1. School of Medicine Open Day Introduction to the Keele Medical Curriculum Professor Andrew Hassell Director of Undergraduate Programmes

2. Who are we? A young medical school with 650 students across five academic years. What is our goal? “Graduating excellent clinicians”

3. What are our criteria? Outcomes expected of “Tomorrow’s Doctors” (2009) The doctor as a scholar and a scientist The doctor as a practitioner The doctor as a professional

4. Keele: Excellent Clinicians Effective Learning: Modern, spiral, integrated curriculum Extensive clinical experience: 100 weeks of placements in Primary Care, Secondary Care and community organisations Student-centred Learning: Emphasis on feedback and student engagement Promotion of professional, socially responsible, globally- aware attitudes Excellent facilities: Purpose built medical school, 4 hospitals, 100+GP surgeries

5. Effective Learning: Modern, spiral, integrated curriculum

6. Themes

7. What? Three Themes The doctor as a scholar and a scientist The doctor as a practitioner The doctor as a professional The Keele Curriculum

8. Course outline Year 1 Getting started, acquire knowledge of normal structure & function, test vocation, exposure to all areas of medicine Years 2, 3 & 4 Learning in context, develop competence in clinical, scientific and social settings Year 5 Extended placements in clinical settings, preparation for practice

9. Curriculum Overview Year 1Phase 1 Challenges to Health Community placements 90:10 science:clinical Year 2Phase 2a Integrated clinical pathology 1 Adult health contexts (hospital) 80:20 science:clinical Year 3Phase 2b Integrated clinical pathology 2 Childhood, aged care and further adult health contexts. Readiness for clinical rotations 50:50 science:clinical Year 4Phase 3 Integrated clinical practice Mainly hospital based Readiness for workplace Yr 5 ‘apprenticeship@ model 20:80 science:clinical Year 5Phase 4 Preparation for Professional Practice Workplace-immersed preparation Application of knowledge and skills 10:90 science:clinical

10. Seminar rooms, laboratories, skills labs, lecture theatre  Social & healthcare settings in community and hospital The Keele Curriculum Where?

11. Discovery Learning PBL  Experiential learning  Mentored reflection The Keele Curriculum How? A variety of learning methods Clinical exposure throughout High level of integration Small groups Self-directedness

12. Years 1 and 2 Majority of time spent on campus –Learning underpinning basic and behavioural sciences –Developing communication and some other clinical skills Regular time spent off campus –Healthcare and 3 rd sector placements –Developing skills –Understanding healthcare settings

13. Year 3 6 x 4-week blocks in hospital placements –Medical x 2 –Surgical –Child health –Mental health –Elderly Care 1 day/week on campus 4 week GP placement consolidating clinical skills 2 student-selected 4-week blocks

14. Year 4 All clinical placements: 6 week blocks –Medicine + neuro; Medicine + musculoskeletal –Surgery –Women’s health 4 week blocks –Child health; Mental health; GP 2-week reading pre-exams 4 week student selected component –Career focus

15. Year 5 15 weeks in hospital placements –Surgery, Medicine, Critical care 15 weeks General Practice 8 week elective 1 week preparation for practice

16. What do students do in Year 1? Weekly: –PBL Sessions - 3-4 hours –Lectures - 4-6 hours –Practicals - 2-8 hours (Dissection, IT, Labs) –Resources - 3 hours –Experiential learning- 4 hours –Private Study - 25 hours

17. And…. Each Semester or Yearly: –Student Selected Components –Assessments (Written and Skills) –Record of Professional Development, portfolio, appraisal

18. MonTuesWedThursFri AMPBL 1LecturesSelf Study or Group Work Lectures Labs or Experi- ential Learning PMLabs or Experi- ential Learning Anatomy/ Resource Room PBL 2 Wrap-up session A typical student week in Year 1 A student’s journey

19. What is Problem Based Learning? One method of learning and teaching Students work in groups, backed by individual study Learning is centred around a “case” Students “open” the case in one tutorial; they identify the gaps in their knowledge They spend a week learning what they didn’t know (sometimes with a second tutorial) They “close” the case in a final tutorial explaining to each other, and the tutor, what they have learned

20. “Tell me and I forget. Teach me and I remember. Involve me and I learn.” Benjamin Franklin 1706-1790 Quoted in Scientific American 2012 February edition page 3 Why use Problem Based Learning?

21. Keele PBL Structured sessions with timed release of information PBL linked to all other content Clinically realistic scenarios Spectrum of case design - appropriate to individual units’ intended learning outcomes

22. The case is set at midnight on a Saturday night in a large urban Emergency department. Paula and Ravi, both 17yr old students, arrive in the department. They have been out to see a film after a day of playing tennis and football with friends. After they left the cinema they were mugged and assaulted. Paula has a large laceration to her right cheek which is bleeding fairly freely so they are both taken straight to the triage nurse after giving their details to the receptionist at A + E. Ravi tells her that his chest is feeling sore as he thinks he was kicked in the chest; the triage nurse checks his breathing and says she will find him a trolley in a moment. He sits down worrying that he might have cracked a rib.

23. The triage nurse applies a dressing to Paula’s wound and asks her to return to the waiting room where she waits for 2 hours. Paula is seen by a doctor. The doctor takes a history of the alleged assault and asks about Paula’s general health, medications and any allergies. After examining the wound he tells Paula that her wound is deep with some skin loss. The wound needs repairing in an operating theatre and may require a skin graft. The doctor says Paula must wait to see the plastic surgeon. She returns to the waiting room. Meanwhile Ravi has been put on a trolley and has had his pulse and blood pressure checked by a junior nurse. The department is very busy and there is a wait to be seen. Ravi sends a brief text to his mother. Suddenly Ravi complains of difficulty in breathing and collapses…

24. Lectures, weeks 1+2 Chest wall and lung anatomy Ventilation and gas exchange Psychological impact of injury Gas transport and blood gases

25. Lab Practicals, weeks 1+2 Dissecting room: –Introduction –Chest wall and lungs Microscopy: –Introduction –Histology of skin –Histology of trachea and lungs

26. Resource room and other practicals, weeks 1+2 Introduction to the resource room and to examination principles Surface anatomy of the chest wall Basic life support Assessing vital signs

27. Experiential learning, weeks 1+2 Introduction Reflection and portfolios Working in teams

28. Extensive clinical experience: 100 weeks of placements in Primary Care, Secondary Care and community organisations Excellent facilities: Purpose built medical school, 4 hospitals, 100+GP surgeries

29. Course location Years 1-3: Based in North Staffordshire Years 4-5: Bases in North Staffs, Shropshire & ‘Rest of Staffs’

30. Settings for clinical experience North Staffordshire –University Hospital of North Staffs –General practices and other community settings Shropshire –Shrewsbury and Telford hospitals –General practices + other community settings Mid-Staffordshire –Mid-Staffordshire NHS Foundation Trust –General practices + other community settings

31. Student-centred Learning: Emphasis on feedback and student engagement

32. Student engagement Student Council Student representatives on all School Committees –Curriculum, Assessment, Professional Development & Welfare Annual student awayday

36. Promotion of professional, socially responsible, globally-aware attitudes

37. Medical student engagement with the community Community focussed student societies –Teddy Bear Hospital –Anthony Nolan Bone Marrow –Medsin Keele –Keele first responders –Keele Heartstart society –Keele medics Charity Society

38. Y1SSc and Y5 Community Cluster Projects

39. Medical Research Pathway at Keele All students learn about: principles of medical research; numerical and critical appraisal skills Research pathway for those who want to go further –Student selected component “Learning how to do research” –Summer internship ARUK National Primary Care Centre –Intercalated year (MPhil, MSc, MMedSci) Postgraduate pathway –Academic Foundation programme –Academic clinical fellowships

40. Opportunities for Intercalated Degrees at Keele A year away from the undergraduate curriculum End of Year 4 Opportunity to gain a Masters degree in: –Laboratory science: Bioengineering; Molecular Parasitology; Anatomy –Clinical Research (M Phil) –Masters in Medical Science (MMedSci) –Medical ethics (MA) –Humanities (M Res)

41. “I believe that my experience at medical school has prepared me well for my foundation posts” Graduating excellent clinicians

42. I believe that my experience at medical school has prepared me well with the…. Graduating excellent clinicians

43. Graduate 2012 “I have enjoyed a large amount of clinical experience throughout the later years of my degree. I feel I have been well supported and taught in all aspects of medicine and feel more than capable of meeting my foundation years with relevant clinical experience and knowledge behind me. I am proud to be in the pioneering year of Keele university medical degree and am thankful for all the education I have received”. Graduating excellent clinicians

44. Questions?