Simulated Ward Rounds involving patients as teachers using the 'Patients as Educators' Programme

Authors

Dr. Amir Burney
Mr Martin Hague

Theme

Simulation and Simulated Patients

Category

Simulated Patients

INSTITUTION

University of Sheffield

Conclusion

 

Patients offer personal experiences and provide powerful feedback to the participating students thus helping students develop confidence for future patient interactions.

Students are engaged with the "Simulated Ward Rounds" and recognise the benefits for the development of skills that are critical for their training and professional development.

The foundation doctors obtain experience of facilitating a learning experience and providing feedback.

Background

 

  The ‘Simulated Ward Rounds' provide medical students the opportunity to engage with patients recruited from the Patients as Educators (PaE) programme. ‘Simulated Ward Rounds’ were first introduced for fourth year medical students in 2007 to provide an adjunct to clinical experiences gained in primary care and hospital settings. In 2008, the concept was extended to final year students prior to their clinical competency assessments and also introduced for the third year medical students. Students use a model of learning based on a ten minute interaction with each patient undertaking a physical examination or a patient history. Each ward round lasts for one hour giving the student the opportunity to interact with six individual patients. The ward rounds are facilitated by the Academic Lead and Year 2 Foundation doctors.  

 

 

 

Summary of Work

 

 In order  to evaluate and further develop the "Simulate Ward Rounds" feedback was obtained from the Patient as Educators group (n=10) and final year medical students (n=100) who attended the simulated ward rounds conducted during February 2012. Following completion of the ward rounds medical students were requested to complete a questionnaire responding to eight statements using a four point Likert scale – strongly agree, agree, disagree, and strongly disagree. Additionally open text questions were also asked so that students could freely express their opinions (response rate 80%)

The PaEs were requested to provide feedback on three domains including organisation, training and assessment using a five point Likert scale – strongly agree, neither agree or disagree, strongly disagree and not applicable. Additionally an open text question was also asked for patients to freely express any further comment (response rate 80%)

 

Additionally post round video interviews were conducted with medical students and patients. Open ended questions were asked so that students and patients could freely express their opinions. 

 

The quantitative responses were analysed using excel and qualitative data subjected to a thematic analysis.

 

Results are listed in the details section

Take-home Messages

 

Students have the opportunity to see real patients in a controlled and safe setting, helping them to gain valuable insight into a variety of patient conditions and learning valuable clinical skills integral to their training as future doctors.

Acknowledgement

 

 The authors would like to thank the Patient as Educators (PaE) group and medical students from University of Sheffield who provided us with their valuable feedback. A special thanks to our colleagues at the Academic Unit of Medical Education, University of Sheffield and the Clinical Skills Centre, Northern General Hospital, Sheffield for their support and help to run the PaE program and Simulated Ward Rounds.

 

Summary of Results

 

Feedback from patients

 

From the free text responses patients suggested that : Simulated ward rounds gave them the opportunity to contribute to the training of medical students and provide verbal feedback.

Simulated Ward Rounds provided them the opportunity "to give something back to system" as token of their appreciation for the healthcare they recieved from the NHS

A small number felt that that they did not recieve enough training prior to the simulated ward rounds

 

Feedback from students

 

From the free text responses students suggested that : Simulated ward rounds enhanced confidence, communication skills, physical examination skills and time management skills

Simulated Ward Rounds provided the opportunity to recieve feedback from patients and facilitators

A small number felt that that they did not recieve enough feedback from the facilitators

A small number of students felt that there was not enough time at each station

References

 

All references are listed in the details section

Conclusion
Background

Simulated Ward Rounds are conducted at the Clinical Skills Centre, Northern General Hospital (Fig 1 and 2) .Patient and student briefings are conducted prior to the start (Figure 3). A debriefing for medical students is carried out following completion of the ward round. These are conducted by the Academic Lead or a senior member of the clinical skills team.

 

 

 

Figure 1: Photograph showing a ward set up for "Simulated Ward Rounds"

 

 

 

        

Figure 2: A typical station set up on the simulated ward round circuit.

 

 

 

 

Figure 3: Patient Briefing

 

 

 

All patients (PaEs) are offered training in the following areas to help facilitate their interaction with medical students.

 

History taking - Aim of training is to help the PaEs prepare for the style, type and depth of questions asked of them by medical students

 

Physical examination - Guidelines for PaEs are provided to help assist medical students. These include consenting, correct positioning, and exposure, and any concerns or anxieties that may arise during physical examination

 

Giving feedback - Guidelines for PaEs to provide feedback to medical students

 

Assessment - PaEs are provided with a questionnaire including a checklist to assess medical students' performance.

Summary of Work

Feedback from patients - PaE group

 

 

 

Student Feedback - Results reporting the findings from final year medical students (n=100)

 

Take-home Messages
Acknowledgement

A "Thank You Party" for our Patient as Educators group - A yearly fixture to express our gratitude to the patients who help with training medical students at the Medical School, University of Sheffield.2011

Summary of Results

Video - Comments from a Patient as Educator may be watched via the following link

 

 

“All the students I spoke with were very polite, respectful and grateful for the patients’ perspective/contribution.  An excellent group of young people whom I felt had been well briefed about the session.”

 

“I enjoyed the sessions immensely. Very polite students and they were very easy to talk to. Good to feel I can ‘give something back’ for the help and treatment I have received.”

 

“I found the experience very enlightening and enjoyable.  The students were really considerate”

 

 

Video  - Comments from  two Final Year medical students may be watched via the following links

 

 

Student comments

"Direct patient contact, I got to apply what was learned in lectures/books to real life practise.  Taught me how important it is and how much a Dr can learn by listening carefully”.

 

“Meeting real patients instead of looking at textbook cases shows the whole patient not just the symptoms.  Meeting patients who were so knowledgeable about their condition – learnt a lot!”

 

“Meeting patients, getting their opinions on their conditions and seeing how the way doctors treat patients can have an impact on their lives”.

References

   

General Medical Council. Tomorrow's Doctors: Outcomes and standards for undergraduate medical education. GMC 2009

 

Dolmans DHJM, Wolfhagen IHAP, Heineman E, Scherpbier AJJA. Factors adversely affecting student learning in the clinical learning environment: a student perspective. Education for Health (2008)

General Medical Council. Tomorrow's Doctors: Outcomes and standards for undergraduate medical education. GMC 2009

 

Dolmans DHJM, Wolfhagen IHAP, Heineman E, Scherpbier AJJA. Factors adversely affecting student learning in the clinical learning environment: a student perspective. Education for Health (2008)

 

Parry J, Mathers J, Thomas H, Lilford R, Stevens A, Spurgeon P. More students, less capacity? An assessment of the competing demands on academic medical staff. Medical Education (2008)

 

Hutchinson L. Challenges of training doctors in the new English NHS. BMJ (2006)

 

Howe A. and Anderson J. Involving patients in medical education. BMJ (2003)

 

McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, De Cristifaria A, Kerr EA. The quality of healthcare delivered to adults in the Unites States New England Journal of Medicine (2003)

Parry J, Mathers J, Thomas H, Lilford R, Stevens A, Spurgeon P. More students, less capacity? An assessment of the competing demands on academic medical staff. Medical Education (2008)

 

Hutchinson L. Challenges of training doctors in the new English NHS. BMJ (2006)

 

Howe A. and Anderson J. Involving patients in medical education. BMJ (2003)

 

McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, De Cristifaria A, Kerr EA. The quality of healthcare delivered to adults in the Unites States New England Journal of Medicine (2003)

 

General Medical Council. Tomorrow's Doctors: Outcomes and standards for undergraduate medical education. GMC 2009

 

Dolmans DHJM, Wolfhagen IHAP, Heineman E, Scherpbier AJJA. Factors adversely affecting student learning in the clinical learning environment: a student perspective. Education for Health (2008)

 

Parry J, Mathers J, Thomas H, Lilford R, Stevens A, Spurgeon P. More students, less capacity? An assessment of the competing demands on academic medical staff. Medical Education (2008)

 

Hutchinson L. Challenges of training doctors in the new English NHS. BMJ (2006)

 

Howe A. and Anderson J. Involving patients in medical education. BMJ (2003)

 

McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, De Cristifaria A, Kerr EA. The quality of healthcare delivered to adults in the Unites States New England Journal of Medicine (2003)

 

General Medical Council. Tomorrow's Doctors: Outcomes and standards for undergraduate medical education. GMC 2009

 

Dolmans DHJM, Wolfhagen IHAP, Heineman E, Scherpbier AJJA. Factors adversely affecting student learning in the clinical learning environment: a student perspective. Education for Health (2008)

 

Parry J, Mathers J, Thomas H, Lilford R, Stevens A, Spurgeon P. More students, less capacity? An assessment of the competing demands on academic medical staff. Medical Education (2008)

 

Hutchinson L. Challenges of training doctors in the new English NHS. BMJ (2006)

 

Howe A. and Anderson J. Involving patients in medical education. BMJ (2003)

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