Undergraduate education in anaesthesia, intensive care, pain, and perioperative medicine: The development of a national curriculum framework

Abstract

Introduction: The study describes the development of the first UK national framework to guide undergraduate education in anesthesia, perioperative medicine, critical care, and pain medicine.

Methods: We followed an inclusive process of curriculum design aiming to promote high-level learning amongst students. We conducted telephone interviews with senior anesthetic educators at 33 UK medical schools to establish current provision and practice. We then held a consultative national workshop for educators, using focus group interviews to set broad aims for the final framework and gather information.

Result: Anesthesia undergraduate educators demonstrated a conceptual focus that moves beyond simple acquisition of knowledge to one geared to encouraging clinical behavioral change in learners to equip them for practice as new doctors. Respondents also highlighted the opportunities for promoting spiral, integrated, and longitudinal learning within the undergraduate curriculum. We also formulated eight key domains of practice in anesthesia and critical care and mapped 63 of the 106 General Medical Council’s Outcomes for Graduates against these domains, and created a brief suggested syllabus.

Conclusions: The framework aims to provide support and guidance for medical schools in the development of competent, well-rounded doctors who are able to provide safe, patient-centered care in all areas of medical practice.

Acknowledgements

We thank those who participated in the workshop events and commented on the draft framework.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Community of practice: A persistent, sustaining, social network of individuals who share and develop an overlapping knowledge base, set of beliefs, values, history, and experiences focused on a common practice and/or mutual enterprise.

Barab SA, Barnett M, Squire K. 2002. Developing an empirical account of a community of practice: characterizing the essential tensions. J Learn Sci. 11:489–542.

Tacit knowledge: Knowledge that has not been (and perhaps cannot be) formulated explicitly and therefore cannot be stored or transferred entirely by impersonal means. It is typically acquired via demonstration followed by practice. Whereas explicit knowledge is formal and easily specified, for example by being written down in textbooks and journals, tacit knowledge is less visible and consists of skills learned through experience. This tacit knowledge seems to require direct personal contact between an expert and a learner for transmission to take place.

Smith AF, Goodwin D, Mort M, Pope C. 2003. Expertise in practice: an ethnographic study exploring acquisition and use of knowledge in anaesthesia. Br J Anaesth. 91:319–328.

Additional information

Funding

We also acknowledge the financial and organizational support of the Royal College of Anaesthetists.

Notes on contributors

Andrew Smith

Andrew Smith, BM, BS, PhD, MRCP, FRCA, FHEA, FAcadMEd, is a Consultant Anaesthetist at the Royal Lancaster Infirmary and Visiting Professor of Anaesthesia at Lancaster University, UK. He is also Year 4 Director for Lancaster Medical School.

Christopher Carey

Chris Carey, MBBS, FRCA, is a Consultant Anaesthetist, Brighton & Sussex University Hospitals NHS Trust, Associate Postgraduate Dean for Health Education England for Kent, Sussex and Surrey and Senior Lecturer at the Brighton & Sussex Medical School. He is also on Council of the Royal College of Anaesthetists.

Jonathan Sadler

Jonathan Sadler, Clinical Fellow in Anaesthesia, RCoA education fellow 2016–7. Led the organization and development of the Framework Document on behalf of the RCoA.

Helen Smith

Helen Smith, MBBS, MA (Med Ed), MA (Cantab), FRCA, FHEA, is an Associate Lecturer at the University of Cambridge and Consultant Anaesthetist at Addenbrooke’s Hospital, Cambridge.

Robert Stephens

Robert Stephens, BA, MBBS, FRCA, MD, FFICM, is a Consultant Anaesthetist, UCL Hospitals NHS Trust and Honorary Senior Lecturer and lead for Undergraduate Anaesthesia & Perioperative Medicine at UCL.

Claire Frith

Claire Frith, MB, BChir, MRCP, MCEM, FRCA, is a Specialist Registrar in Anaesthesia, Central London School of Anaesthesia, and was Education Fellow at University College Hospital, 2015-16. She co-designed and conducted the survey of undergraduate teaching in UK medical schools.