Developing teachers and trainers in undergraduate medical education

Transcription

1 Supplemetary advice Developig teachers ad traiers i udergraduate medical educatio Advice supplemetary to Tomorrow s Doctors (2009) Cotets Page Key poits 02 Itroductio 02 Backgroud to the GMC s productio of supplemetary advice 02 What does Tomorrow s Doctors (2009) say about developig teachers ad traiers? 03 Purpose of the supplemetary advice 03 Who is the advice for? 04 Who are teachers ad traiers? 04 Selectig teachers ad traiers 05 Support ad recogitio 06 Dedicated teachig ad developmet time 06 Support etworks 06 Recogitio ad reward 07 Resources 07 Staff developmet ad traiig 08 Importace of faculty developmet 08 What makes for a competet teacher? 08 Teacher developmet programmes 09 Studets as teachers 09 Appraisal 10 Evaluatig teachig effectiveess 10 Carryig out appraisal 10 Aexes 11 Extracts o developig teachers ad traiers from Tomorrow s Doctors (2009) 11 Related documets 11 Local examples 12 Selectig teachers ad traiers 12 Support ad recogitio 13 Teacher developmet programmes 14 Studets as teachers 19 Appraisal 19 Refereces 19 Edotes 20 May

2 Developig teachers ad traiers i udergraduate medical educatio Key poits The GMC s requiremets i relatio to udergraduate teachers ad traiers are outlied i Tomorrow s Doctors (2009) i Domai 6 at paragraphs 122, 128, 148 ad 149, as well as Domai 2 at paragraphs 41 ad 51, Domai 3 at paragraph 58 ad Domai 7 at paragraphs 152, 156 ad 157. This documet sets out supplemetary advice. It does ot cotai ay ew regulatory requiremets or stadards. The advice icludes the followig major compoets. (a) (b) (c) (d) (e) (f) (g) Medical schools should esure that appoitmets to teachig roles are made o the basis of competece, aptitude ad the ability to be a good role model rather tha experiece or cliical traiig aloe (paragraphs 21 24). Teachers ad traiers should have dedicated time i their job plas (or juior doctors traiig schedules) to deliver their educatioal resposibilities ad udertake their ow traiig ad developmet (paragraphs 26 27). Schools should strive to establish ad maitai the ifrastructure that will eable ad ecourage formal ad iformal workig relatioships betwee schools, uiversities, placemet providers ad idividual teachers ad traiers (paragraphs 28 33). Schools should support ad ecourage recogitio ad reward of teachig excellece through a variety of meas, icludig teachig awards, academic promotio ad formal educatio programmes ad qualificatios (paragraphs 34 38). Teachig should be appropriately resourced. Medical schools should take every opportuity to raise the profile of teachig locally ad esure robust maagemet ad icreased trasparecy i accoutability for the use of teachig fuds (paragraphs 39 40). Schools should cosider itroducig developmet programmes which are varied ad tailored to the eeds of each teacher ad traier. The programmes could iclude some stadardised core compoets supplemeted by developmet which is focused o the topic the traier is deliverig ad o their developmet eeds (paragraphs 47 52). Obtaiig the views of a wide rage of idividuals is the best way of deliverig a objective ad comprehesive evaluatio of performace. More formal measures of quality assessmet by traied assessors could supplemet iformal feedback, measurig both teachig kowledge ad skills ad iterpersoal qualities (paragraphs 56 58). (h) The teachig performace evaluatio ad 360 degree feedback, together with the teacher s persoal reflectio, should feed ito appraisal. Teachers ad traiers may be appraised by schools/ uiversities or by other educatio providers. Educators employers should work together to eable joit appraisals of both cliical ad educatioal activities. If a joit appraisal is ot appropriate or possible, iformatio relatig to teachig or cliical performace should be sought from ad shared with the other party to facilitate whole practice appraisal ad miimise duplicatio. The outcome should iform the educatioal elemets of the teacher s persoal developmet pla or ay other actio (paragraphs 60 63). Itroductio Backgroud to the GMC s productio of supplemetary advice 1 The GMC sets requiremets for medical schools i Tomorrow s Doctors. The 2009 editio reflects lessos from the first full cycle of the GMC s process of Quality Assurace of Basic Medical Educatio (QABME) ad respods to issues that emerged sice the 2003 editio. It aims to esure that ew graduates will be fit to practise ad prepared for traiig i the Foudatio Programme ad employmet i the NHS ad for their further educatio ad traiig beyod that. The 2009 editio followed a extesive period of developmet, egagemet ad cosultatio ad drew o research o the preparedess of graduates commissioed by the GMC. 2 Medical schools are required to be compliat with the stadards ad outcomes i Tomorrow s Doctors (2009) by academic year 2011/ The GMC has supported medical schools i implemetig the ew requiremets. This has ivolved a series of implemetatio workshops across the UK ad askig schools to produce Ehaced Aual Returs (EARs) o their progress. The workshops brought together represetatives from the medical schools i a regio as well as studets, postgraduate traiig bodies ad employers. They served as a chace for schools to discuss their progress i becomig compliat with Tomorrow s Doctors (2009) ad to highlight ay challeges they were facig. 4 It became clear that the schools felt that they eeded extra advice from the GMC as to how certai requiremets i Tomorrow s Doctors (2009) should be take forward. May

3 Developig teachers ad traiers i udergraduate medical educatio 5 The GMC has therefore udertake to develop a series of advisory documets supplemetary to Tomorrow s Doctors (2009) i the followig areas: (a) assessmet (b) cliical placemets, particularly studet assistatships (c) developig teachers ad traiers (d) ivolvig patiets ad the public. The documets have bee developed with draftig advice from experts i these fields. Their support is gratefully ackowledged. 6 A aex cotais some examples of local arragemets, as described by the medical schools or istitutios ivolved or as set out i previous publicatios. These are icluded as sapshots which may be of iterest ad use to other schools as they develop arragemets appropriate for their ow eeds ad circumstaces. 7 Schools are free to make use of this advice isofar as they fid it helpful i light of local circumstaces. It covers relevat issues ad icludes suggestios. The advice is expressed as steps that schools could or should take, but it does ot idicate ay ew regulatory requiremets or stadards. What does Tomorrow s Doctors (2009) say about developig teachers ad traiers? 8 Tomorrow s Doctors (2009) emphasises the eed for all those ivolved i educatig medical studets, whether or ot employed by the school, to be appropriately prepared for ad supported i their role. The uderlyig requiremet is set out i Domai 6 o Support ad developmet of studets, teachers ad the local faculty, amely that: 128. Everyoe ivolved i educatig medical studets will be appropriately selected, traied, supported ad appraised. 9 Tomorrow s Doctors (2009) specifies particular requiremets for traiig ad evaluatio of teachig delivery, ad the formal steps which medical schools should take to esure support of teachig at ay teachig locatio. These iclude the eed for teachers to have kowledge of Tomorrow s Doctors (paragraph 148) ad traiig i equality ad diversity (paragraph 58), ad to recogise their resposibilities as role models (paragraph 149). The medical schools are expected to put i place formal agreemets with other educatio providers i ad mechaisms for moitorig the quality of teachig ad staff developmet programmes (paragraphs 41, 51 ad 148). Beyod these requiremets, Tomorrow s Doctors (2009) allows flexibility i how the local faculty is prepared ad supported, as log as they have the ecessary kowledge ad skills for their role (paragraph 148). 10 More detailed extracts from Tomorrow s Doctors (2009) ca be foud i a Aex to this documet. Purpose of the supplemetary advice 11 This advice sets out possible approaches to selectig, supportig, traiig, developig ad appraisig teachers ad traiers. 12 The GMC recogises that most teachers ad traiers provide high quality educatio, ad may medical schools ad other orgaisatios have mechaisms for developig ad supportig them. The GMC seeks to ecourage a appropriate framework of faculty developmet that supports those who teach ad uderpis excellece i educatio delivery for all medical studets i the UK. This would bear i mid the ecessary differeces i approaches ad the resource challeges that schools, uiversities ad other educatio providers experiece. 13 This documet outlies some core attributes ad areas of kowledge ad skill required by everyoe ivolved i educatig medical studets. These reflect the views of the may experts we have cosulted. Teachers ad traiers play a crucial role i the delivery of the curriculum ad i ifluecig studets attitudes ad behaviours by beig their role models. There is a rage of professioal stadards frameworks, developed by various orgaisatios, to which schools could refer for further detail. The GMC is developig its framework for approval of traiers who support ad evaluate udergraduate, foudatio ad postgraduate learers. The GMC framework will recogise a variety of existig accreditatio frameworks alogside other sources of possible evidece for approval ad maiteace of approval. 14 May teachers ad traiers ivolved i educatig medical studets i cliical settigs are also traiers ad supervisors of postgraduate traiees. Therefore, they are subject to the Stadards for traiers set out i the The Traiee Doctor 1. The GMC traier approval framework aims to put i place oe system across the cotiuum. Through its differet ature ad scope, the advice i this documet does ot compromise the madatory Stadards for traiers but rather supplemets them where appropriate. Where this advice touches upo a aspect which is covered elsewhere i the postgraduate cotext, this is icluded for ease of referece. However, this documet is midful of some fudametal May

4 Developig teachers ad traiers i udergraduate medical educatio differeces betwee academic ad cliical learig eviromets, ad betwee the skills required of teachers of udergraduate medical studets ad those supervisig more experieced traiees. 15 This advice is writte o the premise that the majority of medical studets educators are doctors. The GMC, however, welcomes the learig opportuities delivered by other health professioals ad by patiets ad the public, ad aspects of this advice may apply to o-medical teachers ad traiers of medical studets. Who is the advice for? 16 Medical schools are the primary audiece of this advice. Other parties ivolved i deliverig of medical studets educatio, such as NHS bodies ad idividual teachers ad traiers, may also fid it useful. 17 Tomorrow s Doctors (2009) assigs a umber of resposibilities to medical schools, NHS orgaisatios ii ad idividual doctors, for example: (a) Medical schools are resposible for providig support ad traiig to teachers ad supervisors (paragraph 3(g)) (b) NHS orgaisatios are resposible for: i. esurig that performace of teachig resposibilities is subject to appraisal (paragraph 4(b)) iii ii. icludig, whe appropriate, a cotractual requiremet for doctors to carry out teachig (paragraph 4(c)) iii. releasig doctors ad others to complete the traiig eeded to be teachers (paragraph 4(d)) (c) Idividual doctors are resposible for: i. followig the requiremets of Good Medical Practice, icludig beig willig to cotribute to the educatio of studets (paragraph 5(a)) ii. developig the skills ad practices of a competet teacher if they are ivolved i teachig (paragraph 5(b)) iii. meetig cotractual requiremets, icludig those relatig to teachig (paragraph 5(f)). 18 Tomorrow s Doctors (2009) calls for more structured arragemets for educatioal provisio uderpied by agreemets betwee medical schools ad other educatio providers. This reiforces the role ad resposibilities of the other educatio providers. Medical schools should state clearly their expectatios of provider orgaisatios ad what evidece of teachig quality will be required. Agreemets should iclude arragemets for appoitig teachers ad traiers ad evaluatio of their performace iv. Who are teachers ad traiers? 19 It is easier to defie ivolvemet i teachig i the academic settig tha i the cliical eviromet. Most doctors from as early as their Foudatio Programme traiig, ad some other healthcare professioals, are ivolved i teachig ad supportig medical studets ad juior doctors to some extet. Educatioal activities i cliical or vocatioal settigs could iclude: formal educatioal activities timetabled evets such as providig tutorials or teachig ward rouds, assessig studets, coductig educatioal appraisals ad beig ivolved i educatioal maagemet, such as co-ordiatig placemets or committee work ad iformal educatioal activities the educatio that occurs i a spotaeous case-specific way withi the cliical role such as supervisig practice, workplace assessmets ad givig feedback, beig observed i theatre or cliic ad providig uplaed explaatios ad iformatio. 20 This advisory documet applies to ay idividual with resposibility for, or a role i, medical studets educatio, icludig cliical academics as well as NHS ad other cliicias. Arragemets would be proportioate to their level of ivolvemet. This advice predomiatly refers to teachers ad traiers, or educators, meaig all those who oversee learers developmet ad practice. However, we recogise that a variety of terms are used, for example: teacher or educator ay idividual with a role i teachig, traiig ad supervisio traier a experieced practitioer who is ivolved i teachig, traiig ad supervisio i the workplace, particularly for traiee doctors 2 medical academic a doctor employed by a uiversity to provide teachig to udergraduate medical studets ad/or postgraduate doctors. They are employed by uiversities or other May

5 Developig teachers ad traiers i udergraduate medical educatio higher educatio istitutios. Those who also hold hoorary cotracts with NHS istitutios are kow as cliical academics. They may teach studets ad/or traiees i lectures, semiars, practical laboratory demostratios ad cliical attachmets, but could also be resposible for curriculum desig, plaig of assessmets, quality assurace, admissios ad studet support 3. They will ofte also have research resposibilities educatioal supervisor a doctor resposible for cosiderig the idividual studet s progress agaist learig objectives set either by themselves or by the medical school. The educatioal supervisor should also facilitate the studet s reflective learig by discussig with them the patiets ad procedures they have gaied experiece from durig their placemet. The educatioal supervisor ca either be based withi the placemet provider where the studet is udertakig their placemet or withi the medical school Selectig teachers ad traiers 21 Not everyoe is aturally good at educatig others. Idividuals stregths may lie elsewhere, for example i research or direct patiet care. With ever icreasig demads o the curriculum ad expectatios regardig graduates, the role ad expertise of traiers is becomig more importat tha ever. Approval of traiers has bee a requiremet i geeral practice for some time 4, but ot yet i udergraduate settigs or the secodary care sector. While Good Medical Practice 5 expects all doctors to be willig to cotribute to educatioal activities, it is advisable that teachers ad traiers i academic ad/or cliical settigs be selected for these roles. 22 The GMC will be cosiderig the issues i relatio to selectio of cliical traiers as it develops the framework for approval of traiers. A variety of approaches to selectig educators curretly exist. Some are i favour of selectio o the basis of experiece 3, others focus more o the educators traiig or qualificatio(s). cliical supervisor ay doctor or other healthcare professioal resposible for the supervisio or assessmet of a studet o a placemet v examier or assessor ayoe resposible for markig, assessig or judgig studets performace, regardless of the termiology used i ay particular school. I the postgraduate cotext: The Traiee Doctor icludes the followig defiitios: A cliical supervisor is a traier who is selected ad appropriately traied to be resposible for overseeig a specified traiee s cliical work ad providig costructive feedback durig a traiig placemet. Some traiig schemes appoit a educatioal supervisor for each placemet. The roles of cliical ad educatioal supervisor may the be merged. A educatioal supervisor is a traier who is selected ad appropriately traied to be resposible for the overall supervisio ad maagemet of a specified traiee s educatioal progress durig a traiig placemet or series of placemets. The educatioal supervisor is resposible for the traiee s educatioal agreemet. (Edote 2) I the postgraduate cotext: The Stadards for traiers i The Traiee Doctor state: 6.36 Traiers with additioal educatioal roles, for example traiig programme director or director of medical educatio, must be selected agaist a set of criteria, have specific traiig for their role, demostrate ability as effective traiers ad be appraised agaist their educatioal activities GP traiers must be traied ad selected i accordace with the Medical Act Medical schools should esure that appoitmets to ad allocatios of teachig roles are made o the basis of competece, aptitude ad the ability to be a good role model rather tha experiece or cliical traiig aloe. Those with a iterest i teachig ad the potetial to become excellet educators should be ecouraged ad give a opportuity to do so, icludig the ecessary support ad traiig. Selectio of teachers should, wherever possible, reflect the diversity of the local studet ad patiet populatio. This ca be especially importat for female studets ad those from miority ethic backgrouds i terms of role models. 24 Selectio o the basis of attributes other tha traiig or qualificatios is a developig area, ad medical schools might cosider sharig their experieces i relatio to criteria ad process. Later i this documet we discuss the characteristics ad skills which it might be helpful for educators to have. May

6 Developig teachers ad traiers i udergraduate medical educatio However, these should ot be see as madatory selectio criteria, ot least because some skills ca be acquired followig appoitmet ad some characteristics ca oly be evaluated over time. Support ad recogitio 25 A multitude of factors ifluece the medical educatio eviromet. Budgetary costraits ad reductio i time available for teachig lead to icreasig tesios i both cliical ad uiversity settigs, with competig priorities to deliver high quality patiet care, research ad teachig. The GMC would expect medical schools ad uiversities to show cotiuig recogitio of the value of medical educatio ad support for teachers ad traiers. Dedicated teachig ad developmet time 26 Teachers ad traiers should have dedicated time i their job plas (or juior doctors traiig schedules) to deliver their educatioal resposibilities. This would aid recogitio of the value of teachig ad raise its priority 6. Some professioal orgaisatios have issued guidace o recogitio of teachig resposibilities i job plas 7,8,9 which medical schools should cosider. 27 Teachers ad traiers should also have the time to udertake their ow traiig ad developmet. Agreemets betwee medical schools ad other educatio providers ca offer a lever for the schools to implemet ad moitor the availability of study leave for cliical staff to eable teacher developmet. I the postgraduate cotext: The Stadards for traiers i The Traiee Doctor state: Stadard: Traiers must be supported i their role by a postgraduate medical educatio team ad have a suitable job pla with a appropriate workload ad sufficiet time to trai, supervise, assess ad provide feedback to develop traiees Orgaisatios providig medical educatio ad traiig must esure that traiers have adequate support ad resources to udertake their traiig role Postgraduate deaeries must have structures ad processes to support ad develop traiers, ad must provide traiers with iformatio about how to access traiig ad support to help them to udertake their roles ad resposibilities effectively. Support etworks 28 Schools should establish ad maitai the ifrastructure for close workig relatioships betwee schools, uiversities, placemet providers ad idividual teachers ad traiers, icludig those workig at remote sites. These relatioships could be both formal ad iformal, istillig a degree of owership of ad resposibility for the programme amog teachers ad traiers 10 ad supportig them i their role. Tomorrow s Doctors (2009) requires that: 152. Teachers from the medical schools ad other educatio providers will be closely ivolved i curriculum maagemet, represeted at medical school level ad resposible for maagig their ow areas of the programme. 29 Relatioships ad etworks should ivolve the local Foudatio Schools ad postgraduate deaeries. Amog other beefits, this would eable a coordiated approach to teacher support ad developmet, which is highly desirable, cosiderig the sigificat overlap i the teachig faculty membership ad the requiremets of them. 30 Schools should esure that teachers kow what support etworks are available ad how to access them icludig atioal ad iteratioal etworks through bodies such as the Associatio of the Study of Medical Educatio (ASME), the Associatio for Medical Educatio i Europe (AMEE), the Academy of Medical Educators (AoME) ad the Higher Educatio Academy (HEA) subject cetre for medicie, detistry ad veteriary medicie (MEDEV). The etworks should be uderpied by effective two-way commuicatio betwee schools ad teachers, for example relatig to resources or materials, or dealig with problems. Regular updates o developmets should be available to teachers ad traiers, for example aroud curriculum cotet or applicatio of assessmets. Also, there should be mechaisms eablig educators to ifluece the cotet ad methods of delivery of the curriculum, either directly or through their represetatives at medical school level. I the postgraduate cotext: The Stadards for traiers i The Traiee Doctor state: Stadard: Traiers must be ivolved i, ad cotribute to, the learig culture i which patiet care occurs Traiers must esure that cliical care is valued for its learig opportuities; learig, assessmet ad teachig must be itegrated ito service provisio Traiers must liaise as ecessary with other traiers both i their cliical departmets ad withi the orgaisatio to esure a cosistet approach to educatio ad traiig ad the sharig of good practice across specialties ad professios. 31 Schools should facilitate ad ecourage peer support etworks. Some schools hold regular, at least aual, iformal educatio evets such as teachig May

7 Developig teachers ad traiers i udergraduate medical educatio cofereces. These offer teachers a opportuity to keep abreast of developmets, share good practice ad experieces ad participate i the curriculum plaig. This practice is well received by the schools teachig staff. Networks ivolvig other professioals ad lay people ivolved i teachig medical studets could help develop ew perspectives, iovatio ad collaboratio. 32 Schools should also establish or maitai metorship schemes for teachers ad traiers, particularly for those ew to the role or the curriculum. Schools should cosider the possibility of formally egagig metors i teachers appraisal ad developmet plaig, with appropriate support ad developmet provided to the metors. 33 To facilitate commuicatio betwee medical schools ad other educatio providers there should be a udergraduate dea/lead withi each provider resposible for coordiatig ad promotig medical studets cliical traiig. This perso should be resposible for delivery of the agreemet with that placemet provider, for the appoitmet ad developmet of faculty ad for providig support ad directio for studets vi. The udergraduate dea/ lead may be assisted by a variety of udergraduate co-ordiators ad departmet leads i the overall maagemet of educatio locally. The udergraduate dea/lead should be closely ivolved i curriculum developmet ad be kept regularly iformed about ay chages ad the results of studet evaluatio of the locality for which they are resposible. They should be formally appraised i their role to discuss both the provider ad their idividual performace ad developmet eeds. They should hold a positio which eables them to ifluece the provider o educatioal matters. Recogitio ad reward 34 While adequate paymet for teachig resposibilities is essetial, reward is ofte about recogitio. Job plas should reflect relevat activities. There are a variety of ways i which teachig excellece could be rewarded, ad schools should support ad ecourage these. 35 For example, various recogitio schemes could be cosidered, whether local, such as UCL medical school s Top Teacher Awards, or atioal, such as the Natioal Teachig Fellowship Scheme Idividual Awards or fellowships of the Academy of Medical Educators or the Higher Educatio Academy. 36 Also, uiversities should be ecouraged to use academic titles such as Hoorary Lecturer i Medical Educatio to recogise NHS staff, ad to publicise the achievemets of staff that have bee awarded prizes for teachig distictio, just as staff are recogised for research achievemet The academic promotio of teachers is key to icetivisig ad rewardig those ivolved i medical educatio. Traditioally, most uiversities have rewarded research excellece over teachig excellece i promotio procedures. Recetly, the regulatios aroud academic promotio have bee updated i may istitutios, ad the problems are ot with the lack of ackowledgemet of educatio i the criteria, but with their implemetatio. There should be clear guidace o promotio criteria ad medical schools may offer advice to teachers o how promotio criteria ca be met. The schools should also be aware that some groups of teachers may have additioal barriers to promotio, such as family commitmets restrictig their availability out-of-hours, ad cosider whether these could be mitigated. Subject to performace, cliical educatioalists should be promoted at a rate similar to that of cliical researchers 9, Teachers ad traiers should be ecouraged ad supported i pursuig formal medical educatio programmes ad qualificatios 12,13, which may help with evidece for recogitio ad career progressio. Resources 39 Esurig that adequate resources are available for teachig is icreasigly importat i the curret eviromet of fiacial challeges. Allocatio of fudig, traditioally, is perceived to be biased towards research or delivery of direct patiet care 3, 9, 14. While research ad patiet care are crucial, it is also importat to raise the status of teachig ad traiig. High quality teachig is fudametal to developig the ext geeratio of academics ad cliicias, ad therefore the quality of patiet care i the log term. May teachig skills, such as listeig, are trasferable to, ad erich the quality of, patiet care ad are therefore immediately beeficial to the health service providers. There is icreasig recogitio of the resposibility ad accoutability of healthcare providers for educatio ad traiig of their staff. Medical schools should take every opportuity to raise the profile of teachig locally. 40 The fudig that has bee allocated to supportig educatio i the academic ad i cliical settigs should be used for this purpose oly 15. Robust maagemet ad icreased trasparecy i accoutability for the use of teachig fuds, facilitated by agreemets with other educatio providers, would help medical schools moitor this. May

8 Developig teachers ad traiers i udergraduate medical educatio Staff developmet ad traiig Importace of faculty developmet 41 Tomorrow s Doctors (2009) highlights the importace of staff developmet, ad developmet of teachig skills i particular, both at medical school ad at other educatio providers The medical school must esure that staffdevelopmet programmes promote teachig ad assessmet skills. All staff (icludig those from other educatio providers) should take part i such programmes. 42 Tomorrow s Doctors (2009) sets out the uderlyig expectatio that these developmet programmes should aim for preparedess for the role Medical schools must make sure that everyoe ivolved i educatig medical studets has the ecessary kowledge ad skills for their role The medical school must esure that appropriate traiig is provided to these people to carry out their role Doctors with particular resposibilities for teachig studets must develop the skills ad practices of a competet teacher 43 This requiremet is also mirrored i Good Medical Practice: 16. If you are ivolved i teachig you must develop the skills, attitudes ad practices of a competet teacher Beig a good teacher ad role model is ot iate ad the skills ad attributes ca usually be acquired. But this will to some extet deped o a aptitude ad a wish to teach. With the right developmet, traiig ad support, more teachers ad traiers ca be eabled to provide high quality teachig 3, 16. I the postgraduate cotext: The Stadards for traiers i The Traiee Doctor state: Stadard: Traiers must provide a level of supervisio appropriate to the competece ad experiece of the traiee Traiers must eable traiees to lear by takig resposibility for patiet maagemet withi the cotext of cliical goverace ad patiet safety Traiers must uderstad ad demostrate ability i the use of the approved i-work assessmet tools ad be clear as to what is deemed acceptable progress Traiers must regularly: review the traiee s progress through the traiig programme; adopt a costructive approach to givig feedback o performace; esure the traiee s progress is recorded; idetify their developmet eeds; advise o career progressio; ad uderstad the process for dealig with a traiee whose progress gives cause for cocer. Stadard: Traiers must uderstad the structure ad purpose of, ad their role i, the traiig programme of their desigated traiees Traiers must have kowledge of, ad comply with, the GMC s regulatory framework for medical traiig Traiers must esure that all ivolved i traiig ad assessmet of their desigated traiee uderstad the requiremets of the programme. What makes for a competet teacher? 45 All doctors should gai a basic uderstadig of ad skills i teachig ad learig durig their udergraduate ad postgraduate educatio ad traiig. However, those with sigificat ivolvemet i teachig ad traiig will eed more specialised skills. Exact requiremets will vary accordig to the eeds of the role ad the local structures. For example, teachers ivolved i iterprofessioal educatio may eed particular attributes or skills i reflectig ad givig feedback. A umber of detailed frameworks have bee developed which set out the kowledge, skills ad characteristics required of teachers i various roles ad eviromets 12, 13, 17, 18, 19. Medical schools should refer to these as they desig their staff developmet programmes. 46 However, some key attributes for all teachers ad traiers ca be idetified, reflectig the requiremets i Tomorrow s Doctors (2009) ad evidece we have received. This is either a comprehesive or a detailed list. Key attributes ad skills of teachers ad traiers Appropriate professioal behaviour towards patiets, colleagues ad others (Tomorrow s Doctors (2009), paragraph 149) Ability to support, motivate, ecourage ad metor studets, ad ethuse them about carig for patiets Good commuicatio, icludig presetatio ad listeig skills Commitmet to teachig Awareess of the curriculum ad their role withi it, icludig kowledge of the learig objectives ad aims Uderstadig ad applicatio of Tomorrow s Doctors (2009) May

9 Developig teachers ad traiers i udergraduate medical educatio Kowledge of assessmet tools ad ability to assess objectively Ability to aalyse someoe s performace ad give costructive feedback Ability to utilise a rage of commuicatio, learig ad teachig styles ad methods, such as developmet of problem-solvig skills ad learig through active participatio Awareess of the priciples of equality ad diversity ad the relevat school policies, ad ability to treat studets fairly ad impartially, with regard to disabilities ad the variety of cultural, social ad religious backgrouds Keepig up to date with evidece ad developmets i medical educatio, adoptig a flexible approach ad beig ope to chage Followig other guidace set out i Good Medical Practice, icludig keepig up to date with kowledge of cliical practice ad academic advaces i the relevat field, ad recogisig ad workig withi the limits of oe s competece. Teacher developmet programmes 47 The required kowledge ad skills ca be acquired by teachers ad traiers i a umber of ways, such as: formal traiig metorship experiece self-directed learig. 48 Uiversities usually have requiremets for traiig of teachers ad assessors, ad formal traiig remais oe of the key methods of teacher developmet. A variety of medical educatio courses are available to those with or itedig to take up a teachig role, from courses leadig to a teachig qualificatio to short focused local traiig sessios. Medical schools ad other educatio providers should support teachers i pursuig medical educatio courses ad teachig qualificatios whe appropriate 12, 13, but they should also esure that staff developmet is ot limited to formal traiig. Medical schools should make sure that appropriate traiig is provided or arraged for cliical teachers employed by NHS bodies ad other educatioal providers. 49 A developmet programme for someoe with a role i teachig ad traiig medical studets could iclude these broad themes: iductio, icludig requiremets of the role ad the school s support ifrastructure (this should be compulsory o appoitmet to the role) priciples of teachig ad learig expected outcomes of learig, icludig the stadard ad the acceptable level of variatio May methods of curriculum delivery such as the spiral curriculum, group work ad self-directed learig assessmet methodology ad givig feedback priciples of equality ad diversity. 50 Schools should cosider whether it is feasible to itroduce developmet programmes which are tailored to the eeds of each teacher ad traier. The programmes could iclude some stadardised core compoets, for example as part of iductio or refresher traiig. These ca the be supplemeted by a rage of subject-specific traiig which is focused o the topic the traier is deliverig ad o their developmet eeds. 51 The programmes should strive to accommodate a variety of approaches to traiig appropriate to a particular local teachig eviromet, provided the expected outcomes are met. Some schools use iovative ways of deliverig traiig to staff. For example, a umber of schools are takig stadardised courses to regioal sites ad traiig departmets. This approach is provig effective whe a cliical placemet/traiig uit is located some distace from the school that provides traiig, ad it is difficult for traiers to travel to atted courses. Also, some schools have developed web-based materials for teachers ad traiers to access wheever required. However, it is importat that these approaches supplemet rather tha replace face-to-face traiig ad developmet. 52 Schools could cosider usig systems which would allow easy recordig ad trackig of the traiig received by teachers, ad facilitate its recogitio across the local educatio provider boudaries. Studets as teachers 53 The role of the doctor as teacher has received wide ackowledgemet ad recogitio 5, 20. To prepare graduates for this role, Tomorrow s Doctors (2009) emphasises the importace of developig medical studets core skills i educatio ad teachig: 21(f). [A graduate will be able to] fuctio effectively as a metor ad teacher icludig cotributig to the appraisal, assessmet ad review of colleagues, givig effective feedback, ad takig advatage of opportuities to develop these skills. 54 Some medical schools are offerig opportuities which urture teachig skills i studets beyod those required to meet the outcome i Tomorrow s Doctors (2009). These iclude a variety of teachig courses ad opportuities to deliver teachig to peers, subject to appropriate supervisio, ad to receive feedback ad metorig. All schools should

10 Developig teachers ad traiers i udergraduate medical educatio cosider whether this is somethig their course could beefit from. Appraisal Evaluatig teachig effectiveess 55 Tomorrow s Doctors (2009) requires the quality of teachig, learig ad assessmet to be evaluated i uiversity ad cliical settigs. This ot oly measures a importat aspect of quality of the educatio programme, but also idicates where teacher developmet ad traiig is most required, facilitates recogitio of teachig ad eables quality improvemet. 41. The medical schools will have systems to moitor the quality of teachig ad facilities o placemets. 51. There must be procedures i place to check the quality of teachig, learig ad assessmet, icludig that i cliical/vocatioal placemets, ad to esure that stadards are beig maitaied. These must be moitored through a umber of differet systems, icludig studet ad patiet feedback, ad reviews of teachig by peers. 56 A umber of schools are already usig a rage of strategies to evaluate differet aspects of the quality of teachig. These measure the quality of the programme more geerally, such as whether objectives are beig met ad assessmet methods reflect the course 19, as well as the quality of teachig delivered. The methods iclude peer observatio, studet feedback questioaires ad formal visits. Some schools, depedig o the educatioal structures, also seek the views of teachers metors ad udergraduate medical educatio leads at the cliical ad vocatioal placemet providers. 57 It may be challegig to obtai the views of a wide rage of idividuals i relatio to teachig provided by every teacher, but it is the best way of deliverig a objective ad comprehesive evaluatio of performace. More formal measures of quality assessmet could supplemet iformal feedback, ad should measure both teachig kowledge ad skills ad iterpersoal qualities. Those evaluatig teachig performace should themselves be prepared ad traied i assessmet methodology, especially i case of formal assessmets. A multi-faceted ad fair approach to evaluatig the quality of teachig ca idetify stregths ad weakesses ad allow teachig excellece to be rewarded or additioal traiig or remediatio to be provided where appropriate 3. be utilised by schools ad other educatio providers i additio to existig methods 3, 19, Appraisal is a opportuity to review idividuals commitmet to the developmet of their teachig skills. Carryig out appraisal 60 While processes will vary betwee employers, appraisals of those with roles i teachig ad traiig should iclude the educatioal activities they udertake, as suggested i Tomorrow s Doctors (2009): 51. Appraisals should cover teachig resposibilities for all relevat cosultat, academic ad other staff, whether or ot employed by the uiversity. 4(b). NHS orgaisatios vii are resposible for esurig that performace of teachig resposibilities is subject to appraisal. 61 Depedig o their employmet status ad the proportio of their commitmets i academic ad cliical settigs, teachers ad traiers may be appraised by schools/uiversities or by other educatio providers. Educators employers work together to eable joit appraisals of both cliical ad educatioal activities, as agreed i the Cosultat Cliical Academic Cotract 2004 ad outlied i the Follett Review report 22. If a represetative from the other employer caot be preset or a joit appraisal is ot appropriate, iformatio relatig to teachig or cliical performace should be sought from ad shared with the other party to eable whole practice appraisal ad miimise duplicatio The result of the teachig performace evaluatio ad 360 degree feedback, together with the teacher s persoal reflectio, should feed ito appraisal. The outcome should iform the educatioal elemets of the teacher s persoal developmet pla or ay other actio. This approach would eable schools to target traiig ad resources where there is most eed. 63 I time, such arragemets will also support the revalidatio of medical teachers ad traiers. 58 A umber of frameworks have bee suggested for evaluatig the effectiveess of teachig, which may May

11 Developig teachers ad traiers i udergraduate medical educatio Aexes Extracts o developig teachers ad traiers from Tomorrow s Doctors (2009) Domai 2 Quality assurace, review ad evaluatio Criteria 41 The medical school will have agreemets with providers of each cliical or vocatioal placemet, ad will have systems to moitor the quality of teachig ad facilities o placemets. Detailed requiremets ad cotext 51 There must be procedures i place to check the quality of teachig, learig ad assessmet, icludig that i cliical/vocatioal placemets, ad to esure that stadards are beig maitaied. These must be moitored through a umber of differet systems, icludig studet ad patiet feedback, ad reviews of teachig by peers. Appraisals should cover teachig resposibilities for all relevat cosultat, academic ad other staff, whether or ot employed by the uiversity. Domai 3 Equality, diversity ad opportuity Detailed requiremets ad cotext 58 Staff will receive traiig o equality ad diversity to esure they are aware of their resposibilities ad the issues that eed to be take ito accout whe udertakig their roles i the medical school. Domai 6 Support ad developmet of studets, teachers ad the local faculty Stadard 122 Everyoe teachig or supportig studets must themselves be supported, traied ad appraised. Criteria 128 Everyoe ivolved i educatig medical studets will be appropriately selected, traied, supported ad appraised. Detailed requiremets ad cotext: Support for educators 148 Medical schools must make sure that everyoe ivolved i educatig medical studets has the ecessary kowledge ad skills for their role. This icludes teachers, traiers, cliical supervisors ad assessors i the medical school or with other educatio providers. They should also make sure that these people uderstad Tomorrow s Doctors ad put it ito practice. The medical school must esure that appropriate traiig is provided to these people to carry out their role, ad that staff developmet programmes promote teachig ad assessmet skills. All staff (icludig those from other educatio providers) should take part i such programmes. 149 Every doctor who comes ito cotact with medical studets should recogise the importace of role models i developig appropriate behaviours towards patiets, colleagues ad others. Doctors with particular resposibility for teachig studets must develop the skills ad practices of a competet teacher ad must make sure that studets are properly supervised. Domai 7 Maagemet of teachig, learig ad assessmet Criteria 152 Teachers from the medical school ad other educatio providers will be closely ivolved i curriculum maagemet, represeted at medical school level ad resposible for maagig their ow areas of the programme. Detailed requiremets ad cotext 156 Medical school teachers ad other educatio providers ad their staff should be ivolved i maagig their ow areas of the curriculum, ad should be represeted o medical school committees ad groups. 157 The medical school must have agreemets with the other educatio providers who cotribute to the delivery of the curriculum. These should specify the cotributio, icludig teachig, resources ad the relevat curriculum outcomes, ad how these cotributios combie to satisfy the requiremets set out i Tomorrow s Doctors. Related documets Academy of Medical Educators, Professioal Stadards, 2009: aome/?likservid=567ede0b-155d-2b c1c72c7937f&showmeta=0 BMA Board of Medical Educatio, Doctors as Teachers, 2006: doctorsasteachers.jsp?page=1 GMC, The Traiee Doctor, 2011: GMC, Tomorrow s Doctors, 2009: tomorrows_doctors.asp Roald Harde ad Joy Crosby, The Good Teacher is More Tha a Lecturer: The Twelve Roles of the Teacher, Educatio Guide No. 20, AMEE, 2000 Higher Educatio Academy, The UK Professioal Stadards Framework for teachig ad supportig learig i higher educatio, 2006: uiversitiesadcolleges/accreditatio/ukpsf May

12 Developig teachers ad traiers i udergraduate medical educatio Michelle McLea, Fracois Cilliers ad Jacquelie M va Wyk, Faculty Developmet: Yesterday, Today ad Tomorrow, Guide No. 33, AMEE, 2010 QAA, Code of Practice for the assurace of academic quality ad stadards i higher educatio, updated i sectios: codeofpractice/ Yvoe Steiert, Kare Ma, Agel Ceteo, Diaa Dolmas, Joh Specer, Mark Gelula ad David Prideaux, A systematic review of faculty developmet iitiatives desiged to improve teachig effectiveess i medical educatio: BEME Guide No. 8, Medical Teacher, Vol 28, No 6, 2006, pp Local examples Selectig teachers ad traiers Aberdee medical school appoitmet of practicebased tutors Geeral practice attachmets take place i practices aroud Scotlad. GPs are appoited o the basis of quality criteria pertaiig to themselves as tutors ad their practices as teachig eviromets. Formal Uiversity status, as Hoorary (Seior) Cliical Tutors, ad as Accredited Teachig Practices, is awarded respectively, reviewable every two years. Machester medical school etwork of GP educatio facilitators The Health Educatio Zoe (HEZ) model is based aroud a teachig hospital ad its related PCTs localcotacts/ We have 22 GP educatio facilitators (GPEFs) coverig each PCT area withi our boudary ad oe who specialises i traiig for ST3s, support practices ad other tutor traiig requiremets should a GPEF be overloaded with other parts of their role. Most GPEFs work 2 sessios per week for us for which they are paid. I geeral, their role covers: tutor recruitmet quality assurace of placemets icludig dealig with studet cocers ad complaits tutor traiig ad developmet all tutors are required by cotract to udertake 2 sessios of traiig per year so they all eed to ru traiig i their local HEZ atted commuity HEZ meetigs at their base hospital with Commuity Based Medical Educatio (CBME) staff to update o progress ad discuss ay arisig matters atted 3 GPEF meetigs per year which eables us (MMS) to deliver traiig they may require ad have discussios aroud progressig commuity placemets ad curriculum issues (such as curriculum chages). Our mai area of focus this year is probably i the traiig of GP tutors. We are workig with MMS staff developmet to improve ad stadardise the traiig the GPEFs deliver to tutors through a more structured model which would hopefully meet the eeds of the tutors ad improve the studets experiece. We are also itroducig a peer appraisal system which will work towards their revalidatio process ad with more teachig fellows i place there will hopefully be a focus o developig the GPEF model tappig ito idividuals stregths, ad the developmet of the coectio betwee the GPEFs ad GP cosortia i Northumbria NHS Foudatio Trust selectio to cosultat teachig posts For formal Uiversity-liked posts, such as Seior Lecturers, we would always have a represetative of the Newcastle Medical School o the pael. For other Trust appoitmets which have a sigificat teachig commitmet, we have oe of our cliical academics. We have a expectatio that all of our cosultats will be traiers. But ow that we have established our ow iteral appraisal of educatio, there is a possibility that i the future, if quality or quatity of educatio delivery was ot satisfactory, some would have this removed from their job pla. This ties i with our system of teachig ad traiig ow beig explicit withi job plas. Three years ago we decided to review our appoitmet system, put out a teder ad, workig with Edgecumbe Cosultig of Bristol, we established a set of competecies for a Northumbria Cosultat through a series of workig groups with a rage of medical ad ursig staff. All iterviews are agaist these competecies weighted for the characteristics of the post. Our iterviews last for two days. O the first the cadidates complete two psychometric assessmets. The they take part i assessed cliical/teachig/ commuicatio scearios crafted for the particular post. The results of the Psychometrics ad Assessed Exercises are available to the iterview pael. The iterview questio domais will have bee allocated at the plaig meetig followig shortlistig. The weightig score for each competecy will also be agreed ad the questios plaed ad agreed. O the day of iterview, the questios may be modified depedig o the psychometric/assessmet iformatio or if the pael feel areas eed further exploratio or were ot fully aswered. At the ed, the scorig multipliers are applied ad a agreed pael score determied, icludig the scores from the scearios. Appoitmet is by rak order. May

13 Developig teachers ad traiers i udergraduate medical educatio We have adopted a rule that we do ot appoit if the score is less tha 70%. This system has performed extremely well. All of the cliical maagers feel they have a much better kowledge of the stregths ad weakesses of their ew colleagues ad we are able to tailor their post ad developmet ad support. Support ad recogitio NHS Educatio Scotlad (NES) joit workig across udergraduate ad postgraduate educatio NHS Educatio Scotlad (NES) established a Scotlad-wide Faculty Developmet Project. This had support of the Medical Schools, through the Scottish Deas Medical Educatio Group (SDMEG) ad the Scottish Postgraduate Deas, through the NES Medical Executive Team (MDET). These two groups are liked through the NES Medical Advisory Group. A project pla has bee agreed, with four workstreams, ruig i parallel: Phase 1 to review ad sythesise existig literature ad develop teachig competecies for cosultats ad other teachers i Scotlad who are teachig udergraduates ad traiig postgraduates. Phase 2 to cosider the appropriate programmes to deliver faculty developmet ad provide evidece of attaimet. Phase 3 to develop a costed implemetatio pla i cojuctio with stakeholders to deliver the programmes withi agreed timescales to meet GMC requiremets. Phase 4 to develop a electroic system to record teacher traiig udertake by cosultats i Scotlad. Phase 1 of the programme is particularly sighted o the existig GMC stadards for traiers, ad o the work recetly completed by the Academy of Medical Educators ad the Academy of Medical Royal Colleges. Liverpool medical school Problem Based Learig (PBL) teachers as metors Log experiece shows that cotiuig support for PBL facilitators is essetial. There is o substitute for regular briefigs ad a routie of traiig sessios, ad the formal peer review of teachig, but sice the iceptio of the PBL programme i 1996 the school has also bee ecouragig PBL facilitators to omiate metors from a list of voluteers experieced PBL teachers. The selectio is oversee by the Director of PBL, who esures that o voluteer is overloaded. Most people fid the system particularly helpful i their first year or so of facilitatig. Dudee medical school egagig with the local NHS ad NHS Educatio Scotlad NHS Tayside has appoited a Director of Medical Educatio who is a seior cliicia, a member of the Uiversity Medical Educatio Committee (UMEC) ad has a focus o udergraduate educatio. A additioal appoitmet is a full time Quality Assurace Coordiator who is a member of the Curriculum Maagemet Team. These appoitmets have sigificatly improved the process by which udergraduate teachig is coordiated ad delivered by NHS parters ad its quality is moitored. Specific iitiatives ad approaches to esurig a rage of quality experieces which have to date resulted from this strategic appoitmet iclude: overall quality moitorig provided for i the Service Level Agreemet (SLA) by way of the Tayside Teachig Quality Documet a Memoradum of Uderstadig (MOU) betwee NHS Tayside ad the Uiversity of Dudee with a requiremet that cliical teachers show evidece of takig part i staff developmet activities relatig to teachig QA processes oversee by NHS Educatio Scotlad (NES) use of the Additioal Cost of Teachig (ACT) Developmet/Support Fud to ecourage iovative ways to ifluece improvemets i the quality of teachig eg Disciplie based teachig leads, Staff developmet, Cliical skills appoitmets ad IT ad e-learig developmet support ACT local ad regioal groups overseeig quality moitorig ad strategic plaig developmet of a Scotlad wide performace Maagemet Framework to moitor quatum ad quality of teachig i partership with Dudee Medical School improvemets i commuicatio with NHS staff i respect of teachig via the NHS Tayside Itraet/ Blackboard ad Newsletters formal accoutability criteria for ew positios or projects to moitor performace Faculty of Medical Educators (FaME) awards which ackowledge ad celebrate excellece i teachig developmet of a Voicig Cocers Policy to eable studets to voice cocers about teachig or patiet care the joit fudig (NHS ad Uiversity of Dudee) of ew educatio facilities. Leeds medical school egagemet with NHS tutors i geeral practice The Academic Uit of Primary Care (AUPC) at the Uiversity of Leeds adopts a combiatio of approaches to maitai effective relatioships ad close egagemet with NHS tutors i geeral practice. This allows us May

14 Developig teachers ad traiers i udergraduate medical educatio to assess ad improve the quality of our primary care placemets ad GP tutors. A aual Service Level Agreemet which outlies expectatios ad policies; siged by the practice, Uiversity ad SHA. Studet evaluatio completed ad aually retured to practices; ad iformal feedback regardig placemets is actively ecouraged. Aual quality assurace visits; sharig ideas for best practice ad allowig feedback regardig the course ad its orgaisatio. Commuicatio via a bimothly e-bulleti, ad regular ewsletter. A Cotiuig Professioal Developmet programme which icludes a series of Uiversity accredited workshops desiged for GP tutors. Local etwork meetigs; aual cliical teacher away days ad bieial GP tutor away day all ehace commuicatio ad partership. Glasgow medical school aual TALE (the Teachig Ad Learig Evet) TALE is Glasgow Medical School s aual, oe-day coferece for GPs who teach udergraduates i the West of Scotlad. There are 120 delegate places, represetig about half of all GP tutors. Held o campus i September, it begis with a early morig keyote address from a ivited speaker. This is followed by year-specific workshops, plaed ad hosted by members of staff who have resposibility for teachig a particular year or stage of the curriculum. These workshops cover issues raised by tutors, chages to the curriculum, ew teachig materials or documetatio, ad admiistrative issues. After a luch there are afteroo workshops o a diversity of educatioal topics. GP tutors sig up for these workshops, each of which rus for about a hour ad is offered twice i the afteroo, to maximise choice. Each tutor ca therefore atted two workshops of their choice. Some workshops are delivered by colleagues, such as Equality ad Diversity or simulated PBL sessios, ad others are delivered by GP staff. The workshops all feature active participatio of tutors. Each presetatio ad workshop is evaluated, as is the overall evet, ad the collated feedback is preseted to all educatioal providers. Feedback iforms the activity of the TALE plaig group of GP staff who meet throughout the year. Bristol medical school Primary Care Teachig ewsletter We have produced a mothly Primary Care Teachig ewsletter sice August This is ed to all GP teachers o our teachig database (over 300). We regularly ivite ad receive cotributios to the ewsletter from our GP teachers ad have published several origial ideas from GP teachers. It helps us to regularly commuicate with our GP teachers ad to have a virtual presece i their surgeries. We kow from iformal shows of hads at teachig workshops that most GP teachers read it. UCL support with academic promotio for teachig The School is providig iformal guidace ad metorig to teachers who seek academic promotio to help them meet the criteria. Here are some of the key elemets of the advice for achievig promotio for teachig. Success i promotio for those o a teachig track is more likely if the followig areas are covered, ad evidece is provided for: academic scholarship i educatioal iovatio ad research rather tha just delivery of teachig (related publicatios i peer reviewed jourals) a Natioal or Iteratioal role i Medical Educatio, with presetatios at Medical Educatio Cofereces membership of leared societies i Medical Educatio the developmet ad implemetatio of specific local curriculum or assessmet iovatios kowledge trasfer activity for example a widely used text book. I the CV, it is ecessary to emphasise the academic role the applicat has played, rather tha a list of jobs doe. Fially, it is ecessary to pla ahead, ad work with a local metor familiar with the process to develop the CV, ad to select local, atioal ad iteratioal referees who are able to commet o your work. Southampto medical school reward for teachig Each year, the Uiversity recogises ad celebrates idividual staff or teams whose teachig is ispiratioal, iovative or of a particularly high stadard. Oe award is made per School ad each carries a hoorarium of 1,000. It is hoped that these awards will ecourage the sharig of excellet practice. I additio, the School of Medicie has three aual prizes for the persos cosidered by medical studets to be the best cliical course teachers ad ot formal teachig (eg lecturig) ad as follows: a. a prize of 300 to the best Southampto teacher b. a prize of 300 to the best teacher outside Southampto c. a prize of 300 to the best Doctor i traiig teacher: FY1/2 or SPR. May

15 Developig teachers ad traiers i udergraduate medical educatio Bristol medical school rewards We are just about to ivite GP teachers to apply to become Hoorary Cliical teachers for Uiversity of Bristol. This is depedet o the level of teachig ad workshop attedace. We have a database that allows us to track GPs teachig activities ad workshop attedace. We have developed the cocept of Core teachig practice. These are practices which commit themselves to a sigificat amout of teachig i all five years of the udergraduate curriculum at the Uiversity of Bristol ad i retur receive slightly ehaced remueratio paid i mothly istalmets. Teacher developmet programmes Cambridge medical school preparig teachers to teach The Uiversity of Cambridge School of Cliical Medicie appoited a Academic Lead for staff developmet. The three parallel staff developmet programmes are: 1 A established programme, which has bee ruig for several years, for cliical supervisors. This programme is ope to juior doctors (FY2 ad above), from primary ad secodary care, who are appoited by the Uiversity as cliical supervisors. These idividuals facilitate weekly small group bedside teachig with a group of 6 8 studets. I additio to educatioal support of studets, the cliical supervisor also udertakes studet assessmet ad has a pastoral ad metorig role with their group. The allied Cliical Supervisor Staff Developmet programme cosists of a oe year rollig programme of regular staff developmet sessios which allow cliical supervisors to reflect o their teachig over the previous few weeks, discuss areas of difficulty ad share positive experieces. Each sessio has a theme ad the backgroud readig associated with that theme is distributed beforehad. There are five eveig sessios: small group teachig priciples, teachig commuicatio skills, teachig cliical examiatios skills, givig feedback to studets, ad how to udertake assessmet. Oce a year there is a aual half day course o teachig the teachers to teach for cliical supervisors. There is also a aual appraisal/feedback process for all cliical supervisors, coordiated by the Associate Dea resposible for the programme. 2 A secod established programme, for teachers i primary care, has bee ruig for oe year. It is closely aliged with the Cliical Supervisor Staff Developmet programme ad a umber of the sessios are shared betwee both programmes. There are additioal sessios with specific focus o the traiig eeds of the GP tutors. This programme is aimed at all the Uiversity s GP tutors who are ivolved with teachig i primary care. 3 A ew programme that is ope to all staff. It is aimed at more experieced teachers who have previously completed oe of the other two programmes. The programme curretly has teachers from Primary ad Secodary care, from Foudatio traiees to Cosultat ad academic staff, as well as o medical professioals allied to medicie that teach the Udergraduates. The programme is a bleded learig programme with face to face as well as olie ad reflective compoets. The programme has a ibuilt programme of peer review ad completio requires the participats to provide a reflective critique of their learig ad their ow teachig. Participats ca move from the first two programmes to the third ad the Cliical School is lookig at developig a further programme which it hopes will allow iterested applicats to work towards a Master s programme i Medical Educatio. Each of the three programmes is aliged with the UK Professioal Stadards Framework ad participats who complete them are eligible to apply for recogitio by the Higher Educatio Academy (HEA). The first two programmes are accredited to Associate level ad the third to Fellowship level with the HEA. Further iformatio is available o medportal.medschl. cam.ac.uk/courseolie/course/view.php?id=42 Southampto medical school staff developmet programme Southampto medical school staff developmet programme The staff developmet for teachers of medical udergraduates is traditioally desiged with idividual teachers i mid, ad it is usually offered as a separate activity to curriculum developmet. I Southampto we have developed a strategy that reflects the chagig eeds of the istitutio as well as the expressed eeds of idividual teachers. The strategy was determied i close cosultatio with key stakeholders ad through a extesive eeds assessmet with staff. It esures that the educatioal chages we idetify are prioritised through the staff developmet programme. Staff developmet ad curriculum developmet are liked ad the educators collaborate closely with the cliicias ad researchers. The strategy outlies two liked approaches to the delivery of staff developmet: geeric courses ru by our Medical Educatio Developmet Uit; ad embedded staff developmet itegral to the programme maagemet structures. The Teachig Tomorrow s Doctors course is May

16 Developig teachers ad traiers i udergraduate medical educatio oe of the most successful geeric courses ad has so far attracted over 400 participats. This is a four-day course that aims to ehace the kowledge ad skills of idividuals with sigificat teachig roles. Embedded staff developmet takes a umber of differet forms but a recet example would iclude the provisio of educatio expertise ad staff traiig for ew professioalism tutorials i the third year. The cotiuig challege withi the School is to esure that busy cliicias cotiue to value the time spet traiig. The School is producig a e-learig resource to supplemet hads-o courses. This resource, partly fuded by the Strategic Health Authority, is eablig cliicias from across the regio to access iteractive guidace o teachig issues. All staff developmet evets are evaluated usig questioaires ad ope-eded feedback. The feedback ad evaluatios are cosistetly excellet. I additio, the School has coducted log-term evaluatios, which show that the courses cotiue to be highly regarded ad that participats claim a positive ad log-lastig impact o their teachig. The success of the staff developmet activities has also bee oted i key areas where studet evaluatios have improved after itroductio of the programme. Southampto medical school olie staff developmet modules The Medical Educatio Developmet Uit at Southampto has developed a umber of olie staff developmet modules aimed at busy cliicias across the regio. These modules complemet the existig programme of face-to-face courses ad so far iclude assessig the udergraduate Mii-Cliical Evaluatio Exercise (Mii-CEX), the role of the OSCE examier, ad plaig ad preparig lectures. UCL a iter-discipliary teacher traiig course The Teachig Improvemet Project System (TIPS) is a two day practical course desiged to help busy cliical teachers to improve their teachig ad support of learig by: suggestig best practice addig some uderpiig educatio theories to back pedagogical choices learig from the experiece of others givig the opportuity to put their learig ito practice with expert ad peer feedback. Fuded by the Trusts from their SIFT allocatios, this course is offered o a twice mothly basis to a rage of health professioals ivolved i teachig i the udergraduate curriculum. Bristol medical school developig Bristol Uiversity s cliical teachers We bega a formal CPD programme i September Fortuately, we were able to draw upo some SIFT fudig to employ a educatioalist to pla ad deliver the sessios ad co-ordiate the programme. We cavassed eed i the eight cliical academies, ad devised Fit2Teach braded, RCP-accredited sessios which could be atteded as a series or as four stad-aloe modules: plaig ad teachig assessmet ad feedback supportig learig teachig i cliical scearios (added summer 2010). Half day modules make them more accessible to busy cliicias ad ecourage attedace away from oe s home base. They were plaed ad delivered by staff from the uiversity s Teachig ad Learig for Health Professioals (TLHP) programme i medical educatio experieced medical educators, but ot cliicias. The modules were delivered at each of the eight cliical academies, agai to make them more accessible, ad were ope to ayoe iterested at o charge. We taught over 500 people i mostly doctors, but also some urses ad allied health professioals with a average occupacy rate per course of over 75%. Attedace is curretly etirely volutary. Fit2Teach has received excellet feedback, ad courses have bee fully booked i most academies. For may this was the first experiece of traiig i medical educatio, ad a umber of attedees have sice erolled o Bristol Uiversity s Certificate i Teachig ad Learig i Medical Educatio course. Those at cosultat level foud the RCP CPD poits useful. Attedees have bee ethusiastic ad kee to lear ew skills ad reiforce their existig practice with educatioal ratioale. The mix of grades ad professios has also bee useful: Foudatio Programme doctors ad seior cosultats ca lear a great deal from each others teachig approaches ad experieces, ad both groups gai from hearig about a ursig perspective. This differece i approaches ad experieces has also bee a challege; attetio must be closely paid by the facilitator to group dyamics, esurig that workable, mixed groups are formed ad that cosistet achievemet takes place. We felt that the CPD offer remaiig cosistetly comprehesive ad positive should play a major part i improvig the educatioal culture ad ivolvemet i the istitutios with less ethusiastic take-up. This policy appears to be bearig fruit, ad there has bee a oticeable icrease i iterest i Fit2Teach i this secod year of operatio. A possibly liked issue is the geographical spread of delivery across a area of several thousad square miles: we believe that it is vital for the May

17 Developig teachers ad traiers i udergraduate medical educatio uiversity to demostrate educatioal ivestmet ad commitmet i parter trusts may miles from Bristol. The oly credible way to do this is to physically teach i these trusts ad be there for them as a educatioal resource. Sever Deaery curretly provides compulsory structured traiig for its Educatioal Supervisors. There is some overlap betwee this traiig ad Fit2Teach, ad a challege of the ext 1-2 years will be to joi the two programmes. CPD has begu to chage the perceptio ad place of the TLHP Departmet i the medical school, from a deliverer of a stad-aloe Masters-level programme to much closer itegratio ito the MBChB programme. We hope to become a ivaluable resource to the medical school ad the wider cliical academies, workig to support teachig, learig ad assessmet i udergraduate medical educatio at Bristol, as well as cotiuig to offer the TLHP Certificate, Diploma ad MSc i Medical Educatio for those who would like a more rigorous ad formal medical educatio qualificatio. Bristol medical school GP Teacher Developmet i Primary Care Sice 1995 Primary Care has built up a extesive programme of GP Teacher workshops. These are aimed at developig our GPs teachig skills ad kowledge. They address importat teachig competecies icludig maagig ad developig a appropriate learig eviromet, ehacig studets learig experiece, teachig to a curriculum, assessig ad evaluatig. The cotet ad delivery of these workshops have developed i lie with the chages i the Bristol curriculum sice 1995 ad geeral thikig about medical educatio. I additio to appreticeship style teachig i Year 4, GP Teachers have leared how to pla ad deliver dedicated teachig sessios, udertake learig eeds assessmets with their studets, teach to a curriculum ad complete assessmets. I additio we have ru a teacher developmet course which cosists of 2 liked study days every year for four years. This course covered the followig medical educatio topics: Teachig ad Learig, Assessmet ad Evaluatio, Reflectio, Learig theories ad Learig Styles. Over 100 GP Teachers have atteded this course which reflects the kee iterest i medical educatio of our GP Teachers. The course has bee oversubscribed. I the last 18 moths we have developed a half-day workshop to meet specific eeds of GPs ew or relatively ew to teachig. We have over 200 GP practices o our database who are ivolved i some udergraduate teachig. This meas that each year we have a sigificat umber of ew GP teachers or GPs who just wat to fid out more about teachig before committig to takig o studets. These workshops have bee held i a umber of locatios ad addressed teachig i several years. We have developed a workshop which addresses the eeds of GPs i traiig who wat to teach studets i their practices. This has the blessig of the local Deaery ad is well received by GPs i traiig. It is our experiece that GPs brig a lot of persoal experiece of teachig ad learig to their udergraduate teachig role. Workshops are predomiatly iteractive ad we draw ad build o this experiece through activities ad reflectio. Learig poits are distilled from this ad supported by writte material ad short talks o medical educatio topics, much of it evidece based. May skills eeded by GP teachers are also relevat to cliical practice. This icludes teachig patiets about a coditio or givig feedback to colleagues ad staff. We write clear learig objectives for our workshops ad provide detailed attedace certificates highlightig the skills ad kowledge leared i a particular workshop. We ecourage our GP teachers to reflect o the workshops as a learig experiece ad to make a pla for further learig o teachig. For this purpose we have a reflective template o the back of our workshop programmes ad ecourage GPs to start completig this i the course of the workshop. This is also useful evidece for the GP appraisal folders. The teachig pages of the Primary Care website have iformatio how to get ivolved i studet teachig, iformatio o GP Teacher workshops ad hadbooks ad a mothly ewsletter. GP teachers also have access to the learig resources created by primary care for medical studets i Years 1, 3 ad 4 ad a Blackboard course created specifically for GP teachers. Newcastle medical school the staff developmet programme The School s staff developmet programme has bee ruig sice It has full istitutioal support ad a rig-feced budget. Its cotet is based o regular eeds assessmet, participat feedback ad requests for traiig, ad chages to the curricular requiremets ad policy issues. Sessios are very practical, relevat ad participatory. The programme is iclusive ad delivered aroud the Regioal Medical School. A cascade strategy has bee implemeted, whereby staff are ecouraged to share with their colleagues the kowledge ad learig materials they had obtaied through attedace o a particular course. The sessios are ru both i the medical school ad throughout the regio s hospitals, with workshops o cliical teachig ad givig effective feedback through to ager ad coflict maagemet. May

18 Give the importace of assessmet, specific traiig sessios are ru throughout the regio o a regular basis. These focus o videos of mock cliical examiatios which are critiqued ad judgemets compared, which are very well received ad allow for both familiarisatio ad stadardisatio. All sessios are popular, with 607 attedaces i the last 2½ years. There is a further staff developmet arm for GPs, with teachig observatio o offer, ad a aual educatio ad traiig day. A bieial Cliical Teachig Forum with educatio poster displays ad traiig workshops attracts attedees. I parallel, the School rus a Certificate, Diploma, ad Masters i Cliical Educatio o a part-time basis, focused at cliical staff. The Masters is also ow available full-time. Sice iceptio i 1997, there have bee a total of 694 participats. A olie cliical teachig evaluatio ad feedback tool is i the fial stages of refiemet, eablig teachers to hoe their skills. Durham medical school staff developmet programme The School of Medicie ad Health Staff Developmet programme i Durham has bee ruig sice It also has full istitutioal support, ad its ow admiistrative structure, uder the Director of Post Graduate Courses. It is resposive to the eeds ad timetables of participats, ad has ru both as a eveig class ad as a itesive week i the summer. It is aimed at practical uderstadig of teachig ad assessmet at all levels i medical educatio. Durham Uiversity also rus a modular Certificate, Diploma, ad Masters i Medical Educatio programme, which is a little more focussed o research aspects compared with the Newcastle awards. All workshops ad programmes are ope to all staff across the regio. Dudee medical school Gettig started series Gettig Started is a series of booklets produced by the Cetre for Medical Educatio i Dudee. Fuded by NHS Educatio Scotlad, it provides cliicias who teach medical studets a itegrated approach to teachig ad learig cliical competeces i the various cliical veues used to deliver teachig o the Dudee Curriculum. These are the Cliical Skills Cetre, Ambulatory Care Teachig Cetre, Hospital Wards, Primary Care, Itegrated Teachig Area, Day Surgery Uit ad Ambulatory Diagostic ad Treatmet Cetre. There is a booklet for each teachig area with each oe providig practical tips as well as appropriate educatioal theory. NHS cliical teachers were ivolved as co-authors for the guides. The series is available i hard copy to staff ivolved i deliverig teachig to medical studets ad also o the Medical Developig teachers ad traiers i udergraduate medical educatio May School ad NHS itraet. A copy is icluded i the iductio packs of ew cliical staff. Feedback from staff has bee very positive. The South Thames Foudatio School educatioal goverace withi Ket, Surrey ad Sussex Deaery All local educatio providers (LEPs) withi Ket, Surrey ad Sussex (KSS) Deaery, which hosts the South Thames Foudatio School, have established Local Foudatio Faculty Groups (LFGs). These provide the first tier of accoutability for postgraduate medical educatio (icludig Foudatio ad specialty traiig), idetify ay additioal support eeded by traiees at local level ad/ or liaise with the Foudatio/specialty school about ay additioal ecessary actios. LFGs meet at least three times yearly with miutes set to the relevat foudatio/ specialty school. They are required to review the progress of all the relevat postgraduate doctors at each meetig. Each LEP withi KSS Deaery has also established a local academic board (LAB) the seior forum for medical educatio, chaired by the director of medical educatio (DME), which oversees the activities of the multiple LFGs withi the LEP. To esure egagemet with both cliical ad maagerial agedas, LAB membership icludes the medical director, library ad kowledge services maager, huma resources director ad director of fiace ad IT as well as a postgraduate doctor represetative ad a lay member. The LAB actios or sigs off both the satisfactory progress of postgraduate doctors ad the learig eeds that idividual faculties have idetified ad agreed at their LFGs. To support the LAB/LFG structure ad meet the GMC requiremet that all educatioal ad cliical supervisors have received appropriate traiig (icludig equality ad diversity traiig) for their role as educators, supervisors ad assessors, KSS deaery itroduced Qualified Educatioal Supervisor Programme (QESP). QESP Part 1 Certificate i Teachig covers priciples of teachig ad learig. It icludes 3 x 1-hour observatios i real-life cliical settigs coducted by a educatio adviser, followed by a professioal coversatio about the observed sessio. (kssdeaery.org/course/qesppart-1-certificate-teachig) QESP Part 2 Certificate i Educatioal Supervisio focuses o the priciples of practice of assessmet, supervisio, careers advice ad supportig traiees i difficulty. (kssdeaery.org/course/qesp-part-2- certificate-educatioal-supervisio) Withi KSS deaery, all educatioal supervisors of postgraduate doctors must have completed QESP 1 ad 2, ad all cliical supervisors must have either completed QESP 1 or have met KSS criteria for local recogitio of cliical supervisors.

19 Developig teachers ad traiers i udergraduate medical educatio Studets as teachers Birmigham medical school studet selected compoet (SSC) i teachig Durig a Commuity Based Medicie placemet, studets lead ad participate i teachig sessios i small groups. The tutor assesses each studet o the preparatio (25%) ad delivery (25%) of their teachig sessio, ad a reflective activity (report ad viva 50%) o what they have leart about teachig at the ed of the year. I the two years that the Special Study Module of the SSC has bee ruig i this format, studet feedback has bee very positive. They particularly highlight its relevace to future activity as a doctor, the reiforcemet of learig ad the supportive settig i which to teach for the first time. Bristol medical school the Peer Assisted Learig Scheme (PALS) SSC i Year 5 The PALS SSC provides a opportuity for fial year studets (Bristol MB ChB programme) to pla ad deliver teachig o a relevat cliical topic. For this, studets are equipped with basic theory i teachig ad learig, ad have a high level of support from a tutor. The teachig opportuity has bee to deliver bedside teachig for Year 2 studets as part of their Itroductio to Cliical Skills course either idividually or i groups of tow to three. Their teachig is evaluated. Both year 5 ad year 2 studets cosidered it a positive ad useful experiece. Barts ad the Lodo Doctors as Teachers ad Educators Course The Doctors as Teachers ad Educators (DATE) Course was set up to meet the GMC s requiremet for medical graduates to be equipped with the basic kowledge ad skills to uderstad the priciples ad practices of educatio. It is a two day programme that is both theoretical ad practical, ad focuses o preparatio for a effective teachig role i their cliical careers. It utilises educatioal theory to help develop effective cliical ad bedside teachig icludig how to give effective feedback ad self evaluate. The studets have the opportuity to pla ad prepare teachig sessios ad cosider how they might collect evidece o teachig for portfolios ad assessmets. UCL peer teachig iitiatives UCL Medical School has a eight year history of providig opportuities, both formal ad iformal, for studets to be ivolved i peer teachig. Supported by the Divisio of Medical Educatio, these iclude: a umber of SSCs i peer assisted learig i cliical skills (PALS) a Near Peers i the dissectio room activity studet led twilight tutorials. All peer tutors receive traiig for their teachig roles ad gai certificatio of their cotributio to the School as peer tutors. By icorporatig opportuities for learig from more seior studets to all studets i the first three years of the course the School is able to: cosolidate the learig of the peer tutors ad help them to develop key teachig skills, provide safe ad supportive learig for the juior studets, create a strog sese of cohesio ad support withi the School, ad provide powerful ad relevat role models for our juior studets. Appraisal Cardiff medical school peer review of teachig Peer Review of Learig ad Teachig (PRLT) was origially developed i the Departmet of Geeral Practice i 2003, ad is ow beig rolled out to other parts of the school, reflectig uiversity policy. This formative process ecourages teachers to reflect o their teachig ad esures that they receive feedback from colleagues. Southampto medical school appraisal of teachig All NHS cliicias have their educatio roles covered i their NHS appraisals. Where possible we have also itroduced joit appraisals betwee the Uiversity ad the NHS for key NHS cliicias who udertake lead roles i the udergraduate programmes. These work i a similar way to the joit cliical academic appraisals betwee the Uiversity ad the NHS trust (as per the Follett Review). The joit appraisals also esure that the cliicias cotributio to udergraduate educatio is take ito accout i their job plaig. Northumbria NHS Foudatio Trust appraisal of teachig resposibilities A two page Educatioal appraisal form has bee icluded i the Trust s appraisal for the last two years. This followed the decisio to recogise all teachig ad traiig i job plas ad to quality assure this i the same way as ay other cosultat activity. Refereces 1 Geeral Medical Coucil The Traiee Doctor 2 Geeral Medical Coucil Quality improvemet framework 3 Board of Medical Educatio Doctors as teachers. British Medical Associatio 4 The Statioery Office The Geeral ad Specialist Medical Practice (Educatio, Traiig ad Qualificatios) Order Geeral Medical Coucil Good Medical Practice May

20 Developig teachers ad traiers i udergraduate medical educatio 6 Temple, Professor Sir J Time for traiig. A Review of the impact of the Europea Workig Time Directive o the quality of traiig 7 Academy of Medical Royal Colleges Improvig assessmet 8 NACT UK Recogisig educatioal roles i job plas 9 The Academy of Medical Scieces Redressig the balace: the status ad valuatio of teachig i academic careers i the biomedical scieces 10 Hedry, R. G., Kawai, G. K., Moody, W. E., Sheppard, J. E., Smith, L. C., Richardso, M., Mathers, J. M., Parry, J. M Cosultat attitudes to udertakig udergraduate teachig duties: perspectives from hospitals servig a large medical school. Medical Educatio, 39, Moderisig Medical Careers Medically- ad detally-qualified academic staff: Recommedatios for traiig the researchers ad educators of the future. Report of the Academic Sub-Committee of Moderisig Medical Careers ad the UK Cliical Research Collaboratio 12 The Higher Educatio Academy. Lauched The UK Professioal Stadards Framework for teachig ad supportig learig i higher educatio 13 Academy of Medical Educators Professioal Stadards 14 Postgraduate Medical Educatio ad Traiig Board Educatig Tomorrow s Doctors future models of medical traiig; medical workforce shape ad traiee expectatios 15 Upublished. Literature Review o the relatioship betwee medical educatio providers ad placemet providers. Report o work carried out for the GMC by the Peisula College of Medicie ad Detistry (PCMD, Uiversities of Exeter ad Plymouth), PI: Professor Paul Dieppe 16 Stark, P Teachig ad learig i the cliical settig: a qualitative study of the perceptios of studets ad teachers. Medical Educatio, 37, Parsell, J., Bligh, J Recet perspectives o cliical teachig. Medical Educatio, 35, Academy of Medical Royal Colleges ad parters. Udated. The cosesus statemet o the role of the doctor 21 Holsgrove, G Assessmet of presetatio ad teachig skills 22 Departmet for Educatio ad Skills A review of appraisal, discipliary ad reportig arragemets for seior NHS ad uiversity staff with academic ad cliical duties 23 The Coucil of Heads of Medical Schools, the Coucil of Deas ad Heads of Detal Schools, the Coucil of Deas for Nursig ad Health Professios ad the Associatio of UK Uiversity Hospitals The te key priciples for joit workig betwee the Uiversities ad the NHS Edotes i ii iii iv v vi vii Orgaisatios ivolved i the delivery of udergraduate medical educatio outside the medical school itself. We suggest that for the purpose of this advice these resposibilities could be exteded to cover all other educatio providers. Paragraphs of this advice discuss appraisal icludig arragemets for joit appraisal See Cliical placemets for medical studets advice supplemetary to Tomorrow s Doctors (2009) for more iformatio o what the agreemets should cover. Further advice aroud the supervisio ad traiig of medical studets o placemets ca be foud i Cliical placemets for medical studets advice supplemetary to Tomorrow s Doctors (2009). See Cliical placemets for medical studets advice supplemetary to Tomorrow s Doctors (2009) for more iformatio o agreemets. See edote ii 17 Academy of Medical Royal Colleges No-Cliical Work ad Revalidatio. Report ad Recommedatios. The Academy s No-Cliical Workig Group 18 Bleakley, A Pre-registratio house officers ad ward-based learig: a ew appreticeship model. Medical Educatio, 36, 9-15 May