How do national specialty groups develop undergraduate guidelines for medical schools, and which are successful? A systematic review

Abstract

Purpose: To better understand the steps undertaken by medical specialties to develop and implement undergraduate national, and international, educational guidelines for use in medical schools, and to find what makes them successful in terms of uptake and knowledge.

Methods: Systematic review of databases to find inter- and nationally-created undergraduate medical specialty guidelines, and descriptions of development and analysis, from 1998 to January 2015.

Results: Ninety six eligible papers were found, covering 59 different guidelines in 32 specialties. Five documented from development to revision. Development often required multiple stages and methods, 10 using the Delphi technique. Twenty two guidelines mapped to recommended government standards. Twenty papers analyzed curricula. No guideline was used in every relevant medical school.

Conclusions: This is a comprehensive review of the processes involved in creating international and national guidelines, with emphasis of key points for those considering similar undertakings. These include thorough needs analysis of multiple groups involved in the delivery of the curriculum; and engagement of relevant parties throughout development, to ensure relevance and increase buy-in. Flexibility is important, to allow use in medical schools with different methods of teaching. Ongoing evaluation and update are also critical steps that must not be forgotten.

Acknowledgements

The authors wish to thank the medical education staff of the Plymouth University Peninsula Medical Schools of Medicine and Dentistry, especially Pam Baxter, as this project formed part of a Master’s degree in Clinical Education.

Ethical approval: Not applicable.

Disclosure statement

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

Funding

No funding was received for the undertaking of this project.

Notes on contributors

Kathrin Joanna Whitehouse, BSc, MBBCh, MClinEd, FRCS(Neuro.Surg), FHEA, is a neurosurgery registrar at North Bristol NHS Trust Adult Neurosurgery Department, Southmead Hospital, Bristol; and Fellow of the Higher Education Authority, having undertaken a Masters in Clinical Education in Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.

Anne Josephine Moore, FRCS, is a retired consultant neurosurgeon; ex Vice-President of the Royal College of Surgeons of England; and previous President of the Society of British Neurological Surgeons.

Nicolas Cooper, BSc, MMEd, FRCP, FRCPCH, PFHEA, FAcadMEd, is an Associate Professor of Clinical Education and Course Director of Physician Associate Studies at Plymouth University Peninsula Schools of Medicine and Dentistry. He is also Academic Lead of Peninsula Foundation School; and Chair of the Membership Committee/Lead Assessor of the Academy of Medical Educators for the Wales deanery.

Glossary

The Delphi Method: Is an iterative process used to achieve consensus from a group of experts using a series of questionnaires interspersed with feedback. It was originally developed at RAND Corporation for the American military, but is used in many disciplines, including business and medicine.

Questionnaires are designed to focus on problems, opportunities, solutions, or forecasts; and are complete by experts. Subsequent questionnaires are developed based on the results of the previous. The process stops when consensus is reached, theoretical saturation is achieved, or when sufficient information has been exchanged.

The Delphi Method: Techniques and Applications” by Harold Linstone and Murray Turoff, Addison Wesley, 1975.

Schulmoski, Hartman, Krahn. 2007. The Delphi method for graduate research. J Inform Technol Educ. 7:1–21. http://jite.org/documents/Vol6/JITEv6p001-021Skulmoski212.pdf