Advanced Clinical Practitioners Research Articles

Research strategies for trainee and qualified advanced clinical practitioners that enhance evidence-based practice.

Advanced clinical practitioners (ACPs) are integral to modern healthcare, providing high-quality, evidence-based care to patients. While ACPs show some development in clinical practice, leadership, and education, challenges persist in the research pillar. Trainee and qualified ACPs often have difficulties initiating their research journey and may feel uncertain about where to start. Existing studies have explored and emphasised the importance of ACPs developing and maintaining their research skills, yet there remains a gap in understanding how they can effectively demonstrate their research capabilities. Therefore, this article aims to help trainees and qualified ACPs on how to evidence their research pillar capabilities.

The ethics of clinically assisted nutrition and hydration in adults and the role of the advanced clinical practitioner.

Clinically assisted nutrition and hydration (CANH) decision-making in adult patients presents complex ethical dilemmas that require careful consideration and navigation. This clinical review addresses the multifaceted aspects of CANH, emphasising the importance of ethical frameworks and the role of advanced clinical practitioners (ACPs) in guiding decision-making processes. The pivotal role of ACPs is highlighted, from their responsibilities and challenges in decision-making to the collaborative approach they facilitate involving patients, families and multidisciplinary teams. The article also explores ethical principles such as autonomy, beneficence, non-maleficence, and justice, elucidating their application in CANH decision-making. Legal and ethical frameworks covering CANH are examined, alongside case studies illustrating ethical dilemmas and resolutions. Patient-centred approaches to CANH decision-making are discussed, emphasising effective communication and consideration of cultural and religious beliefs. End-of-life considerations and palliative care in CANH are also examined, including the transition to palliative care and ethical considerations in withdrawal or withholding of CANH. Future directions for research and implications for clinical practice are outlined, highlighting the need for ongoing ethical reflection and the integration of ACPs in CANH decision-making.

Supporting advanced practice: feedback from a mental health, community and primary care advanced practice support project in South Yorkshire, UK

Background: Despite the significant input from Heath Education England (HEE), now NHS England (NHSE), there are still significant variations around advanced practice programmes, support and training, particularly in less developed areas such as mental health, community posts and primary care. To help target these areas, and to support the NHS Long Term Plan (2023) to increase the number of advanced clinical practitioners (ACPs), the Faculty of Advanced Practice South Yorkshire recruited three ACP leads from mental health, community, and primary care backgrounds to establish a support project led by one professional lead. These leads were able to utilise their lived experience of completing the ACP MSc programme and working as an ACP to help trainee advanced clinical practitioners (tACPs) navigate their journey. The ACP leads also developed a variety of educational events, which further supported the trainees' needs. Aim: This article reports the feedback given via an online questionnaire from trainees that accessed the project, which ended in March 2024. Its aim is to highlight the often-undervalued concept of using clinicians personal experience regarding advanced training and practice, to mentor, support and ultimately retain the future ACP workforce. Methods: An email with a link to a questionnaire was sent to 128 tACPs or recently qualified ACPs that had applied for their training via the Faculty of Advanced Practice South Yorkshire. The questionnaire, created in Microsoft Forms, was completed anonymously, and produced both numerical and free-text data. The questionnaire solicited feedback around: the number of contacts they had and how they contacted; the ACP leads; types of support accessed; and the educational events available. Free text answers were analysed by the author (CJ) and a second reviewer (SF) to generate a consensus on themes. Results: A total of 64 clinicians responded, of which 43 were tACPs, 10 were ACPs, five had other job titles (community matron, pharmacist, practice nurse) and five did not state what their job title was. Responses suggest that the support accessed from the project was highly beneficial and could not be gained elsewhere. A key factor in the project's success was the ACP leads' lived experience of having previously completed advanced practice training, as well as their ability to tailor learning events to the trainees' needs. Conclusion: Meeting the demands of ACP training in areas where the role is less established remains an ongoing challenge. It seems some of these challenges relate to the lack of practical support being provided by employers or higher education institutions, such as lived experience of completing the task of ACP training. Support projects, like the one discussed in this article, appear aptly placed to help fulfil these needs and begs the question ‘why aren't there more?’, especially when advanced practitioners are fundamental to the future healthcare workforce.

A systemised literature review into the benefits of introducing the advanced clinical practitioner role to palliative care patients

Background: By 2040, it is predicted that at least 42% more people will need palliative care services in England and Wales. It is not known if introducing advanced clinical practitioners (ACPs) to palliative care environments is beneficial to patients and healthcare organisations. Aims: This research aims to evaluate if there is a benefit to incorporating ACPs within palliative care environments through data collection on their effectiveness when working in palliative care. Methods: A systemised review of the literature with a narrative synthesis. Findings: The literature shows that the ACP role has positive benefits on palliative care in three domains: (1) for the patient, through improving quality of life; (2) for professionals, through education; and (3) for organisations, through cost-effective models of care. Conclusions: Incorporating the role of the ACP could enable organisations and trusts to deliver new models of care that are both patient-focused and cost-effective. Further research is needed within palliative care on the impact of nurses educated to an MSc level in advanced clinical practice, compared to the traditional role of the clinical nurse specialist.

Interstitial lung disease: diagnosis and management principles

Interstitial lung disease (ILD) encompasses a diverse group of chronic, often progressive, parenchymal lung disorders with varying aetiologies. Advanced clinical practitioners (ACPs) increasingly play a crucial role in the multidisciplinary management of ILD patients across a variety of healthcare settings, enabling timely access to specialised expertise, co-ordinating multidisciplinary care and enhancing patient understanding. An awareness of the principles of diagnosis and management are key to support patient care, as ACPs will need to consider the type of ILD, and its trajectory and prognosis, with and without treatment. Most importantly, the views and health beliefs of the patient must take centre stage, with careful assessment and counselling required prior to commencing treatment. Multimorbidity is common and may impact on both symptoms and treatment tolerance. Considering the holistic needs of the patient is essential and a focus on quality of life should remain a priority. This review examines the nature of ILDs and summarises their treatment principles, with a specific focus on symptom management.

Exploring the clinical reasoning of an advanced clinical practitioner through a respiratory case encountered in primary care

Advanced clinical practitioners work autonomously, utilising a high degree of complex decision making within situations of clinical uncertainty. This case report examines the clinical reasoning surrounding the decision to refer a patient for a chest X-ray to confirm the presence of lung cancer. Although advocated for within clinical guidelines, the sensitivity of X-ray in the detection of early lung cancer has been questioned, and the value of alternative imaging in the form of low-dose computed tomography proposed. Conditions within clinical practice, including time constraints and fatigue, may negatively impact clinical reasoning. A national move towards 15-minute appointments in primary care would aid this.

The essential role of publishing for advanced clinical practitioners

The essential role of publishing for advanced clinical practitioners

Management of Adults With Bacterial Meningitis in the Emergency Department.

The Leicester Royal Infirmary Emergency Department is one of the largest single-site Emergency Departments in the UK. We evaluated the department's management of bacterial meningitis. The current national guideline recommends that all patients presenting with suspected bacterial meningitis receive antibiotics within one hour. A survey of 100 clinicians (Consultants, Registrars, House Officers, and Advanced Clinical Practitioners) working in the Emergency Department was performed to determine the awareness of the guidelines and a retrospective examination of case notes for patients who presented at the Leicester Royal Infirmary Emergency Department with suspected meningitis was carried out between May 1, 2022, and May 1, 2023. A random sample of 30 patients was drawn from the department's database of 190 patients, identified through discharge coding summaries. Nine (25%) of the prescribers knew of the guidelines for managing meningitis, and six (16.7%) had utilised the hospital guidelines. Thirty-three (91.7%) prescribers acknowledged the importance of administering steroids to patients suspected of having bacterial meningitis (excluding those displaying signs of meningococcal sepsis, such as a rash). However, only seven (23%) of patients received this treatment. Additionally, only one (3.3%) patient was documented as having received a dose within the first hour of presentation. The timely diagnosis and administration of appropriate antibiotic therapy are pivotal elements in managing bacterial meningitis. As a result, we designed a checklist to facilitate the effective management of meningitis within the department by increasing awareness of the guidelines and making the critical principles of suspected meningitis management more accessible.

Empowering advanced clinical practitioners in managing acute dermatological emergencies.

Advanced clinical practitioners (ACPs) encounter patients with acute dermatological presentations ranging from minor to life-threatening conditions in both primary and secondary care settings. However, ACPs often feel unprepared to assess and treat patients with dermatological emergencies. This article aims to provide guidance to trainee and qualified ACPs, whether in acute hospital settings or primary care, in understanding the essential aspects to consider when consulting with patients presenting with acute dermatological emergencies. It also emphasises appropriate referrals to relevant specialties for necessary inpatient or outpatient investigations and ensure prompt treatment.

Developing a multidisciplinary medication review and deprescribing intervention in primary care for older people living with frailty

Abstract Introduction Reducing overprescribing in primary care through targeted structured medication reviews (SMRs) is a national priority. Shared decision-making and a multidisciplinary team (MDT) approach to SMR are recommended for successful deprescribing (stop/reduce inappropriate medications) among older people, specifically those with frailty. Aim To develop a multidisciplinary medication review and deprescribing intervention in primary care for older people with frailty. Methods The intervention development involved two stages and was informed by the Medical Research Council framework for complex intervention. Stage one involved intervention planning and included: 1) a realist review of 28 articles that identified 35 context-mechanism-outcome (CMO) configurations for successful MDT medication review and deprescribing in primary care[1] and 2) a qualitative study with 26 primary care healthcare professionals (HCPs) including GPs, pharmacists, and advanced clinical practitioners, and 13 older people with polypharmacy and their informal carers recruited from two general practices within Wessex. Using the person-based approach, drawing on the COM-B model for behaviour change, and a normalisation process theory lens, the findings of these two studies informed the development of intervention’s guiding principles. Stage two involved intervention development based on six co-design online workshops with key stakeholders (n=25), including primary care HCPs recruited from across the South region, patient and carer representatives, and the research management team. The intervention guiding principles were presented in these workshops and possible intervention content, format and delivery were proposed, discussed and refined through an iterative process. Workshop data were analysed drawing on a rapid analysis method and a final version of the intervention was agreed. Results The final version of the complex intervention consisted of five main components based on findings from stages one and two: 1) Proactive identification of patients with frailty and polypharmacy for targeted SMR using the electronic frailty index embedded in primary care health systems and the UK national polypharmacy prescribing comparators, 2) HCPs preparation to conduct SMR through targeted education on deprescribing and identifying and prioritising high-risk medications for deprescribing using evidence-based deprescribing tool(s), 3) Preparing and educating patients and carers about the purpose of SMR and reasons for potentially stopping or changing medications (patient leaflet sent prior to SMR), 4) Conducting a person-centred SMR that includes in-person, phone or virtual appointments tailored to patient and carer needs and preferences, involving other MDT members based on their expertise, documenting and sharing any agreed changes with patients and other staff members, and 5) Tailored follow-up plans that allow continuity of care and management and include highlighting specific signs and symptoms for patients and carers to monitor following medication changes, and arranging further contact through text, phone or in-person follow-up appointment. Conclusion The use of multiple research methods has led to the development of a complex MDT medication review and deprescribing intervention for older people with frailty and drawing on behaviour and implementation theories could potentially maximise the intervention’s feasibility, acceptability and successful implementation. A mixed-method study in primary care is currently underway to test the feasibility and acceptability of intervention implementation, in preparation for a full trial.

Investigating the retention and attrition of emergency care advanced clinical practitioners in the UK

Background: Advanced clinical practitioners (ACPs) are an integral part of the healthcare workforce, and recognising growth in these roles is a priority for the future. ACPs within emergency care (EC) are often senior clinical decision-makers that work within the multidisciplinary team to provide high-quality care to a variety of patients, presentations and acuity. Reflection upon clinical practice over the last 7 years has revealed an issue with the retention of experienced ACPs. Losing ACPs in a service that is already stretched due to increasing attendance and subsequently longer waiting times places further burden on strained departments. While there is research that examines the retention and attrition of emergency medicine trainees and consultants, there is a dearth of literature on the retention of ACPs. Aims: The aim of this scoping review is to investigate what is already known about retention of ACPs in EC and examine why ACPs leave EC for other areas of practice. Methods: A database search was conducted using keywords, from 2–21 November 2022, across five databases (the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the British Nursing Index (BNI), MEDLINE, PsycINFO and the Cochrane Library). This search identified 892 studies that were examined using a two-stage process against inclusion and exclusion criteria, which resulted in seven articles being selected for inclusion in the review. Findings: Three themes were identified: the importance of a clear career pathway; a structured training programme and education; and concerns regarding working conditions in EC. Conclusion: The review identifies a gap in the literature on the reasons for attrition rates of ACPs in EC. Future research is required to identify the reasons why some ACPs leave EC and what aspects make others stay.

Safe prescribing of oral alendronic acid following hip fracture

In the UK, physiotherapists can train as independent prescribers and are working in increasing numbers as advanced clinical practitioners. This case study examines the safe prescribing of oral bisphosphonates following a fragility fracture of the hip and considers this process in the context of the Royal Pharmaceutical Society's competencies (2021) , which were adopted by the Health and Care Professions Council in 2016. Despite these medications being around since the 1960s, their utilisation in the treatment of osteoporosis remains limited, and low levels of patient adherence continues to present a problem. This case study will look at the ways in which these issues can be addressed and identifies areas for future development. It will also describe the process of bone health assessment, offering non-pharmacological approaches as a way to reduce fracture and falls risks. The shared care nature of osteoporosis management will also be considered, with communication and partnership between primary care and secondary care being key in the provision of this treatment.

Exploring advanced clinical practitioner perspectives on training, role identity and competence: a qualitative study

BackgroundAdvanced Clinical Practitioners (ACPs) are a new role that have been established to address gaps and support the existing medical workforce in an effort to help reduce increasing pressures on NHS services. ACPs have the potential to practice at a similar level to mid-grade medical staff, for example independently undertaking assessments, requesting and interpreting investigations, and diagnosing and discharging patients. These roles have been shown to improve both service outcomes and quality of patient care. However, there is currently no widespread formalised standard of training within the UK resulting in variations in the training experiences and clinical capabilities of ACPs. We sought to explore the training experiences of ACPs as well as their views on role identity and future development of the role.MethodsFive online focus groups were conducted between March and May 2021 with trainee and qualified advanced clinical practitioners working in a range of healthcare settings, in the North of England. The focus groups aimed to explore the experiences of undertaking ACP training including supervision, gaining competence, role identity and career progression. Thematic analysis of the focus group transcripts was performed, informed by grounded theory principles.ResultsFourteen advanced clinical practitioners participated. Analysis revealed that training was influenced by internal and external perceptions of the role, often acting as barriers, with structural aspects being significant contributory factors. Key themes identified (1) clinical training lacked structure and support, negatively impacting progress, (2) existing knowledge and experience acted as both an enabler and inhibitor, with implications for confidence, (3) the role and responsibilities are poorly understood by both advanced clinical practitioners and the wider medical profession and (4) advanced clinical practitioners recognised the value and importance of the role but felt changes were necessary, to provide security and sustainability.ConclusionsAppropriate structure and support are crucial throughout the training process to enable staff to have a smooth transition to advanced level, ensuring they obtain the necessary confidence and competence. Structural changes and knowledge brokering are essential, particularly in relation to role clarity and its responsibilities, sufficient allocated time to learn and practice, role accreditation and continuous appropriate supervision.

Saving ambulance resources: a service evaluation of the identification of non-viable out-of-hospital cardiac arrest in London by advanced paramedic practitioners in critical care.

Advanced paramedic practitioners in critical care (APPCCs) are advanced clinical practitioners focused on the delivery of pre-hospital critical care. While working in an ambulance control room setting, APPCCs seek to identify emergency calls appropriate for operational APPCCs to attend. These would include out-of-hospital cardiac arrest (OHCA). Through interrogation of incoming emergency calls they are also able to identify OHCA calls where resuscitation may be futile. In these cases, and within a governance framework, they stand down multiple ambulance responders, leaving only the closest responding resource to attend, thereby 'saving resources' that can be re-directed to other waiting emergency calls. It is believed that this is the first initiative of this nature in the United Kingdom. A three-year retrospective service evaluation of data was undertaken. The aim was to quantify the number of 'saved resources', including both double crewed ambulances (DCAs) and solo (single-person) responders, and furthermore to equate those savings into potential hours saved, using average known job cycle times (JCTs). Additionally, safety was assessed by searching all mandated incident reports for occasions where, despite cancellation of resources by an APPCC, resuscitation was commenced by the first response to scene. A total of 13,356 ambulance resources were saved. Of these, 6593 (49.4%) were DCAs and 6763 (50.6%) were solo responders. Using the average JCT for deceased patients of 104.8 minutes, the total time saving equated to 23,328.48 hours of work or 1944.04 12-hour shifts. When considering DCAs alone, the average JCT for obviously deceased patients was 110.9 minutes. This equates to 12,186.1 hours of work or 1015.5 12-hour shifts. A total of 15 incident reports were identified. All had been investigated, revealing appropriate decision making in cancelling ambulance resources. No patient harm was identified. APPCCs working within a governance framework safely saved a significant number of ambulance resources over a three-year period. Perceived benefits include 'freeing up' DCA and solo responders, allowing them to be redirected to other emergency calls, leading to potential improvement in response times for patients waiting for an ambulance resource.

The evolving role of advanced clinical practitioners: challenges and opportunities.

This editorial reviews the roles of advanced clinical practitioners, suggesting how the debate could evolve, returning to the original intent behind these roles and progressing towards ways of sustaining high-quality, equitable and safe care under strong medical leadership.

1942 Developing a Frailty SDEC Team at Salford Care Organisation

Abstract Introduction Frail older adults have longer waiting times in emergency departments (ED’s), are more likely to be admitted, and have longer lengths of stay1,2. The NHS Long Term Plan requires hospitals to provide an Acute Frailty Service (AFS) for at least 70 hours/week and complete a Clinical Frailty Score (CFS) within 30 minutes of arrival3. The plan advocates Same Day Emergency Care (SDEC) to reduce admission related harms and discharge patients in a timely way4. The introduction of an acute frailty CQUIN that requires prompt identification of frailty and initiation of CGA is another driver for the development of AFS5. Methods We created an acute frailty SDEC team including a frailty nurse, clinical-fellow, advanced clinical practitioners and GPs. The team was present in ED on weekdays between 9am-5pm with 1-2 team members on each shift. A Consultant Geriatrician provided advice and support. We developed loose frailty SDEC criteria: - Age >=65years with CFS>=5 and - NEWS<3 - Triage note suggests patient may not need hospital admission. Results Over a 4-month period, 262 patients were seen by the SDEC team. Age and CFS score for this population are shown in Graphs 1 and 2. Graph 1: Age of Patients Reviewed by SDEC Team Graph 2: CFS Score of Patients Reviewed by SDEC Team -74% were seen within 2 hours as demonstrated in Graph 3 Graph 3: Minutes patients waited to be seen (WTBS) from arrival at ED triage - 131(50%) of patients were discharged directly from ED. A further 25 patients were later discharged from EAU. Conclusions A frailty SDEC service results in early identification of frailty, timely assessment in ED and a high likelihood of discharge (60%) directly from ED or EAU rather than being admitted to an inpatient ward. Implementation of a 7-day service would only serve to increase these figures.

1998 Advance care planning on the Same Day Emergency Care Older People's Unit - a quality improvement initiative

Abstract Introduction Same Day Emergency Care (SDEC) at St James’ Hospital, Leeds provides urgent care at the interface between primary and secondary care, offering comprehensive geriatric assessment (CGA) to those living with frailty, aiming to prevent hospitalisation and delay frailty progression. Advance care planning (ACP) is a vital component of prioritising care preferences including at end-of-life, but timing often falls short in practice. This quality improvement (QI) initiative aims to proactively open ACP discussions, allowing patients to consider their care goals, ensuring our care is aligned with their priorities. Method Between July 2022 and April 2023, the project involved 1039 patients. Led by Advanced Clinical Practitioners with support from consultant geriatricians and a palliative care specialist nurse, ACP discussions were encouraged through prompts in daily staff huddles and drop-in teaching sessions. Results ACP uptake increased from 7.8 % to 19.3%. Insights from a perception survey involving 83 healthcare professionals revealed key barriers including clinical workload, limited space, lack of experience and confidence as well as prognostic uncertainty and patient factors. Education and training, clinical supervision, patient information leaflets and a conducive environment were positively associated with ACP. Conclusion There has been a cultural shift in the department as the practitioners now routinely prompt staff to undertake ACP in safety huddles. Key catalysts for ACP initiation were found to be progression of frailty, terminal diagnoses, dementia, and recurrent hospital admissions. As a new SDEC unit is scheduled to open in the coming months, with provision of space and privacy, our aim is to improve the quality and quantity of ACP discussions with the patient at the centre of all decision-making. In line with these endeavours, parallel support within the community through our home (virtual) ward will further enhance proactive care planning in older people living with frailty.

1959 De-prescribing within the East Kent Community Frailty Team: assessment of medication review processes and potential cost-savings

Abstract Introduction Older people living with frailty are often prescribed many medications exposing them to potential medicine-related harm. Pharmacists are a new addition to the East Kent Community Frailty Team, which otherwise consists of doctors and advanced clinical practitioners at various levels of training. Pharmacists are ideally placed to develop medication review processes and support fellow clinicians with deprescribing efforts in frailty. This audit set out to determine current levels of medication review and associated cost-savings through deprescribing. Method All patients admitted to the frailty team caseloads in the month of May 2023 had their notes manually reviewed for evidence of medication reconciliation, review, and deprescribing. Medicines were assigned a cost price based on the NHSBSA Drg Tariff (May 2023). Results 192 patients were seen in total, 170 of whom were acutely unwell. 62% of patients had their medication documented, taking an average of 8.2 medicines. The majority of omissions were patients with a zero length-of-stay, which include advice calls. 29% of patients had at least one medication stopped, representing an average 0.7 medicines stopped per patient seen. The monthly cost of medications stopped was £690. There were greater levels of deprescribing in the caseloads with MDT board rounds. Conclusion Rates of deprescribing are low compared to published studies (Ibrahim et al, BMC Geriatr 21, 258 (2021)), although still represent a rolling saving of approximately £8,000 per month on cost of medicines alone, assuming a twelve-month average life expectancy. Lack of standardisation of clinical notes and documentation made data collection difficult and has the potential to lead to transfer-of-care errors. Further work needs to be undertaken to optimise the medication review process and address inappropriate polypharmacy and will be the focus of efforts over the coming year.

Referrals to a Surgical Emergency Clinic in a District General Hospital

Abstract Aims The referral pathway for the consultant-led Surgical Emergency Clinic (SEC) at our District General Hospital has no triage process. Anecdotally there are issues with inappropriate patients being booked for this clinic, taking up valuable slots and consultant time, and causing patient dissatisfaction. This was audited to see how the clinic is being utilised. Methods A retrospective case note review spanning 8 months looked at 250 patients seen in SEC. The origin of referrals, reason for referral, investigations, and clinic outcomes were recorded. Using this, patients were classified as ‘appropriate’ or ‘inappropriate’ for SEC. Results Referrals came from the following sources: 158 from general practice, 54 from the emergency department, and 38 directly from the surgical team. 58% were deemed to be appropriate referrals, while the remaining 42% were deemed inappropriate for SEC. 84 patients (33.6%) had imaging performed on the same day as their appointment, while 74 patients (30%) had investigations requested for a later date. 156 (62.4%) patients were discharged, 25 (10%) were redirected to a suitable surgical specialty outpatient clinic, and 16 (6.4%) were referred to other specialties. 10.4% had an acute surgical admission or same day CEPOD theatre, and 8.4% were listed for theatre on an elective/urgent basis. Conclusion This suggests SEC is not being used optimally and highlights a need to restructure the referral process. Physician Associates and Advanced Clinical Practitioners will be trained to assist consultants and triage referrals to improve patient flow, the efficiency of SEC, and hopefully the patient experience.

Embedding spirituality and compassion into clinical education: A pilot study of Spotlight sessions in Advanced Clinical Practice

ABSTRACT The need for spiritually sensitive and compassionate health care is recognised by health-regulatory bodies, yet, they are often not taught in health professional education. Guidelines identify expected competencies, but the best teaching techniques to develop these competencies, are unknown. Spotlights are a novel teaching method designed to integrate compassion and spirituality into existing academic curricula. Spotlights entail a moment in taught sessions, where the clinical knowledge that is being delivered, is used to scaffold discussions surrounding compassion and spirituality. A pilot project explored Spotlight’s ability to integrate compassion and spirituality into health professional education. Trainee Advanced Clinical Practitioners received between 23 and 46 Spotlights over an academic year. The effectiveness was assessed by an anonymous survey pre- and post-intervention. Mean post-intervention scores were largely unchanged from corresponding pre-intervention scores. High levels of compassion and positive perceptions of spirituality were found before the intervention. The study was not powered to assess efficacy and significance testing was not conducted. Surprising outcomes saw students autonomously incorporating Spotlights into their work and increased discussions surrounding spirituality. Thus suggesting these concepts were becoming embedded into the culture of the trainees. Spotlights were an implementable method, well received by students and educators alike. Highlights Compassionate and spiritually sensitive care is expected of health professionals. Teaching methods to develop these competencies are being explored. Spotlights are a novel teaching method to integrate compassion and spirituality into clinical education.