Teaching undergraduate medical students virtual consultation skills: a mixed-methods interventional before-and-after study.

OBJECTIVES: To evaluate the impact and transferability of a novel teaching method on virtual communication skills for final year medical students. DESIGN: Mixed-methods, interventional before-and-after study. SETTING: NHS Lanarkshire, Scotland. PARTICIPANTS: 21 final year medical students on their obstetrics and gynaecology (O&G) placement from September to December 2020. INTERVENTIONS: A two-part teaching session on virtual communication skills. MAIN OUTCOME MEASURES: Self-reported confidence in conducting consultations preteaching and post-teaching, exposure to virtual consultations, usefulness of teaching and transferability to primary care. Data were collected using preteaching and post-teaching evaluation tools and an online survey. RESULTS: Of 21 participants, 1 student did not attend the second session so was excluded from post-teaching evaluation results and the online survey. Preteaching results were collected from 21 participants and post-teaching results from 20. Mean confidence scores increased across all domains post-teaching. Mean confidence in opening the consultation increased from 2.67 (95% CI 2.21 to 3.13) to 4.70 (95% CI 4.50 to 4.90); history-taking from 3.38 (95% CI 3.07 to 3.69) to 4.45 (95% CI 4.19 to 4.71); decision-making and forming a management plan from 2.62 (95% CI 2.28 to 2.96) to 3.90 (95% CI 3.66 to 4.14) and closing the consultation from 2.81 (95% CI 2.45 to 3.17) to 4.60 (95% CI 4.38 to 4.81). There was no change in exposure to virtual consultations during O&G placement. 16 (80%) participants responded to the online survey; 14 (87.5%) rated the sessions 'very useful' and all 16 considered them worthwhile continuing. 12 (75%) had the opportunity to practise virtual consultations on general practitioner, mostly via telephone. CONCLUSIONS: We found that teaching students virtual consultation skills improved short term confidence and were transferable to primary care placements. Future research is suggested to assess this teaching model following adaptation and incorporation into medical education and training across specialties and grades. It would be useful to evaluate the impact on competence post intervention through observed skills.

Evaluation of Inter-Professional Education (IPE) with medical, nursing and pharmacy students through a simulated IPL Educational Intervention.

INTRODUCTION: Inter-Professional Education (IPE) is becoming an integral part of many professional programmes throughout the United Kingdom, ensuring health professionals are competent to work as part of an inter-professional team upon entry into their profession. IPE has become a fundamental component of curriculum content in health and social care degrees. AIMS: Research aim - to evaluate a simulated IPE intervention. METHODS: A one day IPE intervention, "Evening On-Call" was run involving nursing and medical students and pre-registration pharmacists (student pharmacists in year 5 of training) in an on-call setting. This IPE incorporated manikin and actor patients in a simulated ward. During the intervention, the 3 groups of students are assessed under observation on their clinical, prioritisation and communication skills. Participants perceptions of this intervention were evaluated by completion of a questionnaire to capture their perceptions regarding the experience, the pre-IPL briefing and post-IPL feedback and perceived relevance of this training. Free text sections collected additional comments and a follow-up questionnaire was sent 6 months later. RESULTS: Initial questionnaire feedback was predominantly positive for each professional group. The majority perceived the simulated IPL had given them a greater understanding of other professionals' roles, had enhanced their professional confidence and would help them prioritise workload once qualified. The 6-months follow-up questionnaire supported the initial questionnaire findings. Some responses highlighted that participants believed the simulated IPL had helped them work more effectively with other healthcare professionals, communicate more effectively and better prioritise their workload. There may be some evidence of sustained self-reported effectiveness in teaching certain professional and clinical skills to participants using this type of simulated intervention.

The sociocultural and behavioural characteristics that patients want in psychiatrists: cross-sectional survey of patients' views.

AIMS AND METHOD: There appears to be no research to date investigating patients' preferences for sociocultural characteristics or behavioural qualities of psychiatrists. We aimed to assess which are most important to patients. Patients (132) in community mental health teams across two sites (East Cornwall, East London) completed a questionnaire ranking the importance of different sociocultural characteristics and behaviours of psychiatrists. RESULTS: Patients cared more about age and gender than other characteristics. Four preferences (from a choice of ten) regarding behavioural qualities were clearly identified as important: explaining things clearly, dedication to personal treatment, being friendly and polite, and being up to date with medical knowledge. CLINICAL IMPLICATIONS: Patients are fairly unconcerned about the age, gender, religion and social background of psychiatrists. Characteristics they care about most include communication skills, competence, dedication to personal treatment and friendliness. Explaining things clearly is particularly important. This indicates specific areas of improvement for training and further research.

Preparing medical students for clinical decision making: a pilot study exploring how students make decisions and the perceived impact of a clinical decision making teaching intervention.

BACKGROUND: Junior doctors are frequently faced with making difficult clinical decisions and previous studies have shown that they are unprepared for some aspects of clinical decision making. AIM: To explore medical students' feelings and strategies when responsible for making clinical decisions and to obtain students' views of the effectiveness of a clinical decision making teaching intervention. METHODS: A teaching intervention was developed, consisting of a clinical decision making tool, a tutorial and scenarios within a simulated ward environment. A total of 23 volunteer students participated in individual interviews immediately after their simulator sessions. The qualitative data from the interviews were analysed to identify emerging themes. RESULTS: Despite extended shadowing programmes, students feel unprepared for clinical decision making as FY1s, and lack effective decision making strategies. Experiencing complex decision making scenarios through individually orientated simulation results in students being subjectively more prepared for work as FY1s. CONCLUSION: Students continue to feel unprepared for the responsibility of clinical decision making. A teaching intervention, including simulated individual clinical scenarios, later in undergraduate training, appeared to be useful in improving medical students' decision making, specifically in relation to making a diagnosis, prioritising, asking for help and multi-tasking, but further work is required.

Association between symptoms reported in a population questionnaire and future ischemic stroke: the ARIC study.

The association between computer diagnosis derived from a symptom questionnaire and onset of first hospitalized ischemic stroke during follow-up for up to 11 years has been assessed for 11,804 participants in the Atherosclerosis Risk in Communities Study who had no baseline history of stroke. Of these participants, 578 reported prior positive transient ischemic attack/stroke symptoms, and 265 strokes occurred during the years 1987-1998. Adjusted for age, locale, sex, and race, persons with self-reported baseline symptoms had 2.8 times the hazard rate for incident ischemic stroke of those without symptoms, with 95% confidence interval 1.9-4.1. Greater relative risk was found among younger individuals, women, African-Americans, persons not current smokers, and those with lower white blood cell count.