Planetary health and sustainability teaching in UK medical education: A review of medical school curricula.

BACKGROUND: The doctors of the future need to be empowered to deliver healthcare sustainably while protecting their patients' health in the context of a degrading environment. This study aimed to objectively review the extent and nature of the teaching of planetary health and sustainability topics in UK medical education. METHODS: A multi-centre national review of the timetabled teaching sessions in medical courses in the UK during the academic year 2020/2021 against the General Medical Council's adopted 'Educating for Sustainable Healthcare - Priority Learning Outcomes'. Medical students were recruited and reviewed the entirety of their own institution's online teaching materials associated with core teaching sessions using a standardised data collection tool. Learning outcome coverage and estimated teaching time were calculated and used to rank participating medical schools. RESULTS: 45% of eligible UK medical schools were included in the study. The extent of teaching varied considerably amongst courses. Mean coverage of the 13 learning outcomes was 9.9 (SD:2.5) with a mean estimated teaching time of 140 min (SD:139). Courses with dedicated planetary health and sustainability sessions ranked best. CONCLUSION: There is large disparity in the education that medical students receive on these topics. Teaching may not adequately prioritise sustainability or reflect advances in planetary health knowledge.[Box: see text].

A new approach to OSCE preparation - PrOSCEs.

BACKGROUND: Objectively structured clinical examinations (OSCEs) are a stressful experience for many health care students and professionals in training. Mock OSCEs have been shown to be beneficial for student OSCE preparation. However, due to their expense and administrative burden students may only get a few opportunities to partake in these. To address this gap in student preparation a series of regularly run totally peer led multi-role practice OSCEs (PrOSCEs) was developed. METHODS: Fifteen PrOSCEs were run over five-months. A total of 32 second year medical students took part, all of whom were enrolled on the graduate-entry programme at the University of Southampton. In each PrOSCE, 18 participants rotated through the roles of 'student', 'examiner' and 'patient' in six simulated stations designed by their peers. Peer feedback was provided after each station. At the end of the series of PrOSCEs students were asked to fill in an anonymous online feedback survey to assess the usefulness of the PrOSCEs in exam preparation. RESULTS: Twenty-two students responded to the survey. 100% of respondents deemed routine participation either 'very useful' or 'useful' in preparing for their exam. PrOSCEs were found to improve confidence (mean = 7.9/10, 95% CI 7.4-8.3), expected performance (mean = 7.5/10, 95% CI 6.8-8.2) and help guide revision (mean = 8.3/10, 95% CI 7.6-9.0). Self-perceived teaching performance and confidence in providing feedback was also positively associated with participation. The most beneficial roles were 'student' and 'station creator'. Free-text feedback suggests that the informal setting and regular practice were particularly beneficial. CONCLUSION: The peer-led nature of the PrOSCEs allows for a low cost, low administrative burden and easy to replicate adjunct or alternative to large scale mock OSCEs. In addition the multi-role aspect of this approach could enhance exam preparation and may also improve aptitude as a clinical teacher. Further studies are required to understand if repeated practice has beneficial implications on OSCE performance.

A Questionnaire-based Study Exploring Participant Perspectives in a Perinatal Human Challenge Trial.

BACKGROUND: Pregnant women have historically been excluded from most medical research, including human challenge studies. The proof-of-concept Lactamica 9 human challenge study investigated whether nasal inoculation of pregnant women with commensal bacteria leads to horizontal transmission to the neonate. Given the unique practical and ethical considerations of both human challenge studies and interventional research involving pregnant women and their newborns, we sought to investigate the motivations, concerns and experiences of these volunteers. METHODS: Pre- and post-participation questionnaires were given to all participants in the Lactamica 9 study. These fully anonymized qualitative and Semi-quantitative questionnaires used forced Likert scales, word association and free-text questions. RESULTS: Pre- and post-participation questionnaires were completed by 87.1% (27/31) and 62.5% (15/24) of eligible participants, respectively. Almost all pre-participation respondents agreed with altruistic motivations for participation, and most concerns were related to discomfort from study procedures, with few concerned about the theoretical risks of inoculation to themselves (5/27; 18.5%) or their baby (6/27; 22.2%). Participants most frequently associated the study intervention with the terms "bacteria," "natural," "protective" and "safe." For the post-participation questionnaire, 93.3% (14/15) found all study procedures acceptable, and qualitative feedback was almost entirely positive, with particular emphasis on the research team's flexibility, approachability and friendliness. CONCLUSIONS: The successful completion of the Lactamica 9 study demonstrates that human challenge research in healthy pregnant women can be acceptable and feasible. Participants' initial concerns of potential discomfort were outweighed by predominantly altruistic motivations and perception of the intervention as "natural."

Maturity Has a Greater Association than Relative Age with Physical Performance in English Male Academy Soccer Players.

This study aimed to: (1) examine differences in physical performance across birth-quartiles and maturity-status, and (2) determine the relationships among relative age, maturation and physical performance in young male soccer players. The sample included 199 males aged between 8.1 and 18.9 years, from two professional soccer academies in the English Football League. Data were collected for height, weight, self-reported biological parent heights, 30 m sprint time and countermovement jump (CMJ) height. Relative age was conveyed as a decimal, while maturity status was determined as the percentage of predicted adult height (PAH). There were no significant differences in any measure between birth quartiles, however early maturers outperformed on-time and later maturers in most performance measures. Pearson-product-moment correlations revealed that maturation was inversely associated with 30 m sprint time in U12 to U16 (r = -0.370-0.738; p < 0.05), but only positively associated with CMJ performance in U12 (r = 0.497; p < 0.05). In contrast, relative age was unrelated to sprint performance and only significantly associated with superior CMJ performance in U16. This study indicates that maturity has a greater association with sprint performance than relative age in English male academy soccer players. Practitioners should monitor and assess biological maturation in young soccer players to attempt to control for the influence on physical performance, and avoid biasing selection on absolute performance rather than identifying the most talented player.