A four-tiered approach to optimise the educational benefit of ward rounds for medical students

2021 ◽  
pp. 1-1
Author(s):  
Henna Reddy ◽  
Ryan Lam
PEDIATRICS ◽  
1967 ◽  
Vol 40 (3) ◽  
pp. 510-512

Dr. Kenneth Williams: I think the problem of staff avoidance which was alluded to is one of the major problems in our hospital. For example, on routine ward rounds, our leukemia patients are frequently bypassed with the attending physician saying, "Well, it's a hematology patient." Our children and our parents tell us this directly and indirectly in many ways. Dr. Bergman: I have just completed a rotation as ward attending physician and confess to doing just what you say. Obviously the parents and children are very aware of the regular ward routine and were conscious of being skipped. After becoming cognizant of this situation, I made special efforts to include all patients on rounds. Dr. Hartmann: There are some house staff whom we don't know how to approach. We're the plague; they won't even talk to us when they are assigned to a floor where there are a number of children with malignancies. We must learn some manner in which we can help them approach the dying child with an assured attitude. We ourselves certainly don't always have this. We feel guilty, we avoid the parents, we even tend to avoid the child terminally. There must be some way you can help us, perhaps by going back to the medical student or explaining to all of us who go into pediatrics that, even though we think we're going to cure everybody, we really don't. Dr. Rothenberg: I think part of the answer is when you mentioned medical students, because I certainly think this is where it should begin.


2020 ◽  
Vol 97 (1143) ◽  
pp. 5-9
Author(s):  
Muhammad Tariq ◽  
Sundus Iqbal ◽  
Sonia Ijaz Haider ◽  
Aamir Abbas

BackgroundCognitive apprenticeship model (CAM) is an instructional model for situated learning. There is limited data available on application of the CAM in clinical settings. The aim of the study was to identify learning strategies using CAM, which in the opinion of learners are effective in ward rounds.MethodsParticipants were residents and medical students who rotated through internal medicine at Aga Khan University Hospital, Karachi. We sought learners’ opinion on a structured questionnaire based on four principal dimensions of cognitive apprenticeship. A previously determined set of 10 defined competencies were compared with CAM’s six teaching/learning (T/L) methods (modelling, coaching, scaffolding, articulation, reflection and exploration) as well. Mean and SD were calculated. Mann-Whitney test was used to compare scores.ResultsOf 195 participants, there were 100 men (51.3%) and 95 women (48.7%). Perceived learning for six T/L methods, ranged from 3.7 to 3.9 (max=5). Coaching and scaffolding had the highest scores. Statistically significant difference between the student and resident groups was noted. Medical students perceived coaching and scaffolding (4.1 and 4.05) and residents rated coaching, articulation and exploration as most effective (3.9 and 3.8). Majority (82.1%) reported a positive learning environment in wards.ConclusionsCAM enabled to identify two T/L methods (scaffolding and coaching) that are important for learning in ward round. Limited differences in perceived effectiveness of the T/L methods indicate that variety can be used to sustain interest in learners. Positive learning environment, team diversity and tasks of increasing complexity contribute to learning.


2021 ◽  
Author(s):  
Sarah Pauline Bowers ◽  
Philip J Dickson ◽  
Katharine Thompson

Abstract Background COVID-19 led to global disruption of both healthcare delivery and undergraduate medical education with suspension of clinical placements in alignment with government and university guidelines. To facilitate ongoing palliative care education, we aimed to develop a model for delivering virtual palliative care teaching and to assess the suitability of this as an alternative to in-person teaching. Method Basic technology (iPad and linked computer) were used to facilitate video conferencing, via the secure platform Microsoft Teams, between a consultant-led ward round in a specialist palliative care unit and fourth year medical students located in the education department of the unit. This was evaluated using electronic survey responses from patients, medical students and medical staff with generation of quantitative and qualitative data.Results Medical students greatly appreciated the opportunity to maintain attendance at clinical sessions during COVID-19. Quantitative and qualitative feedback demonstrated that the virtual ward round model effectively met medical students’ educational needs, particularly in relation to holistic assessment, pain management and communication skills. Only minor technological difficulties were noted. Feedback indicated that the use of technology to allow medical education was acceptable to patients, who were open and willing to adapt. Patients acknowledged that without medical students’ physical presence on ward rounds, there was an element of discretion; clinicians also found this to be beneficial. Conclusion COVID-19 has forced changes in the delivery of medical education. Virtual ward rounds are an effective method for delivering high quality palliative care teaching and are acceptable to patients, medical students and clinicians alike. Additional benefits beyond COVID-19 included allowing students to be present discretely during sensitive conversations whilst still meeting their learning outcomes.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S J K Chong ◽  
L Mortimer ◽  
C Quick ◽  
L West ◽  
G Khera

Abstract Aim A UK teaching hospital expanded their established education fellow programme to the General Surgery department to assist with departmental teaching of third-year medical students from the affiliated medical school on clinical placement. Teaching on ward rounds, bedside teaching and clinical tutorials were three areas identified as requiring improvement based on previous student feedback. Observation of Upper and Lower Gastrointestinal (GI) malignancy multi-disciplinary meetings (MDMs) via Microsoft Teams was also introduced as a new teaching initiative. Method Four post-foundation training education fellows were allocated on alternating weeks to supervise third-year medical students on upper and lower GI ward rounds and during GI MDM observation, conduct bedside teaching and facilitate blended-learning clinical tutorials in accordance with the 2020 GMC Medical Licensing Assessment curriculum. A mixed-methods survey was sent to students after surgical placement and the results compared to student feedback from previous years. Results 31 out of 52 students (60%) on placement responded. 100% rated the fellow-led clinical tutorials as “excellent”. 87% of respondents rated the upper and lower GI ward rounds as either “excellent” (52%) or “good” (35%). All respondents rated the implementation of education fellows as either “very helpful” (94%) or “helpful” (6%) for their learning. Most students rated the MDM observation initiative as “good” (36%) or “average” (36%). Conclusions Implementation of education fellows on third-year medical student placements in General Surgery facilitates self-reported student learning and is associated with a drastically improved student learning experience. More work is required to develop GI MDM-based teaching to improve student learning experiences from MDMs.


Author(s):  
WRC Knight ◽  
MA Glaysher ◽  
GAC Wheble

Traditionally, the operating theatre is a suboptimal educational setting for medical students. It is an unfamiliar learning environment for those new to clinical medicine, with its own rituals, protocols and etiquette. Learning objectives are not defined clearly and many students perceive the time spent in the operating department as being of little or no educational benefit. Furthermore, most students receive very little or no formal induction into the theatre environment and this has a negative impact on learning behaviours and, indeed, patient safety.


2021 ◽  
pp. bmjstel-2021-000864
Author(s):  
Tobias Mill ◽  
Shefali Parikh ◽  
Archie Allen ◽  
Gemma Dart ◽  
Daniel Lee ◽  
...  

BackgroundThe COVID-19 pandemic resulted in a loss of clinical clerkship opportunities for medical students. To address this problem while maintaining patient safety, this pilot study explored the feasibility of using a wearable headset to live stream teaching ward rounds to remotely based medical students.MethodsThree live streamed teaching ward rounds were delivered to three groups of medical students (n=53) using the Microsoft HoloLens 2 device and Microsoft Teams software, and results pooled for analysis. Feedback was gathered from students and instructors using the evaluation of technology-enhanced learning materials (ETELM). Patient feedback was gathered using the Communication Assessment Tool to explore any impact on interpersonal communication.ResultsThe response rate for the ETELM-learner perceptions was 58% (31/53), 100% for the ETELM-instructor perceptions. Students strongly agreed that the overall quality of the teaching session and instructors was excellent. However, 32% experienced issues with audio or video quality and one remote student reported cyber sickness. The statement ‘educational activities encouraged engagement with session materials/content’ returned the most varied response. Instructors reported technological problems with delivery while using the HoloLens 2 device and environmental noise in the ward was a disruptive factor. Preparation and skilled facilitation were key to delivering a high-quality teaching session. Patients reacted generally favourably to the technology and no negative effects on interpersonal communication were identified.ConclusionThe experience of live streamed ward rounds was well received by patients, medical students and teaching faculty. However, there remain limitations to the routine use of HoloLens 2 technology in our setting including steep learning curves, hardware costs and environmental factors such as noise and WiFi connectivity. Live streamed ward rounds have potential postpandemic implications for the judicious use of resources, and the possibility for few educationally minded clinicians to teach at scale in a patient-friendly manner.


2021 ◽  
Vol 9 (2) ◽  
pp. 534-538
Author(s):  
Ehigiamusoe FO ◽  
Ighodaro EO

Introduction: Interventional radiology (IR) is an emerging specialty which is more established in the western nations but yet to take root in Nigeria. It involves the use of radiological imaging modalities to perform minimally invasive procedures for patients. The specialty can only grow and be sustained when there is continuous supply of manpower which starts by engendering the interest of medical students. Objective: To assess the level of awareness of IR among medical students following exposure to radiological posting. Methods: This was a cross sectional prospective questionnaire based study carried out at the University of Benin. Subjects were final year and penultimate final year medical students of the school of medicine of the University of Benin. The questionnaires consisted of 16 questions that assessed the students' awareness of interventional radiology. Data analysis was done using Statistical Package for Social Science, SPSS statistics (Version 23; IBM Corp., Armonk, NY, USA). Results: Eighty six of the students (90.5%) knew the definition of IR. Sixty five of the students (69.4%) had poor knowledge of IR. Sixty six students (69.5%) knew that IR patients can be admitted into the hospital while 74 students (77.9%) knew that IR doctors can conduct ward rounds in the hospital. Seventy nine (83.2%) of the students knew that IR outpatients' clinic can be conducted. Many (63.2%) knew the pathway of training for interventional Radiologists in Nigeria. Only 24 of the students (25.3%) were interested in IR in the future. The most common reason for not considering a career in IR in the future was lack of interest (46). Conclusion: There is an abysmally low level of awareness of IR among students in this centre, although this may not be true reflection of the whole country. Hence, a nationwide study may need to be conducted.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1707-1707 ◽  
Author(s):  
F. Cheema ◽  
J. Leuvennink ◽  
C. Ee ◽  
J. Macklin ◽  
J. Graham

It is perceived that negative attitudes towards mental illness in undergraduate medical students can impact student's decision in choosing psychiatry as a medical career. Improvement in psychiatry placements for undergraduate medical students can result in changing student's attitude towards psychiatry as a career choice. We demonstrate how students’ placements from various medical schools at a major psychiatric hospital contributed towards enhancing student's interest towards psychiatry. Medical students who had their placement over the last one year were contacted for an anonymised student perspective survey.While majority of students did not have psychiatry as their potential career choice before they started their placements more than two third rated psychiatry as a potential career choice based on their experience from the placements. This encouraged us to improve the placement standards based on student's perspective. Students suggested that more use of medical training in psychiatry, improvement in teaching and placement standards and more psychiatry placements before specialised training can contribute towards making psychiatry as one of the popular career choices. Student's preferred interactive teaching sessions including case based discussions and informal teaching sessions during ward rounds and clinics. Overall students found their placements helpful but more so to perform well in their examinations as compared to coverage of full psychiatry curriculum.It is planned to conduct the survey again after necessary changes based on student's perspective to evaluate whether further improvement in placements can continue in contributing towards increasing medical recruitment in psychiatry.


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