Prompt identification of struggling candidates in near peer-led basic life support training: piloting an online performance scoring system.

BACKGROUND: Bristol Medical School has adopted a near peer-led teaching approach to deliver Basic Life Support training to first year undergraduate medical students. Challenges arose when trying to identify early in the course which candidates were struggling with their learning, in sessions delivered to large cohorts. We developed and piloted a novel, online performance scoring system to better track and highlight candidate progress. METHODS: During this pilot, a 10-point scale was used to evaluate candidate performance at six time-points during their training. The scores were collated and entered on an anonymised secure spreadsheet, which was conditionally formatted to provide a visual representation of the score. A One-Way ANOVA was performed on the scores and trends analysed during each course to review candidate trajectory. Descriptive statistics were assessed. Values are presented as mean scores with standard deviation (x̄±SD). RESULTS: A significant linear trend was demonstrated (P < 0.001) for the progression of candidates over the course. The average session score increased from 4.61 ± 1.78 at the start to 7.92 ± 1.22 at the end of the final session. A threshold of less than 1SD below the mean was used to identify struggling candidates at any of the six given timepoints. This threshold enabled efficient highlighting of struggling candidates in real time. CONCLUSIONS: Although the system will be subject to further validation, our pilot has shown the use of a simple 10-point scoring system in combination with a visual representation of performance helps to identify struggling candidates earlier across large cohorts of students undertaking skills training such as Basic Life Support. This early identification enables effective and efficient remedial support.

Every doctor an educator?

INTRODUCTION: The education of the future health care workforce is fundamental to ensuring safe, effective, and inclusive patient care. Despite this there has been chronic underinvestment in health care education and, even though there is an increased need for educators, the true number of medical educators has been in relative decline for over a decade. PURPOSE: In this paper, we focus on the role of doctors as medical educators. We reflect on the culture in which medical education and training are delivered, the challenges faced, and their origins and sustaining factors. We propose a re-framing of this culture by applying Maslow's principles of the hierarchy of needs to medical educators, not only as individuals but as a specialist group and to the system in which this group works, to instigate actionable change and promote self-actualization for medical educators. DISCUSSION: Promoting and supporting the work of doctors who are educators is critically important. Despite financial investment in some practice areas, overall funding for and the number of medical educators continues to decline. Continuing Professional Development (CPD) schemes such as those offered by specialised medical education associations are welcomed, but without time, funding and a supportive culture from key stakeholders, medical educators cannot thrive and reach their potential. CONCLUSION: We need to revolutionise the culture in which medical education is practised, where medical educators are valued and commensurately rewarded as a diverse group of specialists who have an essential role in training the health care workforce to support the delivery of excellent, inclusive health care for patients. By reimagining the challenges faced as a hierarchy we show that until the fundamental needs of value, funding and time are realised, it will remain challenging to instigate the essential change that is needed.

Implementing ultrasound sessions to highlight living anatomy for large medical student cohorts.

Background: There is an intrinsic link between radiology and anatomy and the importance of being able to convert knowledge from 3D structure to 2D image, and vice versa. Medical students must learn how to use anatomical knowledge to interpret radiological images, and with the increasing use of point-of-care ultrasound in clinical practice, the ability to interpret ultrasound scans is becoming more of a core skill for graduating doctors. Rationale: Several recent systematic reviews of the literature have been undertaken showing the benefits of incorporating ultrasound in anatomy teaching, including appreciation of the dynamic nature of living anatomy, better understanding of anatomical structure, and improved motivation to study. However, there is a lack of consensus in the way ultrasound teaching should be incorporated into undergraduate medical anatomy. Approach: This article reflects on a pilot of integrating ultrasound into the medical undergraduate anatomy teaching in the School of Anatomy at the University of Bristol. It shares the experience and how some of the challenges cited in the literature have been approached. Recommendation: To help others negotiate the challenges of implementing this valuable teaching experience, a 'Six Step Model' for developing a live ultrasound pilot for undergraduate medical anatomy is offered: Expertise, Education, Ethics, Environment, Equipment, Enlist.