School of Medicine Open Day

Introduction to the Keele Medical Curriculum

Professor Andrew Hassell

Director of Undergraduate Programmes

Who are we?A young medical school with 650 students across

five academic years.

What is our goal?

“Graduating excellent clinicians”

What are our criteria?

Outcomes expected of “Tomorrow’s Doctors” (2009)

• The doctor as a scholar and a scientist

• The doctor as a practitioner

• The doctor as a professional

Effective Learning: Modern, spiral,

integrated curriculum

Themes

What?

Three Themes• The doctor as a scholar and a scientist• The doctor as a practitioner• The doctor as a professional

The Keele Curriculum

Course outlineYear 1

Getting started, acquire knowledge of normal structure & function, test vocation, exposure to all areas of medicine

Years 2, 3 & 4 Learning in context, develop competence

in clinical, scientific and social settings

Year 5 Extended placements in clinical settings,

preparation for practice

Curriculum OverviewYear 1 Phase 1

Challenges to Health

Community placements

90:10 science:clinical

Year 2 Phase 2a

Integrated clinical pathology 1

Adult health contexts (hospital)

80:20 science:clinical

Year 3 Phase 2b

Integrated clinical pathology 2

Childhood, aged care and further adult health contexts.

Readiness for clinical rotations

50:50 science:clinical

Year 4 Phase 3

Integrated clinical practice

Mainly hospital based

Readiness for workplace Yr 5 ‘apprenticeship@ model

20:80 science:clinical

Year 5 Phase 4

Preparation for Professional Practice

Workplace-immersed preparation

Application of knowledge and skills

10:90 science:clinical

Seminar rooms, laboratories, skills

labs, lecture theatre

Social & healthcare settings in

community and hospital

The Keele Curriculum

Where?

Discovery Learning

PBL Experiential learning Mentored reflection

The Keele CurriculumHow?

•A variety of learning methods

•Clinical exposure throughout

•High level of integration

•Small groups

•Self-directedness

Years 1 and 2

• Majority of time spent on campus– Learning underpinning basic and

behavioural sciences– Developing communication and some

other clinical skills

• Regular time spent off campus– Healthcare and 3rd sector placements– Developing skills– Understanding healthcare settings

Year 3

• 6 x 4-week blocks in hospital placements– Medical x 2– Surgical – Child health– Mental health– Elderly Care

• 1 day/week on campus• 4 week GP placement consolidating

clinical skills• 2 student-selected 4-week blocks

Year 4All clinical placements: •6 week blocks

– Medicine + neuro; Medicine + musculoskeletal– Surgery– Women’s health

•4 week blocks– Child health; Mental health; GP

•2-week reading pre-exams•4 week student selected component

– Career focus

Year 5

• 15 weeks in hospital placements– Surgery, Medicine, Critical care

• 15 weeks General Practice

• 8 week elective

• 1 week preparation for practice

What do students do in Year 1?

Weekly:

– PBL Sessions - 3-4 hours– Lectures - 4-6 hours– Practicals - 2-8 hours

(Dissection, IT, Labs)– Resources - 3 hours – Experiential learning - 4 hours– Private Study - 25 hours

And….

Each Semester or Yearly:

– Student Selected Components– Assessments (Written and Skills) – Record of Professional

Development, portfolio, appraisal

Mon Tues Wed Thurs Fri

AM PBL 1 Lectures Self Study or Group Work

Lectures

Lectures Labs or Experi-ential Learning

PM Labs or Experi-ential Learning

Labs or Experi-ential Learning

Anatomy/Resource Room

PBL 2

Wrap-up session

A typical student week in Year 1

A student’s journey

What is Problem Based Learning?

• One method of learning and teaching• Students work in groups, backed by individual study• Learning is centred around a “case”• Students “open” the case in one tutorial; they

identify the gaps in their knowledge• They spend a week learning what they didn’t know

(sometimes with a second tutorial)• They “close” the case in a final tutorial explaining to

each other, and the tutor, what they have learned

“Tell me and I forget.

Teach me and I remember.

Involve me and I learn.”

Benjamin Franklin 1706-1790 Quoted in Scientific American 2012 February edition page 3

Why use Problem Based Learning?

Keele PBL

• Structured sessions with timed release of information

• PBL linked to all other content• Clinically realistic scenarios• Spectrum of case design -

appropriate to individual units’intended learning outcomes

• The case is set at midnight on a Saturday night in a large urban Emergency department.

• Paula and Ravi, both 17yr old students, arrive in the department. They have been out to see a film after a day of playing tennis and football with friends. After they left the cinema they were mugged and assaulted. Paula has a large laceration to her right cheek which is bleeding fairly freely so they are both taken straight to the triage nurse after giving their details to the receptionist at A + E. Ravi tells her that his chest is feeling sore as he thinks he was kicked in the chest; the triage nurse checks his breathingand says she will find him a trolley in a moment. He sits down worrying that he might have cracked a rib.

• The triage nurse applies a dressing to Paula’s wound and asks her to return to the waiting room where she waits for 2 hours. Paula is seen by a doctor. The doctor takes a history of the alleged assault and asks about Paula’s general health, medications and any allergies. After examining the wound he tells Paula that her wound is deep with some skin loss. The wound needs repairing in an operating theatre and may require a skin graft. The doctor says Paula must wait to see the plastic surgeon. She returns to the waiting room.

• Meanwhile Ravi has been put on a trolley and hashad his pulse and blood pressure checked by ajunior nurse. The department is very busy and thereis a wait to be seen. Ravi sends a brief text to his mother. Suddenly Ravi complains of difficulty in breathing and collapses…

Lectures, weeks 1+2

• Chest wall and lung anatomy

• Ventilation and gas exchange

• Psychological impact of injury

• Gas transport and blood gases

Lab Practicals, weeks 1+2

• Dissecting room: – Introduction– Chest wall and lungs

• Microscopy: – Introduction– Histology of skin– Histology of trachea and lungs

Resource room and other practicals, weeks 1+2

• Introduction to the resource room and to examination principles

• Surface anatomy of the chest wall

• Basic life support

• Assessing vital signs

Experiential learning, weeks 1+2

• Introduction

• Reflection and portfolios

• Working in teams

Extensive clinical experience: 100

weeks of placements in Primary Care,

Secondary Care and community

organisations

Excellent facilities: Purpose built medical

school, 4 hospitals, 100+GP surgeries

Course location

Years 1-3:

Based in North Staffordshire

Years 4-5:

Bases in North Staffs, Shropshire & ‘Rest of Staffs’

Settings for clinical experience

• North Staffordshire– University Hospital of North Staffs– General practices and other community settings

• Shropshire– Shrewsbury and Telford hospitals– General practices + other community settings

• Mid-Staffordshire– Mid-Staffordshire NHS Foundation Trust– General practices + other community settings

Student-centred Learning: Emphasis on feedback and student

engagement

Student engagement

• Student Council

• Student representatives on all School Committees– Curriculum, Assessment, Professional

Development & Welfare

• Annual student awayday

Promotion of professional, socially responsible,

globally-aware attitudes

Medical student engagement with the community

• Community focussed student societies– Teddy Bear Hospital– Anthony Nolan Bone Marrow– Medsin Keele– Keele first responders– Keele Heartstart society– Keele medics Charity Society

Y1SSc and Y5 Community Cluster Projects

Medical Research Pathway at Keele

• All students learn about: principles of medical research; numerical and critical appraisal skills

• Research pathway for those who want to go further– Student selected component

“Learning how to do research”– Summer internship

ARUK National Primary Care Centre– Intercalated year (MPhil, MSc, MMedSci)

• Postgraduate pathway– Academic Foundation programme– Academic clinical fellowships

Opportunities for Intercalated Degrees at Keele

• A year away from the undergraduate curriculum• End of Year 4• Opportunity to gain a Masters degree in:

– Laboratory science: • Bioengineering; Molecular Parasitology; Anatomy

– Clinical Research (M Phil)– Masters in Medical Science (MMedSci)– Medical ethics (MA)– Humanities (M Res)

“I believe that my experience at medical school has prepared me well for my foundation posts”

Graduating excellent clinicians

I believe that my experience at medical school has prepared me well with the….

Graduating excellent clinicians

Graduate 2012

“I have enjoyed a large amount of clinical experience throughout the later years of my degree. I feel I have been well supported and taught in all aspects of medicine and feel more than capable of meeting my foundation years with relevant clinical experience and knowledge behind me. I am proud to be in the pioneering year of Keele university medical degree and am thankful for all the education I have received”.

Graduating excellent clinicians

Questions?