External summary

Background: Paediatric Emergency Medicine (PEM) is an emerging and developing specialty.  It has its roots in Emergency Medicine and Paediatrics but also has close filiations with specialties such as Primary Care, Orthopaedics and Public Health.  From quite a diverse background, PEM is now developing into a specialty in its own right.  In the UK there is close similarity and collaboration between the training programmes for those with a Paediatric bias and those coming from Emergency Medicine.  These training programmes layout a recognised curriculum and syllabus, and also the criteria for which will determine whether training can be adequately delivered in any given unit.  On a National UK basis there is a paucity of suitable trainers, a similar lack of suitable training opportunities and a great demand for extra PEM training.  This demand extends to other specialties such as Primary Care, Anaesthetics and Paediatric Intensive Care.  The training difficulties and cross-specialty nature of PEM are not unique to the UK, and there is a demand for a more co-ordinated approach to education in this area worldwide.

What is special about the Edinburgh experience in this degree: There is no other MSc available in Paediatric Emergency Medicine to our knowledge.  The  Certificate/Diploma/MSc in PEM aims to deliver a comprehensive and world-class educational opportunity both on a local and international basis. The programme is designed to be flexible, aiming to provide a complementary set of knowledge to those embarked on other training programmes such as Emergency Medicine and Paediatrics, but will also develop a skill set to enable individuals who have completed the training to be confident that their knowledge and skills will enable them to perform to the highest level. The

programme content is applicable to PEM globally, and includes elective options that can be tailored to meet the needs of the individual student.

Main Programme Outcomes: No matter where emergency care is practised, there are three broad parameters that need to be addressed, and these form the key learning outcomes of the programme:

• Recognition of the critically ill or injured child and the ability to provide immediate and lifesaving treatment

• The ability to recognise a child in pain or distress and to deliver appropriate treatment.

• To recognise a vulnerable child at risk of abuse in any form.

Educational aims of programme

The educational aims are:

• To provide students with a firm grasp of the science and pathophysiology underpinning current understanding of paediatric emergency practice
• To provide students with a deeper understanding of the principles and practice of the management of paediatric emergencies
• To develop graduates with an ability to critically appraise current practice so that they can challenge and develop the specialty of Paediatric Emergency Medicine

Programme outcomes: Knowledge and understanding

The Programme is structured to equip students with a comprehensive knowledge base in Paediatric Emergency Medicine. In years 1 and 2 the Programme aims to provide students with the basis for recognition of generic emergency situations in children. Basic physiology, pathophysiology and elements of therapy are introduced and extended. The student is then introduced to specific disease processes, based on specialty areas (Year 2), and which form a core knowledge base for the practice of paediatric emergency. In Year 3 the student is introduced to advanced disease processes, based on analysis of complex cases, and which form a knowledge base suitable to practice at consultant level with specialty interest in Emergency Paediatrics. The education will revolve around developing problem resolution, critical incident analysis and crisis care. Often there will be no clear pathway so reliance on fundamentals will be crucial. Assessment will be by evaluation of interaction on discussion boards, quality of case analysis, and assignments.

Programme outcomes: Graduate attributes - Skills and abilities in research and enquiry

The aim of the programme is to create a stimulating learning environment by “problem based learning”. This approach can be broken down into 3 main principles:

1. The reapplication of existing knowledge via the problem.

2. Learning within a real world context.

3. Communication of information.

Students are therefore encouraged to develop an integrated knowledge base that spans across disciplines; increasing the retention of information as facts become contextualised. This kind of deep reflective learning improves the level of engagement so that the student has a feeling of ownership over their own educational experience. This in turn improves the overall motivation for study and provides a stimulating learning environment.

Programme outcomes: Graduate attributes - Skills and abilities in personal and intellectual autonomy

• Plan and achieve identified goals in a personal and professional context.

• Work confidently both independently and within a multi-disciplinary team.

• Understanding the mechanisms involved in medical and surgical emergencies.

• Develop confidence in the ability to manage difficult resuscitation.

• Develop the knowledge and skills to provide leadership in crisis situations

• Develop confidence in Child Protection.

Students will also have the opportunity to specialise, depending on their own individual interests, by selecting from within the range of elective courses on offer during the second and third years (see Degree Table Programme).

Programme outcomes: Graduate attributes - Skills and abilities in communication

Student interaction on the discussion fora is a major component of the Programme.

The Programme aims to develop awareness and confidence in effective communication in clinical situations, including

• Resuscitation

• Patient/parent education

• Education of colleagues

• Leadership in crisis situations

• Child Protection

Programme outcomes: Graduate attributes - Skills and abilities in personal effectiveness

• Experience with information technologies for both professional collaboration and personal development.
• Organisational and time management skills.
• Self-directed learning, which promotes continuing professional development beyond the framework of the MSc programme.
• Information literacy skills, the ability to seek out knowledge, then formulate and summarise and deliver this information

Programme outcomes: Technical/practical skills

Programme structure and features

The MSc in Paediatric Emergency Medicine is a distance learning Programme of part time study which is run over 3 years.

 Progression requirements:

Are those of the University of Edinburgh i.e. Regulation 49 ‘For programmes where there is an identifiable taught component followed by a project or dissertation component, students must pass the assessment requirements of the taught stage at an appropriate level at the first attempt before progression to the dissertation. In order to progress to the to the masters dissertation students must:

• pass at least 80 credits at SCQF level 11 with a mark of at least 50% in each of the courses which make up these credits; and
• attain an average of at least 50% for the 120 credits of study examined at the point of decision for progression’

And Regulation 50 for Certificate and Diploma awards attaining an average of 40% for Courses (in 60 Credits of Study for Certificate, and 120 for Diploma)

Teaching and delivery methods:

All courses are taught by distance learning, using the virtual learning environment WebCT as the delivery platform. The Programme combines independent study, online peer discussion, reflective learning, written assignments and critical reviews to develop an understanding of the important concepts and principles of Paediatric Emergency Medicine. Students access courses in Web CT using the MyEd student portal – the gateway to web based services including access to the library, email and the online Programme in Paediatric Emergency Medicine. Course materials are protected by secure username and password access.

The course is run by the two Programme Directors (Clinical and Academic), with the assistance of the Programme Developer, with some Part-time administrative support.

Social responsibility, sustainability, equality and diversity

Opportunities for placement or overseas study – this is an online MSc programme, which will be made available to a global audience.  Therefore, rather than offering placements and overseas study opportunities, it is designed to allow overseas students to study on a University of Edinburgh MSc programme, without the need to travel to the UK.

Marketing – generic marketing tools such as pamphlets and brochures are used, and these are distributed at RCPCH and CEM meetings, among other places. Targeted emails are sent to all trainees in the UK. A Programme website has been developed to facilitate student and donor interest. The Programme team liaise closely with the eLearning Marketing Officer to ensure promotional efforts are optimised and fit within the broader CMVM marketing strategy. Advertising has been through the internet (doctors.org, Facebook) and Emergency Medicine journals and is seen as an essential element of sustainability.

Teaching and learning methods and strategies

Our teaching and learning strategy is centred around clinical case-based scenarios.  These form the basis for the exercises that students submit e.g. questions related to assessment/diagnosis and management of a case, or interpretation of data (e.g. Xrays, ECGs). Feedback is provided to the student immediately they submit their own answers, in the form of expected/model answers. Student learning is further developed by follow-on questions/scenarios on the topic, which students address on the discussion fora. This is a rich source of material as students explore the topic and interact, under the supervision of the Programme Directors and eTutors. Students are encouraged to support their postings with evidence from the literature.

Facilities: students have access to the University library online, and assistance from Marshal Dozier.  

Assessment methods and strategies

Throughout the Programme Assessment is 40% online and 60% written.

Online assessment is primarily via the discussion fora, and related questions.

Criteria for marking are laid out in advance. Where there is a subjective element to answers, two markers are involved.  Written Assignments are generally powerpoint lecture presentations or essays, or case-based exercises.

In the Certificate Year where the discussion forum is generally a new form of learning for students, credit is given for participation and interaction in addition to content, but over the year students are expected to provide more evidence and critical appraisal.

In the Diploma Year students are required to provide and appraise the evidence to support their postings. Critical Appraisal is also used as a format for exercises. In the Options Course written assignments are submitted as workbooks.

In the MSc Year students are asked to debate difficult clinical scenarios, where there is no ‘correct’ answer. The Written Reflective element is a major piece of submitted Written work on a topic and format previously agreed by the Programme Directors.

Career opportunities

The Programme Directors believe that as the Cert/Dip/MSc in Paediatric Emergency Medicine, as a demonstration of the graduates commitment and relevant academic achievement in the field, may be advantageous for doctors in training, particularly where competition exists for training posts.                  

Other items

Library and IT facilities – These are in place for the Programme, and Library facilities are supported by Marshial Dozier.