Royston Alexander P
Department of Internal Medicine, Somerset NHS Foundation Trust, Taunton, UK.
Systems Thinking in Practice, Open University, Milton Keynes, UK.
J Med Educ Curric Dev. 2025 May 9;12:23821205251329750. doi: 10.1177/23821205251329750. eCollection 2025 Jan-Dec.
Several stakeholders are formally recognised when designing undergraduate medical curricula, but past studies have failed to identify them with sufficient breadth, to explore their understanding of the system, or examine their views on curriculum composition. This qualitative study drew on elements of systems thinking to better understand the stakeholders in undergraduate medical education and their role and priorities in curriculum composition.
This study employed an exploratory qualitative methodology. Participants were initially identified from the General Medical Council's list of stakeholders and were recruited using a combination of convenience, judgmental and snowball sampling. Data were collected through semistructured interviewing. Interviews were descriptively coded and then thematically analysed.
In total, 18 participants were interviewed about their perspectives on stakeholders, the purpose of the education, along with their ideal weightings for curriculum subjects. The findings suggested that the breadth of stakeholders exceeded the modest list provided by the General Medical Council. The purposes of the education were themed into: (1) safe patient care, (2) social benefit, (3) service provision, (4) student benefit and (5) provider benefit. Safe patient care emerged as a universally shared purpose, although views on the customer varied between participants. Curricula priorities were more diverse, with competing interests favouring different subjects for emphasis in the curriculum, with views on the value of scientific-learning particularly divided.
Undergraduate medical education likely concerns a broader range of stakeholders than are often engaged. Several stakeholders are formally recognised when designing undergraduate medical curricula but past studies have failed to identify them with sufficient breadth, to explore their understanding of the system, or to examine their views on curriculum composition. This research raised questions about engagement of vital stakeholders and how power is distributed in the system, along with the need to develop roles into the future when renewing curricula.
在设计本科医学课程时，有几个利益相关者得到了正式认可，但过去的研究未能充分广泛地识别他们，未能探究他们对该体系的理解，也未考察他们对课程构成的看法。这项定性研究借鉴了系统思维的要素，以更好地理解本科医学教育中的利益相关者及其在课程构成中的作用和优先事项。
本研究采用探索性定性方法。参与者最初是从英国医学总会的利益相关者名单中确定的，并通过便利抽样、判断抽样和滚雪球抽样相结合的方式进行招募。数据通过半结构化访谈收集。访谈进行描述性编码，然后进行主题分析。
总共采访了18名参与者，询问他们对利益相关者的看法、教育目的以及他们对课程科目的理想权重。研究结果表明，利益相关者的范围超出了英国医学总会提供的有限名单。教育目的分为以下几类：（1）安全的患者护理，（2）社会效益，（3）服务提供，（4）学生利益和（5）提供者利益。安全的患者护理是一个普遍认同的目的，尽管参与者对“客户”的看法各不相同。课程重点更加多样化，不同利益方倾向于在课程中强调不同的科目，对科学学习价值的看法尤其存在分歧。
本科医学教育涉及的利益相关者范围可能比通常参与的范围更广。在设计本科医学课程时，有几个利益相关者得到了正式认可，但过去的研究未能充分广泛地识别他们，未能探究他们对该体系的理解，也未考察他们对课程构成的看法。这项研究提出了关于重要利益相关者的参与以及权力在体系中如何分配的问题，以及在更新课程时未来如何发展相关角色的问题。
