Session 2 Stream 4

SESSION 2, STREAM 4: BEING A TEACHER

Title: Entering the Lion’s Den: Teaching Medical Anthropology in Health Sciences in Egypt and the rest of the Arab World

Authors: Abdalla, Mustafa and Jäger, Margret

According to the World Federation for Medical Education (2015), Medical Anthropology should be integrated in the medical curriculum around the world. Yet, experience shows that anthropologists lack the necessary skills to work and apply their knowledge in settings where health sciences are taught. At the same time, there has been an evident increase in the need for anthropological knowledge, skills and methodologies to be applied in health educational settings, especially in medical schools, in order to improve their outcomes and train future health workers to be more sensitive to the different factors affecting the health of the people they will work with, i.e. social, environmental, economic factors.

To address this challenge, a new program with the goal of introducing Medical Anthropology into educational institutions of health sciences in the Arab world was launched in 2017. The program aims at seeking collaborations with various universities in the region to establish Medical Anthropology as a discipline that students can select as part of their health science curricula and to establish Medical Anthropology as a discipline accessible to health science students, professionals and anthropology graduates alike.

As a start, a collaboration with a number of medical schools in Egypt was established to understand and assess their needs. The continuous discussions with medical school students and staff have shown that there is a growing awareness of the importance of Medical Anthropology in medical settings in Egypt. But the evident shortage in instructors hinders the introduction of the discipline into the medical school curriculum. For this reason and to find a sustainable solution for this obstacle, the initiative `Training of Trainers in Medical Anthropology '' was put into place in order to train future instructors of Medical Anthropology to cater for the augmenting demand in medical schools in Egypt. Towards this end, a seminar was designed for which trainees with social science knowledge were selected. The program was launched in August 2020 for the duration of six months to take place online with a planned week-long on-site training in Alexandria, Egypt at the end of the virtual program. However, with the outbreak of the pandemic COVID-19 and the related complications and travel restrictions have contributed to the extension of the training program for another year. This, however, has allowed for the inclusion of further topics and inviting guest-speakers to participate in the seminar. The on-site training is now planned to take place during the Fall of 2021. The curriculum of the seminar draws from an adapted version of an established module of Medical Anthropology for medical students in Austria and reflects on insights from the longstanding experiences within the field of health sciences in Egypt and other Southern countries.

Thus far, the response to the seminar has demonstrated that there is a growing need and eagerness at both, the institutional and the individual levels, to integrate Medical Anthropology in health sciences. But in order to do that, more training programs of Medical Anthropology need to be established across Egypt and the Arab world to train the cadre of trainers who, in the future, will act as the catalysts in instituting this discipline in Egypt and other Arabic speaking societies.

Title: Teaching Sociology to Medical Students: perceptions and experiences of UK teachers

Authors: Adama Luca, Kathleen Kendall

Background

Sociology has been taught to UK medical students since at least the late 1960s. However, its inclusion in medical curricula became mandatory with the publication of the General Medical Council’s Tomorrow’s Doctors in 1993. Despite sociology being a core part of the medical curriculum since that time, little research has explored the experiences and perceptions of those teaching it.

Summary of work

To explore the perceptions and experiences of sociologists teaching medical students in the UK, ten one-to-one, in-depth, semi-structured interviews were conducted with individuals who had experience of teaching sociology to UK medical students. Twelve medical schools were represented. Interviews were digitally recorded, transcribed and thematically analysed.

Summary of Results

All participants reported that the key benefit of teaching medical students is that it might help improve patient care. However, eight teachers identified a lack of support from and isolation within their schools as well as little career support and progression. They also described being marginalised by mainstream sociologists. These participants responded by modifying their teaching and research practices in ways that often contradicted the norms and values of their home discipline and this consequently created dissonance. The support they received largely came from the Behavioural and Social Sciences Teaching in Medicine (BeSST) professional network. In contrast, two participants working in larger teams of sociologists holding key positions inside their schools acknowledged being supported by their colleagues, having clear career pathways as well as promotional opportunities and therefore experiencing overall work satisfaction.

Discussion and Conclusions

There is a gap between the GMC’s acknowledgement of sociology as a core subject within medicine and the reality that most teachers feel undervalued and disempowered in their schools. This process can be described as decoupling where there is a gap between formal policies and actual institutional practices.

Take home message

Professional networks like BeSST provide important support for individuals teaching sociology to medical students. However, medical schools should strengthen career planning, revisit promotion criteria, appoint sociologists into key positions and help teachers maintain links with their home discipline.

Title: Being a medical educator from the ‘outside’ -the value of the medical registrar’s ‘insider’ perspective

Authors: Kassianos Angelos, Farooqi Mustafa, Plackett Ruth, Sheringham Jessica

Summary

We describe how our model of working with a rolling programme of registrars helps us in our journey as psychologists and social scientists (‘outsiders’ to medical education) to develop, situate and integrate an electronic Clinical Reasoning Educational Simulation Tool (eCREST)

Challenges

The development of each patient scenario entails close and continuous collaboration between medical education, primary care, public health and respiratory medicine experts as well as behavioural scientists, GP trainees and target users (medical students).

As ‘outsiders’ some of the challenges we face/d were

In development
- partners from within the medical education structures were often fully committed and on short term contracts so could input but could not take a substantial role in development and moved on frequently
- we didn’t have the knowledge to pitch a resource at the right level for students
- psychological and educational theory and methods (and our standardized, validated and reliable assessment tools) didn’t appear to be a good fit for the applied world of clinical medicine.
Varying receptivity to the innovation once developed:
- ‘fit’ with existing teaching
- encouraging completion from students

Working with registrars on academic placements - how it helps

Working on eCREST had mutual benefits as:

Educator getting under the skin of eCREST enabled/s registrars to get beyond superficial elements of clinical reasoning to delve into some of the psychological and educational theory underlying it to support development of reasoning skills and measure it robustly, without exhausting our participants with endless scales and surveys

Clinician –increased self-awareness of subconscious thought processes which occur during everyday consultations. Additionally, explicit reflection helped to identify gaps in clinical knowledge and given the time-constrained nature of 10-minute consultations in general practice, registrars gained insight into current inefficiencies within their clinical practice.

Registrars occupy a ‘liminal’ position between student and senior professional:

close enough to the student experience to help calibrate ‘pitch’,
had the ‘hindsight’ to understand both pressures students would be under and also how eCREST could actually help them
Sufficient clinical experience across different medical specialties to be able to design cases which include common pitfalls and with enough breadth and depth to test students
Relatively recent experience as a junior FY1/FY2 doctor to be able to pitch eCREST content at a level that is useful as both a medical student and as a newly qualified doctor
Championed eCREST to students