Issue 2 Winter 2000 Welcome to the 2nd edition of the - School of ...

Issue 2 Winter 2000Welcome to the 2nd edition of the Undergraduate Medical Education. The first editionissued in the summer of this year was well received – many thanks to those of you who gaveus feedback.The newsletter is focusing on two main areas:Links As many of you know, St Andrew's students join the course in Year Three and DrAndrew Riches, Head of Medical Science has written a piece about the course. Dr SusanDilly had written about plans for the new intake of Manchester students that will take place inKeele in September 2002. There is also some news from Peter Morgan-Capner, MedicalDirector about plans for Manchester students in Preston from September 2003 onwards.Developments: Prof David Gordon has written an article below on future developments inthe faculty of Medicine, Dentistry, Nursing and Pharmacy. Prof David Yates and JulianDavies have written about development in the examinations. You will also find informationabout 2 web based developments led by Dr Tim Dornan.As usual you will find news and reports from the various years and sectors to keep you intouch with developments throughout the undergraduate course. Also Alice Shiner, a 4th yearstudent has written a thought-provoking article about her involvement in our staffdevelopment programme.As well as coordinating the research news, Alison Jones has reported on the recent ASMEconference, which was attended by 5 Manchester staff from Faculty, South sector andCommunity sector. The next ASME conference is in July 2001. For more information onthis and other external courses available in Medical Education please look at the webpages athttp://www.medicine.man.ac.uk/staffdev/On the back page you will find information about forthcoming staff development events – welook forward to seeing many of you at these.The next newsletter will be published in Summer 2001. We would welcome your letters,articles or comments for this edition. Please send contributions to me by 31 May 2001.Best wishes for a very Merry Christmas and a Happy New Year!Kathy DuffyStaff Development Officerkaduffy@fs1.with.man.ac.uk

GMC ReportLast time, I gave a brief summary of the Subject Review visit that was carried out in March.We still do not have the full report, so this will have to wait until a future newsletter. We dohave the full GMC report on the visit that was carried out at the same time. This was verypositive, as the summary statement makes clear:‘Although we have identified a number of areas for further consideration we werevery impressed with the undergraduate medical education offered in Manchester. Theexcellent relationship between students and staff has undoubtedly enabled the Schoolto develop its programme so rapidly. The School has successfully implemented a newand innovative course and all those involved, staff and students, deserve praise forwhat has been achieved. We look forward to hearing about further progress in ayear’s time.’In the main report, they GMC highlighted a number of areas of good practice:• The contribution of students• Learning through curiosity• Learning resources• The new ‘Fitness to Practise’ committee• Student support• Preparation for pre-registration yearHowever, they also indicated areas for that we need to consider further:• Clinical experience early in the course• Whether we should widen the options available in the special study modules in years 3-5to include topics not directly related to medicine.• To consider advanced life support training for all final year students in the consolidationperiod• To include opportunities for students to learn about complementary and alternativemedicine in the core part of the course.These aspects of course development will be considered within a strategic plan, which alsoaddresses ways in which we can use the funding brought in by the additional student numbersto improve the programme for all students. We are also in the process of forming a medicaleducation unit that will bring together many important elements such as staff development,research & evaluation and communication skills teaching. As always, even with positiveexternal reports, we want to go on improving undergraduate medical education inManchester.Dr Paul O'NeillAssociate Dean for Medical Undergraduate Studies

NEWS FROM YEARS 1 & 2The new academic year and my stint as Director of Studies began with the largest ever intakeinto year 1 MB ChB. Approximately 325 first year students arrived on September 18 th .Earlier in the summer, new tutors recruited from School of Biological Sciences attended ashort training programme to introduce them to the skills needed to direct group working. Theimmediate problem was to accommodate a total of 42 groups of MB ChB students meetingthree times a week for one-hour PBL sessions. The solution included a cluster of Portacabinsin the Stopford Building car park which have turned out to be surprisingly effective. I makethis judgement in the light of the small number of complaints from academic staff, and nonefrom the students. Meantime the building work on the new teaching block got underway andwe all keep our fingers crossed that it will be ready in time for the start of the 2001-2002session. Of course, the next session will entail a further increase in student numbers so thenew accommodation will earn its keep from day one.There was much additional spending over the summer. MB ChB students will benefit fromthe extensive refurbishment of the Dissection Room, which was completed before the start ofthe new session. An even bigger refurbishment of the First Floor Multiuser Laboratory waspartly finished when the students returned. We can accommodate extra students in bothlaboratories.PHOTOI am particularly grateful to Keith Burdett for organizing the induction programme that wasdelivered to the freshers during the first week. Others, including Paul O’Neill and TimDornan, made large contributions to this important event. One of my problems is to work outhow we deliver the induction programme next year.What are the tasks ahead? The first is to bring in new staff, a problem that is being tackled byBiological Sciences. The need for new staff arises both from the extra intake of students, andthe loss of some staff who have been involved in the new medical curriculum from the start.As well as Keith retiring, we have sadly lost David Evans, and others are planning to retirethis year. Some aspects of the programme in the first two years need refreshing. We havemade a start. The IT course we are currently delivering is extensively revised compared tolast year. The Design Teams that deliver the four semesters need more support. We mustrecruit some recently appointed staff to the teams. Continuing staff training that washighlighted by Keith in the previous edition of this Newsletter is a pressing need.Dr Paul SlaterDirector of Studies, Years 1&2

COMMUNITY NEWSIT Development for Education in the CommunityOver the last year Maria Regan has been evaluating the use of IT facilities by students onCommunity placements (see elsewhere in the Newsletter). She has worked with a smallnumber of practices that provide special facilities for students. These practices cover all threeyears and a broad geographical area. Questionnaires completed by 90 students and 21 GPTutors together with 42 longer interviews with students have helped us discover whatstudents and tutors need in both facilities and training.A by-product has been the writing of “An Internet-based Resource Guide for MedicalStudents and GP Tutors.” This is available in printed form and on disk. For furtherinformation about this (or the Interim report) contact Maria Regan at Rusholme HealthCentre (0161 256 3015 ext.288 or m.regan@man.ac.uk).The next stageThe second stage will consider how students actually use the facilities available, how muchtime they spend and what programmes or websites are useful. We are pleased that in doingthis we are able to collaborate with Project Connect, the NHS Information Authority’sprogramme to facilitate GP connections to NHSnet. They will help us determine theappropriate level of health authority input into GP practice infrastructure and training tosupport undergraduate medical teaching. This will be done by working with an extra 12 Year5 practices.Where is this leading?On-line learning is becoming increasingly important, especially as students are spread far andwide in the Region. Students on community placement can use on-line resources to checkknowledge: that is easier than carrying around a textbook. They can access Medline to searchfor evidence. Soon they will be able to use SkillsBase (produced by Tim Dornan and hiscolleagues) for self-assessment and to find advice on skills training. Above all they can keepcontact with their base if the placement is at some distance and for some time (as in SSM’s orYear 5). It is hoped that as practices link up with the electronic world through NHSNet (orsimilar), they will bear in mind the needs of students. We are now in a position to discussfacilities resources with the Regional Office.Carl WhitehouseProfessor of Teaching Medicine in the Community

Central Manchester ReportThe Central sector was pleased to welcome 136 new students to the third year in October.A new Introductory course for the third year was constructed and organised, largely by GuyNambiar. This was very well received by the students. The design of the course will continueto be revised year on year, and this first version was greatly enhanced by advice fromcolleagues from the South and Hope sectors.A particular success was the Communication skills part of the introductory course, which wasalso new to Central this year. This required an enormous amount of work by RosieIllingworth and Carolyn Chew and their tutors, backed up by Mike Cheshire and the staff inthe undergrad office. Their efforts were greatly appreciated by the students judged by thefeed back received.An innovation which seems to be of some value was an inter-active seminar on “The role ofreligious Beliefs on Patients’ Needs”. This was lead by the Anglican and Jewish chaplains(unfortunately, the Moslem chaplain was unable to attend due to an emergency ). There was alively and wide ranging discussion involving colleagues of many different, and no, religiousbeliefs. This seminar will again evolve, hopefully with other religions involved, but shouldhave a useful role in future years.A further change this year has been in the delivery of tuition to the final year. In addition totheir previous supervision and tutorials the final year students at MRI have been invited tojoin the House officers’ teaching sessions each week. These sessions are a combination ofdidactic and interactive events usually lead by an expert. So far this arrangement has workedwell. There may be some merit in further combined teaching/training sessions for final yearstudents and the House Officers. This approach is currently being examined and developedby Dr Ian Bruce and Mr Richard Napier-Hemy along with Mike Cheshire.Finally warm congratulations are due to Mr Jim Hill, Dr Paul Bannister and Dr D Tunbridgewho were considered to have contributed the most in quality and quantity to theundergraduate teaching at MRI last year.Dr Lawrence CotterConsultant Cardiologist, Hospital Dean

News from South SectorGoodbyesSadly we have had to say goodbye to several key people. Ms Mary Lawson has taken alecturer’s position in Sheffield. Mary has been instrumental in the implementation of theelectronic evaluation system within our Sector. She has also been involved in a number ofother education initiatives.Chris Ward has relinquished his duties as Clinical Tutor for Wythenshawe to concentrate onresearch and clinical activities. The students have benefited greatly from his enthusiasm forteaching and pastoral care and he will be missed.We also say goodbye to Dr Patrick Miller, Clinical Tutor for the Families & Children Moduleat Stepping Hill Hospital who is undertaking the responsibility of Medical Directorship. Thestudents will miss his overall help and guidance during their clinical attachments toStockport.Chris, Mary and Patrick have all contributed significantly to UG medical education in SouthSector which is recognised by both the students and those of us in the Office of the HospitalDean. We thank them for interest and support and wish them well for the future.Evaluation of Teaching in South SectorThe analysis of the year’s data from the evaluation of teaching for South Sector resulted inthe following.Best Year 3 clinical firm – Mr Hawes (A&E)Best Year 3 PBL tutor – Dr McWilliam (Pathology)Best Year 4 clinical firm – Mr Wynn (O&G)Best Year 4 PBL tutor – Dr Bradbury (Paediatrics)A certificate, signed by the Dean of the Medical School Professor Roger Green, recognisingthe achievements of these clinical firms and PBL tutors was sent to the firm leaders and to thePBL tutors.Dr Caroline BoggisHospital Dean

Salford SectorUndergraduate Education at Salford is now part of a newly created Department of AcademicAffairs chaired by Professor Andy Garner. As part of this development, we would like towelcome Judy Hadfield who will take up the post of Business Manager on 11 December.Judy has worked for a number of years within the Emergency Medicine Department. Dr JonShaffer continues to be the acting Hospital Dean and a substantive appointment is anticipatedin the near future.Student Support and Guidance at Salford is continuing to expand and students indicate thatthe services provided are greatly appreciated. Dr Jon Shaffer heads this service, assisted byKaren Gwinnutt. Other key staff involved are:Dr Helen Barker, SpR in PsychotherapyDr Elizabeth Berry, Consultant in Clinical PsychologyDr Asha Bhatt, Consultant in PsychiatryDr Chris Daly, Consultant in PsychiatryDr Leela Joseph, Consultant in MicrobiologyMrs Pam Phillips, Breast Care Nurse SpecialistMs Corinne Siddall, Clinical Skills FacilitatorDr Paul Strickland, Senior Lecturer in PsychiatryOver the past two years the accommodation standards within Salford sector have improvedgreatly due to the persistence of Dr Felicity Stewart, Lead Tutor for Year 5 and KarenGwinnutt. Dr Stewart and Karen have ensured that all student accommodation has now beenupgraded to an acceptable standard and will continue to monitor the residency closely.Implementation of a sign-up system has enabled students to print out their own individualtimetables on a weekly basis. The sign-up system allows students to fulfil their learningobjectives by having access to all clinical teaching facilities available within the Trust. Thesign-up database has evolved due to the hard work of Mark Foster, Year 5 medical studentand the entire Undergraduate Team for making sure the information is regularly updated.Dr Jon ShafferActing Hospital Dean

Research & EvaluationEvaluation of Information Technology Development in the CommunityA pilot study to explore the provision of IT support to medical students during theircommunity general practice placements is currently being undertaken. This research will helpus develop an overall policy and strategy for IT provisions and support in communityplacement sites.We sent a questionnaire to a sample of students on their community placements asking fordetails of previous IT training and experience, current levels of IT skills and current ITcapabilities within the practice as a whole. Interviews were also conducted with students toobtain views on access and use of IT, perception of GP placement, and training and support.Key themes to emerge from the data relate to:♦ The different University sites with IT facilities the students prefer to use♦ The usage students make at teaching hospitals and district general hospitals of ITfacilities and support♦ The usage students make at the pilot practices of IT support♦ The type of teaching methods and teaching styles the students prefer♦ Future areas of training and support the students and GP tutors requireThe Chart shows a comparison of year group, university and gender usage of IT facilitiesprovided at the practices from within the sample.Future research will include exploration of the use of the IT facilities provided at the samplepractices as well as an assessment of the effectiveness of the IT support on undergraduatemedical education.We would like to thank students, GP Tutors and Practice Managers who have taken the timeto complete the questionnaires or attend interviews during the first phase of this work.

Usage of IT Facilities at the Pilot Practices302520No of Students15YesNo1050Year 3Year 4Year 5ManchesterSt AndrewsMaleFemaleStudents were asked to indicate whether or not they used the IT support provided at the pilotpractices during their community placement.Further detailed results are available in the recently completed Interim Report.Maria ReganIT Research Associate

Student Viewpoint on Staff DevelopmentAsked to write an article about tutor training sessions from a student’s stance I was at firstunsure that I was the right person for the task. However, having participated in three trainingsessions and attended the PBL forum in September of this year (as a student voice amongstthe sea of tutors) I suppose I have qualification enough!It would be misleading to say that students only go to PBL training sessions in order tofurther good PBL tutoring. A financial incentive and the prospect of free lunches and coffeegoes a long way towards luring us away from the wards and lecture theatres! However, Iwould like to think that we are not (all) so mercenary: there are many other aspects of thesessions which are enjoyable. Most of us are not afraid to speak our minds about PBL, andhere we are provided with the perfect forum to do so. Once the role-playing is completed weare given the opportunity to discuss PBL with a whole room full of potential tutors. What awonderful chance to teach our teachers about some of the qualities that we would like them tohave! The fact that the audience invariably appears to be engaged and genuinely interested inwhat we have to say is particularly rewarding. On top of this the sessions are good fun andthe mock-tutorials usually reinforce our medical knowledge – and even teach us somethingnew at times!As with anything, PBL tutor training has a number of areas in which there is room forcriticism. An unavoidable occurrence, since this is a voluntary activity, is that only the mostoutspoken students are present. This results in unrealistically articulated and vociferousmock discussion., not usually requiring much input from the tutor. Perhaps a follow up tothese sessions could be to give potential tutors the opportunity to tutor a “real” PBL sessionalongside the group’s usual tutor, allowing them to encounter situations which they may findmore challenging. Also, “refresher courses” for current tutors may be of use. Perhaps theyalready exist, but some tutors do not always give the impression that they recall all of theskills taught at the training courses!I was fortunate enough to be asked to attend the PBL forum, which was something of an eyeopenerfor all students involved! We were given an insight into the mechanics of running aPBL tutorial and the sort of problems that tutors face. We were invited to share our ownexperiences and ideas with the tutors, much as we would in a training session. The wholeevent was interesting, but to me the most intriguing aspect of the afternoon was the disparityin the approach to PBL that seemed to exist between Years 1&2 and Years 3-5 Tutors. Goingthrough the medical course I have noticed the difference in tutoring styles between theyears, the former being more directive than the latter, but always assumed this was due tostudents’ increasing familiarity with the PBL framework. However, the forum has made mequestion this assumption. The majority of Years 1&2 tutors seemed to be confident in theirrole whilst the Years 3-5 tutors were less so, yet in my experience the approaches that eachadopts to PBL tuition have both positive and negative aspects. I felt that there was a need tomerge the two approaches and encourage communication between tutors of all years.Perhaps tutors should learn how to manage discussion groups of students from all yeargroups; if the PBL approach should not differ between years why should there be a differencein tutoring?Alice Shiner4th Year Medical Student

Developments in the Final ExaminationsThis is the time of year when, having recovered from the frenetic activity of one set of finalexaminations, the Year 5 Exam Group settles down to plan next year’s diet. The process ishelped by the constructive comments of both external and internal examiners, the advice ofthe administrative staff and feedback from the students themselves.Our determination to address concerns about the paucity of clinical material in the FinalExamination in 1999 was so successful that we were near to organisational ‘meltdown’ thisyear when, on occasions over 100 patients seemed to be vying for the students’ attention inone day. There is now a general acknowledgement that whilst we have excellent people inpost both centrally and in the teaching hospitals there are simply not enough of them. Wemust, additionally, put more into Information Technology and into internal examiner training.However, I hope that readers will agree with our philosophy of persisting with theeducational objectives of the final examination, whilst working towards the provision of amore comprehensive infrastructure rather than taking a more pragmatic approach and limitingthe examination to fit the current organisational constraintsOver two-thirds of the 300 internal examiners completed critique forms after this year’sexamination and the information which we are gleaning from these forms is extremelyhelpful. However, we must also be able to assess the prognostic value of individual stationsas well as the overall performance of the different sections of the examination. The analysesthat we are able to do at present suggest that the exam is consistent across the three sites andover the three days but, with improved IT, we can and will do better. A new system shouldbe in place for next year’s examination.With so many internal examiners it is quite remarkable that we have been able to embrace thechanges in the style of the final examinations so effectively. But behind the efficient deliveryof the examination on the day there are, ‘backstage’, severe stresses and not a little disquiet.Some problems can be resolved by extending the management infrastructure but others canonly be addressed by working harder with the internal examiners. To this end we will bearranging a series of training sessions over the next few months. It is our hope that themajority of our examiners will have attended one of these courses before next May.With these developments we can be confident that the Final Examination will be seen as anappropriate, fair and consistent celebration of the competence of our undergraduates. Onestep along the road of lifelong learning.Prof David YatesChair, Year 5 Exams Group

RESEARCH AND EVALUATIONAssociation for the Study of Medical Education – Annual Meeting, September 2000In the midst of the petrol shortage, ASME held its annual scientific meeting, this year atCardiff City Hall. This year’s theme was ‘Tomorrow’s Teachers’. Topics covered in thepresentations and keynote speeches included Staff Development, Curriculum Design andMulti-professional Education.Kathy Duffy stimulated much interest with her presentation on ‘Involving medical students instaff development activities’ and Kay Tucker from South sector presented details of her workon the multi-professional training of medical and nursing students. Paul O’Neill’spresentation on ‘What do students think about being given a group mark?’ linked in withother discussions on methods of assessment, giving a qualitative research angle. In a sessionon curriculum outcomes, Alison Jones presented questionnaire data on perceptions of howwell the Manchester course had prepared its graduates for PRHO work. Copies of theabstracts can be obtained from the authors.For information on future ASME meetings have a look at their website: www.asme.org.ukIntegration of Clinical and PBL WorkRecent research asked third and fourth year students how they link PBL to their clinicalexperiences. Results demonstrate that students employ varied methods for successfullearning within a hospital or community context. Two major ways used were either bringingexperience to the group for discussion or making connections outside the group at the time ofseeing patients, often several weeks after an initial group discussion. Many studentscommented that the method they used related to how their group functioned or the particularcase/module being studied. Both PBL and Clinical Tutors were also perceived as importantfor encouraging sharing of relevant experiences or arranging clinical experiences.Alison Jones and Sarah WillisResearch Associates in Medical Education

University of St. Andrews Medical Science Programme.Students from St. Andrews join the Manchester programme after three years study atSt. Andrews having obtained a BSc in Medical Science. The management group responsiblefor Medical Science at St. Andrews consists of Dr. Andrew Riches, Head of Medical Science,Dr. Gordon McPhate, Director of Medical Science Teaching, Dr. David Sinclair, ProDean ofMedical Science and Professor C. Michael Steel, Professor in Medical Science along with theMedical Science Committee.Three new courses have been introduced into the Medical Science Programme at St.Andrews, two of them having commenced this academic session: the Behavioural Sciencescourse co-ordinated by Professors Marie Johnston and Ronan O’Carroll, the AssessingMedical Evidence course by Dr. John McLachlan and the Cellular and Molecular Medicinecourse by Professor C. Michael Steel and Dr. Graham Kemp.Behavioural Sciences:This new integrative course is applied to clinical and community settings and runs as a themethroughout the three year St. Andrews programme. It began this year with the new intake ofmedical students. The course addresses the knowledge base and use of scientific methods inbehavioural science, attitudes to patients and to people in the community and skills incommunication and self-directed learning.Students learn in lectures, in small group workshops, through work in clinical and communitysettings, and in private study. They are given both evidence and “experience of the evidence”.There is a focus on learning about people and society and gaining communication skills ( e.g.in interviews with the same family over 6 months) before the introduction to clinicalexperience in primary care and community settings. Students progress from learning aboutthe social and behavioural processes relevant to healthy people (year 1), to people who arebecoming ill and coping with healthcare (year 2), to people who have ongoing illness (year3). The course structure maps onto primary prevention, acute care/secondary prevention andcommunity care/tertiary prevention.Assessing Medical Evidence.Evidence based medicine, numeracy, statistics and ethics are all intimately associated inmedical decision making. We have therefore devised a new course which integrates all theseelements in a supported self study programme for students. Learning materials include CALethics and statistical programmes, and a Workbook with key illustrative examples provided.Teaching includes tutorials, practical classes and a lecturing load greatly reduced from theprevious statistics course from which this course evolved. Formative assessment is by studentpeer review, to encourage awareness of co-operative team working. Summative assessment isby a variety of routes, including an assignment in which the student selects a medical newsstory from the popular print media, carries out an evidence based medicine enquiry, andproduces a report. In an innovative “open computer” assessment, students are given practicalscenarios involving data, and have to select, execute and interpret the appropriate statisticalanalysis, accessing sources via the Internet. Future plans include the inclusion of healtheconomics and a portfolio approach.Cellular and Molecular MedicineThis new course will run over the first two years and commenced this session. The objectivesof the course are overall to firstly respond to the advances in molecular biology which haveilluminated many aspects of physiology, pathology, pharmacology and microbiology, and

thus introduce students to the fundamental cellular and molecular basis of medicine at theearliest opportunity. Secondly, the course aims to integrate teaching of medical biochemistry,genetics and certain aspects of immunology and haematology into a single theme. Thirdly itwill allow horizontal integration of teaching in (for example) the cellular, molecular andgenetic aspects of specific system disorders.Dr Andrew RichesHead of Medical Science

Undergraduate medical education at Keele University and North StaffordshireThere is a hive of activity at Keele University and North Staffordshire Hospital NHS Trust as weprepare for the first cohort of clinical students awarded jointly to Keele and Manchester Universitiesin 1999. Fifty students are already in year 1 at Manchester and will move to North Staffordshire foryears 3 to 5.North Staffordshire Hospital NHS Trust is a large acute hospital with a wide range of teachingservices and approximately 1300 beds and 140 consultants. Keele University's School of PostgraduateMedicine has 16 professors and 27 senior lecturers so the building blocks are already in place toprovide the students with excellent clinical experience and we are now concentrating on designing thefacilities and working out how best to deliver the curriculum.FacilitiesAlthough North Staffordshire Hospital NHS Trust has taken undergraduate medical studentsfrom a variety of teaching hospitals for many years (most notably the Obstetric andGynaecology students from University College Hospital London who voted the attachmentthe best in the country in 1998), there are no facilities suitable for the number of studentsarriving after 2002. Therefore we are building a new education centre linked to the surgicalblock, which will form the first phase of an integrated academic complex on the City GeneralHospital site. Major re-developments are likely around North Staffordshire Hospital NHSTrust which involve moving the Royal Infirmary and Hartshill activities to the City Generalwithin the decade. This is a wonderful opportunity to develop a medical school as anintegrated part of a major new hospital. There is already a new Acute Psychiatric Unitbuilding under construction on the site and bids have been submitted for funding for researchbuildings and additional undergraduate medical students. This has meant that we needed todevise plans for a series of academic buildings over the next 10 years rather than just thespace for the first cohort of students.CurriculumThe first point to make is that the staff at Keele and North Staffordshire are enormouslygrateful to everyone in Manchester who has spent time providing advice and support. Thishas happened at all levels from Paul O'Neill and Carl Whitehouse through to Hospital Deans,individual specialists, clinical skills co-ordinators and administrators. Thankfully, we are nothaving to devise our own curriculum at this stage and so are making good use of yourexpertise and experience.The Curriculum Implementation Group has been meeting monthly and has been open toeveryone with an interest in being involved. This has resulted in a group of enthusiasticconsultants who have naturally arranged themselves into four module groups with somethemes trailed across modules such as care of the elderly, imaging and pathology. In thesummer, we appointed a Director of Clinical Undergraduate Studies (roughly equivalent to aHospital Dean), Community Medical Education Co-ordinator and Education Co-ordinatorsupported by an administrator and secretary. They will be busy over the next 18 months aswe advertise new posts, dig the foundation for the buildings and work closely with ourpartners in the community, general practice and district general hospitals to ensure thateverything is in place for 2002.Dr. S.A. DillyHead of Undergraduate Medical Education

Developments in PrestonFor many years Preston and other hospitals across Central Lancashire and the Ribble Valleyhave hosted medical students from Manchester. Numbers have been small and arrangementsvariable, however. It is with great enthusiasm that the primary and secondary health caresectors of Lancashire look forward to providing the full clinical course for 30 students a yearfrom 2003. This initiative will provide a major impetus across a range of activities to includethe development of teaching methods, research and development, closer links with academicmedicine, and the additional motivation that will come from meeting the demands of themodern medical student.Secondary care teaching will take place in the hospitals of Blackburn, Blackpool, Burnley,Chorley and Preston, with the hospitals of Morecambe Bay supporting the University ofLiverpool. The population served is over a million, with some 3500 beds and 450consultants, and provides a full spectrum of social groups. An extensive range of specialistand tertiary services are provided, with the exception of organ transplantation, with mostbeing sited in Preston. Recent capital investment has taken account of the needs of medicalstudents with an Education Centre at Royal Preston Hospital costing over £3M being due forcompletion in late 2002. Preliminary discussions have already taken place with theUniversity of Central Lancashire about providing a local ‘social’ environment, and the jobdescription for a Hospital Dean has been finalised. This is a key post as it is essential thatthere is a senior and committed individual with the dedicated time to lead us into the futureand ensure all arrangements are in place for 2003.Peter Morgan-CapnerMedical Director

Web developments to support the curriculumInformation and communications technology (ICT) is assuming increasing importance inhigher education. The School of Medicine initially made it available as a resource for moreIT-literate students (hopefully for more than contacting their friends and lovers via Hotmail)and a means of communication between academic and administrative staff. Gradually, it ischanging from an essentially reactive resource to one that takes an active part in learning.Good examples have been Sue Andrew’s CD image bank, ‘Pathpics’, a sophisticated learningmanagement and timetabling system developed by Mark Foster, then a Year 3 student, aproject to enhance communication between community and central sites, and various sourcesof material supporting PBL cases. But what else can ICT offer? Chloe Baxter, now in her final year, was prominent in leading a move to enhance the studentexperience of PBL, and disseminating understanding of its rationale and process. Successfulinduction sessions to PBL in Y1 were run at the start of the present and last academic yearsbut no supporting materials for students and tutors were available. A students’ and tutors’guide to PBL was written, but it was hard for the rather sterile medium of the printed word tobring to life all that can be good about PBL. Earlier this year, courageous Y3 students, after15 minutes to read through a case they had not seen before, went through the ‘8-step’ processin front of the Media Centre video cameras. More impressive still, they came together at alater date to record a ‘report-back’ tutorial. These completely unscripted sessions providedample illustrative material of the complex cognitive and social processes that go on in wellfunctioningPBL. In the hands of the Media Centre, who meticulously edited and digitised thematerial, and Catherine Lee, a Computing Science MSc student, ‘ParaBLe’ was born. Briefvideo clips were integrated into an attractively-presented textual description of Y3-5 PBL,with separate ‘paths’ for prospective tutors, group chairs, scribes and group members tofollow, and (hopefully) user-friendly descriptions of the principles and process. ParaBLe canbe accessed via www.hop.man.ac.uk, but don’t even think of downloading the video clipsunless your computer is connected to the fast university/hospital network (or you don’t mindgiving up your home telephone line for about 24 hours while 80 mebabytes of datadownload!). The next step will be to make the same material available on CD or DVD.…ParaBle graphic ? still shot from cdrom There is a strong emphasis on clinical skills in the Manchester curriculum but focus groupresearch conducted on students during an options project by Alistair Craig showed asurprising lack of awareness of clinical skills in the ‘curriculum in action’. Neil Maredia andLiam Hosie, while in their fourth year, worked with me to devise a ‘Skills Portfolio’ toincrease awareness of skills but subsequent research showed it to be a complete failurebecause it gave students no guidance about the type of performance they were aspiring to.SkillsBase (also accessible at the URL above, username ‘Andy’ Password ‘Andy’) has thesame philosophy but tabulates the skills curriculum flexibly by module, type of skill, or levelof competence attained. It provides a facility for keeping a reflective diary of progress inacquiring skills, and comparing ones’ self-, peer and tutor assessments with those of youryear group. More important still, it is a gateway to a rich and fast-growing menu of resourceson skills. It offers skills ‘recipes’, videos, web links, a self-assessment facility and even asmall number of OSCE checklists, until now jealously guarded from student view. Skillsexperts are being recruited to offer students an e-mail question and answer facility to supporttheir learning. It is too soon to evaluate SkillsBase’s effectiveness, but we predict that usage

will increase exponentially as OSCEs approach. Formal usability tests show that the twocommitted Computing Science students who did all this work over a three-month period(Catherine Lee and Adam Stopford) have created a product which is intuitive, attractive andeasy to navigate. If students do not find it useful, there will only be the instigator of theproject to blame!Dr Tim DornanSenior Lecturer in Medical Education, Hope Hospital