Duncan Shrewsbury

Department: College of Social Sciences and International Studies
Discipline: Education
Research Centre/Unit: Graduate School of Education

Project Summary

Background:

Dyslexia is the most common Specific Learning Difficulty (SpLD), with an estimated prevalence of about 6% of the global population (Miles, 2004). Within medical education, the numbers of students and trainees disclosing a diagnosis is steadily rising internationally (Hafferty & Gibson, 2001; Shrewsbury, 2011; Gibson & Leinster, 2011). Debate surrounding the fitness to practice, support and provision of reasonable adjustments for medical trainees with SpLD has existed for several decades, but claims remain anecdotal, unevidenced and unsubstantiated (e.g.: Guyer, 1988; Little, 1999; Rosebraugh, 2000). Current practice, with regard to supporting medical trainees with dyslexia, is mostly based on guidance informed by law, or from consensus opinion (e.g. JCQ, 2011; GMC, 2008).

Researchers from professions allied to medicine, such as nursing, have investigated aspects of the impact that dyslexia has on the learning experience and task-specific performance of students on clinical placement.  However, the nature and extent to which dyslexia impacts on the training and practice of doctors remains beyond our understanding.

With diversity of the medical workforce widening, to reflect that of the population it serves, it is vital that the nature of protected characteristics, such as SpLD, are better understood. Within the context of the healthcare profession, the practice of learner support must be defensible by policy and evidence. This is pertinent to the provision of training, as well as maintaining the standards of the service delivery. There is a call for research to fill this knowledge gap. Therefore, this proposal is for a programme of exploratory research, intended to develop understanding of the ways dyslexia affects trainee doctors, their learning and their practice.

 

Research Objectives:

This project aims to answer the following questions:

1). What learning strategies do trainee doctors with dyslexia use in their training, and how do these compare with their non-dyslexic peers?

2). How do trainee doctors with dyslexia cope with their learning difficulties compared to non-dyslexic peers?

3). What are the perceived occupational issues of doctors having dyslexia?

The objectives of the research are to develop a greater understanding of the ways in which dyslexia impacts on the learning experience, performance and practice of trainee doctors. By developing a more solid understanding of this impact on trainee doctors, practice and policy development can be informed to better support widened participation and inclusive access to opportunities within the medical profession. Moreover, by anticipating what dyslexic trainees may struggle with, educational and supportive measures can be put in place to minimise the risks to patient safety and comprise of good clinical care.

 

Methodology:

Theories of adult education reflect that individuals have a tendency to be self- motivated and directed towards their learning, bring valuable experience to the process, and that they have a need for respect, safety and enjoyment from the experience (e.g.: Brookfield, 1986; Maslow, 1943). Medical education is thought to embody learning processes influenced by role modelling, adult learning theory and the cognitive apprenticeship model (e.g.: Stalmeijer et al., 2009; Woolley & Jarvis, 2007). Combining these tenets with attribution theory (Weiner, 1976; 1980) and self-efficacy theory (Bandura, 1977), it will be possible to construct a relationship between learners’ experiences, the outcome of their efforts, characteristics of their dyslexia, and the educational environment.

This project proposes a qualitative enquiry into the intricacies of trainee doctors and their learning difficulties. A combination of interviews and focus groups will be used to gather data. These data will be subject to a Grounded Theory analysis (Glaser & Strauss, 1967; Corbin & Strauss, 2008), complemented by a Framework Analysis (Ritchie & Spencer, 1994) informed by attribution and self-efficacy theories.

Supervisory Team

My primary supervisors are:

  • Professor Brahm Norwich (Graduate School of Education, Exeter)
  • Professor Jane Seale (Graduate School of Education, Exeter)

Co-supervisor:

  • Dr Julian Archer (Director: Collaboration for the Advancement in Medical Education Research & Assessment, Plymouth University)

Wider Research Interests

Current (non-EdD) Research Projects: - Medical students, dyslexia and prescribing: exloring constructs and challenges (funded by an ASME small grant) - Exploration of issues surrounding the inclusion and support of junior doctors with dyslexia in the GPVTS (funded by the RCGP Scientific Foundation Board) - Comparison of international issues and practice around inclusion and support of students with SpLD in undergraduate medical degree programmes (funded by the Sir Arthur Thomson Charitable Trust) Projects