Student and educator experiences of a student-led clinic in general practice.

BACKGROUND: Giving students more responsibility for real patients during medical school may help prepare them for their transition to clinical practice. Student-led clinics (SLCs) may facilitate this. Within SLCs, students take the lead role in delivering patient care while being supported and supervised by qualified clinicians. A general practice SLC was established in Dundee, with four final-year medical students and one GP involved in each clinic. AIM: This study aimed to explore students' and educators' experiences and perceptions of this SLC. METHOD: This was an exploratory case study. Semi-structured interviews were conducted with 11 students and three educators, and 18 hours of observation were conducted over six clinics. Interview transcripts and fieldnotes were integrated and thematically analysed. RESULTS: Overall, students' and educators' experiences and perceptions were positive. Students thrived in their lead role in patient care, gaining a sense of empowerment and developing confidence in their abilities. Both students and educators felt comfortable with students having this level of responsibility due to the students' stage of training and the supervision provided by educators. Teaching within the SLC involved individual discussions and group debriefs. Students felt a sense of belonging as a result of their relationships with their peers and educators. Challenges arose when the clinic ran behind schedule due to unexpected complex patients or lengthy individual discussions. CONCLUSION: The findings suggest that giving students responsibility for real patients is beneficial and feasible when adequate support is provided, and that it is possible for one GP to supervise multiple students successfully.

Professional identity formation in becoming a GP trainer: barriers and enablers.

BACKGROUND: Policy promotes students and doctors becoming GPs, yet there exists little focus on GP trainers' recruitment and retention. AIM: To explore barriers and enablers facilitating the professional identity formation of a GP becoming a GP trainer. DESIGN AND SETTING: A qualitative case study within one training programme of the Scottish Deanery. METHOD: Data were collected between January and November 2018 via semi-structured interviews with 16 GP trainers and 79 regulatory and policy documents. Thematic analysis was applied whilst a reflexive stance as a previous GP trainer was maintained. RESULTS: Findings indicate GPs become GP trainers through experiences and events across three predominant identities: 'Becoming a Doctor', 'Becoming a GP' and 'Becoming a GP Trainer'. Impediment at any of these stages acts as a barrier. The GP trainer role suggests tendencies for clinicians to be understated in their achievements and abilities. GP trainers dually enact and role model that of clinician and teacher; time acts as a significant barrier. The Scottish Prospective Educational Supervisor Course (SPESC), or previous iterations, is a significant enabler. Royal College of GP's contributions towards GP trainers is absent. GP trainer associations with out-of-hours services have changed over time. GP trainer/trainee relationships are essential enablers to a continued GP trainer professional identity. CONCLUSION: The role of the GP trainer as a teacher needs highlighting. Processes that protect and maximise this role may enhance the positive contributions of being a teacher. Understanding these themes may enhance recruitment and retention of GP trainers.

Prostitutes, sailors and professionals - lived experiences of medical school students and staff with tattoos.

Background: The aim of this study was to explore the lived experiences of medical school students and staff to uncover gaps in policy and its effects on those with tattoos. Methods: Adopting a phenomenological design, semi-structured interviews were conducted with ten medical teaching staff and students who had tattoos, within one university medical school. Five key themes emerged: tattoo motives, tattoo content, positive and negative views on tattoos and challenges for establishing policy. Results: Findings suggested that no existing stigma towards staff or students exists, however, there is an absence in existing policy regarding tattoos. Participants' motivations for obtaining tattoos mirrored those of the public, most commonly being artistic expression. Images of tattoos related to nature were common. Views on tattoos suggested the need for a full reform of 'dress code' policy for the profession. Several ethically laden scenarios were espoused, highlighting the need for an official stance on tattoos. Policy discussions flagged challenges for those who construct such documents; cultural and generational differences being commonly identified by participants. Conclusions: Universally there was uncertainty on current policy, with no individual able to recount specific guidance. The existence of a hidden curriculum surrounding tattoos within medical school further increases the need for guidance reform.

Cultural diversity and inclusion in UK medical schools.

BACKGROUND: Racially minoritised groups across the globe continue to experience differential outcomes in both health and education. Medical schools can play an instrumental role in addressing both these disparities, by creating inclusive student communities and ensuring that tomorrow's doctors can care for our increasingly diverse populations. OBJECTIVES: This collaborative, qualitative study led by three United Kingdom (UK) institutions aimed to explore the perspectives of Heads of Primary Care Teaching (HOTs) on cultural diversity and inclusion across UK medical schools. METHODS: In December 2020, five focus groups were conducted remotely with 23 HOTs, or a nominated deputy. We explored participants' opinions regarding opportunities and barriers to cultural diversity and inclusion in medical education, ways to overcome these challenges and shared examples of best practice. Data were transcribed verbatim and thematically analysed by three researchers. RESULTS: Investigators identified six themes from the data: lack of faculty diversity, tokenistic faculty training, institutional mindset, diversifying the formal and hidden curricula, intersectionality and student voice. CONCLUSION: Medical schools worldwide face similar challenges, uncertainties and opportunities when integrating diversity and inclusion throughout the learning environment. Although the importance of the topic is increasingly acknowledged, current efforts are viewed as being passive and tokenistic, hindered by challenges at multiple levels. Partnership with students and collaboration within and between institutions nationally and internationally will enable us to move forwards with both local and global positive, sustainable change.

Let's talk about sex(ual) wellbeing! Staff perceptions of implementing a novel service for people with Multiple Sclerosis.

BACKGROUND: In people with multiple sclerosis (PwMS), a complex interplay of neurological dysfunction, polypharmacy and psychological issues, contrive to impair their sexual and reproductive wellbeing. Realising an unmet need, the Tayside MS service in collaboration with a sexual health clinician (LJ), established a 'Pelvic Health Clinic' to improve quality of life for PwMS. OBJECTIVE: To explore clinician's perceptions of implementing an MS Pelvic Health service with a view to establishing future outcomes for health care professionals about the utility in such a service. METHOD: In this small-scale qualitative case study, we explored clinician's perceptions of such a clinic adjunct. Semi-structured interviews were conducted, transcribed, and thematically analysed in a reflexive manner. RESULTS: Five participants consented. Ten sub-themes emerged, which were organised into three main themes: service tensions, patient needs and practitioner feelings. CONCLUSION: Clinicians highly valued the new MS 'pelvic health clinic'. Knowing that there was a service available empowered clinicians to ask patients about sexual health needs. Specific referral criteria may help further develop the service and improve patient care. Staff welcome training and support in this area or the option to signpost onwards; either mechanism lends itself to enhancing MS patient needs.

Prevalence and Perceptions of Illicit Substance Use Amongst Medical Students.

This article was migrated. The article was marked as recommended. Background: The General Medical Council state illicit substance use by medical students is an example of unprofessional behaviour. Previous research has shown the use of illicit substances to exist amongst medical students in the United Kingdom. This research aimed to determine the prevalence of illicit substance use amongst a single cohort of medical students and gather information concerning perceptions of this behaviour. The study sought to quantify the prevalence of illicit substance use within each year of study and gender identity. Methods: An anonymous online questionnaire was employed to conduct this quantitative research. This included nine questions regarding illicit substance use amongst medical students, with three additional demographic questions. The Statistical Product and Service Solutions was utilised to interrogate the data. Results: Out of 927 students in the medical school 201 (21.7%) people completed the questionnaire. 50.7% of respondents reported an any lifetime use of illicit substances, with 20.9% of the cohort reflecting recent illicit substance use within the previous 30 days. Drug use included amphetamines, amyl nitrate, cocaine and ecstasy amongst others. Cannabis was the most commonly used illicit substance, with a lifetime use of 45.8%. Statistical significance was determined for use of illicit use of substances within the male gender and older cohort years of the medical school. Conclusions: The current cohort had a greater prevalence of cannabis use than previously determined amongst medical students. Males and students in older years had higher rates of illicit substance use than their respective demographics. As such, further research may be necessary to investigate the underlying reasons for these findings.

Teaching, reflecting, and learning: The value of an intercalated medical education programme.

Objectives: Teaching programmes within medicine focus primarily on pathways of a shorter length with little regard to teaching lasting longer than a month. This study is different from other studies as it examines the benefits of a nine month-long medical education degree programme and its impact beyond graduation. This study set out to explore the impact of a medical education intercalated degree programme for its graduates and their careers.Methods: A small scale, exploratory qualitative case study was conducted with 10 graduates of an intercalated degree programme.Results: The findings highlight the longer term value of an intercalated degree programme with particular emphasis on academic and personal skills; research and teaching skills; independence and confidence; its impact on future practice and the notion that 'student as teacher' programmes are a valuable asset to medical education as a whole. Participants advocated more teaching opportunities as a core longitudinal teaching component in preparation for the teaching responsibilities in their working lives.Conclusions: The programme enables the development of a range of academic and personal skills, with particular emphasis on research and teaching skills, independence and confidence.

Taking the learning beyond the individual: how reflection informs change in practice.

OBJECTIVE: The purpose of this research was to explore the value of reflection and its application to practice through the implementation of educational modules within a new Diabetes Care and Education Master Degree Programme in Kuwait, and to realise how this teaching intervention informs changes in practice. METHODS: A small exploratory case study was conducted within the Dasman Diabetes Institute, Kuwait. A qualitative approach using focus group interviews was carried out with seventeen participants all of whom are studying on the Diabetes Care and Education Master Degree Programme in Kuwait. An inductive approach to thematic analysis, which focused on examining themes within data, was performed. RESULTS: The results indicate that participants value the opportunity to study through organised, structured and assessed reflection. The learning provides useful information and support to the participant by highlighting the role which reflection plays to enhance personal and professional development, the value of educational theory, continuing professional development, collaboration and enhancing patient education and practice. CONCLUSIONS: The significance of reflection is often seen in the literature as an important aspect of professional competence. This research has highlighted the value of reflection as a key component within a new educational programme.