Downloaded from http://jme.bmj.com/ on February 8, 2015 - Published by group.bmj.com
Brief report
Medical ethics and law: assessing the core curriculum Angela Fenwick Correspondence to Dr Angela Fenwick, Clinical Ethics and Law, Faculty of Medicine, University of Southampton, Room 4001, Building 85, Highfield Campus, University Road, Southampton SO17 1BJ, UK; [email protected] Received 20 November 2013 Accepted 23 April 2014 Published Online First 15 May 2014
▸ http://dx.doi.org/10.1136/ medethics-2013-101330 ▸ http://dx.doi.org/10.1136/ medethics-2013-101331
ABSTRACT The Institute of Medical Ethics (IME) has produced a guide to the assessment of medical ethics and law (MEL) in UK medical schools which is available on-line. It complements the work which was carried out in 2010 to up-date the MEL consensus statement on what should be considered core content. The guide aims to provide practical help for teachers on what, when and how to assess medical students’ learning. The briefing paper gives a background introduction to the guide, outlines its purpose and plans for future work.
The General Medical Council (GMC) sets out its requirements for undergraduate medical education in the UK in its publication, Tomorrow’s Doctors, which includes the ethical and legal principles it expects graduates to incorporate into their practice.1 In 2010, the Institute of Medical Ethics (IME), through its Education Steering Group chaired by Gordon Stirrat, revised its consensus statement of core content for medical ethics and law in undergraduate medical education which was first produced in 1998.2 3 This was in response to the GMC’s updated Tomorrow’s Doctors and because of concerns expressed by educators in the field about teaching, learning and assessment of medical ethics and law.4 At the same time the Education Steering Group set up an Assessment Working Groupi to look at issues around the assessment of the core curriculum and to explore ways to respond to requests from teachers for support in this area. Teachers had reported that they felt they lacked expertise in this area and that existing generic assessment guides were difficult to apply in the context of the subject area. Moreover, some people expressed a concern that the core content was now ‘too much’ to assess. The outcome of the working group is the report: Medical Ethics and Law: a practical guide to the assessment of the core content of learning, which aims to provide accessible guidance for teachers involved in planning, designing and implementing assessments of students’ learning in medical ethics and law in medical schools.5 It contains general advice on key areas to consider when making decisions about what, how and when to assess students’ learning, and attempts to address concerns about having to assess everything by showing how to sample students’ learning in any given assessment period. Information on different assessment methods is covered as well as how these might usefully be used in a variety of
i
To cite: Fenwick A. J Med Ethics 2014;40:719–720.
This group was set up by Gordon Stirrat; its members were: Angela Fenwick (chair), Carolyn Johnston, Rhona Knight, Georgia Testa and Andrew Tillyard.
different contexts and across a range of learning outcomes. A number of examples of assessments are also presented and these can be adapted for use. The report is available online on the IME website (http:// www.instituteofmedicalethics.org); a hard copy was distributed to participants at the IME annual conference and to all UK medical schools in February 2013. The guidance outlines the relative benefits and drawbacks of different assessment methods and advocates that teachers take a strategic approach towards the assessment of the core curriculum which involves the adoption of a range of assessment methods. This is to ensure that a variety of learning outcomes can be assessed, that students are motivated to learn across the core content and to provide different ways in which they can receive feedback on their learning. In addition, such an approach allows for a balanced programme of assessment where the potential disadvantages of one assessment method can be offset by the advantages of another. Anecdotal evidence has indicated that there is an increasing trend towards a focus on the reliability of assessments in medical schools, where assessment methods such as Objective Structured Clinical Examinations and multiple choice question papers— for example, One Best Answers—are seen as the ‘gold standard’ because they can be shown to be statistically reliable. The report contains examples of how these types of methods can, indeed, be used effectively and how questions on medical ethics and law can be incorporated into such assessments which cover more than one or many disciplines. However, it also highlights potential drawbacks: just doing so will likely limit the range and depth of understanding of medical ethics and law that can be assessed; focusing on the reliability of assessments, at the expense of validity, will, therefore, directly impact on students’ learning. The GMC also acknowledge this issue in their assessment advice: “In practice, each method has its own strengths and weaknesses, calling for a complementary and balanced approach to choosing assessment methods bearing in mind the various criteria.”6 Teachers have also stated that they can feel marginalised in medical schools where medical ethics and law only forms a small part of a much larger curriculum and, because of this, it can be difficult to influence decisions about assessment which are made more centrally. It is hoped that the report can support individual or small groups of teachers by providing guidance that comes from a wider community of practitioners, through the IME. The guidance complements the teaching and learning materials on the IME website. Like these materials, it is not intended to be exhaustive or be the ‘last word’ in the assessment of medical ethics and law; rather, to act as a starting point for
Fenwick A. J Med Ethics 2014;40:719–720. doi:10.1136/medethics-2013-101329
719
Downloaded from http://jme.bmj.com/ on February 8, 2015 - Published by group.bmj.com
Brief report teachers and for further work in the area. While a PDF of the report can be downloaded from the IME website currently, the aim is to adapt it to provide an online version, in the next year or so, which can then be updated and developed on a regular basis and include additional examples for teachers to draw on and adapt to their specific needs. This will also facilitate discussion around new concerns about the assessment of the core content as they arise, alongside those that remain ongoing.
REFERENCES
Collaborators Carolyn Johnston, Rhona Knight, Georgia Testa, Andrew Tillyard and Gordon Stirrat.
5
Competing interests None. Provenance and peer review Commissioned; internally peer reviewed.
720
1 2
3
4
6
General Medical Council. Tomorrow’s doctors: recommendations on undergraduate medical education. London: GMC, 2009. Stirrat GM, Johnston C, Gillon R, et al. Medical ethics and law for doctors of tomorrow: the 1998 Consensus Statement updated. J Med Ethics 2010; 36:55–60. Consensus statement by 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;24:188–92. Mattick K, Bligh J. Teaching and assessing medical ethics: where are we now? J Med Ethics 2006;32:181–5. Fenwick A, Johnston C, Knight R, et al. Medical Ethics and Law: a practical guide to the assessment of the core content of learning. Gloucestershire: Institute of Medical Ethics, 2013. General Medical Council. Assessment in undergraduate medical education. GMC, 2011.
Fenwick A. J Med Ethics 2014;40:719–720. doi:10.1136/medethics-2013-101329
Downloaded from http://jme.bmj.com/ on February 8, 2015 - Published by group.bmj.com
Medical ethics and law: assessing the core curriculum Angela Fenwick J Med Ethics 2014 40: 719-720 originally published online May 15, 2014
doi: 10.1136/medethics-2013-101329 Updated information and services can be found at: http://jme.bmj.com/content/40/10/719
These include:
References Email alerting service
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This article cites 3 articles, 3 of which you can access for free at: http://jme.bmj.com/content/40/10/719#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Undergraduate (96)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Brief report
Medical ethics and law: assessing the core curriculum Angela Fenwick Correspondence to Dr Angela Fenwick, Clinical Ethics and Law, Faculty of Medicine, University of Southampton, Room 4001, Building 85, Highfield Campus, University Road, Southampton SO17 1BJ, UK; [email protected] Received 20 November 2013 Accepted 23 April 2014 Published Online First 15 May 2014
▸ http://dx.doi.org/10.1136/ medethics-2013-101330 ▸ http://dx.doi.org/10.1136/ medethics-2013-101331
ABSTRACT The Institute of Medical Ethics (IME) has produced a guide to the assessment of medical ethics and law (MEL) in UK medical schools which is available on-line. It complements the work which was carried out in 2010 to up-date the MEL consensus statement on what should be considered core content. The guide aims to provide practical help for teachers on what, when and how to assess medical students’ learning. The briefing paper gives a background introduction to the guide, outlines its purpose and plans for future work.
The General Medical Council (GMC) sets out its requirements for undergraduate medical education in the UK in its publication, Tomorrow’s Doctors, which includes the ethical and legal principles it expects graduates to incorporate into their practice.1 In 2010, the Institute of Medical Ethics (IME), through its Education Steering Group chaired by Gordon Stirrat, revised its consensus statement of core content for medical ethics and law in undergraduate medical education which was first produced in 1998.2 3 This was in response to the GMC’s updated Tomorrow’s Doctors and because of concerns expressed by educators in the field about teaching, learning and assessment of medical ethics and law.4 At the same time the Education Steering Group set up an Assessment Working Groupi to look at issues around the assessment of the core curriculum and to explore ways to respond to requests from teachers for support in this area. Teachers had reported that they felt they lacked expertise in this area and that existing generic assessment guides were difficult to apply in the context of the subject area. Moreover, some people expressed a concern that the core content was now ‘too much’ to assess. The outcome of the working group is the report: Medical Ethics and Law: a practical guide to the assessment of the core content of learning, which aims to provide accessible guidance for teachers involved in planning, designing and implementing assessments of students’ learning in medical ethics and law in medical schools.5 It contains general advice on key areas to consider when making decisions about what, how and when to assess students’ learning, and attempts to address concerns about having to assess everything by showing how to sample students’ learning in any given assessment period. Information on different assessment methods is covered as well as how these might usefully be used in a variety of
i
To cite: Fenwick A. J Med Ethics 2014;40:719–720.
This group was set up by Gordon Stirrat; its members were: Angela Fenwick (chair), Carolyn Johnston, Rhona Knight, Georgia Testa and Andrew Tillyard.
different contexts and across a range of learning outcomes. A number of examples of assessments are also presented and these can be adapted for use. The report is available online on the IME website (http:// www.instituteofmedicalethics.org); a hard copy was distributed to participants at the IME annual conference and to all UK medical schools in February 2013. The guidance outlines the relative benefits and drawbacks of different assessment methods and advocates that teachers take a strategic approach towards the assessment of the core curriculum which involves the adoption of a range of assessment methods. This is to ensure that a variety of learning outcomes can be assessed, that students are motivated to learn across the core content and to provide different ways in which they can receive feedback on their learning. In addition, such an approach allows for a balanced programme of assessment where the potential disadvantages of one assessment method can be offset by the advantages of another. Anecdotal evidence has indicated that there is an increasing trend towards a focus on the reliability of assessments in medical schools, where assessment methods such as Objective Structured Clinical Examinations and multiple choice question papers— for example, One Best Answers—are seen as the ‘gold standard’ because they can be shown to be statistically reliable. The report contains examples of how these types of methods can, indeed, be used effectively and how questions on medical ethics and law can be incorporated into such assessments which cover more than one or many disciplines. However, it also highlights potential drawbacks: just doing so will likely limit the range and depth of understanding of medical ethics and law that can be assessed; focusing on the reliability of assessments, at the expense of validity, will, therefore, directly impact on students’ learning. The GMC also acknowledge this issue in their assessment advice: “In practice, each method has its own strengths and weaknesses, calling for a complementary and balanced approach to choosing assessment methods bearing in mind the various criteria.”6 Teachers have also stated that they can feel marginalised in medical schools where medical ethics and law only forms a small part of a much larger curriculum and, because of this, it can be difficult to influence decisions about assessment which are made more centrally. It is hoped that the report can support individual or small groups of teachers by providing guidance that comes from a wider community of practitioners, through the IME. The guidance complements the teaching and learning materials on the IME website. Like these materials, it is not intended to be exhaustive or be the ‘last word’ in the assessment of medical ethics and law; rather, to act as a starting point for
Fenwick A. J Med Ethics 2014;40:719–720. doi:10.1136/medethics-2013-101329
719
Downloaded from http://jme.bmj.com/ on February 8, 2015 - Published by group.bmj.com
Brief report teachers and for further work in the area. While a PDF of the report can be downloaded from the IME website currently, the aim is to adapt it to provide an online version, in the next year or so, which can then be updated and developed on a regular basis and include additional examples for teachers to draw on and adapt to their specific needs. This will also facilitate discussion around new concerns about the assessment of the core content as they arise, alongside those that remain ongoing.
REFERENCES
Collaborators Carolyn Johnston, Rhona Knight, Georgia Testa, Andrew Tillyard and Gordon Stirrat.
5
Competing interests None. Provenance and peer review Commissioned; internally peer reviewed.
720
1 2
3
4
6
General Medical Council. Tomorrow’s doctors: recommendations on undergraduate medical education. London: GMC, 2009. Stirrat GM, Johnston C, Gillon R, et al. Medical ethics and law for doctors of tomorrow: the 1998 Consensus Statement updated. J Med Ethics 2010; 36:55–60. Consensus statement by 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;24:188–92. Mattick K, Bligh J. Teaching and assessing medical ethics: where are we now? J Med Ethics 2006;32:181–5. Fenwick A, Johnston C, Knight R, et al. Medical Ethics and Law: a practical guide to the assessment of the core content of learning. Gloucestershire: Institute of Medical Ethics, 2013. General Medical Council. Assessment in undergraduate medical education. GMC, 2011.
Fenwick A. J Med Ethics 2014;40:719–720. doi:10.1136/medethics-2013-101329
Downloaded from http://jme.bmj.com/ on February 8, 2015 - Published by group.bmj.com
Medical ethics and law: assessing the core curriculum Angela Fenwick J Med Ethics 2014 40: 719-720 originally published online May 15, 2014
doi: 10.1136/medethics-2013-101329 Updated information and services can be found at: http://jme.bmj.com/content/40/10/719
These include:
References Email alerting service
Topic Collections
This article cites 3 articles, 3 of which you can access for free at: http://jme.bmj.com/content/40/10/719#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Undergraduate (96)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
