Student-selected components in the undergraduate medical curriculum: a multi-institutional consensus on assessable key tasks

Meeting the Shared Goals of a Student-Selected Component: Pilot Evaluation of a Collaborative Systematic Review

BACKGROUND

Research methodology is insufficiently featured in undergraduate medical curricula. Student-selected components are designed to offer some research opportunities but frequently fail to meet student or supervisor expectations, such as completion or publication. We hypothesized that a collaborative, educational approach to a systematic review (SR), whereby medical students worked together, may improve student experience and increase success.

OBJECTIVE

This study aimed to establish whether offering a small team of students the opportunity to take part in the screening phase of SRs led by an experienced postgraduate team could enhance the learning experience of students, overcome the barriers to successful research engagement, and deliver published output.

METHODS

Postgraduate researchers from the University of Cambridge led a team of 14 medical students to work on 2 neurosurgical SRs. One student was appointed as the lead for each SR. All students were provided with training on SR methodology and participated in title and abstract screening using Rayyan software. Students completed prepilot, midscreening, and postscreening questionnaires on their research background, perceptions, knowledge, confidence, and experience. Questions were scored on a Likert scale of 1 (strongly disagree) to 10 (strongly agree).

RESULTS

Of the 14 students involved, 29% (n=4) reported that they had received sufficient training in research methodology at medical school. Positive trends in student knowledge, confidence, and experience of SR methodology were noted across the 3 questionnaire time points. Mean responses to "I am satisfied with the level of guidance I am receiving," "I am enjoying being involved in the SR process," and "I could not gain this understanding of research from passive learning e.g., textbook or lecture" were greater than 8.0 at all time points. Students reported "being involved in this research has made me more likely to do research in the future" (mean 8.57, SD 1.50) and that "this collaborative SR improved my research experience" (mean 8.50, SD 1.56).

CONCLUSIONS

This collaborative approach appears to be a potentially useful method of providing students with research experience; however, it requires further evaluation.

Increasing Medical Student Exposure to Neurosurgery: The Educational Value of Special Study Modules, Student Selected Components, and Other Undergraduate Student Projects

Objectives

Neurosurgery is a tertiary specialty, and exposure to medical students limited. One way to increase engagement and offer experience in neurosurgery is through Student Selected Components (SSC), Special Study Modules (SSM), or independent projects. Our aim was to assess the educational value of such projects and evaluate their effectiveness in exposing students to the field.

Methods

A survey was designed and distributed to Edinburgh University medical students and alumni who completed a neurosurgical project within the last 5 years. The survey was anonymous and collected responses over a fortnight. The results were analyzed in Microsoft Excel 2020 Software.

Results

Twenty-four respondents completed the survey −42% were students and 58% junior doctors. Respondents overwhelmingly enjoyed their project (96%) and reported increased interest in neurosurgery (62%). The project helped improve their knowledge of neurosurgical procedures, pathologies, and/or clinical presentations and allowed connections with the local department. On a Likert scale, 37% felt they gained a good insight into the field. Only 33% felt the project was a good “taster” for the specialty. This is reasonable given that 92% of projects focused on data analysis, and none were designed as clinical attachments. A large number of students had their work published (50%) and presented at conferences (55%).

Conclusion

Lack of exposure to neurosurgery at medical school is a known limitation within a busy curriculum. Selected Components/Special Study Modules/independent projects help students learn about certain aspects of neurosurgery and raise their level of interest. A majority of participants either achieved presentation at conferences or published their work. However, our results suggest neurosurgical projects complement but do not replace traditional clinical attachments in providing insight into the craft of this specialty.

Generic skills in medical education: developing the tools for successful lifelong learning

CONTEXT

Higher education has invested in defining the role of generic skills in developing effective, adaptable graduates fit for a changing workplace. Research confirms that the development of generic skills that underpin effectiveness and adaptability in graduates is highly context-dependent and is shaped by the discipline within which these skills are conceptualised, valued and taught. This places the responsibility for generic skills enhancement clearly within the remit of global medical education.

IMPLICATIONS

Many factors will influence the skill set with which students begin their medical training and experience at entry needs to be taken into account. Learning and teaching environments enhance effective skill development through active learning, teaching for understanding, feedback, and teacher-student and student-student interaction. Medical curricula need to provide students with opportunities to practise and develop their generic skills in a range of discipline-specific contexts. Curricular design should include explicit and integrated generic skills objectives against which students' progress can be monitored. Assessment and feedback serve as valuable reinforcements of the professed importance of generic skills to both learner and teacher, and will encourage students to self-evaluate and take responsibility for their own skill development. The continual need for students to modify their practice in response to changes in their environment and the requirements of their roles will help students to develop the ability to transfer these skills at transition points in their training and future careers.

CONCLUSIONS

If they are to take their place in an ever-changing profession, medical students need to be competent in the skills that underpin lifelong learning. Only then will the doctors of the future be well placed to adapt to changes in knowledge, update their practice in line with the changing evidence base, and continue to contribute effectively as societal needs change.

The good student is more than a listener - The 12+1 roles of the medical student

BACKGROUND

The process of medical education, particularly in the fast evolving new era of medical metaschools, is a broad and complex issue. Harden & Crosby claimed that a good teacher is more than a lecturer, and identified 12 roles that certify a good and capable teacher. However, this is only half the truth: the good student is more than a listener. Teaching-and-learning is not simply a one-way process, and, as medical students are not children, the relationship between teacher and students involves andragogy rather than pedagogy. We therefore propose the 12+1 roles of the student. SUMMARY OF WORK: The Harden & Crosby paper was distributed in a class of 90 third year Ioannina University medical students, who were asked to think about the student's roles. A small discussion group brainstormed ideas, which were then refined further by the authors.

SUMMARY OF RESULTS

12+1 roles of the good medical student were produced and grouped into six areas: information receiver, in lectures and clinical context; role model in learning, in class, with the added subarea of comparative choice of role models; teaching facilitator and teacher's mentor; teacher's assessor and curriculum evaluator; active participator and keeping-up with curriculum; resource consumer/co-creator and medical literature researcher. The ideal student should fulfil the majority if not all of these complementary roles.

TAKE-HOME MESSAGE

These 12+1 student's roles are complementary to the 12 roles of the teacher and help reshaping our understanding of today's medical education process.

What do medical students understand by research and research skills? Identifying research opportunities within undergraduate projects

BACKGROUND

Undergraduate research exposure leads to increased recruitment into academic medicine, enhanced employability and improved postgraduate research productivity. Uptake of undergraduate research opportunities is reported to be disappointing, and little is known about how students perceive research.

AIM

To investigate opportunities for undergraduate participation in research, recognition of such opportunities, and associated skills development.

METHOD

A mixed method approach, incorporating student focus and study groups, and documentary analysis at five UK medical schools.

RESULTS

Undergraduates recognised the benefits of acquiring research skills, but identified practical difficulties and disadvantages of participating. Analysis of 905 projects in four main research skill areas - (1) research methods; (2) information gathering; (3) critical analysis and review; (4) data processing - indicated 52% of projects provided opportunities for students to develop one or more skills, only 13% offered development in all areas. In 17%, project descriptions provided insufficient information to determine opportunities. Supplied with information from a representative sample of projects (n = 80), there was little consensus in identifying skills among students or between students and researchers. Consensus improved dramatically following guidance on how to identify skills.

CONCLUSIONS

Undergraduates recognise the benefits of research experience but need a realistic understanding of the research process. Opportunities for research skill development may not be obvious. Undergraduates require training to recognise the skills required for research and enhanced transparency in potential project outcomes.

Learning centred approach for developing the electronic information search processes of students

BACKGROUND

Undergraduate students of the twenty-first century are widely regarded as 'technologically savvy' and have embraced the electronic information world. The literature, however, describes undergraduate students as using a limited range of electronic information sources and not critically evaluating the information they retrieve from internet searches.

AIMS

The aim was to evaluate a purposefully designed intervention that sought to expand the information search and evaluation practices of undergraduate students. The intervention scaffolded an independent learning activity in the form of a group-based project.

METHODS

Survey methodology was used to collect data from student pre- and post-intervention for two cohorts of students who undertook the intervention in 2005 and 2006 involving a total of 71 students. Percentages were used to describe survey findings and chi-square analysis and Fisher's exact test examined differences between groups.

RESULTS

Questionnaires were completed by 59 students (response rate 83%) pre-intervention and 49 students (response rate 69%) post-intervention. Post-intervention there were positive and statistically significant differences in database searching behaviour (p = 0.000), use of Google Scholar (p = 0.035) and number of criteria used to evaluate information retrieved from the internet (p = 0.000) by students.

CONCLUSION

By positively reshaping the electronic information search and evaluation practices of students we are helping students to find informed information sources as they engage in independent learning activities at university and as future health professionals.

Getting the most out of Student Selected Components: 12 tips for participating students

BACKGROUND

Student Selected Components (SSCs) are an established feature of UK undergraduate medical curricula that offer students choice. They represent a large investment in time and resources. Although programmes vary between Schools, the major learning objectives remain broadly similar. Providing students engage fully with the activity, the final learning outcomes should also be comparable. However, engaging effectively and purposefully with such programmes may not be a clear and straightforward process for students.

AIM

To present the challenges and solutions to inform students how to derive the greatest benefit from the learning activities in their SSC programmes.

METHODS

Synthesis of the accumulated experience over more than 10 years of developing, running and evaluating SSCs by the Directors of SSCs in five Scottish Medical Schools, combined with analysis of course evaluation and student feedback.

RESULTS

Consensus defined 12 tips aimed at improving the approach taken by students to their SSCs, and to provide a structure to maximise their final learning outcomes.

CONCLUSION

SSC programmes provide diverse opportunities for students to develop and expand their learning. With increasing emphasis being placed upon student assessment to judge a wide range of professional skills and standards into foundation and specialist training, much greater importance is now being given to SSCs as an opportunity for personal, professional and academic developments. However, it is important that this is performed in a purposeful manner to maximise this opportunity. These 12 tips provide guidance to students on how they can maximise the opportunity presented to them by SSCs.

Student selected components: do students learn what teachers think they teach?

BACKGROUND

It is well recognized that what teachers teach and what students learn may not be the same. This applies to all parts of the undergraduate medical curriculum, but may be especially relevant to student selected components, which vary substantially in their educational content. This has not been studied previously.

AIMS

To compare perceptions of students and supervisors in relation to learning outcomes addressed by student selected components, and thus to examine differences between what is taught and what is learned.

METHODS

Supervisors (n = 69) were asked to indicate which of twelve learning outcomes they felt were components of teaching and assessment. Upon completion of each SSC, students were required to complete the same outcomes template as part of their feedback (n = 644). Perceptions were compared in two ways: (1) a colour-coded 'traffic-light' system was used to record agreement/disagreement between students and supervisors of individual SSCs; (2) differences in perception of outcomes across the entire SSC programme were compared using the chi(2) statistic.

RESULTS

(1) The 'traffic-light' system readily identified individual SSCs where significant disagreement existed and which were subject to further scrutiny. (2) More students than supervisors thought that outcome 2 (competent to perform practical procedures) was a component of teaching and assessment (41.8% v 27.5%, chi(2) = 5.24, p = 0.02), whereas more supervisors than students thought that outcome 6 (competent in communication skills) (97.1% v 82.1%, chi(2) = 6.91, p = 0.009) and outcome 7 (competent to retrieve and handle information) (100% v 93.7%, chi(2) = 4.8, p = 0.02) were.

CONCLUSIONS

Significant disagreement exists about the outcomes addressed by SSCs, suggesting that students do not always learn what teachers think they teach. The use of two complementary approaches allows global and individual comparisons to be drawn and thus provides a powerful tool to address this important issue.

Twelve tips for developing and sustaining a programme of student selected components

BACKGROUND

Student selected components (SSCs) represent a significant component of medical curricula in the UK and a new approach in medical education. Despite the prominence given to SSCs by the General Medical Council in each of its seminal papers regarding undergraduate medical education, there remains a diverse view of the purpose, outcomes, structure and assessment of SSCs. Many Schools have adopted their own perspective of SSCs and created different but often innovative courses.

AIMS

This article brings together the Scottish Medical Schools and their experience in organising SSCs, highlights some of the challenges and offers possible solutions to some of the difficulties encountered.

METHOD

The SSC Director from each of the Scottish medical schools each contributed their own '12 Tips'. From these a consensus was achieved.

RESULTS

Even though the Scottish medical schools have a wide range of curriculum and timetable formats, there was a great deal of agreement in the challenges and problems encountered in their SSC programmes, as expressed through these 12 Tips.

CONCLUSION

There is much diversity in SSC programmes at different medical schools, although there is also much commonality in the challenges that arise. We hope that this paper will promote thought and discussion amongst those involved, and be useful to those involved in curriculum and programme development and also to those new to medical education.