Tom Lewis and Michael Innes provide a student guide

Special study modules (SSMs) are intended to introduce students to areas of medicine that would not normally form part of an undergraduate medical curriculum, encouraging interest in diverse areas and adoption of more independent and questioning learning styles.¹ Despite such worthy ideals, it is apparent that there is some disquiet among students as to the merit and value of many SSMs.²

We believe that SSMs often fail on three levels. Firstly, the topics being offered may not address issues that students find interesting. Secondly, there is often little attempt to break down the traditional barriers between teacher and learner, with the result that students do not identify with the subject matter. Thirdly, teaching may be organised in ways that conflict with other learning demands. Involving students in the conception, design, and running of SSMs may help overcome these problems.

With reference to our experiences of setting up an SSM in global health studies, we offer a guide to students who want to get subjects that they think are important incorporated into the SSM timetable.

Points to bear in mind

Identify and justify topic

Many topics could justifiably be included within the medical curriculum as SSMs. It is important to have an embryonic idea of the aims and objectives of the course and why these would be relevant to medicine.

Approach teaching staff

An SSM will require a lead teacher. Teaching staff are much more likely to be brought on side if they can easily see the merits of the course and can be convinced that there is a genuine demand for teaching.

Design of the course

Student involvement in course design ensures that content matches student priorities, needs, and abilities.³ Ideally, a student representative(s) should be present at all stages of the development process.

Consider university regulations

Consideration must be given to university criteria governing issues such as assessment, attendance, and supervision. In Birmingham, for example, students are marked on their group work and attendance, and are currently obliged to submit an essay and give a presentation at the end of the course.

Allow a realistic time span

The planning of a successful course will usually take several months.

Course evaluation and evolution

Any course should be evaluated to see whether it is achieving its aims. In the case of a student driven SSM, the evaluation plays a key role in involving students in the ongoing design and running of the course.

Birmingham SSM in global health

There are many reasons why global health should be included in the curriculum4 (see box 1). The activity of the Birmingham MedSIN group showed how students were already concerned about the issue, and we were able to approach staff with some ideas of course objectives (see box 2).

Our initial search for someone to front the course centred on the public health department, with little success. It was a chance discussion between TL and a member of the general practice department, who was aware of MI's experience of working in Africa, that led to our collaboration, and this then led to the development of a small network of people with an interest and skills in global health. This shows that while it is worth trying the obvious places first when looking for a lead teacher, students must ask around - some of the unlikeliest people may be interested in the topic.

Initial discussions focussed on the broad format of the course. The possibility of a lecture series was considered, but it was thought that this might reduce enthusiasm for the subject in those who were not ready to confront the issues. Consultations with students highlighted similar problems with the public health course. It was generally felt that SSMs are more appropriate vehicles for introducing global health issues.

In the design of the SSM, student input was important in determining the nature of the teacher led sessions, which gave the course a factual backbone, and balancing these with student led sessions helped with the exploration of new ideas. Consideration of the relative importance attached to topics by students meant that relevant issues were covered and teaching could be pitched at a level that was thought appropriate. Also, on a more practical note, it was easy to point out how particular times and locations might be inconvenient. It took us over a year from the initial concept to the final delivery, over which time the course underwent significant changes in both content and structure.

Evaluating the course

Evaluating the course involved the use of an anonymous questionnaire, a group discussion at the end of the course, and a focus group session six months later involving both students who had taken part and those hoping to do so in the future. This feedback was generally very favourable - participants thought that it was relevant to their education and would strongly recommend it to others. However, it also showed that they found it hard to identify resources, which we have partly addressed by setting up a website containing useful links and supplementary information on each of the sessions. It was also thought that in future a session on rationing might be better spent considering water and the environment.

Conclusions

Involving students in course design ensures that teaching addresses issues that are of concern to students as well as teachers. This helps to keep sessions interesting and promotes enthusiasm - a prerequisite for effective self directed learning. Most importantly, barriers that may exist between teachers and students are broken down, encouraging the kind of dialogue that is essential for the exploration of complex issues.

We would like to thank Mike Rowson of MEDACT for help during the design of this course. We are also grateful to the tutors Jane Cocker, Gilles de Wildt, Paramjit Gill, Rob Moy, and Jonathon Shapiro for their ideas and enthusiasm.

1. General Medical Council. Tomorrow's doctors: recommendations on undergraduate medical education. London: GMC, 1993.
2. Payne G, Thompson A, Flood C. Special study modules must be more diverse. studentBMJ 2000;8:468. (December.)
3. Huppatz C. The essential role of the student in curriculum planning. Med Educ 1996;30:9-13.
4. O'Neale Roach J. Globalising medical education. studentBMJ 2000;8:436. (December.)