Background As a result of the COVID-19 pandemic Imperial College School of Medicine developed a structured volunteering programme involving 398 medical students, across eight teaching hospitals. This case study aims to explore the relationship between the processes, context, participant experiences and impacts of the programme so that lessons can be learned for future emergencies and service-learning programmes. Methods Using an illuminative approach to evaluation we invited all volunteers and supervisors to complete a mixed-methods survey. This explored differences in experience across demographics and contextual factors, correlations between aspects of induction, supervision and overall experience, and reviewed the impacts of the programme. Quantitative responses were statistically analysed and qualitative reflections were thematically coded to triangulate and explain quantitative findings. Follow up interviews were carried out to check back findings and co-create conclusions. Results We received responses from 61 students and 17 supervisors. Student participants described predominantly altruistic motivations and transformational changes to their professional identity driven by feeling included, having responsibility, and engaging in authentic workplace-based learning afforded by freedom from the assessed curriculum. They reported new perspectives on their future professional role within the multidisciplinary team and the value of workplace-based learning. They reported increases in wellbeing and self-esteem related to feeling included and valued, and positively contributing to service provision at a time of need. Significantly higher overall satisfaction was associated with a personalised induction, active supervision, earlier stage of training, and male gender. Gender-related differences were not explained through our data but have been reported elsewhere and warrant further study. The duration, intensity and type of role that volunteers performed was similar across demographics and did not appear to modulate their overall experience. Conclusions Whilst acknowledging the uniqueness of emergency volunteering and the survey response rate of 15% of volunteers, we suggest the features of a successful service-learning programme include: a learner-centred induction, regular contact with engaged and appreciative supervisors, and roles where students feel valued. Programmes in similar settings may find that service learning is most impactful earlier in medical students’ training and that students with altruistic motivations and meaningful work may flourish without formal outcomes and assessments.

Background Safe and effective clinical outcomes (SECO) clinics enable medical students to integrate clinical knowledge and skills within simulated environments. This realistic format may better prepare students for clinical practice. We aimed to evaluate how simulated surgical clinics based on the SECO framework aligned with students’ educational priorities in comparison with didactic tutorials. Methods We delivered two breast surgery SECO-based simulated clinics to Year 3 students during their surgical attachments at a London teaching hospital. All students attended a didactic breast surgery tutorial the previous week. Pre- and post-session surveys and post-session debriefs were used to explore learning gain, processes, preferences and impacts on motivation to learn. Data were analysed using inductive thematic analysis to categorise student views into themes. Results Seventeen students enrolled in the simulated clinics and debriefs. Students expressed that passing examinations was a key extrinsic motivating factor, although the SECO-based format appeared to shift their motivation for learning towards aspiring to be clinically competent. Self-reported confidence in clinical skills such as history taking and examination improved significantly. Active learning methods were valued. Students expressed a preference for simulated clinics to complement, but not replace, tutorial-based learning. Conclusion The SECO-based simulated clinic promoted a shift towards intrinsic motivation for learning by allowing students to recognise the importance of preparing for clinical practice in addition to passing examinations. Integration of surgical simulated clinics into the undergraduate curriculum could facilitate acquisition of clinical skills through active learning, a method highly valued by students.

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Introduction:The COVID-19 pandemic has had an unprecedented impact on students currently preparing to apply for medical school, including lost work experience opportunities and reduced support from schools. This study evaluated an annual widening participation course aimed at supporting Year 12 students local to Chelsea and Westminster Hospital NHS Foundation Trust, which was adapted into an online format in response to these challenges.Methods: Participants completed application forms, pre-course, post-course and daily evaluation questionnaires. Participants' pre-and post-course self-reported preparedness scores were analysed using a two-tailed paired t-test. Thematic analysis was performed on all free-text responses.Results: In the pre-course questionnaire (n=48), participants reported difficulties with applications due to the COVID-19 pandemic, predominantly through lost work experience and a lack of support from schools. In the postcourse questionnaire (n=42), participants gained an understanding of medical school interviews, the application process and insights from doctors. Interactive Q&A sessions and practice interviews were found to be particularly valuable, however some participants were unable to partake due to factors such as poor internet connection.Paired responses from participants completing both pre-and post-course questionnaires (n=40) demonstrated a statistically significant increase in preparedness in all areas assessed. Discussion: With a need for alternatives to clinical work experience and school support with applications, this virtual programme is an effective example of how widening participation activities can be sustained in the current climate and continued in the future. However, inadequate internet access can pose a barrier to participation and ways

Background: Safe and effective clinical outcomes (SECO) clinics enable medical students to integrate clinical knowledge and skills within simulated environments. This realistic format may better prepare students for clinical practice. We aimed to evaluate how simulated surgical clinics based on the SECO framework aligned with students’ educational priorities in comparison with didactic tutorials.Methods: We delivered two breast surgery SECO-based simulated clinics to Year 3 students during their surgical attachments at a London teaching hospital. All students attended a didactic breast surgery tutorial the previous week. Pre- and post-session surveys and post-session debriefs were used to explore learning gain, processes, preferences and impacts on motivation to learn. Data were analysed using inductive thematic analysis to categorise student views into themes.Results: 17 students enrolled in the simulated clinics and debriefs. Students expressed that passing examinations was a key extrinsic motivating factor, although the SECO-based format appeared to shift their motivation for learning towards aspiring to be clinically competent. Self-reported confidence in clinical skills such as history taking and examination improved significantly. Active learning methods were valued. Students expressed a preference for simulated clinics to complement, but not replace, tutorial-based learning.Conclusion: The SECO-based simulated clinic promoted a shift towards intrinsic motivation for learning by allowing students to recognise the importance of preparing for clinical practice in addition to passing examinations. Integration of surgical simulated clinics into the undergraduate curriculum could facilitate acquisition of clinical skills through active learning, a method highly valued by students.