Challenges with unprofessional conduct are turned into growth through guided reflection in the PARTNERS supported-entry route Assessed Summer School.
Our challenge / opportunity
PARTNERS is one of Newcastle University’s supported-entry routes and requires applicants to complete an Assessed Summer School in order to receive a reduced offer for entry to their chosen course. During the medicine strand of the Summer School, we noticed some students exhibiting professional behaviours that were lower than the required standard but not sufficiently low to warrant failing. This included persistent lateness/absence without following the correct procedure, submitting formative work significantly below the required standard or not completing required tasks. The medicine stand of the PARTNERS Summer School has around 120 students. Around 5-10% display behaviours that are below what we expect.
Our solution (approach)
Expectations around conduct, and the consequences of not adhering to these, are outlined clearly and in multiple places. They are described in the Code of Conduct sent to applicants before the Summer School, on the Canvas pages and in the live online Introduction to the Strand session, where it is also possible for students to ask questions. If a student subsequently is identified as having displayed professional behaviour lower than the required standard, we ask them to reflect on this. This mirrors how low-level unprofessional behaviour is dealt with on the course.
As part of the formative assessment for the strand, all students are required to complete a personal reflection on one of their taught sessions (see Small ways to introduce reflection – Part 1). In preparation for this, students are introduced to the “What? So what? Now what?” model of reflection in an in-person timetabled session. Students who are required to complete an additional reflection on professional behaviour have these resources to draw on.
Each student who needs to complete an additional reflection is emailed to explain the reason they are being asked to complete the extra reflection (e.g. missed attendance, lack of engagement, lateness) and asked to complete a reflective report including:
- a description of the issue(s)
- why it happened
- why it was unacceptable
- what they will do to make sure this doesn’t happen should they start the course
- why changing their behaviour is important for their development as a medical student
There is a word count requirement of 250-500 words and students are told not to use generative AI as we want their personal reflections on the situation.
The reflections are reviewed by a clinical colleague who gives feedback that focuses on their insight into the situation, professionalism and its relevance/potential impact to their course, and why positive change may be needed. If the reflection is sufficiently poor, we would consider proposing that the student fail the Summer School (although this is extremely rare).
We make it clear that we are drawing this behaviour to their attention as a learning point. We also emphasise that this additional requirement will not appear on their record once they start the course.
The impact (results)
Student feedback does not mention the additional reflections on professionalism specifically but we believe it is valuable as it alerts students to behaviour which may be problematic if it continues. The process also mirrors how professionalism concerns are dealt with in Stage 1 so provides an insight into what could happen if their behaviour does not change, and aligns with General Medical Council requirements. Our focus at in the Summer School is to be supportive, identify any potential support needs, and provide encouraging feedback. Although we have not carried out any longitudinal analysis of the impact, we hope that we provide students with a professional reality check before they start the programme and are therefore able to hit the ground running and avoid further issues.
Lessons learned
We found that some students were not checking their university email sufficiently frequently, especially after the Summer School, so missed the deadline to complete the additional reflection. We have addressed this by being clearer from the start that we expect students to check their email at least once a day. We are also clearer from the start that we will be contacting students who do not fulfil the expectations of the strand so they are aware of this potential requirement.
A common pitfall of the reflection itself is that students commonly use too much space for generic words of apology. Whilst it is appropriate to identify whether there are any individuals to address a specific apology to, a long-winded generic apology is not what is required. We emphasise that we are looking for a clear understanding of what caused the issue, why the issue is a problem and what changes they will make to avoid this happening in the future.
Tips for colleagues
Although this was part of a supported-entry route Summer School (where the incentive is a reduced offer for passing the Summer School), these small moments of reflection could be incorporated into a taught module at UG or PGT level, particularly professionally-accredited courses. Having said that, there are situations where any student could be asked to reflect on their professional behaviour (for example, after a group work project).
It is important that colleagues giving feedback are familiar with the expectations of the course and with reflection. Personal reflection is deeply personal (especially when it is an additional requirement due to unprofessional behaviour) and unconstructive feedback can have a negative impact on the student.
Skills and attributes
Students were able to develop the following attributes:
Education for Life Strategy
This case study reflects the following aims of the Education for Life strategy:
- Equity: To provide a core, universal offer for all students, including tailored provision where needed, to ensure equity of access, experience and in outcomes for all, regardless of background, identity, nationality, location or mode of study.
- Fit for the future: To ensure our students are fit for their future, our teaching is fit for the future of our offer, and our colleagues are fit for the future of HE
Further resources
We used the University of Edinburgh’s Reflection Toolkit to inform the in-class material on reflection.
https://reflection.ed.ac.uk/reflectors-toolkit/reflecting-on-experience/what-so-what-now-what
We also direct students to this page to give an overview of why reflection is important and examples of questions to think about when reflecting:
https://www.ncl.ac.uk/academic-skills-kit/study-skills/independent-learning/reflective-practice/
Authors
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Dr Alison Graham Senior Lecturer in Medical Sciences Education School of Medicinealison.graham@ncl.ac.uk |