Up-close: Professor Jennifer Cleland

The recently appointed Director of MERSU and Professor of Medical Education Research talks about her research passion, speaking at Transform MedEd 2020 and her plans for LKCMedicine 

What are your thoughts on student performance and how we prepare students for practice upon graduation?

There's an increasing acknowledgement there's more to being a doctor than being able to pass exams. You have to be academically able, you have to be able to manage a heavy workload and hard learning, but you also need to have the right personal qualities: good communication, compassion, integrity. Around the world, medical schools have changed their selection processes so that they assess for personal qualities as well as cognitive abilities. There are some approaches for doing that: Multiple Mini Interviews,  Situational Judgement Tests… It's about basic fundamentals, about positive characteristics.

You bring with you rich data on UK practices and the Western experience. What will you bring to the Singapore context?

I really want to talk to the Ministry of Health (MOH) to find out what the issues are for the Singapore medical workforce and medical training; not just medical students but residency also and professional development for doctors. Are they under-recruiting specialities? Are some specialities not attracting women? Do residents quit training in some hospitals or programmes? We can then think of exploring research questions that may inform MOH decision-making and policy. 

What do you want to achieve here in Singapore?

What I've always wanted for my research is not just academic papers, but that it influences policy and practice. Research in a journal that nobody reads is not useful research. I'm used to feeding up to government and seeing things happen, working with government ministries and designing rigorous, robust research that is also practical and useful.

Will you be teaching as well?

We've been talking about a suite of postgraduate courses, perhaps a PhD in medical education. It's really popular in other countries. A suite so that people can choose which modules they want. In the short-term, I want to observe Team-Based Learning (TBL) as it is new to me. Maybe there is something I can contribute to as a teacher, and perhaps do research into the social processes of how students interact in their teams. What do the students take from the social side of  TBL into the workplace? It must attract a certain type of student. That would be my priority, to look at TBL from a socio-cultural angle.

Professor Jennifer Cleland

What are your plans for MERSU?

To obtain the grants necessary to answer important questions that would have interest internationally. We'll collaborate internationally as well. Good research should be useful research. Some quick wins to show that we're here. It would be good for LKCMedicine to gain a reputation in medical education research.

I'm a big believer in presence –  locally and internationally. Medical education is actually a small world, so it's very important to have the right collaborations and a presence on the international stage. I would like my junior members of staff to attend symposia to gather intelligence and see what people are doing.

What will you be speaking on at Transform MedEd?

I will be speaking on workforce issues. Some countries have many doctors but some countries have too few doctors. Within countries, there are some areas that attract more doctors. More deprived and more rural areas really struggle to recruit and retain doctors. One of the things I've been looking at for many years, from different angles is how you can attract the type of people who go to medical school, and who will then graduate and become doctors who will then deliver to meet the needs of the population? We want to attract a diversity of students who will then work across all specialities, and meet the needs of all patient populations.

It's also how you teach them, what specialities you expose them to, what kind of healthcare you expose them to. There's a lot of evidence to show that when they're in a medical school, they need to be in a community, as well as a hospital. They need to do public health as well as a surgery. They need the experience and exposure of all types of medicine. Only when they have that, will they be able to identify the area of medicine that they enjoy. If you've never experienced it, how will you know?

In the UK, we've looked at how career preferences change between the day they enter and the day they exit medical school. When people enter medical school, they don't know the breadth of medicine. By the end of medical school, in the UK at least, they've had exposure to anaesthesiology, quite a large number decide to be anaesthetists!

Role models are important too, as they teach students how to respect colleagues across all areas of medicine. Students otherwise pick up a hidden curriculum, when they hear a member of faculty say something derogatory about another speciality, they will note it. It's a big issue in the UK.

What UK data will you be presenting?

I've been working on a fairly large UKMED database held by the General Medical Council for 10 years, trying to pull out the patterns of student individual characteristics and their performance at medical school and their career choices, and where they go to train. The database work is supplemented by qualitative studies with junior doctors where we explore what they want out of a career. What are the important factors for them in selecting a medical career? This is about generic factors, such as work-life balance or intellectual stimulation. To find out what drives junior doctors when they think about the next 40 years of work.

Transform MedEd, since we started in 2018, has always had transformation at its core. How will the data you've collected inform, or transform, the training of doctors?

Several areas of impact. One, it can impact how and who we select into medical school. It can provide information as to the nature of the training we offer; the things we need to teach and how we teach. It's not just about the knowledge but also the process of learning. It can also inform the postgraduate world if we can identify what's important to junior doctors. Could we use what we learn to advertise less popular specialities?

Some hospitals can do that too, as some are more attractive to work in than others. They can't change their location but they can change the way they treat their staff. I've been working in the UK for 20 years so this is really just the context.