Developing a standardized national undergraduate curriculum for future healthcare professionals on self-management support for chronic conditions.

This is a report on the development of the second part of a national undergraduate interprofessional standardized curriculum in chronic disease prevention for healthcare professionals in the Republic of Ireland; National Undergraduate Curriculum for Chronic Disease Prevention and Management Part 2: Self-management Support for Chronic Conditions. The development processes involved in Part 1, Making Every Contact Count for Health Behavior Change, were described earlier. This report presents an overview of the development of a national self-management support curriculum and barriers and enablers encountered. The curriculum was developed by a National Working Group, with interprofessional representation from each of the Higher Education Institutions (HEIs) in Ireland and the national health service, i.e. the Health Service Executive (HSE). All phases of the project were overseen by a Steering Group and supported in each HEI by a local working group. The aim of the curriculum is to introduce standardized self-management support education across all undergraduate and graduate entry healthcare programmes nationally to prepare future healthcare professionals with knowledge, skills and attitudes to support individuals to self-manage their chronic conditions.

Is it feasible to learn research skills in addition to audit skills through clinical audit? A mixed methods study in general practice.

BACKGROUND: Involving medical students in research in their undergraduate careers may increase the likelihood that they will be research active after graduation. To date, there has been a paucity of published research of students doing research in general practice. AIM: The study aims to evaluate the impact of general practice clinical audits on early-stage graduate entry students' audit and research self-efficacy and explore feasibility issues from the student and GP perspective. METHODS: Two student questionnaires (pre- and post-intervention), a qualitative GP survey of the 25 participating GPs and semi-structured interviews of a purposeful sample of GPs were conducted. RESULTS: Participating students who completed the follow-up survey found that it had a positive educational impact (55%), increased their understanding of the audit cycle (72%) and real-world prescribing (77%). Research confidence wise, there was a statistically significant difference in the student group who completed the audit project compared to those students who did not in knowledge of the audit cycle and the difference between research and audit (p = 0.001) but not in other research skills. Ninety-six percent of responding GPs would be happy for students to do future audits in their practice but some feasibility issues similar to other research initiatives in general practice were identified. CONCLUSION: We found this audit initiative feasible and useful in helping students learn about audit skills, patient safety and real-world prescribing. GPs and students would benefit more if it were linked to a substantial clinical placement, focussed on a topic of interest and given protected time. Separate research projects may be needed to develop research skills confidence.

Curriculum initiatives to enhance research skills acquisition by medical students: a scoping review.

BACKGROUND: Although it is accepted that providing medical students with opportunities to engage in research activity is beneficial, little data has been collated on how medical degree curricula may address this issue. This review aims to address this knowledge gap by conducting a scoping review examining curriculum initiatives that seek to enhance research experience for medical students. METHODS: This review looks to specifically look at 'doing research' as defined by the MEDINE 2 consensus rather than 'using research' for the bachelor component of the Bologna Cycle. The framework developed by Arksey & O'Malley was utilised and a consultation with stakeholders was incorporated to clarify and enhance the framework. RESULTS: A total of 120 articles were included in this scoping review; 26 related to intercalated degree options and 94 to non-intercalated degree options. Research initiatives from the United States were most common (53/120 articles). For non-intercalated research options, mandatory and elective research projects predominated. The included studies were heterogeneous in their methodology. The main outcomes reported were student research output, description of curriculum initiative(s) and self-reported research skills acquisition. For intercalated degree options, the three main findings were descriptions of more 'novel' intercalated degree options than the traditional BSc, student perspectives on intercalating and the effect of intercalating on medical student performance and careers. CONCLUSIONS: There are several options available to faculty involved in planning medical degree programmes but further research is needed to determine whether research activity should be optional or mandatory. For now, flexibility is probably appropriate depending on a medical school's resources, curriculum, educational culture and population needs.

What factors influence medical students to enter a career in general practice? A scoping review.

BACKGROUND: Internationally, healthcare systems are providing more community-based care. Consequently, there is an increasing demand for GPs and other healthcare professionals to work in primary care and this has implications for undergraduate medical education. AIMS: In this scoping review, we aim to examine 'What factors positively influence medical students to pursue a career in general practice?' METHODS: The five-stage framework developed by Arksey and O'Malley (2005) was utilized to review the extant literature. Fourteen records were included in the review. RESULTS: Medical students are influenced to pursue a career in general practice due to curriculum factors such as exposure, positive clinical rotation experiences, positive GP role models and maintaining a positive view of the profession at an early stage of their time as a medical student. Intrinsic factors such as student attributes, the influence of family, friends and the community where people live and having a strong orientation to social concerns were factors that make students more likely to pursue a career in the specialty. There is a shortage of literature from an Irish context examining the career intentions of medical students specifically. However, those studies which were conducted in Ireland reported similar findings to those conducted elsewhere. CONCLUSIONS: Curriculum and personal factors have a key role in influencing students to pursue a career in general practice. As much of the existing research involves cross-sectional designs involving small numbers of participants, further research adopting prospective, quasi-experimental designs involving larger cohorts is a priority.

Screening for atrial fibrillation in general practice: a national, cross-sectional study of an innovative technology.

BACKGROUND: To test the use of three lead monitoring as a screening tool for atrial fibrillation (AF) in general practice. AF is responsible for up to a quarter of all strokes and is often asymptomatic until a stroke occurs. METHODS: 26 randomly selected general practices identified 80 randomly selected patients aged 70 or older from their database and excluded those known to have AF, those with clinical issues or who had not attended for three years. Up to 40 eligible patients/practice were invited to attend for screening. A 2min three-lead ECG was recorded and collected centrally for expert cardiology assessment. Risk factor data was gathered. OUTCOMES: (i) point prevalence of AF, (ii) proportion of ECG tracings which were adequate for interpretation, (iii) uptake rate by patients and (iv) acceptability of the screening process to patients and staff (reported separately). RESULTS: Of 1447 current patients, 1003 were eligible for inclusion, 639 (64%) agreed to take part in screening and 566 (56%) completed screening. The point prevalence rate for AF was 10.3%-2.1% new cases (12 of 566 who were screened) and 9.5% existing cases (137 of 1447 eligible patients). Only four of 570 (0.7%) screening visits did not record a usable ECG and 11 (2.6%) three lead ECGs required a clarifying 12 lead ECG. CONCLUSIONS: Three lead screening for AF is feasible, effective and offers an alternative to pulse taking or 12 lead ECGs. The availability of this technology may facilitate more effective screening, leading to reduced stroke incidence.