Community action projects: community-engaged quality improvement for medical students.

BACKGROUND: Healthcare Quality Improvement (QI) is an essential skill for medical students to acquire, although there is insufficient empirical research which suggests the best educational methods to do this. This study explored the experiences of medical students participating in two versions of a Community Action Project (CAP) which gave medical students the opportunity to learn QI skills in a community setting. The first version (GPCAP) was pre-pandemic where students identified and delivered QI projects on placement in general practice to improve local population health. The second version (Digi-CAP) ran remotely where students worked on QI projects identified by local voluntary sector organisations focused on local community priorities during COVID-19. METHODS: Semi-structured interviews were conducted with volunteers from the two cohorts of students who had taken part in quality improvement initiatives. Transcriptions were independently coded by two researchers and analysed through thematic analysis. RESULTS: Sixteen students were interviewed. Whilst students had mixed experiences of completing their CAP, engagement and successful learning was associated with the following themes from the two versions of QI CAP projects: finding a sense of purpose and meaning in QI projects; preparedness for responsibility and service-driven learning; the importance of having supportive partnerships throughout the project duration and making a sustainable difference. CONCLUSIONS AND IMPLICATIONS: The study provides valuable insights into the design and implementation of these community-based QI projects, which enabled students to learn new and often hard to teach skills, whilst working on projects which have a sustainable impact on local community outcomes.

Exploring the teaching and training needs of students and clinicians in digital health

There has been exponential growth in technology use within the NHS, further accelerated by the Covid-19 pandemic, and video consultations, e-Consults and remote monitoring are now commonplace. However, undergraduate medical education is not keeping up with this pace and medical schools risk producing graduates who are unqualified to work in a digital NHS.The Medical Education Innovation and Research Centre (MEdIC) led two projects exploring views of primary care educators and medical students. MEdIC is a translational centre bringing cutting-edge evidence from health, education, community and policy into medical education innovations and research.Primary care educators attended a digital health workshop where activities included discussing challenges and risks around digital technology. Key challenges identified included digital consultation skills, access, workload, patient safety and ethics.Third year medical students were invited to enrol on ‘Digital Health Futures’, a specialty choice module. After the module, students were invited to participate in focus groups to reflect on digital health education. Key themes included lack of preparedness for practice, a call for digital to be fully integrated within the curriculum, and concerns around attitude of the medical school to technology and digital innovation.LeadershipImplementing curricular improvement requires strong leadership;and close collaborations and consultation with students and educators is vital. This must be an ongoing and iterative process due to the nature of technological development. Aligning the curriculum to the Topol Report and NHS Long Term plan is key for student learning and ultimately patient care.MEdIC’s dedicated leadership in this area has demonstrated the need for curricular reform at undergraduate, postgraduate and continuing professional development level. This emerging and urgent priority must be tackled across the whole medical education spectrum.