Professionalism Workshops at the Royal College of Anaesthetists
On 10th June, Professor John McLachlan gave a series of workshops on Professionalism at the Royal College of Anaesthetists Away Day on Ethics and Law, held at the RCA Headquarters in Red Lion Square in London. John addressed the mismatch between the 'pious platitudes of professionalism' and how professions actually behave in practice, and small group activities included reflecting on examples of unprofessionalism in anaesthesia, 'failure to fail' poorly performing trainees, and developing an anaesthetic 'Conscientiousness Index'.
Plenary Lecture at the 2015 Australian and New Zealand Association of Clinical Anatomists Conference
Professor John McLachlan has been invited to give the opening Plenary Lecture at the 2015 Australian and New Zealand Association of Clinical Anatomists Conference in Adelaide, Australia. John will address the relationship between clinical performance and anatomy teaching in the past, present and future
Values-Based Practice: How does it translate? By Professor Ed Peile, Professor Emeritus in Medical Education, University of Warwick
CMER and the Wolfson Research Institute co-hosted a Seminar by Prof Ed Peile, on 4 March 2015 on Values-Based Practice: How does it translate?
Values-Based Practice describes the processes for making clinical decisions that are both evidence-based and values-based. Experience is accumulating of teaching clinicians and medical students in the UK with the objective of helping them achieve balanced decisions with patients within a shared framework of values. Values-based practice has been found to be particularly useful when the values at play in a clinical situation are complex or conflicting.
Does values-based practice translate from one clinical discipline to another? Does it translate from one culture to another?
Professor Ed Peile, one of the authors of ‘Essential Values-based Practice’, will describe experience of rolling out Values-Based practice from its origins in Mental Health practice across medicine and allied health disciplines and of work in Africa, Japan, USA and the Balkans.
Professor Peile, who is a Fellow of three Royal Medical Colleges in the UK, was awarded the 2009 President’s Medal of the Academy of Medical Educators for his lifetime achievement in medical education. He has now retired from clinical practice but remains active in academic life, researching and publishing on Values-Based Practice. He was until 2014 the editor of the Journal of Education for Primary Care, and held visiting professorships at Queen’s University Belfast, and the International Medical University in Malaysia. He now undertakes education consultancy and curriculum reviews in the UK and internationally. A member of the Committee for the Karolinska Institutet Prize for research in medical education, Prof Peile also works with the Collaborating Centre for Values-based Practice in Health and Social Care at St Catherine’s College, Oxford.
Centre for Medical Education Research Seminar Series
& International visitors to the Centre September 2014 to November 2014
Professor Karen Mann, Dalhousie University Faculty of Medical Education, Canada visits the Centre for Medical Education Research
Prof Jan Illing and her team were delighted to host Professor Karen Mann's visit in the first week of November. She presented two seminars, the first on 4 November was 'Inter-professional education: How does it benefit patients?'. This was on delivery of health care in collaborative teams, and the imperative for health professions educators to develop and implement interprofessional learning (IPL) experiences and educational programs that help graduates to achieve the required competencies. Evaluations of interprofessional education have explored benefits to learners, effects on health care etc. This seminar explored the benefits to patients collaborative care and what research tells us about these advantages, along with questions that still remain.
On 5 November Prof Mann presented a seminar on curriculum change at Burdon House, Durham. She explained, that as new understandings of learning emerge, along with changing systems of health care delivery , changing patterns of health and illness, and increasing social responsibility, health professions education curricula are continually in review. Sometimes change is at the level of an entire curriculum; other changes may be more focussed. Whatever its scope, curriculum change requires consideration of factors that involve learners, teachers, and institutions. The Seminar explored some of these factors and how the process of curriculum change affects us at organizational, interpersonal and personal levels.
Dr. Mann joined Dalhousie University Faculty of Medicine in 1986, serving as Associate Dean for Undergraduate Medical Education and Student Affairs from 1990-1998( 2001, 2008). Currently, she is Professor Emeritus in the Division of Medical Education, where she was founding Director (1995-2006). She also is Chair in Medical Education at Manchester Medical School, University of Manchester, UK. Karen is involved in teaching, research and development and writing across the medical education continuum. Involvements have included development of a medical education elective for residents in Royal College and College of Family Physicians of Canada (CFPC) programs, and, together with Mount Saint Vincent University, a Master’s program in Medical Education for residents, faculty and staff in medicine, dentistry and the health professions. With colleagues, Tim Dornan, John Spencer, and Albert Scherpbier, she was a co-editor on a textbook of medical education : Medical Education: Theory and Practice. Karen served as Chair of the Group on Educational Affairs of the AAMC, and as President of the Canadian Association for Medical Education; she received the CAME award for Distinguished Contributions to Medical Education in 1996, a Dalhousie Instructional Leadership award in 2000, and the 2005 Award for Medical Education Research from the Society of Academic CME. In 2007, she was awarded honorary membership in the CFPC. In 2010, she received the Merrel Flair Award for Distinguished contributions to medical education in North America, and in 2013 the Royal College’s Duncan Graham award. She is a fellow of the Academy of Medical Educators.
Dr Matthias Weigl
CMER and the Wolfson Research Institute co-hosted a Seminar by Dr. Matthias Weigl on 28 October 2014: 'Work conditions and well-being in hospital physicians and quality of care: Insights from cohort and intervention studies in Germany'
The quality of health care is determined also by the quality of physicians' and nurses' work environment and their well-being. Our research investigates to what extent psychosocial characteristics of the work environment are responsible for the well-being of healthcare professionals. Furthermore we are interested in interventions that encompass the active participation of physicians to improve their work conditions.
The presentation will feature results from a longitudinal investigation in German junior physicians that revealed the effects of poor working conditions on impaired well-being over time, i.e., depressive state in junior physicians. Additionally two controlled studies are discussed that evaluated the effects of an intervention to improve physicians' work conditions in regard to perceived quality of care reported through patients' evaluation
Dr. Matthias Weigl (Diploma and Doctorate in Psychology) is a researcher in industrial and organizational psychology at the Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine of LMU University Munich, Germany. He is Co-Head of the working group “Applied Medicine and Psychology at Work (AMPA)”. His research interests are in the areas of work design, employee wellbeing, performance, and quality in health care organizations. His past research projects investigated physicians work life in the hospital and potential consequences for physician well-being and care quality. He teaches at Munich University as well as at Innsbruck University, Austria. For further information please visit: http://www.klinikum.uni-muenchen.de/Institut-und-Poliklinik-fuer-Arbeits-Sozial-und-Umweltmedizin/de/ueber_uns/Mitarbeiter/weigl/index.html
Dr Jonas Nordquist
Seminar co-hosted by CMER & Wolfson Research Institute, 30 September 2014
How Physical Space Impacts on Learning by Dr Jonas Nordquist, Director Medical Case Centre, Karolinska Institutet, Stockholm
Physical space has been neglected in its impact on the success of learning. Health programs are accommodated in traditional didactic learning spaces: lecture theatres, seminar rooms, and separate buildings for academic disciplines. Hospitals have limited provision for student learning. Yet learning patterns and educational methods have been transformed. What are the trends globally in providing high performance learning spaces that respond better to emerging needs? What are the key design features? What can we learn from the innovative work and learning spaces in the corporate and other sectors? This plenary will address the overall issue of aligning the curriculum with physical learning spaces.
Jonas Nordquist, PhD, is the Director of the Medical Case Centre at Karolinska Institutet and he is the associate DIO, in charge of the strategic educational development for the residency programs at the Karolinska University Hospital. He joined Karolinska Institutet in 2003.
Dr. Nordquist is a Harvard-Macy scholar in medical education at Harvard Medical School. He has been involved in projects in more than 40 countries around the world and is the author of three books and several peer-reviewed papers.
Dr. Nordquist is an affiliated scholar at the Wilson Centre, University of Toronto. He is also visiting faculty at the International Medical University in Kuala Lumpur, Malaysia; Makerere School of Medicine, Kampala, Uganda; medical educational expert to the University of Addis Ababa, Ethiopia; visiting professor and external assessor to the Guatemala Medical Academy. He has served as a WHO expert in medical education.
Dr. Nordquist’s research focuses on educational leadership and also currently on how physical space impacts on learning.
Professor Larry Gruppen, University of Michigan, US visits the Centre for Medical Education Research
'Promoting Academic Productivity through Mentoring Programs; best Practices and Research Evidence' - Professor Larry Gruppen 24 September 2014
Seminar co-hosted by Wolfson Research Institute and Centre for Medical Education Research
Mentoring has real and demonstrable benefits for both mentor and protégé in terms of career satisfaction, productivity, and retention. These benefits often motivate well-intentioned efforts to foster mentoring relationships through mentor training, mentor-protégé assignment, and explicit expectations. These mentoring programs can reflect a significant investment of resources by an institution.
Are such programs worthwhile?
Is mentorship the panacea it is presented to be?
What makes a good mentor, a good protege, and a good mentorship program?
How important is mentoriship to promoting research and scholarly productivity?
These questions will serve to focus this presentation and discussion of the literature on mentoring programs, our personal observations as mentors and protégés, and institutional efforts to promote mentoring.
Larry Gruppen is Professor in the Department of Learning Health Sciences at the University of Michigan Medical School. His research interests center around the development of expertise, knowledge and performance assessment, self-regulated learning, and educational leadership development. He has held the offices of president of the Society of Directors of Research in Medical Education and chair of the Association of American Medical College’s (AAMC) Central Group on Educational Affairs. He was also the founding Chair of the AAMC’s Medical Education Research Certificate (MERC) program. He has over 100 peer-reviewed publications on a variety of topics in medical education, presents regularly at national and international professional meetings, and was recognized for his career productivity by the AAMC’s Central Group for Educational Affairs’ Medical Education Laureate Award. He directs the Medical School’s unique and innovative Master in Health Professions Education that is fully competency-based
Centre for Medical Education Research Seminar Series
Dr Emma Paternotte, MD (St Lucas Andras hospital, Netherlands)
Intercultural communication between doctors and patients, a view from realist perspective
Centre for Medical Education Research Seminar 7 July 2014
Emma Paternotte studied medicine at the Free University of Amsterdam. In 2011 she graduated and started working as a resident in obstetrics & gynecology in the Saint Lucas Andras hospital, a district teaching hospital with an ethnically diverse patient population.
Emma’s research focused on the communication between doctors of the major ethnicity and patients of the minor ethnicity
Emma's seminar reported on a realist review about intercultural communication. In this review she tried to find out mechanisms which could direct the communication outcome (i.e. barrier or facilitator). She therefore included 145 articles and found out that these mechanisms could be divided in behavior, attitude and knowledge. Many of these mechanisms could also be found in general communication. This can be helpful in the development of training for doctors.
Based on this review, she started a Delphi procedure to develop an observational scale which can be used as a framework to evaluate the intercultural communication between doctors and patients.
Dr Michiel Westerman's Seminar 28 May 2014
As part of the Centre's Research Series, Dr Michiel Westerman from VU University Medical Centre, School of Medical Sciences in Amsterdam, Netherlands presented a seminar on
“Transitions within the medical trajectory.”
Three major transitions can be identified within the medical education continuum, i.e. the transition from preclinical to clinical phase of training, the transition to specialist registrar, and the transition to new hospital consultant. Transitions and research thereof can function as a lens for the merits and failings of the current medical educational system. A trans disciplinary research approach on transitions is an approach in which transitions are not merely approached as threats, in accordance with the general medical educational perspective, but as opportunities for rapid personal and professional development. This opens up a fertile area for future research and a possible reform of specialty training. In this talk, I will review the historic origins of transitions in the medical education continuum and how transitions have been investigated, and I will illustrate how transitions are characterized by an intricate interplay between educational, psychological, and contextual factors, by presenting some of my work on the transition to new hospital consultant.”
Michiel Westerman is a post-doctoral researcher within medical education at the VU University Medical Centre, School of Medical Sciences in Amsterdam, Netherlands. After graduating from medical school, Michiel conducted a PhD on the transition from specialist registrar to hospital consultant (thesis: Mind the gap; the transition to hospital consultant. December 2012) Currently Michiel’s main task within research consists of co-supervising several PhD students within medical education on different topics. Furthermore, Michiel is a second year registrar within Internal Medicine.
Dr Hugh Alberti, Sub-Dean for Primary & Community Care, University of Newcastle
From the UK with love: Transferring a medical curricula to Malaysia
Date: Tuesday 4th March
Time: 12.00 till 13.00;
Place: A102 Holliday Building
Newcastle University (NU) medical school opened an international campus in Johor, Malaysia (NuMed) in 2011, to provide a programme of study identical to Newcastle’s UK-based provision. The franchise of Western higher education programmes to the East is rampant. In general, this trend appears to be increasing and specifically in relation to the internationalisation of medical curricula. However, there is a scarcity of discourse around curricular transfer.
Dr Alberti is currently looking at a project looking at the cultural factors influencing the teaching of Clinical Communincation Skills at NuMED. He is also involved in other research projects on cardiovascular disease and diabetes, and student placements in deprived areas. Previous publications are predominantly in the area of diabetes management in primary care.
Details of Medsems held in February 2014
Dr Karen Mattick, University of Exeter Medical School
Dr Rola Ajjawi, Dundee University
MedSem: Dr Rola Ajjawi
Senior Lecturer in Medical Education University of Dundee
Tuesday 4th February 12-1:30pm, D111
Optimising feedback practices within a curriculum: lessons learned
Simply giving feedback does not ensure that learners read, understand or act on it. Student feedback engagement is affected by the credibility of and relationship with the feedback giver as well the context in which feedback occurs. This paints a more complex picture of feedback practices as being imbued by power, identity, social interactions, contexts and materials. In the interACT project, informed by action research, we re engineered our assessment and feedback processes within the Dundee postgraduate medical education programme. In this talk I will present the theoretical basis for the new design along with findings in relation to impact on students and staff and lessons learned.
Rola is Senior Lecturer in Medical Education at the Centre for medical Education, the University of Dundee. She trained and worked as a physiotherapist and clinical educator before moving into academia. Rola started her academic career at the University of Sydney as Associate Lecturer in Medical Education (2006 2010). During her tenure at the University of Sydney, Rola completed doctoral and postdoctoral research and was coordinator of the postgraduate programs in medical education. She joined the Centre in April 2011 from Monash University where she was a Senior Lecturer in Health Professions Education.
MedSem: Dr Karen Mattick
Centre for Medical Education Research
Monday 10th February 12-1:30pm A14, Holliday
Karen Mattick is Co Director for the BMBS (undergraduate medicine) programme at the University of Exeter Medical School, Associate Director of Undergraduate Medical Studies at Peninsula Medical School, and academic lead for medical education research. She has over ten years' experience as a medical educator and medical education researcher. As Co Director, Karen is responsible for the teaching of the medical sciences, research and scholarship within the BMBS programme. Her educational endeavours have been recognized in the award of Principal Fellow of the Higher Education Academy in 2012 and a National Teaching Fellowship in 2005. She has published around 50 peer reviewed research papers in medical education and clinical science, and is an editorial board member for the International Journal of Medical Education. Prior to joining the medical education field, Karen worked for the NHS as a Clinical Scientist, involved in both service delivery and clinical science research. Karen s primary research interest is the experiences of junior doctors and how to prepare medical students for the transition to clinical practice. This has involved a wide range of methodologies including systematic literature reviews, quantitative, qualitative and mixed methods research studies. Her recent research has been funded by the British Society of Antimicrobial Chemotherapy, the Academy of Medical Royal Colleges, NHS Education for Scotland and the General Medical Council.
In this talk, Karen will draw on the findings of a couple of her recent research projects to give some reflections on how to prepare new medical graduates for their first role as a Foundation Year 1 doctor.
An Introduction to a realist approach Workshop by Dr Geoff Wong, University of London
The Wolfson Research Institute and Centre for Medical Education Research co-hosted this workshop at Burdon House, Durham on 28 January 2014.
Realist review and evaluation are relatively new research approaches for making sense of complex interventions. The workshop explained the need for a realist appoach and provided hands on practice in applying a realist approach to make sense of complex interventions. Topics covered were the essentials of realism; developing programme theory and CMO analyses; and the (Ultra rapid) realist review.
Dr Geoff Wong is a Senior Lecturer in Primary Care at Queen Mary, University of London. He is an internationally and nationally recognised expert in realist review and evaluation. He has extensive expertise in undertaking and providing methodological support for both methods as well in their methodological development. He recently completed a UK National Institute of Health Research funded project to develop auality and reporting standards and training materials for realist reviews www.ramesesproject.org. He works part time as a NHS General Pratictioner in London.
Medical Education, e-journal club
The team supporting the journal ‘Medical Education’ hosted its second ever journal club on Twitter on 10 December.
The article is in the October 2013 issue of Medical Education:
'A systematic literature review of undergraduate clinical placements in underserved areas' by Paul E S Crampton, John C McLachlan, and Jan C Illing.
The authors participated in a live Twitter journal discussion. The discussion is now available on a chronicle on Storify.
Comments and further discussion are welcome!
Managing bullying in the NHS
The Centre for Medical Education Research has a new report looking at ways of managing bullying within the NHS workforce. Carried out as part of the National Institute for Health Research Health Services and Delivery Programme, the project involved a detailed literature review, identifying the causes, effects and ways of dealing with workplace bullying.
The report can be downloaded from
Health and Care Professions Council visit the Centre
Dr Anna van der Gaag, Chair of the HCPC, and Mr Michael Guthrie the Director of Policy and Standards, visited the Centre on 25 March 2013 to discuss the on-going research on professionalism funded by the HCPC.
Dr van der Gaag reported that they are hoping the research will inform future decision making.
The HCPC reported that the first stage of the research, completed in 2011, on understanding professionalism within three HCPC regulated professions (podiatrist, occupational therapists and paramedics) is being used widely to raise self-awareness of professionalism issues within the health and care professions.
Seminar by Dr Vicky Tallentire
In March 2013 Dr Vicky Tallentire of Edinburgh University delivered an interesting and well-received seminar on 'Using patterns of error to inform educational strategies'. You can download her abstract here.
Effects of Working Time Regulations
In February the General Medical Council published research completed by the Centre looking at the impact of the Working Time Regulations on medical education and training. The project involved a literature review and primary research in deaneries around the UK. The research involved meetings with senior staff in Deaneries and Trusts, and focus groups and telephone interviews with 82 doctors in Foundation Programme and specialty training. The research was mentioned in a Channel 4 'Dispatches' programme in March 2012 (http://www.channel4.com/programmes/dispatches/4od).
Both reports can be downloaded from
School Seminar 'Construct alignment of judgement-based assessment scales'
Presented by Dr Jim Crossley. Senior Fellow in Medical Education.
Dr Jim Crossley is a Senior Fellow in Medical Education and is working three weekdays in Chesterfield as a Consultant General Paediatrician, one weekday in Chesterfield as Associate Director of Teaching, and one weekday in Sheffield in the Academic Unit of Medical Education. He qualified from University of Oxford and London Hospital Medical College before moving to Sheffield as a Specialist Registrar in Paediatrics. He has published widely in the research fields of psychometrics and assessment.
The future of workplace based assessment is at a crossroads. On theoretical grounds it is unique because it "reaches parts other assessments can't reach". Only at work can one assess authentic, integrated and 'real' performance - the peak of Miller's pyramid. But most published evaluations show very disappointing reliability, and large scale implementations have met with cynicism from within the profession. What are we to do? Some are calling for more training, some are moving the outcome goalposts, and some are lowering their expectations of WBA.
Dr Crossley is convinced that the situation can be improved and that many existing WBA instruments are obscuring rather than clarifying reliable judgements. He will present data showing that differently designed response scales have a major impact on the reliability of WBA judgements and discuss some reasons for and implications of this observation. He will speak for 20-30 minutes to allow at least as long again for questions.
North East Local Education and Training Board Launch
The North East Local Education and Training Board (formerly LETB, but now Health Education North East, HENE) was launched on 11 April 2013 at the Stadium of Light in Sunderland. The Launch was opened by the Chair Prof Oliver James and the Managing Director Mrs Elaine Readhead. Dr Nicki Latham Chief Operating Officer Health Education England (HEE) presented the mission and vision for HEE. Delegates at the meeting were invited to comment on The Strategy of Intent http://hee.nhs.uk/2013/01/31/our-strategic-intent/
Prof Illing, Dr Morrow and Prof McLachlan attended the launch of HENE and displayed relevant research outputs from Durham University. They met with Nicky Latham and Andy Gill from HEE, as well as Professor James and Elaine Redhead, and had the opportunity to describe current research projects with the GMC, HEE, HPC, Deanery, and others.
The meeting concluded with a presentation from Karen Lynas, Deputy Managing Director of the National Leadership Academy. Mrs Lynas highlighted some deep concerns that illustrated a lack of care and compassion from NHS staff and ended with a comment that their behaviours are a reflection on how they are treated as staff.
This perspective resonated with our research on workplace bullying where we identified that leaders who focus only on achieving a task had higher levels of workplace bullying whereas those leaders who were also in parallel concerned about the welfare of staff during the process of achieving a task were less likely to have workplace bullying.
The most commonly referred to word in the Francis report is culture, the question is can we change the culture simply by 'recruiting for values' or it there also a need to care for staff, so that they in turn can care for patients?
Professor Jan Illing's inaugural lecture
In November 2012 Professor Illing gave her inaugural lecture at Queen's Campus in Stockton. The abstract is included below, and you can download the presentation from here.
The training of doctors: concerns, challenges and developments
“Properly planned and carefully conducted medical education is the foundation of a comprehensive health service” The Goodenough Report 1944
News headlines frequently highlight concerns related to the training of doctors; for example, risks to patients from newly qualified doctors, the dependency on non-UK qualified doctors to service the NHS and on-going concerns about fitness to practise. In this inaugural lecture Prof Illing will focus on some of the challenges within the role of the doctor.
Recent research has highlighted gaps in preparedness for the role of a doctor, both at the start of training and also at the end when moving on to become a consultant. The lack of preparedness for the next role leaves doctors unprepared and other staff and patients vulnerable.
The NHS depends heavily on overseas qualified doctors, and assumes that an overseas qualified doctor can fit into an NHS post without regard to the differences in training and the potential impact of these differences for practice.
There is a shortage of certain medical specialities and an awareness that some medial roles are valued more, some are shut out of training and others shut out of education. Equal access to information to support revalidation has highlighted this challenge.
Prof Illing has a background in psychology and worked at Newcastle University in the field of mental health from 1991 until 1998 when she moved into the area of medical education. Still at Newcastle University, she joined the Northern Deanery and in 2000 was awarded a research fellowship from the Association for the Study of Medical Education. In 2010 she moved with her research team to Durham University.
She has worked in formally contracted arrangements with a range of organisations including: the General Medical Council, the Health Professions Council, the Economic and Social Research Council, the Royal College of General Practitioners, the Medical Schools Council, the National Institute for Health Research and organisations within the North East of England, such as the Northern Deanery and local NHS Trusts. She has acted as an independent assessor at the Karolinska Institute in Stockholm, and as one of the academic advisors to the Department of Health's Revalidation Support Team.
Prof Illing and her team have undertaken a range of studies that have influenced national and local policy including the new edition of the GMC's Tomorrow's Doctors. Recent research themes include: medical transitions, professionalism, revalidation and workplace bullying in the NHS.