Healthcare professionals work in a diverse community of different specialities and skills. However, most healthcare professional courses are insular and isolating in their training methods. This results in highly trained individuals, who are unfamiliar with the true multidisciplinary team (MDT) approach in health services [1], leaving them unprepared for working in the NHS. One specific area where teamwork, good communication and appreciation of others’ skills sets are crucial is during medical emergencies and cardiac arrests, where multiple professions (including: Doctors, Nurses, Resuscitation officers, Operating Department Practitioners) work together to achieve the best outcome patients. We aimed to introduce Interprofessional Education (IPE) to cardiac arrest simulations for final year undergraduate medical and nursing students to improve their understanding of working as part of a MDT, to enhance their confidence in dealing with cardiac arrests and prepare them for work in the NHS. Reviewing the literature, there are several key components required to successfully instil IPE including: commitment to IPE, expert facilitation, understanding of roles in different professions, and positive role modelling [2]. When designing the course, we obtained each profession’s learning outcomes for cardiac arrest and planned them into the course; paying particular attention to equal weighting of learning outcomes for both professions and mutual learning outcomes. Furthermore, we identified key skills which we wanted students to demonstrate and designed simulations to incorporate these. For example, nursing students using the defibrillator in manual mode independently and medical students to independently use the defibrillator in automatic mode. To add value to the course we wanted high quality role modelling and profession specific feedback. To do this, we ensured both qualified nurses and doctors with experience in delivering feedback and real-life cardiac arrest cases were present for all sessions. Feedback collated from students and faculty positively supported the introduction of IPE in cardiac arrest simulation, with students specifically commenting on the benefits of teamwork, understanding each other’s competencies, and benefits of workings as an MDT. Due to these simple changes and keeping IPE at the centre of our design and implementation of the cardiac arrest simulation course, we were able to successfully introduce IPE to final year undergraduate medical and nursing students. 1. Choudhury RI, Mathur J, Choudhury SR. How interprofessional education could benefit the future of healthcare–medical students’ perspective. BMC Medical Education. 2020;20(1):1–4. 2. Buring SM, Bhushan A, Broeseker A, Conway S, Duncan-Hewitt W, Hansen L, Westberg S. Interprofessional education: definitions, student competencies, and guidelines for implementation. American journal of pharmaceutical education. 2009;73(4).
The COVID-19 pandemic has had a significant impact on the education of medical students. Many final-year students felt overwhelmed by the pandemic and less confident in the clinical setting having missed a significant proportion of their fourth-year studies. In addition, with increased numbers of critically unwell patients, restructure of services and redeployment of staff, it was inevitable that teaching on clinical placement would be compromised.The aim of the study was to develop an innovative near-peer educational programme with integrated simulation to support the learning needs of students and alleviate pressure from clinical specialities.The team developed a programme whereby students attended a full day of protected small-group teaching each week, equating to a total of 72 taught hours per student over an 8-week placement. Each day centred around a common theme, for example, ‘the breathless patient’, working through patient-centred case discussion, diagnostic workshops and simulation (Integrated design of the themed teaching days delivered to final-year students.This innovative teaching programme was implemented over the 2020–2021 academic year and was well received by students as evidenced in the following feedback: ‘It was really helpful and interesting to have each teaching day themed on a presenting complaint’.‘Protected time so (we) do not miss out if clinicians are busy’‘The best teaching I have had during medical school (…) I loved how interactive, clinically focussed and relevant to F1/F2 each teaching day was’.‘Consistently received feedback which I have been able to act upon to improve my clinical practice’‘The improvement in my confidence, understanding & knowledge has been unbelievable’.‘Simulation session was really useful and enjoyable (…) watching and feeding back is a really helpful way to recognize different clinical presentations and critically analyse ABCDE assessment & communication skills’‘These teaching sessions are great and unlike anything normally provided on placement’.The teaching programme has proved to be of such success that the team continue to develop them to integrate further aspects of clinical practice and inter-professional simulation. Furthermore, the team hope to develop themed teaching days for other student year groups to complement their clinical placements.
COVID-19 has undeniably impacted on learning for medical students, and one of their main concerns was the need for more course material when universities had to abruptly halt medical student placements due to social distancing restrictions. Our team had planned to have face-to-face simulation teaching with second-year medical students, focussing on the essential topic of A-E assessment and management of an acutely deteriorating patient. However, at short notice, we had to adapt this to an entirely online curriculum as a result of COVID-19 measures.The overall aim of the novel session was for students to virtually assess the simulated patient, manage any issues they found and use their examination and investigation findings to formulate a diagnosis and management plan. The presentation of the patient focussed on core conditions such as sepsis and hypoglycaemia.We developed an innovative 2-hour online teaching session designed to be delivered to a group of eight second-year medical students, facilitated in an online capacity over Microsoft Teams. The session ran as follows: using a flipped-classroom approach, the students had been given reading material about the A-E assessment to read prior to the teaching, so we started by discussing this and clarifying key points. Then the facilitator explained how the session would run and briefed the students about the scenario in the style of an SBAR (Situation, Background, Assessment, Recommendation) handover. Following this, students took turns to direct the simulated doctor through the A-E assessment of a low-fidelity simulation mannikin, instructing the doctor of any examinations, interventions or investigations they would like. The facilitator guided the students through the scenario, providing necessary examination findings and investigations for students to interpret and act on. Equipment such as oxygen devices, airway adjuncts and blood bottles were demonstrated to the students throughout.This session was an integral part of our second-year students’ 5-week virtual clinical placement. It was very well received; 95% (n = 21) of students strongly agreed or agreed that the session helped their learning. 90.5% strongly agreed or agreed that they enjoyed the use of technology-enhanced learning. Aspects specifically highlighted in the feedback were interactivity and being able to visualize the assessment of an acutely unwell patient. With online teaching likely to remain an important part of medical education, we have found that remote simulation is a suitable and effective way to introduce the assessment of a deteriorating patient.
NHS Trusts must deliver 30 hours of teaching to Foundation Year 1 doctors (FY1s) per year [1]. Our Trust previously delivered weekly hour-long didactic teaching sessions. Feedback was poor, so a new approach was required. Our Trust employs nine FY3 and FY4 junior doctors as Clinical Fellows in Education and Simulation. It was felt that the team, having recently completed FY1 themselves, could develop a useful and enjoyable FY1 teaching program. STR1DE – Simulation, Teaching, and Reflection for FY1 Development and Education – was developed and delivered by the Fellows. STR1DE involves six full teaching days throughout the year. Each day runs four times with a quarter of FY1s attending, to ensure reasonable class sizes. The team felt that simulation would be beneficial in teaching newly-qualified junior doctors. Simulation is an excellent way to help learners put theory into clinical practice [2], and it was felt that using carefully-designed scenarios would ensure FY1s felt the teaching was useful and relevant. Each STR1DE day therefore involves half a day of simulation using the Trusts’ high-fidelity facilities, alongside half a day of teaching including practical skills, small group teaching, and reflective sessions. All scenarios are designed around clinical scenarios which are commonly faced by FY1s in their clinical practice, alongside a variety of human factors. The scenario is observed remotely by other FY1s and the Fellows. The Fellows lead post-scenario debriefings with emphasis on reflection and peer-to-peer discussion and learning. Feedback has been excellent, with 100% of FY1s rating each session as ‘good’ or ‘very good’. The usage of near-peer teachers, the post-simulation debriefings, and the relevance of scenarios to FY1s’ clinical practice have been noted as factors contributing to this success. The benefits of near-peer teaching have been widely discussed in the literature, though often focus on junior doctors teaching medical students [3]. STR1DE demonstrates that teaching (including simulations) developed and delivered by junior doctors for more junior doctors can be relevant, useful, and enjoyable. Full-day teaching sessions seem to be preferable to shorter weekly teaching, allowing FY1s to focus on learning without worrying about work building up back on the wards. This approach also allows the usage of simulation, which would be difficult to deliver in a shorter session. Full-day teaching sessions, delivered by near-peers, with heavy usage of simulation, can be a highly effective way to deliver FY1 core teaching. 1. UK Foundation Programme. UK Foundation Programme Curriculum. London: UKFPO; 2021. 2. Okuda Y, Bryson E, DeMaria S, Jacobson L, Quinones J, Shen B, Levine AI. The Utility of Simulation in Medical Education: What Is the Evidence?. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine. 2009;76(4):330–343. 3. Rees E, Quinn P, Davies B, Fotheringham V. How does peer teaching compare to faculty teaching? A systematic review and meta-analysis. Medical Teacher. 2015;38(8):829–837.
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