scholarly journals O1 Use of a multi-disciplinary teaching platform for teaching paediatric prescribing

2019 ◽  
Vol 104 (7) ◽  
pp. e2.1-e2
Author(s):  
Lucy Paterson-Brown ◽  
Eoin Dore
Keyword(s):  
Medical Students ◽  
Low Cost ◽  
Formal Structure ◽  
Undergraduate Teaching ◽  
Educational Goals ◽  
Junior Doctors ◽  
List Type ◽  
Teaching Session ◽  
Paediatric Department ◽  
Paediatric Prescribing

AimWe present a case study of the development of a structured, holistic, multidisciplinary prescribing teaching program for medical students in our paediatric department. The aim was to integrate theory and practise into one multidisciplinary delivered teaching session.MethodPrescribing is an area that medical students consistently report as challenging with poor teaching and minimal paediatric specific prescribing teaching as an undergraduate. After collaboration with our pharmacist colleagues the agreed objective was to design a teaching session run by doctors and pharmacists together in order to more accurately simulate paediatric prescribing in clinical practice for the inpatient environment. The method was based on Blooms Taxonomy,1 starting with a pharmacist delivering teaching on the theory of paediatric prescribing. Following this, junior doctors delivered case based prescribing scenarios to allow assimilation and application of theory. At the end of the 150 minute session feedback was collected from both session facilitators and students. These were evaluated to allow for revision and improvement of the session.ResultsBoth facilitators and students very enthusiastically received the session with phrases such as ‘amazing session thank- you!’ added to the feedback forms. Feedback was gathered from 32 students over the first 8-week cycle of the project. The majority of students stated that prior to this session they had little or no paediatric prescribing teaching. When asked the question ‘how prepared do you feel for prescribing in paediatrics?’ and asked to rank themselves from 1 (not at all) to 5 (very well) the average improved from 1.44 pre session to 3.55 post session. The feedback was consistent between sessions demonstrating no significant variation between facilitators. This highlights that the standardised, formal structure of the session allows it to be delivered by pharmacists and doctors of different grades and levels of experience without changing the success of the session for the students.ConclusionThis project demonstrates that there is a significant gap in undergraduate teaching on prescribing, especially paediatric prescribing. This teaching session is low cost, produces similar feedback despite variation in facilitators between sessions, and is easily transferable to multiple inpatient areas. Our students demonstrated that after one teaching session they felt more prepared for prescribing in paediatrics and following the feedback changes have been made to the session and ongoing feedback has further improved. We propose that this style of teaching session could be used across the country for both adult and paediatric prescribing undergraduate teaching sessions. We aim to compare our session with other universities approaches to prescribing teaching and establish whether this is a national area that requires focused educational attention.ReferenceBloom BS. Taxonomy of educational objectives: The classification of educational goals 1956.

11 Filling the void: preparing future junior doctors for challenging conversations

2018 ◽  
Vol 8 (3) ◽  
pp. 363.3-364
Author(s):  
Hannah Costelloe ◽  
Alice Copley ◽  
Andrew Greenhalgh ◽  
Andrew Foster ◽  
Pratik Solanki
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Medical Students ◽  
Small Group ◽  
End Of Life ◽  
Communication Skills ◽  
Skills Training ◽  
Junior Doctors ◽  
List Type ◽  
The Impact

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]

35 Online randomised controlled trial to improve clinical estimates of survival (ORACLES): study design

2018 ◽  
Vol 8 (3) ◽  
pp. 373.1-373 ◽  
Author(s):  
Linda Oostendorp ◽  
Nicola White ◽  
Priscilla Harries ◽  
Sarah Yardley ◽  
Christopher Tomlinson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Randomised Controlled Trial ◽  
Care Pathway ◽  
Low Cost ◽  
Controlled Trial ◽  
Online Training ◽  
List Type ◽  
More Care ◽  
Randomised Controlled

IntroductionClinicians often struggle to recognise whether palliative care patients are imminently dying.1 2 A previous study identified the factors that expert palliative care doctors (with demonstrated prognostic skills) had used to judge the probability of patients dying within 72 hours.Aim and methodsTo evaluate whether an online training resource can teach medical students to formulate survival estimates for palliative care patients that are more similar to experts’ estimates. In this online randomised controlled trial we will recruit 128 students in the penultimate/final year of medical school. Participants are asked to review three series of vignettes describing patients referred to palliative care and provide estimates (0%–100%) about the probability that patients will die within 72 hours. After the first series of vignettes students in the intervention arm are given access to the training resource showing how experts weighted the various symptoms/signs. Participants are asked to complete a second series of vignettes and then a third series after two weeks to assess if any effect has been maintained.ResultsStudents’ survival estimates will be correlated with experts’ estimates to determine the baseline level of agreement and any changes following the intervention. The primary outcome will be the survival estimates provided in the second series of vignettes. Secondary outcomes include the estimates provided at the follow-up the weighting of symptoms/signs and levels of discrimination and consistency.ConclusionThis study will provide evidence about whether a brief low-cost online training resource can influence how medical students make prognostic decisions in an experimental setting.References. Neuberger J. More care less pathway: A review of the liverpool care pathway.Department of Health2013. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212450/Liverpool_Care_Pathway.pdf [Accessed: 30thMay 2018]. White N, Reid F, Harris A, Harries P, Stone P. A systematic review of predictions of survival in palliative care: How accurate are clinicians and who are the experts?PLoS One25 August 2016;11(8):e0161407. Available from: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0161407&type=printable [Accessed: 30th May 2018]

Cheese, ketchup and grapes: a 10-step protocol on how to teach medical students and junior doctors cataract surgery in a simulated environment using household items

2020 ◽  
pp. postgradmedj-2020-139357
Author(s):  
Christopher Norbury
Keyword(s):  
Medical Students ◽  
Cataract Surgery ◽  
Surgical Procedures ◽  
Low Cost ◽  
Junior Doctors ◽  
Surgical Simulators ◽  
Simulated Environment ◽  
Wet Lab

Cataract surgery is one of the most common surgical procedures performed worldwide, yet many medical students and doctors remain uncertain as to what a cataract is or what the operation involves. This protocol provides a simple 10-step approach on how to teach medical students and non-specialist doctors the stages involved in cataract surgery, in a low cost wet lab-based environment, without the need for expensive surgical simulators or operating microscopes.

Introduction of Wireless Buzzer to Improve Efficiency in Gynecology Triage (Preprint)

2020 ◽  
Author(s):  
Nicholas Mark Stansbury ◽  
Erin Nelson
Keyword(s):  
Medical Students ◽  
Nurse Practitioners ◽  
Nursing Staff ◽  
Internal Control ◽  
Patient Flow ◽  
Low Cost ◽  
Work Flow ◽  
Optimal Time ◽  
Nursing Experience ◽  
Asking Questions

BACKGROUND Current workflow in GYN triage has medical students interviewing patients after triage by nursing staff. The optimal time to initiate patient contact is unclear. This confusion has led to duplication of questions to patients, interruptions for nurses and fewer patient encounters for students. OBJECTIVE Determine if a restaurant-style buzzer can streamline workflow in gynecology (GYN) triage. METHODS A Plan-Do-Study-Act approach was used. Stakeholders were medical students, nurses, Nurse Practitioners and physicians. Factors contributing to workflow slowdown: students re-asking questions of patients, interruption of nursing staff, confusion about optimal patient flow. The net result was fewer interviews completed by students. The project was introduced during clerkship orientation. Buzzers were provided on weeks 1, 3, 5 of the rotation. Weeks 2, 4, 6 no buzzers were provided as an internal control. After each clerkship, students received a survey assessing key areas of waste and workflow disruption. A focus group with ten nurses was also conducted. RESULTS From February-July 2019, 30/45 surveys were completed (66%) 1. Very difficult/difficult to know when to begin the encounter: 90% without; 21.4% with buzzer p<.001 2. Students re-asking questions: very often/often 96.7% without; 14.8% with buzzer p<.001 3. Nursing staff interruptions: 76.7% very often/often without; 18.5% with buzzer p<.001 4. The odds of interviewing 5 or more patients per shift are ~10X greater using the buzzer χ²=14.2; p<.001 CONCLUSIONS The 10 nurses interviewed unanimously favored the use of the buzzer. Introduction of a simple, low-cost restaurant-style buzzer improved triage work-flow, student and nursing experience.

scholarly journals 139 Efficacy of Implementation of a Junior Doctors' Teaching Program on The Secondary Prevention of Peripheral Arterial Disease in Vascular Patients

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Daketsey ◽  
M Elkawafi ◽  
A Khallaf ◽  
R Makar
Keyword(s):  
Peripheral Arterial Disease ◽  
Secondary Prevention ◽  
Statin Therapy ◽  
Arterial Disease ◽  
Evidence Base ◽  
Junior Doctors ◽  
Teaching Session ◽  
Prescription Practices ◽  
Best Medical Therapy ◽  
Peripheral Arterial

Abstract Introduction According to NICE Guidelines, the Best medical therapy (BMT) for secondary prevention of peripheral arterial disease includes antiplatelet and statin therapy unless contraindicated. Junior Doctors are usually allocated the job of prescribing patients’ medications. Due to discrepancies in their exposure to vascular surgery in earlier training, we implemented an introductory teaching session for them regarding this BMT and audited the efficacy of this intervention. Method A retrospective review of admission and discharge medications of all vascular ward patients from August 12th to 30th September 2019 was done, and the data was analysed via Excel. Results Out of 127 patients (median age 70), 67% and 64% had antiplatelet and statin medications respectively,while on admission. 1 in each patient cohort was found discharged without either medication. The GP of the patient discharged without antiplatelets was contacted to ensure this was rectified. The other patient had refused statin therapy and thus a discharge note to their GP was conducted to reflect this. Conclusions A teaching session as part of a vascular departmental induction emphasising the evidence base for antiplatelet and statin therapy can contribute to improving prescription practices of junior doctors starting in the department.

scholarly journals Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health

2021 ◽  
Vol 18 (1) ◽  
pp. 349
Author(s):  
Panagiotis Zis ◽  
Artemios Artemiadis ◽  
Panagiotis Bargiotas ◽  
Antonios Nteveros ◽  
Georgios M. Hadjigeorgiou
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Emotional Exhaustion ◽  
Short Form ◽  
Maslach Burnout Inventory ◽  
Junior Doctors ◽  
Digital Learning ◽  
Student Survey ◽  
Medical Studies ◽  
The Impact

Objectives: The aim of this ecological study was to investigate what the impact of digital learning due to the COVID-19 pandemic was on the burnout and overall mental health (MH) of medical students. Background: During the unprecedented era of the COVID-19 pandemic, the majority of countries worldwide adopted very strong measures. Universities closed their doors, and education continued through digital learning lectures. Methods: An anonymous questionnaire was administered to all 189 eligible candidates before and during the COVID-19 pandemic. Mental health was assessed via the MH domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory—Student Survey (MBI-SS). Results: The overall response rate was 81.5%. The overall burnout prevalence did not differ significantly between the two periods (pre-COVID-19 18.1% vs. COVID-19 18.2%). However, the burnout prevalence dropped significantly in year 4 (pre-COVID-19 40.7% vs. COVID-19 16.7%, p = 0.011), whereas it increased significantly in year 6 (pre-COVID-19 27.6% vs. COVID-19 50%, p = 0.01). When looking at each MBI-SS dimension separately, we found that emotional exhaustion decreased significantly in year 4 but increased in year 6, and cynicism increased in all years. The overall MH deteriorated significantly between the two periods (pre-COVID-19 58.8 ± 21.6 vs. COVID-19 48.3 ± 23, p < 0.001). Conclusions: Digital learning in medical studies carries significant risks. Not only does the MH deteriorate, but cynicism levels also increase. Emotional exhaustion was found to increase particularly in final year students, who struggle with the lack of clinical experience just before they start working as qualified junior doctors.

Teaching from junior doctors: The experience of medical students

2015 ◽  
Vol 37 (10) ◽  
pp. 977-977 ◽  
Author(s):  
Khyber Maarij ◽  
Mohammed U Halim ◽  
Naeem Iqbal
Keyword(s):  
Medical Students ◽  
Junior Doctors

scholarly journals How does participation in a voluntary prize exam affect medical students’ knowledge and interest in ENT, plastic surgery, ophthalmology and dermatology?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Razan Nour ◽  
Kerry Jobling ◽  
Alasdair Mayer ◽  
Salma Babikir
Keyword(s):  
Medical Students ◽  
Plastic Surgery ◽  
Pilot Project ◽  
Junior Doctors ◽  
Free Text ◽  
Medical Specialties ◽  
Spare Time ◽  
Before And After ◽  
To Receive ◽  
Interest And Knowledge

Abstract Background Otolaryngology (ENT), plastic surgery, ophthalmology and dermatology are medical specialties which tend to receive less coverage in UK medical school curricula compared to larger, generalist specialties. As a result, there are fewer opportunities for medical students to learn and to cultivate an interest. There are numerous papers that report concerns about junior doctors’ ability to manage conditions within these specialties, which may jeopardise patient safety. The aim of our pilot project was to increase medical students’ interest and knowledge of ENT, plastic surgery, ophthalmology and dermatology. In addition to describing our project, we present and discuss literature on UK undergraduate education in these specialties and its impact on preparedness of junior doctors and future career choices. Methods One hundred twelve final year medical students at Newcastle University were invited to take part in a voluntary two-part (written and clinical) exam, in which prizes could be won and all participants would receive a certificate of participation. We distributed two online surveys to the students, one administered before the exam and one afterwards. Data was collected regarding the students’ motivation for entering the prize exam and the students’ baseline interest and knowledge in these specialties before and after the prize exam. Free-text responses were collected about the students’ opinion of the project and whether participation was beneficial. Results Sixteen students participated in the exam. There was a statistically significant increase in the students’ knowledge in ENT (p < 0.000), plastic surgery (p < 0.000), ophthalmology (p < 0.028) and dermatology (p < 0.012) after participation in the exam, but not in their interest levels. ENT was the preferred specialty of our cohort. The students reported that they found participation beneficial to their learning, particularly receiving exam feedback and explanations to exam questions. Conclusions This pilot project was a useful intervention in increasing medical students’ knowledge in these specialties, but not in their levels of interest. It also demonstrates that medical students are willing to participate in voluntary initiatives (in their spare time) to gain more learning opportunities and that medical students value timely exam feedback to guide their revision.

P28 Reducing medication errors – a tripartite approach. small steps – better outcomes

2018 ◽  
Vol 103 (2) ◽  
pp. e1.33-e1
Author(s):  
Patel Bhavee ◽  
Isaac Rachel ◽  
Vallabhaneni Pramodh
Keyword(s):  
Medication Errors ◽  
Improve Patient Safety ◽  
Medication Administration ◽  
Daily Basis ◽  
Junior Doctors ◽  
Health Board ◽  
Final Report ◽  
List Type ◽  
Microsoft Excel ◽  
Audit Form

AimPaediatric medication errors have everyday potential to cause unintended harm.1 Our aim was to reduce paediatric medication errors on a busy general paediatric medical ward.MethodA prospective audit was undertaken, using an audit form, looking at the number and severity of medication errors from May 2016 to July 2016. The severity of the errors was graded as per the EQUIP study.2 The results were analysed using Microsoft Excel.Action – A study afternoon was arranged in August 2016 to highlight the common themes behind the medication errors followed by a multidisciplinary brainstorming exercise to gather suggestions on reducing medication errors.An education package was introduced:Medical – all trainees were asked to complete a mandatory online module designed by the Royal College of Paediatrics and Child Health, which provides an overview of need for safe prescription practice in children and common themes leading to errors. Further teaching was provided in departmental teaching meetings and the lead paediatric pharmacist undertook targeted teaching.Nursing – an in house competency package was developed based around the principles of the ‘5 rights’ of medication administration, the Health Board controlled drug policy and the All Wales Policy for Medicines Administration, Recording, Review, Storage and Disposal. All staff were encouraged to complete this package. Through one on one sessions with the practice development nurse, staff were coached to follow the five Rs of Right Drug, Right Dose, Right Time, Right Route, and Right Patient.Pharmacy – Lead pharmacist introduced an education tool as advocated by Meds IQ called Druggle3 in the department, where at the end of the safety huddle the pharmacist discusses medication interventions on a daily basis that may have happened on the ward. Through this tool formative education was provided to junior doctors and nurses.Re–audit – After six months of intensive education, a prospective re–audit was undertaken between December 2016 and February 2017 using an audit form. The results were analysed using Microsoft Excel.ResultsThe results showed that 88.6% (141/159) of children admitted had medication errors. 61.2% (87/141) of errors were minor, 34.7% (49/141) significant, 2.8% (4/141) serious and 1.3% (1/141) potentially lethal.The results of the re-audit showed that 12.1% (57/470) of children had medication errors. 77.2% (44/57) of errors were minor and 22.8% (13/57) significant. There were no serious or potentially lethal errors reported.This showed an overall reduction of 76.5% medication errors in the children admitted following the introduction of the education package.ConclusionThe education package through the tripartite approach has achieved a substantial change in the overall rate of prescription errors. We believe medication errors are a significant but preventable cause of harm to children and young people. To ensure this change of practice is sustained we aim to continue the emphasis of education and change management to improve patient safety.ReferencesCass H. Reducing paediatric medication error through quality improvement networks; where evidence meets pragmatism. Arch Dis Child2016;101:414–416.EQUIP final report. http://www.gmc-uk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdf [Accessed: 01/08/16].DRUG-gle (Druggle). http://www.medsiq.org/tool/drug-gle-druggle [Accessed: 01/08/2016].

A new undergraduate teaching session in occupational medicine

2003 ◽  
Vol 37 (11) ◽  
pp. 1033-1034 ◽  
Author(s):  
Paul Grime ◽  
Sian Williams ◽  
Sandra Nicholson
Keyword(s):  
Occupational Medicine ◽  
Undergraduate Teaching ◽  
Teaching Session
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