Dr Ann WylieDept. Primary Care, King’s College LondonDivision of Medical Education King’s College Londonann.wylie@kcl.ac.uk

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Health promotion (HP) is now core in many curricula

It is taught and assessed at KCLSM throughout all years

Since the introduction and development of this core HP and number of positive outcomes have been noted

The approach to integrating core HP was based on sound pedagogy and educational findings – such as ensuring relevance to other learning

There was limited interest in HP SSMs and Public health related core content

Students rarely looked to HP as a potential for publications and bursaries

The HP SSMs were rarely oversubscribed

Conference interest by students was associated with clinical and scientific work

Research in HP and Med Ed was limited

Since 2006 core HP has been taught in years 1,3 and 4(2nd yr – there is a SSM option), final year core started 2007

Assessment approaches include presentations, portfolios and short answer

Students do well, especially with GP/community related year 4 presentation assessments

Tutors involved have reported high levels of satisfaction/interest/new learning for them

The data from 2007/8 and 2008/9 were reviewed relating to;

Students doing HP related SSMs Students requesting and designing HP SSMs Students undertaking HP research needing

ethical approval Students submitting HP conference

abstracts Student applications for bursaries for

electives and other HP studies Student publications linked to HP work

Health promotion SSMs have increased 5 fold

Self designed HP SSMs in years 2, 3, 4 and 5 have also increased, including 3 with complex multi focal themes needing ethical approval

Students have successfully applied for grants and bursaries – notably the Bygott (£750)and Wellcome (£1000) awards

The increased workload has required additional HP specialists for teaching/second marking etc

A internal student prize has been established given the high levels of HP/Community based SSMs and the quality of student work

A conference award has also been established to support students with accepted abstracts

Taught SSMs include: Exploring needs of families with Sickle cell disease Teaching children about health The role of maternal literacy in health outcome Cuban health Health promotion interventions – evaluating Tackling inequalities Smoking policies – exploring impact Drug and alcohol communities provision Victims of torture and assessing needs Health promotion for prisoners Health /social issues for older people in areas of deprivation Natural family planning The “good doctor” – role of humanities

The self designed SSMs include: Evaluating a school mentoring scheme Anti-bullying polices and their implementation Obesity prevention for children with special needs Obesity prevention and management Developing and piloting obesity protocol for pregnant

women Breast screening and resistance Breast feeding and evaluating campaigns Efficacy of sexual health interventions Natural family planning – why is it challenged Health of medical students HIV and stigma Malaria prevention and other SSMs linked to TB in Asia

The major HP focus in core is in year 4 – the penultimate year

Some students have looked at the impact of different placements on them and their well being – looking at personal health and career options with 4 current students doing application for academic and HP/PH related posts

Students have had 3 papers published, 2 in press, 5 in draft

7 conference presentations One student has contribution to three chapters in

book in press 7 newly qualified doctors in academic/HP/PH posts

A positive and supportive attitude to core HP has fostered additional interest for this field

The GMC(Dec 2008)reported favourably on this aspect of curriculum at KCLSM

“Areas of innovation and good practice .. We commend the School on the following areas of innovation and good practice: ,,the integration of public health teaching in Phase 4, where students undertake a pregnancy study looking at longitudinal health aspects (see paragraph 42).”

“The School adequately addresses issues and techniques involved in studying..integrating public health in Phase 4 in which students undertake a

Community Pregnancy Study looking at longitudinal health aspects, including antenatal screening, ethical dilemmas and decision making...the School is undertaking an international longitudinal joint study, with links to Monash University in Australia, on the impact of health promotion in the curriculum. We encourage the School to disseminate any findings from this”

HP is part of core curricula for many schools but it will remain marginal. Our approach suggests:

Acceptance is possible if it is well integrated and relevant to other content/learning experiences

Additional opportunities through SSMs foster wider interest

Constant review and amendments, linked to feedback and evidence, is imperative, as this is an emerging epistemology