Abstracts for Podium Presentation
------
Alok Sharma
InstitutionPrincess Anne Hospital SUHT
Specialty & YearNeonatology Year 5
Simulation in Medical Education-‘A neonatal model’
Sharma A, Wilson H, Francis S, Fielder H
Introduction- Point of care simulation is a novel approach in medical education allowing multidisciplinary teams to train in clinical environments. Drivers for introducing simulation in education include changes in junior doctors hours, evidence base, and trainee feedback (1),(2).
Method-A team trained at Leicester as simulation instructors conducted monthly sessions involving neonatal scenarios as per RCPCH curriculum (3). They were structured with an introduction, simulation sequence and debrief, run by 2 faculty.
Results- 12 sessions have been organised training 100 staff including trainees, nurses, ANNP’s, and midwives. 20 scenarios developed address the neonatal airway, access, respiratory, circulatory, and surgical problems as well as communication. 49 feedback forms received have positive feedback and suggestions for development.
Conclusion-We present a ‘model of simulation’ in education, which complements our training programme by familiarising trainees with common neonatal conditions, procedural skills and highlights areas of risk. We are working towards a multidisciplinary model.
1. Donaldson L. Safer medical practice: machines, manikins and polomints. London, UK: Department of Health 2008.
2. Templeton J. Time for Training: A review of EWTD on the quality of training. Medical Education England. June 2010.
3. (page 107-111)
------Ussamah El-khani
InstitutionImperial College
Specialty & YearCT1 Surgery
Surgical Simulation in Undergraduate Anatomy Education. An Untapped Resource?
Ussamah El-khani, Asit Arora, Shamim Toma, Jean Nehme, Ceri Davies, Neil Tolley
Background: Postgraduate surgical simulators are rarely used to teach undergraduate anatomy, despite possessing many features that would favour their use in such a discipline.
Aims: We present the first prospective controlled trial to evaluate the use of a validated post-graduate surgical simulator in teaching undergraduate temporal bone anatomy
Method: Near-identical temporal bone anatomy modules were created: one used on a surgical simulator, and one as a self-directed PowerPoint tutorial. 25 undergraduates were assigned to the simulator module (n=14) and PowerPoint module (n=11). Pre-and-Post module knowledge, confidence and satisfaction scores were measured.
Results: The knowledge improvement in the simulator and PowerPoint groups was 34% (p<.001) and 33% (p<.001), respectively. The confidence score improvement was 32% (p<.001) and 28% (p<.001), respectively. There was no difference in satisfaction scores (p=.758).
Conclusions: Simulation-based modules present a useful adjunct for undergraduate anatomy education, but a well-developed non-interactive module can produce similar improvements in knowledge gain.
------
Frederick Speyer
Specialty and YearCMT2 Medicine
Work done forNHS South Central
Killing Sepsis with Education and Team working – Reducing harm through education innovation across NHS South Central
Dr Frederick Speyer, Dr Matthew Inada-kim
Severe sepsis kills 1400 people worldwide/day, costs £21 billion to treat, and has a ~50% mortality.
By tackling the cultural hurdles that prevent multi-professional education, a new model for learning has been created by devising a modular in-situ education package - a learning resource that can be taken off the shelf and used by anyone to deliver ‘Sepsis Symposia’ to staff in the workplace without needing dedicated 'time-off'.
The Sepsis Symposia aim to improve the practitioners’ knowledge of the disease process and how applying a Human Factors approach can impact upon the efficiency and effectiveness of care to save lives.
A ‘Train the Trainer’ programme is running to create a region-wide faculty of educational facilitators (25 personnel trained to date).
By providing consistency in learning and shared knowledge, multi-disciplinary teams can be connected together to provide harmonised therapy that has been proven to reduce length of stay and save lives.
Abstracts for PosterPresentation
------
Charlotte Allan
InstitutionOxford Health NHS Foundation Trust
Specialty & YearST4 Old Age Psychiatry
Encouraging specialty recruitment: Foundation taster days in psychiatry
Charlotte L Allan, Helen Lee, Denis O’Leary
Background: Foundation taster days were introduced in Oxford Deanery (September 2011) to stimulate interest in psychiatry, inform career choices and encourage recruitment.
Aims: To provide a realistic introduction to psychiatry incorporating a range of activities: observation of clinics and ward rounds, shadowing psychiatry trainees, participating in teaching and the opportunity for career advice.
Methods: Taster programmes were designed to meet individual needs, with the scheme organiser co-ordinating placements in consultant-led teams.
Results: Nine doctors have participated so far, and all completed an evaluation. Participants valued the clinical experience, informal career discussions and cited the programme as helpful to their career choices. Six now plan to apply for speciality training in psychiatry.
Conclusions: Taster days can be a useful way to make connections with Foundation doctors, to encourage recruitment in psychiatry. The scheme will be continued in Oxford Deanery in 2011-12 and could be extended to other regions or specialities.
------
Indraneil Basu
InstitutionMilton Keynes General Hospital
Specialty & YearCT1 Gen Surg
E-Assessments – Current perceptions in clinical practice
S. Parvizi, I. Basu, P. Subramanian, K. Chin
Clinical assessments are shifting towards formalized web based systems. Evidence suggests these have a limited impact on learning and performance. This study investigates whether clinicians understand these systems and find them useful.
Questionnaires were given to 50 trainees and 10 consultants to assess their perceived usefulness and educational value.
Consultant opinion suggested they were moderately intuitive (VAS-5/10), were an average reflection of true ability (VAS-4.5/10) but of minimal overall benefit (VAS-3.4/10).
Trainees found consultant assessments particularly difficult to obtain. In addition consultant assessments were thought to be taken less seriously (4.4/10vs5/10) and to be of less academic value (4/10vs4.8/10) than those from other grades. Overall e-assessments were regarded as a poor reflection of clinical acumen (VAS-2.9/10).
These results suggest the current use of e-assessments is not conducive to effective training. Of particular interest is the poor opinion of consultant based assessments. To be effective a significant culture change is required
------
Dr Andrew Boyd
InstitutionGP Dorset
Specialty & YearGPST4 academic fellow
Fixing a broken mirror? The impact of a reflective writing workshop for GP trainees
Dr Andrew Boyd
The learning log, where trainees record clinical reflections, forms part of the compulsory GP trainee eportfolio. Attitudes to the value of reflective practice for personal development are mixed. Many GP trainees engage reluctantly or not at all, resulting in trainer's concerns as to the ‘depth’ and ‘quality’ of learning log entries.
This project aimed to explore attitudes to reflective practice in a group of first year GP trainees, before and after two reflective writing workshops. A focus group discussion was followed by the workshops, which aimed to develop the trainees’ reflective writing skills and understanding. The same group completed questionnaires exploring their attitudes to reflective practice after the workshops.
The study found that GP trainees were receptive to clinical reflective writing, but expressed anxieties and frustrations with the eportfolio as it stands. The workshop was well received by trainees, and could be reproduced elsewhere using the freely available online materials.
------
Aurelia Butcher
InstitutionSouthbourne Surgery & Dorset GP Centre
Specialty/YearGP ST4 (Med Ed Fellow)
The Dorset GP Infonet - a local information resource for GP trainees & their patients.
Dr Aurelia C R Butcher, Dr Peter D Perkins, Dr Ian Wyer, Dr Samantha Scallan
Background The registrar year of GP training is daunting. Registrars struggle to identify sources of help for:
- Their own education/professional development
- Accessing patient services
- Sourcing information/education for patients regarding their own health.
Summary of work GP trainees' views were sought regarding the need and/or usefulness of a scheme to collate information into a guide for GP trainees, and the format of the resulting "handbook".
Summary of results A handbook, the Dorset GP Infonet, was created to address identified unmet needs of GP trainees, who felt they would benefit from such a scheme.
Conclusions The Infonet forms part of the Dorset GPCentre website for GPs and trainees. It has sections addressing local services, patient resources, and professional resources & direct links to key sites/documents. The poster depicts sample Infonet pages.
Take-home message We identified areas in which GP trainees and their patients would benefit from information and collated this in an easy-reference guide.
------
Robert Driver
InstitutionBasingstoke & North Hampshire Foundation Trust
Specialty & YearCT2 Core Medical Training
Learning on the take – can core medical trainees cover their core competencies by clerking general medical admissions?
Dr. Robert Driver
The core medical training curriculum identifies ‘the top 20’ common medical presentations and a further 40 other important presentations in which each trainee must show competence. Trainees rely on the unselected medical take to gain this experience and complete their workplace based assessments. In this study I have reviewed 246 patients whom I clerked during my CT1 year, analysing the frequency of each presentation.
All 20 ‘common presentations’ were seen at least once and 18/20 (90%) were seen at least five times. 71% of all presentations were in the ‘top 20’ category. 33/40 (83%) of the ‘other important presentations’ were seen at least once.
This study shows the breadth of experience available at a district general hospital, but further specialty experience is necessary to cover all competencies. It is hoped that further similar studies might be carried out by trainees in larger teaching hospitals to assess the breadth of experience.
------
Thomas Dobbs
Specialty and YearFoundation Year 1
Work done forAs part of medical education course “MedEd”
Confidence in core practical procedures among clinical medical students
T. Abbott, T. Dobbs, C. Bulstrode
Every medical student is required to be competent to perform the duties of a Foundation Year 1 doctor when they graduate from medical school, including simple practical procedures. Whilst competence is routinely assessed, little attention is paid to confidence. We surveyed self-assessed confidence in performing practical procedures of 339 clinical medical students from 12 UK medical schools (2.2% response rate) using an online questionnaire.
We found that whilst confidence increases as students progress through medical school, less than 90% of final year students would be confident to carry out the procedures required by the GMC during their first foundation year. We demonstrate that practise in a clinical skills laboratory does not improve confidence and that over three-quarters of students would like further training.
We recommend that more attention is paid to checking confidence as well as competence before passing medical students as fit to start their foundation year training.
------
Nikki Dunne
InstitutionWycombe Hospital, Oxford Deanery
Specialty & YearGeneral Surgery, ST6
“A Rough Guide to...... Your On-Call” A new cross-specialty run course for Foundation Doctors.
Miss N Dunne, Dr D Kelly, Dr K Russell
Background“A Rough Guide to....Your On-Call” was devised as a survival guide for new Foundation doctors run by a general surgeon, an anaesthetist and a physician.
Aims
- To give a general approach to any sick patient, increasing confidence at assessment and management. To recognise the ceiling of treatment options available in a ward setting, and when, how and who to call for help.
- Fluid prescribing, pain management and talking to relatives are also covered.
MethodsA voluntary morning session ran 2 days prior to the new doctors starting and 36 attended. There were some short lectures followed by small group interactive sessions working through scenarios of reviewing sick patients.
ResultsFeedback forms were completed by all. 22 rated it extremely useful and 14 useful. 20 rated the course excellent overall and 16 good. Active involvement in small group sessions was most popular.
ConclusionsMost said it had increased their confidence and made them feel better prepared, and we plan to roll it out deanery-wide next year.
------
Thomas Foong
InstitutionUniversity of Southampton & Southernhealth NHS Trust
Specialty & Year ST4 Psych
Effectiveness of a mock OSCE practice session for medical students
Thomas Foong, Jay Amin, David Baldwin
Aim & method: Medical students in Southampton University have voiced concerns in approaching psychiatric scenarios in their end of year OSCE. In response, a 6-station mock OSCE practice session was designed to aid students' exam preparation. In this first cycle audit, the benefits of the mock OSCE was compared to a standard set by a published observation study.
Results: 30 students were selected. There were noticeable improvements in all the measured items before and after the mock OSCE. For example, in the measured item 'I feel prepared for the OSCE' there was an increase in median score of one likert-scale-point. The mean results of the each measured items also reflect a similar improvements.
Conclusion and recommendations: The re-audit cycle will take place next year to consolidate the above findings. At the time when there is a recruitment crisis in psychiatry, this mock exam may increase the students' exposure to psychiatry.
------
Renee Ford
InstitutionRoyal Hampshire County Hospital
Specialty & YearAnaesthesia ST5
Making Connections with Africa – experience with AMREF (African Medical Research Foundation)
Renee Ford
Background: As a volunteer physician for AMREF, I was based at Wilson Airport in Nairobi for one month, on call 24/7 for the emergency air ambulance service that not only served Africa, but also flew patients from the rest of the world back to their home countries in emergency medical evacuations.
Aims: I undertook this post in order to see parts of Africa that would normally not be seen by the average traveller, and to have the opportunity to work with people from a culturally different background. I expected to gain more insight into the challenges they face in their working environment and to find ways to support the valuable work that they do through education.
Methods: Daily meetings with the chief medical operator, the chief operations manager, the fleet of flight engineers and flight nurses based at Wilson airport. This helped to plan for the dispatch of emergency flights and to triage incoming telephone requests. Accordingly, the day’s work would slowly unfold.
Results: The medical evacuations took me all over parts of East Africa, both domestic within Kenya, as well as further afield in countries such as war-torn Mogadishu in Somolia and politically unstable Kinshasa in Congo. The work brought me in touch with aid-worker heavy Uganda, the jungle covered land of Djibouti, and the mysterious language of Amharic, spoken in Ethiopia. I learnt that the art of diplomacy was far more useful in getting through customs in Kampala at 3 am, than the presentation of any official papers or identification badges.
Key messages: This is a unique opportunity to experience a side of Africa that very few foreigners will see. The unexpected challenges that arise from every flight evacuation meant that lateral thinking and the ability to problem-solve will determine relative success or failure! I was hugely humbled by the work that can be done without the resources that we have in the UK, whilst recognising that a little teaching can go a long way in helping to form a uniform approach to clinical problems.
------
Suzanne Gill
InstitutionOxford Deanery GP VTS ST4
Specialty & YearGP VTS ST4 Clinical Leadership Fellow
Insight, Influence and Impact – Introducing a co-ordinated leadership programme into the Oxford Deanery GPVTS ST3 year.
Dr Suzanne Gill, Ros Crowder and Maggie Woods
Insight, Influence and Impact is a co-ordinated leadership programme being introduced to the Oxford Deanery GPVTS ST3 year. The programme aims to increase trainees’ knowledge, skills and enthusiasm about leadership in order to help develop future GP leaders and improve patient outcomes.
The programme is being developed by two CPD tutors with a Clinical Leadership Fellow. It is based on the NHS leadership framework and is directly linked to MRCGP curriculum outcomes. The content includes leadership self-assessment, action learning sets, master classes and quality improvement projects.
Evaluation will include feedback from trainees, trainers and programme directors as well as outcomes from self-assessments, quality improvement projects and action learning sets. As the programme is being introduced this academic year the findings are not yet available. Presenting a poster would give the perfect opportunity to share progress and plans and learn from the experiences of others in different deaneries and specialities.
------
Hannah Jacob
InstitutionWhittington Hospital, London
Specialty & YearST1 Paediatrics
Teaching medical students on call: a firm experience
Dr Hannah Jacob, Dr DJM Reynolds
Background Teaching is integral to the professional development of doctors. We show how medical students shadowing junior doctors during on-call shifts promotes individualised teaching and establishes professional relationships beneficial to doctor and student.
Methods Each student on a medical firm shadowed one of the firm’s junior doctors, spending at least one evening or weekend on-call shift with them.
Results The junior doctors felt more confident in their teaching abilities and found that spending time with each student individually helped them understand the students’ particular learning needs.
The medical students felt empowered by using the clinical skills they had learnt. They enjoyed having individualised teaching and felt more confident seeking professional advice from the junior doctors subsequently.
Key Messages All junior doctors should participate in one-to-one medical student teaching during on-calls. This promotes the development teaching skills in the doctor and offers a more personalised learning experience for the student.
------
Rosalind Jarvis
InstitutionSUHT
Specialty & YearST3 O&G (OOP year in medicine)
The Educational Theory Underpinning a Clinical Workbook: ‘Prevention of Thromboembolic Disease for Obstetricians and Midwives’.
Dr Rosalind Jarvis
Thromboembolic disease is one of the leading causes of morbidity and mortality in pregnancy within the United Kingdom. Awareness and prevention are paramount. In translation of theoretical knowledge to clinical practise a gap exists and learners may develop apathy towards such a familiar subject. I designed a novel workbook for use by obstetricians, midwives and students to address these issues.