Keywords: Undergraduate medical students, new curricula, navigating guidelines, complex medicine, nominal group technique
Understanding how to navigate medical guidelines is an essential skill for future doctors. Recent emphasis has been placed on the importance of prioritization and time management when implementing guidelines into clinical practice. However, traditional medical education is offered topic by topic, with less emphasis given to patient-centred care, grading of recommendations and sometimes conflicting guidelines.
Our objective was to develop a two-week elective subject titled "The Medical Profession: Navigating Medical Guidelines" for third-year medical students in Oslo. Through an intensive application of the nominal group technique (NGT), a group of five experienced primary care physicians and teachers collaborated during a two-day session to design the subject and its curriculum.
Initially, we had concerns about the complexity of this topic for students at the third-year level due to their limited clinical experience. To assess the subject, the examination was designed to include an individual reflection note and a group presentation. Out of 16 students, 14 consented to having their reflection notes used for educational research purposes.
The NGT process led to development of a subject with interactive lectures, group and plenary discussions, as well as a clinical rotation day. Key topics included research guidelines, sensible choices and sustainability, patient-centered care, medical uncertainty, multi-morbidity, and navigating conflicting guidelines. A longitudinal patient-case video presentation accompanied the teaching with increasing complexity each day. Students were divided into two groups for the clinical rotation day at out-of-hour emergency care and nursing home facilities. Two teachers were present each day of the course to facilitate skill development and discussions. Students provided positive feedback, appreciating the reflection on their future professional roles.
The NGT process proved effective in creating an elective subject well-received by both teachers and students. We encourage others to consider using similar models when designing new curricula.
Points for discussion:
How can we teach medical students in a way that encourages them to think like competent general practitioners?