BMJ Learning

How to set up a course: an up to date guide

د. حسين محمد جمعة
اختصاصي الامراض الباطنة
البورد العربي
كلية طب الموصل
2010

Have you ever thought about setting up a medical course? Do you have the drive to share your knowledge and skills with a wide range of people? Ben Turney and Rick Harrison provide an essential guide to getting started.
Learning outcomes
After completing this module you should appreciate:
Why you might want to organise a course
How to plan and prepare your course
How to run the course on the day
How to handle problems and avoid pitfalls.

About the authors

Ben Turney is a research registrar in urology at the Weatherall Institute of Molecular Medicine in Oxford, and lecturer in anatomy at Balliol College, Oxford University.
Rick Harrison is a GP trainee in Windsor, Berkshire with an interest in information technology.
Both have an interest in medical education. They have organised several courses and have worked with others to run courses in Oxford.


Why we wrote this module
"Training in medicine and surgery is shorter than it used to be, so it is not surprising that the concentrated teaching available on courses is becoming more popular.
Courses help doctors meet their learning needs and keep up to date.
It's important that courses are tailored to the needs of the attendees so they get maximum benefit.

We have organised several courses in different areas over the last few years and, mainly through trial and error, we have developed and improved these courses. Here we offer some practical guidance based on our experience. Any course will have its own special features but there are some underlying principles that will ease the organisation of any course.
"Although organising a one off course can be difficult and time consuming, it can also be enjoyable."

Read

Courses are an integral part of medical and surgical training and are an important way for fully trained doctors to maintain their skills and knowledge.
Courses have many advantages for both teachers and learners:
Learners benefit from a concentrated and dedicated period of teaching with experts that they may not otherwise have come into contact with in their daily practice
Teachers have a chance to share their knowledge with interested colleagues and trainees.

Teaching is a good way of learning, and teaching a course can provide an opportunity to explore gaps in your knowledge and then to fill these gaps.
The interaction between teacher and learner can generate ideas for further research and it also allows the teacher to improve their techniques of teaching and presentation.
Organising a successful course reflects well on the teachers and organisers, and will enhance local, national, or even international reputations. You can also put your experiences of teaching on your CV.

Will people come to your course?

The first thing to ask yourself is whether there is a real need for your proposed course. Who is it meant to appeal to, and will they be willing to spend their precious time and money on it?
Although you may find an obscure subject interesting, there is no point running a course that hardly anyone wants to go to. It can be embarrassing to have more teachers than learners on your course.


There are many reasons why people attend courses. The most common ones are to gain accreditation (for example, all surgical SHOs must go on a course on basic surgical skills) or to improve a learner's chance of clearing a hurdle in their career (such as passing an exam or getting a job at an interview). Other reasons why people go on courses are:
To get continuous professional development points
To enhance their CV (for example, by demonstrating their competency in a certain area)

Peer pressure (for example, their manager may advise them to go on a course on information technology).
The best reason to go to a course is because you are interested in the topic or because you think the course will help you fulfil a learning need.

Costs of setting up a course

First, you should consider money. Costs include the:
Venue
Catering
Advertising
Teacher and speaker fees
General administration.

These are variable depending on the facilities available to you. For example, organising a course in hospital lecture theatres with hospital catering will be very different from hosting a course in a conference centre with outside professional caterers.
You must anticipate the expectations of your target audience and what they are prepared to pay to come on a course. You can establish the cost per head for catering in advance and calculate the cost per head for the venue.

Perhaps the most expensive ingredient of a new course is advertising. To advertise in a widely read journal, such as the BMJ, will cost about £200 to £500 per advert, per week, depending on the size of the advert. Sending out a mailshot will cost less than £1 per addressee, which takes into account the paper, envelope, labels, printing, postage, and administration.

In the worst case scenario, you could pay for advertising and not attract any attendees. The size of your start up funds will determine whether you are able to cover this potential risk. You need to decide whether you can accept an initial loss and hope that numbers will grow next time.


Occasionally a course will attract lots of learners from the start, but you should be prepared to start small and build up. You should accept that you may lose some money on your first few courses.
Calculating costs is a bit of a juggling act.
Estimate how much you think you can charge for the course based on similar courses available or your own experience of attending courses

Then calculate the total costs of the venue, catering, teacher fees, advertising, and general administration
Finally, work out how many people you need to come to cover your costs
Be realistic and cautious. Is this achievable? If not, adjust the course price or reduce your costs until the numbers balance. Start small and expand if things go well.

Numbers

How many people do you want on your course? This will depend on the format and the subject that you're dealing with. If the course is lecture based it might be possible to have a large number of learners without compromising the quality of the course. But courses involving practical skills or interactive sessions thrive on smaller groups.

Time is an obvious constraint on a course. Clear objectives need to be set for small group sessions, which usually require a facilitator to guide the learners to make optimum use of their time and to provide feedback at the end of the session.
You should stick to your planned numbers even if you are oversubscribed. Limits such as room size and catering facilities can be a restraint but, more importantly, increasing numbers dilutes the teaching and may compromise the quality of your course.

Word of mouth is important advertising and if the quality is compromised it will create bad publicity. In addition, it reflects well on your course if there is a waiting list; people may be more likely to book early in future and this makes planning easier for subsequent courses. If you are oversubscribed, consider offering more places on the next course having adjusted the teacher levels appropriately. Establishing a maximum number is important when calculating the fee.

Teachers

Getting a good team of teachers is vital to the success of your course. The profile of your teachers depends mainly on your target audience. If you are trying to attract a local audience and educate them about local practice, then you will want local speakers. For a course on an exam, national experts with experience as examiners will be better.
Depending on the format and content of your course a mixture of keynote speakers, teachers, and facilitators can be useful. Keynote speakers add credibility and look impressive on advertising, but often demand large fees and may not necessarily be the best teachers.

A pool of speakers

If you intend to run the course regularly, consider developing a pool of speakers. Many members of your pool may be reluctant to commit to a two day or three day course more than once a year. Having a large pool of potential speakers spreads the load and reduces the individual commitment needed.
But make it clear from the start that you won't invite them all every year. If you don't point this out, they may worry that no invitation amounts to a vote of no confidence in their last performance.


Recruiting and confirming speakers can be one of the most difficult parts of course organising. Establishing who is available and when can lead to difficulties in organising and reorganising a timetable. Doctors are generally overbooked and all have other commitments. A pool of speakers can make this easier in that you do not have to revolve around one person's timetable.

When deciding who to recruit, focus on who is regarded to be good at teaching the subject. In our experience by talking to students, junior doctors, and consultants it quickly becomes clear who are the best people for the job. It also helps if they are well known (locally or nationally) because this will add credibility to your advertising. Interestingly, we have found that these are often the same people.
Make life easy for your speakers. Try to arrange parking for them and offer to pay the costs of their travel and accommodation. Depending on who and how you recruit your speakers determines the financial outlay. If you recruit outsiders you should expect to pay higher fees.

The exact amount will depend on their seniority and level of expertise. The only way to broach this is to ask directly what their fee will be. This can be awkward because most medical people are not used to it. On the other hand, if you recruit locally among colleagues and peers then often they will become involved without an honorarium or in exchange for your participation in something else.

Brief your speakers

It's always best to let your speakers know broadly what you want them to cover in their presentation (to avoid significant overlap between teachers) and how long they have to speak or teach.
Be sure to let them know what methods of presentation you have available. It is worth getting hold of the teachers' presentations several weeks before the course by email or by a posted CD (if the presentation is too big).

You can then load the presentations onto a single computer in good time. This also allows you to check that they are going to talk about what you agreed.
Trust your teachers; if you have chosen the right people they will adopt the style with which they are comfortable and successful.

Format of the presentation

Find out what your speakers need: many will assume you have the necessary equipment.
While most presenters these days use PowerPoint, some may still want to use overhead projectors. You can (and probably should) insist that all presentations are given in a specific format and that only computer presentations are allowed. It is increasingly difficult to find conventional projectors for acetate slides and most presenters will find it very difficult to tell the audience what is on the slides if the projector breaks down.

Timing

The time of year that you organise a course is important. You should avoid dates that clash with other well established courses. If you are using accommodation at a university, your course will have to be organised outside of term. You'll also have to consider the schedules of your potential attendees (dates of exams, school holidays, religious ceremonies).
You will need plenty of notice to organise tutors and advertising. For the various courses that we have run we have approached potential teachers at least six months in advance.


Administration
Running a medical course can involve considerable administration. As the course organiser, you will be responsible for communicating with the attendees and the teachers. You could, of course, appoint a dedicated course organiser (for example, a secretary or a willing junior doctor).
Try to anticipate administrative problems, rather than get caught up in tiresome troubleshooting. We have found that we can reduce administration problems by the following measures.

Website

A course website can be an invaluable source of information. Potential learners can find out information at their convenience. In basic terms you will need to provide information about:
The timetable Course content - what will be covered and in what format Speakers, dates, and location(s) (including maps)
Cost
Transport availability
Accommodation details
How to communicate with the course organisers (telephone, fax, and email details).
You can update your website to answer common problems or questions.

A website can also:

Reduce the amount of detail needed in adverts (making them cheaper)
Eliminate the need for letters
Enable learners to pay online (which eases the administration surrounding payment and receipts)
Allow feedback forms to be sent electronically after the course.We have considered publishing a list of attendees with, or without, contact details on the website, but there are issues with data protection, privacy, and security.
The website doesn't have to be professional, but it does need to convey the information clearly and concisely and needs to be kept up to date.

Advertising

This is key to any successful course, but it can be difficult to get right. There is a temptation to spend a lot of money on advertising, and if the initial response is low you may be tempted to spend even more in a desperate attempt to boost recruitment.
Try to put yourself in the situation of your target audience and think about where you would look for a course or what would encourage you to go on it. You need to time the advertising just right. You may miss the boat if you advertise in a monthly journal one month before your intended course date: no one will have had time to organise leave or to apply for study leave. Consider advertising at least three to six months in advance.


Medical journals
Advertising revenue is an important source of income for medical and surgical journals, and in our experience placing an advertisement is simple. You can easily find phone numbers and email addresses in copies of the journals you want to advertise in.
The cost varies depending on the size of the readership and the policy of the individual journal. Some allow small free adverts to advertise forthcoming courses and events, whereas others charge hundreds of pounds for a small advert.

Mailshots

Another method of recruitment is the personal mailshot. This is a relatively cheap way of letting people know about your course. There is obviously a limit to the number of letters you can send, and this method will be suitable only for specialties with relatively small numbers of doctors (where the target audience is small).
This targeted method of advertising does have a personal touch.

The costs are usually between 50p and £1 per mailshot, depending on the quality of the stationery and printing. The problems with the mailshot approach are it relies on you knowing the addresses of your target audience and, as a rule of thumb, only 1 in 10 mailshot recipients will come on the course, at best.

Once your advertising is arranged you will enter a period of nervous waiting. Nothing will happen for weeks. Remember, it takes time for your learners to organise study leave, get funding, and apply for the course.

Information packs and the application

If your information pack is not on a website, learners should be able to get hold of one by phone, fax, email, or post. When you expect small numbers of applicants, they can request the pack by phone or email. They can then return the information pack by email.

If you opt for the conventional approach where applicants send for an information pack, you will need to carefully design the information pack and the application form to ensure that you collect all the information you need. It is frustrating if you don't know how many vegetarians are coming or how many will be attending the course dinner until the morning of the course.

On the application form ensure the following details are included:

Full name and contact details (phone, mobile, email)
Dietary requirements
Accommodation requirements
Attendance at optional social events in the course (such as a course dinner)
Feedback on your advertising (for example, ask "where did you hear about this course?")


Accommodation
For courses lasting more than a day, you will need to arrange accommodation for learners. You can include the cost of this in the registration fee, with an appropriate reduction for those who live locally or who decide to travel to the course every day.
Alternatively, you could give attendees a list of suitable hotels or college accommodation, and they could make arrangements themselves.

However, splitting people up across several sites does reduce the opportunities for socialising in the evening, which is one of the highlights of a course.
University accommodation is generally far cheaper than hotels. Some universities and colleges require deposits for accommodation bookings, but because the overall cost of rooms is generally low, your financial losses will be relatively low if you are unable to fill all places on the course.

Cost and payment

Are you looking to make a profit? When deciding the fee, consider the number of people attending and set that against the fees for teachers, costs of catering, costs of the venue, advertising costs, and the costs of support services and administration. Be prepared to make a loss on your first course.

We have organised several courses now and although encouraged by the thought of future profits we have had mixed success to date.
If you are thinking of running further courses remember to keep a float for advertising the next one. Costs such as advertising and administration are paid in advance of the course, so keep enough to set up the next course.

Even small courses may have high turnovers. You will have to process subscriptions and payments; you will almost certainly need a bank account for this. For ease of organisation it is easier if this is separate from other accounts. Most banks will allow you to open "treasurers" accounts, but if you're running the courses for a profit then you'll need a proper business account, you'll need to register as a company with Companies House, and to produce annual formal accounts. Remember to keep all receipts of incomings and outgoings.

Collecting subscriptions

The standard way to take payments is by cheque. The disadvantage of this is increased administration; they have to be banked and there is a delay in processing.
Online payment is convenient for the applicant and the organiser. The applicant can apply day or night via the internet, receive immediate automatic confirmation of a place on the course by email, and the details can be automatically updated into a list of attendees that can be viewed online.

Should refunds be necessary you can do this easily via electronic banking. There are several companies that run online banking services. They all charge a commission, annual subscription, or both, and charge a premium for credit card payments, but you can pass the premium on to the customer.
If you run more than one course, you can process all payments through one subscription.


Catering
You need to organise this well in advance. Catering arrangements will depend to a certain degree on the venue for the course. If you are running the course in a hospital or university, the relevant catering department of that organisation will usually be very happy to provide food for lunches and coffee and biscuits for breaks. Alternatively, you can use outside caterers. Your caterer, whether internal or external, will usually provide a selection of menus.

Support services

You need to identify who will provide support services, such as answering phone enquiries and replying to emails. Technology can help here: answerphone messages can be forwarded to an email address, and standard emails to all attendees at set intervals before the course can reduce the number of routine enquiries.
Email is best because you can respond at the organisers' convenience. However, people still like to have a personal contact.

Whatever you do there will be problems with refunds and cancellations, accommodation requests, parking questions, and so on. Someone will have to deal with these. If it isn't you then you must identify someone to do it, and determine how much will you need to pay them to do these tasks. You will have to build this into your budgeting.

On the day

The first day of your course is stressful but exciting.
Staffing
Try to find one or two people who are not teaching on the course to keep things running smoothly. They can look after the registration process and supervise catering arrangements while the teachers concentrate on teaching.

Registration

Efficient registration provides an air of professionalism and saves time later on. You can check dietary requirements and also give out name badges, maps, and programmes. Remember to organise refreshments for the registration period. This provides an opportunity for people to chat over a cup of coffee before the course starts.

Audiovisual equipment

Check your audiovisual equipment several days before the course. Ideally there should be backup equipment available (for example, two computers and two digital projectors).

The list of potential problems with equipment is long, but includes:

Incompatible hardware or software
Security (for example locked doors and password protected equipment)
Insufficient power or extension leads
Projector bulb failure
Microphones, amplifier, and speakers malfunctioning.
Most of these can be rectified by checking things through in advance.


Summary
Organising a medical course requires effort, determination, and a lot of time, but it can provide an enormous sense of achievement. There is an administrative hurdle in initiating a course, but once this has been jumped things become easier. We have found that using modern technology can significantly reduce the ongoing administrative burden.
We have organised courses in areas in which we have experience and expertise.

Our basis for organising a course is that we feel it is an important topic that people need to know about. Often the courses provide information about areas that are not covered well (if at all) in training.
Organising a course creates a good team spirit that improves ongoing working relationships and offers an opportunity to share and develop ideas for implementation into day to day working practices, research, and further teaching.

Reflect

How to reflect
Reflecting isn't just about closing your eyes and having a think. To really reflect you should ask yourself these questions:
What do I think this learning module was about?
Can I apply it in my work?
What barriers am I likely to come across?
How will I manage these barriers?
How will I know if I'm doing things better?

To help consolidate your learning from this module, work through these questions and answers.
At the end of a course one of the delegates complains that he did not get much from the course, and that it didn't cover the topics he expected. What should you do?
Try to avoid this happening in the first place. Make sure your advertising and information is accurate and realistic. Try to include some examples of content, such as an accurate timetable with named speakers, so that people don't come with false hopes.

Explain in your advertising what you are going to cover, how you will present the content, and why you are doing it in that way. Reiterate this information at the start of the course. If you have a website consider photographs of previous courses to give an impression of what the learners can expect.


If you do get an unsatisfied delegate, you must listen to them and apologise. It can be difficult to accept that your course (which you spent hours organising) is being criticised. Try to offer additional help to meet the delegate's expectations, such as links to useful websites, handouts of lecture material, or the opportunity to talk to the speakers

Consider a refund if you think the complaint is justified and implement changes in the design of your next course.
You ask a journal to publish your advert and agree a price. The journal prints some of the details incorrectly. What should you do?
Check that it was the journal that made the mistake and not you. Contact the journal immediately and explain what has happened with evidence that they made the error. Depending on the nature of the error you should be able to get a refund or ask for the correct version to be published in the next journal for a discount or for free.

Mistakes do happen, and this emphasises the importance of early advertising.

A speaker drops out at short notice. What should you do?
Try to prevent this happening by organising speakers many months in advance and sending reminders as the big day approaches. Try to build up a bank of speakers so you have options if people can't make it.

If the course is in your subject, consider not timetabling yourself as a speaker so you can fill the gap if someone drops out. Always request speakers' presentations in advance so if someone fails to turn up you or a colleague has something to work with on the day.

What should you do if only a few people apply for your course?

Try to identify why this is the case. It could be due to several factors:
Content - is there a need for your course?
Cost - is your course too expensive?
Timing - does your course clash with other established courses?
Advertising - has your advertising been effective, will enough people have seen it, can you afford more?

Once you have reviewed this you must decide whether to:

Cancel the course and organise a full refund for those that booked
Spend more on advertising (if there is still time)
Continue with the course, at a loss, and hope that you develop a good reputation or improve your recruitment in future.
Which option you choose will depend on your financial situation, and how much you really believe in your course.