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King's Undergraduate Medical Education in the Community

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King's Undergraduate Medical Education in the Community King’s Undergraduate Medical Education in the Community Evaluation Report – Executive Summary 1 KUMEC – The Community Campus 2013-14 INTRODUCTION The KUMEC Team, as the King’s College London School of Medicine Community Campus provides supports and promotes medical education in community contexts. This is implemented through fostering learning opportunities with and for patients, students and community teachers. We are all working towards the preparation of caring and well trained doctors. The KUMEC central team is part of the King’s College London Department of Primary Care and Public Health Sciences; is housed on the Guy’s Campus; and consists of administrative (5.6 FTE) and academic (6.4 FTE) staff. Many of the academic staff also have NHS clinical commitments. The central team leads on the development and delivery of undergraduate medical education in primary care to our 2,000+ King’s medical students. The KUMEC community teaching network that delivers the teaching is made up of approximately 600 teachers, 310 teaching practices (general practices) and 30 community-based student learning centres where seminars take place. Teaching practices are mostly situated in south-east London but a significant proportion, mainly those who teach students on the final year eight-week placement, can be found in south-east England and other parts of the UK. One-to-one and small group teaching allows good supervision, support and honest and insightful feedback, mirroring the doctor-patient relationship. The KUMEC team and network teaches 195,000 student hours each year and we teach in each year of the curriculum. In Years 1 and 2 we focus on why patients attend the GP, the consultation, health and illness, and chronic illness and the health care team; in Phase 3 the clinical examination and patient-centred care; in Phase 4 the longitudinal pregnancy study and health promotion; and in Phase 5 an eight-week apprenticeship in general practice and the community. We also run a number of 12-day student selected components that cover all kinds of community-based health related topics ranging from the impact of sickle cell on families, to early literacy, health care in Cuba, smoking cessation, prison health care, community care of older people and ‘the good doctor’. Teacher development is key to our success and a full programme of support, briefing and training events is organised through KUMEC. In addition all teachers, particularly those that are just starting out, are encouraged to complete the two day ‘Introduction to Teaching in Primary Care’ course run jointly by the London Deanery and the London Medical Schools. The KUMEC programme is robustly evaluated by students and teachers and, based on that information, continually updated. We also have a system of practice visits for quality assurance and we take great pride in delivering a strongly student- and patient-centred programme of community- focused teaching and learning. The past year has gone well and we have continued to place our students in the community in all years of the curriculum and provide supporting sessions centrally as part of their primary care programme. We have brought in a number of new teachers, some of whom now teach on-campus, as well as provide ongoing teacher briefing and training events and a number of visits to existing teaching practices. 2 A new King’s undergraduate medical curriculum is being developed to start, for Year 1, in 2016. This is in response to the changing needs of patients and the public with more people living with multiple long-term conditions; the advance of technology transforming clinical relationships; advances in genomics and personalised care; and the drive for an integrated approach delivering whole-person care closer to home. We are also wanting to focus on medical students and in developing their resilience and professionalism as well as improving population health. The new curriculum will be divided into three stages: Foundations of Medicine (Year 1); Principals of Clinical Practice (Years 2 and 3); and Integrated Clinical practice (Years 4 and 5). There will be a focus in the early years on scenario-based teaching and integrating clinical and biomedical sciences. Assessment will be stream-lined with some years having formative assessment only and other years having summative assessments, and the final year assessment will be brought forward to allow the students time to focus on the transition to becoming an F1 doctor. Planning the details is in in the early stages. In the last year we have continued to respond to repeated challenges reported in the National Students’ Survey, with our focus on providing excellent administrative support and improving the feedback that we give our students by engaging with our teachers to help students feel that they belong; signposting feedback to our students; encouraging students to ask for feedback; and reminding students them that our primary care teaching practices are part of King’s College London. Each year, in introductory sessions we also let students know what we have done to address the evaluations they have made of our programme. KUMEC staff are heavily involved in Medical School initiatives. This includes Anne Stephenson who is sub-Dean for Student Support, leads on professionalism for the School and is a senior clinical adviser; Ann Wylie who is part of the School global health initiative and leads on Phase 4 SSCs within the School; Ruth Sugden who deputises for the School Phase 5 Lead and leads on the Phase 5 programme for re-sit and struggling students; and Russell Hearn who is now Deputy Lead for Phase 3. Kerry Boardman and others in the team have leadership roles in the development of the new curriculum. Maria Elliott has developed professionalism symposia for Year 1 and Phases 3 and 5. Kay Leedham-Green is doing research into the literacy and reflective capabilities of our Year 1 students. Tina Challacombe who for many years has been part of our team as Teacher Support Lead, has retired this year and we are very grateful for her wise counsel and hard work. Tasnim Patel is now a permanent member of our team as Research & Teacher Development Administrator I would once again like to thank the KUMEC team, especially the administrators, who work tirelessly and with considerable expertise and enthusiasm both for primary care teaching, for the Medical School, and for medical education nationally and internationally. Dr Anne Stephenson, Director of Community Education, December 2014 3 Members of the Central KUMEC Team for the Academic Year 2013-2014 Anne Stephenson Senior Clinical Lecturer, Director of Community Education, Deputy Dean for Student Support, Senior Clinical Advisor and Professionalism Lead for the School Ann Wylie Deputy Director and Senior Teaching Fellow: KUMEC Phase 4 Lead, SSC and Health Promotion Lead and SSC Phase 4 Deputy Lead for the School Kay Leedham-Green Teaching Fellow: Year 1 and 2 KUMEC Lead Russell Hearn Teaching Fellow: Phases 3 KUMEC Lead and Phase 3 Deputy-Lead for the School Ruth Sugden Senior Teaching Fellow; Phase 5 KUMEC Lead and Phase 5 Deputy-Lead for the School Kerry Boardman Senior Teaching Fellow; Teacher Development Lead Rini Paul Senior GP Tutor; Phase 5 KUMEC Assistant Sandra Roscoe Senior GP Tutor: Phase 3 and 4 KUMEC Assistant (until 31 July 2014) Maria Elliott Senior Teaching Fellow; Professionalism and Teacher Training Roles within the KUMEC team Tina Challacombe Honorary Senior Teaching Fellow; Community Teacher Support Lead for KUMEC (until 30 September 2014) 4 Simon Power KUMEC Manager, Phases 3 and 4 KUMEC Administrator Anna Quinn Years 1 and 2 KUMEC Administrator Monica Martin Phase 5 KUMEC Administrator Lorraine Thompson Finance Administrator for KUMEC Aysegul Cakir Database Developer for KUMEC Tasnim Patel Research & Teacher Development Administrator 5 YEAR 1: EXPLORING MEDICINE IN THE COMMUNITY Executive Summary This year KUMEC placed 364 students for four visits at 41 practices. Students interviewed patients, observed consultations, and went on two home visits. They attended four seminars, a lecture on general practice, and a symposium on long-term conditions, giving an assessed presentation at their final seminar. The course continues to be highly valued by students, with a majority of students providing strongly positive feedback: “Both Dr S and Dr B were encouraging, knowledgeable, and helpful in providing feedback. My most valuable experience of the year.” MBBS1 student Word cloud of all feedback: However satisfaction relating to placements is lower in some areas than last year which we attribute to a higher proportion of students being placed in trios rather than pairs. The number of teaching practices continues to fall putting greater pressure on existing practices to take more students than they might comfortably accommodate. Equivocal feedback tended to relate to travelling time and to GP teachers that did not adhere to the suggested session content. Poor feedback tended to relate to cancelled sessions, too many students at one practice, unprepared teachers, or insufficient patients for students to talk to. Changes since last year include: • A clarified, simplified KUMEC handbook • A new slide set for seminars • An observed written task was piloted 6 YEAR 2: ACCESS TO HEALTHCARE AND THE MEDICAL HISTORY Executive Summary This year KUMEC placed 405 students for two visits in 38 practices. Students attended two symposia, one on eliciting a medical history, one on access to healthcare, and four seminars centred on practising eliciting a medical history through role play, and access to healthcare. Students developed the skill of eliciting a medical history and critically analysed the care of vulnerable patient groups and their access to healthcare issues. The course continues to be highly value by students, with the majority of students providing strongly positive feedback: “Wonderful practice, helpful staff and overall feel it has been a real benefit to my education” MBBS2 student Word cloud of all feedback: Equivocal feedback tended to relate to travelling time, lack of opportunity to speak to appropriately chosen patients, or GPs that did not adhere to the learning objectives.
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