Educating doctors for the future: Evaluation of undergraduate medical education in Finland

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Marjukka Mäkelä, Riitta Möller, Cristopher Stephens, Gerda Croiset, Joel Telkkä, Ermo Haavisto, Hannele Seppälä, Kirsi Mustonen, Kirsi HIltunen, Mira Huusko

The first national evaluation of undergraduate medical education in Finland was carried out by the Finnish Education Evaluation Centre (FINEEC) in 2016–2018. The evaluation covered all five universities that offer the Licentiate Degree in Medicine programme: Universities of Eastern Finland, Helsinki, Oulu, Tampere and Turku. The evaluation is based on the principles of enhancement-led evaluation, emphasising active participation and trust. Both the process and its results are intended to help education providers to identify the strengths, good practices and areas in need of development in undergraduate medical education. The evaluation aimed at producing an overall picture on the current state, strengths and challenges of undergraduate medical education, and developing recommendations that reflect the changing competence requirements in doctors’ work and their future operating environment. The evaluation team identified the following areas as strengths that apply to all five Medical Schools:
* Undergraduate medical education programmes are regularly reviewed and developed; various drivers for changes have been identified and processes of quality management exist, and the Schools seem committed to improve their education continuously.
* Each School has many good practices of education planning and implementation that others can share.
* National collaboration is increasing, and joint analyses of core learning contents have started.
* Student engagement is particularly strong; the students are involved in the development of education in all five Schools at all levels of studies through feedback and representatives.
* All Schools provide decentralised clinical placements outside the university hospital and early patient contact, often in primary care. There is good collaboration with teaching units outside the university, especially in primary health care featuring enthusiastic teachers as role models.

The core recommendations to support the development of undergraduate medical education are:
* Defining the “Finnish Doctor”. To engage effectively with the forthcoming health and social care (SOTE) reforms, there must be a consensus on the skills, attitudes and role of a newly graduating doctor. Currently there is no national consensus about what is a “Finnish Doctor” – how they are educated and what they should master at graduation. The structure of medical curriculum varies between universities. Medical Schools need to take more of a leadership role in defining the “Finnish Doctor” and involve a range of stakeholders (patients, students, other health professions, employers) to develop a shared vision and agree on key curricular outcomes.
* Curriculum mapping and alignment. Curriculum mapping – displaying the key elements of curriculum and the relationship between them – can make curriculum planning more effective, the scope and sequence of student learning explicit, and the result more transparent to all stakeholders. Medical Schools could then continue collaboration to align the curricula so that shared national programme outcomes can be taught, learnt and assessed with certainty.
* Development of key skills. A doctor’s key task is diagnostic work with patients. Particularly important for learning, then, is assessment of clinical skills and reasoning in patient encounters with constructive feedback. Readiness to apply new technologies with a critical attitude, teamworking skills, and abilities to manage difficult situations constructively are also core competencies to be facilitated throughout undergraduate learning.
* Learning environment. Increased medical student intake has coincided with organizational and budget changes, affecting student and staff well-being. Larger groups especially in the clinics increase teacher workload and decrease opportunity for hands-on experience and personal feedback. Medical Schools’ approaches to preventing, identifying and managing problems in student and staff well-being should be developed.
* Valuing teacher skills. Medical School teachers balance between demands from teaching, clinic, research, and family. Finnish Medical Schools should explore ways of appreciating teaching and consider creating tenure tracks in medical teaching. Centres for medical education could support systematic provision of pedagogical training for all who teach medical students.
Achieving changes required by the rapidly changing operating environment can be done while protecting the unique flavours of the five Medical Schools. The Faculties can collaborate to ensure that graduates are trained in the skills they need as fledgling practitioners, in further speciality training, when taking on roles in research, management, education or health policy, and for lifelong learning. Ultimately the changes will improve the quality of graduates, increase patient safety, and result in better medical care in Finland.
Original languageEnglish
Place of PublicationTampere
Edition1
Number of pages113
ISBN (Print)978-952-206-451-6, 978-952-206-452-3
Commissioning bodyMinistry of Social Affairs and Health
Publication statusPublished - 2018
SeriesFinnish Education Evaluation Centre Publications
Number14
Volume2018
ISSN2342-4176

ID: 220448679