Tag: teaching practice

Hot Topics in Medical Education Research: Interdisciplinary Medical Education – Learning Better Together

Posted on by sarah.allsop

In the second hot topics blog of 2024, Fiona Holmes considers the benefits and challenges of interdisciplinary learning. The inspiration for this came from teaching Clinical Perfusion Science students (clinical scientists who operate the heart-lung bypass during cardiac surgery) who come from different disciplinary backgrounds (bioscience/bioengineering and nursing/ODP), and who learn together and from each other and work as part of a complex multidisciplinary team.

Photo by National Cancer Institute on Unsplash

What is IDL?

The World Health Organisation defines interdisciplinary learning (IDL) as ‘students from two or more professions learning about, from and with each other to enable effective collaboration and improve health outcomes’ and has stated that ‘interprofessional education and collaborative practice can play a significant role in mitigating many of the challenges faced by health systems around the world’.

What are the benefits of IDL?

Shared knowledge. Healthcare students face careers in increasingly complex healthcare systems where mutual understanding and integration of complementary expertise, communication, collaboration and decision making is key to comprehensive patient care and best outcomes. Medical issues and clinical situations often require a holistic understanding that goes beyond a single discipline; generalists and specialists need to work together. Practioners can’t know everything about everything!

Widened horizons. IDL can help students appreciate the interconnectedness of various factors important for patient care such as physiological, psychological, and social. IDL can expose students to different knowledge and perspectives such that they can analyse complex cases from different angles and integrate knowledge leading to more effective problem-solving in clinical settings. It can increase the ability to recognise bias, think critically and tolerate ambiguity.

Effective teamwork. IDL develops effective communication, collaboration and teamwork among healthcare professionals, important for delivering comprehensive and coordinated patient care. This can better prepare students for work in diverse healthcare settings and equip them with broader skills, enabling them to be more versatile and adaptable in their careers and enhancing their professional development.

Improved student experience. IDL can improve the student experience; by and large studies have shown that students express higher levels of engagement and satisfaction when exposed to IDL, which can contribute to improved learning outcomes.

How can IDL be implemented?

IDL can be incorporated into medical education in a number of ways, but to be effective it needs to be purposefully integrated into the curriculum and explicit in learning sessions (you can’t just throw students together and expect the learning to happen spontaneously). IDL lends itself to learning opportunities that can be designed to be authentic real-life situations such as:

  • Case-based learning (CBL) – students work together on case studies that require input from various professions to help them understand each other’s roles and contributions to patient care;
  • Simulated scenarios / role playing – students from different professions (or playing the role of different professions) collaborate to address the simulated patient’s needs, honing their teamwork and communication skills in a safe environment as well as understand the perspectives and responsibilities of each profession;
  • Interprofessional clinical experiences – students from various professions complete clinical placements together to expose them to the interprofessional dynamics of healthcare delivery in reality;
  • Team-based learning (e.g. clinical rounds) – students discuss patient cases and treatment plans collaboratively (builds upon CBL);
  • Interprofessional workshops/projects – bring students from various disciplines together to collaborate and develop solutions for healthcare challenges;
  • Reflective practices – such as team debriefing sessions and individual reflective journals to contemplate experiences, challenges, insights and opportunities for improvement, with a focus on the IDL.

What are the challenges of IDL?

Resource implications. Implementing IDL can pose logistical and resourcing (appropriately skilled staff – ideally interprofessional team teaching, time, costs) challenges; it can be difficult to coordinate curricula and schedules to bring different healthcare students together at appropriate time in their educational journey.

Timing. The jury is out as to when is the best time to implement IDL and for how long (e.g., periodic exposure or continuous immersion). Ideally team dynamics need time to develop, so communication becomes more open and collaborative, with trust and appreciation of diversity of knowledge.

Experience levels. While the point of IDL is to bring together diverse students for learning, there may be issues associated with this such as: Learner-level matching (do they have sufficient background knowledge and experience to work together effectively?); differences in learning preferences may be more exaggerated due to prior teaching and learning experiences; epistemics (the disciplinary ideas about what knowledge is and how to use and produce knowledge) and specific manner of communication are part of the culture of particular disciplines that may hinder IDL.

Perceptions and Biases. Perceptual barriers in competence perceptions may lead to a lack of self-confidence or respect for co-learners and personal characteristics such as curiosity, respect, and openness, patience, diligence, and self-regulation have been suggested to be important characteristics for enabling cognitive advancement in IDL.

Measures of impact. Evaluating the effectiveness of IDL can be challenging. Traditional assessment methods may not adequately capture the depth and breadth of knowledge, behaviour and attitudes or ‘interdisciplinary thinking and doing’ – i.e., the capacity to integrate knowledge and ways of thinking and doing across areas of expertise to produce a better outcome than could be achieved otherwise.

Future Research

While the general consensus is that IDL should be an integral part of the curriculum for healthcare students, the importance of IDL is largely based on theory and there remains a lack of large, multi-centre long-term studies. Therefore, currently it is unclear what strategies are best for long-term behaviour change and positive patient outcomes.

Some additional further reading:

Attitudes towards Interprofessional education in the medical curriculum: a systematic review of the literature | BMC Medical Education | Full Text (biomedcentral.com)

Experiential Learning of Interdisciplinary Care Skills in Surgery Assessed From Student Reflections – ScienceDirect

Interprofessional team-based learning (TBL): how do students engage? | BMC Medical Education | Full Text (biomedcentral.com)

Interdisciplinary education affects student learning: a focus group study | BMC Medical Education | Full Text (biomedcentral.com)

Building Community: Enhancing the International Student Experience

Posted on by sarah.allsop

In this blog, Dr Liang-Fong Wong shares some key insights into how we foster an inclusive environment for international students within our university academic systems and culture.

As 2023 drew to a close, I attended a ‘Show, Tell and Talk’ workshop run by the Bristol Institute of Learning and Teaching (BILT) on International Student Experience.

This is an area of work that is close to my heart – being an international student at Bristol myself many moons ago, my international roles, and serendipitously, it was being organised by my netball teammate Catriona Johnson, from the Centre for Academic Language and Development (CALD).

L-R: Assoc Prof Liang-Fong Wong, Dr Fiona Holmes, and Dr Claire Hudson at BILT International Student Experience workshop, 2023.

Catriona and I had previously shared many courtside and car conversations about her project work on academic language and literacy, but have never interacted within our work capacities. I was delighted to turn up on the day to find fellow BMERG members Fiona Holmes and Claire Hudson there as well!

International staff and students are an important community at our institution: they are invaluable to the diversity of our campuses, adding richness and vibrancy to our learning environments and making us all much better global citizens for now and the future. There is so much that we can learn from each other across different cultures.

During the session, we were given an overview of the numerous BILT-funded projects across the university that explore themes such as increasing inclusivity in the international classroom, decolonising curricula and developing sense and belonging.

Fiona Hartley (BILT/CALD) presented the ‘3 shocks’ that international students can experience:

  • Pedagogical (knowing what to expect academically)
  • Language (how to express oneself academically)
  • Cultural (feeling a sense of belonging and community in Bristol)

What was really interesting was the observation that some of these shocks may not be unique to international students, and indeed may be familiar to others in the wider student population, particularly first-year students.

We discussed in small groups how different schools use effective interventions and ways to enhance teaching and learning experience within and outside of the classroom. There were so many great examples, such as:

  • optional induction modules
  • allocating groups and facilitating group work sensitively
  • academic integrity training
  • peer-assisted support sessions
  • promoting opportunities through the Global Lounge, Bristol Voices and Bristol Connects initiatives

Through sharing experiences across the whole university and across disciplines, it gave us ideas on how we can implement some of these strategies in our own practices.

All in all, I really enjoyed the session; it was such an enriching discussion and I got to know many people outside of the medical school.

I am very much looking forward to going to more of these workshops in 2024 and if you, like me, would like to participate here is the events link to the BILT website: Events | Bristol Institute For Learning and Teaching | University of Bristol

More about this blog author:

Dr Liang-Fong Wong is one of the University of Bristol’s Associate Pro-Vice Chancellors for Internationalisation as well as working as an Associate Professor in regenerative medicine. She also works with the undergraduate students as the Year 4 co-lead for the medical programme and is one of the inaugural members of the BMERG committee.

Hot Topics: Researcher skills – Creating your database search strategy

Posted on by sarah.allsop

This blog is kindly written for BMERG by one of our amazing subject librarians, Richard Kielb. Richard takes us through some top tips around searching databases whilst undertaking your research, and some tips for breaking down the process.

Books on shelves
Photo by Paul Melki on Unsplash

When it comes to research, different search strategies are needed dependent on the nature and context of your work. Sometimes you may just need a book or a few relevant articles on a subject, and in this situation a quick search of your local library catalogue can often be sufficient. For more detailed research, it is likely to be more important to be able to carry out a comprehensive review of the literature, and this will usually require an advanced search using bibliographic databases.

So what is a bibliographic database? A database will allow you to search across very large numbers of academic sources simultaneously. Most of these sources will be academic journals, but some databases will include book chapters, conference proceedings, systematic reviews etc.

Different subjects will be supported by particular databases, so it will be important to identify the ones that are most relevant for you. Medical education would be a good example of a topic which would cross over more than one subject, so you would need to consider searching in databases recommended for both Medicine and Education as well as others with a multi-disciplinary focus.

Which databases you choose to use will depend very much on the topic you are researching and also what resources you have access to as an individual or a member of an institution. Many databases are not free to access and can be extremely expensive, but they are often provided by library services in organisations such as Universities and in the NHS.

Although the various databases have search interfaces that look quite different, the basic principles listed below will generally apply to all of them. Some of the functionality and ‘wildcard’ symbols etc might be slightly different, but there are usually help pages and guides available that will help indicate how it all works.

There are four basic stages to the database searching process:

  • Break your question down to its main concepts
  • Decide on the relevant search terms
  • Combine your search terms
  • Review your results

Breaking your question down to its main concepts

For clinical questions you may have come across the PICO formula to identify your concepts, and you can consider doing something similar for your medical-education topic. The social science framework called SPICE can be useful:

S – Setting Where does the research happen?
P – Population Who is your research focused on? Is your population defined by age, gender, ethnicity etc?
I – Intervention What are you investigating? Is it the use of technology or participation in a particular educational programme?
C – Comparator Are you comparing anything with your main intervention?
E – Evaluation Appraising the value, validity, or effectiveness of the intervention.

As with PICO you do not necessarily need to have a concept for every SPICE element.

Decide on the relevant search terms

Next you will need to consider what terms to search in relation to all of the different concepts. Include likely variations in terms in order to carry out a comprehensive review and to avoid missing any papers which are relevant to your topic. It will be important to factor in all synonyms, related terminology and any variations in spelling (particularly UK/US).

Keyword searching, also known as free-text searching, is where you will look for exact matches for your search terms in the titles and abstracts of journal articles. It is also useful to include searches in any controlled vocabulary offered by your chosen database, for example resources like Medline, ERIC and Cinahl offer ‘Subject Headings’, which make it easier to locate papers on a specific subject. Each article listed in the database is assigned a number of Subject Headings which represent what topics it covers. The advantage of this is that all of the articles on the same subject will be given the same subject heading, independent of the terminology used by the individual authors.

Combine your search terms

The Boolean search operators (OR, AND, NOT) can be used to combine your searches effectively.

  • Use OR to combine searches about the same concept – synonyms, related terms, variant spellings (e.g. Vitamin C OR ascorbic acid). This will broaden your search.
  • Use AND to combine searches about different concepts (e.g. caffeine AND asthma). This will narrow your search.
  • Use NOT to exclude terms from your search. This can be useful if you are retrieving some irrelevant content but use an element of caution as this can also remove useful material that may have mentioned the excluded term.

Review your results

Critically appraise your results (are they relevant to your research topic?) and decide if you need to make any changes to your search strategy. When you have run your search, you will often find that you either have more or fewer results than you were expecting.

  • Too many? Look for ways to make your search more specific. Can you add concepts? Are there valid ways to limit your results (publication date range, age group, language etc)?
  • Too few? Look for ways to make your search more general. Are there any terms that could be removed? Would broader search terms be useful?

Setting ‘limits’ can also be helpful as many of the databases will provide a series of in-built limits and filters, so it can be useful to investigate the options available.

Remember that your local Librarian will be more than happy to answer any questions you might have about using bibliographic databases and finding information more generally! At the University of Bristol you can find your subject specific librarian at: www.bris.ac.uk/library/subject-support/