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Context This paper sets out to analyse and interpret the complex events of the last 20 years in order to understand how the teaching and learning of clinical communication has emerged as a core part of the modern undergraduate medical curriculum in most medical schools in the UK. Methods The paper analyses the effects of key political, sociological, historical and policy influences on clinical communication development. Results Political influences include: the effects of neo-liberalism on society and on the professions in general; the challenging of traditional notions of professionalism in medicine; the creation of an internal market within the National Health Service, and the disempowerment of the medical lobby. Sociological influences include: the effects of a ‘marketised’ society on medicine and subtle shifts in the doctor−patient relationship because of this; the emergence of globalised information through the Internet, and the influence of increased litigation against doctors. Historical influences include: the effects of a change in emphasis for medical education away from an inflated factual curriculum towards a curriculum that recognises the importance of student attitudes and the teaching and learning of clinical communication skills. Policy influences include the important effects of Tomorrow's Doctors and the Dearing Report on the modern medical curriculum. Conclusions The paper concludes with a developmental map that charts the complex influences on clinical communication teaching and learning and a brief commentary on the growing body of teachers who deliver and develop the subject today. [ABSTRACT FROM AUTHOR]

Aims This paper describes the process of validating the Readiness for Interprofessional Learning Scale (RIPLS) for use with postgraduate health care professionals. Context The RIPLS questionnaire has proved useful in the undergraduate context, enabling tutors to assess the readiness of students to engage in interprofessional learning (IPL). With the drive in the National Health Service (NHS) to deliver health care in interprofessional teams, it seems logical to ask whether postgraduate education should, or could, be delivered successfully in interprofessional contexts. As a preliminary to undertaking an extended IPL project, the researchers tested the validity of the RIPLS tool in the postgraduate health care context. Method A modified version of the RIPLS questionnaire was administered to all general practitioners, nurses, pharmacists and allied health professionals in the Dundee Local Health Care Cooperative (LHCC) ( n = 799). A total of 546 staff responded (68%). Results Three factors, comprising 23 statements, emerged from the statistical analysis of the survey data, namely, teamwork and collaboration, sense of professional identity and patient-centredness. The internal consistency measure was 0.76. Analysis of variance suggested some key differences between the different professions in respect of the factors. Conclusions The RIPLS questionnaire was validated for use in the postgraduate context, thus providing researchers with a tool for assessing health professionals' attitudes towards interprofessional learning at practice level, community health partnership level or at a national level of education and training. Significant differences between professional groups should be taken into account in designing any interprofessional learning programme. [ABSTRACT FROM AUTHOR]

Introduction Recent policy initiatives in the United Kingdom (UK) have underlined the importance of public health education for health care professionals. We aimed to describe teaching inputs to medical undergraduate curricula, to identify perceived challenges in the delivery of public health teaching and strategies that may overcome them. Methods We undertook a cross-sectional survey; questionnaires were sent electronically to 28 teaching leads in academic departments of public health in UK medical schools. These were followed-up by telephone interviews. Results We obtained a 75% response rate. We found a great deal of variability between schools in teaching methods, curricular content and resources used. In 76% of medical schools, public health and clinical teaching were integrated to some extent. The proportion of teaching delivered as lectures is decreasing and that of self-directed learning is increasing. A range of methods is used to assess students and in 33% of schools these assessments contributed to final Medical School marks. More than half the medical schools had difficulty finding teachers and staffing levels had deteriorated in 55% of schools. Many interviewees felt that their contributions were undervalued. Few were aware of the level of funding received to support teaching. Discussion There is a need to increase the supply of well-trained and motivated teachers and combine the best traditional teaching methods with more innovative, problem-based approaches. Faculties need to share ‘learning about what works’ and teaching resources across medical schools as well as addressing a culture of neglect of teaching in some departments. Suggestions are made as to how undergraduate public health teaching can be strengthened. [ABSTRACT FROM AUTHOR]

Objective To determine whether the recommendations of the Consensus Statement published 7 years ago have been implemented. Design Postal questionnaire survey of 28 UK medical schools. Methods A survey was sent to the lead individual for teaching and learning at each medical school. This questionnaire enquired about the undergraduate ethics and law curriculum, including its design, teaching, assessment, staffing, and individuals' hopes and concerns for the future. Main outcome measures Information relating to undergraduate ethics teaching in UK medical schools. Results Significant changes in the teaching and assessment of medical ethics and law that could be directly attributed to the Consensus Statement were identified. Whilst most schools covered all 12 recommended topics in their curriculum, only 3 felt all the topics were covered thoroughly and 3 schools said at least 1 topic was not covered at all. Only 16 schools identified 1 or more full-time academics who took direct responsibility for ensuring undergraduate medical students learnt about ethics; these were usually at lecturer grade. Conclusions The Consensus Statement has had a significant impact on the teaching of undergraduate ethics but, even 7 years on, not all its recommendations have been implemented fully. [ABSTRACT FROM AUTHOR]

Objectives To assess any recent change in the commitment to occupational medicine teaching in UK undergraduate medical curricula.Design A questionnaire survey of the teaching of occupational medicine to undergraduates in all medical schools listed in the UK Universities and Colleges Admissions Service prospectus for 1999–2000 (n = 24).Results Nineteen UK schools medical schools returned a completed questionnaire, giving a response rate of 79%. A comparison of results from this survey with previous surveys of teaching of occupational medicine to undergraduates in the UK shows that fewer schools now provide lectures, project work or ward‐based tuition in the subject. Workplace visits were not undertaken by any institution. Only two of the schools setting an examination question also had a syllabus.Conclusion Despite the prominence given to issues related to occupational health in recent UK government policy, this study suggests a declining commitment to occupational medicine on the part of UK medical schools. Urgent action needs to be taken to address the lack of training in occupational medicine in UK medical schools. [ABSTRACT FROM AUTHOR]

Objectives To assess any recent change in the commitment to teaching of occupational medicine in UK undergraduate medical curricula. Design A questionnaire survey of the teaching of occupational medicine to undergraduates in all medical schools listed in the UK Universities and Colleges Admissions Service prospectus for 1999–2000 (n = 24). Results Nineteen UK medical schools returned a completed questionnaire, giving a response rate of 79%. A comparison of results from this survey with previous surveys of teaching of occupational medicine to undergraduates in the UK shows that fewer schools now provide lectures, project work or ward-based tuition in the subject. Workplace visits were not undertaken by any institution. Only two of the schools setting an examination question also had a syllabus. Conclusion Despite the prominence given to issues related to occupational health in recent UK government policy, this study suggests a declining commitment to occupational medicine on the part of UK medical schools. Urgent action needs to be taken to address the lack of training in occupational medicine in UK medical schools. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore an approach for informing the development of regional policy by eliciting the considered views of GP participants at an educational event. In particular we discuss the reaction of GP participants to this approach. (In this instance our GP participants were trainers and the evolving policy under discussion was that of ‘clinical governance’.) MethodAn educational event was planned to facilitate discussion and the recording of the considered views of GP trainer participants. The acceptability of this approach to the participants was evaluated via observation and through feedback forms. ResultsWhile observation suggested that the participants were involved in many lively and constructive discussions, the feedback generated showed that many participants felt uncomfortable about the use of an educational event to inform development. DiscussionWe recognize the need to inform and facilitate change through the involvement of those who will be participants in the change process. The rapid timescales imposed by change and the ‘burden’ of additional research involvement on practitioners are issues. Approaches based on action research and participatory research principles may have potential and can throw light on the difficulties we experienced. ConclusionWe need to identify approaches which will allow us to ground development within the views of those to be affected by change. Our own attempt demonstrated difficulties. We would welcome further debate over methods and approaches applicable in this border territory between research, development and education. [ABSTRACT FROM AUTHOR]

ObjectiveTo compare student perception of teaching in general practice (GP), district general hospitals (DGHs) and teaching hospitals (THs) and their examination results. SettingThe medical school at Queen’s University, Belfast. Subjects and methodsA total of 161 medical and 34 dental students completed an objective structured clinical examination and questionnaire at the end of their second semester of basic skills teaching. They scored the course for teaching style, educational value and enjoyment. Teaching attributes of the tutors were similarly recorded. Students were also asked to quantify how time was used and to comment on the course. InterventionsA new programme for teaching first- and second-year students basic clinical skills in the community. ResultsTeaching in GP and DGHs was reported to be more educational and enjoyable than in the TH. In GP most time was spent being lectured, in DGHs most time was spent with the patient, and in THs, waiting for the tutor. General practitioners and doctors in DGHs were more likely to model positive teaching attitudes such as showing interest in students and providing feedback. The most common complaints related to insufficient time spent with patients in GP and poor tutor preparation in THs. All teaching sites achieved similar examination results. ConclusionClinical skills can be taught to medical students early in their curriculum using GP tutors. Student preference was strongly for being taught by GPs rather than in THs. Simple steps such as prior preparation and the locating of a suitable patient could markedly improve student experience both in GP and in hospitals. [ABSTRACT FROM AUTHOR]