Professor of Medical Education and Honorary Professor of Clinical Communication Skills
The most influential scholarship project in my career has been about using narratives (or stories) in teaching medicine, and also in understanding what goes on in consultations between doctor and patient. I spent several years working as a health broadcaster for the BBC and an editor at the BMJ (British Medical Journal) where I was trained to use stories to communicate with audiences and highlight the patient’s voice; so I was baffled that my own teacher training when I started in medical education made no mention of stories at all. As a result, I chose to focus on narrative learning in medical education in my EdD studies and published a paper about how medical lecturers use stories in their teaching. This has been a central focus of my education practice and scholarship.
At the core of my work in communication skills is the art and science of giving and receiving effective feedback; this has been another important scholarship project for me. I have had to develop my own skills in feedback, as well as approaches to supporting faculty in giving feedback and students in receiving it, often in very different cultures. I have had to become very familiar with models of feedback in order to run faculty development workshops for educators, QMUL faculty tutors, the amazing actors we work with in communication skills teaching, and students. I have learned through reading the literature, shared experiences running workshops with colleagues, and developing and piloting new models of feedback; for example one developed for undergraduate students which led to a publication in a peer-reviewed journal for primary care educators.
Supporting the development of empathy (essentially the ability to “put oneself in another’s shoes”) in medical students, and helping faculty to do the same, is a key priority in my teaching. Empathy is central to both doctor-patient communication, and in valuing the patient’s story in healthcare; and it is associated with improved patient satisfaction, as well as better diagnostic and clinical outcomes for patients. My interest and expertise in helping students develop their empathy skills has been constantly evolving through formal learning, collaboration with patients (both actors and real patients), reading, research, podcasts, and publications.
I have never been particularly strategic about my own career progression, but looking back, these projects have played a key role. I do remember a friend and mentor advising me, as I started out in academia, to pick an area of scholarship that I feel passionate about and develop a real expertise in that area. This prompted me to focus on narratives; and turned out to be very good advice. I think that has led to fruitful connections (some with my heroes in the field), and opportunities in publication and dissemination that help to raise one’s profile. I am sure that, combined with other scholarship projects on empathy and feedback, was influential in my eventual appointment as Professor of Clinical Communication Skills.
It's also worth saying that evidence of scholarship is often explicitly linked to academic appointments, promotion and professional accreditation or awards and prizes. In my case, all these projects and some others have done a lot of heavy lifting in job applications, application for Senior Fellowship of Higher Education Academy (SFHEA), Education Excellence Awards from QMUL and the Faculty of Medicine, and nomination for a National Teaching Fellowship.
My scholarship in the field of narratives has had influence at a national and international level in promoting the use of stories to foreground the patient voice in higher medical education. This has been mainly through faculty workshops and publications aimed at higher education audiences. My paper How medical teachers use narratives in lectures: a qualitative study has now been cited 75 times, in papers ranging from practical guides on using stories in case discussions and podcasts, to a major systematic review on promoting empathy and compassion in medical students. I have been invited to run many workshops and give several talks about the power of stories in medical education at medical schools, and national conferences. I have also been invited to contribute chapters about stories in the consultation for three books, all of which are designed to support educators in higher medical education to use this narrative approach. These workshops and publications have been at the heart of a growing movement in medical higher education to adopt a narrative approach in the consultation.
My scholarship activities around feedback have included writing, with a colleague, an update on the latest thinking about feedback in clinical settings which I have since incorporated into my workshops. This personal self-reflection and development has underpinned my own teaching of clinical communication skills, and has led to numerous invitations to support others in the development of their feedback skills, through workshops and publications, both in the UK and overseas.
In the field of empathy, scholarship has shifted my understanding of empathy in clinical contexts and has influenced how we teach and assess it in medical students, and has led to being invited to write an editorial about socio-cultural influences on empathy in a leading medical education journal.
I would say that scholarship and practice go together – you can’t really have one without the other. They feed off each other, enrich each other. So whatever your educational practice, scholarship should be guiding your reflection on it, and shaping where you take it next.
Alongside this general scholarly approach, I would echo the advice my mentor gave me; choose a specific focus that you are passionate about, and make a real go of that in particular.
Scholarship and publication are not always straightforward, so it really helps if you are passionate about one key area to start with. Developing real expertise in a focused field can also help with raising your profile and opening up career opportunities.