The Undergraduate Medical Programme. Linköping, Sweden. Linköping University 3 campus. Linköping

Transcription

1 The Undergraduate Medical Programme Linköping, Sweden Torbjörn Ledin, programme director Helsinki August 20, Linköping Sid 2 Linköping University 3 campus Campus Norrköping students Campus Valla students Campus US (Universitetssjukhuset) students Sid Sid 4 1

2 History Håkan Hanberger, coordinator clinical education Medical faculty since late 60s Existence threaths late 70 s Joint venture University County Council: Ideas from McMaster, Maastricht, Beer Sheeva Community centered Student centered Integrated horizontal / vertical Multidisciplinary Multiprofessional Scientific project Approved by state mid 80 s Faculty of Health Sciences inaugrition Sid Sid 8 Development since 1986 Today ca 800 students / year start at FHS 8 Undergraduate programmes and 2 Master joint programmes All students study together the first 7 weeks, and later on 5 wks Medical students up from 60 / year to 180 / year Medical programme: superior national evaluation 1997 Redesigning curriculum from 2004 Critique => curriculum redesign Increased basic sciences later on in studies More emphasis on health and social aspects Four consecutive full weeks at all clinical rotations Responsibility: redesigned structure Superior national evaluation in 2006 Award of Excellent Quality in Higher Education Sid Sid 10 National self assessment evaluations at end of internship Sid Sid 12 2

3 Study introduction first eight weeks Programme studies: Vertical and horizontal integration One week programme introduction Following 7 weeks: Health-Ethics-Learning HEL-1 course: Beginners from all programmes together Study groups of 8 and seminars with 4 * 8 students PBL introduction in tutorial 8-groups with dedicated tutor Meet twice a week 2-3 hours to process scenarios Written community based study report by the group Individual Personal Improvement project Portfolio Sid Sid 14 Emphasis on the Tutorial group Twice a week - two hours with tutor Webscenarios of everyday situations - triggers Sid Sid 16 Pyramids with important concepts - supporting the learning outcomes Teaching principles: Student centered learning Tutorial groups often precede lectures Lectures at a higher level, no aim to cover the field Teaching limited to about 11 hours/week (+4 hrs tutor groups) Self studies dominate Workload estimation (evaluation surveys): Around 40 hours/week Sid Sid 18 3

4 Thematic studies Outline during the first 5 semesters The 7 thematic groups organize teaching and examinations Sid Sid 20 Any Pediatrics? Any Pediatrics? Sid Sid 22 Early introduction to clinical skills The Strand Starts semester 1, half a day a fortnight in primary care Humanistic Ethic Strand Semesters 1B 2 : Literature groups with teacher read Fiction literature 5 books in 1.5 semesters Semesters 3-4 : Ethics discussion groups with teacher meet to discuss Ethical dilemmas based on selected articles Students encouraged to take part in Ethics Forum once a month with invited guest speaker Sid Sid 24 4

5 Clinical rotations 3 times 4 full weeks per semester Clinical teaching ideally one to one Students take doctoral responsibility at World Premier Student ward Sid Sid 26 Time line of a clinical rotation Kl MÅNDAG TISDAG ONSDAG TORSDAG FREDAG 07:45 Morgonmöte 08:00-08:30 Övrig tid placering vid Intro Rtg-rond + 08:30-09:00 jour, avdelning, morgonmöte 09:00-12:00 konsult och mott; separat schema 12:00-13:00 L U N C H 13:00-13:30 Kandidat- 1 Kandidat- Radiologi Kandidat- Theory, 2 weeks Clinical rotation, 4 weeks Theory, 2 weeks 13:30-14:00 rond rond Tillämpn. rond 14:00-14:30 M av radio- 14:30-15:00 Radiologi logiska Basgrupp 15:00-15:30 A Strålnings- principer 15:30-16:00 körkort 16:00-16:30 J 16:30-17:00 Kl MÅNDAG TISDAG ONSDAG TORSDAG FREDAG 07:45 Morgonmöte Monday week 1 Introduction Expectations discussion End of rotation week 4. Feedback and evaluation Presentation seminar for EBM written task 08:00-08:30 Övrig tid placering vid Intro Rtg-rond + 08:30-09:00 jour, avdelning, morgonmöte 09:00-12:00 konsult och mott; separat schema 12:00-13:00 L U N C H 13:00-13:30 Kandidat- Kandidat- Kandidat- Kandidat- Kandidat- 13:30-14:00 rond rond rond rond rond 14:00-14:30 Hygien 14:30-15:00 Resemedicin Basgrupp 15:00-15:30 inkl. vaccination Klin mikro 15:30-16:00 "Fallbaserad 16:00-16:30 diagnostik" 16:30-17: Sid Sid 28 Individual plan for the clinical rotation and Individual EBM based writing tasks twice/semester Evaluation of every clinical rotation Sid Sid 30 5

6 Clinical teaching and Supervision A common responsibility University Health Care Authorities * Regional cooperation * Staff training * Financial incentives * Recruitment basis International contacts Exchange programmes Sid Sid 32 Scientific project weeks Semester 6 Organization and economic steering Individual project, or in some cases two students Planned in semester 5, supervisor must be PhD Written report Presentation with T11 student opponent in semesters 6 up to 9 Rest of semester 6 can be used for elective courses or extra clinical rotations of interest Course in Global Medicine (West Africa or India trip) very popular From 2010 mandatory 20 weeks project (Bologna requirement) Sid Sid 34 Examinations MEQ Subject area Infectious diseases T7 Each semester = Practice requirements + endpoint exam 50/50 Final two weeks of all semesters used for examinations Grades: fail / pass All semesters except T1+2 use MEQ Phase examinations: Phase T1-2 : Literature search triple jump task Phase T3-5: Written MEQ, principles of pathology and therapy Phase T6-11: OSCE in T9, CRE in T10, Scientific methods T11 Retention of large amounts of knowledge shown to be an obstacle to 5-10% of students Experience is being gained Previously oral practical + theory exams with hardly any failing students, questioning validity You hold a temporary summer position, being on call the third night. Ayaan 14y, born in Sweden, parents Somalian. 5 days coughing, common cold, breathing pain. History of intermittent pulmonary obstructivity. Findings: Breathing rate 32/min, crepitations upper right. Oxygen saturation 92%. Temp 39 deg. WBC 3.5, CRP 300. Q1. What cultures before iv treatment, what agents suspected? Sid Sid 36 6

7 CRE example Anna 23y, healthy, acute left sided hemiparesis. Explain why - using the ultrasound findings of the heart (using iv contrast). Kontrastbubblor i höger förmak och kammare 4-rumsvy av hjärtat Fråga 1 Kontrastbubblor Sid Sid 38 Students as resources in development Students have elected representatives in every committee at LiU the union is a speaking partner to faculty directorate own house on Campus with restaurant / study halls constructed web based evaluation system of teaching elders act as mentors to the younger students organize support for younger colleagues with study problems mentoring projects between doctors clinical students Summary Excellent Quality in Medical Undergraduate Education Fully implemented student centered learning Horizontal + vertical integration of subjects and theory/practice Alignment of teaching, learning and examinations Professional and scientific development supported Strong interprofessional contents Clinical practice from first semester and later on in long periods Quality assurance and student involvement at all levels Strong IT resources for teaching and administration Multiple stages of change carried through since 1986 Has resulted in repeated superior evaluations by national authorities, by alumni in internship and the Award of Excellence Sid Sid 40 Web address Thank you for your attention! Click Hälsouniversitetet, Utbildning, Läkarprogram Google: läkarprogram Linköping! Torbjorn.Ledin@liu.se Sid 41 7

8 Kom ihåg: Kom ihåg: undervisning är en sak Don t make it too complicated! inlärning något annat!!! Sid Sid Sid 45 8