Session 1 Stream 2

SESSION 1, STREAM 2: INTEGRATED TEACHING AND ASSESSMENT

Title: Embedding psychology and physiology in the undergraduate medical curriculum: lecture co-presentation and integrated learning content

Authors: Dr Karen Adams (presenter) and Dr Alan Harper, Keele University

Background

Social and behavioural sciences (SBS) is a core component of the medical curriculum (BeSST, 2006; GMC, 2020) and there are diverse ways in how this can be achieved (Brauer & Ferguson, 2015). Years 1 and 2 of the Keele MBChB programme delivers a hybrid curriculum, whereby students have weekly problem-based learning (PBL) sessions in which SBS topics are included alongside other subject areas. This encourages students to take a holistic and integrated approach to their learning. However, PBL is supported by other teaching, including lectures, which focus on specific subjects in isolation. Consequently, students (and some colleagues) can struggle to see how SBS relates to other subjects. Medical students do not always appreciate the value of SBS topics, therefore PBL discussions can become tokenistic, rushed, and lack detailed consideration (Dikomitis, 2021). Aiming to improve this, a team-teaching approach (Willey, Lim & Kwiatkowski, 2018) was taken to co-present a one-hour interdisciplinary lecture.

Summary of Work

A co-presented lecture on ingestive behaviour was delivered by two lecturers with backgrounds in psychology and physiology to highlight the interdependence of the subjects. This supported the week’s PBL case centred on eating disorders. A biopsychosocial perspective (Engel, 1977) covered the regulation of eating, food preferences, and factors that lead to unhealthy eating. The co-presenters took an integrative and complementary delivery approach to consider a range of relevant issues. For example, comfort eating was discussed as emerging from an individual’s beliefs, values, and the symbolic significance placed on different food types, alongside biological considerations of neurotransmitters and the reward pathway.

Discussion and Conclusions

The ‘co-presentation’ approach was advantageous to both students and staff. It benefitted medical educators by providing an opportunity to communicate information and educate each other when developing the lecture, as well as providing an unforeseen opportunity for peer review. The collaborative teaching and pedagogy enabled colleagues to model an integrative and interdisciplinary approach to students, demonstrating how knowledge construction can take a more varied perspective, thus enhancing and promoting critical thinking (Eisen & Tisdell, 2002).

Take-home messages

Co-presentation of lectures enables medical educators to better appreciate the multidisciplinary links in medical education. Furthermore, it provides valuable opportunities for staff to act as role models for students, showing how bioscience and SBS subjects can be integrated.

Title: Integrating Psychology Teaching within Clinical Placements

Authors: ALICE E. HOON and Dr James Wiley

Background: Medical students’ attitudes towards the importance of the Psychology curriculum can vary greatly. One possible way of elevating the importance of Psychology and improving student understanding of how psychological factors impact patients, is by incorporating this teaching within clinical placements.

Summary of Work: Psychology teaching was delivered as usual through a traditional lecture format. However, in addition to this, a Psychology Lecturer attended a first year General Practice placement. The General Practitioner (GP) invited patients to come and discuss with students how their physical and/or mental health condition affected their daily living. The GP interviewed the patient, whilst the students were tasked with identifying and noticing specific psychological concepts. Once the patient consultation was over, there was an opportunity for discussing the case with students.

Discussion and Conclusions:The present format enabled students to consider concepts from the lecture content in a real-world clinical setting, and contextualised the content. A key strength of this approach was in the collaborative working between the Psychologist and GP, which encouraged a more holistic view of the patients’ needs. Additionally, both professionals’ benefit from each other’s respective expertise. Results of student feedback will be discussed in the presentation. One major challenge of this approach is the practicalities of upscaling the format to multiple GP placements.

Take home messages: Incorporating Psychology teaching within clinical placement offers an opportunity to contextualise the academic content, whilst highlighting the importance of psychological factors in health and medicine.

Title: Assessing health psychology knowledge and application in year 1 medical students using the objective structured clinical examination

Authors: Lavallée, J. F., Shepherd, S., Hart, J., & Byrne-Davis, L.

Background: Assessment has a central role in medical education and can drive learning, but there is much uncertainty about how to teach and assess psychology within medical education. Students form perceptions and apply meaning to assessment in relation to the form and importance, and see psychology as a ‘nice to know’ rather than a ‘need to know’ subject. We will discuss how we designed and implemented a health-psychology-informed objective structured clinical examination (OSCE) for year 1 medical students in May 2021.

Summary of work: Throughout this academic year, we have provided students with the opportunity to learn and practise applying their health psychology knowledge to consultation skills. Often students’ knowledge of psychology is assessed using multiple choice questions. An opportunity arose to develop an OSCE station for behaviour change. This station included a four minute consultation with a simulated patient about their smoking behaviours and three questions from examiners about behaviour change theory. We were able to recruit 14 expert examiners and delivered this OSCE station to over 450 year 1 medical students. Students were able to ask the simulated patient theory-informed questions to gather information about their smoking; but some found it challenging to combine these questions with their usual communication skills and to demonstrate knowledge of the underlying theory during the examiner questions. Once the OSCE results are available, we will compare this station to other communication stations.

Discussion and conclusions: We were able to implement a behaviour change-informed OSCE station for the first time with year 1 medical students. We chose smoking as the behaviour as we discuss smoking during many of our webinars and smaller group teaching. Students tend to ask about smoking and drinking behaviours as part of the patient’s personal and social history, but generally do not gather information beyond whether the person smokes or not. In the past students have explained that for psychology to become a ‘need to know’ subject, it needs to be included within the OSCEs and this was the first step towards this change.

Take-home messages: It is possible to develop a valid and reliable behaviour change-informed OSCE station. Further work is needed to develop the teaching and learning activities to better reflect this type of assessment; and to train tutors and simulated patients in these theories and behaviour change conversation skills to better equip them for facilitation and feedback during smaller group sessions.