The Psychiatrist (2007) 31: 107-109. doi: 10.1192/pb.bp.106.010827
© 2007 The Royal College of Psychiatrists
Teaching psychiatrists to teach: qualifications in clinical education for psychiatrists
Stephen Dinniss, Consultant Psychiatrist
Home Treatment, Glenbourne Unit, Morlaix Drive, Derriford, Plymouth PL6
5AF, email:
stephendinniss{at}hotmail.com
Richard Bowers, Specialist Registrar
Carrick Community Mental Health Team, Truro
Antony Christopher, Locum Consultant in Old Age Psychiatry
Wonford House Hospital, Exeter
Declaration of interest
None.

Introduction
The education and training of medical students and trainees
is a key role
of senior clinicians, and the General Medical
Council states we must
develop the skills, attitudes
and practices of a competent teacher
(
General Medical Council,
2005).
The Royal College of Psychiatrists places the role of
educator
as a core competency for psychiatrists
(
Bhugra, 2005) and believes
we
should understand the principles of education and
use teaching methods
appropriate to educational objectives
(
Royal College of Psychiatrists,
2004).
Furthermore, one of the aspirations within Modernising Medical Careers
(Department of Health, 2003) is
to push consultants to become more involved in the education and formative
assessment of trainees. These changes also involve a reduction in the length
of training, requiring increasing emphasis be placed on quality
(Mukherjee & Nimmagadda,
2005). Alongside this, recent psychiatric literature has pointed
to the need for consultants to have skills that fulfil the educational needs
of trainees as well as medical students
(Bhugra & Holsgrove, 2005;
Brown & Bhugra, 2005;
Brown et al, 2005) and
has called for foundation year 1 doctors to have experienced medical
educators to supervise their assessment, appraisal and educational
programmes (Brown & Bhugra,
2005). Despite this, most consultants have no formal
qualifications in teaching and have had little training as educators.
We have an interest in clinical education and are looking to develop lead
roles in education as consultants. We used the special interest sessions of
our specialist registrar training to complete a higher degree in education and
are coming to the end of our masters degree in clinical education. We would
like to share our experience of completing this degree, reflect on its
strengths and weaknesses and discuss the value of formal qualifications in
education for psychiatrists.

What is the MSc in clinical education?
We completed our degrees through the Peninsula Postgraduate
Health
Institute (PPHI) which is the postgraduate education
branch of the Peninsula
Medical School and the Faculty of Health
and Social Work and is affiliated
with the Universities of
Exeter and Plymouth. Similar courses are run
elsewhere (
Cohen et al,
2005;
see Box 1.) with further organisations offering postgraduate
MEd courses (
Burton, 2000). The
MSc at PPHI is a 3-year course,
aimed at developing the teaching expertise of
health professionals
and preparing them for lead educational roles within
clinical
settings. The key learning aims are given in Box 2.
| Box 1. A selection of postgraduate education courses available
The following offer postgraduate certificate, diploma and masters (either
MSc or MA) in clinical/medical education:
|
The MSc is modular in structure with optional and compulsory modules worth
10-20 credits each. There is an option to exit after 1 year (60 credits) with
a Postgraduate Certificate in Clinical Education (PGCE) or after 2 years (120
credits) with a Diploma in Clinical Education (see Box 3). Year 3 requires a
dissertation involving a significant piece of research demonstrating a
contribution to improvement in educational practice (Peninsula
Postgraduate Health Institute prospectus 2006) leading to the award of the
MSc. At the time of writing, the cost is £3600 for the full degree or
£220 per 10-credit module (£8450 and £422 respectively for
overseas students).
The MSc itself would suit those with a well-developed interest in education
and a desire to make this a significant part of their ongoing career. However,
for those who simply have training and education as a component of their job,
completing the PGCE or even one or two core modules on teaching would be
sufficient to ensure that they provide accurate and expert teaching to
students, trainees and other members of staff.
| Box 2. Key learning objectives for the MSc in Clinical Education at the
Peninsula Postgraduate Health Institute
- Apply teaching and learning methods appropriate to your discipline
- Critically review your educational practice
- Develop expert knowledge and practice in health and social care
education
- Use research evidence to improve education and practice.
|
| Box 3. Format of the MSc in Clinical Education at the Peninsula
Postgraduate Health Institute
Postgraduate Certificate in Clinical Education
- 40 credits compulsory modules
- 20 credits, choosing from 4 options according to need (e.g. primary care,
social care etc.)
Postgraduate Diploma in Clinical Education
- 10 credit module in either quantitative or qualitative research
- 20 credit compulsory module
- 30 credits of optional modules (to include a project planning module if
doing dissertation)
Master of Science in Clinical Education
- Dissertation for 60 credits
|

How much work is it?
The workload, as well as the ratio of in-house teaching to self-directed
learning, varies between courses. At PPHI, each 10- to 20-credit
module
requires attendance at 4-5 days of in-house teaching.
There is a further
expectation of 68 hours of self-directed
learning for each 10 credits.
However, it is possible to meet
the learning objectives with less time
committed to self-directed
learning. Assessment for some modules included an
end of module
examination but more often involved the completion of a written
assignment of 20005000 words; these were usually in
the form of essays
or portfolios and represent the greatest
challenges to time and require
commitment and motivation to
complete.
The final dissertation also requires a significant amount of time and
energy. It is a suitable project for completion within the specialist
registrar research day, but would be a challenge to complete without this
privilege.

Strengths of an MSc in clinical education
The MSc course undoubtedly has improved our teaching skills
and knowledge
of educational theory, promoting a more reflective
and empathic approach to
teaching. Learning non-lecture-based
teaching methods and gaining
understanding of the assessment
and implications of learning styles have been
practical skills
invaluable when teaching small groups and individuals.
Curriculum
and course planning skills have also been utilised in the local
development of educational and training courses. These have
included skills in
the assessment and examination of students,
which are increasingly relevant
with the advent of foundation
training programmes.
Completing a significant research project under supervision has developed
our research skills, which were also enhanced through formal modules in
quantitative and qualitative research. Completing research within an academic
rather than a clinical setting is a further valuable experience.

Weaknesses and obstacles
This MSc course is aimed at a wide audience including social
care workers.
This leads to a diverse range of objectives and
aims, and some modules are
therefore only marginally relevant
to doctors. These diverse aims reduce the
opportunities for
active teaching, with few formally observed teaching
sessions.
Assignments usually consisted of lengthy essays, which seemed out of place
in a course teaching modern methods of assessment. Furthermore, the process of
developing a dissertation proposal, finding a supervisor, gaining ethical
approval and proceeding with the research is time-consuming and at times
frustrating. The financial cost is a significant consideration but may be an
appropriate use of money gained from staff teaching activities by trusts, for
example Service Increment for Teaching (SIFT) money in England. Furthermore,
there is funding available for such training through organisations such as the
Workforce Development Confederation.

Tips for those considering a postgraduate degree in education
Decide what you want to achieve from a course. If you intend
to take lead
educational roles or pursue academic teaching
posts it may be necessary and
useful to complete a masters
degree (or even a PhD for academic posts). For
those who teach
as part of their job and wish to update their skills, gaining
some knowledge of educational theory as they do so, a postgraduate
certificate
in education or a single module may be sufficient.
Having established what level you wish to reach, it is worthwhile
appraising the variety of courses available, as they vary significantly and
some are available nationwide through distance learning (for example, Dundee
University). Find out about the courses content and assess its
relevance to you. Establish how much in-house teaching and self-directed
learning is expected.
If looking to complete a masters degree, consider how long you wish take.
Most courses have a maximum possible period of 5 years to complete the degree
but this may be negotiable. If completing the degree within a specialist
registrar training scheme, start early in order to finish within the 3 years
of training. Begin the dissertation process early in the second year, because
gaining ethical approval can be time-consuming. You have 1 year to complete
the dissertation from the point of approval so this can be gained before your
third year.

The bottom line: is it worth it?
We have had mixed experiences in completing this degree and
have some
reservations in recommending it to everyone. Some
modules have only marginal
relevance and therefore did not
fully meet our expectations of gaining skills
in teaching and
learning. This might indicate a need to develop specific
modules
or courses to meet the demands of medical educators and possibly
even
the needs of individual sub-specialties. However, on balance
it has been a
valuable and stimulating experience that has
provided us with both skills and
knowledge in teaching and
a well-recognised and formal degree in education. We
feel the
MSc is a worthwhile qualification for consultant psychiatrists
looking to take lead roles in the increasingly demanding and
evolving
environment of medical education.

References
- BHUGRA, D. (2005) Training for consultants in 2020.
Psychiatric Bulletin,
29, 46.[Free Full Text]
- BHUGRA, D. & HOLSGROVE, G. (2005) Patient-centred
psychiatry: training and assessment: the way forward. Psychiatric
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- BROWN, N. & BHUGRA, D. (2005) Modernising Medical
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- BROWN, N., BHUGRA, D. & OYEBODE, F. (2005)
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- BURTON, J. (2000) Get a masters degree in education.
BMJ Careers Focus, 320, S2
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http://www.gmc-uk.org/education/foundation/new_doctor.asp
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