Dominique Waterval, Ph.D. (D.G.J.)

COPY BUT NOT PASTE An exploration of crossborder medical curriculum partnerships

Goal: Introduction
Crossborder curriculum partnerships are a growing form of internationalisation in higher education in the medical domain. In a crossborder curriculum partnership, a curriculum developed in one institution (the home institution) is transferred across borders and implemented in another institution (the host institution). The partners offer their curriculum simultaneously and aim to provide comparable learning experiences to both groups of students. This definition includes partnerships that award the same degree to students in both locations, as well as host institutions that issue their own degree. 
These partnerships are challenging from a pedagogical perspective, because their purpose is to ensure that the curriculum in the host institution is as similar as possible to the curriculum in the home institution, despite differences in teaching and learning, resources, the organisational environment and cultural values. The partners seek to strike a balance between standardisation on the one hand – to ensure that the learning experience is close to identical – and adaptation on the other hand – to respect the aforementioned local factors as much as possible. 
These pedagogical challenges have largely been ignored in the literature. The lack of research on crossboder curriculum partnerships in the medical domain have raised the following three research questions: What are the main challenges when establishing and maintaining a crossborder medical curriculum partnership? How do crossborder medical curriculum partnerships balance standardisation and adaptation? What are the strategies for establishing and maintaining a sustainable crossborder medical curriculum partnership?

Methods
This doctoral report consists of a series of five studies that build upon each other and investigate medical crossborder curriculum partnerships from five different angles e.g. a narrative literature review of the challenges, interviews with medical programme directors of host and home institutions, a Q-study to capture the experiences and perceptions of host teachers, a survey among host students, and a case study from a home institution perceptive. In addition, the studies include multiple partnerships in order to identify case-exceeding factors.

Results
This thesis report shows the logistic complexity and educational challenges to establish a crossborder curriculum partnership. It reveals the additional challenges medical curriculum partnerships face such as organising comparable learning experiences in the clinical phase. Nevertheless, they seem feasible not the least due to host students’ flexibility to adapt to the home institutional didactical model. 
Delivering standardised programs was not the aim of partners, although stakeholders indicated many similarities in medical content. In practice, different types of adaptations of the programme were made by host teachers to bridge contextual differences. 

Discussion & Conclusions
As these partnerships are expected to grow in the medical domain as well, this study aims to be of guidance by practical tips and to well-intentioned leaders and programme directors who are on the verge of establishing similar types of partnerships. 
Furthermore, it touches upon a debate on whether this form of internationalisation is desirable in the first place by looking at a number of ethical arguments, e.g. brain drain, dangers of ethnocentricity. By doing so, it opens a discussion on how partnerships could be organised.

• Waterval, D. G. J., Frambach, J. M., Driessen, E. W., & Scherpbier, A. J. J. A. (2015). Copy but Not Paste: A Literature Review of Crossborder Curriculum Partnerships. Journal of Studies in International Education, 19(1), 65-85. https://doi.org/10.1177/1028315314533608

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• Waterval, D. G. J., Frambach, J. M., Oudkerk Pool, A., Driessen, E. W., & Scherpbier, A. J. J. A. (2016). An exploration of crossborder medical curriculum partnerships: Balancing curriculum equivalence and local adaptation. Medical Teacher, 38(3), 255-262. https://doi.org/10.3109/0142159X.2015.1019439

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• Waterval, D., Tinnemans-Adriaanse, M., Meziani, M., Driessen, E., Scherpbier, A., Mazrou, A., & Frambach, J. (2017). Exporting a Student-Centered Curriculum: A Home Institution's Perspective. Journal of Studies in International Education, 21(3), 278-290. https://doi.org/10.1177/1028315317697542

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Accepted for publication: Waterval DGJ, Frambach JM, Driessen EW, Muijtjens A, Scherpbier AJJA. Connected, attracted, and concerned: A Q study on medical crossborder curriculum partnerships. Medical Teacher. 2018. DOI: 10.1080/0142159X.2018.1431618

Accepted for publication: Waterval DGJ, Driessen EW, Scherpbier AJJA, Frambach JM. Twelve tips for crossborder curriculum partnerships in medical education. Medical Teacher. 2018.

DOI: 10.1080/0142159X.2018.1429585