A Handbook for Teaching and Learning in Higher Education Enhancing academic and Practice

426 ❘
Teaching in the disciplines
free agents. Other impinging matters include the unit of resource for clinical teaching
and the difficulty of attracting doctors and dentists into clinical academic posts.
The General Dental Council (GDC) and the General Medical Council (GMC)
have statutory responsibility for approving undergraduate/graduate entry courses
and publish curriculum guidelines and recommendations. For dentistry the Quality
Assurance Agency (QAA, 2002a) Subject Benchmark Statement is expected to
be updated in 2007/2008, while the statement for medicine (2002b) will be subsumed
into a new version of the GMC’s curriculum recommendations over a similar
time-scale.
In 1993 the GMC set out radical and extensive requirements for undergraduate
curricula. The updated GMC document, Tomorrow’s Doctors (2003), the outcomes of
further consultation (GMC, 2006a), The New Doctor (GMC, 2005) and Good Medical Practice
(GMC, 2006b), set the context and requirements for university medical curricula. Among
newer expectations and recommendations are the encouragement of innovation around
a core curriculum of skills, knowledge and attitudes taught in an integrated manner,
interprofessional training and greater emphasis on reflective and ethical practice. Greater
emphasis is also placed on learning and study skills, being curious and critical in
approaching knowledge and acquiring understanding of underlying principles, concepts
and mechanisms rather than the teaching and regurgitation of enormous amounts of
material. This is compatible with contemporary understanding of how students and
professionals learn (see Chapter 2), but also needs to be aligned with provision of highquality
and safe patient care. Today most UK schools have a ‘core plus options’ approach
to curricula, and use case or problem-based methods of delivery (see section on PBL,
p. 427). Some core skills and knowledge are now often taught with other healthcare
undergraduates, including nurses, therapists and radiographers. Preparation for
professional practice is emphasised. Assessment has generally lagged a little behind other
curricular reforms.
Early this century the desire to change the demographics of medical student entry led
to the creation of new medical schools and graduate entry programmes. These, pioneered
in the UK by St George’s Medical School, University of London, attract graduates from
higher education. With more mature learning skills these students pass through an
accelerated programme. This, the merger of several London medical schools creating
year cohorts of over 350 students, and the changing knowledge of undergraduates
entering higher education, have challenged curriculum leaders to devise bespoke and
effective solutions, including means of accessing patients or exploring effective
alternatives (see sections on simulation and technology, pp. 436, 437).
The GDC radically revised undergraduate curriculum recommendations in the
late 1990s, and further updated them in 2002; these recommendations brought
an evolutionary shift. The GDC emphasised its desire to see educationally progressive
ideas and improved methods of study incorporated into curricula that were also to exhibit
reduced congestion and earlier patient contact. The GDC recommendations are more
prescriptive of ‘essential elements’ than the medical equivalent. The composite recommendations
of the GDC visits to dental schools provide a good summary of recent