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Managing the relationship between medical schools and clinical settings in the UK. Professor Sam Leinster School of Medicine, Health Policy and Practice University of East Anglia. East Anglia Joint Venture Medical School. From 1 st year. The role of the clinical placements is to provide

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managing the relationship between medical schools and clinical settings in the uk

Managing the relationship between medical schools and clinical settings in the UK

Professor Sam Leinster

School of Medicine, Health Policy and Practice

University of East Anglia

East Anglia Joint Venture Medical School

slide2

From 1st year

The role

of the clinical placements

is to provide

experiential learning

slide3

The requirements

for

experiential learning

kolb learning cycle
Kolb learning cycle

Experience

Reflection

Action

Theory

reflective practice
Reflective practice

Reflection-in-action

mentor

Reflection-on-action

Schon 1990

communities of learning8
Communities of learning

Lave and Wenger

Apprenticeship

Legitimate peripheral participant

a high quality clinical placement
A high quality clinical placement

Experiential

Learning

Educational Requirements

1 Experience

2 Reflection

Access to adequate numbers of appropriate patients

a high quality clinical placement10
A high quality clinical placement

Experiential

Learning

Educational Requirements

1 Experience

  • Effective mentoring
  • Personnel
  • Time
  • Ready access to educational resources

2 Reflection

3 Learning community

a high quality clinical placement11
A high quality clinical placement

Experiential

Learning

Educational Requirements

Educational Requirements

1 Experience

2 Reflection

Active involvement with clinical teams

3 Learning community

slide12

Pressures on

the

clinical placements

pressures on resources
Pressures on resources

Commissioned Clinical Service

£250M

Education & training

Other sources

£40M

Income Streams

Financial balance

Teaching

£10M

Payment by Results

Government targets

Clinical outcomes

pressures on nhs teachers
Pressures on NHS teachers

Education & training

Appraisal & CPD

Administration

Government targets

National guidelines

Clinical outcomes

Payment by Results + Choose and Book

pressures on clinical academics
Pressures on clinical academics

Education & training

Research Assessment Exercise

Appraisal & CPD

Administration

Government targets

National guidelines

Clinical outcomes

Payment by Results + Choose and Book

pressures on patients
Pressures on patients

Sicker patients

IDTC

Shorter stays

Shift to community settings

slide17

Management

of

clinical placements

organisation of medical education in the uk
Organisation of medical education in the UK

The Queen

Central Government

Privy Council

HEFCE

NHS

Medical Education

Universities

Clinical services

organisation of medical education in the uk19
Organisation of medical education in the UK

General Medical Council

Healthcare Commission

Central Government

HEFCE

NHS

Medical Education

Universities

Clinical services

funding of medical education in england
Funding of medical education in England

Central Government

Department for Education and Science

Department of Health

£7,500

£35,000

HEFCE

SIFT

Medical School

Clinical Settings

Student fees £3,000

old sift v new sift
Calculations based on overall excess costs

Expenditure lost in general accounts

Distribution of major fraction historical

20% follows student

Bottom up calculation of actual costs

Transparent assignment of SIFT to teaching

Distribution based on reality

100% follows students

Old SIFT v New SIFT

NO ACOUNTABILITY

ACOUNTABILITY

monitoring placement quality
Monitoring placement quality
  • Educational environment
    • Learning resources, ethos
  • Teachers
    • Qualifications, training, availability
  • Patients
    • Type, numbers, accessibility

SIFT

accountability
Accountability
  • Specify requirements
  • Audit compliance
  • Adjust SIFT payments

General Medical Council

  • Inspection visits
  • Student questionnaires
  • Student logbooks
  • Consultant appraisals
  • Service level agreement for:
  • Resources
  • Number and type of sessions for teaching
  • Job plans for teachers
  • Type and frequency of patient contacts

Regular validation visits

the east anglia joint venture
The East Anglia Joint Venture

NHS Trust Board

NHS Trust Board

NHS Trust Board

NHS Trust Board

University Council

NHS Trust Board

Policy Budgets

University Senate

Joint Venture Board

NHS Trust Executive

University Executive

Medical School Exec

the east anglia joint venture25
The East Anglia Joint Venture

Medical School Exec

NHS Trust Executive

Overall strategy

Research strategy

Human Resouces

slide26

Content

of

clinical placements

controlling the content
Controlling the content

Medical School Exec

Curriculum Group

NHS

NHS

NHS

Academic

Unit Team

NHS

NHS

NHS

Student

Student

Other

slide28

The role

of the clinical placements

is to provide

experiential learning