Using community diagnosis on primary care placements for medical students.

BACKGROUND: Over 35 years ago Julian Tudor Hart highlighted how medical undergraduate education needed to adapt to produce clinicians who were better situated in communities. However, we still struggle to engage medical students in understanding the social and environmental determinants of health, the value population level data and public health interventions. Our approach: Third year medical students carried out a community diagnosis project where they evaluated quantitative, qualitative and observational data for the community in which they were living. They examined Public Health England fingertips data to choose a topic, gathered and evaluated further information, considered potential solutions, and created a 5-min presentation for their small group tutorial. The students were supported by GP tutors from East London, allowing a novel role for GP tutors to teach on this topic. EVALUATION: GP tutors and students gave positive feedback on both the design and delivery of the module. Students frequently made the link between their previous theoretical teaching in public health and the application of it in the GPCD module, appreciated the value of investigating their local area and commented upon the opportunity to consider the wider determinants of health. The GP tutors felt the project gave the students an insight into the lived realities of others. CONCLUSIONS: This module was an effective cross-collaborative approach between primary care and public health. It gave a practical application to build on previous theoretical public health learning, and evidence of transformational learning for the students, helping them to understand the impact of health inequalities.

Undertaking a high stakes virtual OSCE ("VOSCE") during Covid-19.

BACKGROUND: The Covid pandemic and associated lockdown forced medical schools globally not only to deliver emergency remote teaching, but to consider alternative methods of high stakes assessment. Here we outline our approach to the resit virtual OSCE ("VOSCE") for final year medical students that we undertook during "lockdown" in the current pandemic. METHODS: The original 'pre Covid' examination blueprint was reviewed and modified for the virtual environment in both format and content. In anticipation of the new format delivery, a number of pre-training sessions took place for all parties, and standardised templates were developed. RESULTS: A total of 9 students undertook the VOSCE, which took the form of a two-part exam (a communication and clinical examination component, and a practical procedures component). The VOSCE was completed by all students, examiners, simulated patients and invigilators on an online digital platform with no issues with regards to technical problems. CONCLUSIONS: A total of 6 students passed the VOSCE and as such progressed to graduation. The limitation of assessing some particular types of skills across the remote format (such as practical procedures) was recognised. The training and the templates developed were helpful in case the VOSCE format needs to be adopted in future at short notice and/or expanded in future.

COVID-19: Causes of anxiety and wellbeing support needs of healthcare professionals in the UK: A cross-sectional survey.

BACKGROUND: COVID-19 has caused acute changes in healthcare delivery; this may impact mental health and wellbeing needs of healthcare professionals (HCPs). AIMS: We aimed to identify the causes of anxiety in HCPs during the COVID-19 pandemic, to assess whether HCPs felt they had adequate mental health and wellbeing support and to identify their unmet support needs. METHOD: We used a web-based survey utilising an online tool circulated to UK HCPs over 5 weeks. Self-perceived anxiety levels prior to and during the COVID-19 pandemic were measured on a 10-point Likert-type rating scale. RESULTS: The survey was completed by 558 HCPs. During the pandemic, self-perceived anxiety scores significantly increased from a median of 2 to 7 (paired Wilcoxon signed-rank test; p<0.001). The main reasons were concerns about exposure to SARS-CoV-2 and lack of personal protective equipment. Other wide-ranging reasons were identified. Only 41% of respondents felt there was adequate support. Thematic analysis of what support HCPs wanted identified 13 wide-ranging themes; including effective leadership and peer support. CONCLUSION: Anxiety levels in HCPs significantly increased during the COVID-19 pandemic and the main causes were identified. Many HCPs felt there was inadequate support and identified what support they needed. Implementing effective strategies to support HCPs' unmet wellbeing needs are required as a matter of urgency.

The virtual home visit.

Previous research has identified the 'unique experience' of home visits for medical students, yet in-training health professionals' exposure to them is limited and there is not a structured method of performing them. It is already recognised that simulation prior to clinical experience improves knowledge and confidence with the additional benefit that the experience can be standardised. We ran a 'Virtual Home Visit' for falls assessment for third year medical students as part of their teaching on multidisciplinary team (MDT) working. Students considered a clinical scenario involving a lady who had fallen at home and fractured the wrist of her dominant hand. They then watched a short video of her home, where each room was filmed in turned. They were then asked to identify both falls risks and possible adaptations. The session was co-facilitated by a GP Educator and an Occupational Therapist. The students enjoyed the session and performed well in a related OSCE assessment. The technology required was minimal to run the session. The facilitators also recognised the potential to use such a session in an interprofessional education environment.