An Online Survey of Australian Medical Students' Perspectives on Spiritual History Taking and Spiritual Care.

It is reported that little spiritual care communication skills training occurs in Australian medical schools. This survey explored the experience of final year students in this domain in order to inform the construction of a new curriculum. Medical students in their final year at four Australian medical schools were invited to participate in an online survey, which included questions about demographic details, exposure to spiritual history taking, perceived learning needs, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being 12 item Non-Illness score. Two-hundred and sixty students from a cohort of 766 responded (34%). One in nine students had witnessed spiritual history taking, and one in ten students had been given the opportunity to do so. Barriers and enablers were identified. Two-thirds of the students reported no recollection of any training in spiritual care. When it did occur, it was limited in scope and structure. Final year medical students recognise that spiritual care deserves a place in the modern, broad-based medical school curriculum. This supports the argument for inclusion of spiritual care training as part of all medical student curricula in Australia.

Systematic review of medical education on spirituality.

BACKGROUND: Spirituality is a fundamental dimension of our human nature that impacts on medical care and yet is relatively neglected by medical education courses in Australia. AIM: This systematic review was conducted to assess the curriculum content currently used to develop medical student understanding of, and engagement with, spirituality in the context of patient care. METHODS: Studies published in English from 2010 to the review date were included in order to focus on the most recent curricula. Studies included medical students in undergraduate or postgraduate programmes, doctors in resident training programmes and registrars. Interventions considered for inclusion were curriculum modules on communication skills in spirituality, spiritual needs assessments and holistic care planning. Six databases, including PubMed, Scopus, PsycINFO, Embase, Medline and CINAHL, were searched electronically using the following keywords and MeSH search terms: 'medical students', 'doctor', 'physician', 'spirituality', 'spiritual care', 'religion', 'education', 'history taking' and 'communication skills training' from 2010 to 2020. RESULTS: For 342 articles, three researchers screened the titles and abstracts; disagreements were resolved by discussion. Full-text articles were assessed for eligibility based on study and report characteristics; 17 papers were included in the analysis. Curriculum content of each study was reviewed. The following key features were employed frequently: chaplain shadowing, communications skills training, self-reflection, examining evidence and relationship building. CONCLUSION: This review has determined the core content, aims and objectives to guide construction of spirituality curricula in Australian medical education.

The challenge of generalist care in remote Australia: Beyond aeromedical retrieval.

OBJECTIVE: To examine clinical service activity amongst patients of the Royal Flying Doctor Service South Eastern Section in Far West New South Wales and to evaluate the management of chronic disease among frequent users of evacuation services. DESIGN: A retrospective audit of the Royal Flying Doctor Service South Eastern Section patient database inclusive of patients within the geographical study area who accessed a clinical or remote consultation, or evacuation service at least once between 1 July 2008 and 30 June 2013. Frequent users of evacuation services (≥3 evacuations per year) were investigated through RFDS patient files for determinants of chronic disease management. MAIN OUTCOME MEASURES: Category of service accessed, clinical consultation amongst frequent evacuees, determinants of chronic disease management. RESULTS: Total number of evacuees increased by 5.4%; number of remote and clinical consultation patients increased by 5.4%. Of the 47 frequent users of evacuation services, 19 (40%) were infrequent or non-users of clinics (≤3 attendances per year) and 32 (70%) did not have a general practice management plan. Frequent evacuees averaged 2.7 chronic conditions per patient and had seen an average of 16.8 primary care physicians over the 5-year evaluation. CONCLUSION: Most frequent evacuees had several chronic conditions, multiple primary care providers, did not have a general practice management plan and had infrequent clinic reviews. This evidence highlights the challenge of remote primary care and the need to improve systems of chronic disease management. It underlines the importance of current local efforts to improve electronic records, follow-up and team care and to explore further telehealth implementation.

Crash simulation: an immersive learning model.

BACKGROUND: Far West New South Wales Local Emergency Management Committee runs an annual crash simulation exercise to assess the operational readiness of all local emergency services to coordinate and manage a multi-casualty exercise. CONTEXT: Since 2009, the Broken Hill University Department of Rural Health (BHUDRH) has collaborated with the committee, enabling the inclusion of health students in this exercise. It is an immersive interprofessional learning experience that evaluates teamwork, communication and safe effective clinical trauma management outside the hospital setting. INNOVATION: After 7 years of modifying and developing the exercise, we set out to evaluate its impact on the students' learning, and sought ethics approval from the University of Sydney for this study. At the start of this year's crash simulation, students were given information sheets and consent forms with regards to the research. Once formal debriefing had finished, the researchers conducted a semi-structured focus-group interview with the health students to gain insight into their experience and their perceived value of the training. Students also completed short-answer questionnaires, and the anonymised responses were analysed. Crash simulation … evaluates teamwork, communication and safe effective clinical trauma management IMPLICATIONS: Participants identified that this multidisciplinary learning opportunity in a pre-hospital mass casualty situation was of value to them. It has taken them outside of their usually protected hospital or primary care setting and tested their critical thinking and communication skills. We recommend this learning concept to other educational institutions. Further research will assess the learning value of the simulated event to the other agencies involved.

The PAUL Suit(©) : an experience of ageing.

BACKGROUND: An ageing population worldwide makes it increasingly important that health students understand issues that elderly people face and can provide empathic care to them. CONTEXT: This teaching department in an isolated rural setting developed an interprofessional learning session to assist health students to understand issues of functional loss and social isolation that can affect elderly people. INNOVATION: The Premature Ageing Unisex Leisure (PAUL) Suit(©) was developed as part of a 1-day learning session for undergraduate health students - including students of medicine, nursing and allied health - attending clinical placement in far-west New South Wales. The suit was developed locally and can be adjusted to simulate a wide range of functional losses in the wearer. Students undertake a range of daily tasks in the community while wearing the suit in the company of a student 'carer'. Over the past 4 years, approximately 140 students have participated in the simulation. Post-simulation evaluations report that students gain a greater understanding of some functional issues associated with ageing, and of the social isolation that can be associated with these. The experiential nature of the activity leads to some powerful insights. This activity is an innovative, experiential tool to deepen students understanding of issues related to ageing IMPLICATIONS: This activity is an innovative, experiential tool to deepen students understanding of issues relating to ageing. The interprofessional nature of the activity is an important factor in the success of the day, and produces a wide range of shared insights. The activity also enhances the partnerships between the university, the health service and the local community. Our experience supports the value of simulation in providing a deep learning opportunity in the area of ageing and disability.