A Sustainable Model for Patient follow-up following an International Cleft Mission: A Proof of Concept.

PURPOSE: Patient follow-up after cleft missions is imperative if we are to critically assess the quality of care provided in these settings. The adoption of mobile telephones among disadvantaged families abroad may enable such an undertaking in a cost-effective manner. This project aimed to assess the efficacy of cellular phone-based follow-up in a developing country following a cleft mission to Thailand. METHODS: Changing Children's Lives Inc. performed a cleft surgical mission to Udon Thani, Thailand, in January 2013. Telephone numbers collected at that time were used to survey the patients or their parents 1.5 years postoperatively. RESULTS: Of the 56 patients who underwent cleft lip and/or palate surgery during the mission, more than 50% ( n = 30, 54%) were reachable by telephone; all chose to participate in the study. The cost for families was U.S. $124.92 (56.15); 26 families (87%) believed their money was well spent. Follow-up care was received by 22 (73%) patients, and all but one family ( n = 29, 97%) felt that their child received all of the medical care and support required. All families ( N = 30) would recommend similar cleft care to a friend. Of the patients younger than 18 years of age ( n = 24, 80%), 20 (80%) families found their child more comfortable interacting with peers, more comfortable interacting with adults, and more confident postoperatively. CONCLUSION: In one month, a survey response rate of more than 50% was obtained by leveraging the increased adoption of mobile phones in rural settings. Nearly all patients/families treated during the cleft mission were satisfied with the care that they received.

Differential Attainment Within the Specialised Foundation Programme: Creating an Accessible Mentorship Scheme to Increase Diversity Within Academic Medicine.

The Specialised Foundation Programme (SFP), formerly the Academic Foundation Programme, is a highly competitive pathway into academic medicine. There is minimal information available on the demographics of those who apply to the programme, how it scores its applicants and who is successful, making it difficult to assess whether the application process is accessible to all students and promotes a diverse workforce. There are varying levels of support available with coaching, either geographically ring-fenced by universities or available through paid courses. As a result, there is a risk of differential attainment between students who have financial constraints or attend universities where the SFP is less promoted. The aim of the study was to assess student opinion on barriers to the SFP and academic medicine and the demand for the creation of a national, free-to-access SFP mentorship programme to reduce differential attainment amongst student cohorts. Students in the programme received mentorship, peer learning and scheduled teaching events over a six-month period. Surveys were distributed pre- and post-course, and qualitative and quantitative analysis was conducted. Of the respondents, 76% felt that medical schools provided insufficient information on SFP, 31% did not feel financially stable at university and 53% stated that they would not enrol if a cost was present. Applicants were tested on pre- and post-course confidence, all of which showed an increase in mean Likert (1-5) scoring post-mentorship. Financial, institutional and geographical barriers to students applying to the programme were identified. Whilst further research is required to better understand the barriers to academic medicine, national, free-to-access mentorship may effectively reduce differential attainment and improve accessibility amongst students.

Improving physical health monitoring and interventions in a learning disabilities forensic psychiatric secure service.

BACKGROUND: Patients in psychiatric inpatient settings are at increased risk of developing physical health complications due to the structure of inpatient wards, the metabolic side-effects of antipsychotic medications and socioeconomic factors. Robust physical health monitoring and interventions are paramount in reducing this health inequality. OBJECTIVE: To improve the quality of physical health interventions in the ward environment and empower patients to follow healthy lifestyle guidance to reduce their risk of metabolic syndrome. METHODS: Patient weight and waist circumference data were collected at baseline and weekly throughout the 8-week intervention period. A questionnaire was recorded from baseline to week-5 to assess patient understanding. Two Plan-Do-Study-Act (PDSA) cycles were completed: (1) Series of weekly psychoeducation sessions and group exercise and (2) Implementation of healthy living diaries. RESULTS: Our data did not demonstrate any definitive impact upon the waist circumference and weight of participants. However, analysis of the questionnaires showed a consistent trend in knowledge improvement. CONCLUSION: Whilst our aim of reducing patient weight and waist circumference was not realised, there was a significant impact on participant's knowledge, demonstrating a subjective benefit of our interventions. Our project also highlighted inconsistencies in physical health measurements and data collection, providing vital information for further quality improvement measures.

Creating Diversity in Tomorrow's Doctors: A Student Led, Widening Participation Outreach Programme.

Since its founding in 2017, InsideMed, an entirely voluntary medical student led innovation, has offered local London state school students a unique perspective exploring the application process and realities of a career in medicine. Our aim of promoting diversity and widening participation (WP) amongst future medical school applicants is reflected in the fact 80.2% of the students enrolled are from Black Asian and Minority Ethnic groups (BAME). Over an 18 month period, our students are invited to monthly seminars hosted at King's College London (KCL), where all things "medical school" are explored. Students are paired with current KCL medical student ambassadors and are grouped into 'Families'. Between sessions, students and ambassadors are facilitated to communicate freely, but safely through the online platform Brightside. Early establishment of our key stakeholders allowed us to anticipate how InsideMed would impact each in turn and, therefore, design our scheme to ensure maximal mutual benefit. Continual feedback and review ensures that we are constantly improving to meet the needs of our students. Feedback also allows us to identify how closely we have served our aims for each cohort; common themes which consistently arise include the creation of community, learning more about specifics of the medical application process, and building self-confidence and student independence. InsideMed has the unique quality of being designed by WP students and constantly updated to ensure the support provided best meets WP needs. This has fed into our tangible and impressive impact, whereby 7 out of 18 respondents from our 2017 cohort of students have been accepted into medical school. Going forward, we hope to expand our scope to include a wider catchment area and will continue online in the COVID era. We aim to create an expansive alumni community to inspire other students from comparable socioeconomic backgrounds that they too can have a career in medicine.

Integration of Technology in Medical Education on Primary Care During the COVID-19 Pandemic: Students' Viewpoint.

The COVID-19 pandemic has forced medical schools and clinicians to transition swiftly to working online, where possible. During this time, final-year medical students at King's College London, England, have received some of their general practice teachings in the form of virtual tutor groups. The predominant feature of such groups is online patient simulations, which provide students a valuable experience to help gain insight into current clinical practice amid the pandemic and inform how their practices as incoming junior doctors would continue. Even in the absence of face-to-face teaching and clinical placements, students have been able to hone their medical knowledge and soft skills through these virtual, simulated consultations. They have been exposed to a new consultation style while in a safe and collaborative learning space. Here, we explore how medical students have benefited from these virtual tutor groups and how similar small-group online teaching opportunities can add value to the medical curriculum in the future.