1 APPLICATION FOR CENTRE OF EXCELLENCE IN UNIVERSITY EDUCATION 2010-2012 The Faculty of Medicine The best results and practices of the Faculty: Since 1993 over 200 Faculty teachers have completed university-pedagogical train- ing. Learning assessment methods such as the Progress test and the OSCE are peda- gogically well-grounded, versatile and in line with learning objectives. Continuous curriculum development through assessment and feedback, and com- parisons of educational practices with the practices of the best units (benchmark- ing). Basic degree students can begin their thesis research through the high quality re- searcher training of the MD, PhD Programme. 1. Primary mission Description of the unit: The Faculty of Medicine is a high-level academic research and educa- tion environment. Faculty has been developing its education with persistence and with the emphasis on quality in teaching. Since 1997 the Faculty has received several awards at the university and national levels for the quality of its teaching. The application and its background: The Faculty working group for quality in teaching pre- pared the application. The group comprises teacher representatives from all of the Faculty’s departments as well as student representatives, the head of academic affairs and representa- tives of the Research and Development Unit for Medical Education (TUKE). The group has been elected to serve for the 2007-2009 strategy period, with the lecturer specialised in uni- versity pedagogy serving as group chair. The coordinators for doctoral and specialist training also participated in preparing the application. The application has drawn upon the Faculty’s earlier educational evaluation processes, including the materials that were compiled for these processes and also the feedback received. Educational missions and their significance: The Faculty’s mission is to educate high stan- dard medical doctors and dentists who are able to critically assess and apply new information and skills throughout their careers. The Faculty has national responsibility for providing medical doctoral training in Swedish and therefore also has a Swedish-language track of medical studies. In addition, the Faculty is in charge of professional postgraduate degrees in medicine and dentistry, providing students with specialist knowledge and skills needed to work in their specialty fields. The Faculty offers students and professional researchers a vibrant and multifaceted interna- tional research environment, recruiting talented researchers and supporting young researchers in their science careers. The Faculty’s doctoral training aims to produce postgraduates with optimal abilities for advancing their own scientific fields and with internationally competitive scientific expertise. Multi-disciplinary research activities are performed collaboratively with national and international research institutes and with various universities and faculties. The Faculty offers training for the following degrees: Doctor of Medical Science, Doctor of Den- tal Science and Doctor of Philosophy. 2 Resource development and utilisation: The Faculty’s target and policy programme defines the framework for the basic and project funding received from the University. The Faculty Council decides on the principles by which funds are distributed within the Faculty. The Faculty supports its educational mission by recruiting academically qualified teachers with good teaching skills. Pedagogical training and research structures have been created in order to utilise and develop the Faculty’s human resources in teaching. The Faculty has sup- ported teachers’ pedagogic skills through providing pedagogical training since 1993. Over 200 Faculty teachers have taken the ten ECTS credit course on university pedagogy. Research is organised into research groups. The principal investigators and their research groups com- prise the Research Faculty. The undergraduate students are recruited with a high-quality entrance examination, which is carefully conducted each year in order to admit motivated and talented students into the Fac- ulty. The national entrance examination is a problem-based materials test based on pedagogi- cal research. It also functions to prepare students for their coming studies. A national-level development group has been in charge of planning and developing the examination for over 10 years. 2. Educational planning Compiling the curriculum: The basic degrees include contributions from every department. The curriculum is composed of study units, each including specific learning goals, contents and methods of assessment. A course coordinator is assigned to each study unit, and an aca- demic year coordinator is assigned to each study year. Departmental steering groups and the Planning Committee for Undergraduate Medical Education and the Planning Committee for Undergraduate Dental Education review the curricula. The planning committees make pro- posals to the Faculty Council on the overall content of the degrees, on teaching methods and on student options for completing studies. The committees help to ensure that the study units form a coherent and cohesive curriculum. Students have an active role in planning and developing education at the departmental, com- mittee and Faculty Council levels. Students are represented in the working groups on teaching and they also take part in teaching development work at the national and international levels. The doctoral training strategy is prepared by a Research Council, which also makes proposals on doctoral training principles and resource allocation. The Doctoral Committee monitors the progress of doctoral degree studies. The board of the MD, PhD Programme admits students into the programme and follows programme progress in cooperation with the graduate schools connected with the Faculty. The Docent Committee is responsible for the qualifications of the Faculty’s docents, who are important resources for teaching and supervision. The Specialist Training Committee and the Committee for Specialist Training in Dentistry are responsible for the study requirements and development of professional postgraduate degrees. The Research and Development Unit for Medical Education (TUKE), under the Dean of Edu- cation, is an important contributor to the work of educational planning and development. TUKE comprises the Finnish, Swedish and dental studies coordinators, the international edu- cation coordinator, the lecturer specialised in university pedagogy, the lecturer for IT educa- tion and the specialist in educational technology. TUKE is responsible for the pedagogical training of Faculty teachers. 3 The working group for education in Swedish develops, plans and coordinates the Swedish study track. Swedish-language teaching resources are allocated for group instruction and communication skills studies. Clinical training is held in bilingual hospitals and health cen- tres. All examination questions are available in Finnish and in Swedish. The Faculty participates in both national and international teaching development. It takes part in national educational planning that formulates development policies for the training of Fin- nish doctors and dentists. Faculty teachers and students also actively participate in interna- tional medical and dental education congresses (such as AMEE and ADEE). Degrees, their continuity and accumulation: The basic degrees form a progressive whole in which essential skills and knowledge systematically increase towards their practical application in medical and dental work. A survey of essential informational and professional competencies has been performed, and a computer application was developed for this purpose. This core cur- riculum analysis concentrates on the stages at which the essential contents of studies are learned and on how the students’ knowledge increases while they progress through their stud- ies. In the basic degree planning, vertical integration of core curricula is a central challenge. The basic degree in medicine or in dentistry and a licence to practise medicine or dentistry in Finland are prerequisites for a professional postgraduate degree. Each specialty field has a training programme that is congruent with EU policies and aims for consistency at the national level. Research training in postgraduate level is multidisciplinary, and doctoral students enter Faculty’s PhD training from a variety of fields, also outside medicine and dentistry. The degree is composed of general doctoral training, field-specific education and writing the dissertation. The postgraduate study plan is drawn up with a dissertation supervisor, and takes into consid- eration the student's previous studies. Interaction between research and education: Faculty teaching is based on the latest, evidence- based medicine. The teachers utilise practices and learning methods that have proven benefi- cial in university pedagogical studies (evidence-based teaching). The Faculty offers a research environment to several Centres of Excellence and over 300 research groups to which students are recruited also during their basic degree studies. The established educational activities of 14 graduate schools provide a wide array of courses and results of high international quality. The Faculty’s MD, PhD Programme, founded in 1994, offers students the opportunity to begin their PhD thesis research in a research group with supervision already after their first year of studies while they are pursuing a basic degree. The research groups and graduate schools are a part of the international scientific community. This enables international researcher exchanges during the doctoral training stage. Correspondingly, foreign postgraduate students are recruited into the Faculty’s doctoral training. Lifelong learning and feedback from the working life: Medical knowledge is being constantly renewed along with the rapid expansion of information. An educational goal is therefore to provide students with the foundation to pursue lifelong learning and to be able to critically assess and apply new information and skills throughout their careers. The basic degree in medicine includes compulsory clinical training (amanuensis service) as well as study units completed in professional practices, hospitals and health centres. A goal of the clinical train- ing is for students to acquire the skills and knowledge needed for the profession and for their learning to take place in a supervised, clinical work environment. Log books are being intro- duced in the clinical training, providing a tool for assessing students’ clinical accomplish- ments as well as for systematic feedback from working life. Clinical training relating to dental 4 studies occurs mostly in University dental clinics, and the clinic teachers provide feedback. The Finnish medical and dental associations and speciality field associations provide work- ing-life feedback and suggestions for improving training. The Faculty is responsive to these development suggestions. University Career Services and the Finnish medical and dental as- sociations provide follow-up of employment. 3. The implementation of education Teaching methods: The Faculty’s teaching methods and forms have been developed on the basis of international examples, teaching experiments and teachers' own development work. A learning-based student-oriented approach is emphasised in the Faculty’s teaching. A primary learning method is problem-based learning (PBL), which students become familiar with at the outset of studies. An educational starting point aims to bring theory and practice together compatibly in the practical work of a doctor or dentist. A large number of the Faculty’s stud- ies are taught in small groups as tutor-and-mentor sessions applying PBL methods. In the clinical stage, the majority of learning is based on actual patient situations. Experimental learning methods (using actors as patients, for example) are included in the diverse and wide- ranging communication skills studies of the Faculty. The Research and Development Unit for Medical Education (TUKE) offers teachers extensive pedagogical training, including instruction in the planning of teaching and in the use of vari- ous learning and assessment methods. TUKE provides teachers with a ten ECTS credit course in university pedagogy, a foundational course in PBL, PBL tutorial advanced courses, cus- tom-designed short courses and educational theme days, all of which support their pedagogi- cal competencies and opportunities for networking. The Faculty keeps abreast of international developments in medical and dental education and also conducts research on its own teaching. Skills labs are used as an aid to learning clinical skills both in medicine and dentistry. Stu- dents can thus practice their clinical skills aside from actual patient work. The skills labs are also used for student assessment. A Virtual Patient Bank (VPB) has been developed at the Faculty, enabling students to autonomously practice patient diagnostics and treatment, whether for study units or independently. The Finnish Medical Students’ Association, com- prising all of the Finnish medical student organisations, recognised the VPB with its Educa- tion Award for 2007. Learning assessment: The Faculty has received several awards for the quality of its teaching. The Faculty uses a versatile learning assessment system. The assessment methods have been developed to be diverse, pedagogically well-grounded and congruent with learning objectives. The assessment system aims to evaluate not only students’ informational competencies, but also their progressive application of knowledge and skills, in realistic patient treatment sce- narios and patient simulations and, as studies proceed, in actual situations. The Faculty’s teachers receive pedagogical training in a variety of assessment methods as well as assess- ment planning and implementation. The basic degree includes learning-situation assessments that support the learner’s own devel- opment. The teachers have been trained so that the role of self-evaluations and constructive feedback will increase in the learning situations. The clinical stage involves the use of log books. These enable assessment of the student’s own knowledge and skills as applied to actual work environments (in hospitals or health centres) and provide diverse feedback on working life. Clinical training in dentistry uses an online real-time log book. 5 The Faculty has been using a Progress test since 2002. Its goal is to offer students the opportu- nity to track progressive accumulation of their knowledge of the field as they proceed through studies. The test covers all of the most important themes of the study units that are compulsory for a degree. The test is held at the same time and in the same form for all students twice per academic year, in the autumn and spring terms. The examination system includes tests on the contents of individual study units as well as ex- aminations of entire stage of studies. The first extensive examination surveys the breadth of the students’ command of theoretical knowledge from his or her first two study-years. The final examination of the clinical stage assesses the student’s comprehension, command and applied knowledge of the field. The objective structured clinical examination (OSCE) is taken at the final stage of studies. It is carried out with simulators and with actors as patient in situations corresponding closely to actual clinical situations. This examination assesses the student’s skills as a physician in situations that may arise in practice: clinical, communication and prob- lem solving skills. The examination system emphasises transparency. Model responses to examination questions show the assessment criteria used. For some assessments (Progress test and OSCE) the stu- dents receive an email on their results relative to the results of other students. Most of the specialist training takes place in actual working-life situations. The training util- ises a log book, which allows both the teacher and trainee to follow the trainee’s development. The log book can also be used in supervisory review discussions. A real-time web-based ad- ministrative system has been developed for specialist training. The system registers the trainee information, the services he or she has completed as well as log books and other assessments. 4. Results achieved Qualitative and quantitative results: The Faculty has received several awards for its teaching. It meets its quantitative degree goals remarkably well. Nearly all medical students graduate. The graduation rates in the dental training programme have also been lifted in recent years, meeting the national goals. The Faculty emphasises quality of learning by courses on study skills and using student-oriented learning methods and small group work. The system for evaluating student learning has been developed to broadly assess student knowledge and skills, particularly the capacity to apply them to patient situations. Clinical competencies and communication skills are assessed at the end of studies by the OSCE examination. The Faculty has received national and international recognition for its doctoral training and research. Students apply for postgraduate scientific training from other Finnish medical facul- ties, other faculties and universities, and from abroad. The Faculty annually produces 90 to 100 doctoral graduates. The postgraduate research is carried out professionally in research groups and graduate schools. Doctoral training often begins alongside the basic degree in the MD, PhD Programme or by carrying out dissertation work in a research group. Supervisors and Thesis Committees monitor the progress of doctoral students. Dissertations are usually composed of peer-reviewed published articles appearing in leading international journals. Doctoral degrees are followed by the Doctoral Committee, which includes representation from the different research fields. The Research Council is in charge of the Faculty’s doctoral training strategy and the evaluation of research quality. The Faculty is the largest national medical specialist training unit, training over 40% of Finland’s medical specialists. Specialist training is extensive, including approximately 2,000 6 specialists at over 200 training sites in 49 specialty fields. Some 200 trainees per year gradu- ate with specialist degrees. Half of the trainees are recruited from other universities. Balance of qualitative and quantitative results: The versatile assessment system of the basic degree helps to ensure that student competencies are at high levels at the end of their studies. Doctoral training aims to foster in students an international level of expertise. To achieve this, doctoral student supervision has been further developed and the position of research groups has been improved. Professional postgraduate training is challenged by the large number of trainees and specialty fields and by the wide-ranging geographical distribution. Trainee com- petencies are evaluated through nation-wide final examinations. An electronic management system has been developed for educational quality assessment. 5. Educational development Teaching development: The cornerstone of educational quality assurance at the Faculty of Medicine is the persistence in teaching-development work. This work evolved from the Fac- ulty’s need for curriculum development in the 1990s. Committees play a key role in develop- ing the curricula and include teacher representatives from all of the departments as well as student representatives. Since 1993 the Faculty has organised pedagogical training for teach- ers, thereby laying the foundations for quality teaching. Teachers’ pedagogical training has continually expanded, and pedagogical and virtual education support for teachers is being fur- ther developed. The feedback system and its utilisation: The Faculty has a well-functioning system for receiv- ing student feedback. Student feedback has been collected on all Faculty courses since 1994, and the system became web-based in 2002 (WebOodi). The course feedback response rate is over 80%. Feedback is reviewed in departmental teaching meetings and forms the basis for the development of education. The challenge in this is to inform the students of the changes made on the basis of feedback. This information has been given through student representa- tives and WebOodi and it has also been integrated in the beginning of the courses. Student and working life feedback has been taken into account in the educational development. The Faculty has channelled resources for developing the courses that have received poor feedback (e.g. additional resources and teaching experiments in the teaching of general practice, after which its feedback improved considerably). Teaching practices attracting positive feedback are presented to teachers at university pedagogical training and on educational theme days. Teaching development activities: The developmental focus concerning learning assessment systems has shifted from the examination system to developing the feedback given in actual learning environments and in the workplace. A log book has been developed for the clinical training and is being piloted for constructive feedback and self-evaluation. An electronic sys- tem for continuous evaluation of clinical training is being developed for dental education. Skills labs are being further developed in learning and assessment of clinical skills. Use of the Virtual Patient Bank (VPB) is being analysed and expanded. With the Progress test material, students’ comprehensive knowledge is being analysed as they progress through studies. Post- graduate study planning and its related student guidance services are being developed for ba- sic degree, scientific and professional postgraduate degrees.