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

Medicine and dentistry
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The rapidly changing UK postgraduate training environment has brought with it
increasing direct assessment of trainees in the workplace. The assessments being used
include the mini-CEX (clinical evaluation exercise), direct observation of procedures
(DoPs), case-based discussion (CbD) and multisource feedback (MSF), as well as reflective
logs. For a full description see MMC (2007a). While still in an evolutionary phase, these
assessments give a measure of validity to an individual’s training, and allow competence,
excellence and perhaps most importantly underperformance to be documented,
discussed and used for progression and competitive interview; they have both alternative
and summative character. Recording will become increasingly electronic. The introduction
of these assessment formats has not been trouble-free. Work-based assessment
is becoming increasingly used at undergraduate level.
OVERVIEW
Medical and dental teaching and learning have recently undergone ‘major surgery’ with
the aim of ‘anastamozing’ sound educational theory with traditional teaching and
learning methods. New curricula, with student-driven learning, ‘objectification’ and
innovation within assessment, and the changing postgraduate structure have left much
for the ‘jobbing’ clinician and new teacher to keep up with.
Many in the older undergraduate schools question whether the revolution in medical
and dental education is worthwhile. Evidence, although measured on older criteria,
suggests that these major changes are not producing a ‘better’ graduate but are producing
a different, perhaps more rounded, individual, one in whom the public can place confidence.
As professionals, we are coming under increasing public scrutiny and this is never
truer than in education. We must apply the same evidence-based approach to our teaching
practice as we do to scientific research or clinical practice. Traditional methods do not
necessarily need to be thrown away, but can be improved and brought into line with
modern educational theory and practice and the requirement for a ‘safe’ doctor or dentist
in the twenty-first century.
REFERENCES
Albanese, M and Mitchell, S (1993) ‘Problem-based learning: a review of literature on its
outcomes and implementation issues’, Academic Medicine, 68 (1): 52–81.
Barrows, H (1993) ‘An overview of the uses of standardized patients for teaching and
evaluating clinical skills’, Academic Medicine, 68: 443–453.
Boud, D and Feletti, G (eds) (1997) The Challenge of Problem-based Learning, London: Kogan
Page.
Case, S and Swanson, D (eds) (1996) Constructing Written Test Questions for the Basic and Clinical
Sciences, Philadelpia, PA: National Board of Medical Designs.
Crosby, J (2002) ‘Assessment’, in S Huttly, J Sweet and I Taylor (eds), Effective Learning and
Teaching in Medical, Dental and Veterinary Education, London: Kogan Page.