Continuous enhancement of educational quality - fostering a quality culture: AMEE Guide No. 147.

Internal quality assurance (IQA) is one of the core support systems on which schools in the health professions rely to ensure the quality of their educational processes. Through IQA they demonstrate being in control of their educational quality to accrediting bodies and continuously improve and enhance their educational programmes. Although its need is acknowledged by all stakeholders, creating a system of quality assurance has often led to establishing a 'tick-box' exercise overly focusing on quality control while neglecting quality improvement and enhancement. This AMEE Guide uses the concept of quality culture to describe the various dimensions that need to be addressed to move beyond the tick-box exercise. Quality culture can be defined as an organisational culture which consists of a structural/managerial aspect and a cultural/psychological aspect. As such this AMEE Guide addresses tools and processes to further an educational quality culture while also addressing ways in which individual and collective awareness of and commitment to educational quality can be fostered. By using cases within health professions education of both formal and informal learning settings, examples will be provided of how the diverse dimensions of a quality culture can be addressed in practice.

Mind the gap: Teachers' conceptions of student-staff partnership and its potential to enhance educational quality.

Introduction: Student-staff partnerships as a concept to improve medical education have received a growing amount of attention. Such partnerships are collaborations in which students and teachers seek to improve education by each adding their unique contribution to decision-making and implementation processes. Although previous research has demonstrated that students are favourable to this concept, teachers remain hesitant. The present study investigated teachers' conceptions of student-staff partnerships and of the prerequisites that are necessary to render such partnerships successful and enhance educational quality.Method: We conducted semi-structured interviews with 14 course coordinators who lead course design teams and also teach in 4 bachelor health programmes, using Bovill and Bulley's levels of student participation as sensitising concepts during data analysis.Results: The results pointed to three different conceptions of student-staff partnerships existing among teachers: Teachers teach and students study; teachers teach and value students' feedback; and teachers and students co-create. The prerequisites for effective co-creation teachers identified were: Teachers must be open to involve students and create dialogues; students must be motivated and have good communication skills; the organisation must be supportive; and teachers should have the final say.Conclusion: We conclude that teachers' conceptions are consistent with Bovill and Bulley's levels of student participation. Under certain conditions, teachers are willing to co-create and reach the highest levels of student participation.

Avoiding counterproductive results: an experimental pretest of a harm reduction intervention on attitude toward party drugs among users and nonusers.

In two experimental studies, the authors tested written health education materials on the personal acceptance of party drug use. Following a harm reduction strategy, the materials provided information on minimizing potential hazards associated with drug use. Among users and nonusers, potential aversive effects of these materials were examined on measures of attitude, intention, and outcome expectancy toward party drug use. Participants were recruited in the city center of Maastricht, The Netherlands, in nightlife settings that were popular among young people. In the first experiment, a leaflet on ecstasy use was evaluated among ecstasy users and nonusers. Results showed neither health promoting effects, nor counterproductive results on the outcome measures. In the second experiment, the effects of two different formats (leaflet vs. infocard) about two different kinds of party drugs (ecstasy vs. GHB) were compared within a nonusing population. Again, results showed no positive changes on the outcome measures toward ecstasy use as a result of exposure to the ecstasy materials. However, exposure to the GHB materials resulted into a more negative attitude toward GHB use (leaflet and infocard) and lower estimates of the likelihood of positive outcomes of use (infocard). The study's limitations and implications are discussed, including the need for experimental pretesting.

Designing effective health education materials: experimental pre-testing of a theory-based brochure to increase knowledge.

The aim of this study is to demonstrate the usefulness of developing health education materials with a theoretical and empirical research basis. With a specific focus on increasing knowledge, the authors utilized well-researched principles in cognitive psychology to increase the message comprehension of an existing health education brochure. The brochure used was produced by a Dutch national campaign office for preventing alcohol abuse among undergraduate students. In two experimental studies, the original version of the brochure was compared with the theory-based modified version on measures of knowledge and psychosocial determinants of alcohol use among undergraduate university students. The results show significant differences in knowledge uptake between the two versions. In both experiments, the modified version elicited higher scores on knowledge uptake than the original version. These findings underscore the importance of theory in the design of health education brochures. Despite these positive findings, no differences in more proximal psychosocial determinants of behavior could be found. As a result, the authors conclude that principles in cognitive psychology should be complemented by determinant-specific theory-driven change methods if behavior change is to occur.