Training final year medical students in telephone communication and prioritization skills: An evaluation in the simulated environment.

Introduction: Receiving clinical tasks via the telephone and correctly prioritizing job lists are integral to patient safety. However, structured training on these skills is currently lacking in many medical curriculums. This study evaluated the impact of telephone communication and prioritization training on the ability of final year medical students to carry out these skills during an on-call simulation. Methods: Twenty-five final year King's College London medical students underwent a training session focused on telephone communication and task prioritization (group A). The performance of group A students in an on-call simulation involving these tasks was compared with twenty-five untrained final year students (group B). All participants completed a questionnaire about their training and/or simulation experience. Results: Group A compared to B students asked for more task-related information during each simulated call and correctly prioritized the resultant job list on significantly more occasions. Significantly more group A students reported being confident in answering calls and prioritizing their lists. The majority of students supported the addition of telephone communication and prioritization training into the medical curriculum. Conclusions: This study demonstrates the educational benefit of structured teaching on the ability of final year medical students to receive telephone handovers and prioritize job lists.

Comparing reactogenicity of COVID-19 vaccines: a systematic review and meta-analysis.

OBJECTIVES: A number of vaccines have now been developed against COVID-19. Differences in reactogenicity and safety profiles according to the vaccine technologies employed are becoming apparent from clinical trials. METHODS: Five databases (Medline, EMBASE, Science Citation Index, Cochrane Central Register of Controlled Trials, London School of Hygiene and Tropical Medicine COVID-19 vaccine tracker) were searched for relevant randomized controlled trials between 1 January 2020 and 12 January 2022 according to predetermined criteria with no language limitations. RESULTS: Forty-two datasets were identified, with 20 vaccines using four different technologies (viral vector, inactivated, mRNA and protein sub-unit). Adults and adolescents over 12 years were included. Control groups used saline placebos, adjuvants, and comparator vaccines. The most consistently reported solicited adverse events were fever, fatigue, headache, pain at injection site, redness, and swelling. Both doses of mRNA vaccines, the second dose of protein subunit and the first dose of adenovirus vectored vaccines were the most reactogenic, while the inactivated vaccines were the least reactogenic. CONCLUSIONS: The different COVID-19 vaccines currently available appear to have distinct reactogenicity profiles, dependent on the vaccine technology employed. Awareness of these differences may allow targeted recommendations for specific populations. Greater standardization of methods for adverse event reporting will aid future research in this field.

Incidental findings in UK healthy volunteers screened for a COVID-19 vaccine trial.

The safety of novel therapeutics and vaccines are typically assessed in early phase clinical trials involving "healthy volunteers." Abnormalities in such individuals can be difficult to interpret and may indicate previously unrecognized medical conditions. The frequency of incidental findings (IFs) in healthy volunteers who attend for clinical trial screening is unclear. To assess this, we retrospectively analyzed data for 1838 "healthy volunteers" screened for enrolment in a UK multicenter, phase I/II severe acute respiratory syndrome-coronavirus 2 (SARS-COV-2) vaccine trial. Participants were predominantly White (89.7%, 1640/1828) with a median age of 34 years (interquartile range [IQR] = 27-44). There were 27.7% of participants (510/1838) who had at least one IF detected. The likelihood of identifying evidence of a potential, new blood-borne virus infection was low (1 in 238 participants) compared with identification of an elevated alanine transaminase (ALT; 1 in 17 participants). A large proportion of participants described social habits that could impact negatively on their health; 21% consumed alcohol in excess, 10% were current smokers, 11% described recreational drug use, and only 48% had body weight in the ideal range. Our data demonstrate that screening prior to enrollment in early phase clinical trials identifies a range of IFs, which should inform discussion during the consent process. Greater clarity is needed to ensure an appropriate balance is struck between early identification of medical problems and avoidance of exclusion of volunteers due to spurious or physiological abnormalities. Debate should inform the role of the trial physician in highlighting and advising about unhealthy social habits.

Combining medical, physiotherapy and nursing undergraduates in high-fidelity simulation: determining students' perceptions.

High-fidelity simulation (Hi-Fi SIM) is increasingly used to provide undergraduate interprofessional education (IPE). Although research has reported positive student feedback, studies have predominantly involved medical and nursing specialties. The present study sought to further explore this area by determining the perceptions of medical, physiotherapy and nursing students participating in the same simulation session. A total of 145 medical, physiotherapy and nursing undergraduate students jointly participated in a novel Hi-Fi SIM IPE programme. Immediately before and after their session, students completed the KidSIM ATTITUDES questionnaire where statements were rated regarding simulation, IPE and human factors. A high score indicated a more positive attitude. Physiotherapy students reported the lowest level of previous Hi-Fi SIM experience. Students from each specialty had more positive attitudes related to simulation, IPE and human factors following their simulation. Physiotherapy students had predominantly less positive attitudes compared with nursing and medical students. Participation in an IPE Hi-Fi SIM session positively impacted on the perceptions of medical, physiotherapy and nursing students regarding the relevance of simulation, IPE and the importance of human factors. Such findings support the use of this learning modality for the provision of IPE in a range of specialties.