Clinical academies and the TLHP Programme

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Clinical academies and the TLHP Programme

• innovative partnerships to deliver clinical
  education

Dr Stephen Greenwood Dr David Mumford
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Teaching and Learning for Health Professionals
(TLHP) Programme

• Teacher training for the health service since
  2001
• New lecturers in FMD
• PG Cert, PG Dip and MSc stages
• HE Academy, NMC accreditation
• Over 380 (500) professional learners
• http//www.tlhp.bris.ac.uk/

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The programme

• Various awards and routes
• PG Cert (60 credits) and GP Trainers Route (30
  credits)
• HE Academy Accredited, 88 of current students
• NMC Approved Route to lecturer/practice educator
  status (90 credits)
• PG Dip (120 credits)
• MSc (180 credits)

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Teaching format

• Flexible modular delivery
• Small groups, mixed methods
• Inter-professional
• Multi-site delivery

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Modules

• Contact time 2 study days
• Support/materials
• Handbook email VLE phone
• Work-based assignments (2000-3000 words)
• Portfolio (reflective account evidence)

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Bristol medical school

• Programmes offered
• 5 year MBChB, 1 year premedical course
• 5 year BDS course
• 4 year graduate fast track for MBChB
• Various research and taught MScs, PhD programmes
• Medical clinical curriculum taught at 7
  clinical academies with a Dean, teaching staff
  and resources
• Taught by NHS and academic staff
• Varied but standardised learning experience

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Communities of practice

• an activity system about which participants
  share understandings concerning what they are
  doing and what that means in their lives and for
  their community. Thus, they are united in both
  action and in the meaning that that action has,
  both for themselves, and for the larger
  collective. (Lave and Wenger, 1991 98)
• And emerge spontaneously from (largely informal)
  networking among groups of individuals who have
  similar work-related activities and interests.
  (Swan 2002 478)
• The intersection of two or more communities of
  practice can produce radical innovations
  disrupting current practices Knowledge is
  exchanged within communities but less so between
  them (Swan 2002)

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Innovation in educationWestura (2004)

• Educational innovation is complex diverse
• Transformational (radical leap, discontinuity)
• Top-down / centralised approach necessary
• Procedure Redesign, Business Process Redesign
• Substitutional (stepwise)
• Bottom-up / decentralised common in education
• Total Quality Management, Kaizen management
• Not mutually exclusive

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Translating Wengers model into testable outcomes

• 1. To what extent does Wengers model fit for
  clinical academies?
• Is there face validity in the applicability of
  the model?
• Features of the clinical academies that map onto
  Wengers model.
• 2. Are we creating the foundation for a community
  of practice?
• Are TLHP students being recruited from all the
  local communities?
• What proportion of each local community is
  enrolled in TLHP?
• 3. Are we creating the ethos of a community of
  practice?
• Is there evidence for the model working in
  practice?
• Do they see themselves as an emerging community
  of practice?
• 4. What else would be predicted from Wengers
  model?
• What benefits are likely to accrue in time?
• What are the potential markers of success?
• What outcomes should we expect?

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Proportions involved in teaching
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ResultsEnhancements

• New designs / trying new things
• Redesigned an induction programme
• Created and implemented a new 14 unit course
• Changed to small groups from didactic lectures
  we changed what we normally do completely and
  the feedback was loads better. And it was good
  to see fellow teachers in a buzz after
  teaching, because they actually came away on a
  high because it was good and it worked.
• One thing the course helped with was in
  challenging us to try things we hadn't tried
  before.

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ResultsEnhancements

• Organisational change
• the first thing that this course made me do was
  to question our own teaching practices
• working in an environment where people are
  learning to be teachers encourages others to go
  and do it as well
• it was interesting realising that people in
  the meeting hadn't set their learning
  objectives. Which was so fundamental, and it
  meant that we were talking in a circular way
• I think it helps though in our department that
  lots of people are doing this course so
  everyones thinking along the same lines, so the
  way we teach has changed quite a lot dramatically
  over the last few years

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ResultsCommunity

• with the development of the academies we have
  our first sort of group meeting, for people who
  you are teaching just our block the
  Musculo-Skeletal block all around educational
  issues and course design and where people felt
  there was room for improvement and that sort of
  thing, so I think were quite lucky in certain
  pockets that there is actually quite a good
  community.
• Im still actually quite isolated. Obviously
  Id love it to be like that but, as I said again,
  because Im the only one in the department doing
  this and the people on the course, its great
  when theyre here on the study days and then
  everyone goes off and I never see them again
  until the next time, and you could email each
  other but in the end it just doesnt happen

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ResultsThe future

• I think its, its very important to have that
  body there as a facilitator for staff development
  within the academy because we dont want to just
  survive on the people that weve got at the
  moment, therell be newer people coming through
  and theyll want to keep registrars interested in
  that teaching, and I think its very important to
  have a central role for the TLHP course in that.
• I think youve got to create, well we have to
  create an environment for ourselves to promote
  similar thinking and similar ideas.

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Clinical academies and the CfME the future?
Academy

• Linked communities of practice
• Academies
• CfME
• Infrastructure, e-Learning
• Staff support development
• TLHP

Academy
Academy
TLHP
TLHP
CfME
Academy
TLHP
Academy
Academy
Academy
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References

• Lave, J. and Wenger, E. (1991) Situated Learning
  Legitimate Peripheral Participation. Cambridge
  Cambridge University Press.
• Swan J, Scarbrough H, Robertson M (2002). The
  construction of 'communities of practice' in the
  management of innovation. Management Learning,
  33 (4) 477-496.
• Wenger E (2000) Communities of practice and
  social learning systems. Organization, 7 (2)
  225-246.
• Westera W (2004). On strategies of educational
  innovation Between substitution and
  transformation. Higher Education, 47 (4)
  501-517.