Teaching social science research methods to undergraduate medical students
| Published date | 01 October 2017 |
| Date | 01 October 2017 |
| DOI | 10.1177/0144739417715894 |
| Subject Matter | Articles |
Article
Teaching Public Administration
Teaching social science
2017, Vol. 35(3) 280–300
ª The Author(s) 2017
research methods to
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DOI: 10.1177/0144739417715894
undergraduate medical
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students: The state of
the art and opportunities
for practice and
curriculum development
Simon Forrest
School of Medicine, Pharmacy and Health, Durham University, UK
Abstract
There is an expectation that medical students in the UK will be able to demonstrate
conversancy with social science relevant to medicine and health, including the means by
which the relevant bodies of knowledge are generated through the use of social science
research methods. This paper explores the structural and pedagogical challenges and
opportunities posed by this demand. To achieve this a small scale research project
seeking to establish the ‘state of the art’ with respect to teaching and learning about
these research methods was implemented. It was found that there is little formal
reporting of practice in the literature and that this is a field largely unsupported with
materials and resources. However, there were some common features in the ways that
practitioners approach, organise and deliver the provision; and it was found that almost
all the provision takes place in the early part of medical education. It is suggested that
continuing problems with the status of social sciences, lack of clarity about whether the
purpose is to enrich medicine with knowledge about health and generated by the social
sciences, and/or explore the ontological and epistemological tensions between natural
and social sciences coupled with the status of social scientists in medical education, may
limit capacity to develop the field.
Corresponding author:
Professor Simon Forrest, School of Medicine, Pharmacy and Health, Durham University, Holliday Building,
Queen’s Campus, University Boulevard, Stockton-on-Tees TS19 6BH, UK.
Email: simon.forrest@durham.ac.uk; Telephone: 00 44 (0)191 334 0341
Forrest
281
Keywords
Curriculum and programme development, medical education, social science research
methods
Introduction
The relationship between the social sciences and medicine has a long and rich history
which has, since the 1970s, been recognised in requirements that United Kingdom (UK)
graduates in medicine must demonstrate knowledge about both the psychological and the
social dimensions of health and medicine (Bloom, 2002; Todd Commission, 1968).
Recently, in a revised version of the statement of expected outcomes of graduates in
medicine entitled ‘Tomorrow’s Doctors’, additional emphasis has been placed on
understanding of social science research methods (GMC, 2009). Specifically, graduates
in medicine are now required to demonstrate that they can:
. . . critically appraise the results of research including qualitative and quantitative studies as
reported in the medical and scientific literature; formulate research questions and design
studies including in those within a psychosocial paradigm; and, apply the findings of studies
to specific clinical problem. (GMC, 2009: 18)
A number of the other graduate outcomes spelt out by the profession’s regulator also
imply conversancy with social science research methods, especially those relating to the
knowledge base dealing with population health and improving health and health care
(GMC, 2009: 11).
The General Medical Council (GMC) does not provide detailed guidance in the form
of a curriculum on how these outcomes are to be met. As a consequence, individual
Medical Schools in the UK exercise a considerable degree of freedom in terms of the
organisation, structure and content of provision that enables learners to meet the out-
comes. There continue to be efforts to help populate this space through the production of
core curricula by practitioners in the various fields and disciplines that make up medical
education – for example, on ethics (Stirrat et al., 2010), public health (Myles et al., 2014)
and psychology (Bundy et al., 2010)). Very recently there has been work to plug the gap
relating to the sociological contribution to medical education through the production of a
core curriculum for sociology in medical education (Collett et al., 2016). This involved
extensive consultation with teachers, students, clinicians and patients (Brooks et al.,
2011, 2013).
Despite increasing recognition of the contribution of social science research methods
to medical practice (Alderson, 1999; Pope et al., 2000) and the publication of various
textbooks and guides which either make reference to or deal directly with undertaking
sociological research as a healthcare professional and/or research into social dimensions
of health (e.g. Bell, 2005; Cunningham et al., 2013), detailed accounts of pedagogic
practice are extremely rare and there has been no review of the literature (e.g. Rifkin and
Hartley, 2001). As a consequence, little is known about the structure, content and
organisation of teaching and assessment and the associated challenges and opportunities
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Teaching Public Administration 35(3)
in educating undergraduate medical students about social science research methods
(Brooks et al., 2013; Forrest et al., 2013).
Whilst evidence of lack of information about curriculum and pedagogic practice
coupled with the imperatives of GMC requirements provides a sound rationale for research
in this field, it is important to recognise that there are also other additional motives.
First, post-graduation and especially in senior roles, medical doctors may play
important roles in planning, commissioning and undertaking research, some of which may
have social science components or include social science methodologies. This might be
research with direct clinical relevance, involve service development or evaluation, explore
patient or practitioner views, or be undertaken by medics involved in and developing
medical education. We should anticipate that interest in research in fields relevant to
sociology, and questions which have a sociological dimension or inflection will only
continue to increase. This is an effect of the increasing importance of Evidence-Based
Medicine with its focus on ensuring that service, treatment and care in all their dimensions
draw on research and indeed take into consideration a recent special emphasis on issues
such as more and better understanding of patient experience of ill-health and attention to
interdisciplinarity (Greenhalgh et al., 2014). In this context sociological research methods
have much to offer in terms of doctors’ ability to ask and answer phenomenologically
informed questions or to interrogate the links between health and social inequalities.
Second, the scale of the enterprise is important. The number of students studying
medicine at undergraduate level in the UK at any one time stands at round 30,000 (HESA,
2014). This represents a significant body of learners, creating a great deal of scope for
social scientists to reach into medical education and have an effect on the future thinking
and practice of doctors. It is also the case that, because of the potential scale of activity, an
understanding of the practice and experiences of teaching social science research methods
in medicine represents an important contribution to understanding of the social science
pedagogy that takes place outside the home discipline. For those sociologists already
teaching in medicine, the support provided by a sense of what is plausible, feasible and
appropriate to teach by way of social research methods has obvious value.
Third, the opportunity represented by need and the size of the student body has to be
counterbalanced against a broadly consistent body of evidence suggesting that teaching
social sciences to medical students involves challenges. There is a need for an evidence
base on which to build a better understanding of, and address, these challenges.
Understanding the specifics of pedagogic practice, structures, challenges and barriers
regarding teaching social science research methods helps to enrich both our under-
standing of these broader issues, and their influence and what may be done to address
them. Challenges often reported include those associated with the attitudes towards the
social sciences held by both clinical staff and medical students. For example, members of
both groups may struggle to see the relevance of social scientific knowledge, and
epistemological tensions between the disciplines represented in this multi-disciplinary
environment are particularly manifest regarding assessment of knowledge and under-
standing (Russell et al., 2004; Scambler, 2010). The attitudes of staff and students are
situated in a series of connected structural problems, which include curriculum and
timetable pressures, historic models of pedagogy which are characterized by extremely
Forrest
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high levels of contact time, and the status attached to provision of particular forms of
factual knowledge creating a context in which social science teaching and learning may
be lost such that is to be found ‘everywhere and nowhere’ in the provision.
This environment creates the opportunity to ask a number of pedagogically oriented
questions addressing the issue of how to support the development of teaching of social
science research methods in undergraduate medical education. The present paper reports
on a piece of work focused on answering two of these questions: what is the current
practice relating to teaching social science research methods...
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