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The Monash Scholarly Intensive Placement

The compulsory, six-week, full-time research training program introduced by Monash Medical School in 2020 has been a great success with students, despite initial concerns about the school’s capacity to supervise more than 500 students per year doing short research projects. 

University Affiliation
Monash University
Title of the Program
Scholarly Intensive Placement (SIP) Monash School of Medicine
Team Members
A/Prof. Megan Wallace (Director of Medical Student Research and SIP Convenor)
A/Prof. Bernadette Ward (SIP Coordinator, Monash Rural Health)
A/Prof. Jennifer Lindley (Director, Medicine Course Curriculum)
A/Prof. Basia Diug (SIP Coordinator and Head, Quality and Innovation, Medical Education Research and Quality Unit, School of Public Health and Preventive Medicine).
Date the project commenced
January 2020

Why was the program undertaken? 

The Scholarly Intensive Placement was one of several changes introduced to the Monash medical degree in its transition from MBBS (Hons) to Masters Degree (Extended) BMedSc/MD. 

To provide context, the Monash medical degree is a large (more than 500 students/year level), geographically distributed degree operating across Monash Australia and Monash Malaysia campuses (more than 33 clinical locations in metropolitan and rural Victoria and Malaysia). Most students at Monash Australia and all students at Monash Malaysia commence directly from high school into a five-year degree (Years 1-5). Monash Australia also has a four-year graduate-entry degree (Years A-D). The final three years are clinical years and are identical for both cohorts. A full study load is 48 credit points per year. 

Three major changes were made to the clinical years during the transition to the MD: 

  1. Introduction of a compulsory series of new, interactive online Research Methods in Medicine modules, which include a major data analysis assignment in Year 3/B. 
  2. A doubling of the Patient Safety Module (from six to 12 credit points) in Year 5/D 
  3. A compulsory new six-week, full-time 12-credit point unit called Applied Studies in Medical Research and Professional Practice in Year 5/D, replacing an elective rotation. This unit is colloquially known as the Scholarly Intensive Placement (SIP). 

Consistent with the Australian Quality Framework (AQF) definition of a Masters Degree (Extended), the overarching aim of the SIP is to develop “individuals who apply an advanced body of knowledge in a range of contexts for professional practice and as a pathway for further learning” [1]. The SIP was designed to enable final-year students to work full-time for six weeks on a scholarly activity to gain in-depth knowledge in an area of interest, relevant to medicine. The unit was strategically placed in the final year to enhance students’ research skills, particularly their ability to search and critique the literature, immediately before they commence their lifelong journey as evidence-based medical practitioners.  

We drew inspiration for the SIP program by reviewing published literature for similar research-intensive experiences for medical students at other universities (for example [25]) to identify key success criteria. The review indicated that having an organisational research culture and protected time within a well-structured and well-supported program, with quality supervision and a degree of student autonomy and project choice, would be critical to improve student research skills, attitudes and scholarly outputs [6]. We considered surveys of medical students about their research experiences and attitudes to research [7, 8] and sought input from Monash University student representatives. We also drew inspiration from a very popular Monash undergraduate unit for Bachelor of Science and Bachelor of Biomedical Science students, called Action in Research. 

We knew that the project types undertaken by the SIP students needed to be broad-based, given the large student numbers and geographic distribution of the Monash MD program. We also needed project options that utilised research skills but could be overseen by supervisors who might not be research-active themselves.  

We envisaged that projects would largely fall under one of three (not mutually exclusive) streams:  

  1. A research stream, where students could contribute anywhere along the pipeline of a research project – a literature review, designing a project, developing research tools (e.g. survey), data collection, data analysis or project write-up. 
  2. A professional practice stream, where students could contribute to a professional practice issue in a clinical setting (e.g. quality improvement audits, development of clinical guidelines, governance or policy documents, review of treatment and/or management options for a specific disease). 
  3. An education stream, where students could develop or evaluate educational materials for patients, the general public, other students or health professionals. 

How was the SIP program implemented?  

The SIP is led by the Director of Medical Student Research and six dedicated SIP Coordinators, responsible for recruiting supervisors, approving topics, reviewing students’ preferences and supporting SIP students and supervisors at their school. The Director and SIP Coordinators meet monthly to ensure consistency across sites, resolve unforeseen issues and identify opportunities for improvement. 

No financial incentives are given to SIP supervisors but the faculty funded five 0.2 FTE SIP Coordinator roles, and administrative support is provided by current staff at each school. The cost of the program, therefore, is primarily academic salary support equating to less than $200,000 per year.  

A central SIP website has been developed to provide students and supervisors with an overview of the program. Each school also has its own SIP website to promote the range of projects available at that school. Students and supervisors receive a SIP guide, and a dedicated learning management system (Moodle site) contains the SIP guides, assessment instructions and additional support resources, and links to upload assessment items. At any one time, there are 80-90 students undertaking the SIP across six clinical Schools in Australia (15 sites) and Malaysia (three main sites). 

To minimise unexpected delays, SIP projects must either already have or not require ethical approval; alternatively, the development of an ethics application can form part of the SIP project itself.  

Learning Outcomes 

The learning outcomes for the SIP are: 

  1. Utilise specialist knowledge and skills to justify the need for a research, teaching or professional practice issue to be investigated or evaluated. 
  2. Devise and implement a plan for the placement and identify key outputs. 
  3. Review, synthesise and critically appraise clinical and scientific literature in a specific area of medical science, education or professional practice. 
  4. Practice and demonstrate an understanding of academic integrity, research integrity and ethical behaviour in the context of medical science and/or delivery of care. 
  5. Collect and categorise information related to a key question relevant to the community and to medicine. 
  6. Analyse and summarise information related to a key question relevant to the community and to medicine. 
  7. Justify and reflect upon approaches to solve a complex problem relevant to their placement. 
  8. Communicate critical concepts and findings to a professional audience in oral and written formats. 

Assessment 

The SIP assessment strategy consists of five assessment items (Items 2 and 3 are Hurdles):  

  1. A series of online modules on Good Research Practice, Academic Integrity and Citing and Referencing, all assessed by a quiz 
  2. A Student-Supervisor Learning Agreement to ensure the student understands the supervisor’s expectations, tasks to complete and what to include in the Scholarly Report 
  3. A 4000-word Scholarly Report about their SIP project, including a 250-word executive summary (abstract) 
  4. An oral presentation about their SIP project  
  5. A reflection on their SIP experience. 

What is the program achieving?  

Based on formal and informal student and supervisor feedback, the SIP has been a resounding success, despite very significant impacts from COVID-19 in its first and second years of operation.  

Prior to starting the SIP in 2020, there were substantial concerns about the capacity to supervise more than 500 students per year doing short projects, but this proved to be an unfounded concern. In 2021, there have been about 230 separate supervisors, each supporting between one and six students for the year. Informal feedback from supervisors indicates that they have been very impressed with the dedication and quality of the work that the SIP students are producing. Evidence from students’ oral presentations, scholarly reports and student reflections also indicates that students are achieving the learning outcomes, learning a great deal about their topics, and reflecting on the impact of the SIP experience and how they will take their scholarly learnings forward into their clinical practice.  

However, the COVID-19 pandemic did have major impacts on the SIP program in both Victoria and Malaysia. In 2020, COVID began to impact clinical placements during the second rotation for the year with the strictest lockdown in Melbourne (Victoria) lasting for four months. In Malaysia, a Movement Control Order in 2020 caused all medical students to be removed from clinical placements for about five months. To keep students meaningfully occupied during this time, many SIPs were altered to run concurrently with the limited clinical placements that were available – over an extended period rather than six-weeks full-time. The students and supervisors coped remarkably well with the rapidly changing and evolving situation, but many projects did have to be altered at short notice so they could be completed remotely.  

The impact of COVID-19 on the SIP has continued to be very significant in Malaysia in 2021 but at Monash Australia, the program has reverted to six-weeks full-time for all final-year students, with relatively few projects impacted by Victorian/Melbourne lockdowns. 

A selection of SIP students are profiled in internal and external media articles to promote the program, the variety of projects available and the outcomes that can be achieved from the SIP: 

A manuscript describing the first-year evaluation of the SIP program and the impacts of COVID-19 on the program will be submitted for publication soon. It will be important to continue evaluating the SIP in future years when the impacts of COVID-19 are further reduced, however, feedback thus far indicates that the vast majority of students and supervisors have had positive and satisfying experiences and that the SIP is achieving its objectives to enhance students’ research skills, confidence to practice EBM and interest in undertaking research and other scholarly work. 


References: 

[1] Australian Qualifications Framework Council, Australian Qualifications Framework, 2nd Edition, 2013. p. 59. 

[2] Bierer, S.B. and H.C. Chen, How to measure success: the impact of scholarly concentrations on students-a literature review. Acad Med, 2010. 85(3): p. 438-52. 

[3] Chang, Y. and C.J. Ramnanan, A review of literature on medical students and scholarly research: experiences, attitudes, and outcomes. Acad Med, 2015. 90(8): p. 1162-73. 

[4] Havnaer, A.G., A.J. Chen, and P.B. Greenberg, Scholarly concentration programs and medical student research productivity: a systematic review. Perspect Med Educ, 2017. 6(4): p. 216-226. 

[5] Laskowitz, D.T., et al., Engaging students in dedicated research and scholarship during medical school: the long-term experiences at Duke and Stanford. Acad Med, 2010. 85(3): p. 419-28. 

[6] Cornett, M., et al., A realist review of scholarly experiences in medical education. Med Educ, 2021. 55(2): p. 159-166. 

[7] Eley, D.S., et al., What will it take? Pathways, time and funding: Australian medical students’ perspective on clinician-scientist training. BMC Med Educ, 2017. 17(1): p. 242. 

[8]  Muhandiramge, J., et al.,The experiences, attitudes and understanding of research amongst medical students at an Australian medical school.BMC Med Educ, 2021. 21(1): p. 267. 

 

 

PDF of case studies available here: Research in the Medical Curriculum, Volume 1 – A window on innovation and good practice 2022