scholarly journals Understanding junior doctors’ experiences of teaching on the acute take: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlotte Hayden ◽  
Jedd Raidan ◽  
Jonathan Rees ◽  
Abhishek Oswal
Keyword(s):  
Undergraduate Students ◽  
Clinical Skills ◽  
Clinical Care ◽  
Clinical Work ◽  
Undergraduate Curriculum ◽  
Junior Doctors ◽  
Workplace Education ◽  
Clinical Exposure ◽  
Medical Graduates ◽  
Educational Role

Abstract Background New medical graduates are significantly unprepared to manage acutely unwell patients due to limited first-hand clinical exposure in the undergraduate curriculum. Supporting undergraduate learning in the acute setting can be challenging for junior doctors when balancing teaching and clinical responsibilities. Our aim was to explore junior doctors’ first-hand experiences of supporting undergraduate education in the acute admissions environment(take). Methods Fourteen junior doctors in one teaching hospital in South West England took part in semi-structured focus groups (4–6 participants in each) which were audio-recorded, transcribed, and thematically analysed. Results Junior doctors described their educational role as comprising: teaching, demonstrating, coaching, and supervising. They perceived the acute take as a highly variable, unpredictable setting that offered a broad scope for learning. Tensions between doctors’ clinical and educational roles were described, influenced by internal and external factors. Clinical work was prioritised over teaching and participants lacked confidence in supervisory and clinical skills. Doctors felt pressured to meet students’ expectations and lacked understanding of their educational needs. Senior colleagues were highly influential in establishing an educational culture and were often a source of pressure to deliver timely clinical care. Organisations were perceived not to value teaching due to the lack of provision of dedicated teaching time and prioritisation of limited resources towards patient care. Participants managed tensions by attempting to formally separate roles, demoting students to passive observers, and they sought greater continuity in placements to better understand students’ abilities and expectations. Conclusions Educational opportunities for undergraduate students on the acute take are varied and highly valuable. This study provides insight into the provision of workplace education and its challenges from junior doctors’ perspectives. We highlight areas for improvement of relevance to educational providers.

scholarly journals Understanding Junior Doctors’ Experiences of Teaching on the Acute Take: A Mixed-Methods Study.

2020 ◽  
Author(s):  
Charlotte Hayden ◽  
Jedd Raidan ◽  
Jonathan Rees ◽  
Abhishek Oswal
Keyword(s):  
Undergraduate Students ◽  
Active Role ◽  
Undergraduate Curriculum ◽  
Shared Responsibility ◽  
Junior Doctors ◽  
Clinical Team ◽  
Clinical Environment ◽  
Patient Acuity ◽  
Clinical Exposure ◽  
Acute Admissions

Abstract Background New medical graduates report significant unpreparedness in managing acutely unwell patients, due to limited first-hand clinical exposure in the undergraduate curriculum. Supporting undergraduate learning around acute admissions can be challenging for junior doctors balancing teaching and clinical responsibilities. We aimed to explore junior doctors’ first-hand experiences of supporting undergraduate education in the acute admissions setting (take).Methods Fourteen junior doctors in one teaching hospital in South West England took part in a short web-based questionnaire exploring frequency, duration, efficacy, planning and delivery of teaching in the clinical environment. Participants subsequently took part in semi-structured focus groups (4-6 participants in each) which were audio-recorded and transcribed verbatim before being thematically analysed.Results Quantitative results demonstrated junior doctors reported difficulties finding time to teach, with many feeling their teaching was ineffective and rarely planned, with challenges finding suitable resources to support teaching delivery.Key qualitative themes were organised into six key areas: junior doctor, medical student and clinical team factors alongside clinical service, educational service, and resource factors. Junior doctors perceived themselves as novice clinical practitioners and lacked confidence in their ability to teach. Medical students were felt to be poorly engaged with clinical learning due to variable learning value of acute take experiences. Participants recognised value of the clinical team in ensuring student integration and noted a shared responsibility for teaching, driven by senior team members.Clinical service was prioritised over delivery of education, though workload variations were common, and patient acuity often affected the degree to which students could actively participate. Educational experiences in this environment are frequent but highly varied; teaching must be adapted in response to opportunities that arise. Participants noted scarcity of resources to support teaching and these were prioritised for patient care. Improvements are suggested in defining an active role for students, supporting junior doctors to deliver education, and providing appropriate resources.Conclusions Educational opportunities for undergraduate students on the acute take are varied, yet highly valuable. This study provides insight into provision of workplace education and its challenges from a junior doctors’ perspective and offers focus for targeted improvement for educational providers.

scholarly journals Junior doctors’ aspirations for careers in ophthalmology: 40 years of surveys of UK medical graduates

JRSM Open ◽  
2020 ◽  
Vol 11 (5) ◽  
pp. 205427041989215
Author(s):  
Trevor W Lambert ◽  
Atena Barat ◽  
Michael J Goldacre
Keyword(s):  
Systematic Change ◽  
Junior Doctors ◽  
Clinical Exposure ◽  
Career Preference ◽  
Medical Graduates ◽  
First Choice ◽  
Questionnaire Surveys ◽  
Using Data ◽  
One Year ◽  
Career Specialty

Objective Using data from 40 years of national surveys of UK medical graduates, we report on ophthalmology as a career choice. Design, setting, and participants Self-administered questionnaire surveys of all graduates from all UK medical schools in selected years of qualification between 1974 and 2015. Main outcome measures Career specialty preferences of doctors one, three, and five years after graduation; career specialty destinations 10 years after graduation. Results One year after graduation, ophthalmology was the first career preference of 1.6% of the qualifiers of 1974–83, 2.2% of 1993–2002, and 1.8% of 2005–15. The corresponding percentages three years after graduation were 1.5, 1.8, and 1.2%. Men were more likely than women to choose ophthalmology: among graduates of 2005–15, 2.4% of men and 1.4% of women did so at one year, as did 1.7% of men and 0.7% of women at five years. Seventy per cent of doctors practising as ophthalmologists 10 years after qualification had told us in their first post-qualification year that ophthalmology was their first choice of career. Conclusions There has been no systematic change in recent years in the proportion of recent medical graduates intending to have a career in ophthalmology when surveyed one year after graduation. However, the proportion at three and five years after graduation was lower than that at year 1. Suggestions for maintaining interest in the specialty include improved career advice, greater early clinical exposure to ophthalmology, and improved access to flexible training. Most practising ophthalmologists had made early decisions that this was their intended career.

scholarly journals 1107 Supplementing Orthopaedic Education outside of the Medical Curriculum: The Utility of a 1-Day Orthopaedic Revision Course for Medical Undergraduates

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Argyriou ◽  
S Michael ◽  
K Nadeem ◽  
G Batra
Keyword(s):  
Medical Curriculum ◽  
Clinical Skills ◽  
Undergraduate Curriculum ◽  
Feedback Form ◽  
Medical Graduates ◽  
Surgical Trainees ◽  
Medical Undergraduates ◽  
Knowledge Levels ◽  
Orthopaedic Education

Abstract Introduction Orthopaedic undergraduate education is both minimal and variable across UK medical schools. Furthermore, the clinical skills required to treat musculoskeletal injuries have been found inadequate by several studies assessing UK medical graduates. Method Orthopaedic revision courses organized by the student surgical society consisted of lectures and workshops covering clinical orthopaedic knowledge and skills required for university assessments. Five identical courses were run between December 2017 and December 2019 following the completion of fourth year’s musculoskeletal clinical block. Course tutors ranged from foundation year doctors (57%) to orthopaedic consultants and trainees (43%). An anonymous feedback form was handed out at each event and 5-point Likert scale questioning assessed participant perceptions prior to and following the course. Results This course led to a significant mean increase in students’ perceived knowledge levels with an average increase of 0.96 (19.2%) across all clinical examinations and lectures (p < 0.01). Tutor grade did not affect mean participant self-reported value of station, with stations taught by consultants and surgical trainees showing similar results to stations taught by FY doctors (p = 0.776). Conclusions The feedback revealed significant increases in student self-reported knowledge levels while poor pre-course scores reported might suggest inadequate coverage of orthopaedics in the undergraduate curriculum. The similarity in results when assessing the quality of tutorship suggests that FY doctors can be equally as valuable teaching tools for such courses as surgical trainees and consultants. These results suggest 1-day orthopaedic revision courses of this format can be highly beneficial in supplementing the undergraduate curriculum.

scholarly journals Compulsory community service for dentists - Opportunity for meaningful reform

2021 ◽  
Vol 76 (04) ◽  
pp. 201-206
Author(s):  
Motimedi L Machete ◽  
Nokukhanya L Makwakwa ◽  
Pusetso D Moipolai ◽  
Pagollang D Motloba
Keyword(s):  
Community Service ◽  
Clinical Skills ◽  
Quality Care ◽  
Clinical Work ◽  
Cross Sectional Study ◽  
Independent Practice ◽  
Cross Sectional ◽  
Clinical Exposure ◽  
Dental Procedures ◽  
Provide Quality Care

Previous studies indicate that the delivery of the compulsory community service (CS) programme was far from the intended objectives. It is plausible that the intended vision of the programme for the young graduates to“…develop skills, acquire knowledge, behaviour patterns and critical thinking that would help in their professional development and future careers.” may not be realizable. This study evaluated the extent to which CS programme nenabled CS dentists to develop clinical skills. A national cross-sectional study was undertaken on CS dentists. Adapted visual analogue scale (VAS) assessed the frequency of work performed and levels of skills or competency acquired. A total of 217/235 dentists participated, (response rate of 92.34%). The clinical work undertaken and skills/competence acquired were positively correlated; [Mean (SD)= 1.10 (0.326), 1.10 (0.359); r =0.945, p=<0.000, n = 217] respectively. This finding validates the associated loss of skills and competence because of lack of clinical exposure during CS. Specialised dental procedures were never or rarely performed during CS (89.5%). Similarly the level of skills acquired during CS was minimal. CS in its present form disrupts continuing education and the development of learning and clinical skills. These cohorts of dentists have entered independent practice less prepared; may fail to provide quality care to the public. The CS programme is regressive, and requires urgent review and reform.

scholarly journals A comparative assessment of the impact of computer assisted learning of knowledge and skill based competencies among undergraduate students in a medical college in South India

2018 ◽  
Vol 7 (4) ◽  
pp. 612
Author(s):  
Jeyalalitha Rathinam ◽  
Divakar R. ◽  
Subahan S. P. ◽  
Preethi A. ◽  
Vanitha G. ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Clinical Skills ◽  
Integrated Approach ◽  
Computer Assisted ◽  
Medical College ◽  
Medical Graduates ◽  
Study Results ◽  
Competency Based ◽  
Teaching Pattern ◽  
The Impact

Background: Pharmacology has always been one subject ultimatum and a cornerstone in building up competency, based on applied therapeutics among medical graduates in prescribing and practicing skills. A focus on an integrated strategical approach towards teaching pharmacology for better proficiency in achieving clinical skills is mandatory. Thus, this study has been done to assess the impact and retainment of overall knowledge gained on various domains, based on a revised method of teaching in pharmacology.Methods: An observational, questionnaire based comparative study was done in a medical college, in Chennai. The study included two group of students, one who have completed their pharmacology course based on the revised pattern of teaching with a comparative group of students who have not been exposed to the revised pattern of teaching. A feedback survey was also done.Results: The study results indicated that the average scoring based on the questionnaire was 84% with the students who have been exposed to revised pattern of teaching in comparison to the average scoring of 70% with the students who have not been exposed to the new pattern of teaching. The average scoring of the students who were found to agree to several questions on the new method of teaching was 74% and 22% of the students were found to disagree. 4% of students were non responders.Conclusions: The ultimate improvement in the outcome of health care education can be achieved through appropriate skill building through a simple strategical modification of the regular teaching pattern with an integrated approach involving pharmacologists and clinicians. A refresher course in pharmacology in the final year curriculum and CRRI involving pharmacologists is mandatory.

scholarly journals The Level of Confidence, Readiness and its Associated Factors Among Medical Graduates Prior to House Officer (HO) Training

2019 ◽  
pp. 41
Author(s):  
Aneesa Abdul Rashid ◽  
Sazlina Shariff Ghazali ◽  
Iliana Mohamad ◽  
Dalila Roslan ◽  
Husna Musa ◽  
...  
Keyword(s):  
Medical Training ◽  
Clinical Skills ◽  
Junior Doctors ◽  
Cross Sectional ◽  
Medical Graduates ◽  
Adequate Knowledge ◽  
Level Of Confidence ◽  
Preparatory Course ◽  
Training Company ◽  
The Impact

Introduction: House officers are reported to feel less confident in working, especially in the initial part of their training. Among the factors that make them feel unprepared are in terms of adequate knowledge, clinical skills and dealing with workload. The impact of less confident house officers (HO) can lead to detrimental effects.Objectives: This study aims to look into the confidence and readiness levels of medical graduates prior to starting a HO preparatory course and factors associate.Methods: This is a cross sectional questionnaire study done among medical graduates between April – September 2018. This is part of a bigger study looking into the effectiveness of this course, which was initially organised under the Islamic Medical Association of Malaysia (IMAM) and later privatized to Medicorp (a medical training company for junior doctors). 238 participants who fulfilled the inclusion and exclusion criteria, completed the adapted IMU Competency survey pre and post the course. Their level of confidence and readiness to work was scored out of a Likert scale of 1 to 5. The higher the score, the higher the confidence or readiness to work.Results: We found significant association of confidence levels pre-course with ethnic it y (p=0.038). The scores were 2.0 (IQR=2.0), 2.0 (IQR=2.0), 3.0 (IQR=1.0), 2.5 (IQR=1.25) for Malay, Chinese, Indian and others respectively. We report significant associations with level of confidence (p=0.03) and readiness (p=0.08) not only prior, but levels of confidence (p<0.001) and readiness (p<0.001) after the course in association with place of study. Significant association was found for levels of confidence (p=0.048) and readiness (p=0.07) according to gender for scores post-course which were both 3.0 (IQR=1.0) and 4.0 (IQR=1.0) for females and males respectively.Conclusion: Confidence level to start work were higher for the Indian ethnicity before the HOpreparatory- course. Confidence and readiness levels were higher in male after the course, and locally graduated participants pre and post course.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 41

scholarly journals Risk factors associated with physician trainee concern over missed educational opportunities during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny S. Lou ◽  
Charles W. Goss ◽  
Bradley A. Evanoff ◽  
Jennifer G. Duncan ◽  
Thomas Kannampallil
Keyword(s):  
Risk Factors ◽  
Clinical Education ◽  
Medical Center ◽  
Clinical Care ◽  
Academic Medical Center ◽  
Clinical Work ◽  
Educational Opportunities ◽  
Missed Opportunities ◽  
Physician Trainee ◽  
At Home

Abstract Background The COVID-19 pandemic resulted in a transformation of clinical care practices to protect both patients and providers. These changes led to a decrease in patient volume, impacting physician trainee education due to lost clinical and didactic opportunities. We measured the prevalence of trainee concern over missed educational opportunities and investigated the risk factors leading to such concerns. Methods All residents and fellows at a large academic medical center were invited to participate in a web-based survey in May of 2020. Participants responded to questions regarding demographic characteristics, specialty, primary assigned responsibility during the previous 2 weeks (clinical, education, or research), perceived concern over missed educational opportunities, and burnout. Multivariable logistic regression was used to assess the relationship between missed educational opportunities and the measured variables. Results 22% (301 of 1375) of the trainees completed the survey. 47% of the participants were concerned about missed educational opportunities. Trainees assigned to education at home had 2.85 [95%CI 1.33–6.45] greater odds of being concerned over missed educational opportunities as compared with trainees performing clinical work. Trainees performing research were not similarly affected [aOR = 0.96, 95%CI (0.47–1.93)]. Trainees in pathology or radiology had 2.51 [95%CI 1.16–5.68] greater odds of concern for missed educational opportunities as compared with medicine. Trainees with greater concern over missed opportunities were more likely to be experiencing burnout (p = 0.038). Conclusions Trainees in radiology or pathology and those assigned to education at home were more likely to be concerned about their missed educational opportunities. Residency programs should consider providing trainees with research or at home clinical opportunities as an alternative to self-study should future need for reduced clinical hours arise.

scholarly journals Culturally competent, safe and equitable clinical care for Ma¯ori with bipolar disorder in New Zealand: The expert critique of Ma¯ori patients and Wha¯nau

2021 ◽  
pp. 000486742110314
Author(s):  
Tracy Haitana ◽  
Suzanne Pitama ◽  
Donna Cormack ◽  
Mau Te Rangimarie Clark ◽  
Cameron Lacey
Keyword(s):  
Bipolar Disorder ◽  
New Zealand ◽  
Cultural Competence ◽  
Health System ◽  
Clinical Care ◽  
Clinical Work ◽  
Culturally Competent ◽  
Structured Interviews ◽  
Clinical Culture ◽  
Competence Framework

Objective: Research designed to increase knowledge about Māori with bipolar disorder is required to understand how health services support wellbeing and respond to identified levels of community need. This paper synthesises the expert critique of Māori patients with bipolar disorder and their whānau regarding the nuances of cultural competence and safety in clinical encounters with the health system. Methods: A qualitative Kaupapa Māori Research methodology was used. A total of 24 semi-structured interviews were completed with Māori patients with bipolar disorder and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data. Results: Three themes were evident from participants’ critique of clinical components of the health system. Theme 1 established that the efficacy of clinical care for bipolar disorder was dependent on Māori patients and whānau having clear pathways through care, and being able to access timely, consistent care from clinically and culturally competent staff. Theme 2 identified the influence of clinical culture in bipolar disorder services, embedded into care settings, expressed by staff, affecting the safety of clinical care for Māori. Theme 3 focused on the need for bipolar disorder services to prioritise clinical work with whānau, equip staff with skills to facilitate engagement and tailor care with resources to enhance whānau as well as patient wellbeing. Conclusion: The standard of clinical care for Māori with bipolar disorder in New Zealand does not align with practice guidelines, Māori models of health or clinical frameworks designed to inform treatment and address systemic barriers to equity. Research also needs to explore the role of structural and organisational features of the health system on Māori patient and whānau experiences of care.

IMPACT OF COVID-19 ON MENTAL HEALTH AND CONCERNS REGARDING CURRICULUM IN FINAL YEAR MBBS STUDENTS

2021 ◽  
pp. 11-13
Author(s):  
Mruthyunjaya N ◽  
Vaibhavi PS ◽  
Vinod Kulkarni G
Keyword(s):  
Mental Health ◽  
Undergraduate Students ◽  
Sleep Disturbances ◽  
Online Survey ◽  
Clinical Skills ◽  
Psychiatric Morbidity ◽  
P Value ◽  
Medical Undergraduate ◽  
Spss Software ◽  
Study Participants

Background: The current SARS CoV-2 pandemic has affected the mental health of various sectors of the country while it has also jeopardised the education system. In this background the present study was done to explore the mental health of the nal year medical undergraduate students and their concerns regarding the curriculum. Materials and Methods:An online survey was conducted among the nal year MBBS students in India and psychiatric morbidity was measured by the Depression, Anxiety, and Stress Scale-21. A total of 83 complete responses out of 130 were received and the data was assessed using SPSS software. Results: Out of the 83 study participants, about 34.9% were depressed, about 39.5% and 32.9% were having anxiety and stress, respectively. Sleep disturbances were signicantly associated with depressive symptoms (p value - 0.0001) and those with stress (p value - 0.01) while change in appetite was also signicantly associated with stress (p value - 0.01). Conclusion: The current pandemic has led to growing concerns in the educational sector especially medical education where MBBS students are facing psychological distress along with newer challenges in their academics like distant education as against traditional bedside teaching for acquiring clinical skills.

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