Translating government policy into practice: how new UK medical schools enact widening participation
Introduction: Increasing the diversity of medical students, or widening participation (WP), is critical for social justice and healthcare delivery, and many governments are setting policies to encourage WP. However, establishing policy is only the first step in an educational change process: we also...
| Main Authors: | , , , |
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| Format: | Journal Article |
| Language: | English |
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2024
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| Online Access: | https://hdl.handle.net/10356/179512 |
| _version_ | 1826116168572731392 |
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| author | Cleland, Jennifer Buxton, Jordan Hughes, Elizabeth Patterson, Fiona |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Cleland, Jennifer Buxton, Jordan Hughes, Elizabeth Patterson, Fiona |
| author_sort | Cleland, Jennifer |
| collection | NTU |
| description | Introduction: Increasing the diversity of medical students, or widening participation (WP), is critical for social justice and healthcare delivery, and many governments are setting policies to encourage WP. However, establishing policy is only the first step in an educational change process: we also need to know "how" policy is enacted or how medical schools interpret and put into practice WP policy. Addressing this gap, the aim of this study was to examine policy enactment in six new UK medical schools with an explicit WP mandate.
Methods: This qualitative study, underpinned by social constructivism, used semi-structured interviews to explore the experiences of key actors (6 Deans and 14 Admissions staff) of putting policy into practice when setting up a new medical school. Data coding and analysis were initially inductive, using thematic analysis. We then applied Ball's theory of policy enactment to organise the data into four contextual dimensions of 'situation', 'professional', 'material' and 'external'.
Results: On the surface, there were many similarities across the six schools in terms of the four dimensions. However, how these dimensions interacted illuminated tensions and differences. For example, some schools found themselves increasingly subjected to local and extra-local rule systems, including pressure to follow host university norms and hosts struggling to accept that medical schools are heavily regulated. There were also tensions between the new medical schools and the medical education "establishment", including lack of power and being judged by overly narrow outcomes.
Discussion: Different contexts seem to influence the enactment of WP to medicine in different places, even in the same country, even in medical schools established at the same time. That policy enactment is a complex, non-linear process of enactment is important to acknowledge: context is critical. Our findings will inform future policies and practices that aim to increase WP in medicine. |
| first_indexed | 2024-10-01T04:06:37Z |
| format | Journal Article |
| id | ntu-10356/179512 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T04:06:37Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | ntu-10356/1795122024-08-11T15:38:03Z Translating government policy into practice: how new UK medical schools enact widening participation Cleland, Jennifer Buxton, Jordan Hughes, Elizabeth Patterson, Fiona Lee Kong Chian School of Medicine (LKCMedicine) Medicine, Health and Life Sciences Medical schools Government policy Introduction: Increasing the diversity of medical students, or widening participation (WP), is critical for social justice and healthcare delivery, and many governments are setting policies to encourage WP. However, establishing policy is only the first step in an educational change process: we also need to know "how" policy is enacted or how medical schools interpret and put into practice WP policy. Addressing this gap, the aim of this study was to examine policy enactment in six new UK medical schools with an explicit WP mandate. Methods: This qualitative study, underpinned by social constructivism, used semi-structured interviews to explore the experiences of key actors (6 Deans and 14 Admissions staff) of putting policy into practice when setting up a new medical school. Data coding and analysis were initially inductive, using thematic analysis. We then applied Ball's theory of policy enactment to organise the data into four contextual dimensions of 'situation', 'professional', 'material' and 'external'. Results: On the surface, there were many similarities across the six schools in terms of the four dimensions. However, how these dimensions interacted illuminated tensions and differences. For example, some schools found themselves increasingly subjected to local and extra-local rule systems, including pressure to follow host university norms and hosts struggling to accept that medical schools are heavily regulated. There were also tensions between the new medical schools and the medical education "establishment", including lack of power and being judged by overly narrow outcomes. Discussion: Different contexts seem to influence the enactment of WP to medicine in different places, even in the same country, even in medical schools established at the same time. That policy enactment is a complex, non-linear process of enactment is important to acknowledge: context is critical. Our findings will inform future policies and practices that aim to increase WP in medicine. Published version Higher Education England (HEE) fundedthis work. 2024-08-06T05:25:36Z 2024-08-06T05:25:36Z 2024 Journal Article Cleland, J., Buxton, J., Hughes, E. & Patterson, F. (2024). Translating government policy into practice: how new UK medical schools enact widening participation. Medical Education, 1-10. https://dx.doi.org/10.1111/medu.15403 0308-0110 https://hdl.handle.net/10356/179512 10.1111/medu.15403 38726561 2-s2.0-85192488650 1 10 en Medical Education © 2024 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. application/pdf |
| spellingShingle | Medicine, Health and Life Sciences Medical schools Government policy Cleland, Jennifer Buxton, Jordan Hughes, Elizabeth Patterson, Fiona Translating government policy into practice: how new UK medical schools enact widening participation |
| title | Translating government policy into practice: how new UK medical schools enact widening participation |
| title_full | Translating government policy into practice: how new UK medical schools enact widening participation |
| title_fullStr | Translating government policy into practice: how new UK medical schools enact widening participation |
| title_full_unstemmed | Translating government policy into practice: how new UK medical schools enact widening participation |
| title_short | Translating government policy into practice: how new UK medical schools enact widening participation |
| title_sort | translating government policy into practice how new uk medical schools enact widening participation |
| topic | Medicine, Health and Life Sciences Medical schools Government policy |
| url | https://hdl.handle.net/10356/179512 |
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