"More than just a medical student": a mixed methods exploration of a structured volunteering programme for undergraduate medical students.

BACKGROUND: As a result of the COVID-19 pandemic Imperial College School of Medicine developed a structured volunteering programme involving 398 medical students, across eight teaching hospitals. This case study aims to explore the relationship between the processes, context, participant experiences and impacts of the programme so that lessons can be learned for future emergencies and service-learning programmes. METHODS: Using an illuminative approach to evaluation we invited all volunteers and supervisors to complete a mixed-methods survey. This explored differences in experience across demographics and contextual factors, correlations between aspects of induction, supervision and overall experience, and reviewed the impacts of the programme. Quantitative responses were statistically analysed and qualitative reflections were thematically coded to triangulate and explain quantitative findings. Follow up interviews were carried out to check back findings and co-create conclusions. RESULTS: We received responses from 61 students and 17 supervisors. Student participants described predominantly altruistic motivations and transformational changes to their professional identity driven by feeling included, having responsibility, and engaging in authentic workplace-based learning afforded by freedom from the assessed curriculum. They reported new perspectives on their future professional role within the multidisciplinary team and the value of workplace-based learning. They reported increases in wellbeing and self-esteem related to feeling included and valued, and positively contributing to service provision at a time of need. Significantly higher overall satisfaction was associated with a personalised induction, active supervision, earlier stage of training, and male gender. Gender-related differences were not explained through our data but have been reported elsewhere and warrant further study. The duration, intensity and type of role that volunteers performed was similar across demographics and did not appear to modulate their overall experience. CONCLUSIONS: Whilst acknowledging the uniqueness of emergency volunteering and the survey response rate of 15% of volunteers, we suggest the features of a successful service-learning programme include: a learner-centred induction, regular contact with engaged and appreciative supervisors, and roles where students feel valued. Programmes in similar settings may find that service learning is most impactful earlier in medical students' training and that students with altruistic motivations and meaningful work may flourish without formal outcomes and assessments.

Video-assisted reflection: improving OSCE feedback.

BACKGROUND: Objective Structured Clinical Examinations (OSCEs) are commonly used to provide feedback to students on their performance in formative examinations. However, students are often unable to act independently on the feedback they receive. This study explored how the use of video-assisted reflection in OSCEs can enhance students' ability to reflect and engage in sustainable feedback. METHODS: Twenty-one students undertaking a mock-final OSCE consented to have one of their examination stations filmed. Participants completed a series of reflective forms immediately after the OSCE, after verbal feedback from an examiner and finally, after watching the video of their own performance. Students were asked to predict their overall grade as well as list areas for improvement. Pearson r correlations examined the relationship between the examiners' grades and the candidates' self-predicted grades. Wilcoxon signed-rank tests were used to compare the length of reflections at each stage. Semi-structured interviews were conducted to explore students' beliefs on self-efficacy and how the video-assisted reflection altered their ability to act on feedback. RESULTS: The students' ability to self-assess and gauge their own performance improved significantly after undertaking the video-assisted reflection (p < 0.01). Furthermore, video-assisted reflection significantly increased the length of the student's reflections. In interviews, participants described multiple ways in which the video-assisted reflection improved their confidence and ability to act on feedback, highlighting a clear enhancement in self-efficacy. DISCUSSION: Video-assisted reflection of recorded OSCE stations represents an effective approach to increase student self-efficacy and subsequently improve engagement in sustainable feedback practice.

Acciones municipales de promoción de la alimentación saludable, la actividad física y la lucha contra el tabaco / Municipal actions to promote healthy eating, physical activity and the fight against tobacco

Las Enfermedades Crónicas No Transmisibles (ECNT) tales como las enfermedades cardiovasculares, la diabetes, el cáncer y las enfermedades crónicas respiratorias representan las principales causas de muerte en nuestro país. El tabaquismo, la mala alimentación y la inactividad física son los principales factores de riesgo de estas enfermedades, por lo cual es necesario implementar intervenciones dirigidas a la población que ayuden a combatirlos y disminuir su impacto.se pretende que esta guía sea apropiada por los decisores locales que están convencidos de la necesidad de promover la salud de su población, a través de estrategias de gran impacto y muy bajo costo, lo que se conoce en la salud pública como estrategias ôcosto efectivasö. El resultado de la implementación de dichas estrategias repercutirá no sólo en el mejoramiento de la calidad de vida de la población sino también en la prevención de varias enfermedades y su consecuente ahorro de gastos en salud. a lo largo de estas páginas se brindará una descripción de la problemática de las EcNt a nivel global y nacional y se presentarán las estrategias y acciones de promoción de la salud que el ministerio de salud de la Nación impulsa y recomienda para su implementación por los gobiernos locales.

Estrategia nacional de prevención y control de enfermedades no transmisibles componente promoción de la salud / National strategy for the prevention and control of noncommunicable diseases, health promotion component

Estrategia Nacional de prevención y control de enfermedades crónicas No Transmisibles (ECNT) tales como las enfermedades cardiovasculares, la diabetes, el cáncer y las enfermedades crónicas respiratorias representan las principales causas de muerte en nuestro país. El tabaquismo, la mala alimentación y la inactividad física son los principales factores de riesgo de estas enfermedades, por lo cual es necesario implementar intervenciones dirigidas a la población que ayuden a combatirlos y disminuir su impacto, muchas de las acciones de prevención se han venido desarrollando a nivel nacional y provincial. Sin embargo, los municipios son un ámbito fundamental para el efectivo control de las ECNT. Sostenemos que los gobiernos locales ûlos más cercanos a la poblaciónû pueden cumplir un rol central en la introducción de cambios en el entorno local que ayuden a la gente a tomar mejores decisiones en relación a su alimentación, la actividad física que realiza y el consumo de tabaco. El Ministerio de Salud de la Nación está trabajando sobre esta problemática desde la Dirección de Promoción de la Salud y Control de ENT a través del Plan Nacional Argentina Saludable, el Programa Nacional de Control de Tabaco y el Programa Nacional de Lucha Contra el Sedentarismo, entre otros, articulando y sinergizando sus acciones con el Programa de Municipios y Comunidades Saludables con el objetivo de mejorar la salud y la calidad de vida de las comunidades locales. Este manual presenta intervenciones concretas y efectivas basadas en la evidencia científica, y constituye una herramienta más para prevenir las ECNT a nivel municipal.