Clinical support during COVID-19: An opportunity for service and learning? A cross-sectional survey of UK medical students.

PURPOSE: Medical students providing support to clinical teams during Covid-19 may have been an opportunity for service and learning. We aimed to understand why the reported educational impact has been mixed to inform future placements. METHODS: We conducted a cross-sectional survey of medical students at UK medical schools during the first Covid-19 'lockdown' period in the UK (March-July 2020). Analysis was informed by the conceptual framework of service and learning. RESULTS: 1245 medical students from 37 UK medical schools responded. 57% of respondents provided clinical support across a variety of roles and reported benefits including increased preparedness for foundation year one compared to those who did not (p < 0.0001). However, not every individual's experience was equal. For some, roles complemented the curriculum and provided opportunities for clinical skill development, reflection, and meaningful contribution to the health service. For others, the relevance of their role to their education was limited; these roles typically focused on service provision, with few opportunities to develop. CONCLUSION: The conceptual framework of service and learning can help explain why student experiences have been heterogeneous. We highlight how this conceptual framework can be used to inform clinical placements in the future, in particular the risks, benefits, and structures.[Box: see text].

COVIDReady2 study protocol: cross-sectional survey of medical student volunteering and education during the COVID-19 pandemic in the United Kingdom.

BACKGROUND: The coronavirus disease 2019 pandemic has led to global disruption of healthcare. Many students volunteered to provide clinical support. Volunteering to work in a clinical capacity was a unique medical education opportunity; however, it is unknown whether this was a positive learning experience or which volunteering roles were of most benefit to students. METHODS: The COVIDReady2 study is a national cross-sectional study of all medical students at medical schools in the United Kingdom. The primary outcome is to explore the experiences of medical students who volunteered during the pandemic in comparison to those who did not. We will compare responses to determine the educational benefit and issues they faced. In addition to quantitative analysis, thematic analysis will be used to identify themes in qualitative responses. DISCUSSION: There is a growing body of evidence to suggest that service roles have potential to enhance medical education; yet, there is a shortage of studies able to offer practical advice for how these roles may be incorporated in future medical education. We anticipate that this study will help to identify volunteer structures that have been beneficial for students, so that similar infrastructures can be used in the future, and help inform medical education in a non-pandemic setting. TRIAL REGISTRATION: Not Applicable.

Parallel consulting method: student and tutor evaluation in general practice.

The parallel consulting method (PCM) is widely used by general practitioners (GPs) for teaching medical students. Studies have described individual aspects of bedside teaching in community settings, including the logistics of using the PCM, but there has been no evaluation of it as a teaching method. This study aimed to evaluate the PCM and whether it helped students develop consultation, clinical and clinical reasoning skills. The study was based at the Oxford University Primary Care Department. Penultimate clinical year students (n = 63) were recruited to take part in this mixed methods study. Students completed a questionnaire with closed and open-ended questions rating the PCM. A focus group explored questionnaire themes. GP tutors completed a questionnaire about the PCM and the logistics of delivering it. Three tutors took part in semi-structured interviews. The PCM helped develop students' consulting, and clinical reasoning skills. Teaching was improved when tutors were unrushed and had increased time to provide feedback and teaching. Delivery logistics of the PCM impacted on whether tutors were rushed and found it difficult to teach. Most benefit was derived when students were well briefed with sufficient debriefing time following a consultation. The following steps are recommended for effective delivery of the PCM teaching model: ensure tutors are appropriately trained; comprehensively brief the student about how to gain the most out of the learning experience; plan the logistics; ensure appropriate review and debriefing following consultation; review clinical cases after the session teaching on any outstanding aspects.

The development and evaluation of a simple method of gestational age estimation.

AIMS: The aims of this study were to develop and evaluate a shorter gestational age estimation method based on the Dubowitz scoring system (DSS) that could be taught easily to untrained health-care workers. METHODS: Using the DSS, seven criteria were identified that explained 90% of the variance in gestational age estimation. Ventral suspension was excluded, skin texture was substituted for skin colour and ear bending was for ear firmness. The final six criteria comprise the short DSS (SDSS). The study population was 100 babies, 51 Caucasian, 34 Aboriginal. Birth weight ranged from 1351 to 5430 g. The gestational age range was 29.6-41.7 weeks. Three researchers (medical student 1 (MS1), medical student 2 (MS2) and a paediatrician) who were blind to other available gestational age estimations assessed babies within 72 h of birth using the DSS and SDSS. RESULTS: MS1 found the 95% limits of agreement (LOA) between SDSS and DSS to be -1.1 to 1.7 weeks. In the 27 babies who had first trimester foetal ultrasound (USS), the LOA between USS and SDSS were -1.9 to 1.4 weeks and -2.3 to 1.9 weeks, respectively. Using the SDSS, the LOA for the three researchers were within +/-2 weeks. CONCLUSION: The data presented suggest that the SDSS is approximately equivalent to the DSS in the relatively limited population studied, and within these limitations appears to be a simple alternative to the DSS. Further evaluation is needed before firm conclusions about the accuracy and clinical utility of the SDSS can be made.

Predatory spider mimics acquire colony-specific cuticular hydrocarbons from their ant model prey.

The integrity of social insect colonies is maintained by members recognising and responding to the chemical cues present on the cuticle of any intruder. Nevertheless, myrmecophiles use chemical mimicry to gain access to these nests, and their mimetic signals may be acquired through biosynthesis or through contact with the hosts or their nest material. The cuticular hydrocarbon profile of the myrmecophilous salticid spider Cosmophasis bitaeniata closely resembles that of its host ant Oecophylla smaragdina. Here, we show that the chemical resemblance of the spider does not arise through physical contact with the adult ants, but instead the spider acquires the cuticular hydrocarbons by eating the ant larvae. More significantly, we show that the variation in the cuticular hydrocarbon profiles of the spider depends upon the colony of origin of the ant larvae prey, rather than the parentage of the spider.

Mimicry of host cuticular hydrocarbons by salticid spider Cosmophasis bitaeniata that preys on larvae of tree ants Oecophylla smaragdina.

The salticid spider Cosmophasis bitaeniata preys on the larvae of the green tree ant Oecophylla smaragdina. Gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) reveal that the cuticle of C. bitaeniata mimics the mono- and dimethylalkanes of the cuticle of its prey. Recognition bioassays with extracts of the cuticular hydrocarbons of ants and spiders revealed that foraging major workers did not respond aggressively to the extracts of the spiders or conspecific nestmates, but reacted aggressively to conspecific nonnestmates. Typically, the ants either failed to react (as with control treatments with no extracts) or they reacted nonaggressively as with conspecific nestmates. These data indicate that the qualitative chemical mimicry of ants by C. bitaeniata allows the spiders to avoid detection by major workers of O. smaragdina.