SESSION 3: CURRICULUM DEVELOPMENT

Title: Building a behavioral sciences curriculum with human rights and culture competence manners: a model for Problem Based Learning (PBL) program
Authors: Suhad Daher-Nashif, Tanya Kane

Background

In this presentation, the authors present the development of behavioral and social sciences curriculum (BSSC) for phase II at the College of Medicine (CMED) in Qatar University. CMED was established in 2015. It is one of two medical schools in Qatar, and includes multinational students with an Arab-Muslim majority. The BSSC was first delivered to year 2 in 2016, but it was not based on clear, evidence based, and/or mature vision, but a collection of topics based on the experience and ideas of a team, dominated by basic medical scientists.

We decided that with a growing college we have to build a long-term curriculum that prepares the students for the international exams, but also establishes among them awareness to global, local and humanitarian issues. 

Summary of Work

At the end of the first year, we examined thoroughly the topics required in the latest versions of Caplan, USMLE and IFOM textbooks. We checked topics suggested in two recent textbooks on behavior and medicine, and we read research studies on approved curriculums in three Ivy League universities from three continents. After mapping and selecting the topics from these resources, both authors selected human rights issues relevant and important to medical students. Both authors are well established in research on vulnerable groups and gender issues. We ended with a list of subjects that combines international expectations, regional and local cultural issues/needs, and global-regional human rights issues. We mapped the final topics in front of the cases/problems of each unit (12 system-based units; each unit includes 5-10 cases) and decided which case is the best to deliver each topic. We also modified the cases to fit with our objectives.

Discussion and Conclusions

While it is important to prepare medical students for the behavioral and social sciences topics required for the international qualification exams, it is important to incorporate issues related to humanity as part of preparing cultural and global competent doctor. Teaching these topics through cases/stories creates a meaningful and impactful process of learning. Some contextual cultural values challenged us and imposed wisdom and creativity in delivering several sensitive topics.  

Take-home Messages

Despites the challenges, behavioral and social sciences curriculums are THE space to prepare future doctors who are aware to socio-cultural and global human issues.

Title: Is the General Medical Council harming the role of Psychology in Medicine?

Authors: Dr Penny List and Dr Karen Adams, Keele University

The General Medical Council (GMC) has published its ‘Outcomes for graduates’ three times: in 2009, 2015 and 2018.  In 2009, section 9 was titled Apply psychological principles, method and knowledge to medical practice.  Section 9 comprised seven outcomes which were, mostly, relevant to the whole population.  Only one outcome used the word patients.  In 2015, the title and outcomes stayed the same as in 2009.

 

In 2018, there were substantial changes.  The title (of section 23) was now Applying psychological principles: Newly qualified doctors must explain and illustrate by professional experience the principles for the identification, safe management and referral of patients with mental health conditions.  Again, there were seven outcomes.  The GMC produced a mapping document which mapped the seven previous outcomes to six of the new ones.  The final new outcome related to the role of psychology in health and safety.  The 2018 outcomes demonstrated a substantial shift away from considering the whole population, with four of the outcomes now using the words patient or patients.    

 

We feel that the GMC’s 2018 ‘Outcomes for graduates’ may harm the role of Psychology in Medicine through two routes.  Firstly, by use of the new section title that is specific to patients with mental health conditions (which is misleading, as the outcomes themselves do not focus on mental health).  Secondly, by the shift in the outcomes away from the whole population and towards patients.  If the GMC is feeding messages to medical students and doctors that Psychology is of minimal relevance to the population as a whole, then this is surely a harmful belief to propagate.

Title: Integrating Education for Sustainable Healthcare into Medical Sociology: Student-staff partnership

Authors: Michele Peters  and Susannah Black

Traditionally medical education has included little teaching on sustainability in healthcare, but sustainability and the environment are a pressing concern in modern societies. Since 2020, a group of medical students at the University of Oxford have been collaborating with faculty in the Medical Sciences Division to encourage education of sustainable healthcare (ESH) in the medical curriculum across all 6 years. The vision of embedding ESH as a thread throughout the pre-clinical and clinical curricula is seen as both a challenge and an exciting opportunity to make significant positive changes to medical education without any one department having to make major sacrifices or changes.

The combined student-staff facilitated group workshops for Medical Sciences teaching staff and faculty members had a number of aims. These workshops intended to encourage integration of ESH into the medical curriculum, to provide ideas and a platform for discussion on how to achieve this for the both the overall curriculum and specific topics, such as medical sociology, and to review progress.

Guided by suggestions from the workshop and further reading, the eight lectures for medical sociology were reviewed and adapted with the aim to embed ESH content in every single lecture. The amount of content varied between lectures with two bullet points in the ‘Patterns of disease’ lecture to 7 slides in the ‘Introduction to Medical Sociology’ lecture. This demonstrates that for some topics it is easier to identify relevant content but it could be done for all lectures. The lecture content was reviewed in relation to the General Medical Council Outcomes for Graduates and was found to cover approximately 80% of the recommended outcomes, with remaining outcomes more appropriate for public health teaching. Thirty-two (of 160) students provided feedback with 28 rating the material highly relevant/relevant and 28 believing it was very important/important to include EHS content in the medical sociology. Approximately a third of students demonstrated their learning on sustainability and the environment in their assessment (NB. It was not relevant content for all assignment questions). The approach taken for ESH in the medical sociology lectures was presented to colleagues at a second workshop, and was received very positively by students, teaching and faculty colleagues. We have demonstrated that student-staff partnerships can lead to meaningful and successful changes to the curriculum; and that it is possible, where relevant, to successfully include EHS teaching into the existing medical curriculum.

Title: Embedding Academic Literacy Support in Behavioural and Social Sciences Teaching (BeSST) in Medicine

Authors: Evie Papavasiliou, Robbie Duschinsky

Clinically focused higher education programs such as medicine or nursing require advanced literacy and language skills, without which students are at risk of academically underperforming, achieving unsatisfactory outcomes on clinical placements, and failing to successfully progress and complete their undergraduate studies1. Inadequate literacy and language skills and insufficient support have been linked to poor academic performance, low achievement, poor progression, and high attrition rates2,3.

 

Supporting students to develop tertiary level academic literacy and language skills is therefore essential, with an increasing demand for embedding academic literacies within the curricula of different disciplines4. Evidence on embedded academic literacies suggests that over a quarter of students have no idea about academic literacy requirements prior to commencing their program of study, whereas those with poor prior performance experience high levels of anxiety and express lack of confidence in their writing abilities5.

 

Providing academic literacy support, however, comes with various challenges including i. study skills being devalued as irrelevant to science or medicine; students feeling that paying attention to study skills may distract them from discussing and learning substantive content and iii. students not feeling empowered or growing in self-efficacy getting overfocused on the technique aspect and, thus, not identifying how it can contribute to self-expression.

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Insights from the Social and Ethical Context of Health and Illness (SECHI), a pre-clinical course introducing the perspective of medical practice, working with patients and colleagues, both in hospital and in the community taken by students wishing to become doctors in Year 1 at the University of Cambridge reaffirm that embedded literacy support can enhance academic performance and attainment.  It is critical to note that questions and concerns raised by students during seminar discussions related mostly to academic literacy requirements rather than the contents of the course itself. Improved performance in all writing tasks students were required to complete as part of their formative assessment was observed following input on academic literacy skills, materials and resources shared and detailed feedback on key features of academic writing. Receiving academic literacy support made students feel motivated and empowered, boosted their confidence in academic writing and offered them a sense of achievement learning how to improve their own writing, a highly transferrable skill, leading to increased self-efficacy.

 

Embedding academic literacy support in BeSST in Medicine is therefore highly recommended as a guide for good practice in higher education to promote engagement, enhance the learning experience and ensure student success.