UNIVERSITY OF EDINBURGH
COLLEGE OF MEDICINE AND VETERINARY MEDICINE
MBChB PROGRAMME COMMITTEE
Note of the meeting of the College of Medicine and Veterinary Medicine MBChB Programme Committee held
at 10.30 am on Monday, 16 June 2014 in the Board Room (SU302), The Chancellor’s Building, Little France.
Present:
1.
Professor A N Turner
Professor J Davies
Dr P Johnson
Dr A Jaap
Professor H Cameron
Dr F Kristmundsdottir
Dr S Riley
Dr M Cullen
Ms S Doyle
Dr D Thomson
Dr A Elder
Dr J Harden
Professor J Rees
Dr M King
Ms G Clark
Ms C Maxwell
Mrs C Tomlinson
Head of Undergraduate Medical Education – Convenor
Year 1 Director
Year 4 Director
Year 5 Director
Director, CME
Dean of Pastoral Care
Director, Student Selected Components
PTH, Personal Professional Development/Senior Tutor
Deputy PTH, Personal Professional Development
PTH, The Consultation
PTH, Presentation, Diagnosis and Management
Deputy PTH, Social Science and Public Health
Convenor, Year 5 Board of Examiners
NHS Lothian Undergraduate Lead
MSC Vice Convenor
Temporary Undergraduate Manager
Committee Secretary
WELCOME AND APOLOGIES
Professor Turner welcomed everyone to the meeting and those present introduced themselves.
Apologies were conveyed from Professor K Boyd, Professor H Campbell, Professor R Knight, Mr J Casey, Mr
M Begg, Dr I Johannessen, Kristmundsdottir, Dr J Skinner, Dr D Swann, Dr N McCormick, Dr K Fairhurst, Dr K
Boyd, Dr L Fialova, Dr A Hathorn, Dr H Rodgers, Ms E Rowson, Ms P Huddar.
2.
MINUTES OF MEETING HELD ON 23 APRIL 2014
Professor Turner took the Committee through the main points of the minutes, which were subsequently
approved.
It was noted that the Admissions document (item 8), which will go out for wider circulation, is still being
finalised.
3.
MATTERS ARISING/ACTION FROM PREVIOUS MINUTES NOT DEALT WITH ELSEWHERE
Item 5. Year 3 report (Paper 13/PC/35) – outstanding Appendices. As only one Appendix (from the ACT
Officer) was available it was agreed that both Appendices, together with Appendices to the Year 1 report (item
4 below) should be deferred to the August meeting.
ACTION: Dr N McCormick/Mr K Wylde
Professor Turner informed the Committee that the “highlights” of the meeting of 23 April was available at:
EEMeC – Other info – Governance – Prog Committee.
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Scheduled items
4.
YEAR 1 REPORT (Professor J Davies) – Paper 13/PC/42
Professor Davies presented his report, focusing on changes which had taken place over the last academic
year.
This year had seen a significant change in the HES assessment in Semester 2 which now follows the
Semester 1 pattern by having a major component of HES assessed in-course, now contributing 34% of the
semester mark - 29% ICA and 5% exam.
Although student performance had been an improvement on last year, 20 students required to undertake resit
examinations in August.
The main innovation last year was the piloting of further ‘flipped classroom’ approaches by Professor Simon
Maxwell in Semester 2.
Last year’s pilots with feedback have now been built upon and OSCA-FM formative examinations have been
run successfully prior to each summative examination. This year, as a ‘one-off’ experiment about one-third of
the questions from the last module to be examined were carried over from the formative exam to the
summative exam. There was no statistical evidence to show that these questions were answered any better
than the new questions. A feedback session will be held in September.
No Year 1-specific regulatory changes have been made apart from changes adopted regarding late hand-in
absence, etc, as agreed by Programme Committee.
Dr Rory Mitchell has replaced Dr Simon Parson as the module organiser responsible for the second half of
Semester 1.
It was also noted that a Year 1 Exam Board Convenor still required to be appointed. Professor Davies
thanked Dr Ingo Johannessen for acting as Deputy Convenor throughout 2013/14.
ACTION: HUME
Finally, Professor Davies reported that future, longer-term, challenges included the fact that the proposed 6year MBChB programme was likely to affect Year 2 and, to some extent, Year 1 as it would be necessary to
ensure that students are fully prepared for the type of study they will be undertaking in the intercalated year.
The move of Anatomy teaching for the Royal College of Surgeons building will also pose a challenge.
Dr Cullen reported that Year 2 had been trialling professional assessment, particularly ICP and possibly PBL.
The Year 1 Director was also interested and the PPD Theme will liaise with him about this.
5.
PRESENTATION, DIAGNOSIS AND MANAGEMENT (PDM) THEME REPORT (Dr A Elder) –
Paper 13/PC/43
Dr Elder presented his report.
As the PDM is extremely broad theme in clinical undergraduate teaching, learning and practice it is difficult to
dissect out all the areas in which specific teaching, learning or assessment relating to the Theme may occur.
There is also some overlap between the Theme and others, particularly The Consultation (Presentation) and
Clinical Pharmacology and Therapeutics (Management). For this reason, Dr Elder intended to focus on the
Presentation and Diagnosis elements.
It is believed that consistency in approach to relevant teaching of the Theme would be improved, for both
students and clinical teachers, if a ‘core’ list of presentations, diseases, investigations and treatments could be
compiled and agreed
This year a list of ‘Core Presentations’ for the Edinburgh MBChB was produced (Appendix 2). It was,
however, difficult to engage all specialties and therefore currently feedback from specialties on this approach
remains incomplete. The aim is to summarise the presentations that the Medical School would expect an
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Edinburgh medical student to be familiar with by the end of Year 5 and express them in a common and
consistent language.
In 2013, didactic teaching was introduced and delivered to Year 3 by means of a one-hour lecture on the
principles of diagnostic thinking. In 2014, a single one-hour lecture was also introduced and delivered to Year
4 which builds on the material presented in Year 3. The lecture uses examples of misdiagnosis and students
were asked to contribute to what may have gone wrong. No structured feedback has yet been received. On
the same day Dr Donald Thomson also gave a presentation on General Practice diagnosis
No overview currently exists of the methods used across the 5-year programme to assess diagnostic thinking,
clinical reasoning, knowledge of the causes of misdiagnosis, statistical methods used to express diagnostic
reliability or the ability to apply theoretical knowledge.
The Year 5 Clinical Practice Examination assesses students’ ability to gather clinical information through
history and physical examination and thereby generate a diagnostic and initial management approach.
However, this exam is relatively short and inevitably limits not only the content and range of assessment
undertaken but also more intense summative assessment of the Theme’s Learning Outcomes.
Currently the Theme has a module lead but no other support. In 2014/15 efforts will be made to recruit clinical
teachers with an interest in developing the didactic programme, core presentation ideas and/or other teaching
methods to improve students’ clinical reasoning and diagnostic thinking.
6.
PROPOSED CHANGES TO COURSE ASSESSMENTS IN YEAR 5 MBChB (Dr A Jaap) –
Paper 13/PC/44 & Appendix
Dr Jaap explained that course assessments account for 40% of the total assessment mark in Year 5 and
students have to achieve an average of 60% across the different modules to be eligible to sit Finals, allowing
compensation for a poor performance in one or more modules with a better performance in others. Over the
years individual modules have developed their own approach to course assessments and the resulting
disparities have been criticised by the GMC and University in recent teaching reviews. In addition, the global
tutor assessment has been unpopular.
It is therefore proposed to introduce the following changes at the start of academic year 2014/15:
1. The use of tutor global marks will be abandoned.
2. Summative assessment will be via end of module online MCQ exams, based around clinical scenarios
and in single best answer format, similar to the Finals SiP exam. Short formative MCQ exams in a
similar format will be introduced for each module. Students will continue to need to achieve an
average of 60% across all the summative MCQ assessments to be eligible to sit Finals.
3. Portfolio case report marks will no longer form part of the module mark. They will be included with the
Portfolio overview essay mark as part of the final synoptic assessment.
4. As a guide, students will be expected to complete one supervised learning event (SLE) per week
during each module, using accepted tools such as Mini-CEX, DOPS, etc. Innovative means of
recording free-text feedback comments on performance, such as the ‘postcard’ system, will be piloted
in some modules at the start of the year and subsequently rolled out if successful. Student
performance in all SLEs will be compared to the level expected of a new F1. It is therefore anticipated
that many will fall short of this standard during the early part of the academic year, but steadily
improve thereafter, so that most hit this target by the 4th or 5th carousel.
5. Taking the above into account, students will be deemed to have satisfactorily completed a module on
the basis of:
a. Meeting individual module requirements in terms of clinical experience and learning
opportunities (clinical sessions attended, case presentations, skills logs, etc).
b. Completion of any compulsory teaching sessions (e.g. simulator, child protection).
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Students will be strongly encouraged to engage with the formative assessments on offer, but it is not
planned to make these compulsory in the first instance. Revised credits and assessment weightings
are outlined in the attached file ‘MB ChB List of Assessments 2014-15 (Appendix)’, prepared by Neil
McCormick.
6. The Year 5 Board of Examiners has found information from the new Professionalism assessment pilot
to be extremely helpful in their deliberations on the small number of students with performance issues
in this domain. Discussion of professionalism issues raised has become an integral part of Board of
Examiner activity and experiences in this area will continue to be developed to inform decisions on
remedial action for students with professionalism issues, including potential exclusion for the rare
student with recurrent issues.
7. Building on the success of the professionalism assessment, it is proposed to develop a similar
assessment tool and process for communication skills, due to the particular difficulties the Board of
Examiners has had in dealing effectively with students with communication issues in the last year.
Dr Jaap also informed the Committee that Child Life and Health were considering the possibility of including
some acute clinical assessment as part of their modular exam. This stand-alone (ie must pass) assessment is
still under development.
The Committee were also informed of challenges to implementation, including reduced student
engagement/attendance with clinical sessions due to withdrawal of ‘incentive’ of tutor mark and focus on MCQ
assessment. This will be closely monitored and reviewed as part of the evaluation of the proposed changes.
The proposal was approved.
6A.
CURRICULAR CHANGES IN THE PPD THEME (Dr M Cullen) – Paper tabled
Dr Cullen informed the Committee of some curricular changes in the PPD Theme which she and Sarah Doyle
have been working on:
Promoting resilience in medical students – Dr Alastair Dobbin, a local GP, has offered students access to an
online system of modules which support self-care and mental wellbeing. The programme is already used by
GPs and has been reviewed by Dr Robby Steel in his capacity as psychiatric adviser to the College.
Year 2 students will be offered two workshops followed by access to the online modules for the rest of their
time at medical school. Assessment is via self-reflection in the GPS form. It is recognised that many students
experience significant stress in Year 5, a brief introduction to these modules will also be given to students in
the Year 4 PPD SJT lecture with access provided if interested.
Patient Safety – To reflect what will be delivered in this area, the PPD Theme would like to change the name
to ‘Patient Safety & Quality Improvement’. Dr Cullen also alerted the Committee to updates to the curriculum
in this area (Suggested changes to teaching Patient Safety and Quality Improvement – pages 2 and 3 of the
paper).
The proposed changes were approved.
For information
7.
LEAVE OF ABSENCE/INTERRUPTION
EXECUTIVE (Prof A N Turner)
OF
STUDIES
–
UPDATE
FROM
PROGRAMME
Requests for interruptions of study by 5 students (2 x Year 4 and 1 x Year 2 due to ill health; one for high-level
sporting activity and one to intercalate outwith Edinburgh) were approved.
8.
EEMeC DEVELOPMENT PROGRESSION, “AT RISK” LIST (Prof A N Turner) – Paper 13/PC/45
Professor Turner explained that all the curriculum and most conetns pages were now in new EEMeC but
some editing is still required. Most of old EEMeC will close down during this academic year. It is now
possible to stream video and limit this to logged-in users. New EASE login means that in future all staff users
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will have University of Edinburgh logins. Professor Davies and Professor Maxwell are creating an online
guide to Pharmacy.
Professor Turner reported on development in progress and other attached applications under review, such as
OSAC/OSCA+, EROS/PathCAL, Portfolio, eDrug, Statistics index/info, Assessment Engine, Evaluations,
OPAL+, Chooser/admin for SSCs, Room Booking system, Personal Tutor system and MSC Voting. Several
other issues were under discussion.
It was noted that the Professionalism Concerns system was not working. Professor Turner will raise this at
the EEMeC meeting to be held tomorrow.
9.
STAFF CHANGES
Ruth Stewart is leaving on 1 August to take up a position in Glasgow, as is Colette Maxwell, Temporary
Undergraduate Manager.
Nicola Crowley will be returning as Undergraduate Manager in August.
Emma Woods is leaving to take up a post in the CME.
10.
CLOSED BUSINESS
10.1.
Fitness to Practise report (Ms R Stewart) – Paper 13/PC/46
The report has been circulated.
11.
AOCB - none
Date of next meeting – Friday, 22 August at 10.30 am in the Board Room (SU302),
The Chancellor’s Building.
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