Medical Education Conference for Trainees
Wessex Deanery 7th Annual
Medical Education Conference for Trainees
8th November 2012
‘Aspiring to Excellence’
Podium Presentations
Title: Involving medical students in monitoring patient experience at the John Radcliffe Hospital, Oxford
Author(s): K Collins, H Salisbury, T Kelley, S Shale, M Scarfe
Background: The GMC and NHS recognise the value in learning from patients. The experiences they share with us provide the NHS and its care practitioners, both present and future, with regular opportunities to improve outcomes and performance.
Aims:
1. Improve student awareness of patients’ experiences;
2. Involve students in service improvement;
3. Provide the hospital with benchmark data on patient experience.
Methods: Medical students distributed questionnaires to all acute medical patients, discussed patients’ answers with them, and assessed their AMTS. Students were given the opportunity to be involved in data collation, analysis and feedback to the department.
Results: Three key areas for improvement were identified and specific actions defined to address them. Students listed many insights into life as a patient.
Conclusion / Key Message: Involving students in understanding patient experience can help to achieve excellence for students and hospitals.
Title: Education in Chronic Childhood Ilness: A Single Centre Study of Patient Led Initiatives
Author(s): Haiko Jahn, Julia Antich Duran, Mario Tristan, Orlando Urroz
Background: Chronic childhood illness and high quality education has been closely linked to better outcomes long term. The World Health Organisation (WHO) support an initiative since 2004 where it was concluded that patient safety and education given by the patients themselves is paramount.
Method: A single centre prospective study in Costa Rica. Six illnesses chosen, including, cerebral palsy, leukaemia, cystic fibrosis, diabetes mellitus, epilepsy and spina bifida. Four patients from each group were nominated as patient educators.
Qualitative feedback was taken and analysed in comparison to experiences of illness education from health care professionals.
Results: The facilitation of this project found from qualitative data that there was a greater autonomy and understanding from the patients diagnosed with these conditions in the groups educated by fellow patients diagnosed with the same condition.
Conclusions: To enable high quality patient education with compliance to WHO guidance, a high degree of importance on education between patients themselves should be looked upon at an early stage of illness diagnosis.
Title: A pilot peer-assessed vitual OSCE as exam preparation for final year medical students
Author: Charis Manganis
Abstract: Staging ‘mock’ Objective Structured Clinical Examinations (OSCEs) requires assessors and actors/patients. Consequently, practice for students under exam-like conditions is scarce.
The aim of this pilot was to develop an effective, practicable model for medical student OSCE preparation.
Twelve final-year medical students were invited to participate. In the first half, half students were candidates and half acted as simultaneous assessors/ patients; groups then swapped. Twelve stations were set up, as per the exam. ‘Candidates’ rotated between stations. ‘Assessors’ used scripts of commonly-encountered cases whilst a candidate performed an examination. Images of examination findings were provided.
Feedback was collected after publication of final examination results. All students passed. All reported improved confidence. None reported that acting as assessor/patient was not useful.
A peer-assessed OSCE using virtual cases is a useful tool in OSCE preparation.
This model does not require assessors, actors or patients and can be straightforwardly expanded and offered to large student numbers.
Title: Development of a multi-media peer-to-peer medical education tool – MQ Magazine
Author(s): van Boxel GI, Zenkner A, Watts E, Daley-Morris F, van Duren BH
Abstract: Medical students and Junior Doctors often have difficulty in publishing articles in peer-reviewed journals – a recognised pre-requisite for career development.
The aim was to develop an educational magazine facilitating opportunities for publishing peer-to-peer educational articles.
Contributors gain experience in writing articles and responding to editorial feedback to create a published article in our journal, senior clinician input assuring quality.
We have published 5 issues to date, currently reaching 16 medical schools nationwide through 3500 copies. Furthermore, the on-line journal (www.medquarterly.com) has been accessed in over 40 countries worldwide resulting in article submission from around the globe.
MQ Magazine allows opportunities for medical students and junior doctors to gain exposure and experience in medical publishing. Moreover, it is proving a useful and popular educational tool in terms of its content.
MQ Magazine provides a medium for students and junior clinicians to learn how to prepare, submit and publish a journal article.
Poster presentations
Title: Design, implementation and evaluation of a structured clinical teaching programme for final year medical students delivered by junior doctors
Authors: Albayati MA, Abay J, Hayes MC
Aims: We aimed to develop a structured teaching programme for medical students and evaluate the effectiveness of teaching by junior doctors on the student learning experience.
Methods: A rolling 6-week teaching programme for final-year medical students rotating in surgery at University Hospital Southampton was developed. The programme was designed under the supervision of the Undergraduate-Lead for Surgery and Final-Year-Coordinator, and delivered by FY2-trainees.
Results: Three student cohorts(39-students) were enrolled over a 24-week period. A total of 222(94.8%) end-of-session feedback questionnaires were analysed. 81.1% rated session content as ‘very high’. 78.4% stated that junior doctors delivered teaching comparable to consultant-led teaching and 96.8% reported the programme had a positive influence on their learning. Overall, 83.3% felt better equipped to prepare for Mini-CEX assessments.
Conclusions: Structured teaching delivered by junior doctors has the potential to enhance the student learning experience and improve performance at assessment. Additionally, near-peer teaching may be comparable to conventional consultant-led teaching in this setting and should be encouraged.
Title: Curriculum planning- The importance of feedback
Author(s): Shikha Arora & Asma Khalil
Background: Trainee feedback is a vital part of tailoring learning needs and assessing gaps in the teaching curriculum to ensure satisfaction in training.
Aims: The aim is to achieve trainee satisfaction with the monthly teaching and ensure their learning needs are met.
Methods: A questionnaire titled ‘How can we improve our monthly teaching’ was sent to 75 trainees. 20 responses were collected. Trainees were asked if their educational needs were being met, what topics they need covering, design of each day, and separate days for ST1-2 and ST3-7.
90% of trainees felt their learning objectives were met. A range of topics to suit junior and senior trainees were suggested. A mixture of teaching styles was felt most appropriate. 70% felt that ST1-2 training could be separated from ST3-7; however juniors felt that the joint training days were beneficial too.
Conclusion: Trainee feedback to ensure satisfaction that learning objectives are met and being taught appropriately is instrumental to ensure training needs are met. We continue to collect monthly feedback and suggestions for changes annually to ensure clinical excellence.
Title: Inter-disciplinary teaching: An effective way to improve urology patient care on a general surgical ward.
Authors: Helen Cui, Angela Birnie, Heidi Tempest. Urology Department, Churchill Hospital, Oxford
Abstract: Urology nurses gain many specialist skills necessary to manage patients admitted with acute urological conditions. In our trust however, patients with urological problems may be admitted to the Surgical Emergency Unit (SEU) where care is provided by nurses trained in general surgery but not urology.
In an attempt to enhance urological care for the benefit of our patients, we initiated a small group teaching programme run by urology trainees for nurses on SEU focusing on ward-based urology skills and essential knowledge.
Questionnaires from 49 nurses showed lack of familiarity in managing patients with haematuria and ureteric stones, areas which the teaching then focused upon. The same questionnaire, completed by 29 nurses who have received teaching to date, show improvement in skill confidence and knowledge levels in all areas. It is essential for us to continue educating and receiving feedback from our nurses to ensure a high quality urology service.
Title: Wessex Anatomy Training for Surgeons and the MRCS: Lessons from two years.
Author(s): JF Donaldson, M GIbson, C Bamford, J Knight, A Talwar
Background: A working knowledge of anatomy is crucial for surgical practice and MRCS examinations. London was the only UK Deanery offering prossection-based teaching in 2009.
Aims: To facilitate clinically focused anatomy teaching to Wessex Trainees.
Methods: Senior surgeons delivered 16 half-day free sessions between Aug’10-May’12. Written feedback was obtained.
Results: Feedback was extremely good: 100% of candidates rated sessions extremely or very useful. A defined syllabus for each session and a “mock exam” session were suggested - both were extremely well received. On average 6.2 trainees attended each session (range 3-12) which were usually facilitated by 2 tutors. Feedback showed candidates preferred small group sizes. Candidates suggested measures to improve attendance.
Conclusions: We have facilitated the delivery of excellent surgical anatomy teaching to Wessex trainees. Attendance was disappointing: we are implementing changes to improve numbers.
Key Messages
· Increased surgical anatomical knowledge for trainees.
· Improvements resulted from trainees’ feedback.
Title: Sport Based Insights into Commissioning
Authors: Dr Richard Elliott
Work done for: Education Fellowship
Background: Commissioning is set to bring major changes to general practice, and trainees need to understand the principles underpinning it. We sought inspiration from the summer of sport to give trainees direct exposure to novel team-based task with relevance to commissioning.
Methods: General practice trainees (ST1/2) were divided into six groups. Each was given a non-medical scenario based upon commissioning, and the groups competed against each other to attain an overall goal. The participants were observed during the day, and structured feedback was gathered at the end of the session. The data were collated and analysed.
Results: Teamwork within the small groups was excellent, but rivalry between the all groups meant that the overall goal of the day was not achieved. Feedback was positive.
Conclusions/ Key Messages: Trainees found this a useful introduction to commissioning. Feedback indicated that they learned about leadership, team-working and the importance of recognising the overall goal.
Title: Medfest 2012: Using film as a way to explore medicine and mental health
Author(s): Laura Evans & Larissa Ryan
Background: Medfest is a national medical film festival, organised by psychiatry trainees and medical school psychiatry societies.
Methods: A questionnaire was offered to all attendees at all the Medfest events around the country.
Results: Southampton attendees were asked to rate the event on a scale of 1-5 with 1 being ‘not successful’ and 5 being ‘highly successful’. The average rating was 4.2. Attendees were also asked if the event had changed their likelihood of wanting to do psychiatry as a career. 59% said they were ‘more likely’ or ‘much more likely’ to choose psychiatry as a career following the event.
Conclusions: Southampton Medfest 2012 was well regarded by attendees and appeared to have a positive result in terms of improving attitudes and recruitment to psychiatry.
Key messages: Using film is an interesting and exciting way to stimulate discussion among medical students.
Medfest 2013 is coming in Spring next year.
www.medfest.co.uk
Title: Identification of appropriate blood transfusion requests in paediatric surgery: an analysis of service and financial implications.
Author(s): J H Frost, H Dagash, C Choruschyj, J Durell, H Jahn, N Patwardhan
Introduction: As with many areas of surgery, paediatric surgery often requires careful pre-operative planning in regards to the need for transfusion intra or post-operatively. This study aims to analyse the need for peri-operative transfusion planning in relation to paediatric surgical procedures.
Method: Retrospective review was undertaken over a twelve month period between 1st January 2011 to the 31st December 2011. Data was collected from a single centre. 2159 GS requests and 4487 CM units of red cells from patients <16 years old were analysed.
Results: Analysis of (n=6646) CM and GS requests was undertaken and after exclusion criteria (n=155) GS requests and a correlating (n=48) CM units were processed. A statistically significant rate of 14.82% was found which includes all units that were transfused after CM request. There was a per patient overspend of £104.04 on each request.
Conclusion: Pre-operative blood transfusion planning in paediatrics is so far not widely evidence based. Our studies results suggest that clinical need for pre-operative cross-matching is not always justified in all paediatric procedures. These results justify further studies in to this area to allow for improved and appropriate clinical and economic outcomes.
Title: Perceptions of learning and teaching in postgraduate neurology training
Author(s): Stephan Hinze & Sai Loo
Abstract:
There has only been a limited amount of research into learning and teaching in postgraduate neurology education.
Questionnaires (40 registrars, 28 consultants) and interviews (4 registrars and 1 consultant) were analysed using quantitative, as well as qualitative measures.
There are significant differences between consultants and trainees. Early trainees prefer a higher degree of formal teaching, incorporating specific objectives with provision of a specific clinical context. In general, outpatient clinic exposure should have a greater emphasis than inpatient care (60% to 40%). There should be an equal divide between a time and competence based curriculum approach. Formative assessment should be slightly favoured over summative assessment.
Clinical experience associated with context specific discussions and feedback seems to be the most important aspect of learning in postgraduate neurology education. Trainee input into curriculum design is likely of benefit in view of changing perceptions on learning and teaching between registrars and consultants.
Title: Death of the Cadaver
Author(s): Zaibun Khan, Amjad Ali and Sherief Alsayed
Introduction: Core knowledge of anatomy is an integral part of undergraduate medical curriculum and GMC’s Tomorrow’s Doctors. The objectives of this survey are to review anatomy teaching in UK and junior doctors’ (FY1 level) confidence in their anatomical knowledge.
Method: 356 medical students from 20 medical schools answered a questionnaire on their experience of anatomy education in the UK between 2005 and 2010.
Results: Cadaver dissection as a main teaching method has continued to decline.The main method of anatomy teaching was problem-based learning (35%), lectures (28%) and cadaver dissection (27%). In contrast, dissection was the most preferred method of leaning anatomy followed by tutorials and lectures respectively. Furthermore, most students regarded their knowledge as inadequate at an FY1 level.