Saran Santhosh
Medical education is an integral part of clinical practice, yet clinicians often receive limited formal training in how to teach effectively. While clinical expertise provides the foundation for teaching, understanding how students learn is equally important.
Having completed a Postgraduate Certificate (PGCert) in Clinical Education alongside my role as a Clinical Teaching Fellow, I have developed a greater understanding of educational theory and its practical applications.
In this article, I reflect on my experience of undertaking the PGCert, explore how I have applied its principles to undergraduate ophthalmology teaching, and consider the value and limitations of the qualification.
What is a PGCert in Clinical Education?
A PGCert in Clinical Education is a postgraduate qualification designed to develop the knowledge and skills of healthcare professionals involved in teaching and training. Typically comprising 60 credits at master’s level, programmes cover topics such as educational theory, curriculum design, teaching methods, assessment, feedback and reflective practice.
Although course structures vary between universities, the overarching aim is to equip clinicians with an informed approach to education. Many programmes are delivered part-time, allowing healthcare professionals to undertake the qualification alongside their clinical responsibilities. A PGCert can also provide a foundation for further postgraduate study, including a Postgraduate Diploma or Master’s degree in Medical Education.
Planning a Teaching Session
One of the most valuable lessons from undertaking a PGCert is the importance of designing teaching around intended learning outcomes rather than simply delivering content.
Biggs’ concept of constructive alignment emphasises the importance of aligning learning outcomes, teaching activities and assessment methods (1).
For example, when designing a session on direct ophthalmoscopy, I began by establishing the intended learning outcomes. I then selected teaching activities that would support students in achieving these outcomes, incorporating practical demonstrations and supervised practice. Finally, I designed a formative assessment to evaluate whether students had acquired the intended skills.
This structured approach ensures that teaching activities are purposeful and that assessment measures what students are expected to learn.
Optimising Teaching
Another valuable concept I learned through the PGCert was cognitive load theory, which recognises the limited capacity of working memory when processing new information (2).
Cognitive load has traditionally been divided into three categories: intrinsic load, determined by the complexity of the material and the learner’s prior knowledge; extraneous load, generated by how information is presented; and germane load, associated with the cognitive processes involved in constructing and refining knowledge.
The aim is to manage intrinsic load, minimise unnecessary extraneous load and support the cognitive processes that contribute to meaningful learning.
Studying this theory has made me more conscious of the volume and complexity of information I deliver during teaching sessions.
This is particularly relevant to undergraduate ophthalmology, where students encounter unfamiliar terminology, specialised examination techniques and a broad range of conditions within a relatively short placement.
Consequently, I have become more selective about the depth and breadth of information I include in teaching sessions, recognising that providing more information does not necessarily translate into better learning. Instead, I aim to strike a balance between delivering sufficient clinical detail and ensuring that students have the opportunity to process and consolidate their understanding.
Designing Educational Resources
Effective teaching depends not only on the content delivered but also on how that content is presented.
Slideshow-based presentations remain a central component of theoretical teaching, making their design an important consideration.
One of the most useful frameworks I encountered during the PGCert was Mayer’s cognitive theory of multimedia learning, which provides a set of principles for combining words and images to support learning (3).
These include the coherence principle, which encourages the removal of unnecessary information; the signalling principle, which highlights essential material; and the redundancy principle, which cautions against presenting identical information simultaneously through narration and extensive on-screen text.
In ophthalmology education, clinical photographs and diagrams play an important role in helping students understand ocular anatomy and recognise pathology. Applying Mayer’s multimedia learning principles has therefore helped me optimise how I present visual information to students, making teaching resources clearer and more accessible.
Is a PGCert Necessary?
Undertaking a PGCert has provided me with a theoretical foundation for planning, delivering and evaluating teaching. Perhaps its greatest benefit has been encouraging me to make more deliberate educational decisions rather than relying solely on intuition or previous experience.
However, I do not believe that a PGCert is essential to becoming an effective clinical educator. Many excellent teachers develop their skills through experience, mentorship and reflective practice. Equally, obtaining a postgraduate qualification does not necessarily guarantee effective teaching.
There are also practical limitations. I was fortunate to have my PGCert fully funded, but tuition fees can be substantial and may present a barrier to clinicians interested in pursuing formal educational training.
Furthermore, much of the course content is theory-based and can occasionally feel detached from the practical realities of contemporary clinical teaching. Experienced educators may also find that some educational frameworks formalise principles they already apply intuitively.
For clinicians interested in developing their understanding of educational theory without undertaking a formal qualification, I would recommend Understanding Medical Education: Evidence, Theory, and Practice (4). This comprehensive textbook provides an accessible introduction to many of the concepts underpinning effective medical education.
Conclusion
Completing a PGCert in Clinical Education has made me more intentional in how I approach teaching. It has provided me with a theoretical framework to inform educational decisions and helped me design more purposeful, learner-centred teaching experiences.
In undergraduate ophthalmology, where teaching time is often limited, applying educational theory to session planning, content selection and resource development can help make teaching more focused and effective.
Ultimately, the value of a PGCert lies not simply in obtaining an additional qualification, but in developing a more thoughtful, reflective and evidence-informed approach to clinical education.
References
1.Biggs J. Enhancing Teaching through Constructive Alignment. Higher education. 1996;32(3):347-64.
2.Sweller J. Cognitive load during problem solving: Effects on learning. Cognitive science. 1988;12(2):257-85.
3.Mayer RE. Multimedia learning. 3rd ed. Cambridge: Cambridge University Press; 2021.
4. Understanding Medical Education: Evidence, Theory, and Practice. 3rd ed. Swanwick T, Forrest K, O’Brien BC, editors. Hoboken: Wiley-Blackwell; 2018.