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Research in the Health Professions Education Unit

Our current research projects

Enhancing selection of the healthcare workforce: a programme of psychometric epidemiology

Title: Enhancing selection of the healthcare workforce: a programme of psychometric epidemiology
Timeframe: 2016 - 2021
Funder: National Institute for Health Research
Contact for more information: Dr Paul Tiffin

The purpose of this research is:

1. To understand how me might improve the selection of UK doctors by analysing information from the UK Medical Education Database (UKMED)

2. To develop the use of Situational Judgment Tests to select staff into Mental Health Services

This fellowship funds a programme looking at selection into healthcare. Specifically we are using the UKMED, which is a large data repository containing information on all UK doctors who entered medical school in 2007, join training schemes from 2012. By conducting data analysis where are able to say what factors at selection are likely to be associated with certain desirable, or undesirable, outcomes later on in a doctor’s career. For example, we have been looking at predictors related to future fitness to practice issues. 

A separate strand is understanding how situational judgement tests (written tests which portray scenarios which challenge professionalism) could be used to improve staff selection for mental health services.

Outputs

Patterson F, Tiffin PA, Lopes S, Zibarras L. (2018). Unpacking the dark variance of differential attainment on examinations in overseas graduates. Medical education, 52(7), pp. 736-746. doi: 10.1111/medu.13605

Mwandigha LM, Tiffin PA, Paton LW, Kasim AS, Böhnke JR. (2018). What is the effect of secondary (high) schooling on subsequent medical school performance? A national, UK-based, cohort study. BMJ open, 8(5), pp. e020291. doi: 10.1136/bmjopen-2017-020291

Finn GM, Mwandigha L, Paton LW, Tiffin PA. (2018). The ability of 'non-cognitive' traits to predict undergraduate performance in medical schools: a national linkage study. BMC medical education, 18(1), pp. 93. doi: 10.1186/s12909-018-1201-7

Paton LW, Tiffin PA, Smith D, Dowell JS, Mwandigha LM. (2018). Predictors of fitness to practise declarations in UK medical undergraduates. BMC medical education, 18(1), pp. 68. doi: 10.1186/s12909-018-1167-5

Smith DT, Tiffin PA. (2018). Evaluating the validity of the selection measures used for the UK's foundation medical training programme: a national cohort study. BMJ open, 8(7), pp. e021918. doi: 10.1136/bmjopen-2018-021918

Tiffin PA, Orr J, Paton LW, Smith DT, Norcini JJ. (2018). UK nationals who received their medical degrees abroad: selection into, and subsequent performance in postgraduate training: a national data linkage study. BMJ open, 8(7), pp. e023060. doi: 10.1136/bmjopen-2018-023060

Tiffin PA, Alexander K, Cleland J. (2018). When I say … fairness in selection. Medical education, 52(12), pp. 1225-1227. doi: 10.1111/medu.13628

Patterson F, Tiffin PA, Lopes S, Zibarras L. (2018). Unpacking the dark variance of differential attainment on examinations in overseas graduates. Medical education, 52(7), pp. 736-746. doi: 10.1111/medu.13605

Further information

Implementing a longitudinal integrated clerkship; identifying key barriers and enablers

Title: Implementing a longitudinal integrated clerkship; identifying key barriers and enablers
Timeframe: 1 year until September 2019
Funder: Hull York Medical School / MSc dissertation
Contact for further details: Dr Kevin Anderson

This is a qualitative research study analysing the process of implementing a longitudinal clerkship (LIC) at a medical school, particularly the key barriers and enablers.

LICs are a relatively new type of medical student placement that proponents suggest can deliver a transformative approach to clinical education using continuity and the development of relationships between students, patients and physicians to underpin (and ultimately optimise) the student experience. There is a relative paucity of evidence about the challenges and enablers encountered during the implementation an LIC as part of a medical school curriculum. This project will seek to address this gap through a thematic analysis of semi-structured interviews conducted with medical educators in a variety of medical schools around the world.   

Navigating the ‘social jungle’: An exploration of medical professional identity

Title: Navigating the ‘social jungle’: An exploration of medical professional identity
Timeframe: 3 years (PhD)
Funder: Hull York Medical School
Contact for further details: Dr Megan Brown

The purpose of this research is to investigate undergraduate medical student professional identity formation and influences upon this. There will be investigation into the impact of longitudinality upon identity formation, with a focus upon the impact of longitudinal integrated clerkships.

Possessing a medical professional identity enables an individual to think, feel and act like a doctor. There are many associated benefits to acquiring a strong sense of identity throughout medical school. Yet, it remains unclear the exact process through which this happens and what key influencing factors upon this process are. A relatively new type of medical student placement is being developed within Hull York Medical School - a longitudinal integrated clerkship. This work will investigate whether participation in these type of clerkships impacts upon medical student identity through both national and international collaborative research. 

The development, implementation, and evaluation of an interprofessional intervention for healthcare promotion: Repurposing the Teddy Bear Hospital

Title: The development, implementation, and evaluation of an interprofessional intervention for healthcare promotion: Repurposing the Teddy Bear Hospital
Timeframe: 2018-2020
Funder: Health Education England
Contact for more details: Professor Gabrielle Finn and Dr Jimmie Leppink

Teddy Bear Hospital (TBH) is an initiative founded by the European Medical Students’ Association (EMSA) intended to help 3-12 year-olds to lose their fear towards doctors and hospital environments. This project enables healthcare students from different programmes to work together to develop TBH events focused on health promotion. 

Through this cross-university collaboration, we bring together students from the Medicine, Nursing (child, adult, disability and mental health), Paramedic and Physician Associate cohorts to develop health promotion events for children, while simultaneously researching how such activities help these aspiring healthcare professions cohorts to develop their interprofessional relationships.

The research element focuses on exploring:

  • Barriers and promoters to participating in interprofessional education (IPE)
  • Lessons learned on: IPE collaboration and other professions, working with a paediatric audience, leadership and team-working, perceptions of outreach initiatives.
  • Ideas for future development and what will be taken forward into their future clinical practice.

Collaborators

  • Professor Julie Jomeen, Professor of Midwifery/ Dean, Faculty of Health Sciences, University of Hull
  • Professor Martin Veysey, MB BS Programme Director, Hull York Medical School
  • Kate Bowers, Lecturer / Academic Lead for Nursing Programmes, Faculty of Health Sciences, University of Hull
The use and hidden curriculum of occupational and black humour in medical education

Title: The use and hidden curriculum of occupational and black humour in medical education.
Timeframe: 2018-2020
Funder: Hull York Medical School
Contact for more details: Professor Gabrielle Finn, Angelique Duenas and Karen Kirkness (PhD students)

The purpose of this project is to investigate the use of occupational humour, including black humour, and  its associated hidden curriculum, within medical education.

Humour in the workplace is common, especially in challenging environments. Often the use of humour can be regarded as a way to stress defuse, or build camaraderie. Issues arise when humour is misconstrued, unprofessional or offensive.

This study explores the use of humour in undergraduate, clinical and dissecting room environments, aiming to establish an understanding of the context of and hidden curriculum associated with its use.

The study uses an international survey of academics and clinicians, as well as focus groups with staff and students in key clinical and anatomical environments where humour may be rife.

Outputs

Should Black Humor Be Put to Death? Examining Student and Staff Views on Black Humor in Anatomy Labs
Poster presentation at the American Association of Anatomists, Orlando, April 2019. 

An assessment of Gateway Year programmes in the UK

Title: An assessment of Gateway Year programmes in the UK
Start date: October 2018 (PhD)
Funder: Hull York Medical School
Supervisors: Professor Gabrielle Finn and Dr Paul Tiffin
Contact for further details: Angelique Dueñas

This study aims to provide an assessment of the current state of Gateway programmes across the nation to help understand best practices for success of Gateway Year programmes.

In the past few years there has been a rapid increase in the number of Gateway to Medicine programmes across the UK, rising from only 7 recognized programmes in 2017 to a total of 17 planned to launch in 2019. However, there is currently very limited research about academic progression of Gateway Year students through their medical education. This study aims to provide an assessment of the current state of Gateway Year programmes across the nation to help understand best practices for success of Gateway Year programmes.

Evaluation of the NHS GP Induction and Refresher Scheme Assessments

Title: Evaluation of the NHS GP Induction and Refresher Scheme Assessments
Timeframe: March-June 2019
Funder: Health Education England (HEE)
Contact for further details: Dr Jimmie Leppink

The NHS GP Induction and Refresher Scheme provides a safe, supported and direct route for qualified GPs to join or return to NHS general practice. It is designed for GPs who have previously been on the GMC Register and NHS England’s Medical Performers List (NMPL) and would like to return to general practice after a career break, raising a family or time spent working abroad. The scheme also supports the safe introduction of overseas GPs who have qualified outside the UK and have no previous NHS experience.

A revised scheme was launched in March 2015 to enable doctors who hold a recognised qualification in general practice and GMC registration to begin or return to practice as GP. It is aimed at GPs who have qualified overseas and not worked in the NHS before (induction) and those who have worked as a NHS GP before but been away for over two years or more (refresher). Co-ordinated through the GP National Recruitment Office (GPNRO), doctors have a single standardised entry point. This project will look at a number of questions concerning the entry requirements (e.g. does the programme avoid “setting up doctors to fail” in complex environments?), outcome appraisal (e.g. is the current programme of assessment fit for purpose?), and completion rates (e.g. are the current standards appropriate to ensure patient safety and patient-centred practice?) of the scheme.

To ensure patient safety and simultaneously minimise the risk of failing doctors who are competent, it is of paramount importance to have an assessment system that is fit for the intended purpose, facilitates feedback, informs future learning, and allows for setting standards that helps us to distinguish between competent and less competent candidates. This project focuses on these questions for the NHS GP Induction and Refresher Scheme.

Defining and measuring professionalism in Mental Health Staff: A mixed methods approach

Title: Defining and measuring professionalism in Mental Health Staff: A mixed methods approach
Award: PhD
Timeframe: 2016-2019
Funder: Hull York Medical School scholarship
Supervisors: Professor Gabrielle Finn and Dr Paul Tiffin
Contact for further details: Lauren Aylott

Lauren’s PhD aims to develop a situational judgement test that will assess practitioners’ knowledge of professionalism within a mental health service context. This will support a values-based recruitment approach; recruiting staff with the right values, as well as knowledge and skills for the role.

Situational Judgement tests have been used for many years to support the recruitment of staff. A situational judgement test in this context, will present test-takers with job-related hypothetical scenarios, to which individuals will need to select the most appropriate behaviour out of a list of potential response options.

Publications

Aylott, L.M., Tiffin, P.A., Saad, M., Llewellyn, A.R. and Finn, G.M., 2018. Defining professionalism for mental health services: a rapid systematic review. Journal of Mental Health, pp.1-18.