Curriculum for Change - Enabling medical students to develop skills that will lead change in a modern health care environment.

Background
The NHS in Scotland faces increasing challenges when providing quality of care with ever limiting resources. For this to be addressed doctors, along with other healthcare professionals, should appreciate the value and necessity of quality improvement in healthcare early in their careers. ScotGEM, a graduate entry medical program delivered jointly between Universities of Dundee and St Andrews, offers innovative training that aims to produce graduates that are inspired, competent and confident to influence change: In other words to ‘not only deliver but develop healthcare’.

Agents of Change (AoC), a unique part of the ScotGEM programme, will help
students identify opportunities for improvement by leading, engaging and working with staff, patients and communities.

Summary of Work
By developing a curriculum that includes taught materials and projects in
placement through all four years of study, students develop their expertise in change management and leadership. The development and delivery of these projects is supported through interprofessional collaboration with primary care teams. This method of education enables students to learn the value of patient safety, quality improvement whilst appreciating the importance of effective relationships. Taught material to support these projects includes Quality Improvement, Informatics, Service Learning, Prescribing and Therapeutics, and Public Health.

Summary of Results
A curriculum that spans all 4 years of the programme is now established. 153
healthcare improvement projects have been completed that have resulted in 4
overarching topic areas identified: sustainability, clinical management, prescribing and monitoring of drugs, and improving practice systems. To date 2 cohorts of medical students have graduated that are able to contribute effectively to embedding healthcare improvement and change management in their future medical career.

Discussion and Conclusions
The AoC curriculum develops knowledge and skills among medical students that
can influence attitudes towards improving healthcare delivery. Experiential learning in clinical practice enhances understanding for sustainable prescribing, have a positive impact on clinical staff, healthcare organisations and ultimately patient safety. Our work shows how students are trained and empowered to be drivers of sustainable change.

Take Home Messages
The overall outcome of AoC is to influence medical education to drive forward
positive change, embracing a “wider systems” thinking approach to deliver optimal healthcare tailored for Scotland in the 21st century.