Keele Research Repository

Background
Consultation skills are the core competencies required at graduation of the doctor as a practitioner. Every medical school has its own system of teaching and assessing consultation skills. These are generally amalgams of previous curricula and not rigorously developed. We took the opportunity presented by a new undergraduate medical curriculum to systematically develop the consultation skills curriculum from classroom teaching to OSCE assessment and formative workplace-based assessment and feedback.

Methods
The consultation skills curriculum and assessment system were developed by action research. Data were collected using mixed methods involving questionnaires, focus groups, participant interviews, student reflective summaries and routine monitoring of usage of an app which we developed for generating feedback summaries in the clinical workplace. Participants were teachers and students at Keele University school of medicine. In addition, clinical tutors from seven other UK medical schools participated in a Delphi study of undergraduate medical consultation skills competencies.

Results
A case study of curriculum development by action research is presented in nine published papers.

Conclusion
This work has contributed to medical education knowledge as follows: an instrument for assessment of consultation skills has been developed and validated; and a set of strategies for improvement of these consultation skills have been developed and validated. It has added to understanding about transfer of learning from the classroom to the workplace; the impact of assessment grades on medical students’ learning and self-perception; and the value of a system of formal workplace-based assessment.
Additionally this work was one of the first applications of realist methods in medical education research, and it has developed guidance on feedback in the workplace for individual tutors and educational institutions.