2014

Transcription

2014

Queen’s University Belfast, Centre for Medical Education
Summer Studentship Project Summaries
2014
Project 1: Improving the Thinking and Decision-Making Skills of Medical Students
Proposer: Ms M Boohan
Collaborators (if any): Professor Frank Kee (Centre for Public Health) and Dr Kinga Morsanyi (School
of Psychology, QUB)
Project description:
This project is designed to:
1. assess the changes in the judgment and decision-making skills of medical students as they
progress through their course
2. develop effective educational tools for improving the decision-making skills of medical
students
3. reduce the costs of medical decision-making errors and improve patient safety
Errors in medical decision-making are extremely costly for society. Kohn et al. (2000) reported that
in the US, medical errors were the eighth leading cause of death. Focussed training of medical
students can reduce these errors (Hershberger et al., 1994). What is less clear is whether traditional
undergraduate medical education in itself might lead to a reduction in typical decision making
biases. Training in decision making skills is included in Outcome 2, 14F Tomorrow’s Doctors 2009.
During Semester 1 2013/2014 first and third year medical and psychology students completed a
number of questionnaires related to this.
Initial findings suggest that while medical students are generally good decision-makers, their course
performance is mostly unrelated to these skills. These findings highlight the need to develop
effective educational interventions to improve decision-making skills, and to incorporate them into
medical education.
The medical student will assist the project team with the development of teaching resources to be
included in the third and final year curriculum. Resources will include case based scenarios
highlighting good and poor examples of clinical decision making.
Benefits to the student:
 Development of clinical case writing skills
 Experience of how to produce and develop an active training package
 Gain insights into the role of medical education as an academic discipline
 Learn about vertical and horizontal integration of a learning resource
 Understanding of how the needs of medical students are taken into consideration when
curricula are being developed
 Experience and learn from a multidisciplinary team approach to project delivery, with the
opportunity to make an important contribution to the enhancement of the undergraduate
medical curriculum
Project Duration: 6 weeks
http://www.qub.ac.uk/schools/mdbs/medicine/CurrentStudents/SummerStudentships/
1
2014
Project 2: Promoting Well-Being and Resilience for Medical Students
Proposer: Dr Ciaran Mulholland
Collaborators: Caroline Donnelly CME, Eimear King CME, Ciaran Shannon School of Psychology,
Vivienne Crawford CME
The GMC document “Supporting medical students with mental health conditions” (2013) has drawn
attention to an under-addressed area and the need to promote resilience and well-being in medical
students. The GMC has also sought to identify good practice across all medical schools with regard to
addressing these areas (“Identifying good practice among medical students in the support of
students with mental health concerns” (2013)). The GMC conclude that “as well as supporting
medical students who have mental health conditions, medical schools should also promote wellbeing among all of their students”.
The aim of this studentship is to explore ways in which QUB CME might seek to promote well-being
and resilience among the student body.
The successful student will carry out the following tasks with the active assistance of proposers and
collaborators: a) review literature with regard to resilience and medical students b) explore lessons
to be learned from resilience programmes at other medical schools (both in UK and elsewhere) c)
consider possibility of building upon existing student support mechanisms at QUB d) draft a possible
resilience programme for adoption by CME.
Student will gain valuable experience in the skills required for a literature search, the writing up of a
scientific review and the approach required to translate policy into practice.
2
2014
Project 3: Development of Role-Play Scenarios for use in SSC Teaching
Proposers:
Dr David Bell & Dr Vivienne Crawford
Collaborators (if any): Mission Africa, Northern Ireland Forum for Ethics in Medicine and Healthcare
The benefits of role-play simulation in undergraduate medical education in developing students’
moral reasoning and communication skills within a safe learning environment are increasingly
recognised. In relation to the Murder or Mercy SSC, we have utilised a Canadian Bioethics OSCE
resource for a number of years which is now becoming dated, while several years ago we
successfully devised and recorded our own role-plays for use in the Wholeness in Healing SSC
addressing spiritual history taking and whole-person care in collaboration with PRIME. Role-plays
have also been piloted this year in the Livingstone SSC. In this studentship we would like to design
additional role-plays and associated marking schemes for use in each of these SSCs. In regard to the
Murder or Mercy SSC specifically, the priority would be to develop several scenarios placed within a
local context and incorporating up-to-date legal and professional guidance in regard to withholding
and withdrawing treatment, handling requests for VAE and suicide tourism. In the Livingstone SSC, in
collaboration with Mission Africa, we would like to simulate clinical scenarios that students might
encounter during their medical electives in Africa. The student would work with the supervisors in
prioritising, devising scripts, marking schemes and recording the selected scenarios, with assistance
of volunteers from amongst staff and students and Mission Africa personnel.
The student will gain experience in developing the role play station(s) and marking schemes as an
educational resource and will also have opportunities to enhance their own communication skills as
well as knowledge and moral reasoning relating to the chosen themes.
3
2014
Project 4: Developing an SSC in eLearning
Proposer: Dr Kieran McGlade
Collaborators (if any): Centre for Education Development QUB, Dr Vivienne Crawford, Mrs Clare
Thomson.
The purpose of this project is to develop learning materials and processes for a proposed Student
Selected Component in eLearning for first delivery in the 2015/2016 academic year. It is envisaged
that the SSC would be delivered in the second semester of second year. It would have both
theoretical and practical components with the latter focusing on the production of learning objects
which students would find helpful in revising for the End of Phase Exam in second year.
The studentship will entail the following:
Researching and building up a set of appropriate teaching and learning materials to be used in the
SSC
 Liaising with colleagues with similar schemes in other Universities ( eg.University of
California, Davis, University of Bristol, Barts etc.) in order to inform the design of the SSC
 Assisting with the construction of a course website
 Researching and collecting suitable open source and freely available software tools for use in
the SSC
 Developing an accompanying study guide
 Drafting the necessary SSC submission paperwork
The studentship would also be able to contribute to some of the preparations for a proposed
Student eLearning conference to be held in QUB in October 2014.
The student will have the opportunity to:
1. Participate in an education development project
2. Collaborate with external partners
3. Contribute to peer teaching.
4. Acquire skills in educational design and gain experience in working with different media
5. Learn about up to date education technologies
6. Potentially co-author a paper in a peer review journal
7. Take part in the preparation of abstracts/ presentations at medical education conferences.
4
2014
Project 5: Creating Online Support Materials for Phase 1 Students
Proposer: Dr Nigel Hart
Collaborators (if any): Ms Clare Thomson
Background: Peer learning and teaching has been promoted in education for many years on the
basis that one student (the expert) produces material to teach other students (novices) on topics
within their discipline. This has benefits for all parties: the student creating the materials gains a
deeper understanding of the subject matter by having to scrutinise and repurpose it for their peers;
those using the materials find them easier to engage with due to a familiar discourse that comes
from a perspective that is shared with the creator.
The ‘Clinical and Other Skills’ Module sits alongside the other core curriculum modules in Phase 1
and covers a diverse collection of topics designed to orientate the students to a number of
academic, clinical and professional skills that will be of use to them through their undergraduate
career and beyond. The module has traditionally been delivered through lecture, tutorial and
seminar-type timetabling.
Aims: This project will develop electronic resources for Phase 1 and 2 students. These resources will
be based on topics which the current students report finding difficult or uninteresting but which are
regarded as important topics for inclusion in the undergraduate curriculum. Potential topics will
include: reflective writing, referencing, Turnitin, using excel, presenting information in posters and
oral presentations. The resources will be shared within the Medical Education Portal.
Methods: The student will initially research and present proposed topics to project members and
from this research one or two topics will be chosen to create online teaching materials.
The student will gain many transferable skills such as communication, project management, time
management, information gathering. They will also gain invaluable insight into medical education in
general. There will be the opportunity to gain/enhance specific IT skills using different pieces of open
source and available software to create the multimedia materials for online delivery. Project
presentation skills will be developed both within and outwith the project as the student will have the
opportunity to submit for educational conferences. Finally, they will also gain a much deeper
understanding of the selected topics.
5
2014
Project 6: Patient Safety & Professionalism – Development of Story-Based Learning Resource
Proposer: Nigel Hart
Collaborators (if any): Clare Thomson, Mairead Corrigan, Jenny Johnston
Background: Patient safety and Professionalism are two of the important cross-curricular themes
that are commenced within the Clinical and Other Skills module in the first semester of year 1
undergraduate medicine. These topics are currently developed in Phase 1 through several lectures
and a tutorial.
Stories are the oldest and most natural form of sense-making. Stories are the "means [by] which
human beings give meaning to their experience of temporality and personal actions". People have
an innate ability and predisposition to organize and represent their experiences in the form of
stories. Engaging in stories assists in: Understanding human action, intentionality and temporality by
facilitating the understanding of past events and the planning of future actions facilitates the
attainment of vicarious experience by helping us to distinguish the positive models to emulate from
the negative models to avoid. The GMC used a story-based paradigm, “Julia’s Day”, to engage the
public when they were drafting an updated version of Good Medical Practice.
The combination of story-based learning and eLearning approaches to curriculum delivery has the
potential to be a powerful vehicle for developing a firm foundation in the areas of Patient Safety and
Professionalism.
Aims: This project will develop a weekly story-based interactive narrative tool for Phase 1 in which
students will be able to anonymously record their thoughts and ‘vote’ on courses of action that they
feel should be taken by those in the story. An important component of the programme will be the
requirement for students to complete a reflective entry in their ePortfolio.
Methods: The studentship student will help to develop the narrative of the story and assist in
constructing the resource using a number of eLearning tools chosen in collaboration with the
eLearning Developer.
The student will gain many transferable skills such as communication, project management, time
management, information gathering. They will also gain invaluable insight into medical education in
general. There will be the opportunity to gain/enhance specific IT skills using different pieces of open
source and available software to create the multimedia materials for online delivery. Project
presentation skills will be developed both within and outwith the project as the student will have the
opportunity to submit for educational conferences.
6
2014
Project 7: A Review of Elements of Years 1&2 Curriculum, Including the ‘Systems, People and
Populations’ Module and the ’End-of-Phase’ Tutorials and Examinations
Proposer: Prof Pascal McKeown
Collaborators (if any): Dr Melissa McCullough, Dr Madeleine Rooney, Prof Michael Shields, Dr
Michael Williams, Dr Mairead Corrigan
The GMC document ‘Tomorrow’s Doctors 2009’ recognises the importance of ‘The Doctor as a
Scholar and Scientist’ as well as ‘The Doctor as a Practitioner’ and ‘The Doctor as a Professional’.
Some of the key modules addressing these outcomes in the first two years of study include the
‘Systems, People and Populations’ (SPP) module and the ‘End-of-Phase’ (EOP) tutorials and
examination.
Analysis of student feedback / evaluations has revealed that they do not fully appreciate the links
between the different and rather diverse elements of the SPP module. The EOP has been designed
to ensure that students are able to integrate knowledge and skills across all the different modules
which are taught in the first two years.
In recent years, summer studentships have provided an opportunity for students to provide very
useful insights in relation to other modules in years 1 and 2 (eg Genes Molecules and Processes /
Concepts in Peoples and Populations).
In addition, there is a recognition that the increasing diversity of the medical student intake creates
challenges for delivery of subjects where the prior knowledge level varies greatly.
This project seeks to:
1. Review the SPP curriculum to identify key priorities and linkages
2. Review the tutorials and assessments related to EOP
3. Explore opportunities for enhanced learning for all medical students, in particular through
horizontal and vertical integration in light of curricular developments in the later years of the
curriculum.
1. Gain insights into the role of medical education as an academic discipline
2. Evaluate how relevant academic issues are addressed in the QUB undergraduate medical
curriculum and suggest areas for development.
7
2014
Project 8: A Review of the Artscare SSC in Third Year
Proposer: Prof Pascal McKeown
Collaborators (if any): Dr Jenny Elliott, Dr Vivienne Crawford
In recent years, there has been increasing interest in the role of medical humanities and medical
education. As part of the undergraduate SSC curriculum, there has been an ongoing partnership with
Artscare, which has facilitated placements for up to 20 students each year.
In a recent article entitled ‘Humanities in Undergraduate Medical Education: A Literature Review’,
the authors (Jakob Ousager and Helle Johannessen) have reported:
‘Evidence on the positive long-term impacts of integrating humanities into undergraduate medical
education is sparse. This may pose a threat to the continued development of humanities-related
activities in undergraduate medical education in the context of current demands for evidence to
demonstrate educational effectiveness’ (Acad Med. 2010; 85:988–998).
This project seeks to:
1. Review the current provision of the Artscare SSC
2. Develop a scholarly project to review the medium-term impact of participation in a medical
humanities SSC by undertaking a research project with fourth and final yr students who
completed the Artscare-based SSC in the third yr of the curriculum.
1. Gain insights into the role of medical education as an academic discipline
2. Evaluate how relevant academic issues are addressed in the QUB undergraduate medical
curriculum and suggest areas for development.
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2014
Project 9: Student Perceived Perception of their Learning Needs in Ageing and Health
Proposer: Dr I Maeve Rea
Collaborators (if any): Dr Mike Stevenson
Understanding our learning needs is fundamental to the safe, effective and knowledge based
practice of medicine and facilitates a culture of life-long learning. Students do not automatically
consider their own learning needs as they enter each new module of undergraduate medicine.
The aim of this study is to assess and analyse collected visual Likert scale information obtained from
student perceived learning needs for important elements of core curriculum before and after the 4
week core and clinical teaching module in Ageing and Health (A&H)
Medical students were previously invited to participate in their own perceived learning needs at the
beginning and end of the modules in A&H by using anonomyised visual linear likert scales where
zero (0) represented little knowledge/skills and the end (10) represented very good
knowledge/skills.
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Comparison of Likert scale data for student blocks between the beginning/end of modules in
A&H for calendar year and academic years.
Changes in student perceived learning to recent curriculum changes
Comparison of module student responses to career in A&H, before/after A&H module.
Data analysis using -student t-test, correlation and multiple regression.
Literature search, appropriate research ethics and data written for abstract and paper
publication.
Student will have opportunity to
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Be personally responsible for a research project and understand research methodology
Understand the importance of using research to evidence teaching and teaching methods.
Understand appropriate research ethics documentation
Obtain training and carry out a literature review appropriate to subject area
Understand and use a range of statistical methods to produce meaningful data outcome/s
Write up abstract for presentation and paper towards publication giving valuable
presentation experience with appropriate citation for student curriculum vita.
Improved understanding of own self perceived learning and understanding towards
maintaining safe and effective medical practice in medical practice
9
2014
Project 10: Evaluating the Patient Safety Culture within an NHS Organisation
Proposer: Dr Niall Leonard
Collaborators (if any): Dr David Hill (R&D dept) Mrs Brenda Carson (Patient Safety dept), Dr Kieran
McGlade (QUB), Dr Nigel Hart (QUB)
The South Eastern Trust is working to enhance knowledge and skills to enable frontline staff to
identify and measure indicators of Safety, Quality and Experience at a local level. The success of this
will be dependent upon the change of culture within the work environment, i.e. whether the
organisation promotes Innovation and Improvement. The SE Trust is in its 3rd year of a Safety,
Quality and Experience (SQE) inter-professional Quality Improvement (QI) programme and in
January 2014 will move to a newly designed Quality Improvement and Innovation Centre, adjacent
to the Medical Education Centre. This year the SE Trust is leading a pilot project incorporating QI into
the final year curriculum.
The proposed project will be to evaluate the QI culture within four identified areas using a culture
survey tool. Two students will be involved in carrying out interviews and focus groups to assess staff
knowledge and skills against the regional attributes framework: Supporting Leadership for Quality
Improvement and Safety in Health and Social Care. The areas will cross the traditional boundaries of
care and include: Mental Health inpatients, Paediatric Inpatients, Adult Learning Disability and
Looked after Children Services. This trust-wide evaluation of a new QI programme is pioneering and
encapsulates the essence of both Quality Improvement and inter-professional working.
The successful applicants will be based in a new state of the art QI facility and receive guidance,
support and mentoring from the on-site QI faculty. They will assist in the production of a report
based on their interviews and focus groups.
The students will:
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Gain valuable insights into inter-professional working at different levels across both Health
and Social Care.
Gain an in-depth understanding of the process of training for Patient Safety and Quality
Improvement.
Through collaboration with the Patient Safety Team, gain experience in the development of
a sustainable evaluation methodology for measuring the improvement culture within an
organisation.
Gain experience of presenting findings, for example: Trust SQE Steering Committee chaired
by the Medical Director; Preparation of abstracts/presentations at medical education and
Quality Improvement conferences and potentially co-author a paper in a peer reviewed
journal.
Project Duration: 2 students x 8 weeks each
10
2014
Project 11: Developing an Online Training Resource for Portfolio Tutors
Proposer: Dr Mark Harbinson
Collaborators (if any): Dr Vivienne Crawford, Ms Clare Thomson
The GMC mandates that medical students complete a ‘portfolio containing reflections,
achievements and learning needs’1. Staff engagement with the portfolio program could be
improved; recently only 19 of 55 tutors attended for training, over six separate sessions2. Staff
queries are frequent. Furthermore, changes planned include summative assessment by tutors of
their own students, and the introduction of an electronic portfolio for years 2 and 5.
This project will develop an electronic resource for portfolio tutors which will be both an interactive
training tool and a library of relevant information. The aims are to improve staff familiarity with the
portfolio system, improve accessibility to and convenience of training, ensure a standardised
approach to portfolio assessment, and facilitate the introduction of the planned changes. Ultimately
this should improve student experience.
An online training resource will be developed, utilising current training presentations and study
guides augmented with appropriate new material. The resource will be formatted for interactive
online use. The resource will comprise a short online training package, as well as an archive of useful
information, frequently asked questions, and examples of good practice. It will also list mandatory
entries for each year, and provide examples of good and poor entries as an assessment
benchmarking exercise.
References
1. Outcome 3, Tomorrow’s Doctors 2009, GMC.
2. Personal communication (Dr V Crawford).
Through designing and collating training materials, the student will better understand, and be able
to disseminate, the benefits of the portfolio program. The student will obtain generic/transferable
skills in information handling, programming, how to edit and repurpose paper based information for
on screen display, and how to arrange it appropriately in a package for online study. He/she will gain
experience in using a range of open source software tools to create multimedia elements. The
project also promotes student involvement in education and assessment, an important aim for CME
with proven educational benefits. As this work is relevant to all medical schools using the NHS
eportfolio, the student may also have the opportunity to present the work at local/national
educational meetings.
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2014
Project 12: Disability Inclusion and Full Spectrum Medical Training: Development of Role Play
Stations for OSCE and MMI Examinations
Proposers: Dr David Bell & Dr Vivienne Crawford
Collaborators (if any): Fleming Fulton School
GMC’s Tomorrow’s Doctors states that medical graduates should be able to communicate effectively
with disabled patients and treat them with respect. We need to challenge our students to adapt and
modify their clinical and communication skills accordingly during such consultations and to raise
awareness of such modification in caring for disabled people as an integral part of their patient base.
Recent in-house research analysed current learning opportunities relating to physical disability in our
undergraduate medical curriculum and evaluated the impact on attitudes towards physicallydisabled children and young adults. “A limited proportion of QUB medical students currently receive
training relating to physical disability. Trained students have better insight into needs of the
physically disabled; this impacts positively on students’ behavioural attitudes and professional
development.”
This project aims to develop a teaching resource using input from relevant stakeholders namely staff
and former and current pupils (aged 18+) from Fleming Fulton School and staff from CME. Initial
discussion of experiences of good and bad practice identified in medical consultations will inform
design of the scenarios. The student will then work in partnership with the supervisors and staff and
students from Fleming Fulton School to devise a role play scenario(s) and marking scheme(s)
involving consultation with physically-disabled adults as a training resource in video format. Consent
to film will be obtained from participants. The selected student will undergo updated AccessNI
clearance if necessary.
The student will have the privilege of working with disabled adults and those experienced in
providing care to physically disabled subjects and will therefore have their own experience and
knowledge significantly enhanced. They will also gain experience of developing the role play
station(s) which involves many academic and educational activities including construction of learning
outcomes and design of teaching materials and assessment criteria.
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2014

Transcription

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