C21: Modernising Medical Education in Cardiff Annual Curriculum Away Day Friday 16 th September 2011, All Nations’ Centre Phase 2 Rhian Goodfellow

How have we gone about it? What do we want to produce? Not made bad Doctors but what’s wrong with making even better Doctors? Competent, confident, F1 doctors who are also inquisitive, thirsty for knowledge and have the capacity, with the correct nurturing to transform into ANY specialty doctor

Good Practice “Don’t throw the baby out with the bath water” All Wales experience Good clinical teachers Small group teaching Early clinical attachments Oncology Project experience Student choice projects

Not so good Inconsistency Inadequate learning in context Passive learners Tick box mentality Students don’t make the most out of opportunities- perhaps not sign posted well enough Do not use patients as the basis of their learning, don’t follow patients regularly through their journey

Not so good Whole group teaching Lectures in year 3 Patchy use of innovative teaching methods Do we share “best practice”? Teachers don’t get to know students and see them develop

Guidance-Tomorrow’s doctors 09 UG clinical placements should be consistent and structured -incorporating experiential learning across a range of specialities Students are responsible for: their own learning, including achieving all the outcomes set out in Tomorrow’s Doctors, whatever their personal preferences or religious beliefs

Patient Pathways Opportunities to make the patient the focus of students’ learning Blur the primary/secondary care divide “Hospital Front Door” “Chronic Disease 1” “Oncology”

Potential Year 3 C21 Oncology Hospital Front Door Chronic Disease 1/2 week Introduction and Consolidation Options/Choices/ SSC programme 6 weeks in total 3 weeks reading weeks/assessmen ts Placement 8/10 weeks Patient pathways All in South East Wales

Key Players Acute Physicians Cardiologists A+E General Surgeons Trauma Intensivists Skills Examination Communication skills Data interpretation Knowledge Pathology Pharmacology/Therap eutics Possible Indicative Cases Acute chest pain SOB PUO Acute abdo White limb Haematemesis KNOF ?Hot joint Attitudes/Professionalis m/Ethics Primary/Secondary interface 4 hour wait ………….. Assessment/Course work Data Interpretation

Key Players Surgeons Breast GI Urology ENT Oncologists Haematologist Respiratory Physicians Palliative Care GP ?Radiologists Skills Examination Breaking Bad News Communication MDT working Placement team member Diagnostic Knowledge Pathology Pharmacology/Therap eutics “Red Flags” Indicative Cases Breast lump Haematuria Prostate Lump in neck Upper GI/Dysphagia Lower GI/ altered bowel habit Haemoptysis Palliative care Attitudes/Professionalis m/Ethics Screening High Cost Drugs Clinical trials End of Life decisions Assessment/Course work Project Related to current oncology project

Year 4 Increasing complexity skills, knowledge, diagnostics, management All Wales – Women Child and Family – Chronic disease 2, complex needs, rehabilitation – Neurology, Ophthalmology and Mental Health/Psychiatry – Science in practice Pathology Anaesthetics Immunology/Transplant CU institute based teaching

“We understand that ensuring that clinical placements have genuine educational value can be difficult for medical schools. The relationship with local NHS services can be challenging, especially at a time when budgets for all services are under pressure. Nevertheless schools and the NHS should acknowledge that they have a shared interest in enabling new medical graduates to enter practice safely and efficiently. Neither can do this in isolation” Tomorrows doctors 09 Challenges

Can we make this happen? Challenges – Encouraging enthusiastic innovative module leaders – Student density and capacity – Explicit learning outcomes to ensure consistency – Excellent administration both centrally and locally – Student education

YES WE CAN! But we/I need help WORKSHOP 2

“It’s not the strongest of the species that survive nor the most intelligent but the most responsive to change”

C21: Modernising Medical Education in Cardiff Annual Curriculum Away Day Friday 16 th September 2011, All Nations’ Centre Questions