Understanding Medical Education

Professor Tim Swanwick is Dean of Postgraduate Medical Education for Health Education North Central and East London, and Visiting Professor of Medical Education at the University of Bedfordshire

This is the second edition of the popular, well-read and well-recognised volume which aims to provide an ‘introduction’ to the ever important business of medical education. Its brief is ambitious. It aims to be a ‘synopsis of educational theory and practice,’ of use both to ‘scholarly medical educators and educational scholars’ all within an acknowledged context of complexity, contestation and political dialogue. This ambitious brief is largely accomplished. For the reader wishing to access ready and organised ideas there are boxes with key messages and important principles, but there are also opportunities for the reader with more substantive concerns to access and engage in competing discourses. The latter is nowhere more evident than in the chapter on Quality in medical education by Alan Bleakley, Julie Browne and Kate Ellis where ‘it is recognised that ‘quality’ has competing ‘managerial, economic, scientific, aesthetic, ethical, professional, social and political discourses. Familiar and traditional areas of study are seen through the lens of contemporary theory. Clare Morris and David Blaney’s account of Work-based learning, the very nub of medical education, provides a re-interpretation of traditional concepts like the clinical apprenticeship through the application of theories drawn from the cognitive and social sciences.The coverage of the volume is comprehensive. The authors are a truly international group representing the best writers and thinkers in the discipline. All the major areas of medical education are covered through the five sections of the book: Foundations, Educational Strategies, Assessment, Research and Evaluation and Staff and Students. There are some omissions. The increasing adoption of longitudinal integrated clinical clerkships and the evidence about their efficacy probably deserves a chapter on its own. Similarly the current concern for medical education to drive the social accountability imperatives of medical schools deserves consideration. Fiona Patterson, Eamonn Ferguson and Alec Knight list ‘political validity’ as one of the multiple validities to be considered in Selection into medical education and training. This required stakeholders and stakeholding groups to be decision-makers in selection. Antony Americano and Dinesh Bhugra give well-constructed account of Dealing with diversity. What is missing is the synthesing of ideas such as these and application to the responsibilities of medical schools to their communities in their selection processes, student population and educational programs. The coverage within each section is also comprehensive. The section on Assessment can serve as an example. It opens with a chapter on How to design a useful test: the principles of assessment by Lambert Schuwirth and Cess van der Vleuten. Chapters on Written assessment by Brian Jolly and Work-place assessment by John Norcini follow. Structured assessments of clinical competence are carefully explained by Katharine Boursicot, Trudie Roberts and William Burdick while André De Champlain takes up the important question of Standard setting methods in medical education. Diana Wood rounds off the section with a consideration of Formative assessment. Both the scholarly medical educators and the educational scholars have much to gain from reading this section. There is plenty of contemporary theory, lots of sound advice and practical tips, tables and examples. There is not much on assessment that has escaped the collective authors’ attention and those planning assessment programs would benefit from a close reading. The section could be improved by some conceptual and theoretical linking of the chapters. For example formative assessment, as discussed in the last chapter, has a particular function in programmatic approaches to assessment which is the basis of the first chapter on the principles of assessment. Some clearer linking would be of benefit.In sum this second edition of Understanding Medical Education will prove to be every bit as popular as it predecessor. It retains the coverage of the field but updates it expands it and gives it more contemporary justification. It does what its title claims; promote understanding of the major ideas in this important field. Such an understanding is essential for all those who work as medical educators whether they be practitioners, clinicians, theorists and academics or those with the good fortune to perform a combination of these roles.(David Prideaux, Emeritus Professor of Medical Education, School of Medicine, Flinders University, South Australia)

• Contributors, viiForeword, xiPreface, xiiiPart 1: Foundations, 11 Understanding medical education, 3Tim Swanwick2 Teaching and learning in medical education: How theory can inform practice, 7David M Kaufman and Karen V Mann3 Principles of curriculum design, 31Janet Grant4 Quality in medical education, 47Alan Bleakley, Julie Browne and Kate EllisPart 2: Educational Strategies, 615 Problem-based learning, 63Mark A Albanese and Laura C Dast6 Interprofessional education, 81Della Freeth7 Work-based learning, 97Clare Morris and David Blaney8 Supervision, mentoring and coaching, 111John Launer9 Teaching and leading small groups, 123Peter McCrorie10 Lectures and large groups, 137Andrew Long and Bridget Lock11 Technology-enhanced learning, 149Alison Bullock and Peter GM de Jong12 e-Learning, 161Scott Rice and Jean McKendree13 Simulation in medical education, 175Jean Ker and Paul Bradley14 Portfolios in personal and professional development, 193Erik Driessen and Jan van Tartwijk15 Self-regulated learning in medical education, 201Casey B White, Larry D Gruppen and Joseph C Fantone16 Learning medicine from the humanities, 213J Jill Gordon and H Martyn Evans17 Patient involvement in medical education, 227John Spencer and Judy McKimmPart 3: Assessment, 24118 How to design a useful test: The principles of assessment, 243Lambert WT Schuwirth and Cees PM van der Vleuten19 Written assessment, 255Brian Jolly20 Workplace assessment, 279John J Norcini21 Structured assessments of clinical competence, 293Katharine AM Boursicot, Trudie E Roberts and William P Burdick22 Standard setting methods in medical education, 305André F De Champlain23 Formative assessment, 317Diana F WoodPart 4: Research and Evaluation, 32924 Thinking about research: Theoretical perspectives, ethics and scholarship, 331Jan Illing25 Quantitative research methods in medical education, 349Geoff Norman and Kevin W Eva26 Qualitative research in medical education: Methodologies and methods, 371Stella Ng, Lorelei Lingard and Tara J Kennedy27 Programme evaluation: Improving practice, influencing policy and decision-making, 385Chris Lovato and David WallPart 5: Staff and Students, 40128 Selection into medical education and training, 403Fiona Patterson, Eamonn Ferguson and Alec L Knight29 Career progression and support, 421Caroline Elton and Nicole J Borges30 Managing remediation, 433Deborah Cohen, Melody Rhydderch and Ian Cooper31 Dealing with diversity, 445Antony Americano and Dinesh Bhugra32 Developing medical educators: A journey, not a destination, 455Yvonne Steinert33 Educational leadership, 473Judy McKimm and Tim SwanwickIndex, 493