October 26th 2011
The last couple of weeks have seen the start of our first organised high-tech simulation programme for the 5th year medical students at UHSM. This approach to teaching is rapidly gaining international recognition as an effective part of learning both at undergraduate and postgraduate levels in health care settings. It’s been a sharp learning curve for us over the past couple of years - learning how to effectively operate and programme the manikin was key, but probably more difficult was the process of producing effective learning encounters and facilitating constructive debriefing sessions to try and maximise the learning potential from each session.
What do we mean when we talk about simulation? Actually the vast majority of what we do in the clinical skills unit could be considered to be simulation. Our simplest simulators allow students to practice a particular task e.g. basic life support or arterial blood gas sampling. Then we have some slightly more sophisticated models that can simulate different patient conditions e.g. prostate abnormalities or abnormal lung sounds. We also work with an excellent group of actors who we use as “simulated patients” in order to help students learn, practice and reflect upon the non-technical aspects of medicine- like effective communication skills. The key concept behind all of this is that it is possible to learn and rehearse skills in an artificial environment, which should then prepare the learner to practice more effectively in a “real world” setting.
So what about the high-tech simulator? This is an extremely sophisticated piece of machinery designed to closely mimic several body systems so that it can be used to provide a high fidelity representation of an unwell patient. It can be set up to mimic a range of different conditions, and learners can be directed to examine the manikin using the same techniques they would with a ‘real’ patient. They can also practice a number of different interventions and see the effects on the patient as the software model that runs the simulator reacts to the interventions they use. Sessions are recorded and can be played back during the debriefing process to illustrate points.
So at the moment we’re just getting started - but there are plans in place to build a dedicated simulation suite and to expand these programmes beyond what we can currently deliver. Hopefully this will form an integral part of our educational delivery for the future and enable us to continue driving up standards in both education and care.
October 6th 2011
It’s been a few weeks since I’ve managed to blog, a wedding, a honeymoon and an extremely busy week getting back to work all seemed to get in the way.
So what’s going on in the skills unit at the moment? Well life continues as normal with it’s regular challenges and a few new ones along the way. The third years are out and about on their first clinical firms and we see each group every two weeks for skills teaching. This weeks topic- How to examine the rectum and testicles - not the most pleasant of subjects but two skills that are at least as much about good communication as they are about the practical aspects of what you are trying to do. The fourth years are getting quite close to their first practical exam of the year and can occasionally be seen popping in for extra support, advice or practice – although I most often see them in the corridors as their firm timetables are so packed they don’t leave much time for “off the ward” teaching. The fifth years are coming towards the end of their 2nd block- just two more to go before Christmas and so we’re rolling out the teaching programme for them with massive support from a large number of colleagues from a wide range of specialities- all of whom contribute towards making this period the best learning and revision period we possibly can for our students, and hopefully will give them their best chance in their final exams this year.
This week sees the start of the early experience hospital visits for Year 1 medical students. These students will be spending the next two years mostly shut away in the University buildings learning the theoretical and applied life sciences that they will need to form a foundation for the clinical years of their training. We have these students out to a hospital twice during each semester over this two year period, and they also have visits to community services. These visits help them start to gain an appreciation of the reality of working with patients, and to gain further experience of putting communication skills into practice in a professional context.
Running these visits involves a number of our ward based staff who help us identify suitable patients for these (mostly) inexperienced students to talk to. It also involves our patients, who may find themselves being approached by very nervous looking students- who just want to talk to them. We also involve other members of our multi-disciplinary team, as we begin to re-enforce the vital importance of inter-professional team working throughout in every medical speciality. The students universally appreciate these visits and are very grateful for the experiences that we as a Hospital provide for them. As a team we are also extremely grateful for the support we get from everybody who helps make these sessions work so well. By providing positive learning experiences for these students so early in their medical careers we can all contribute to helping them become the best doctors they can possibly be.
September 6th 2011
How do you take 130 medical students, most of whom have rarely set foot in a hospital before, and in the space of two weeks make them ready to join in as part of a clinical team and begin their hospital based learning?
It sounds like the beginning of a very long and involved joke, but that’s what’s currently occupying our team. Things are better than they used to be- at least now in years one and two of the medical course the students visit a hospital for a few hours once or twice a semester. But that’s still a long way from knowing how to function as part of a large and varied team in a complex environment.
Like all new starters these students have a number of important local and global induction activities to complete, but mixed in and around this we have a number of essential educational outcomes we need to achieve. Today is all about examining the respiratory and cardiovascular systems, we have recruited as many junior doctors as we can, and a number of healthy volunteers so that the students can get some supervised hands on learning. Throughout these two weeks we rely heavily on input from a number of our colleagues throughout UHSM, and we are proud to say that every year they rise to the challenge and this important programme continues to run. For me personally, and my fellow tutors, these are by far the busiest and most challenging weeks of the year. Looking at my timetable this week I see I am teaching subjects as diverse as Moving and Handling, Communication Skills, ECG interpretation, Basic Life support and Venepuncture/Cannulation- and I’m not even the lead for this programme.
So busy times, but experience has shown us that the students retain a terrific amount of what they are taught during this period, and that giving them this “Introduction to Clinical Learning” helps them get a running start into their year 3 programme.
August 30th 2011
Fourth year medical students are back from their summer break this week, with fifth years coming back next week, and a whole new batch of third years starting with us the week after.
The past few weeks have been spent putting together their skills teaching programmes for the coming academic year and making sure that we’ve got enough equipment in to run the sessions we’ve planned for the start of the year.
This period always feels a little bit like the calm before the storm, we don’t have the constant visits from students “just wanting to go over..” and so get the chance to catch up with some desperately needed admin and planning. It’s also a useful time to reflect on the past year and what we’ve achieved, and to evaluate programmes to see if there are ways we can improve what we do in the future.
Undergraduate Medical Education is a core part of what we do here at UHSM with around 400 medical students based here at a time. These students are in the final three years of a (normally) 5 year medical degree and will be based here and at our associated teaching hospitals for the majority of that time.
Almost all of the staff who work in the hospital will have contact with Medical Students as they progress through their training, and we take our responsibilities towards these students extremely seriously, after all they are (as the GMC points out) “Tomorrow’s Doctors.
Those of us who are fortunate enough to work extensively with these students can tell you just how much they appreciate the learning opportunities that our patients and staff give them during their time here. They don’t always get to say it personally, but each and everyone of them leaves here extremely grateful for the time, effort and understanding that people have given to them. So as they start to descend on us once again it’s quite nice to spend a bit of time thinking about the broader context of what we do, and resolving to make September into “lets smile at a student” month.