Developing Negotiated Imaging Modules: The University of Leeds experience

Jane Arezina

Aim of the session

• To share our experience in developing negotiated imaging modules in specialist/focussed areas of diagnostic imaging.

UoL MSc Diagnostic Imaging Programme

• Created by merging existing Breast Imaging and Medical Ultrasound programmes

• Preserved the existing high-quality student experience

• Increased opportunities for inter-professional learning

• Streamlined delivery to ensure programme viability and sustainability

Rationale for Restructuring

• Accommodate existing and emerging/niche specialists areas of practice

• Course and module design to enable students to negotiate learning and

assessment on an individual basis

• Introduce flexibility and future-proofing

Negotiated Modules

• Developed in response to increasing service and practitioner demand

• Two negotiated imaging practice modules (15 credit and 30 credits options)

• Accommodate the increasing number of areas of specialist professional

development within Diagnostic Imaging

• Enable students to undertake focussed or broader area study in a speciality

depending on their individual clinical requirements

Specialities currently delivered in NIP and FNIP

• Image Guided Interventional Procedures

• Breast Ultrasound

• Peripheral Vascular Ultrasound

• Focussed aspect of a module e.g. First Trimester Obstetric Ultrasound

• Not delivered 12-13 but done in past

– Musculoskeletal Ultrasound

– Cardiac Ultrasound

Negotiated Imaging Practice (NIP) and Focussed Negotiated Imaging Practice (FNIP)

• Multiple small groups studying a variety of clinical applications

• Students negotiate their own learning, teaching and assessment with

guidance from the module and strand leaders

• Learning, teaching and assessment proposal moderated by Learning

Contract Review Panel

The collaborative approach

• Students develop and submit a learning contract outlining their proposed

individualised programme

• Panel of subject specialists (strand leaders) moderate to ensure parity,

fairness and academic integrity of learning, teaching and assessment plan.

• Locates academic control in successful student / tutor partnerships.

• Clinical partners – Mentors monitor progress and undertake the summative

clinical assessment in conjunction with academic from UoL

• Aim Summarise your overall aim(s) for this module

• Justification Explain your reasons for undertaking this module

• Knowledge base Provide a list of key literature and resources

• Learning objectives Describe what you wish to achieve using 5 or 6 specific ‘knowledge & understanding’ and ‘skill’ outcomes

» what do you want to know, understand and / or be able to do, that you do not know / understand / cannot do, now?

• Methods Outline a proposed programme of study» how will you be taught? what learning activities will you undertake?» describe in terms of hours / topics and numbers / case mix» how do you want your progress / practice / development of competence to be monitored?

• Assessment Design your own assessment schedule» what evidence will you submit (and when) to demonstrate that you are making progress

(formative assessment)?» what evidence will you submit (and when) to demonstrate that you have achieved your

learning objectives (summative assessment)?

Assessment

• Students in a sub-group may all be undertaking the same assessment if the

learning outcomes are the same for all students; e.g. Breast ultrasound

• Assessment within a sub-group may be different if students are studying the

same ‘subject’ but in different clinical areas of practice e.g. Image-guided

interventional procedures

• Use of the School of Healthcare assessment tariff ensures that assessment

is equivalent across the module

Application Written work Performance audit Clinical Learning record

HyCoSy

1 x 1200 word case study; 3 x 400 case reports –

to include one patient complication and one unexpected result.

30 successful unassisted procedures

30 unassisted procedures; documentation,

report and follow up / reflection

US BreastFNA & NCB

2 x 1200 word case studies 1x FNA/ Cyst aspiration, 1x 14g NCB

30 FNA (70% adequate sampling);

30x 14g NCB (80% B2 or B5 result) - unassisted procedures

At least 30 Breast FNA, 15 Cyst aspirations &

30 14g NCB – unassisted procedures.

images / pathology reports

X-ray breastSNCB & HW

1 x 3000 word case study SNCB technique;

3 x 750 case reports –to include one patient complication, one

discrepant result, one hook-wire procedure.

30 unassisted SNCB – 80% B2 or B5 result;

10 successful hookwire (10mm threshold)

At least 30 unassisted SNCB; 10 unassisted hookwires

images / pathology reports

US MSKJoint injections

1 x 1200 word case study3 x 400 case reports

to include one patient complication; one unexpected result

30 unassisted proceduresOxford shoulder score audit

30 unassisted procedures; documentation, images patient questionnaires

Written work100% or 60% weighting

OSE40 % weighting

Clinical AssessmentPass / Fail

Clinical Learning recordPass / Fail

IGIP(FNIP – 15)

2 x 1200 word case studies X30 FNA

30x 14g NCBunassisted procedures

At least 30 Breast FNA, 15 Cyst aspirations

30 14g NCB- unassisted procedures

Obstetric(FNIP – 15)

1500 word case report 30 minutes2 clients

1 x less than 9 weeks gestation1 x 10-14+2 weeks

Minimum 150 casesinclude 50 dating and

50 early pregnancy complications

Vascular(FNIP – 15)

1500 work case report 30 minutes2 patients

1 x arterial 1 x venous study

Minimum 150 patients include arterial & venous studies

Breast(NIP - 30)

3000 word case study1500 word essay

30 minutes3 patients

3 different referral reasonto include 1 whole breast and axilla

Minimum 100 cases

How it works

• The negotiated aspects of the programme are not more than 50% of the

award

• Students without a previous PG imaging qualification need to do a

programme of study. This has a minimum of two compulsory modules

– Fundamentals of Science and Technology of Diagnostic Imaging

– Professional Issues in Diagnostic Imaging

• Students with a previous postgraduate (PG) imaging qualification can do

these modules for Continuing Professional Development (CPD)

Creativity and Innovation in learning and teaching

• Embeds the philosophy of student-led learning and teaching

• Empowers students to take responsibility for their own learning

• Enhanced integration of research and teaching

• Motivates students to succeed

Student Focussed Learning

• The flexibility of NIP/FNIP enables students to be self-directed learners

• Negotiate learning to enhance individual clinical skills requirements

• Experiential work-based learning enhanced by greater theoretical knowledge

• Innovative assessment : negotiated to ensure assesses the individual learning

outcomes including clinical competence

Problems (challenges) with NIP

• Co-ordination of information to students

• Timely administration of negotiated contract process

• Co-ordination of assessment

• Presentation of assessment results

• Transcripts

• Progression monitoring

•Multiple ‘versions’ of the module

•Duplication of learning

Outcomes

This innovative approach has allowed us to:-

• Achieve financial viability for specialist modules with low student numbers

• Maintain an excellent student experience at Leeds

• Be flexible and responsive to evolving clinical practice.

Feedback-March 2011

The MSc Diagnostic Imaging validation panel, including representatives from the Consortium for the Accreditation of Sonographic Education and the College of Radiographers, considered these modules to be excellent, innovative in postgraduate study and a model suitable for integrating research into learning and teaching.

‘‘…the Negotiated Learning modules, which were considered innovative and a model that could be extended to integrating research into learning and teaching’’

‘‘This was considered by the panel to be an excellent idea for postgraduate study. ’’

Student feedback

• ‘Experiential learning enabling linking theory to practice, multidisciplinary team work and communication enhancement’

• ‘Planning the workbased project very useful experience to structure ones own

learning’

• ‘Having the scope to do relevant work and change practice’

• ‘Interactive teaching sessions enabled students to glean different practices in

different departments and reflect on one’s own departmental processes’

Student feedback

‘Excellent module with good content and academic support. Would definitely

recommend this to future students’

‘Interactive discussions enabled different procedures, protocols and practices to be

explored’

‘I feel this has prepared me to perform a range of procedures with confidence and

additional knowledge to reflect on in reference to professional guidelines and role

extension’

Thank you

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References