Consensus Building Helps Integration Between Science And Humanism

Background and Purpose – based in the philosophy of andragogy [1], we sought to identify whether there were benefits from consensus building [2] in curriculum development in the different contexts of undergraduate human medicine for public health, professionalism and ethics [3]; specialist training for oncology; and undergraduate veterinary medicine for communications across the full breadth of veterinary practices [4]. Benefits were considered in terms of the quality of the learning environments as perceived by learners and educators and the implications for education governance [5].

Methodology – using individual semi-structured interviews, focus groups and the nominal group technique (NGT), we discussed with learners and separately with educators their perspectives on the official curricula for these subjects, what is provided through the curricula in action, and what is in the hidden curricula [6].

Results – the NGT made explicit many issues in the three curricula in a non-threatening way by drawing on different values and experiences. Integrated activities including longitudinal case studies, real world clinical involvements, and observing role models served to connect clinical sciences with humanities and achieved better outcomes than non-integrated activities like lectures, specialised awareness days, technical skills simulation sessions. Mentorship by a more experienced professional was identified as helping enculturation and enabling individual learning needs to be met particularly through assessments and regular, structured feedback. New ideas for facilitator training, assessments and research also emerged through the use of the NGT.

Discussion and Conclusions – the results show that learners acquired the scientific skills of the clinician as they progressed from undergraduates to postgraduates. However there were deficits in their humanities’ learning notably in the development and nurturing perspectives [7] and in creating reflective environments. Also, at the level of curriculum planning in veterinary schools, the use of the NGT enabled the development of a broader curriculum pertinent to veterinary practices [8]. Overall the NGT assisted the identification of priorities for curriculum development and implementation through shared ownership.

The use of these consensus techniques has promoted measurements of high validity and reliability about the curricula, engaged learners and educators, acted as a lever for curricula changes, and improved the quality of the learning environments in these different contexts.

[1] Curzon LB. Teaching in Further Education. 5th ed. London: Cassell 2004.
[2] Fink A, Kosecoff J, Chassin M, Brook RH. Consensus Methods: Characteristics and Guidelines for Use. American Journal Public Health. 1984;74:979-83.
[3] Nestel D, Robbé IJ, Jones K. Personal and Professional Development in Undergraduate Health Sciences Education. Journal of Veterinary Medical Education. 2005;32(2):20-32.
[4] Radford AD, Stockley P, Silverman J, Taylor IR, Turner R, Gray CA, et al. Development, Teaching and Evaluation of a Consultation Structure Model for Use in Veterinary Education. Journal of Veterinary Medical Education. 2006;33(1):38-44.
[5] Robbé IJ. Drawing Together Quality Issues, Institutional Benchmarking and Revalidation. In: Sweet J, Huttly S, Taylor I, eds. Effective Learning and Teaching in Medical, Dental and Veterinary Education. London: Kogan Page 2003.
[6] Cribb A, Bignold S. Towards the Reflexive Medical School: the Hidden Curriculum and Medical Education Research. Studies in Higher Education. 1999;24(2):195-209.
[7] Pratt DD, Collins J. Five Perspectives on Teaching in Adult and Higher Education. Malabar, Florida: Krieger 1998.
[8] Gray CA, Blaxter AC, Johnston PA, Latham CE, May S, Phillips CA, et al. Communication Education in Veterinary Education in the United Kingdom and Ireland: the NUVACS Project Coupled to Progressive Individual School Endeavours. Journal of Veterinary Medical Education. 2006;33(1):85-92.

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