Connie Wiskin

Background: The Clinical Communication Team at the University of Birmingham are undertaking an ambitious project where students across all healthcare programmes will interact within a single virtual healthcare community – ‘Wood Brooke’ – via simulation activities. The vertical nature of the programme means students can ‘follow’ the illness/life journeys of a series of families that they meet early in the course over a 3–4 year timeframe. Additionally, they can meet and interact with simulated healthcare professionals working in Wood Brooke’s virtual primary, community, and secondary care facilities. Wood Brooke is already well-established throughout our 4-year Pharmacy degree, being integrated into teaching and testing not just for communication, but linked to other clinical aspects of the Programme. We will share our model, and experiences, successes, and challenges. Methods: Recently Wood Brooke was adapted for Birmingham’s 3-year BNurs programme as a vertically integrated clinical communication/professionalisation strand. It is well documented that nursing students should be trained in patient-centred communication [1]. Students from Adult, Child, and Mental Health Nursing mix in the sessions for intra-professional learning and breadth of peer support and feedback. Sessions in Year 1 focus on cases relating to three families from Wood Brooke from patient and relative/carer perspectives. Year 2 builds on the simulation to consider intra and interprofessional colleague interactions in community-based and acute settings through telephone and face to face role play simulation. This builds on the 3 family cases introduced in the first year, introducing other members within the family. Year 3 is under development. Results: Feedback from learners about the Programme has been positive. This is not a research project so we will not be presenting ‘data’. A result in progress is rolling Wood Brooke out to other Programmes, including Medicine and Dentistry, as part of curriculum review. Discussion may focus on the potential benefits of healthcare students having shared visibility of patient narratives/experiences where that patient is accessing care under more than one service. Conclusion: Inclusivity and designing a ‘community’ reflective of the population has been central. The vertical development of patient narratives over several years enables adaption of the programme to meet new priorities and needs (including, e.g., shift to remote working for COVID-19, and evolving patient demographics). References 1. Gutiérrez-Puertas L, Márquez-Hernández VV, Gutiérrez-Puertas V, Granados-Gámez G, Aguilera-Manrique G. Educational interventions for nursing students to develop communication skills with patients: a systematic review. International journal of environmental research and public health. 2020;17(7):2241. Background: The Clinical Communication Team at the University of Birmingham are undertaking an ambitious project where students across all healthcare programmes will interact within a single virtual healthcare community – ‘Wood Brooke’ – via simulation activities. The vertical nature of the programme means students can ‘follow’ the illness/life journeys of a series of families that they meet early in the course over a 3–4 year timeframe. Additionally, they can meet and interact with simulated healthcare professionals working in Wood Brooke’s virtual primary, community, and secondary care facilities. Wood Brooke is already well-established throughout our 4-year Pharmacy degree, being integrated into teaching and testing not just for communication, but linked to other clinical aspects of the Programme. We will share our model, and experiences, successes, and challenges. Methods: Recently Wood Brooke was adapted for Birmingham’s 3-year BNurs programme as a vertically integrated clinical communication/professionalisation strand. It is well documented that nursing students should be trained in patient-centred communication [1]. Students from Adult, Child, and Mental Health Nursing mix in the sessions for intra-professional learning and breadth of peer support and feedback. Sessions in Year 1 focus on cases relating to three families from Wood Brooke from patient and relative/carer perspectives. Year 2 builds on the simulation to consider intra and interprofessional colleague interactions in community-based and acute settings through telephone and face to face role play simulation. This builds on the 3 family cases introduced in the first year, introducing other members within the family. Year 3 is under development. Results: Feedback from learners about the Programme has been positive. This is not a research project so we will not be presenting ‘data’. A result in progress is rolling Wood Brooke out to other Programmes, including Medicine and Dentistry, as part of curriculum review. Discussion may focus on the potential benefits of healthcare students having shared visibility of patient narratives/experiences where that patient is accessing care under more than one service. Conclusion: Inclusivity and designing a ‘community’ reflective of the population has been central. The vertical development of patient narratives over several years enables adaption of the programme to meet new priorities and needs (including, e.g., shift to remote working for COVID-19, and evolving patient demographics). References 1. Gutiérrez-Puertas L, Márquez-Hernández VV, Gutiérrez-Puertas V, Granados-Gámez G, Aguilera-Manrique G. Educational interventions for nursing students to develop communication skills with patients: a systematic review. International journal of environmental research and public health. 2020;17(7):2241.

On elective students may not always be clear about safeguarding themselves and others. It is important that placements are safe, and ethically grounded. A concern for medical schools is equipping their students for exposure to and response to uncomfortable and/or unfamiliar requests in locations away from home, where their comfort and safety, or that of the patient, may be compromised. This can require legal, ethical, and/or moral reasoning on the part of the student. The goal of this article is to establish what students actually encounter on elective, to inform better preparing students for safe and ethical medical placements. We discuss the implications of our findings, which are arguably applicable to other areas of graduate training, e.g. first medical roles post-qualification. An anonymised survey exploring clinical and ethical dilemmas on elective was issued across 3 years of returning final year elective medical students. Questions included the prevalence and type of potentially unsafe scenarios encountered, barriers to saying ‘no’ in unsafe situations, perceived differences between resource poor and developed world settings and the degree to which students refused or consented to participation in events outside of the ‘norms’ of their own training experience. Three hundred seventy-nine students participated. 45% were asked to do something “not permissible” at home. 27% were asked to do something they felt “uncomfortable” with, often an invasive clinical task. Half asked to do something not usually permissible were “comfortable”. 48% felt it more acceptable to bypass guidelines in developing settings. 27% refused an offer outside their experience. Of interest are reasons for “going along with” uncomfortable invitations, e.g. “emergency”, self-belief in ‘capability’ and being ‘more qualified’ than host-personnel. This “best pair of hands available” merits scrutiny. Adverse scenarios were not exclusive to developing settings. We discuss preparing students for decision-making in new contexts, and address whether ‘home’ processes are too inflexible to prepare students for ‘real’ medical life? Ethical decision-making and communicating reluctance should be included in elective preparation.

Introduction: Many doctors, across grades and specialities, supervise or advise students and juniors undertaking elective placements. Electives form part of medical curricula on a worldwide scale. The Medical Schools Council ( MSC ) Electives Committee in the UK identified a gap in the current literature in relation to provision of comprehensive recommendations for the design and management of undergraduate elective programmes. Electives afford many known benefits for medical and other health care students, but the context, and risks (impacting potentially on patient, public and student well‐being) are usually different from those associated with ‘home’ clinical placements. Aim: The aim is to share experiences and good practice within UK Medical Schools, and inform and inspire others involved with similar programmes across the globe. Method: This paper reports the results of the formation of a sub‐group to draft a set of recommendations, drawing on the reported experiences of academic elective leads across all UK schools, and including input from the MSC , and the student group Medsin (to capture the learner voice). The final document was the result of a national consultative process of four iterations. The end document was approved at school level, e.g. by curriculum committee, by each of the participating schools. Recommendations: The recommendations consolidate the experiences of 30 participating UK medical schools. The consultation process generated 17 pre‐departure recommendations, seven during elective recommendations, 11 post elective recommendations and a further four recommendations relating to infectious disease. Conclusion: We believe developing elective programmes using collective recommendations will provide a basis for a safer and more structured approach to a medical elective without losing the uniqueness and creative experiences valued by participants. Issues relating to undergraduates leaving their home school to experience medicine in a new context or country replicate across sites, so many recommendations will be transferable internationally.

This article reports changes in mindset and attitudes of a cohort of 798 NHS managers in relation to the implementation of a new NHS trust-wide performance appraisal system. This was measured through two methods: the statistical analysis of data collected before and after an intensive training/orientation intervention by means of χ2 tests; and a corpus linguistic analysis of word associations and text comments that is novel to the literature.

As the first point of contact for patients and witnesses of stroke, General Practice receptionists can be instrumental in deciding the urgency of clinical contact. Despite the considerable complexity of this task, reception staff are not clinically trained. Minimising the time taken to access thrombolysis is crucial in acute stroke as treatment must be initiated within 4.5 hours of the onset, and the earlier the better, to achieve the best outcomes. Research suggests that patients who first contact their General Practice following the onset of stroke symptoms are less likely to receive thrombolysis, in part due to significant delays within Primary Care.

All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools.

Sex, sexuality and sexual health beliefs are individual, impacting on physical and mental health. Sexual history taking is rarely taught in General Practice (GP). However, ‘sex’ is routinely relevant in this setting. Birmingham students practice discussing sexual history with a simulated-patient in GP. Simulated-patient inclusion in teaching/assessment is well-documented, but no study evaluating the impact of role play on attitudes to people who need STI testing was identified. We aimed to identify whether facilitated simulations featuring a sexual history scenario effected change in students’ attitudes towards people who need STI testing. A randomised-controlled-trial was used to compare attitudinal scores between students exposed to an STI role play and a control group who did not receive the role-play teaching until after data capture. There were no significant differences in attitude, either in negative or positive direction, observed between control and intervention groups. Ethnicity was a significant variable, with white-British students self-reporting more positive attitudes. Twenty five percent students admitted personal STI exposure. Again response varied significantly between ethnic groups (the white-British group reporting 4× the exposure). Females reported more positive attitudes than males, most marked in relation to ‘willingness to date’ someone who admitted to STI testing.

A number of recent developments in medical and nursing education have highlighted the importance of communication and consultation skills (CCS). Although such skills are taught in all medical and nursing undergraduate curriculums, there is no comprehensive screening or assessment programme of CCS using professionally trained Standardized Patients Educators (SPE's) in Ireland. This study was designed to test the content, process and acceptability of a screening programme in CCS with Irish medical and nursing students using trained SPE's and a previously validated global rating scale for CCS.

Education is integral to reducing stigma toward the mentally ill. Medical educators have a key role in delivering education that reduces that stigma. Undergraduate psychiatric training and specific education programs are both effective in reducing stigma. However, many students are exposed to concepts of mental illness at a much earlier stage in their education. No previous study has explored the effect of intervention such as role-play on student attitudinal development. This study's objective was to identify whether undergraduate role-play exercises featuring mental illness influenced development of attitudes toward the mentally ill. A randomized controlled trial was used to compare attitudinal scores between students exposed to a mental illness role-play as part of routine teaching and a control group that did not receive the teaching. A total of 332 students provided data. There were no between-group differences for any attitudinal scores, although gender (being female) and experience of mental illness were associated with more positive attitudinal scores. Single high-intensity routine teaching sessions such as role-play involving metal illness do not influence student attitudes.