The immune system

This article considers the immune system. The reader is introduced to the immune system and how the body defends itself against infectious organisms, foreign cells and self-cells that have gone awry (such as, cancer cells). The article focuses on the organs of the immune system, and vaccination is briefly discussed. The healthcare assistant (HCA) and assistant practitioner (AP) must have an understanding of the immune system if they are to offer person-centred, safe and effective care and support to people. The article concludes with a glossary of terms and a set of questions intended to reinforce learning.

The endocrine system: regulator of body activities

The endocrine system has an important role to play in the regulation of body activities and does this in conjunction with the nervous system. This article offers the healthcare assistant (HCA) and assistant practitioner (AP) an overview of the anatomy and physiology of the endocrine system and its functions; key glands are discussed. An understanding of the endocrine system can help the HCA and AP offer people care and support that is informed. There are a number of conditions that might affect the endocrine system and result in a negative impact on a person's health and wellbeing. The article includes a glossary of terms and a series of questions that can assist in learning.

A pilot project evaluating a fixed drainage system (U-Drain) for automated peritoneal dialysis

U-Drain is a fixed drainage system for automated peritoneal dialysis (APD) connecting the dialysis effluent outflow directly to the household drainage system thus avoiding the need for drain bags, with considerable potential advantages for patient convenience and reduction of plastic clinical waste. Here we present a pilot project reporting on U-Drain patient and staff experience based on questionnaires and on the safety of the technology derived from analysis of characteristics of peritonitis episodes. Overall, 15 patients were included in the pilot project and were followed up over 3 years; 11 patients completed a questionnaire exploring their experiences of APD and U-Drain. A family member 55%, carer 10%, healthcare assistant 10% and patient themselves 25% would normally carry the full drainage bags for disposal. Following the installation of U-Drain, 90% of patients reported that the system saved them time setting up and clearing the machine after dialysis, 80% noted a reduction in storage space required for consumables and all patients noted a reduction in non-recyclable waste requiring disposal. All patients who completed the questionnaire were very satisfied with the installation. All staff members who completed the questionnaire reported that their role was easier and the system was time saving. In total, there were 8 peritonitis episodes, including 2 recurrent infections due to biofilm, over 313 patient months follow up. There was no increase in incidence of peritonitis infection (0.3 episodes per year at risk) compared to that in the unit’s population (0.64, 0.42 and 0.5 episodes per year at risk for the years 2017, 2018 and 2019, respectively) or delays in diagnosis. Approximately 0.8 kg of non-recyclable clinical waste was saved per treatment day from domestic waste by avoiding the use of PD drain bags. This pilot demonstrates increased patient satisfaction and acceptable safety profile of U-Drain technology.

The brain: our control system

The largest and the most complex organ in the body is the brain. In this article, the healthcare assistant and assistant practitioner (HCA and AP) are introduced to the fundamental features that are associated with the anatomy of the brain. The body's central nervous system is made up of the brain, along with the spinal cord. This is the main control system for the body's functions and abilities, allowing conscious communication with the body and automatic operation of the vital organs, for example, the heart. In this article, specific functions of the brain are considered. The four lobes of the brain are reviewed and also the three coverings of the meninges. Having insight and understanding related to how the brain functions can help the HCA and AP offer people care that is founded on a sound knowledge base. A glossary of terms is provided and a short quiz has also been included.

Human reproductive systems: the wonder of life

The female and male reproductive systems are considered in this article. While these two systems are very different, there are some fundamental issues that concern both systems, for example, the approach that the healthcare assistant and associate practitioner (HCA and AP) takes when offering care and support to people. This article provides an overview of the reproductive systems, their location and their functions. A glossary of terms has been provided and a range of multiple-choice questions is included, so as to aid learning and recall.

Qualitative exploration of medical student experiences during the Covid-19 pandemic: implications for medical education

Background During the Covid-19 pandemic medical students were offered paid roles as medical student healthcare assistants. Anecdotal reports suggested that students found this experience rich for learning. Previous studies have explored alternative models of student service, however this defined medical student support role is novel. Methods Individual semi-structured interviews were recorded with 20 medical students at a UK medical school exploring their experiences of placement learning and experiences of working as healthcare assistants. Responses were analysed qualitatively using a framework approach. The framework was developed into a model describing key findings and their relationships. Results Interviews yielded data that broadly covered aspects of (1) Medical students’ experiences of clinical placement learning (2) Medical students’ experiences of working as medical student healthcare assistants (3) Learning resulting from working as a healthcare assistant (4) Hierarchies and professional barriers in the clinical environment (5) Influences on professional identity. Participants described barriers and facilitators of clinical learning and how assuming a healthcare assistant role impacted on learning and socialisation within the multidisciplinary team. Students became increasingly socialised within the healthcare team, contributing directly to patient care; the resulting social capital opened new opportunities for learning, team working and enhanced students’ interprofessional identity. Students described the impact of these experiences on their aspirations for their future practice. Conclusions Changes to work patterns in healthcare and delivery models of medical education have eroded opportunities for students to contribute to healthcare delivery and be embedded within a team. This is impacting negatively on student learning and socialisation and we suggest that medical curricula have much to learn from nursing and allied health professional training. Longitudinal embedment with a multidisciplinary team, where students have a defined role and work directly with patients may not only add value to clinical service, but also overcome current barriers to effective placement learning and interprofessional identity formation for medical students.

The respiratory system

Breathing allows oxygen to be delivered to internal tissues and cells where it is needed, as well as facilitating the removal of carbon dioxide. An overview of the respiratory system and its key functions is provided in this article. The upper and lower respiratory tracts are discussed. It is important for the healthcare assistant and assistant practitioner (HCA and AP) to develop an understanding of the anatomy and physiology of the respiratory system and how it functions if care that is provided is to be safe and patient-focused. At the end of the article, a glossary of terms is provided and, to aid recall, a short quiz has been included.

Qualitative Exploration of Medical Student Experiences during the Covid-19 Pandemic: Implications for Medical Education

Background During the Covid-19 pandemic medical students were offered paid roles as medical student healthcare assistants. Anecdotal reports suggested that students found this experience rich for learning. Previous studies have explored alternative models of student service, however this defined medical student support role is novel.Methods Individual semi-structured interviews were recorded with 20 medical students at a UK medical school exploring their experiences of placement learning and experiences of working as healthcare assistants. Responses were analysed qualitatively using a framework approach. The framework was developed into a model describing key findings and their relationships.Results Interviews yielded data that broadly covered aspects of 1. Medical students’ experiences of clinical placement learning 2. Medical students’ experiences of working as medical student healthcare assistants 3. Learning resulting from working as a healthcare assistant 4. Hierarchies and professional barriers in the clinical environment 5. Influences on professional identity. Participants described barriers and facilitators of clinical learning and how assuming a healthcare assistant role impacted on learning and socialisation within the multidisciplinary team. Students became increasingly socialised within the healthcare team, contributing directly to patient care; the resulting social capital opened new opportunities for learning, team working and enhanced students’ interprofessional identity. Students described the impact of these experiences on their aspirations for their future practice.Conclusion Changes to work patterns in healthcare and delivery models of medical education have eroded opportunities for students to contribute to healthcare delivery and be embedded within a team. This is impacting negatively on student learning and socialisation and we suggest that medical curricula have much to learn from nursing and allied health professional training. Longitudinal embedment with a multidisciplinary team, where students have a defined role and work directly with patients may not only add value to clinical service, but also overcome current barriers to effective placement learning and interprofessional identity formation for medical students.

The experience of implementing and delivering group consultations in UK general practice

Background: Group consultations are a relatively new concept in UK primary care and are a suggested solution to current workload pressures in general practice. However, little is known about the experience of implementing and delivering this approach from staff and organisational perspectives. Aim: To explore the experience of implementing and delivering group consultations in general practice. Design: Qualitative telephone interview study. Methods: Topic guides explored the perspectives and experiences of general practice staff on the implementation and delivery of group consultations. Data analysis adopted principles of the Framework Method underpinned by Normalisation Process Theory. Results: Interviews were conducted with 8 GPs, 8 Practice Nurses, 1 Nurse Associate, 1 Practice Pharmacist, 1 deputy Practice Manager, 1 Healthcare Assistant. Four themes were identified: sense making of group consultations; the work associated with initiating group consultations; the experiences of operationalising group consultations; and sustaining change. Group consultations made sense to participants as a mechanism to reduce burden on primary care, enhance multi-disciplinary working, and provide patient-centred care. Implementation required strong leadership from a ‘champion’, and a facilitator had a pivotal role in operationalising the approach. The associated workload was often underestimated. Barriers to embedding change included achieving whole practice buy-in, competing practice priorities, and system-level flexibility. Conclusion: General practice clinicians enjoyed group consultations, yet significant work is required to initiate and sustain the approach. An implementation plan considering leadership, roles and responsibilities and wider organisational support is required at the outset. Further research or evaluation is needed to measure process outcomes.