ABSTRACT
Background/Aims In 2000, a survey of medical educators was published exploring undergraduate rheumatology training across medical schools in the UK. This has recently been repeated. However, neither have surveyed the opinions of the medical students themselves - arguably the most important stakeholders. To evaluate how students perceive their rheumatology training, understand how they best learn and to explore how they engage with rheumatology on clinical placements, especially in the context of the COVID-19 pandemic. Methods An online survey was emailed to students from medical schools across the UK. 'Snowball sampling' was used, where individual social contacts were used to create a network of medical students from each of the 37 medical schools across the UK through social media such as SMS, WhatsApp, Facebook messenger, and Instagram. Students were asked similar questions as those in the teacher survey;however, emphasis was placed on their perspective of teaching methods and their clinical placements. Results 30 completed surveys were returned (81%) but not all questions were answered. Of those, 27/28 (97%) identified some sort of MSK teaching, in contrast to only 16/28 (57%) being able to identify specific rheumatology teaching. This was delivered in diverse ways;42% (10/ 24) learnt it in a block, while 38% (9/24) had this teaching spread out over a longer period of time. Teaching was quite varied amongst the schools. On average 9 days were spent learning rheumatology. The most commonly used methods were lectures, small-group teaching, and online tutorials. This contrasts with what students felt was most effective, which were small-group sessions, expert patient teaching and teaching OSCE's. It was noted that medical education and placements had been very different over the previous 18 months with a 41% decrease in patient contact during COVID-19 pandemic. Most students found rheumatology as a difficult field to approach. 66% (14/ 21) were not aware of any specific rheumatology SSCs or personal excellence pathways. 86% (19/22) stated there was limited-to-no promotion of rheumatology as a specialty in their medical school, and 87% (26/30) weren't aware of VA, ARUK, or BSR resources to assist in their rheumatology education. Conclusion This is the first survey to evaluate the views of medical undergraduates on their rheumatology teaching in the UK. It is intended that this data will be triangulated with the medical teacher survey. The findings highlight that what students would prefer in terms of teaching i.e. face to face teaching with patients, is not what is currently being delivered (mainly lectures, on-line tutorials). Of some concern there appeared to be a general lack awareness of available online resources, especially from VA and BSR, suggesting marketing of these may not be effective.
ABSTRACT
Background/Aims Since the last UK wide survey of undergraduate (UG) education in rheumatology in 2000 (1), the landscape of both university teaching and clinical services has altered significantly. There has been an increase in the number of medical schools (26 to 37), rise in student numbers, curricula expansions, plus the impact of Covid-19. This survey evaluates the current status of rheumatology teaching in the UK and highlights areas for the Rheumatology community to consider when planning future training. Methods In early 2021, a 'Survey Monkey' was emailed to named MSK leads representing all 37 UK schools. This included open and closed questions and explored themes from previous published surveys. Reminders were sent after 2 and 4 weeks. Results Responses were received from 34/37 (92%) schools. There is wide variation in what, when and how teaching is delivered, but the vast majority deliver rheumatology specific teaching spread across years 1- 5. Overall length of clinical rheumatology exposure varied from 3 days to 7 weeks, delivered either as separate days (e.g. in integrated placements or PBL), as formal blocks (often with orthopaedics) or within a student selected component. Approximately 25% of teaching is delivered in primary care. Most is delivered in Year 4. Most schools have a designated rheumatology lead: a clinical academic or clinician. Teaching is acknowledged in most job plans with educational roles discussed at appraisals. Small group teaching remains the most common method of delivering formal teaching, followed by on-line learning and lectures. The majority of teaching is delivered by consultants, trainees and research fellows. A wide range of barriers were noted including competing pressures from clinical work, lack of physical space for teaching and the volume of medical students. Due to COVID-19, 50% of medical schools suspended placements at some point during the pandemic. 70% of schools reported a 50-75% reduction in patient contact time for students reflecting the national data re: 20% of rheumatology departments functioning at less than 50% during the pandemic (2). Many schools reported designing new innovative (often online) resources to support learning during the pandemic. Available resources such as the Versus Arthritis patient examination videos (available on YouTube) and flipbook were noted to be particularly useful learning resources. Conclusion Over the past 20 years, rheumatology UG teaching has remained strong but time for dedicated rheumatology training has reduced in some centres. Remote learning has become more common, which coupled with Covid, has raised concerns amongst teachers that students are not getting sufficient clinical exposure. There is interest for a rheumatology UG community to create and share online resources and act as a source of support.