Learning about teaching as part of the undergraduate medical curriculum : perspectives and learning outcomes
Ross, Michael Taylor
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The General Medical Council now requires that all new medical graduates in the United Kingdom should be able to ‘function effectively as a teacher’. This thesis explores multiple perspectives on what this means, and the implications for medical student learning in relation to teaching. There is a lack of existing literature exploring how those involved in the undergraduate medical curriculum conceptualise teaching or what it means to function effectively as a teacher. There is also a lack of literature on what teaching recent medical graduates undertake, and what, if any, learning outcomes in teaching they and other key stakeholders think should be core for the undergraduate medical curriculum. To address these gaps in the literature, original data were gathered using 1) a Delphi study with eighteen experts in medical education, 2) semi-structured interviews with nineteen recent medical graduates, and 3) focus group interviews with twelve final year medical students. The three data sets were analysed individually, compared, then synthesised with the existing literature. All three participant groups articulated a wide range of conceptions of teaching, with considerable variation both within and between groups. The great majority thought that all medical students should learn about teaching as part of the undergraduate medical curriculum. Almost all of the recent graduates and medical students viewed teaching as part of the role of junior doctors working in the UK, although only two thirds of the recent graduates said they saw themselves as teachers. The recent graduates reported having delivered a wide range of teaching in their first year of work as junior doctors, and this correlated well with the range of teaching medical students reported having received from junior doctors. Teaching undertaken by recent medical graduates could be grouped into three broad categories: informal opportunistic teaching, semi-formal pre-arranged teaching, and formal organised teaching. A total of 153 learning outcomes in teaching were suggested and rated by the expert Delphi panel in terms of how appropriate they were for UK undergraduate medical curricula. Many of the graduates and students also suggested some learning outcomes in teaching before rating the 153 learning outcomes arising from the Delphi. All three groups indicated that they thought most of the 153 learning outcomes in teaching should be core for all UK undergraduate medical curricula, although there was some variation within and between groups. The majority of these learning outcomes have not been previously suggested in the literature for UK undergraduate medical curricula, but are consistent with literature on teaching competencies expected of more senior doctors. This thesis offers new insights on what teaching means to experts in medical education, recent medical graduates and current students, comparing these between groups and with the educational literature. It also offers multiple perspectives on core learning outcomes in teaching for UK undergraduate medical curricula, and greater understanding of the teaching undertaken by UK medical graduates. This thesis could help those responsible for undergraduate medical curricula to prioritise, refine and exemplify detailed learning outcomes in teaching, ensuring their graduates are more prepared for practice. It will also be of interest to policy-makers, programme directors, teachers, students, junior doctors, administrators and academics involved in medical and allied healthcare education. It is hoped that this thesis will encourage stakeholders to reflect on what teaching means to them, the role of junior doctors as teachers and the implications of learning about teaching as part of the undergraduate medical curriculum, leading to greater engagement, scholarly debate and research in this area. This in turn may lead to doctors delivering better quality teaching, to students and trainees in medicine and other disciplines receiving better teaching, and consequently to patients experiencing better healthcare.