Facilitators and barriers for implementation of a UK standardized core curriculum for medical schools, a dermatology perspective

Sharma, Maulina (2023) Facilitators and barriers for implementation of a UK standardized core curriculum for medical schools, a dermatology perspective. PhD thesis, University of Nottingham.

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There is no standard medical curriculum across UK medical schools. The General Medical Council (GMC) provides generic learning outcomes for medical schools.Specialty curriculum implementation in medical schools is varied and inconsistent. This PhD thesis aimed to explore the facilitators and barriers for implementation of a nationally recommended specialty core-curriculum for UK medical schools, using Dermatology as a specialty perspective.

Methodology and methods: A mixed-methods research (MMR) research methodology was used and multiple methods incorporated to address the research question. A scoping review was conducted to identify the available specialty curricula for UK medical schools, and the drivers for their development. A curriculum mapping study at a UK medical school reviewed the local undergraduate (UG) dermatology curriculum against the national British Association of Dermatologists’ (BAD) standards. An online cross-sectional questionnaire survey of UK dermatology UG teaching leads helped to understand the possible facilitators and barriers to specialty- specific implementation across UK medical schools. Finally, semi-structured interviews with Deans of medical education of UK schools were undertaken to gather their perspective on specialty curriculum implementation.

Results: The scoping review provided a comprehensive overview of the curricula developed by specialties, in alignment with GMC outcomes. Twenty-six specialties developed a core curriculum to provide specialty specific guidance to medical schools on minimum standards for knowledge and skills required for all graduates. Drivers for development of these included fear for patient safety, burden of disease, medical schools not including it in their curricula and graduates feeling ill prepared to practice confidently and safely. Curriculum mapping enabled visualisation of dermatology and its relationships between other specialties. The cross-sectional survey revealed knowledge gaps amongst UG leads with respect to mapping and blueprinting of core-curricula and the GMC’s proposed implementation of the Medical Licensing Assessment (MLA) in 2024-25 (Medical licensing assessment – GMC, 2020). Perceived barriers to curriculum implementation included National Health Service (NHS) clinical workloads, dermatology not deemed a priority in school curricula, and difficulty influencing changes at medical school level. The Deans of Medical Education recognised the importance of including dermatology in the undergraduate curriculum. The skill set, and enthusiasm of the ‘specialty champions’ was an important factor for engaging medical students. National and local political driven health agendas (e.g. the UK government, the GMC, MLA, and Health education boards) influenced teaching, learning and assessment methods. Cultural attitudes between specialties, NHS Trusts, and Universities, and student feedback determined how well curriculum integration took place. Paucity of adequate clinical staff for teaching, and impact of Covid-19 pandemic were other challenges that influenced curriculum implementation. Perceived facilitators included improved workforce planning with support from inter-professional educators. Transparency in funding to the NHS Trusts towards UG medical teaching and educational governance were considered paramount in ensuring monies followed and reflected the students’ experience. Strategies to develop UG lead roles as medical educators included appropriate recognition in job plans and review of professional development in yearly appraisals. Medical education

qualifications and leadership skills were considered valuable for clinicians or academics taking on roles as UG education leads.

This research study identifies facilitators and barriers for UG specialty-specific (dermatology) curriculum implementation in UK, which could be generalizable and relevant to other specialty core-curricula. The study supports creation of practical strategies, and provides a basis for national collaborative ways to improve implementation of specialty core-curricula across medical schools.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Doody, Gillian
Murphy, Ruth
Patel, Rakesh
Keywords: undergraduate, curriculum, medical education, dermatology, implementation, barriers, facilitators
Subjects: W Medicine and related subjects (NLM Classification) > W Health professions
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 76765
Depositing User: Sharma, Maulina
Date Deposited: 13 Dec 2023 04:40
Last Modified: 13 Dec 2023 04:40
URI: https://eprints.nottingham.ac.uk/id/eprint/76765

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