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Promoting reflection on experience and developing students' reflective skills is an important element of curricula across the health professions. Students often do not find reflection easy and educators use a range of approaches to facilitate this. This qualitative study analysed final year medical students' written reflections about important and difficult concepts they had encountered at medical school and personal change. As part of this, students were expected to look back on their written reflections from earlier years of the undergraduate programme. An initial analysis identified 'learning from past reflections' as an important theme. Here we report an in-depth analysis of this theme. Thirty-six final year volunteer students' reflections were analysed and 6 themes identified where students explicitly referred to earlier written reflections. These were: managing emotions; holistic, patient-centred care; uncertainty and ambiguity; self-regulation; growth in identity and sense of self efficacy; and reflective practice changes. Asking students to reflect on past reflections appeared to help students identify personal change, and how their understanding of 'important concepts' and their views and approach to reflective practice have developed. Experienced by students as a motivating, profound, sometimes cathartic process, this activity could be a useful addition to reflective writing training in health professions. [ABSTRACT FROM AUTHOR]

Integrated Training Posts (ITPs) were conceived in the 1990s and have recently increased in the Southwest of England. Most ITP evaluations have been small and undertaken over 13 years ago, so do not reflect the current training landscape. This qualitative study aimed to explore the views and experiences of ITPs amongst general practice trainees and educators. The location has increasing numbers of general practice trainees, International Medical Graduates (IMGs) and less-than-full-time trainees. Semi-structured interviews were undertaken with six trainees and two educators; all had experienced at least one ITP. Recordings were transcribed verbatim and coded. Thematic analysis was undertaken. Three themes were identified: 'The role: expectations versus reality', 'Relevance of ITPs to future GP role' and 'Educational Challenges'. Most trainees valued the additional clinical experiences ITPs offered, as well as being able to trial 'portfolio' working. Trainee and educator expectations varied considerably, particularly whether the role was primarily service or observational. Working across multiple settings could limit contact between educator and trainee and make it difficult to identify a struggling trainee. There is a need to clarify the roles of trainees and educators involved in ITPs and whether and how this might vary between posts. Further studies could explore whether choice of ITP influences retention of general practitioners, and whether all trainees including those working less-than-full-time or IMGs benefit from ITPs. [ABSTRACT FROM AUTHOR]

Aim: To understand the experiences of students and problem-based learning (PBL) facilitators during an evidence-based curriculum change to a PBL programme within an undergraduate medical course in South West England., Methods: Four novel PBL cases were designed and implemented, based on educational theory and evidence. Eight focus groups were undertaken with Year-1 and -2 students (n = 18) and PBL facilitators (n = 14) to explore the experiences of participants. Thematic analysis and conceptual abstraction led to insights into the intended and unintended consequences of the change., Results: Participant responses to the change process were influenced by the perceived relevance and value of the change (e.g. benefit to student learning), which was shaped by individual beliefs and preferences (e.g. presumed purpose of PBL, relative value placed on different curriculum topics, and desire for uniform educational experience), and the wider education context (e.g. expectations of assessment). It appears that the three distinct elements must align for the changes to be received positively. We updated our PBL curriculum in response to new evidence DISCUSSION: This study describes how we updated our PBL curriculum in response to new evidence, and demonstrates the importance of communicating the pedagogic rationale behind changes, and meticulous planning, preparation and alignment, even in distant parts of the curriculum. Engaging with existing views and attitudes is an essential requirement for successful curriculum change., (© 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)