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Clinical academies and the TLHP Programme

Clinical academies and the TLHP Programme. innovative partnerships to deliver clinical education. Dr Stephen Greenwood Dr David Mumford. Teaching and Learning for Health Professionals (TLHP) Programme. Teacher training for the health service since 2001 New lecturers in FMD

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Clinical academies and the TLHP Programme

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  1. Clinical academies and the TLHP Programme innovative partnerships to deliver clinical education Dr Stephen Greenwood Dr David Mumford

  2. Teaching and Learning for Health Professionals (TLHP) Programme • Teacher training for the health service since 2001 • New lecturers in FMD • PG Cert, PG Dip and MSc stages • HE Academy, NMC accreditation • Over 380 (500) professional learners • http://www.tlhp.bris.ac.uk/

  3. The programme • Various awards and routes • PG Cert (60 credits) and GP Trainers Route (30 credits) • HE Academy Accredited, 88% of current students • NMC Approved Route to lecturer/practice educator status (90 credits) • PG Dip (120 credits) • MSc (180 credits)

  4. Teaching format • Flexible modular delivery • Small groups, mixed methods • Inter-professional • Multi-site delivery

  5. Modules • Contact time = 2 study days • Support/materials • Handbook + email + VLE + phone • Work-based assignments (2000-3000 words) • Portfolio (reflective account + evidence)

  6. Bristol medical school • Programmes offered • 5 year MBChB, 1 year premedical course • 5 year BDS course • 4 year graduate fast track for MBChB • Various research and taught MScs, PhD programmes • Medical clinical curriculum taught at 7 “clinical academies” with a Dean, teaching staff and resources • Taught by NHS and academic staff • Varied but standardised learning experience

  7. Communities of practice • “an activity system about which participants share understandings concerning what they are doing and what that means in their lives and for their community. Thus, they are united in both action and in the meaning that that action has, both for themselves, and for the larger collective.” (Lave and Wenger, 1991: 98) • And “emerge spontaneously from (largely informal) networking among groups of individuals who have similar work-related activities and interests.” (Swan 2002: 478) • The intersection of two or more communities of practice can produce radical innovations disrupting current practices; Knowledge is exchanged within communities but less so between them(Swan 2002)

  8. Innovation in educationWestura (2004) • Educational innovation is complex & diverse • Transformational (radical leap, discontinuity) • Top-down / centralised approach necessary • Procedure Redesign, Business Process Redesign … • Substitutional (stepwise) • Bottom-up / decentralised – common in education • Total Quality Management, ‘Kaizen’ management … • Not mutually exclusive

  9. Translating Wenger’s model into testable outcomes • 1. To what extent does Wenger’s model fit for clinical academies? • Is there ‘face validity’ in the applicability of the model? • Features of the clinical academies that map onto Wenger’s model. • 2. Are we creating the foundation for a community of practice? • Are TLHP students being recruited from all the local ‘communities’? • What proportion of each local community is enrolled in TLHP? • 3. Are we creating the ethos of a community of practice? • Is there evidence for the model working in practice? • Do they see themselves as an emerging community of practice? • 4. What else would be predicted from Wenger’s model? • What benefits are likely to accrue in time? • What are the potential markers of success? • What outcomes should we expect?

  10. Proportions involved in teaching

  11. ResultsEnhancements • New designs / trying new things • Redesigned an induction programme • Created and implemented a new 14 unit course • Changed to small groups from didactic lectures:“… we changed what we normally do completely and the feedback was loads better. And it was good to see [fellow teachers] in a buzz after teaching, because they actually came away on a high because it was good and it worked.” • “One thing the course helped with was in challenging us to try things we hadn't tried before.”

  12. ResultsEnhancements • Organisational change • “the first thing that this course made me do was to question our own teaching practices ” • “working in an environment where people are learning to be teachers encourages others to go and do it as well…” • “…it was interesting … realising that people [in the meeting] hadn't … set their learning objectives. Which was so fundamental, and it meant that we were talking in a circular way …” • “I think it helps though in our department that lots of people are doing this course… so everyone’s thinking along the same lines, so the way we teach has changed quite a lot dramatically over the last few years…”

  13. ResultsCommunity • “…with the development of the academies … we have our first sort of group meeting, for people who you are teaching just our block – the Musculo-Skeletal block … all around educational issues and course design and where people felt there was room for improvement and that sort of thing, so I think we’re quite lucky in certain pockets that there is actually quite a good community.” • “I’m still actually quite isolated. Obviously I’d love it to be like that but, as I said again, because I’m the only one in the department doing this and the people on the course, it’s great when they’re here on the study days and then everyone goes off and I never see them again until the next time, and you could email each other but in the end it just doesn’t happen …”

  14. ResultsThe future… • “I think it’s, it’s very important to have that body there as a facilitator for staff development within the academy because we don’t want to just survive on the people that we’ve got at the moment, [there’ll be] newer people coming through and they’ll want to keep registrars interested in that teaching, and I think it’s very important to have a central role for the TLHP course in that.” • “I think you’ve got to create, well we have to create an environment for ourselves to promote similar thinking and similar ideas.”

  15. Linked communities of practice: Academies CfME Infrastructure, e-Learning Staff support & development TLHP Clinical academies and the CfME – the future? Academy Academy Academy TLHP TLHP CfME Academy TLHP Academy Academy Academy

  16. References • Lave, J. and Wenger, E. (1991) Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press. • Swan J, Scarbrough H, Robertson M (2002). The construction of 'communities of practice' in the management of innovation. Management Learning, 33 (4): 477-496. • Wenger E (2000) Communities of practice and social learning systems. Organization, 7 (2): 225-246. • Westera W (2004). On strategies of educational innovation: Between substitution and transformation. Higher Education, 47 (4): 501-517.

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