Undergraduate Education Programme in Medicine Markku Koulu and ...


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Undergraduate Education Programme in Medicine Markku Koulu and ...

  1. 1. Undergraduate Education Programme in Medicine Markku Koulu and Pekka Kääpä
  2. 2. Faculty of Medicine in the University of Turku • University founded in 1640 (Academy of Turku) • Faculty of Medicine founded in 1943 • Four Master's Degree Programmes in the Faculty: • Medicine • Dentistry • Nursing Science • Health Life Science • 1198 students (874 in Medicine) • 356 teachers • Programme in Medicine 360 ECTS / 6 years TURKU *
  3. 3. Challenges in the Undergraduate Medical Education • Expansion of the biomedical and clinical knowledge • Insufficient consideration of cultural, psychological and social dimensions in undergraduate medical education • Need of optimal balance between different learning environments (university hospital vs. health care centre) • Relevance of education for working life • Multiprofessionalism in patient care (team work; patient-centered approach) • Humanism in Medicine
  4. 4. The Process of the Curriculum Renewal • Based partly on the recommendations of an international evaluation panel in 1996 and self- evaluation in 1999 • Performed under the guidance of the Faculty during years 2001-2008 • Main principles of the new curriculum was outlined by a steering group • Core modules designed by multidisciplinary working groups with students representations • Coordinating role in the renewal process was dedicated to Medical Education Research and Development Centre founded in 2002
  5. 5. Central Aims of Reformulation "Doors open to science, culture and society" • To stress the significance of evidence-based medicine and scientific thinking • To improve students' perception of the competencies reached during the education • To enhance students' understanding of cultural and psychosocial factors for health and disease • To decentralise a substantial part of teaching outside the university hospital • To utilise electronic learning environments and teaching technologies • To support professional growth of students • To offer pedagogic education to teachers
  6. 6. Best Practices in the Undergraduate Programme in Medicine 1. New, innovative educational collaboration with society: • Extensive decentralisation of medical education • Medical Humanities Programme (Asklepios Programme) • Swedish language course "Medicine and Culture in the Archipelago" • Course on exercise, health and nutrition with the Sports Institute of Finland in Vierumäki • Doctor and Civil Defence-course, in co-operation with the Finnish Defence Forces • Great variety of elective courses provided by the Faculty 2. Comprehensive and developing student and teachers support mechanisms: • Comprehensive personal tutoring of the students since 2003 • Pedagogical training of the teachers since 2003 3. Foundation of the Medical Education Research and Development Centre: • Organisation and evaluation of personal tutoring of the students and pedagogical education of the teachers in the Faculty • Development and organisation of feedback systems in the Faculty • Pedagogic research and research-based development of education • National and international collaboration in medical education 4. Progressive personal and professional growth of the students: • Professional Growth Track
  7. 7. Aims of Decentralisation of Medical Undergraduate Education 1. To provide sufficient educational impact on general medical problems 2. To increase insight into family and preventive medicine 3. To illustrate functions of health care organisations 4. To improve learning environment and learning 5. To provide more opportunities to practise clinical skills during training 6. To expose young doctors to working life outside the university hospital
  8. 8. Loimaa regional hospital Raisio Hospital Vakka-Suomi Hospital, Uusikaupunki Salo regional hospital The Turku UniversityThe Turku University Hospital (Hospital (TYKS)TYKS),, Main HospitalMain Hospital FACULTY OFFACULTY OF MEDICINEMEDICINE Paimio HospitalTurku City hospital Turunmaa regional hospital Turku Teaching Health centre © V-ML 2006 Satakunta, Pori: Central hospital + Teaching Health centre
  9. 9. Medicine and Culture in the Archipelago •Swedish is the second official language of Finland and all graduating doctors and dentists should have sufficient oral and written skills in Swedish. •The course of Medicine and Culture in the Archipelago addresses these dimensions and also gives insight to the culture of the Swedish speaking Finns.
  10. 10. "Då jag var 15 år tänkte jag att jag aldrig skulle tala svenska men där satt jag hos dessa trevliga människor i flera timmar och talade. Vi hade jätteroligt. Jag log hela vägen hem och var glad i tre dagar.// When I was 15 years I thought I would never be speaking Swedish but there I was sitting with these nice people for hours and speaking. We had a very great time. I smiled all the way home and was glad for three days.” "Det här var första gången i mitt liv som jag talade med en över 70 år gammal person utanför sjukhuset. Givande.// It was the first time I discussed something outside a hospital with a person over 70 years of age. It was rewarding." Medicine and Culture in the Archipelago
  11. 11. Medical Ethics at the University of Turku, Faculty of Medicine Medical ethics covers issues such as the ethics of medical care in general, terminal care, the treatment and care of disadvantaged and vulnerable persons, end-of-life decisions and euthanasia as well as issues concerning priorities within medical and health care. Widely interpreted, the discipline also covers (bio)medical research ethics. Aims of Medical Ethics Education: 1.Awareness of the values and principles that commonly apply to discussions on medical ethics, such as human dignity, informed consent and patient autonomy, confidentiality, and justice 2.Improved communication and decision-making skills in ethically and culturally problematic situations 3.Familiarity with ethical and professional guidelines and recommendations and relevant health care and medical legislation
  12. 12. Elective Studies • Large selection and volume of elective courses (up to 50 ECTS / 360 ECTS • Several elective study tracks: Cardiovascular Medicine 16 ECTS Neuroscience 10 ECTS Nutrition Science 11 ECTS Infections and Immunological Diseases 12 ECTS Operative Medicine 17 ECTS Doctor´s Work in Health Care 10 ECTS Multiprofessional Pain Treatment 6 ECTS • Medical Humanities (Asklepios Programme) 15 ECTS
  13. 13. Medical Humanities Programme, "ASKLEPIOS Programme" Aims of the Medical Humanities Programme (15 ECTS): 1. Discussion and interaction of students in the medical, humanities and social science faculties of the university 2. Introduction and comparison of the scientific methods of the medical, humanistic and social sciences 3. Critical study of the different human concepts and needs of health and illness • The modules in the Programme comprise symposia and seminars. Each module has a tutor who organises the module. Students prepare learning diaries of each module which are assessed by the tutors. • 170 student participated since 2002 • Course of the Year in the University of Turku in 2006.
  14. 14. Medical Humanities Programme, "ASKLEPIOS Programme" Special study modules 2008-2009 (Theme: Suffering and Health) •Asklepios: Introduction Course (2 ECTS) •Asklepios I: Art and Suffering (3 ECTS) •Asklepios II: Values of Health (3 ECTS) •Asklepios III: Suffering, Disgrace and Medicine (3 ECTS) •Asklepios IV: Research Project (4 ECTS)
  15. 15. Special Research Tracks In order to emphasise the important link between education and research, the Faculty has organised two specific research tracks: an early-starting biomedical and a later clinical track. The Modules of the Biomedical Research Track Year 1 Spring 12 ECTS Basics of Working in the Laboratory Basic Techniques of Cell Biology Basic Biomolecular Techniques Year 2 Autumn 12 ECTS Basic biomolecular techniques Bioinformatics Animal Research Course Year 2 Spring 8 ECTS Medical Biotechnology Theory of Medical Science Year 3 Autumn 8 ECTS Conference Procedures and Communication Theory and Ethics of Science Philosophy of Science Career of the Researcher
  16. 16. Medical Education Research and Development Centre • The Centre was founded in 2002 • The Centre acts as a community of scholars to investigate, plan, prepare, implement and develop education. • Professor, 2 study coordinators, project leader, 2 study designers • Advisory Committee, which brings the interest groups of medical education, e.g. professional experts as well as representatives of education, health care services and other faculties of the University, together to review and anticipate the future needs of the educational function of the Faculty.
  17. 17. Medical Education Research and Development Centre
  18. 18. Medical Education Research and Development Centre Tasks of the R&D Centre: 1.Development of Teaching and Learning in the Faculty a. Decentralised teaching b. Core and general knowledge and skills c. Assessment methods of teaching and learning d. feedback on learning 2.Promotion of professional growth of the students 3.Personal Tutoring of Students 4.Pedagogical Training of Teachers 5.Quality Assurance of Undergraduate Education in the Faculty 6.Research Projects a. Learning Medical Expertise (LeMEx) b. Conceptual change during medical studies
  19. 19. Professional growth - track • Early Patient Contact Year 1 • Simulated Patient Exercises: communication Year 3 • Meet Medical Practitioners – seminars Years 1 and 6 • Medical Ethics Years 1, 3 and 6 • Graduating Medical Student-module Year 6 • Personal Tutoring Years 1-6 • Regular Self-reflections Years 1, 3 and 5
  20. 20. Supporting Professional Growth – the Programme of Early Patient Contact (EPC) •Since 1993 organized by the Department of Family Medicine. •The aims of the programme are orientation of the students to phycian’s work in primary health care and learning the basics of doctor-patient communication • "The most impressible were the patients. In them we saw a wide cross- section of finnish people during only one day. There were infants and elderly, and they all had different problems and illnesses. I learned that a physician must have a wide and comprehensive view to be able to do this work and I learned how differently young and elderly patients have to be observed both in terms of their illnesses and in terms of communication." (PV, fragment of a diary). • "I believe, that the first EPC-day will have influence on my future studies. This was the first time that I was in a doctor’s appointment room not as a patient but as something else. It was breathtaking to understand, that so it will be from now on. It takes time to get used to that. It makes me wonder, how I am going to feel next time I go to see a doctor as a patient, as I have seen the other side of the doctor-patient relationship." (KR, fragment of a diary).
  21. 21. Personal Tutoring Programme of the Undergraduate Students Aims of the Personal Tutoring Programme: 1.Learning support 2.Support of personal growth of the students 3.Support of professional development of the students 4.Regular feedback to students
  22. 22. Plan for Personal Tutoring Year 6 Year 5 Year 4 Year 3 Year 2 Year 1 EarlyPatient Contact Death Patient Disease Working Life Professional Growth Self-reflection Studying Personal Tutoring Knowledge,skills and attitudes Group Meetings PSP/Portfolio Group Meetings PSP/Portfolio PSP/Portfolio Group Meetings PSP/Portfolio Group Meetings PSP/Portfolio Group Meetings HOPS/Portfolio Peer tutoring
  23. 23. Learning Portfolio in Undergraduate Medical Education Aims of the portfolio: 1.support of personal and professional growth 2.promotion of feedback 3.development of reflective learning
  24. 24. Learning Portfolio in Undergraduate Medical Education ePortfolio StorageFolder (Personal) LearningPortfolio (AccessibletoPersonalTutor) Portfolio-tasksand Self-evaluations selectingsamples PersonalStudyPlan
  25. 25. Pedagogical Education and Training of the Medical Teachers Medical Pedagogy (10 ECTS) Learning environments Current Challenges in Medical Education Teaching with foreign language (5 ECTS) PedagogicalmeetingsinFacultyofMedicine Further pedagogical training in Educational Development Unit of University of Turku up to teachers formal qualification (60 ECTS) Paths of pedagogical education and training in the Medical Faculty Teaching and learning concepts in medicine Small group instruction and interaction Communication and educational technology Guidance and assesment in medical education Quality evaluation in medical curriculum Basics of problem based learning (half- day) Web-based teaching (3-5 ECTS)
  26. 26. Learning Medical Excellence (LeMEx) • A multi-center multidisciplinary education research project together with the University of Oulu and Tampere • longitudinal follow-up of a chort of medical and dental students (n=343), started in 2006 • main goals: • cumulative learning • development of medical expertise • conceptual change during medical studies
  27. 27. LeMEx : Research Questions • What is the study orientation of medical students like at different stages of medical education? • How does medical knowledge become organized into wholes during the course of medical education? • How does the students’ medical thinking develop in the course of the studies? • How do the students see, at different stages of their education, their role and duties in the doctor-patient relationship? • What properties do the students consider to be characteristic of a good physician at different stages of their studies? • How can the learning follow-up data be used as a tool of continuous quality assessment in medical education?