32
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Academic and scientific education in medical curricula in the Netherlands: a programme director’s view

      ,

      Perspectives on Medical Education

      Bohn Stafleu van Loghum

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background The role of scholar is one of the seven CanMEDS roles of the medical practitioner as described in the 2009 Framework for Undergraduate Medical Education in the Netherlands, adopted by all eight University Medical Centres (UMCs) [1]. In order to realize the desired competency level of ‘scholar’, academic and scientific training is an integral and substantial part of medical curricula [2]. We wish to share our reflections on the development of academic and scientific training in medical programmes, with emphasis on the undergraduate programme, triggered by rapidly expanding medical knowledge, and by the changing health care environment as described in the inspiring paper by Frenk et al. [3]. We address four basic questions regarding academic and scientific education: what, why, when and how. What The 2009 Framework describes the scholarly abilities of future physicians in Chapter 5: ‘As scholars, physicians make scholarly contributions to the assessment, establishment, and understanding of knowledge and skills in health care. Physicians engage in teaching tasks and/or facilitate the education of their students, patients, and others. Whenever possible, physicians take clinical decisions based on a scientific footing, recognize the importance of life-long learning, and act as role models for others’ [1]. In addition, the Framework specifies that medical graduates are able to design and implement a small-scale empirical scientific research project, i.e. formulate a problem definition and a research question, conduct a literature survey, draft a simple methodologically sound research design, collect data, perform simple data cleaning and data entry tasks, perform simple statistical analysis, report research results in writing and present and discuss research outcomes. The above abilities should be attained at the end of 6 years of medical education and serve as a solid basis for life-long learning. Academic and scientific training aims at development of a critical academic attitude and scientific skills of the medical student. This will lead to, at the very least, a critical user and applier of science in medical practice, and often to the development of a researcher who will ‘produce’ science. Why Future physicians are expected to perform as academic professionals in medical practice using evidence-based medicine wherever possible. From an educational viewpoint we consider the following qualities pivotal for our graduates: The ability of independent, critical thinking and reflection. This ability includes adequate problem analysis and solving, dealing with limitations of and fallacies in diagnostic results, the critical interpretation of medical literature and commercial information, and the awareness of lack of knowledge or skills and one’s own blind spots. The ambition to understand the nature of the patient’s complaints, symptoms and needs. The curiosity to ask questions and develop ideas helping to define and to design new research directives to improve care and prevention. The ability to actively participate in research, varying from basic projects to clinical studies. The ability to convey expertise to colleagues, students, patients and others, i.e. teaching qualities. Students at university medical centres or medical schools are part of larger academic communities. Not all students will pursue academic careers later in life. However, as medical professionals, no matter in which practice their future will be, they are expected to have attained a firm academic and scientific basis during their education at medical school and thereafter. To this end their curriculum should include guidance during theoretical instruction in basic sciences, as well as in clinical sciences. They should have the opportunity to meet a variety of scientists for informal and critical discussions on scientific approaches, results and conclusions. Guided hands-on training focused on application of acquired academic and scientific competencies is an essential part of the educational programme. Studying medicine is popular amongst talented students. These students are usually well-motivated and will flourish in a stimulating academic and scientific environment, supported by a programme which offers intellectual challenges and opportunities to participate in research projects, locally and internationally. Taken together, academic and scientific development is a sound basis for life-long learning. Teachers play a crucial role in the academic and scientific development of students as guides and supporters. They make an important contribution to the realisation of the aforementioned student goals. In the cycle of life-long learning, teachers have the privilege—and in our view also the obligation (1) to convey their research and teaching expertise to the next generation of health professionals and researchers, (2) to share their scientific abilities and enthusiasm for research and teaching and (3) to think beyond the obvious and stimulate curiosity. The reciprocal is true as well: teacher-researchers will profit from students’ unconventional and creative thinking and should enjoy challenging and inspiring students to critically think and discuss interesting scientific problems. Moreover, teaching offers scientific investigators the opportunity of talent scouting and identifying future PhD students and colleagues in research projects. We think this is an essential asset for maintaining and further improving the quality of scientific research. Patients want—and deserve—physicians who provide the best available care, physicians who continuously seek to better understand the nature of the patient’s condition and physicians who are able to critically reflect on their own abilities, both their strengths and their limitations. Patients expect -and deserve- best care at the individual level and, more indirectly, the identification and execution of preventive measures at the population level, the latter being equally relevant from the societal perspective. The fundamental skills of critical thinking and understanding are crucial for every physician at every stage of professional life. Once properly seeded during the medical curriculum it is the challenge for each professional to keep these abilities active life-long. Each physician should at any time ask him or herself: ‘Do I (still) understand the nature of the patient’s problem?’ Physicians have an important role in society. Developments in research as well as a scientific approach in public health contribute significantly to the quality and effectiveness of medical care and preventive measures. General problems in medical practice, such as patient safety and the need for the reduction of costs of the health care system, will require research to find appropriate solutions and medical leadership to address these issues. When and how The medical curricula in the Netherlands have adopted a three-year Bachelor’s and three-year Master’s structure, in line with the Bologna agreement. The Bachelor-Master structure aims to facilitate movement of students and research is a good opportunity to cross borders, by intensifying existing and initiating new international exchange programmes for research and education. In order to provide a thorough understanding of the human organism and its relation to the environment, Bachelor’s programmes provide integrated basic and clinical sciences courses, usually with the emphasis on the basic sciences. Basic scientists have teaching roles in many courses and convey scientific reasoning often implicitly. Students will profit when their academic and scientific abilities are explicitly challenged. In most, if not all, Bachelor’s courses academic and scientific development can and should be an integral part of the course learning goals. Early seeding of academic and scientific abilities for all medical students will contribute to fruitful medical careers. Research electives as part of mandatory electives in Bachelor’s programmes offer great opportunities to engage in academic and scientific development. During Dutch Master’s programmes all students dedicate on average 3 months (ranging from 14 to 24 weeks) to an individual research project of their choice. Students write a research proposal, which they carry out themselves, perform experiments and analyse and report the data. This enables them to develop their scientific skills ‘hands on’, by doing, presenting and writing guided by a scientist. Both Bachelor’s and Master’s courses offer opportunities to develop and engage in teaching qualities, i.e. literature searches, EBM teaching, critical appraisal of a topic (‘CAT’), presentations on the basis of assignments and internships should be used extensively. Conclusion We consider academic and scientific development to be a key element in medical education. Academic and scientific competencies are vital for proper care at the individual as well as the population level. Patients and society require curious, independent and critically thinking physicians with a scientific attitude and the ability to transfer expertise. To achieve this goal medical curricula should offer challenging scholarly programmes that match and stimulate academic and scientific talents of students and teachers.

          Related collections

          Most cited references 2

          • Record: found
          • Abstract: found
          • Article: not found

          Comparing the educational environment (as measured by DREEM) at two different stages of curriculum reform.

          The medical programme at Lund University, Sweden, has undergone curricular reform over several stages, which is still ongoing. Students have been somewhat negative in their evaluations of the education during this time. To find out how the students perceived the educational climate using the Dundee Ready Education Environment Measure (DREEM), and to compare the findings taken at two given points in time. The DREEM instrument was distributed in semesters 2, 6 and 10 in 2003 and 2005, to a total of 503 students. The students rated their climate as positive. The total DREEM score (145) was somewhat higher than other published results and in the same range as for other reformed curricula. There was hardly any difference between the genders in their perceptions of the climate. Certain items were rated low and became subject of development between the measurements. These items concerned a perceived lack of a support system for stressed students and a lack of feedback and constructive criticism from teachers. Some improvement was detected in 2005. The educational climate was high in a reformed curriculum and could be maintained high during on-going curricular reform. Educational development resulted in better results on some items.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Scientific output of Dutch medical students.

            In medical curricula, considerable effort is put into scientific education and research training. The output of these efforts, however, is not known. To assess the number of students who published at least one scientific paper during the course of their medical studies. Names and initials of all students who received their medical degree in 2006 or 2007 in one of the six participating university medical centers in the Netherlands were searched in the Web of Science database using a well-validated algorithm. Of the 2973 students, 14.5% had published at least one scientific paper during the last 3 years of their medical studies. These papers were of good quality, as the average number of citations per paper is above the average for papers published in their field. Based on the results of our survey, we conclude that medical students in the Netherlands are productively involved in research during their studies. Due to publication delay, the true number of papers is likely to be higher than we counted, but the bibliometric index chosen gives a robust estimate of the effect on the output of the scientific climate of a medical school. Using such an index on a larger scale may stimulate medical faculties to recognize and cultivate academic talent among their students.
              Bookmark

              Author and article information

              Contributors
              a.j.de_beaufort@lumc.nl
              a.degoeij@maastrichtuniversity.nl
              Journal
              Perspect Med Educ
              Perspect Med Educ
              Perspectives on Medical Education
              Bohn Stafleu van Loghum (Houten )
              2212-2761
              2212-277X
              5 September 2013
              5 September 2013
              September 2013
              : 2
              : 4
              : 225-229
              Affiliations
              [ ]Leiden University Medical Center, V7-48, PO Box 9600, 2300 RC Leiden, the Netherlands
              [ ]Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, PO Box 616, 6200 MD Maastricht, the Netherlands
              Article
              76
              10.1007/s40037-013-0076-x
              3792235
              24005869
              © The Author(s) 2013

              Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

              Categories
              Eye-Opener
              Custom metadata
              © The Author(s) 2013

              Education

              Comments

              Comment on this article