DIY special study modules
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.
AP PHOTO/KABIR AHMED
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).
Box 1: Reasons for including global health studies in the undergraduate curriculum
- UK clinical relevance
Better understanding of multicultural issues; treatment of economic refugees and asylum
seekers; treatment of victims of torture; giving travel advice; medical electives and work
abroad.
- Understanding disease and its treatment
Learn from other societies; learn from other healthcare systems; understanding
epidemiological change; understanding determinants of health.
- Moral
Understand the potential of medical professionals as agents of abuse; tradition of doctors
as advocates for the disadvantaged; wider medical responsibility for ensuring good health;
professional cooperation and communication.
- Development of the well rounded professional
Understand the forces that mould society; development of the ability to analyse change;
appreciation of cultural diversity; ability to function in a range of circumstances;
appreciation of new research techniques
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.
Box 2: Objectives of a global health SSM
- To consider the impact of factors such
as environment, political systems, and
wealth on health and illness all over
the world
- To appreciate the different roles
of healthcare workers in different
societies
- To reflect on the health system in
the United Kingdom using the understanding
of worldwide influences on
health
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.
More details on the global health course can be found on our website: http://www.globalhealth.cwc.net
Michael Innes, fourth year medical student, University of Birmingham
Email: m.a.innes@bham.ac.uk
Tom Lewis, clinical research fellow
studentBMJ 2001;09:171-216 June ISSN 0966-6494
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- Payne G, Thompson A, Flood C. Special study modules
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- Huppatz C. The essential role of the student in curriculum
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- O'Neale Roach J. Globalising medical education.
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