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ASME PublicationsUnderstanding Medical Education is a series of extended papers designed to meet the needs of all newcomers to medical education whether undergraduate or postgraduate, including those studying at certificate, diploma or masters level. It provides an authoritative, up-to-date and comprehensive resource summarising the theoretical and academic bases to modern medical education practice.
Contemporary in style, easy to read and above all, useful. After reading a publication in the series the reader should not only be better informed about their field of interest but be able to assimilate their new knowledge into their clinical teaching or academic activities.
Understanding Medical Education was launched in September 2006 and has received excellent reviews:
"A really valuable addition to the literature"
Nigel Purcell, Senior Education Adviser, Higher Education Academy"These are easy to read, but authoritative review articles that effectively bridge the gap between the theory and practice of clinical education. Each edition of Understanding Medical Education is a stand alone reference work. Collecting the series will allow busy clinical teachers to develop a greater understanding of the principles behind modern clinical teaching methods. I highly recommend them."
Dr Bill Reid, Honorary Secretary, The National Association of Clinical Tutors (UK)
Understanding Medical Education is edited by Tim Swanwick, Director of Postgraduate General Practice Education in the London Deanery.
Workplace-based assessment in clinical training John Norcini
Workplace-based assessment is becoming increasingly important in the delivery of postgraduate training programmes. This paper provides a framework for assessment based on observation in a clinical setting and describes some of the popular methods and briefly reviews of the research on their validity. The possibility for educational feedback as part of the implementation of these methods is stressed as is the importance of faculty development. A series of challenges remain so it will be important to deploy these methods appropriately and to ensure that they are only one piece of a larger assessment programme.
Thinking about research: frameworks, ethics and scholarship Jan Illing
Quantitatative, qualitative, positivism, postpositivism, post-modern, naturalistic, interpretivism, constructionism, participatory, grounded theory, ethnography, phenomenology, hermeneutics, conversation analysis, and narrative: a plethora of research approaches that may leave the novice researcher feeling rather daunted. This paper aims to provide a map through this forest of theoretical concepts and will also address the practical issues that the researcher needs to consider before starting out on their project.
Educational leadership Judy McKimm and Tim Swanwick
In this wide-ranging paper, McKimm and Swanwick describe the many and varied models of educational leadership. Theories of management and leadership are dissected and the management of change in environments of high complexity discussed. Challenges for healthcare education leaders are identified and recommendations made for leadership development. For those wishing to explore this huge area further, the paper also provides a comprehensive list of references and texts for further reading.
Teaching and Learning in Medical Education: How Theory Can Inform Practice David Kaufman and Karen Mann
Kurt Lewin famously asserted 'there's nothing as practical as a good theory'. In this extended paper, Kaufman and Mann demonstrate the truth in that statement for medical education. As professional practice is better understood, it is clear that theory has the potential both to inform, and to be informed, by practice, and in this paper, the authors illuminate eight strands of educational theory and explore their implications for medical teaching and training.
Problem-based learning Mark Albanese
Problem-based learning has been one of the most influential developments in medical education. From its beginnings at McMaster University in the late 1960's, it has supplanted the traditional lecture-based learning model in many medical schools and has expanded around the world and beyond medical education into a host of other disciplines. This scholarly primer addresses the different and developing conceptions of problem-based learning, discusses issues of implementation and describes the current state of research into its effectiveness as a vehicle for medical education.
Portfolios, personal development and reflective practice John Pitts
Much has already been written about the portfolio-based approach to learning. The first part of this paper will consider key messages from the literature and argue that an understanding of portfolios can only follow from consideration together of the three issues of content, purpose and assessment. Assessment of portfolios will then be discussed further in the context of the educational philosophy that underpins what it means to practise as a reflective professional. Practical aspects of design, implementation and acceptability are dealt with throughout.
Principles of curriculum design - Janet Grant
Curriculum design has many components. This paper addresses the definition and structure of curriculum, and the factors that affect curriculum design. These include current ideas about curriculum models, theories of learning, and the theory and practice of the discipline of medicine. The purposes of curriculum design are discussed and steps in the process outlined, with options for each described. It is stated throughout that at each stage it is for the curriculum designer to decide which option to choose. There are no ‘right’ answers, only answers that suit the agreed purposes of the curriculum.
e-learning - Jean McKendree
e-learning covers a broad range of teaching approaches, tools and techniques. These include computer-assisted learning packages, simulations, online and blended continuing professional development courses, virtual learning environments and emerging technologies such as wikis and podcasts. This paper emphasises the importance of designing a curriculum or learning approach in which such tools serve as a part of a larger educational environment, and presents a summary of evidence and best practice to assist those who wish to integrate such tools effectively into their own teaching and learning.
Supervision, mentoring and coaching - John Launer
This paper describes the pedagogy of all one-to-one encounters in undergraduate and postgraduate medicine aimed at enhancing competent and reflective practice. It promotes a consistent and coherent approach to supervision across the medical career cycle, from the undergraduate years, through the foundation years and specialty training, and into lifelong learning. While there is some overlap with technical training, the emphasis here is on educational encounters that are based on lived, complex professional experience rather than on abstract or factual knowledge. The focus of such encounters may be on casework with clients and patients, on issues arising within the workplace or professional network, on career choices, or on any combination of these.
Teaching and leading small groups - Peter McCrorie
Facilitating learning in small groups is at the heart of this paper, and the principles discussed will apply equal to both undergraduate and postgraduate medical education. The paper defines small group work and presents illustrative experiences of students and trainees. Practical issues are aired and different tutoring styles discussed. A range of techniques for running small groups is presented, together with some suggestions for dealing with difficult group members and maintaining group boundaries. It answers some frequently asked questions, and all of the above is supported through recommendations for further reading and a comprehensive list of key references.
How to design a useful test - Lambert Schuwirth and Cees van der Vleuten
This is an essential introduction to assessment for all medical educators by two of the foremost academics in the field. The concepts fundamental to good assessment design are described: reliability, validity, educational impact, cost-effectiveness and acceptability. No single assessment instrument is perfect and a good assessment programme will encompass a variety of test methods. The authors summarise the strengths and weakness of the most popular assessment methods in medical education today and discuss how the results of these may be combined and standards set.
Structured examinations of clinical competence - Kathy Boursicot, Bill Burdick and Trudie Roberts
A variety of formats for assessing clinical competence have been developed over the years and in this extended paper, Boursicot and colleagues review the classic long and short case formats as well as describing newer formats such as the Objective Structured Clinical Examination (OSCE) and Objective Long Case Examination Record. The authors describe the stages of planning and implementing OSCEs and offer practical advice on blueprinting, station development, examiner and simulated patient training, organisational issues and standard setting.
Simulation in medical education Jean Ker and Paul Bradley
This is an exciting time to be involved in simulation, as with an increasing professional and societal emphasis on patient safety, simulator training is becoming an essential component of medical education, both undergraduate and postgraduate. In this comprehensive paper, Jean Ker and Paul Bradley outline the type of simulations and simulators in current use, their theoretical basis and supporting research evidence. The role of feedback is discussed in some detail and the paper contains a wealth of practical advice on the design and delivery of effective simulation events.
Learning from the humanities Jill Gordon and Martyn Evans
'Professional competence is enhanced when students are broadly educated' argue Jill Gordon and Martyn Evans, and the humanities can do just that, fostering personal and professional maturation by providing insights into the human experience. In this paper the authors place the humanities firmly within the medical curriculum but highlight that its position there can be precarious as the liberal arts vie for teaching time with more techno-rational areas. The paper summarises the arguments for the teaching of 'medical' humanities and provides a wealth of useful advice for curriculum and course designers.
Qualitative research methods in medical education - Lorelei Lingard and Tara Kennedy
In this paper, Lorelei Lingard and Tara Kennedy explore the qualitative paradigm, its world views, research approaches, methodological tools, ethical considerations, and principles of rigour. It aims to position qualitative research within the broad landscape of medical education research, offering insights into its relationship with quantitative approaches and the history of its evolution in this domain. Framed as an introductory primer for medical educators new to this approach, this booklet references methodological treatises and applied studies to translate the complexities of qualitative research.
Formative assessment - Diana Wood
Formative assessment and effective feedback are fundamental to any programme of teaching and learning. In this paper, the purpose of formative assessment is discussed alongside underpinning research evidence. The role of feedback in formative assessment is explored and the paper includes helpful and practical advice on how to give feedback effectively. Examples are provided from a variety of learning settings.
Selection for medical education and training - Fiona Patterson and Eamonn Ferguson
Selection in medical education is a vastly under-researched topic, and there exist many uncharted territories for further exploration. Fiona Patterson and Eamonn Ferguson consider what is unique to selection in medicine emphasising the central role of job analysis studies and continual evaluation, to inform selection system design. A wide variety of key concepts that underpin robust selection systems are introduced alongside a description of the current state of selection processes - in both undergraduate and postgraduate medical education - around the world. Recommendations for best practice are made together with suggestions for a future research agenda.
Interprofessional education - Della Freeth
This paper examines the nature and diversity of interprofessional education, its characteristics and modes of delivery. The paper explores the challenges of facilitating and assessing interprofessional education and Della Freeth argues that good interprofessional education is just a special case of good professional education. The differences lie in realising the potential of learning within a deliberately mixed group and in overcoming, whether in person or electronically, the inevitable challenges of bringing mixed groups together.
Managing remediation - Deborah Cohen, Melody Rhydderch and Ian Cooper
The management of poor performance in doctors poses considerable challenges to both employing organisations and educational bodies. The problem is complex and goes beyond a simple question of ability, since personality, motivation and organisational factors all impact on individual performance. In this paper, Cohen, Rhydderch and Cooper take us through the diagnostics and delivery of remedial training, which, they argue, is a multiprofessional activity, based around an individualised plan, with clarity and client engagement essential every step of the way.
Evaluation: improving practice, influencing policy - David Wall
In this extended paper, David Wall covers the wide role of evaluation in medical education from micro- to macro-; from the evaluation of individual teaching episodes to entire curricula; for the purposes of improving pedagogy to influencing national policy. Evidence from rigorous and well-conducted educational evaluation, he argues, is essential to achieve the best medical education for our students, our trainees and all doctors engaged in continuing professional development.
Self-assessment and self-regulated learning - Casey B. White and Larry D. Gruppen
The need for physicians to engage in effective self-regulated learning is well documented and pressing, given the links between continuing medical education and the quality of health care. However, there is little published evidence that medical schools and postgraduate training institutions are successfully helping students become effective self-regulated learners. Casey White and Larry Gruppen attempt to assure medical educators that self-regulated learning can be taught and that teachers play a pivotal role in helping students to develop the necessary skills. Their paper provides a theoretical and practical framework for self-regulated learning and proposes a model for its integration into medical education.
Lectures and Large Groups - Andrew Long and Bridget Lock
In this paper, Andrew Long and Bridget Lock explore the difficulties of the lecture format from both theoretical and educational perspectives and offer practical solutions as to how the organisation and delivery of lectures can be adapted to meet the educational needs of both students and practising clinicians.
Dealing with Diversity - Antony Americano and Dinesh Bhugra
Diversity is not a straightforward concept, and confusion surrounds its meaning and aims. Diversity is complex, multi-factorial and its value contested. The aim of this paper is to assist the reader in understanding this complexity, in particular as it relates to clinical education.
Quantitative Research in Medical Education - Geoff Norman and Kevin Eva
In this authoritative and thought provoking paper Geoff Norman and Kevin Eva explore the range of quantitative methods available to researchers in medical education. Experimental, epidemiologic, psychometric and correlational research traditions are discussed in detail together with methods of review and meta-analysis. The authors demonstrate emphatically that even in a complex social setting like medical education, quantitative research studies, appropriately conceived, applied and interpreted are vital to the advancement of the field.
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