Effective Learning and Teaching in Medical, Dental and Veterinary Education

Sharon Huttly, John Sweet, Ian Taylor

• Publisher: Routledge
• Year: 2003
• eBook ISBN:
  9781135727109
• Topic: Medicine
• Subtopic: Education General

The Effective Learning and Teaching in Higher Education series will include over 20 volumes, each packed with up-to-date advice, guidance and expert opinion on teaching in the key subjects in higher education today and backed up by the authority of the Institute for Learning and Teaching.
This book covers all of the key issues concerning the effective teaching in medical, dental and veterinary education. It includes contributions from a wide range of experts in the field, with a broad and international perspective. It includes material on teaching and the support of learning, effectively using learning materials and IT in clinical education, assessment, developing effective learning environments, developing reflective practice, and personal development.

1
Opportunities in medical, dental and veterinary (MDVv) educational development

John Sweet

Introduction

The opportunities for learning and teaching in MDV education are immense. For a start, it is not enough for strategies to be just student-centred; they must be patient-centred as well. They must also be robust enough to enable teachers and learners to handle the various third party, individual and corporate forces that can either enhance or impinge upon the care of patients. Effective strategies often entail situated learning, which ranges from tertiary level to working within the community. The long length of the course and potentially invasive nature of treatment often dictate a favourable ratio of staff to students, which can be exploited. However, some foci in MDV education are very short of staff. The team healthcare approach at work can also be simulated in MDV education through ininterprofessional education and vertical integration of student years and extended into concepts of lifelong learning in postgraduate courses. Effective communication is an essential skill in MDV practice that can be taught and assessed. The practitioner needs to master a range of information technology (IT) skills and writing genres, within a multidisciplinary environment. Few fields outside the MDV world offer the possibilities of depth and range of activity, which teachers can use to nurture new reflective practitioners who, using best evidence, can attempt to treat patients optimally.

The approach in this chapter is to concentrate on how an MDV School within the university setting could utilize a centre for educational development. This complements Chapter 10, which concentrates on a lecturers personal teaching strategy.

I set out a personal view, which, firstly, tries to articulate a range of activities a centre should take in its main function as a community of staff and students. Secondly, the reader is prompted to think about their own organization, identify how learning and teaching is currently supported and to envisage what further developments might be appropriate. Fortunately, forward-thinking vice-chancellors are putting forward their own vision for the future of their universities but are also offering to be receptive to ideas especially if they provide solutions. This chapter is therefore designed to stimulate management either directly or indirectly to fund and organize educational development appropriately within their institutions. Another aim is to encourage lecturers to envisage the contribution they might make towards the organization’s success. A similar but wider ranging Centre for Higher Education Development for a predominantly non-healthcare university is well documented on the World Wide Web (Coventry University, 2002).

My concept of educational development for a hypothetica MDV university includes a learning and teaching Centrex that can lead and nurture teaching but primarily provides a home base for a community of educators. This is a creative unit that allows the lecturer to work with the Centrex and so achieve more than they would working alone. This, in essence, is what teaching enhancement and educational development is about—evolving participatory collaboration, critically testing learning activities and creating credible evidence of their impact.

Functions of the centre

Communication

One of the major functions of the centre must be to improve communication and the impact of educational developments on improving the learning of students. In an inspiring chapter, Boyer (1989) states that ‘In the end, the quality of a College can be measured by the quality of communication on the campus’. This includes the relationship between MDV professional and patient (outlined in Chapter 3 in this book). As Boyer says ‘the doctor who knows only disease is at a disadvantage alongside the doctor who knows as much about people as he or she does about pathological organisms’. But communication must also provide a healthy link between teachers and between teachers and students. Within the process of lifelong learning the teachers become lifelong students. Boyer would also reciprocate and say that ‘we need to create a climate…in which students are teachers, too’.

Teacher development

A major thrust of the centre is to encourage educational self-development. It is clear that there cannot be curricular development without staff development, for it is the staff interactions with students, the materials they prepare and systems they put in place that deliver an environment that the students will apprehend as the educational climate (Genn, 2001).

Practical tips and useful literature

Many who teach in MDV are busy doing something else; either research or a practical clinical service commitment to patients. This can be most helpful in the teaching programme because the teacher is in a position to converse about the topic content or patient management with authority. When it comes to enhancing the learning experience of students, the busy teachers will be looking for useful teaching tips. The centre should encourage these lecturers to attend forums, to share good practice and attend both presentations and workshops geared to enhance teaching skills. The centre should also direct these lecturers to some of the very good generic books on this topic such as Fry, Ketteridge and Marshall (1999);Gibbs, Habeshaw and Habeshaw (1988) and Race (1999). Specific tips for MDV education on how to enhance lectures, small group teaching and assessment are contained in Chapters 5, 6 and 7 of this book, but throughout there is equal emphasis on educational theory, as this can inform and help deliver appropriate teaching practice as outlined below.

Influences of the organization

The degree to which lecturers can take the initiative in enhancing their teaching may depend as much on the nature of the organization they are working for, as their own interest and motivation. Teachers fairly new in post may find it particularly useful to assess their current teaching situation and to realize the importance of gaining the support of heads of departments in order for teaching initiatives to prove successful.

The overall plan

The centre should be a focussed facilitator of positive action to help formulate and implement a learning and teaching strategy for university-wide impact. It should be sensitive to the expectations and opportunities afforded by external agencies such as the Quality Assurance Authority (QAA). The centre should concentrate on forming functional links through secondment and collaboration to bring about actions with outcomes that make a difference. It should assure all parties that it is not attempting to duplicate or compete with existing activities or initiatives.

It should not be a central authority to pronounce on educational matters, giving out advice, or just giving out information, but provide resources to nurture self-development of staff so that they may become teaching authorities themselves.

It should hold a learning inventory of case studies where changes in teaching, ways of working with students and the uptake of new ideas are recorded. It should take responsibility for induction of new lecturers with teaching duties. The centre should organize meetings, conferences and forums that are largely participatory and publish a newsletter/journal and Web site. This can be achieved through leadership, organization and dedication of its staff and adequate funding.

Personnel positions, recognition and funding

Full-time members of staff would take a lead facilitatory role. Vital to the overall impact of the centre is the principle of collaboration. Two major ways in which this could be achieved would be through joint projects with other close functioning departments such as information services, and yearly secondment of staff from other academic departments. Staff throughout the university who make a longer-term commitment to the development of learning and teaching should be recognized, and a Teaching Fellowship scheme, critically evaluated over a period of five years, would help achieve this. Teachers who have shown outstanding educational development should be designated Teaching Champions and be funded to read a paper at an international educational conference.

Whilst the main impact of the centre should be on teachers who can cascade this influence to the learners, there is a good case for involving students at some stage to close the loop, to be assured that the educational developments facilitated by the centre are indeed enhancing students’ learning. A promising initiative to produce this result would be to employ student liaison officers. These are experienced students who are willing to take a year out some way through their course (Bratley, Francis and Wilson, 2001). They could prove to be an invaluable resource. They will be in a position to help individual students find the support they need and thus may help student retention levels by keeping them on track. Student liaison officers will also be able to give important feedback to the centre that educational enhancements are having an appropriate impact.

A further evaluation of centre activities can be achieved through the appointment of dedicated Research Fellows, who can analyse the success of specific activities and overall functioning of the centre as a community. Central funding for full-time staff and students and Teaching and Research Fellowships and Teaching Champions would be necessary as these are completely new initiatives. However, some of the joint projects will promote shared responsibility between departments and the secondments should expand the educational teaching and research capacity of individuals within those departments. Some form of top-sliced funding to the centre may ensure that educational development occurs in departments appropriate to their needs, and joint projects with the centre would have a focus on functional outcomes.

Leadership of teaching

The institution can make statements of visions and values and institute manuals of policies and procedures, but unless deans and heads of departments support these, they will have limited impact (Candy, 1996). From questionnaires and semi-structured interviews with heads of academic departments, Martin et al (1997), were able to describe six categories of conceptions of leadership. The most inspired leadership to further progressive teaching in the widest educational context was described as having an emphasis on students’ experience and initiating discussion with teachers and students on how to enable further improvement of this experience: a continuous curriculum change model.

The leader of the centre would clearly have to support this approach and be in a position to encourage other heads of departments. Martin et al (1997) categorized a further three types of fairly enlightened leadership that was willing to discuss with other teachers the students’ experience, their roles, responsibilities, practice of teaching or the subjects and the discipline. Least enlightened concepts of leadership were where roles, responsibilities and teaching practices were imposed, or where structure and organization was imposed. Good academic leadership enables people to achieve and focusses on change whilst understanding the internal and external pressures on the educational process to achieve appropriate outcomes (Ramsden, 1998). The role of staff in the department must be to encourage and support their leader in accepting change and taking the necessary risks to develop more successful and satisfying learning and teaching.

Who should be a member of the centre? Monthly forum meetings should be open to all. A faculty-wide ininterprofessional education day for first-year students, in their first week, requires large numbers of staff to act as tutors for break-out groups—and this is an opportunity for staff to contribute and gain experience of ininterprofessional education in action.

Projects and collaborations

The centre will provide the public face of educational development for the institution. The centre can respond to specific issues and collaborate with other departments as task and finish exercises. An example could be a perceived difficulty of downloading and uploading materials to the MDV Web site. A collaborative exercise with the IT department could help clarify the primary educational issues on the one hand and the advantages and limitations of the software and hardware on the other. In these collaborative projects the primary aim is action to produce an achievable outcome. Action learning sets could be particularly helpful for participants to balancing reflection with action. Other collaborations could be considered long term, such as the establishment of a course and Postgraduate Certificate in Educational Development (PGCED) examination jointly with an existing awarding postgraduate section or department.

The focussed inventory of educational development case studies could be catalogued and supported in a joint library services venture. Some important issues cross all disciplines and sections of society, such as communication, promotion of a healthy lifestyle, smoking cessation and coping with change. The centre should play an active role in brokering partnerships to further community.

The programme for the secondees

• There should be dedicated time for individual teachers to reflect on their current teaching position, to upgrade and update andragogy by following a set of core learning objective and values and the option of gaining a Postgraduate Certificate in Educational Development (PGCED);
• They should help to determine the learning and teaching needs in their own department;
• They should select an aspect of learning and teaching in their own department and institute educational change and write this up as a short case study;
• Paired with a cross-professional/disciplinary colleague they should contribute to a range of chosen and allocated activities within the centre;
• They should help with the peer assessment of teaching within their department;
• At the end of their appointments they should mentor the following secondees from their department.

Teaching Fellows and Champions

Two underlying threads of activity can be served by the creation of Teaching Fellows and Teaching Champions. Firstly, staff can be given recognition for educational development efforts that they are making and maintain a high profile public face for the centre. Secondly, they serve as levers to encourage excellence in teaching and provide encouragement for academics to choose a teaching career. Teaching Champions could be nominated sequentially during each year for recognition of work done in educational development. These could be awarded to secondees or others who have developed a ...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• About the editors and specialist contributors
• Acknowedgements
• Foreword
• Preface
• Introduction
• 1: Opportunities in medical, dental and veterinary (MDV) educational development
• 2: Culture, collegiality and collaborative learning
• 3: Communication skills: on being patient-centred
• 4: Curriculum
• 5: Assessment of the student practitioner
• 6: Large group teaching and interactive lectures
• 7: Learning in small groups and problem-based learning
• 8: Using information technologies and teaching online
• 9: Supporting students
• 10: Learning environments a teacher’s strategy
• 11: Learning in the clinical environment
• 12: Developing reflective clinical practice
• 13: Drawing together quality issues, institutional benchmarking and revalidation
• 14: The way ahead for medical, dental and veterinary education