Commercial Learning Platforms in UK Undergraduate Medical Education: A Qualitative Study of Benefits, Limitations, and Integration

BackgroundIncreasingly junior doctors are taking a year out of the traditional training pathway, and some opt to spend a year in a clinical teaching fellow (CTF) post. The CTF post mainly involves delivering hospital-based teaching to undergraduate medical students. In NHS hospital Trusts in the West Midlands, Heads of Academy (HoAs) have oversight of medical education at each Trust and therefore have responsibility for employing and directing the work of CTFs. Currently, only limited literature exists about the CTF role and exploring this from the point of view of different stakeholders in medical education is important in terms of contributing towards development of the role. This study aimed to explore the views of HoAs in the West Midlands region regarding CTFs employed at their Trusts.MethodsAll HoAs at the NHS Trust/teaching hospitals associated with the University of Birmingham were invited to take part in an in-depth interview about CTFs at their Trusts. Interviews were held via Zoom recorded using Zoom’s recording functionality. Interview transcripts were then coded and analysed using thematic analysis.ResultsSeven out of 11 HoAs participated in an interview. Seven themes were identified: CTF duties/Job role, Relationship with students, Benefits of having CTFs, Challenges associated with CTFs, Popularity of the role, What Trust offers CTFs, and Future of the role. Primarily it was felt that having CTFs at their Trust was beneficial in terms of the amount of teaching they provide for medical students. The HoAs were keen to ensure the CTF posts were of maximum benefit to both the post holders and to the Trusts where they were based. The CTF role is one that they felt would continue and develop in the future.ConclusionThis study has provided the first insight into the CTF role from the point of view of senior doctors with responsibility for delivery of undergraduate medical education. The consistency and reliability of teaching provided by the CTFs was identified as a key benefit of the role. Future work exploring the role from the point of view of post holders themselves would be beneficial to contribute to development of the role.

AimsClinical Teaching Fellows (CTFs) are doctors who are employed to teach, bridging the gap between medical education and clinical practice. Worcestershire Acute Hospitals NHS Trust (WAHT) decided to employ a...

Clinical teaching fellows (CTFs) enhance medical students' education, yet their role in early undergraduate years is less understood. This study explores the key attributes of CTFs, as perceived by medical students, CTFs and staff, that contribute to the quality of students' learning experiences in the early years of medical school. This mixed-methods study was conducted at a UK medical school, involving surveys and focus groups with 102 early-year MBChB (Bachelor of Medicine, Bachelor of Surgery) students, five CTFs and 15 staff. Participants identified CTF attributes contributing to students' learning experiences in the first 2 years of the programme. Data were analysed using descriptive statistics and thematic analysis. The study identified 364 attributes, categorised into 12 themes. Key attributes included helpful/supportive, friendly/approachable and educator/facilitator. Students valued CTFs' approachable nature, while staff emphasised their educational role. Focus groups further highlighted the importance of CTFs' mentorship and pastoral care, interpreting helpful/supportive as sharing personal experiences and career guidance, friendly/approachable as building relatable connections and educator/facilitator as providing academic support. Our study shows that in the early years of medical education, students value the mentoring skills of CTFs over their academic and clinical expertise. Medical schools should provide formal opportunities for CTFs to enhance their mentoring and pastoral care skills and ensure academic staff support these extended roles, potentially leading to improved student satisfaction and better preparation for clinical years. These insights could inform policy and training programs in medical schools globally, enhancing the overall quality of early medical education.

Bedside teaching performed by experienced clinicians is an expected component of medical student training. As clinicians often have high clinical demands and a lack of formal training in teaching methods, clinical teaching fellowships have been established. In clinical teaching fellowships, clinicians with an interest and expertise in medical education provide medical students with standardised teaching. Studies about the impact of clinical teaching fellowships have demonstrated benefits for both clinical teaching fellows (CTFs) and medical students. However, studies have not evaluated the impact of these fellowships on other clinicians or learning relationships within the institution. In this study, we aimed to address this gap by gathering data on the perspectives of CTFs, medical students and hospital consultants. A mixed-method design was used, utilising a combination of surveys for CTFs, medical students and hospital consultants and semi-structured telephone interviews for CTFs. Quantitative and qualitative data were obtained. The combination of data from CTFs, medical students and consultants enabled a more comprehensive understanding of the impact of the CTF programme within the institution. Although benefits were identified for CTFs and medical students, the consultant group noted that they were less involved in teaching medical students and that the CTFs were not well integrated into the ward team. This research highlights the importance of considering not only direct outcomes of teaching and learning but broader influences on more implicit teaching opportunities and relationships within hospital teams.

BackgroundMany UK junior doctors are now taking a year out of the traditional training pathway, usually before specialty training, and some choose to work as a clinical teaching fellow (CTF). CTFs primarily have responsibility for delivering hospital-based teaching to undergraduate medical students. Only a very small amount of literature is available regarding CTF posts, none of which has explored why doctors choose to undertake the role and their expectations of the job. This study aimed to explore the expectations and experiences of CTFs employed at NHS hospital Trusts in the West Midlands.MethodsCTFs working in Trusts in the West Midlands region registered as students on the Education for Healthcare Professionals Post Graduate Certificate course at the University of Birmingham in August 2019 took part in a survey and a focus group.ResultsTwenty-eight CTFs participated in the survey and ten participated in the focus group. In the survey, participants reported choosing a CTF role due to an interest in teaching, wanting time out of training, and being unsure of which specialty to choose. Expectations for the year in post were directly related to reasons for choosing the role with participants expecting to develop teaching skills, and have a break from usual clinical work and rotations. The focus group identified five main themes relating to experiences starting their job, time pressures and challenges faced in post, how CTF jobs differed between Trusts, and future career plans. Broadly, participants reported enjoying their year in a post at a mid-year point but identified particular challenges such as difficulties in starting the role and facing time pressures in their day-to-day work.ConclusionThis study has provided a valuable insight into the CTF role and why doctors choose a CTF post and some of the challenges experienced, adding to the sparse amount of literature. Understanding post holders’ experiences may contribute to optimisation of the role. Those employing CTFs should consider ensuring a formal handover process is in place between outgoing and incoming CTFs, having a lead person at their Trust responsible for evaluating changes suggested by CTFs, and the balance of contractual duties and personal development time.

BackgroundThe majority of junior doctors in the UK do not proceed directly into specialty training after completing mandatory foundation training but instead take a year out of training. A common post undertaken during a year out of training is a clinical teaching fellow (CTF) role which is used to provide undergraduate medical student teaching. There is only a small amount of literature available regarding CTF posts, and very little of this explores experiences or reasons for taking up such as post. An understanding of the reasons why doctors are choosing to work as CTFs and what their experiences are in post will contribute to how the role is further developed and utilised within the NHS. This study aimed to explore the experiences of CTFs employed in the West Midlands at NHS hospital Trusts.MethodsCTFs working in Trusts in the West Midlands region registered as students on the Education for Healthcare Professionals Post Graduate Certificate course at the University of Birmingham in August 2019 and 2020 who were enrolled in a longitudinal study were invited to take part in an individual interview asking about their experiences as CTFs.ResultsNine CTFs participated in an interview. Five main themes were identified which related to their experiences in post and plans for future careers. Participants reported choosing to undertake a CTF role due to wanting a break from clinical work and having previously enjoyed delivering teaching. Positive experiences in post included lifestyle related benefits and self-development opportunities. Challenges identified with the role included the impact of COVID-19 and volume of students.ConclusionThis is the first study to use interview methodology to explore experiences of CTFs, and has provided a valuable insight into the experiences of those in post in the West Midlands region. Understanding why doctors chose this job and what their experiences are could help to further develop and refine the role. To guarantee demands for teaching staff are met those employing CTFs should be aware of reasons why doctors apply for the post and ensure the post remains a desirable option.

PurposeUndergraduate clinical placements have the potential for significant improvement. Previous research has shown the growing value of clinical teaching fellows (CTFs) within medical education. Changing traditional placements to a model whereby CTFs have defined roles and lead the majority of teaching can positively reinvent undergraduate clinical teaching. We wanted to see how a structured teaching programme delivered by CTFs could affect student experience and personal development within a large associate teaching hospital. We consider how such a model could be implemented and explore the opportunities for CTFs to develop in personal and professional capacities.MethodsA mixed methods study was organised to assess student experience of a CTF-led placement. A novel structured teaching programme was delivered by 14 CTFs, who provided or were involved with the majority of teaching for all medical students. Thematic analysis was conducted on focus groups with 48 final year medical students from Queen Mary University of London following completion of their clinical placements. The same students were asked to complete an anonymous survey from which results were analysed using modified 5-point Likert scales.ResultsEight themes were identified from the focus groups. Students appreciated the increased individualisation, relevance and variety of teaching and the ability to record progress. Other perceived effects were higher teacher to student ratios, more learning opportunities and increased familiarity and reliability with CTFs. Of the students surveyed, 96% felt their overall placement experience was very good in comparison to previous placements elsewhere. Survey results supported focus group themes and demonstrated perceived growth in students’ personal development.ConclusionPlacement models where CTFs lead most teaching can improve medical undergraduate experience and training. A move towards CTF-delivered teaching can be of financial benefit to hospital trusts whilst allowing time for junior doctors to explore different clinical specialities and hone their teaching skills.

Aims: The mental wellbeing of medical students has remained a pressing issue. A recent longitudinal study named ‘less supportive’ educational environments as a contributing factor to this ill-health. Anecdotally, authors of this study have found topics taught within psychiatry can be emotionally affronting for students. During their psychiatry placement, 4th-year medical students at the University of Birmingham and Aston University were offered voluntary interventions with the aim to foster an environment of wellbeing. These included 1) an Open-Door Policy with Clinical Teaching Fellows (CTFs), 2) a formal Drop-in Session, 3) a Psychiatry Film Club Evening, and 4) a Creativity Prize, for students to submit reflective pieces in any artistic medium. A mandatory final wellbeing lecture included personal testimony from two CTFs on their own mental health journeys.Methods: All students were asked to complete pre- and post-placement questionnaires accessed online on their first and last day, no matter their participation with interventions. During the placement, interventions were promoted after plenary lectures and on an ad-hoc basis. The post-placement questionnaire ascertained student participation in interventions. Questionnaires used a forced Likert scale to measure agreement with various statements. Statements were developed by adapting validated tools (such as ATP-30 and MICA-4) to cover three domains: perceptions of psychiatry’s culture of wellbeing; stigma toward others’ mental health; stigma toward one’s own mental health. 117 responses were gathered. All responses were anonymous and could not be linked to individual students.Results: Of the 177 respondents: 99% attended the mandatory wellbeing lecture, 11% attended the formal CTF drop-in, 9% participated in the creativity prize, 7% joined the film club, and 3% used the informal open-door policy. Across all domains, there was a general shift toward more favourable perceptions. Notably, responses to the statement “Psychiatry prioritises the wellbeing of its clinicians” improved from a median of “agree” to “strongly agree”. This was a statistically significant change. Stigma toward personal and colleagues’ mental health remained more resistant to change.Conclusion: Results suggest that these interventions had a meaningful impact on students’ perceptions of psychiatry as a supportive specialty. Aside from obvious personal benefit, integrating wellbeing initiatives into clinical placements may be key in promoting psychiatry as a speciality to medical students. Larger sample sizes and additional data collection may be needed to detect more nuanced effects of these interventions: particularly in areas concerning self-stigma. Incorporating free-text responses in future evaluations could provide valuable qualitative insights into students’ experiences.

The principle teachers of the undergraduate medical curriculum are junior doctors and consultants, who may not necessarily be trained to teach. In addition, pressurised clinical environments may limit teaching time and decrease teaching quality. Clinical teaching fellows (CTFs) are doctors employed to teach, often undergoing a teaching qualification. This makes them well placed to bridge this gap between clinical practice and medical education. How useful are CTFs as a teaching resource for medical students, from a student perspective? This is an evaluation of CTF teaching from student perspectives, with discussion relating to the role of CTFs. Questionnaires were given to 70 final-year medical students during the academic year 2011-2012. Questions related to teaching throughout medical school and involved scoring teaching numerically, with additional free-text sections for qualitative data. A total of 38/70 (54%) students responded. All had received CTF teaching. All of the students said that CTFs were 'extremely useful' for teaching. There were many reasons given for this. Students also highlighted the managerial and pastoral benefits of CTFs. We believe that CTFs could be a useful asset in all medical schools by delivering high-quality, reliable, standardised teaching for students, as an adjunct to consultant teaching, with additional managerial roles and trainee benefits. CTFs can benefit non-CTF trainees by facilitating and encouraging them to teach. CTFs can organise sessions and advise on curriculum topics, allowing trainees to deliver more targeted teaching. Teaching students may improve trainees' communication, management and leadership skills, which are useful for clinical practice.

ABSTRACTIntroductionPeer‐assisted learning (PAL) is a well‐recognised pedagogical approach in medical education; however, research on its effectiveness in online settings remains limited. Multiple‐choice questions have been the predominant method for assessing PAL outcomes, despite Short Answer Questions (SAQs) being the superior tool for evaluating knowledge. This study compares online peer and faculty teaching in enhancing medical students' higher‐order thinking skills and assesses students' perceptions of these methods.MethodsThird‐year medical students undergoing surgical placements were consented and recruited for the study. Three pre‐defined cohorts were randomised to the following arms: no intervention (n = 41), online PAL teaching (n = 37) and online faculty teaching (n = 35). Peer teaching was delivered by fourth‐year students (n = 6) and faculty teaching by Clinical Teaching Fellows (CTFs) (n = 6). Academic outcomes were assessed using end‐of‐block SAQ formatives, and teaching quality was evaluated using the validated SEEQ questionnaire. Knowledge gain and self‐perceived confidence were assessed through pre‐ and post‐session tests, validated with a reference group of learners.ResultsConsent for SAQ exam scores was obtained from n = 19 (no intervention), n = 29 (PAL) and n = 21 (CTF). No significant differences were seen between the groups (p = 0.650). SEEQ completion was n = 24 (PAL) and n = 30 (CTF). CTF tutors received significantly higher ratings in domains of Learning (p = 0.017) and Group Interaction (p = 0.036). Pre‐ and post‐session tests showed no significant differences in scores (p = 0.957) or self‐perceived confidence ratings (p = 0.454).ConclusionThis study shows that online PAL is a viable alternative to faculty‐led teaching for enhancing SAQ skills and knowledge acquisition. However, faculty‐led teaching offers a superior educational experience.

University of Missouri School of Medicine in Columbia

Council on Medical Student Education in Pediatrics

Increasing numbers of clinical teaching fellows are responsible for a significant proportion of undergraduate teaching nationally. Developing a regional community of practice can help overcome the isolation of these posts, with potential benefits for all involved. A community of practice relies on the mutual engagement of people in a similar situation working towards a common goal. Working together and sharing resources enables teaching fellows to make the most of their post, which ultimately benefits those that they are teaching. We developed a regional clinical teaching fellow community of practice in Bristol in 2010/11. Our community has continued to develop since completing our posts as clinical teaching fellows, and has provided a platform for new communities to develop amongst the groups of subsequent teaching fellows coming through. We encourage all regions who have clinical teaching fellows to develop a regional community of practice We encourage all regions who have clinical teaching fellows to develop a regional community of practice. We also encourage trainees to join TASME (Trainees in the Association for the Study of Medical Education), a new national community of practice for trainees involved in medical education.

Keck School of Medicine of the University of Southern California.

University of South Carolina School of Medicine.