The joys of teaching health economics to medical students

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The joys of teaching health economics to medical
students

• the MB/BS at UEA

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The MB/BS at UEA

• Based on the PBL system of learning
• Natural and social sciences integrated throughout
  
• Students set loose on patients from week one
• Much emphasis on communication skills and
  holistic approach to patient care

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Example PBL scenario (unit 1)

• Jim was delighted to get his bowel screening
  pack through the post and thought it was a great
  idea. When he rang his identical twin brother ,
  who lived in Cornwall, he was surprised to hear
  that he hadn't got one. Jim suggested that John
  write a letter of complaint to his MP.
• Jim's wife Doreen, aged 51, got a letter through
  telling her that her next cervical smear was due.
  Soon after she got a letter asking her to go for
  a mammogram. She didn't like going, but having
  read all the stories in Women's Own she knew it
  was a good idea.

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Example learning objectives

• Explain the justification for the screening
  programmes currently offered in the NHS.
• What role does the state play in protecting and
  promoting health and preventing disease?
• Outline how health needs are assessed and
  decisions about resource allocation are made in
  the NHS.
• Discuss the role of the media in disseminating
  information about health and how this alters
  peoples perception about their health.

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Weekly teaching slots

• Core lectures attended by all students
• Seminars attended by at least 2 members of each
  PBL who feedback to others
• Clinical communication skills training
• sessions
• Primary care day

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Health economic input

• Lectures/seminars
• SSS presentations posters
• Fourth year projects
• PBL tutoring

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Health economic assessment

• Short answer questions (PBL-based)
• Extended matching questions (EMQs)
• - e.g. which of these terms means maximising
  output for a given input?
• SSS assessments
• - need to pass on presentation content

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First year SSS questions

• Escalating health care costs are largely due to
  the aging population. Discuss.
• The fundamental principle of the NHS is equality
  of access (for equal need) How far have we
  achieved this objective?
• Quality Adjusted Life Years (QALYs) are used by
  health economists (and NICE) to measure outcome.
  What are QALYs and why do we use them?
• Should we ration healthcare? If so, how, and to
  whom?
• Different countries across the world adopt
  different health care systems. Which health care
  system is best- give your justifications.
• Solving the funding crisis why don't we just
  refuse treatment to smokers, drinkers and
  drug-users?

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Strengths?

• Good to have the importance of health economics
  recognised
• UEA medical students cover more health economics
  than most (we guess!)
• When focused adequately (as in SSS), most
  students do engage with HE methods and principles

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Weaknesses?

• The PBL system makes it difficult for students to
  follow methodological threads
• HE suffers from being lumped together with
  psychosocial sciences and wishy washy stuff
• The degree of integration makes ownership of
  the HE curriculum difficult
• Not all assessment methods are ideally suited to
  examine HE knowledge

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Ongoing challenges

• Breaking out of the social science stigma
• Overcoming prior beliefs about what HE is all
  about (e.g. fixation on cost cutting)
• Balancing what medical students need to know
  with what they engage with
• Being more imaginative/flexible about
• learning processes in this situation