More people in the UK are living with cancer than ever before. With an increasingly ethnically diverse population, greater emphasis must be placed on understanding factors influencing cancer outcomes. This review seeks to explore UK-specific variations in engagement with cancer services in minority ethnic groups and describe successful interventions. The authors wish to highlight that, despite improvement to engagement and education strategies, inequalities still persist and work to improve cancer outcomes across our communities still needs to be prioritised. There are many reasons why cancer healthcare inequities exist for minority communities, reported on a spectrum ranging from cultural beliefs and awareness, through to racism. Strategies that successfully enhanced engagement included language support; culturally-sensitive reminders; community-based health workers and targeted outreach. Focusing on the diverse city of Leicester the authors describe how healthcare providers, researchers and community champions have worked collectively, delivering targeted community-based strategies to improve awareness and access to cancer services.
Background Covid-19 has had a seismic impact on medical training, in ways that are continually being realised. In response to the call to establish a ‘new normal’, we performed a detailed evaluation and thematic analysis of recent trainee experiences, which identifies the priorities for developing an innovative training framework that is adaptable during the peaks and troughs of a pandemic. Methods A 14-item survey was sent to junior doctors at a large teaching hospital. Data was analysed using a grounded theory framework and cycles of open and axial coding allowed for identification of emergent themes. Explanatory models were developed using inductive analysis to postulate thematic relationships. Results 137 junior doctors responded to the survey. Respondents across all grades reported benefits to themselves, clinical teams and the profession. A notable benefit to junior trainees was the greater consultant support, fostering a more supportive work environment. Respondents also identified several challenges to working practice, including the availability of suitable PPE, burnout and the general pressures on physical and mental wellbeing. Discussion Trainees’ perceived value was inferred typically from how ‘busy’ they were, possibly as postgraduate training is largely competence based. Educational bodies should attempt to highlight the equal value of non-technical skills, such as mentorship and problem-solving for a rounded curriculum. Trainees highlighted the inequity of opportunities due to sometimes inappropriate redeployment, suggesting that educational bodies should strive to develop personalised training programmes. Covid-19 has shown that a sense of personal physical and psychological safety to be of paramount importance to trainees.
Background The COVID‐19 pandemic has necessitated the need to develop teaching innovations that provide safe, authentic clinical encounters which facilitate experiential learning. In tandem with the dissemination of teleconsultation and online teaching, this pilot study describes, evaluates and justifies a multi‐camera live‐streaming teaching session to medical students from the clinical environment. Approach Multiple audio and video inputs capturing an outpatient clinic setting were routed through Open Broadcast Software (OBS) to create a customised feed streamed to remote learners through a videoconferencing platform. Sessions were conducted between September 2020 and March 2021. Twelve students sequentially interacted with a patient who held an iPad. Higher quality Go‐Pro cameras captured the scene, allowing students to view the consultation from the patient and doctor's perspective. A consultant then conducted a ‘gold standard’ patient consultation observed by students. A faculty member remotely facilitated the session, providing pre‐clinic teaching and debriefing. The equipment required with costing for a standard and low‐cost version is described, as well as a set‐up schematic and overview of ideal conditions and barriers encountered during trials. Evaluation All students completed a post‐participation questionnaire, rating the overall quality of the sessions as 9.7/10. The quality of online facilitation, utility of observing peers' and consultant interaction with the patient, opportunity for peer‐to‐peer learning and availability of multiple camera angles were particularly valued by students. Implications This innovation permits an authentic clinical interaction to be experienced by multiple students remotely, promoting equitable access to high‐quality teaching, while maintaining the safety of students and patients.
Background The first UK wave of COVID-19 led to the temporary suspension of medical school placements. Medical students were offered paid employment through a COVID Responder Scheme (CRS). We aimed to qualitatively assess the experience of those who participated in this scheme in comparison to traditional clinical attachments. Summary of work A bespoke questionnaire was designed to explore key themes identified through theme selection, literature review and consensus. Following piloting and validation, the questionnaire was circulated to students recruited to the CRS. A grounded theory analytic framework was used to analyse data. A modified-Delphi consensus process was used to reach a consensus on ‘what makes you feel most valued as a medical student’. Summary of results 36 students (46.2% response rate) responded. 86.1% of respondents felt their contribution was worthwhile. 65% reported being significantly more integrated into a team than in their university attachments. Concerns prior to starting CRS work included availability of PPE and the ability to contribute effectively, but refreshingly these concerns did not present as challenges. The steep learning curve of experiential learning alongside virtual teaching commitments proved difficult to juggle when facing physical, mental and emotional fatigue from long hours working busy clinical shifts. Respondents cited the educational benefit of the CRS throughout the survey. Recognition and commendation were highly effective in providing a sense of value ahead of renumeration. 44.4% of respondents were concerned about their future training and a reduction in clinical exposure. Discussion The majority of respondents reported CRS work as worthwhile, with reasons including increased responsibility for patient care and a sense of contribution to the clinical team. This in turn led to autonomous practice and task accountability, which further integrated them into the team and developed their clinical confidence. A student’s sense of value was strongly linked to being identified in emotional responses from colleagues and patients ahead of financial renumeration, suggesting scope for improvement within unpaid attachments / rotations. Conclusion There is an opportunity to take value from the COVID-19 medical student experience to improve undergraduate medical education through and beyond the pandemic.
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