Funded mini-projects
(567) A practice survey and systematic literature review of teaching, learning and assessment of law in undergraduate medical education
N.B. The information below is authored by the mini-project applicants, not by staff of the subject centre.
This text represents the views and opinions of the mini-project team
only, not those of the subject centre or its affiliates.
Principal investigator
Judy McKimm, University of Bedfordshire
Full list of project partners
Professor Michael Preston-Shoot
Topic
This is a MINI-PROJECT proposal ,support dissemination of good practice to a wider audience ,promote collaboration to enhance new and existing partnerships ,raise awareness of new national initiatives, recommendations and government policy ,promote evaluation and high quality educational research studies including systematic review
Background
The drive towards integrated services and changing professional roles mean that the professional and legal responsibilities of different health and social care professionals need to be ever more clearly defined. Professional identity develops from the inter-relationships between an individual’s personal beliefs, values and morals; professional codes of practice and ethical frameworks and the legal structures within which the professional practises. Consideration of the way in which professionals acquire their knowledge of the law is the focus of research being carried out by Michael Preston-Shoot and Judy McKimm (funded by a National Teaching Fellowship). This study (2007-09) includes a comparison of teaching, learning and assessment of law in medical and social work education. It explores the experience and perception of confidence and competence in law relating to medicine of 2000 medical students, from four participating universities. Data collection is through documentary analysis, self audit questionnaires, mind-mapping, focus groups and individual interviews, involving staff and students.
Preliminary data analysis indicates varying perceptions and understanding of the law and how it is used in practice. The next stage of the research systematically evaluates the outcomes for practice of different curricular approaches to teaching, learning and assessment of law in the four schools. It explores medical students’ ‘position’ towards the law, perceptions and understanding of law as it relates to professional practice, values, ethics and their role as a future practitioner. The study also identifies curricular structures that enable students to acquire and retain knowledge of the legal rules relating to medicine and develop skills in practising law relating to medicine.
We have found that generally the literature has not researched the quality, effectiveness or outcomes of different methods of teaching, learning and assessment of law in medical education. Understanding of the law tends to be coupled with medical ethics1, introduced as part of the development of professionalism2,3 or acquired during clinical attachments relating to different client groups. We therefore propose that a comprehensive literature review is carried out to provide an evidence base from the published literature on law as it relates to medical education and to medical practice.
Our research indicates variation in practice in how law is taught, learned and assessed in undergraduate medical education. The second part of the mini-project is a systematic practice survey of how law specifically is taught and assessed in all UK medical schools. The practice survey, will, in conjunction with the NTFS research and literature review, provide new knowledge and a baseline for deepening understanding of how law teaching is conceptualised in medical curricula and, more importantly, how UK medical schools approach and address the teaching of law as it relates to professional medical practice.
The practice survey will provide examplars of practice in how law is taught, learned and assessed, will highlight implications for curriculum development in this area and will reveal variations in how curricula support medical students in developing a professional identity and ‘professionalism’ which incorporates a real understanding of law.
References
1 Consensus Group of Teachers of Medical Ethics and Law in UK Medical Schools. Teaching medical ethics and law within medical education: a model for the UK core curriculum. J Med Ethics 1998; 24: 188-192
2 Goldie, J, Dowie, A, Cotton, P and Morrison, J. 2007. teaching professionalism in the early years of a medical curriculum: a qualitative study. Medical Education, 41:6, 610-617
3 Jha, V, Bekker, H, Duffy, SRG and Roberts, TE. 2007. A systematic review of studies assessing and facilitating attitudes towards professionalism in medicine. Medical Education 41:8, 822-829
Proposed activities
August/September 2008
Develop search strategy for literature review (including grey literature)
September – November 2008
Carry out literature review
Scope out practice survey of law teaching template and activities in conjunction with MEDEV and other colleagues involved in law teaching in a workshop. This will include defining the boundaries between law and ethics teaching and how to identify law teaching that is embedded, eg. learning about child protection law in paediatric or A&E clinical attachments
Identify contacts in all UK schools via MEDEV institutional contacts and personal networking
December 2008
Produce literature review report
January - March 2009
Carry out practice survey via email completion of questionnaire, collection of curriculum documents and telephone interviews
Analyse data and write draft practice survey report, including examples of practice from each school
April 2009
Circulate draft for comment and correction of factual inaccuracies by key contacts
May 2009
Produce final practice survey report
Reports uploaded onto MEDEV website and circulated to key stakeholders
June 2009
Hold national workshop to disseminate results and generate ideas for further research and next steps
Proposed outcomes
The main outputs of the project will be:
1. A practice survey report that summarises how law is currently taught, learned and assessed in UK medical schools.
2. A literature review of law as it relates to medical education and to medical practice.
These will be made available to all UK schools (and other interested parties such as the General Medical Council) via the MEDEV website and direct communications.
3. We also anticipate holding a national workshop or conference to disseminate the report and take forward the findings of the practice survey. The workshop will provide opportunities for professional bodies and agencies, curriculum developers, ethicists, law teachers, student’ and junior doctors’ groups to discuss issues raised
The benefits for the medical education community are great. Not only will medical educators be able to see the various ways in which the different schools approach the teaching and assessment of law, through the good practice exemplars and literature review, they will also be able to identify areas for curriculum development in their own schools and have the opportunity for debate and discussion at the national workshop. This work will also contribute to the current debates and interest on all aspects of ‘professionalism’ and the development of professional identity. The focus to date has been much more on the ethical and regulatory dimensions of practice than the legal aspects which, in curriculum and learning terms, have tended to be assumed, tacit and implicit rather than overt and explict.
All undergraduate medical students (around 6000 intake per annum) and Foundation doctors will be indirectly affected by the report as this will provide a baseline against which all schools can evaluate and enhance the provision of teaching, learning and assessment of law as it relates to medical practice.
Expertise of grant holder and project team
Judy McKimm and Michael Preston-Shoot are experienced academics and project managers with respective backgrounds in medical education and law in social work. They have been working successfully together since 2005 at the University of Bedfordshire.
Judy McKimm is currently working at Auckland University in the Centre for Medical and Health Sciences Education and is a Visiting Professor of Healthcare Education and Leadership at the University of Bedfordshire. She also works as an independent medical and healthcare education Consultant. She was Director of Undergraduate Medicine and Head of Curriculum Development at Imperial College London from 1997 – 2003. She subsequently worked as Senior Adviser (Accreditation and Standards) for the Higher Education Academy and as Associate Dean, Bedfordshire and Hertfordshire Postgraduate Medical School. She has worked with a number of other UK and overseas schools of medicine and nursing, assisting with organisational development issues, curriculum and staff development programmes and with developing educational quality and evaluation systems. She was an accreditor for the ILTHE, a subject reviewer in Medicine for both the English and Welsh Funding Councils, is an external examiner/reviewer on a number of Masters' level medical/healthcare education programmes and was a GMC visitor. She carried out impact evaluations for the MEDEV and SWAP Subject Centres and the mhhe project. She has excellent contacts within and knowledge of UK and international undergraduate and postgraduate medical education.
She trained initially as a nurse and has extensive experience in teaching and training in Further, Higher and Adult Education and for the voluntary sector. She has been an invited speaker and workshop facilitator at many UK and international conferences, most recently at the ASME, AMEE and Leadership Foundation's conferences presenting on healthcare education leadership and clinical education topics. She co-leads the MEDEV Staff and Educational Development Special Interest Group. She has researched and published on medical and healthcare education and leadership.
Judy's independent UK based project management work includes managing a national FDTL funded project which aims to develop approximately seventy leaders in health and social care education through a modular, sustainable leadership development programme and was network co-ordinator for the interprofessional national ICS-HE project. She is a highly experienced project manager, having worked in Portugal (undergraduate medical education and quality assurance); Georgia (developing an accreditation system for Higher Education); Central Asia (two USAID projects on evaluating and reforming undergraduate medical schools); Uzbekistan (World Bank and DfID health reform project in reviewing undergraduate medical education and developing a licensing programme for doctors and pharmacists); Bosnia and Herzegovina (World Bank project to develop a health management programme); Macedonia (World Bank project on accreditation and licensing for doctors, dentists and pharmacists) and Moldova (World Bank project on healthcare management). She has been working since 2006 with Professor Michael Preston-Shoot on the NTFS funded research project investigating into the effectiveness of teaching, learning and assessment of law in social work and medicine.
Recent and forthcoming publications
McKimm, J and Swanwick, T. 2006. Understanding Medical Education; Educational Leadership. ASME: Edinburgh (42 pages)
McKimm, J and Hill, F. 2008. Educational leadership: a core clinical teaching skill?. International Journal of Clinical Skills. Vol 3
McKimm, J. 2008. ‘Assuring quality and standards in teaching’ chapter in Fry, H., Ketteridge, S. and Marshall, S. (eds) A handbook for teaching and learning in Higher Education: enhancing academic practice.
(3nd edition, in press, due for publication June 2008). Kogan Page, London
McKimm, J. Personal Support and Mentoring in Cooper, N and Forrest, K. Essential Guide to Educational supervision in the Foundation Programme, Wiley-Blackwell
(in press, due for publication August 2008)
McKimm, J. Leadership roles in clinical education in Phillips, K and Alsop, A. Defining and engaging in leadership: emerging roles for health and social care professionals. Blackwell
(in press, due for publication December 2008)
Michael Preston-Shoot is Professor of Social Work and Dean of the Faculty of Health and Social Sciences, University of Bedfordshire. Since 1988 he has been researching and teaching law to non-lawyers, especially social workers, for which he was awarded a National Teaching Fellowship in 2005 by the Higher Education Academy. He has national and international standing for this research and teaching, which has culminated in a series of commissions from the Social Care Institute for Excellence to develop the knowledge and evidence-base in respect of teaching, learning and assessment of law in social work education. This research has resulted in key publications, namely:
Braye, S. and Preston-Shoot, M., with Cull, L-A., Johns, R. and Roche, J. (2005) Teaching, Learning and Assessment of Law in Social Work Education. London: Social Care Institute for Excellence.
Braye, S. and Preston-Shoot, M. (2006) Teaching, Learning and Assessment of Law in Social Work Education: Resource Guide. London: Social Care Institute for Excellence.
In 2007 the Social Care Institute for Excellence published ten e-learning objects on social work law, jointly written by Michael Preston-Shoot and Suzy Braye, who have now been commissioned to evaluate the outcomes of their use by educators and students. This two-year project will report in 2010. One of these objects (“All in a day’s work”) won first prize for the Best/Most Innovative Learning Object Award 2007, Association of Learning Technology (ALT) Conference. ALT is the acknowledged lead organisation in the application and research of e-learning.
Previously he has contributed to curriculum development for regulatory authorities on social work law, undertaken research for the social work subject centre and published papers which are widely regarded internationally as authoritative in this field of research and teaching and learning. These include:
Braye, S. and Preston-Shoot, M. (1990)`On teaching and applying the law in social work: it is not that simple.' British Journal of Social Work. 20 (4) 333-53.
Braye, S. and Preston-Shoot, M. (1991)`On acquiring law competence for social work: teaching, practice and assessment.' Social Work Education. 10 (1) 12-29.
Ball, C., Preston-Shoot, M., Roberts, G. and Vernon, S. (1995) Law for Social Workers in England and Wales. London: CCETSW.
Preston-Shoot, M., Roberts, G. and Vernon, S. (1998) ‘Social work law: from interaction to integration’. Journal of Social Welfare and Family Law. 20(1) 65-80.
Preston-Shoot, M., Roberts, G. and Vernon, S. (1998) ‘Working together in social work law’. Journal of Social Welfare and Family Law. 20(2) 137-150.
Braye, S. and Preston-Shoot, M. (1999) ‘Accountability, administrative law and social work practice: redressing or reinforcing the power imbalance?’ Journal of Social Welfare and Family Law. 21(3) 235-256.
Preston-Shoot, M., Roberts, G. and Vernon, S. (2001) ‘Values in social work law: strained relations or sustaining relationships?’ Journal of Social Welfare and Family Law. 23(1) 1-22.
Braye, S. and Preston-Shoot, M. (2005) ‘Emerging from out of the shadows? Service user and carer involvement in systematic reviews’. Evidence and Policy. 1(2), 173-193.
Braye, S. and Preston-Shoot, M. (2006) ‘The role of law in welfare reform: critical perspectives on the relationship between law and social work practice’. International Journal of Social Welfare. 15(1), 19-26.
Braye, S. and Preston-Shoot, M. (2006) ‘Broadening the vision: law teaching, social work and civil society’. International Social Work. 49(3), 376-389.
Braye, S., Preston-Shoot, M. and Johns, R. (2006) ‘Lost in translation? Teaching law to non-lawyers: reviewing the evidence from social work’. The Law Teacher. 40(2), 131-150.
Braye, S., Preston-Shoot, M. and Thorpe, A. (2007) ‘Beyond the classroom: learning social work law in practice’. Journal of Social Work. 7 (43), 322-340.
Similar work
The project partners are aware through their research and teaching on law in social work and medical education that a number of resources exist on law, ethics and professional development in medical education, some of which have been indicated and referenced above. We are presenting some of the preliminary findings from the NTFS project at the MEDEV/ASME conference on Professionalism on 5 June 2008 which will consolidate and develop useful contacts for this project.
One particular project, carried out by Deborah Murdoch-Eaton for MEDEV in 2006, produced case studies for medical students on ethical issues. As part of this project, a group of clinicians, lawyers, ethicists and philosophers was involved. It would be helpful to make contact and involve some of this team in the proposed mini-project.
It is planned that, through their own and Subject Centre networks, contact will be made with teachers of law and ethics in medical education to ensure that the literature review and practice survey are useful, not only to less experienced teachers of law (such as clinical teachers in various specialties or those new to teaching law) but also to those currently delivering law and ethics teaching in undergraduate medicine.
The project will also liaise with the Law SC: UKCLE, with relevant CETLs (such as the IDEA CETL and those concerned with professional development eg. DPMS and IPPS and practice learning eg. ALPS).
Murdoch-Eaton, D. 2006, Practical Teaching Packages on Ethics and Law in Medicine and Related Sciences Project
Contact details
Grant holder: Judy McKimm,
University of Bedfordshire
Amount awarded: £1,500 (in collaboration with Academy Subject Centre UKCLE who have funded £3,500)
Subject centre project contact: Megan Quentin-Baxter and Tracey Varnava (UKCLE)
Reports
