Teaching the Teachers
Dr Phil Davies, Deputy Dean writes: -
On the afternoon of Thursday 19th of December the Academy held the second of what is now hoped to be an annual review for its educational leads. Tom Millard skilfully organised an exciting programme, which hopefully stimulated the twenty five attendees. Some of the highlights of the afternoon are discussed below.
Workplace Learning
Tom Millard provided an excellent review of current educational theory regarding workplace learning. Following this, two of our educational fellows Ben Savage and Michael Fox provided an excellent practical and very interactive example of applying this theory.
Using the example of the potential pitfalls of teaching medical students whilst on call and particularly whilst running (and initially running to) a cardiac arrest, they were able to tease out practical strategies for involving learners with little experience to involve them in high stakes education in a practical setting. Themes discussed included:
· whether students should attend cardiac arrest calls before basic or advanced life support training
· whether students should be allowed or encouraged to participate in practical procedures such as cardiac massage without prior knowledge of their skills or fears of doing something wrong
· do students need to be treated in a similar way to relatives who witness an arrest by ensuring that they are accompanied by a member of staff who is able to explain the process of resuscitation as it evolves
· what sort of debrief do students need after witnessing a successful or unsuccessful resuscitation?
The take home message from this session seemed to be that forward planning and preparation of students is the major contributory factor to successful workplace learning, whether this be on the ward or in a clinic, or in a routine or emergency situation. It was agreed that setting aside a few moments to explain to students how an educational session in the workplace will function will benefit both of them and the teacher in maximising the educational time in a busy working environment. In practice, this translates into an acceptance that the student cannot expect to
have detailed teaching on every patient or clinical situation that they will witness. Factoring in an introduction and a ten minute debriefing session at the end of the teaching session affords the opportunity to summarise the teaching opportunities that have been witnessed, allowing a student to clarify any factual points and plan further learning.
Simulated Teaching
Hannah Chant, our Undergraduate Clinical Skills Facilitator, kindly gave us a very practical overview of the equipment is now available in the clinical skills room where students are increasingly practicing examination skills such as venepuncture, blood gas sampling, PR, breast and intimate abdominal examinations. The skills room provides a safe teaching environment, where it is that it is acceptable and indeed even encouraged to practice, experiment and even make mistakes in the knowledge that such behaviour can develop correct practical skills before they are repeated when reviewing real patients in a supervised clinical environment. Within ever increasing focus on high fidelity simulation with high cost simulators Hannah's exhibition was a reminder of how low cost manikins still have an important place in medical education, especially when they are blended into clinical scenarios and situations.
Definition of a Curriculum
The final part of the afternoon focused on how we define a curriculum and how this may differ depending on your viewpoint as a teacher or a student. Teachers will have a view on what they should be teaching but need to be mindful of whether this agrees with the views of the University and what medical students are expecting to be taught.
Teaching Outside the Curriculum – can we teach empathy?
We also discussed the difficult problem of how students are taught about issues that do not necessarily figure on a true clinical curriculum but are vitally important to working as a doctor; issues that have been addressed by the General Medical Council in Tomorrow’s Doctors by advising how students not only need to be a taught how to be a scientist and a scholar, but also a practitioner, and a professional.
There was a mixed response to the viewing of a video made by the Cleveland Clinic (www.youtube.com/watch?v=cDDWvj_q-o8) Empathy - the human connection to patient care. The video shows staff, visitors and patients as they pass through the hospital. It encourages you to think of what they are thinking or what has brought them to the hospital.
The more sceptical in the audience pointed out that the Cleveland Clinic is one of the most affluent hospitals in the world and can therefore afford the infrastructure and the space to promote an empathic culture. Whether this is possible to achieve within the NHS is a more difficult question to answer. Whatever your viewpoint the video contains some striking images that may make you think differently about that last potentially heart sink patient that you see at the end of a busy day. Why not watch the video yourself and make up your own mind?
Many thanks to everyone who helped organize the afternoon. Make sure that you keep a space in your December itinerary for the 2014 annual review.