to tell their own truth well. This will lead to a wealth of diverse views and analysed experience. The science of medical education must seek many truths.

Preparing Neurology Residents and Advanced Practice Providers for the COVID-19 ICU-A Neurocritical Care Led Intervention

Background and Purpose

With the surge of critically ill COVID-19 patients, neurology and neurosurgery residents and advanced practice providers (APPs) were deployed to intensive care units (ICU). These providers lacked relevant critical care training. We investigated whether a focused video-based learning curriculum could effectively teach high priority intensive care topics in this unprecedented setting to these neurology providers.

Methods

Neurocritical care clinicians led a multidisciplinary team in developing a 2.5-hour lecture series covering the critical care management of COVID-19 patients. We examined whether provider confidence, stress, and knowledge base improved after viewing the lectures.

Results

A total of 88 residents and APPs participated across 2 academic institutions. 64 participants (73%) had not spent time as an ICU provider. After viewing the lecture series, the proportion of providers who felt moderately, quite, or extremely confident increased from 11% to 72% (60% difference, 95% CI 49-72%) and the proportion of providers who felt nervous/stressed, very nervous/stressed, or extremely nervous/stressed decreased from 78% to 48% (38% difference, 95% CI 26-49%). Scores on knowledge base questions increased an average of 2.5 out of 12 points (SD 2.1; p < 0.001).

Conclusion

A targeted, asynchronous curriculum on critical care COVID-19 management led to significantly increased confidence, decreased stress, and improved knowledge among resident trainees and APPs. This curriculum could serve as an effective didactic resource for neurology providers preparing for the COVID-19 ICU.

Threshold Concepts and Teaching Psychiatry: Key to the Kingdom or Emperor's New Clothes?

Psychiatry, more than most medical specialties, must engage with undergraduate medical education to prevent the further marginalisation of mental health within medicine. There is an urgency to the need for psychiatrists and educationalists to communicate, and for psychiatrists to be aware of developments in educational theory. The idea of ‘threshold concepts’ is currently widely discussed by educationalists. Threshold concepts are described as areas of knowledge without which the learner cannot progress, and which, when grasped, lead to a transformation in the learner's perspective and understanding. Threshold concepts have been criticised on conceptual grounds, and there is a lack of clarity as to how to identify them empirically. While they may represent a fruitful approach to the task of engaging medical students in psychiatry teaching, it is suggested that further development of the idea is required before it could be usefully applied. However empirical studies in other disciplines suggest that there may be associated benefits to the teaching of the discipline from trying to identify threshold knowledge.

Evaluating interprofessional education: The tautological need for interdisciplinary approaches

This paper explores some issues associated with evaluating interprofessional education (IPE) programs. It proposes options that harness the synergy made possible through interdisciplinary and multi-method approaches. Both qualitative and quantitative research approaches are suggested. It is argued that traditional, control group experimental designs may not be adequate, appropriate or reasonable as the sole means of evaluating interprofessional education. The example of the four-year Rural IPE (RIPE) project, from southeastern Australia, is provided to suggest ways to identify indicators and implement features of successful IPE programs. It offers an interdisciplinary approach to measuring the effectiveness of IP programs. A particular focus is the use of self-assessment to both monitor and promote structured reflective learning and practice. Sample triangulatory data are presented from a range of evaluation methods collected from the RIPE project. The results suggest evidence of some significant educational gains as a result of this intervention. The data, the methods and the analyses may be useful for others interested in implementing or strengthening interprofessional education. The paper suggests a judicious, customized and balanced blend of methods and methodologies may offer more useful ways forward than relying on single method controlled studies which are, in any case, rarely feasible.

Australian evidence for interprofessional education contributing to effective teamwork preparation and interest in rural practice

A pilot interprofessional education (IPE) placement for undergraduate health care professional students was undertaken in rural Victoria, Australia from 2001 to 2003. Medical, nursing, physiotherapy and pharmacy students were involved, and the project is ongoing. This paper briefly outlines the educational model, then focuses on the evaluation methods and results obtained from student evaluations. The placement experience improved self-reported teamwork skills and knowledge, and supported participating students' belief in the value of interprofessional practice. Placements strengthened nursing and allied health students' intention to work in rural health settings after graduation. The rural interprofessional educational experience improved interprofessional abilities in a group of students who have the potential to influence change towards collaborative practices in their future workplaces. The results obtained provide sufficiently strong evidence to justify the continuation and expansion of this educational model in the Australian setting. Pedagogical and evaluation modifications are discussed that may benefit future IPE programs.

SOMOSAT: Utility of a web-based self-assessment tool in undergraduate medical education

BACKGROUND

Relatively few studies have rigorously assessed the effectiveness of computer-based self-assessment in medical education.

AIM

To assess whether an online self-assessment tool can be an effective adjunct to a traditional curriculum for second-year medical students.

METHODS

The NYU School of Medicine Online Self-Assessment Tool (SOMOSAT) consists of >450 multiple-choice questions spanning disciplines of internal medicine, administered as separate modules focused on individual organ systems. Questions are coded on multiple dimensions, permitting second-year medical students to receive low-stakes, highly specific feedback regarding their knowledge and performance. Students can also review their answers to guide future study. We employed data collected during SOMOSAT operation to assess its utility and effectiveness.

RESULTS

Overall, SOMOSAT accurately predicted student performance on future exams. SOMOSAT participants generally performed better than non-participants on subsequent graded course examinations (p < 0.05). Students using SOMOSAT subsequently experienced greater improvement in areas in which they initially performed poorly, compared with those in which they initially performed well. Students reported that SOMOSAT was most helpful in filling knowledge gaps, and providing opportunities to practice exam-style questions.

CONCLUSION

The ability of SOMOSAT to enhance learning and exam performance suggests that web-based self-assessment tools can be effective adjuncts to traditional educational methods.

Problem-based learning: where are we now?

The definition of problem-based learning (PBL) as an educational concept is as elusive in 2008 as it has been since the concept was first expressed over forty years ago. A definitive guide to the practice of PBL is equally elusive. Like all worthwhile educational ideas, PBL has proved attractive to those teachers who seek improvements for their courses. Its appeal has transcended the traditional boundaries in formal education so that there are examples of PBL from primary to tertiary education, and across many disciplines within these. Dissemination, however, has wrought confusion in understanding and practice, and consequent difficulties for researchers in evaluating its efficacy, and lack of clear advice for those who would like to adopt PBL. Rather than attempting to be definitive, this Guide explores the various interpretations and practices that claim the label PBL, and critiques these against the original concept and practice. The primary aim is to provide insight into the causes of the confusion about PBL in 2008. The second aim is to point a feasible way forward so that, where appropriate, the potential of PBL as a whole-of-curriculum concept may be realised; and, where it is not possible to implement the whole concept, worthwhile educational principles that have been associated more or less with PBL may be recognised as such and given value in their own right.

Towards evidence-based medical education in Saudi medical schools

(EBME) [corrected] is an attitude of mind that entails the creation of a culture in which teachers think critically about what they are doing, look at the best evidence available and on this basis, make decisions about their teaching practice, and subsequently, undertake the necessary revision and change. More medical schools have opened in Saudi Arabia in the last few years than have existed over the last three decades. Currently, the education of health professionals is based on assumption and traditions and rarely on research findings. Medical teaching has evolved from being opinion-based to evidence-based and the art of teaching is rapidly becoming the 'science' of teaching. The need for evidence in our teaching and medical education practices is as important as it is in assessing a new therapy. This approach to education is not only associated with better results in terms of better learning, from the side of the students (the consumers), but also has a wider impact on patient care and the community. Moreover, in this age of accountability, litigations and quality assurance, the need for BEME becomes greater. Some suggestions to implement BEME in Saudi Arabia have been put forward and these are the training of medical education professionals in the use the existing information systems, and disseminating information through the creation of a BEME journal (secondary publication) that publishes a critically appraised summary of medical education articles that are both valid and of immediate clinical use.

Validating the Readiness for Interprofessional Learning Scale (RIPLS) in the postgraduate context: are health care professionals ready for IPL?

AIMS

This paper describes the process of validating the Readiness for Interprofessional Learning Scale (RIPLS) for use with postgraduate health care professionals.

CONTEXT

The RIPLS questionnaire has proved useful in the undergraduate context, enabling tutors to assess the readiness of students to engage in interprofessional learning (IPL). With the drive in the National Health Service (NHS) to deliver health care in interprofessional teams, it seems logical to ask whether postgraduate education should, or could, be delivered successfully in interprofessional contexts. As a preliminary to undertaking an extended IPL project, the researchers tested the validity of the RIPLS tool in the postgraduate health care context.

METHOD

A modified version of the RIPLS questionnaire was administered to all general practitioners, nurses, pharmacists and allied health professionals in the Dundee Local Health Care Cooperative (LHCC) (n = 799). A total of 546 staff responded (68%).

RESULTS

Three factors, comprising 23 statements, emerged from the statistical analysis of the survey data, namely, teamwork and collaboration, sense of professional identity and patient-centredness. The internal consistency measure was 0.76. Analysis of variance suggested some key differences between the different professions in respect of the factors.

CONCLUSIONS

The RIPLS questionnaire was validated for use in the postgraduate context, thus providing researchers with a tool for assessing health professionals' attitudes towards interprofessional learning at practice level, community health partnership level or at a national level of education and training. Significant differences between professional groups should be taken into account in designing any interprofessional learning programme.

Comparison of directed and self-directed learning in evidence-based medicine: a randomised controlled trial

OBJECTIVES

To compare 2 educational programmes for teaching evidence-based medicine (EBM).

DESIGN

Prospective randomised controlled trial accompanied by a qualitative evaluation.

SETTING

University of Oslo, Norway, 2002-03.

PARTICIPANTS

A total of 175 students entered the study. All tenth semester medical students from 3 semesters were eligible for inclusion if they completed baseline assessment and consent forms and either attended teaching on the first day of the semester or gave reasons for their absence on the first day in advance. Interventions One intervention was based on computer-assisted, self-directed learning (self-directed intervention), whilst the other was organised as workshops based on social learning theory (directed intervention). Both educational interventions consisted of 5 half-day sessions.

MAIN OUTCOME MEASURES

The primary outcomes were knowledge about EBM and skills in critical appraisal. A secondary outcome measured attitudes to EBM. Outcomes were compared on an intention-to-treat basis using a stratified Wilcoxon rank-sum test.

RESULTS

There were no differences in outcomes for the 2 study groups in terms of EBM knowledge (mean deviation 0.0 [95% confidence interval - 1.0, 1.0], P = 0.8), critical appraisal skills (MD 0.1 [95% CI - 0.9, 1.1], P = 0.5), or attitudes to EBM (MD - 0.3 [95% CI - 1.4, 0.8], P = 0.5). Follow-up rates were 96%, 97% and 63%, respectively.

CONCLUSIONS

This trial and its accompanying qualitative evaluation suggest that self-directed, computer-assisted learning may be an alternative format for teaching EBM. However, further research is needed to confirm this and investigate alternative educational models.

Problem‐based learning: a dissemination success story?

The demand to implement clinical and educational strategies based on evidence has increased in the past two decades. Over a similar time frame, the problem-based learning (PBL) approach has been widely adopted by undergraduate medical schools, in spite of empirical reviews suggesting that its effectiveness may be limited. Students claim that PBL provides a more satisfying learning experience than traditional methods. While such an outcome is desirable, it is substantively less than the original promise of the approach. We hypothesise that the widespread adoption of PBL may be more a consequence of the approach meeting criteria for successful dissemination than of demonstrable positive educational outcomes. We suggest that greater effort should be taken to articulate and measure important undergraduate educational outcomes. Alternatives to the PBL approach should be actively considered.

The teaching of surgery in the undergraduate curriculum. Part II--Importance and recommendations for change

In the past decade, the teaching of surgery in the undergraduate curriculum has undergone considerable changes in quantity, mode and method of delivery. This is a result of the radical reforms of higher education, the health service and the undergraduate medical curriculum. The changes are complex and require us to ask the questions: how important is the teaching of surgery in the modern medical undergraduate curriculum and is there a need for change? We aim to tackle these questions and propose practical action which medical schools can take to ensure that they deliver effective surgical teaching within the modern medical curriculum and health service.

The case for educating health care students in professionalism as the core content of interprofessional education

BACKGROUND

Professional teams are becoming more central to health care as evidence emerges that effective teamwork enhances the quality of patient care. Currently, health care professionals are poorly prepared by their education for their roles on the team. In parallel, there are increasing demands from consumers for health care professionals to serve the interests of society and patients through engaging in effective professional partnerships. Professionalism for health care providers is now being defined as a commitment to standards of excellence in the practice of the profession that are designed primarily to serve the interests of the patient and to be responsive to the health needs of society. Yet, there are multiple barriers impeding the development of professionalism beyond a uni-professional frame of reference.

METHOD

Incorporating teamwork and professionalism into health care professional curricula at pre-registration level is proving to be challenging. These 2 areas of learning are brought together in this paper through a discussion of the role of interprofessional education in preparing all health care professional students for the workforce.

CONCLUSION

Interprofessionalism is presented as a pre-registration curriculum framework that includes values shared by all health care professionals, which should be learned in order to more adequately prepare students for working in health care teams. It will be argued that interprofessional education provides appropriate methods by which to learn interprofessionalism, and that this will ultimately contribute to overcoming uni-professional exclusivity.

Towards evidence-based practice in medical training: making evaluations more meaningful

CONTEXT

The evaluation of training is problematic and the evidence base inconclusive. This situation may arise for 2 main reasons: training is not understood as a complex intervention and, related to this, the evaluation methods applied are often overly simplistic.

METHOD

This paper makes the case for construing training, especially in the field of specialist medical education, as a complex intervention. It also selectively reviews the available literature in order to match evaluative techniques with the demonstrated complexity.

CONCLUSIONS

Construing training as a complex intervention can provide a framework for selecting the most appropriate methodology to evaluate a given training intervention and to appraise the evidence base for training fairly, choosing from among both quantitative and qualitative approaches and applying measurement at multiple levels of training impact.

Learning for real life: patient-focused interprofessional workshops offer added value

OBJECTIVES

This paper reports relevant findings of a pilot interprofessional education (IPE) project in the Schools of Medicine and Healthcare Studies at the University of Leeds. The purpose of the paper is to make a contribution towards answering 2 questions of fundamental importance to the development of IPE. Is there a demonstrable value to learning together? What types of IPE, under what circumstances, produce what type of outcomes?

DESIGN

Pre-registration house officers (PRHOs), student nurses and pre-registration pharmacists attended a series of 3 workshops intended to develop participants' understanding about each other's professional roles, to enhance teamworking and to develop communication skills. Evaluation covered the process of development of the workshops, the delivery of the workshops and their effects on both facilitators and participants.

RESULTS

The course was well received by the participants. The learning reported by the participants reflected 2 project objectives. Participants emphasised communication skills--both with other professionals and patients--and the development of increased awareness of others' roles. These 2 aspects were interlinked.

CONCLUSIONS

The project aims and 2 of the learning outcomes were achieved. There was a demonstrable value to learning together, particularly with regard to interprofessional communications. This project was effective and can make a contribution towards answering the question 'What types of IPE, under what circumstances, produce what type of outcomes?'

Infusing the Interdisciplinary into Medical/ Health Sciences Education: Vitamins or Vaccines?

Academic medical institutions have responded to recent changes and challenges confronting the health care system with various recommendations for curricular reform; many grouped under the rubric of interdisciplinary training. The ultimate goal is to create physicians, with mastery over specialized knowledge, who can practice cost-effective, humanized medicine. This article elaborates a conceptual classification system that categorizes curricular reform recommendations into one of two approaches ? Vitamins or Vaccines ? that highlights differences in the processes of curricular reform programs. Programs seeking the same goal may create different types of practitioners depending on the approach dominating the professional training and socialization process. The Vitamins approach is reactive, supplemental, and incremental, often imparting instruction instead of education. The Vaccines approach is proactive, addresses fundamental factors, and seeks long-term solutions from a preventive perspective. As educators, our choice of approach, Vitamins or Vaccines, for curricular reform will determine how academia prepares physicians for the future.

Teaching medical students exposure therapy for phobia/panic - randomized, controlled comparison of face-to-face tutorial in small groups vs. solo computer instruction

OBJECTIVE

To compare the teaching value of one session of computer-guided solo instruction in exposure therapy for phobias with that of one face-to-face small-group tutorial.

DESIGN

Non-blind, randomized, controlled study.

SETTING

King's College Hospital Medical School, London.

PARTICIPANTS

Thirty-seven third-year medical students and 11 behaviour therapists.

MAIN OUTCOME MEASURES

Seventy-five true/false multiple choice questions relating to (b) below answered at pre- and post-teaching by students and just once by behaviour therapists to obtain 'expert' scores; pre- and post-teaching ratings of interest in behaviour therapy and post-teaching ratings of educational and enjoyment value. EDUCATIONAL INTERVENTIONS: (a) All students had a 20-minute group lecture on basic concepts and historical aspects just before randomization to: (b) 90 min of either solo computer or group face-to-face tutorial teaching. Computer instruction used a short version of 'FearFighter'- a self-help computer system for people suffering from phobias.

RESULTS

Solo computer instruction taught exposure therapy principles effectively but improved multiple choice question scores marginally less than did small-group tutorial teaching. Tutorial teaching required 5 times more teacher time but led to knowledge scores that did not differ significantly from those of behaviour therapists. Students clearly rated face-to-face small-group tutorial teaching as more enjoyable.

CONCLUSION

The knowledge gain from a solo computer session resembled that from a small-group face-to-face tutorial, and required far less teacher time, but was less enjoyable. Enjoyment might rise if the computer session was group-oriented and aimed at students rather than patients. In general computer teaching might be best used to complement rather than replace conventional teaching.

Working and learning together: good quality care depends on it, but how can we achieve it?

Educating healthcare professionals is a key issue in the provision of quality healthcare services, and interprofessional education (IPE) has been proposed as a means of meeting this challenge. Evidence that collaborative working can be essential for good clinical outcomes underpins the real need to find out how best to develop a work force that can work together effectively. We identify barriers to mounting successful IPE programmes, report on recent educational initiatives that have aimed to develop collaborative working, and discuss the lessons learned. To develop education strategies that really prepare learners to collaborate we must: agree on the goals of IPE, identify effective methods of delivery, establish what should be learned when, attend to the needs of educators and clinicians regarding their own competence in interprofessional work, and advance our knowledge by robust evaluation using both qualitative and quantitative approaches. We must ensure that our education strategies allow students to recognise, value, and engage with the difference arising from the practice of a range of health professionals. This means tackling some long held assumptions about education and identifying where it fosters norms and attitudes that interfere with collaboration or fails to engender interprofessional knowledge and skill. We need to work together to establish education strategies that enhance collaborative working along with profession specific skills to produce a highly skilled, proactive, and respectful work force focused on providing safe and effective health for patients and communities.

Working and learning together: good quality care depends on it, but how can we achieve it?

Educating healthcare professionals is a key issue in the provision of quality healthcare services, and interprofessional education (IPE) has been proposed as a means of meeting this challenge. Evidence that collaborative working can be essential for good clinical outcomes underpins the real need to find out how best to develop a work force that can work together effectively. We identify barriers to mounting successful IPE programmes, report on recent educational initiatives that have aimed to develop collaborative working, and discuss the lessons learned. To develop education strategies that really prepare learners to collaborate we must: agree on the goals of IPE, identify effective methods of delivery, establish what should be learned when, attend to the needs of educators and clinicians regarding their own competence in interprofessional work, and advance our knowledge by robust evaluation using both qualitative and quantitative approaches. We must ensure that our education strategies allow students to recognise, value, and engage with the difference arising from the practice of a range of health professionals. This means tackling some long held assumptions about education and identifying where it fosters norms and attitudes that interfere with collaboration or fails to engender interprofessional knowledge and skill. We need to work together to establish education strategies that enhance collaborative working along with profession specific skills to produce a highly skilled, proactive, and respectful work force focused on providing safe and effective health for patients and communities.

Palliative care: a suitable setting for undergraduate interprofessional education

Effective delivery of high-quality palliative care requires effective interprofessional teamworking by skilled health and social care professionals. Palliative care is therefore highly suitable for sowing the seeds of interprofessional teamworking in early professional education. This paper describes experiences of running undergraduate interprofessional workshops in palliative care for medical, nursing, social work, physiotherapy and occupational therapy students. These workshops are unusual in three respects: first, the involvement of family carers mean that these learning experiences are rooted in clinical reality; secondly, there is no attempt to 'tidy up' the story for the students; thirdly, unlike many undergraduate interprofessional programmes, these workshops have been sustained over several years. Evaluation of these workshops demonstrate that students value and enjoy the opportunity to work together; they find the experience moving, informative and interesting. Feedback from carers showed that they appreciated the opportunity to present their real-life experiences to students. Our evidence suggests that palliative care is a suitable subject for undergraduate interprofessional education.

Improved student learning in ophthalmology with computer-aided instruction

PURPOSE

Recent changes in the medical school curriculum and in teaching styles have stimulated the development of novel learning resources. We investigated the impact of computer-aided learning in the field of ophthalmology at a large Australian undergraduate medical school.

METHODS

Clinical case studies describing common ophthalmic conditions were incorporated into a computing program which uses a problem-solving format. The program was made available to 85 medical students for a 2 week period. A control group of 20 medical students did not have access to this material. Acquisition of new knowledge was assessed as the improvement in score on a knowledge-based multiple-choice examination which students took both before and following the learning interval.

RESULTS

Students in the control group showed no improvement over the test period, whilst the students who had access to the computer significantly increased their knowledge base, both for material provided on the program (p = 0.0001) and in related areas (p = 0.0015).

CONCLUSIONS

Suitably constructed material on the computer is a useful aid in teaching ophthalmology to medical undergraduates. The material and the medium may also act as a stimulus for further learning.

Computer-assisted learning in critical care: from ENIAC to HAL

Computers are commonly used to serve many functions in today's modern intensive care unit. One of the most intriguing and perhaps most challenging applications of computers has been to attempt to improve medical education. With the introduction of the first computer, medical educators began looking for ways to incorporate their use into the modern curriculum. Prior limitations of cost and complexity of computers have consistently decreased since their introduction, making it increasingly feasible to incorporate computers into medical education. Simultaneously, the capabilities and capacities of computers have increased. Combining the computer with other modern digital technology has allowed the development of more intricate and realistic educational tools. The purpose of this article is to briefly describe the history and use of computers in medical education with special reference to critical care medicine. In addition, we will examine the role of computers in teaching and learning and discuss the types of interaction between the computer user and the computer.

The computer-based lecture

Advancing computer technology, cost-containment pressures, and desire to make innovative improvements in medical education argue for moving learning resources to the computer. A reasonable target for such a strategy is the traditional clinical lecture. The purpose of the lecture, the advantages and disadvantages of "live" versus computer-based lectures, and the technical options in computerizing the lecture deserve attention in developing a cost-effective, complementary learning strategy that preserves the teacher-learner relationship. Based on a literature review of the traditional clinical lecture, we build on the strengths of the lecture format and discuss strategies for converting the lecture to a computer-based learning presentation.

Developing an evidence base for interdisciplinary learning: a systematic review

AIM OF THE STUDY

The overall aim of the study was to explore the feasibility of introducing interdisciplinary education within undergraduate health professional programmes. This paper reports on the first stage of the study in which a systematic review was conducted to summarize the evidence for interdisciplinary education of undergraduate health professional students.

METHODS

Systematic reviews integrate valid information providing a basis for rational decision making about health care which should be based on empirical and not anecdotal evidence. The accepted principles for systematic reviews were adapted in order to allow integration of the literature to produce recommendations for educational practice and guidelines for future research.

FINDINGS

The literature on interdisciplinary education was found to be diverse, including relatively small amounts of research data and much larger amounts of evaluation literature. Methodological rating schemes were used to test for confounding influences in the research studies. The number of studies found was 141 but only 30 (21%) were included in the analysis because of lack of methodological rigour in the research and poorly developed outcome measures.

CONCLUSIONS

Student health professionals were found to benefit from interdisciplinary education with outcome effects primarily relating to changes in knowledge, skills, attitudes and beliefs. Effects upon professional practice were not discernible and educational and psychological theories were rarely used to guide the development of the educational interventions.

The development of undergraduate curricula in surgery: I. General issues

Undergraduate surgical education is evolving in line with societal changes, the growth of information technology, developments in educational processes, and shifts in the health-care industry. The underlying principles include the establishment of a strong linkage between the objectives and content of curricula, the identification of core knowledge and appropriate attitudes, achieving competence in basic skills, the creation of greater integration, and the promotion of study in depth. The aim of the present paper was to provide surgeons with an overview of these developments.

Clinicians and computers: friends or foes?

BACKGROUND

Computer-aided learning is accepted by students as a learning resource, but the views of the teaching community are largely unknown.

PURPOSE

To document clinicians' experience with computers and to record their attitudes toward computer usage in clinical practice and student education.

METHODS

Questionnaire mailed out to all clinicians, including interns and residents, fellows, and attending physicians in 3 major teaching hospitals in South Australia, with a total of 646 clinical staff.

RESULTS

Replies were received from 246 staff. Eighty percent of clinicians had at least 2 years of experience with computers and used computers for at least 2 hr each week. Despite this, there was an obvious lack of conviction among clinicians that computer-aided learning was of use in student education and assessment. This may reflect their lack of experience with this medium as an educational tool.

CONCLUSIONS

If computer-aided learning is to make any significant impact on medical student education, it must be carefully and objectively evaluated, and its benefit must be clearly demonstrated to clinical teachers.

Tribes or teams? The challenge of multiprofessional education

Evolving service development initiatives and clinical governance systems will require greater use of multiprofessional teamwork, underpinned by multiprofessional education delivered in clinical teams. Current professionally based education and training systems do not help to deliver this agenda.