ABSTRACT
Background/AimsMedical students need to gain patient contact to develop their skills inhistory taking and examinations. In year three, undergraduate studentstypically rotate across various hospitals and specialties and areexpected to have dedicated rheumatology exposure for history andexamination competencies. Rheumatology as an out-patient specialtycan limit opportunities for medical students to have broad exposure torheumatological conditions.MethodsIn January 2018, we designed an annual rheumatology half-dayteaching workshop ('Rheumatology Carousel') using a combination oflecture-based teaching and small group based guided clinical historyand examination stations, aimed at third-year medical students fromthe University of Birmingham. This covered key presentations inrheumatology: axial spondyloarthropathy, rheumatoid arthritis, systemic sclerosis (connective tissue disease), osteoarthritis, and vasculitis. Each station required a Clinical Teaching Fellow or RheumatologyST trainee, overseen by one consultant facilitator. We designed patientproforma's incorporating consent, demographics, key clinical history, therapy, and examination findings. We produced a written patientguide, and consultants invited appropriate patients to volunteer for theday. We designed a one-hour lecture-based tutorial. A lesson plan andschedule were created outlining faculty requirements;including time, roles, and faculty numbers. We invited five to six patients to eachsession, with a plan of four to five focussed examinations. Wedesigned the carousel to accommodate up to 40 students, split intotwo groups running over a day. Focussed examinations involvedstudents in groups of four, with each student being a lead examiner inat least one station, each station lasting 20 minutes. Best practiceexamination techniques for each condition were assessed andemphasised. Following a debrief, we collected feedback fromstudents, faculty, and patients (online and written feedback), usingLikert scores for teaching content, and quality of the session delivery.ResultsThe carousel ran in February 2018, 19, and 20. The sessions werepositively evaluated by students, faculty, and patients. In total, 93students attended, 89/93 completed feedback. Satisfaction scores(mean;SD;range) were high (1-strongly disagree, 5-strongly agree) forcontent (4.8;0.49, range 3-5) and quality of delivery (4.7;0.54;3-5). Allpatients who participated volunteered to return for future teachingsessions, with several patients attending all three years. Free textfeedback indicated students valued structured exposure to coreconditions and called for more sessions of this nature.ConclusionThis sustainable reproducible intervention ensures students havestructured exposure to important rheumatological conditions. Themethodology allows reproducible sessions that are positively evaluated despite rotating clinical teaching staff. We have made all ourteaching materials, logistical plan, and scheduling tools available asopen access resources under a Creative Commons license for free reuse and adaptation by any healthcare professional, via a web link. Weplan to record an electronic version to distribute post the COVID-19pandemic.