With the launch of the new MBBS 2012 curriculum, there was an opportunity to develop a half-day session to introduce the concepts of Acute Medicine into new year 4 at UCLMS. The Lead for Integrated Clinical Care, Paul Dilworth tasked Nick Murch (Locum Consultant Physician in Acute Medicine and Medical Education, Royal Free Hospital) and James Goldring (Consultant Respiratory Physician, Royal Free Hospital) with developing an innovative session for the facilitation of learning in Acute Medicine.
After mapping to the curriculum and identifying several areas of knowledge and skills to target, four clinical scenarios were developed to introduce the students to common acute medical conditions. A core team consisting of Nick Murch, Winnie Chen (Core Medical Trainee), Ben Lovell and Sanjay Krishnamoorthy (both Specialist Trainees in Acute Medicine) collaborated to write and pilot the scenarios.
The sessions were designed such that an electronic voting system (EVS) would be integral. EVS devices have been shown to increase audience participation and may result in improved test results for participants. The ‘clickers’ will be familiar to those who teach in the Cruciform at the Bloomsbury site, but this is the first regular use of the system at the Royal Free Hospital. Profoundly learner-centric, these systems can provide a feedback loop that allows the facilitator to dynamically assess the effect of their teaching before moving on. From the learners’ perspective, this type of interaction is challenging and encourages sustained attention, reflection, self-assessment, and a view of how the group as a whole is doing. Small and whole group discussion and debate is actively promoted to try to encourage peer-assisted learning.
The sessions have also been designed to be as immersive and inclusive as possible. If a clinical test is indicated it is performed in a simulated manner on a mannequin and the results provided to the group. If a course of medical management is advocated each student is asked to prescribe the treatment indicated on drug charts provided with the use of a British National Formulary. Roaming facilitators ensure accurate and legible prescribing, helping with any questions as required.
Feedback has so far been universally positive:
“Interesting, fun, relevant – more like this please!”
“Most engaging and interesting…”
“Very well taught and relevant – brought plenty of knowledge together in a relevant clinical context – very informative.”
“Fantastic. Best session so far this year.”
“Great preparation for MAU – really interactive and fun!”
The sessions have been designed in order to be delivered over the course of the year by a team of teaching fellows and Royal Free Hospital doctors. An ongoing process of review and improvement is underway, using an action research model; the sessions have already been modified by Karim Keshwani, Clinical Teaching Fellow, and lesson plans are being developed to ensure the sustainability of the Acute Medicine Day. It is hoped by the team that these sessions will become an integral part of year 4 at UCLMS.
Palmer EJ, Devitt PG, De Young NJ, Morris D. Assessment of an electronic voting system within the tutorial setting: a randomised controlled trial BMC Med Educ. 2005 Jul 7;5(1):24.