G423(P) Teaching clinics in secondary care for undergraduate students: achievable and affordable. (May 2019)

• Record Type: Journal Article
• Authors: Coombe, E; McAvoy-Yau, A
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 2
• Page Start: A171
• Page End: A172
• Publication Date: 2019-05
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-rcpch.408
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: Develop a model for facilitating year 4 medical students to lead consultations in outpatient clinics. Operationalise a new clinic including booking patients, environment, supervision and administrative support. Evaluate the challenges and success and expand to other sites if successful. Method: This project was initiated by 2 clinical teaching fellows; level 2 paediatric trainees taking out of programme experience. It was overseen by a consultant departmental lead for undergraduate teaching, who supervised the teaching fellows. Support with clinic setup was sought from the outpatient booking service, and administrative support from the supervising consultant's secretary. Spencer's 'Hot Seating' model 1 was used to allow students opportunity to lead the consultation. Results: 24 clinics were held, 56 patients (9 new, 47 follow-up) were seen with 42 students. 9 patients did not attend booked slots. Students were orientated to the style of outpatient clinic consultations. They were supported to review old notes and referral letters, and guided them to access guidelines or refresh their knowledge of the presenting problem. Students attended in pairs and took turns to lead consultations in 40 min slots, with 4 slots per clinic. The leading student took a history and performed an examination. They then had a choice to form a management plan in front of the patient/parent with support from the fellow, or ask the patient/parent to sit outside the room and form a plan with the fellow, before inviting them back in to discuss the plan. A Plan, Do, Study, Act (PDSA) method was used to pilot teaching clinics in one hospital. The University also hosts students on paediatric attachments in 4 other hospitals so our aim if the pilot were successful, would be to use PDSA cycle evidence to expand teaching clinics across the hospitals in the region. Teaching clinics were well received by students with 97% reporting they found it enjoyable and 94% reporting it as useful. Conclusion: Teaching clinics are an achievable and affordable way of improving the medical student experience in paediatrics but workforce pressures mean they would be challenging to provide without teaching fellows. Reference: Spencer, J. Learning and teaching in the clinical environment. British Medical Journal. 2003; 326; 591–594.