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Training in Medical Education
- Jennifer K McLachlan, Helen Rumbold (1 February 2008)
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Jennifer K McLachlan, Locum Consultant Anaesthetist Southampton University Hospital Trust, Helen Rumbold
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Editor – We read the article by Rashid and colleagues1 detailing the results of a survey of College Tutors with great interest. We were not surprised to learn that so few College Tutors have a formal teaching qualification and would agree that this is concerning given the current climate of dramatic, and for some writers misinformed, change in so many areas of medical education. We believe that formal training in education, either through a teaching degree or short course, is invaluable to anyone responsible for ensuring the effectiveness of a programme of medical education and we would like to add a slightly different perspective on the results of this survey. A sound understanding of the nature of good educational practice may be the only way College Tutors can defend trainees from the potentially negative effect of numerous new initiatives that have been introduced to specialty training in recent years. We are concerned that many of these initiatives, that are now key elements of new medical curricula, have limited educational value. Competency-based training continues to be a major component of training in anaesthesia and is increasingly popular with curriculum planners in other specialties. While these curricula focus heavily on the assessment of technical competence, they often fail to give guidance on how education should be organised to support the development of this competence, let alone higher-order capabilities such as professional judgement. Furthermore, many educationalists show that breaking down the complex practice of medicine into individual, neat ‘competencies’ at best is illogical and at worst erodes professionalism2. More recently, the introduction into the anaesthetic curriculum of a multitude of workplace-based assessments is shifting the emphasis of medical education from a holistic process model towards a more reductionist product model where assessment has become all-important. While assessment has been shown to be a useful way of promoting learning3, there is a real danger of it becoming an exercise in ticking boxes. As a recent survey in our department of anaesthesia demonstrated, these processes are poorly understood and their educational value thus further diminished: only 30% of consultant anaesthetists had had any formal training in how to carry out workplace-based assessments (personal communication, J.Stubbing). These initiatives have gathered momentum with Modernising Medical Careers and the entire re-structuring of postgraduate medical training which is set to continue, albeit in a more measured way following the publication of the final report by Sir John Tooke4. These changes, and the ongoing pressure to measure trainee progress, threaten to divert the attention of those responsible for organising training away from the other processes underpinning effective education: maintaining the quality of theatre-based training, protecting formal teaching, and creating an environment that encourages professional conversation. Formal training in medical education seems essential for College Tutors given the challenge they now face of upholding good educational practice while managing and supporting trainees faced with a myriad of initiatives that all seem to have their basis in assessment. 1. Rashid A, Doger A, Gould G. National survey of College Tutors regarding training in medical education. Br J Anaesth 2008; 100: 42-44 2. Fish D, Coles C. Medical Education: Developing a Curriculum for Practice. Maidenhead: Open University Press, 2005. 3. Broadfoot P. Educational Assessment: the myth of measurement. In: Woods P, ed. Contemporary Issues in Teaching and Learning . London: Routledge, 1996; 203-230 4. Tooke J. Aspiring to Excellence. Findings and Recommendations of the Independent Inquiry into Modernising Medical Careers. 2008 Conflict of Interest:None declared |
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