Project Register - Keele University

School of Medicine

Project Register

Project: Faculty and student development and face validation of a set of strategies for improvement of consultation skills

J Lefroy, A Thomas, S Williams, S Gay, F O’Mahony, R Kinston, C Harrison, RK McKinley

Keele theme: Judgement and feedback

Background and purpose

Workplace-based assessors can readily identify what was done well and what a learner needs to improve but the feedback given is often non-specific and does not assist the learner to address the deficit between the observed and desired performance (1). The Generic Consultation Skills (GeCoS) assessment tool is used in workplace-based assessment at a UK Medical School(2). A key element of GeCoS is a series of pre-formulated strategies for improvement to help tutors provide specific feedback. Each competency in GeCoS has a corresponding set of strategies for improvement. Although GeCoS has been validated, the strategies for improvement have not.

The aim of this study is to systematically develop and validate the strategies for improvement by a process involving both clinical tutors and medical students in order to enhance its utility for workplace-based assessment in both hospital and GP and enhance its utility to students for self-assessment and feedback.

 (1) McKinley RK, Williams V, Stephenson C. Improving the content of feedback. The Clinical Teacher 2010;7:161.

(2) Lefroy J, Gay SP, Gibson S, Williams S, McKinley RK. Development and face validation of an instrument to assess and improve clinical consultation skills. International Journal of Clinical Skills in press 2012. 

 

Research Proposal:  J Lefroy R Jones RK McKinley J Cleland

Grades or no grades in formative workplace-based assessment?

Keele theme: JUDGEMENT AND FEEDBACK, Also SOCIAL INTERACTIONS to a minor extent as they apply to the tutor-student feedback relationship

Aims:

To

1)      Understand the meaning which  third year medical students’ construct from workplace-based assessment and feedback:

  1. With grades;
  2. Without grades; and 
  3. The choice of feedback with or without grades.

2)      Quantify whether given choice, students choose to have feedback with or without grades

3)      Gather preliminary data to explore whether tutors perceive feedback with or without grades affects the relationship between teacher and learner.

A secondary aim is to develop more effective feedback processes.

 

Project: What influences medical students in deciding for or against a career in general practice?

AdrianHastings, Department of Medical and Social Care Education, Leicester Medical School

University of Leicester

Robert K McKinley, Keele University School of Medicine, Keele University 

Sandra Nicholson, Academic Unit for Community-based Medical Education, Barts and TheLondonSchoolof Medicine and Dentistry, Queen Mary University of London

This study explores medical students’ perceptions of their learning experiences within hospital and general practice settings, any differences in medical school culture and curriculum design, between seven medical schools, and how this may influence their career preferences.

Focus groups which facilitate exploration of factors which encourage or discourage students to favour general practice as a career choice will be formed using a sampling frame which includes schools of different types, from different regions, and whose graduates are more or less likely to choose a career in general practice1. Students who have made choices a) for general practice and b) specifically against general practice will be included as will students who are undecided. Transcripts will be thematically analysed combining empirical coding of data with the application of the relevant concepts. 

Lambert T, Goldacre M. Trends in doctors' early career choices for general practice in the UK: longitudinal questionnaire surveys. Br J Gen Pract 2011; 61(588):e397-e403.

Project:  Assessing competence in the Family Medicine Consultation:

an internationally transferable concept?

Researchers involved: Kay Mohanna

IMGs have a significantly higher failure rate in the CSA exam of the RCGP. Much of the published research on the consultation has been done in a western setting and the RCGP assessment process is based on a model that privileges patient centeredness and mutuality of decision making. The purpose of this project it to start to gain a better understanding of differences in the family medicine consultation in differing contexts starting in South Asia (where nearly 60% of West Midlands trainees come from) so that we can also better understand the challenges in assessment. 

Project: Understanding ‘success’ and ‘failure’ in multimorbidity: Can realist synthesis identify how social learning and workplace practices can be optimised?

Sarah Yardley

Multimorbidity has significant impact on life experiences. Implementation of strategic policies for ‘integrated care’ is challenging as few studies explain how or why healthcare interventions meet (or do not meet) people’s multiple needs. Professionals and patients may have differing priorities and conceptualisations of risk-benefit balance.  In Primary Care professionals must reconcile two different goals: provision of appropriate individualised healthcare and provision of constructive workplace-based learning for future professionals. Achievement of both goals depends on social and cultural mechanisms. Interactions and tensions between these goals affect healthcare delivery. Theoretical frameworks are needed to inform interventions accounting for clinical and educational goals if we are to develop high quality care for people with multimorbidity.

This project is a realist synthesis which initially explored the relevance of Vygotskian theories of workplace learning and social practices to multimorbidity. Realist synthesis identifies and makes sense of variable outcomes caused by interaction between mechanisms and contexts. A synthesis of social science, education and primary care literature aimed to: understand perceptions of ‘success’ and ‘failure’ in multimorbidity, and; identify how social learning and workplace practices could be optimised. The findings are being used to further clarify provision of optimal workplace learning and integrated care in multimorbidity.