Authors | Institution | |
Miss Amanda Ebejer Mr Paul K Jones Dr Sharon Hartwell Professor Judy McKimm |
Swansea College of Medicine |
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Swansea-Gambia link - A global partnership developing local educational resources |
Clinical skills teaching at Swansea School of Medicine makes use of clinical skills videos to demonstrate gold standard clinical examinations to students. The videos form a pool of learning resources which all Swansea students have access to.
In this way the standards by which all clinical teachers should use for their teaching is achieved as well as informing the students the way in which they ought to carry out these skills.
In contrast, clinical skills teaching at the Royal Victoria Teaching Hospital, Gambia relies on direct experience in the clinical area and is largely ad hoc bedside teaching by foreign clinicians. It was mutually recognised that the Gambia could benefit from a more structured approach, and a series of clinical skills videos were filmed as part of a project funded by the Welsh Government under the Wales-for-Africa scheme.
Two experienced clinical skills tutors and one medical student from Swansea worked with Gambian medical students to produce standardised videos in clinical examination. It emerged that a need was for neurological examination. Each video consisted of a full, thorough examination with annotations and short presentation of clinical findings.
After editing in Swansea, these resources were taken back to the Gambia, along with a new computer to be used in a newly set up clinical skills laboratory.
In order to ensure sustainability and enthusiasm from the Gambian students it was important for them to develop ownership of these resources so the videos were filmed by Gambian medical students in their own country. Experienced Gambian medical educators approved the sequencing and techniques used in each of the videoed examinations. This local context contributed to the Gambian students having that sense of ownership over the learning resources which would be passed on to each new student cohort.
One of the reasons the Gambia was chosen as a site for these resources to be developed was that two cohorts of Swansea students undertake a two-week Apprenticeship in the Gambia in December and January of each year. In this way, the efficacy of the videos can be evaluated and updated by future groups of Swansea medical students working alongside Gambian students as part of this medical apprenticeship scheme in the Gambia. Sustainability was an important consideration in choosing this area as this formula allows for monitoring of such resources over time.
Seven videos were filmed over a fortnight in the Gambia:
- Cardiovascular system examination
- Respiratory system examination
- Gastro-intestinal system examination
- Peripheral neurological examination of the upper limb
- Peripheral neurological examination of the lower limb
- Cranial nerve examination
- General examination
Early evaluation of the students improved abilities were achieved by the completion of questionnaires by participating students which did demonstrate an increase in confidence when performing clinical examinations.
E-learning resources and their development have been found to be the first step on the road to improved access to medical education (Frehywot et al, 2013). The students found the filming of the videos useful and their clinical skills techniques appeared to be improved even in the early stages. This was evidenced in completion of the questionnaires and that they have asked for further videos to be made. Future evaluation will be carried out by subsequent Swansea students during Apprenticeship experiences.
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The growing partnership between Swansea School of Medicine and the medical school in the Gambia has allowed for such projects of mutual benefit to be undertaken. - E-learning resources such as clinical skills videos are an effective way of implementing structure to clinical skills training and providing students with an effective and timeless learning tool.
We would like to thank all the Gambian medical students who volunteered their time and patience to film the videos.
A special thank you for the support from all the medical staff, and of course the Media Resources team at Swansea University for their work with editing the videos
Frehywot S., Vovides Y., Talib Z., et al. E-learning in medical education in resource constrained low- and middle-income countries. Human Resources for Health 2013, 11:4.