Clinical Teaching Fellows Research Articles

Experiences as a clinical teaching fellow: interviews with clinical teaching fellows in the West Midlands

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.

The Clinical Teaching Fellow role: exploring expectations and experiences

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.

Undergraduate medical education at a district general hospital: facilitating the transition from student to medical professional

Background: The transition from student to medical professional represents a major challenge for all medical students. Every intake of newly qualified doctors increases potential risks to patients. In the UK, this is often colloquially referred to as the ‘August Effect’. At one District General Hospital, a ‘Ward-Craft and Bleep Simulation Programme’ was implemented for final year medical students. This aimed to equip students with the procedural knowledge and soft skills to support the transition from undergraduate training to professional working life as a junior doctor. Methods: A series of six, weekly, two-hour workshops which focussed on common clinical problems encountered by newly qualified doctors was delivered to final year medical students (‘Ward-Craft Programme’). Students then participated in a two-hour high fidelity, in-situ, ‘Bleep Simulation Programme. The programme was facilitated by a Clinical Teaching Fellow and evaluated through an anonymous feedback survey Results: 98.9% of students (n=259) agreed, or strongly agreed, that the programme helped them feel more prepared and confident for life as a junior doctor. Participants provided overwhelmingly positive feedback, specifically noting that the programme addressed feelings of confusion, anxiety, and the feeling of being overwhelmed by the work of junior doctor. Conclusions: The Ward-Craft and Bleep Simulation Programme has been positively received by medical students from universities with very different types of learning styles and courses. The replication of similar programmes for final year medical students is a valuable training opportunity for final year medical students and may help mitigate the challenges posed by the ‘August effect’.

The Clinical Teaching Fellow role: views of the Heads of Academy in the West Midlands

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.

1342 DO NOT ATTEMPT CONVERSATIONS PRE-REHEARSAL: TEACHING MEDICAL STUDENTS TO HAVE DNACPR CONVERSATIONS

Abstract Introduction The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form is widely adopted to document advanced care plans, including Do Not Attempt Resuscitation (DNACPR) decisions. Communication between clinicians and patients, or next of kin is required for completion. It is widely documented UK medical students have little exposure to these experiences, including being asked to leave whilst they are occurring. During the COVID19 pandemic, Foundation Year 1 (FY1) doctors led discussions with increased frequency and autonomy, with no documented concurrent training. We present a novel learning experience designed to aid these discussions. Students were timetabled to a 1.5 hour workshop, facilitated by a clinical teaching fellow. They were invited to complete ReSPECT form for a celebrity to familiarise themselves with the layout. They then considered a patient admission scenario in 3 different groups from the perspective of the patient, family and medical team, and used this to contemplate potential, future, emergency treatments. Subsequently a discussion surrounding CPR effectiveness, ways of communicating this, and legal advanced decision documents occurred. The session concludes with scrutinising example ReSPECT forms provided by the Resuscitation Council UK. Method Students' confidence levels were measured pre and post session using a Likhert scale questionnaire. Results 90 students attended workshops across 6 rotations. 80% students completed post - session questionnaires, of which 100% reported an increase in confidence with having a DNACPR/advanced care planning discussion compared to before the session. Conclusion DNACPR conversations can incite anxiety in any seniority of health care professionals. Medical educators need to adequately prepare medical students during their training in advanced care planning and DNACPR discussions. This can be done with simulated workshop experiences, reinforced with opportunistic or organised observational experience. Adequate preparation will lead to increased confidence in discussions, ultimately leading to better experiences for patients and their families.

The rise of the clinical teaching fellow: a personal view of the postgraduate experience.

Clinical teaching fellowships are becoming increasingly popular, with the numbers of posts ever-expanding. This increase has accelerated as education and training start to recover from the effects of the COVID-19 pandemic. However, the nature of these roles, the entry requirements and the potential benefits are often poorly defined. This article outlines the author's experience of working as a clinical teaching fellow for a year and provides tips on what to look out for when considering these roles, as well as how to get the most out of them.

1002 Improving the Medical Student Experience of Trauma and Orthopaedic Education – a Quality Improvement Project

Abstract Aim The medical student experience of clinical placements is closely linked with quality of teaching, varied educational opportunities and sense of belonging within the team. Surgical rotations such as Trauma and Orthopaedics (T&O) have a stereotype for being challenging. At a London teaching hospital student satisfaction of T&O placements was low (8% satisfaction) as assessed by feedback. This quality improvement (QI) project aimed to improve the quality of educational experiences and overall student satisfaction in T&O. Method Student feedback from end of placement evaluation forms from academic years 2016–19 was reviewed. A QI driver diagram was created based on the themes raised in the feedback. These were 1) formal teaching, 2) structure and organisation, 3) curriculum content and 4) student engagement and belonging. Each theme was subdivided into multiple achievable strategies to improve student experience while on T&O placements. This included allocated clinic and theatre sessions, bedside teaching, named tutors, curriculum map, WhatsApp communication and a dedicated clinical teaching fellow in the department. Results As a result of the implemented QI strategies, student satisfaction improved over the subsequent semesters to 100%, 89%, 100% and 75%, with a greater number of students providing feedback. Conclusions The project achieved greater student satisfaction of T&O education and improved the student experience of surgical placements. It also validates student feedback as a valuable tool in developing surgical education.

SP7.4 Near-peer surgical simulation & teaching day for newly qualified FY1 doctors

Abstract Aims The aims of this study were to ascertain how prepared newly qualified Foundation Year 1 (FY1) doctors felt for their surgical rotation and to evaluate the effectiveness of a surgical-themed teaching day for new FY1 doctors. Methods A near-peer surgery-themed teaching day was delivered to 44 newly qualified FY1 doctors and delivered by clinical teaching fellows (FY3 doctors). The day involved four surgical-themed simulation scenarios: (i) haemodynamically unstable pancreatitis, (ii) anastomotic leak following ileocaecal resection, (iii) septic shower post ureteric stent and (iv) post-operative pulmonary embolism. Classroom-based teaching included: (i) microbiology and antibiotic prescribing (ii) interpreting abdominal films and (iii) insulin prescribing (including for nil by mouth patients). FY1s were randomly allocated a participant number and completed pre- and post-session anonymised questionnaires. Results Only 31.7% (13/41) agreed that Medical School had adequately prepared them for their surgical foundation job and 46.3% (19/41) felt less prepared for surgical rotations compared with medical rotations. When compared with the pre-session scores: 93% (58% pre-session) felt prepared to manage acutely unwell surgical patients and 84% (43.9% pre-session) were confident with escalating patients to level 2/3 care. Confidence improved across the board for classroom-based sessions. Conclusion This study has highlighted a need to ensure newly qualified FY1 doctors feel better prepared for their surgical rotations. The introduction of a mixed simulation and classroom teaching day has, in this instance, improved confidence across a number of important domains. Teaching delivered in the near-peer style may be the key to imparting relevant knowledge to new FY1s.

An Alternative to Traditional Bedside Teaching During COVID-19: High-Fidelity Simulation-Based Study.

BackgroundBedside teaching is integral to medical education and has been highlighted to improve clinical and communication skills, as well as clinical reasoning. Despite the significant advantages of bedside teaching, its usage within medical education has been declining, and COVID-19 has added additional challenges. The pandemic has resulted in a significant reduction in opportunities to deliver bedside teaching due to risk of viral exposure, patients declining student interactions, and ward closures. Educators have therefore been required to be innovative in their teaching methods, leading to the use of online learning, social media platforms, and simulation. Simulation-based education allows for learning in a low-risk environment and affords the opportunity for deliberated repeated practice with case standardization. The results demonstrate that simulation-based training can increase students’ confidence, increase the rates of correct clinical diagnoses, and improve retention of skills and knowledge when compared with traditional teaching methods.ObjectiveTo mitigate the impact of COVID-19 upon bedside teaching for third year students at Hull York Medical School amid closure of the cardiorespiratory wards, a high-fidelity simulation-based model of traditional bedside teaching was designed and implemented. The objectives of the teaching session were to enable students to perform history taking and a focused cardiorespiratory clinical examination in a COVID-19–safe environment using SimMan 3G.MethodsFour clinical teaching fellows with experience of simulation-based medical education scripted histories for 2 common cardiorespiratory cases, which were asthma and aortic stenosis. The simulation sessions were designed for students to take a focused cardiorespiratory history and clinical examination using SimMan 3G. All cases involved dynamic vital signs, and the simulator allowed for auscultation of an ejection systolic murmur and wheezing in accordance with the cases chosen. Key aspects of the pathologies, including epidemiology, differential diagnoses, investigations, and management, were summarized using an interactive PowerPoint presentation, followed by a debriefing session.ResultsIn total, 12 third year medical students undertook the sessions, and overall feedback was highly positive. Of the 10 students who completed the feedback questionnaires, 90% (n=9) felt more confident in their clinical examination skills following the teaching; 100% (n=10) of the students responded that they would recommend the session to a colleague; and implementation of regular simulation was frequently requested on feedback. These results are in keeping with the current literature.ConclusionsBedside teaching continues to face ongoing challenges from the COVID-19 pandemic as well as declining patient recruitment and fluctuations in clinical findings. The support for simulation-based medical education is derived from high-quality studies; however, studies describing the use of this technology for bedside teaching in the undergraduate curriculum are limited. The authors describe a highly effective teaching session amid the pandemic, which allowed for maintenance of staff and student safety alongside continued education during a challenging time for educators globally.

Undergraduate medical education at a district general hospital: facilitating the transition from student to medical professional

Background: The transition from student to medical professional represents a major challenge for all medical students. Every intake of newly qualified doctors increases potential risks to patients. In the UK, this is often colloquially referred to as the ‘August Effect’. At one District General Hospital, a ‘Ward-Craft and Bleep Simulation Programme’ was implemented for final year medical students. This aimed to equip students with the procedural knowledge and soft skills to support the transition from undergraduate training to professional working life as a junior doctor. Methods: A series of six, weekly, two-hour workshops which focussed on common clinical problems encountered by newly qualified doctors was delivered to final year medical students (‘Ward-Craft Programme’). Students then participated in a two-hour high fidelity, in-situ, ‘Bleep Simulation Programme. The programme was facilitated by a Clinical Teaching Fellow and evaluated through an anonymous feedback survey Results: 98.9% of students (n=259) agreed, or strongly agreed, that the programme helped them feel more prepared and confident for life as a junior doctor. Participants provided overwhelmingly positive feedback, specifically noting that the programme addressed feelings of confusion, anxiety, and the feeling of being overwhelmed by the work of junior doctor. Conclusions: The Ward-Craft and Bleep Simulation Programme has been positively received by medical students from universities with very different types of learning styles and courses. The replication of similar programmes for final year medical students is a valuable training opportunity for final year medical students and may help mitigate the challenges posed by the ‘August effect’.

Clinical Teaching Fellows, the new norm?-Experiences of fellows and education faculty.

BackgroundIn the United Kingdom, there is an increasing tendency for doctors in the first 2 years after graduation, to step off the training pathway and take up Clinical Teaching Fellow (CTF) positions. We aimed to explore stakeholder experiences of CTF positions to inform future planning and support.MethodsIndividual semi‐structured interviews with 10 stakeholders (five CTFs and five education faculty members) from one institution in England were conducted. Interviews explored the participants' views of the CTF position, its benefits and challenges. Inductive thematic analysis was performed.ResultsCTFs and education faculty views strongly aligned and three themes were identified. These were (1) developing a career, (2) developing confidence and competence as a clinical teacher and (3) developing a position that works for all. Participants reported that the CTF position allowed time for specialty decision making and curriculum‐vitae strengthening and provide CTFs with the opportunity to work autonomously and to establish a better work–life balance by stepping away from training pressures and focusing on other aspects of life. There were differing thoughts on how the position should be structured, although retaining a clinical role with boundaries to constrain competing responsibilities was important.ConclusionA brief hiatus in clinical training, where individuals feel supported to progress personally and professionally and to renew their energy for the next steps of clinical training, seems important. The ideologies of providing the CTFs with autonomy, time to explore options, recharge and form connections with colleagues should be considered when structuring the posts.

Top tips for teaching during a pandemic: reflections on teaching ophthalmology

As clinical teaching fellows, we have had the privilege to teach medical students between August 2020 to August 2021. In a usual year, this would involve exclusively face-to-face teaching for both lectures and clinical examination sessions. However, following the announcement of the second lockdown in October 2020 we had to adapt our programme. To reduce the number of students on site, one day a week became a ‘virtual learning day’, involving both small and large group tutorials. Following being tasked with the responsibility of teaching ophthalmology to the fourth-year medical students, an important question loomed: how can we ensure that teaching via a virtual learning platform is both engaging and beneficial? This was further compounded by the fact that ophthalmology is a sub-speciality in which most medical students have limited teaching in the UK . Following our experiences, we have outlined the key strategies which enabled us to teach effectively during the pandemic.

Reinventing Undergraduate Clinical Placements with a Switch to Delivery by Clinical Teaching Fellows: A Medical Student's Perspective [Response to Letter

Reinventing Undergraduate Clinical Placements with a Switch to Delivery by Clinical Teaching Fellows: A Medical Student's Perspective [Response to Letter

Reinventing Undergraduate Clinical Placements with a Switch to Delivery by Clinical Teaching Fellows: A Medical Student's Perspective [Letter

Reinventing Undergraduate Clinical Placements with a Switch to Delivery by Clinical Teaching Fellows: A Medical Student's Perspective [Letter

Two-year longitudinal observational study of junior doctors as clinical teachers: the Associate Clinical Teaching Fellow Program

Introduction: Most clinical teachers are not trained to teach, though they are critical to determining the quality of clinical learning environment. The General Medical Council, United Kingdom, recognises that being a good teacher is not innate, but that skills and attributes can usually be acquired. Clinical teaching is part of training of junior doctors in the United Kingdom, and from learners’ perspectives, junior doctors are effective clinical teachers, but there are few structured opportunities to learn how to teach during clinical training. The Associate Clinical Teaching Fellow (ACTF) program was developed to provide such structured platform for clinical trainees. The aim of this paper is to evaluate the quality of teaching by the trainees against the current-standard of clinical teaching in the first 2 years of its inception, and to adapt validated feedback questionnaires for practical use. Methods: A prospective longitudinal observational study was done over 2 years in a large 1,215 bed tertiary hospital. Multiple cross-sectional assessments of teachings by ACTFs and consultant teachers were done using two validated questionnaires, the Stanford Faculty Development Program-26 (SFDP-26) and the Clinical Teaching Effectiveness questionnaire (CTEQ), and an in-house global (IHG) feedback form prepared by third- and fifth-year students. Both trainees and consultants were unaware of the timing of the SFDP-26 and CTEQ feedbacks. A graphical representation of all responses was used to create a grading system for practical feedbacks. Results: A total of 507 of 765 (66%) of SFPD-26 and CTEQ and 224 of 286 (78%) of IHG questionnaires were returned for 26 trainees and 31 consultants by 266 medical students. There was a statistically significant higher ratings of trainees in seven of eight domains of SFDP-26, and the median (interquartile ranges [IQR]) overall score was 115 (105–126) and 108 (99–121) for trainees and consultants, respectively (P < 0.0001). Similarly, trainees were rated significantly higher in seven of nine CTEQ domains, and this was reflected in the overall score. The patterns were similar for third- and fifth-year students, and the type of learning exposure did not make a difference. With these students, the overall teaching effectiveness correlated (Spearman Correlation Coefficient [SCC]) the most with enthusiastic and stimulating (SCC 0.711; P < 0.0001), establishes rapport (SCC 0.69; P < 0.0001) and is accessible (SCC 0.67; P < 0.0001) in CTEQ, and with learning climate (SCC 0.62; P < 0.0001), communication of goals (SCC 0.54; P < 0.0001) and evaluation (SCC 0.52; P < 0.0001) in SFDP-26. At the end of their rotations, 30% of both groups of students were neutral or disagreed that consultants were essential to their clinical programs compared to 15% (P = 0.001) and 11% (P < 0.0001) of third- and fifth-year students, respectively, felt about trainees. By applying a new grading system derived from the full database of responses, the trainees would be graded 1 and consultants 7 out of 10 possible grades. Conclusions: Teaching delivered by doctors in training within a formal teaching program is of good quality and well received by medical students. There is a need for an equivalent program for trainee clinical educationalists like the Integrated Academic Training scheme of the National Institute of Health Research (NIHR), UK, for trainee academics. More qualitative studies are needed to analyse some of the findings in this study.

Reinventing Undergraduate Clinical Placements with a Switch to Delivery by Clinical Teaching Fellows.

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.

777 Changing Student Perceptions of Surgical Careers

Abstract Aim Increasing student interest in pursuing a surgical career at an undergraduate level. Background Data suggests that interest in surgical specialties may be declining, even from as early on as medical school. However, studies suggest that engagement with extra-curricular activities influences their likelihood to pursue surgical careers. Our study aimed to assess changes in student perception towards surgical careers following participation in a three-week surgical course. Method Students on placement at St Peter’s Hospital, Chertsey were invited to a course of 3 one-hour sessions covering practical surgical skills and lectures. Participants were tutored by Foundation-Year-Two doctors, with oversight of a surgical clinical teaching fellow and senior consultant. Students completed pre- and post-course surveys focusing on surgical interest, surgical skill confidence, placement-participation, and career preparation. The course was delivered through two cycles. Results Cycle one showed statistically significant improvements in suturing-confidence (mean increase 4.05 out of 10, p = 0.001), confidence in hand-ties (3.63 out of 10, p = 0.015) and understanding of developing a surgical portfolio (mean increase 1.95 out of 10, p = 0.005). After a second cycle, including the introduction of a surgical portfolio development lecture, students demonstrated a statistically significant improvement in mean scores across all areas. Notably, interest in pursuing a surgical career increased from mean 5.85/10 to 8.8/10 (p = 0.028). Conclusions We demonstrate that a short and easily accessible course can significantly improve student interest and understanding of a surgical career; equipping them with fundamental skills to pursue engagement at the undergraduate level.

A Weighted Evaluation Study of Clinical Teacher Performance at Five Hospitals in the UK.

IntroductionEvaluation of individual teachers in undergraduate medical education helps clinical teaching fellows identify their own strengths and weaknesses. In addition, evaluation data can be used to guide career decisions. In order for evaluation results to adequately reflect true teaching performance, a range of parameters should be considered when designing data collection tools.MethodsClinical teaching fellows at five London teaching hospitals were evaluated by third-year students they had supervised during a ten-week clinical attachment. The questionnaire addressed (a) general teaching skills and (b) student learning outcome measured via comparative self-assessments. Teachers were ranked using different algorithms with various weights assigned to these two factors.ResultsA total of 133 students evaluated 14 teaching fellows. Overall, ratings on teaching skills were largely favourable, while the perceived increase in student performance was modest. Considerable variability across teachers was observed for both factors. Teacher rankings were strongly influenced by the weighting algorithm used. Depending on the algorithm, one teacher was assigned any rank between #2 and #10.ConclusionBoth parts of the questionnaire address different outcomes and thus highlight specific strengths and weaknesses of individual teachers. Programme directors need to carefully consider the weight assigned to individual components of teacher evaluations in order to ensure a fair appraisal of teacher performance.

Bedside teaching: an invaluable tool in undergraduate medical education

AimsBedside teaching is one of the most important modalities in medical education. Sir William Osler stated, “Medicine is learned by the bedside and not in the classroom”. Despite this, the use of bedside teaching in the undergraduate curriculum has been declining, potentially due to changes in course design, increasing clinical workloads and reducing inpatient numbers. In my role as a Clinical Teaching Fellow (CTF), I have aimed to maximise bedside teaching and promote it as the primary approach for student learning.MethodAs a CTF, I deliver teaching to students from the Universities of Glasgow and Edinburgh during their placements in NHS Lanarkshire. Weekly teaching is provided to groups of 2-4 students, with around 50% of sessions delivered ‘at the bedside’.Within psychiatry, there is a vast range of potential bedside teaching topics. Given the length of time required to conduct a full psychiatric history and mental state examination (MSE), teaching sessions instead focus on one specific component of the patient interview, for example, assessing perceptual abnormalities or delusions, conducting a substance use history or exploring social circumstances and the functional impact of illness. This approach allows for more focussed feedback and teaching. Session structure is based upon Cox's model of bedside teaching, which I have modified slightly for the psychiatry setting.Student feedback has been collected via an anonymous electronic end-of-block questionnaire.ResultQualitative feedback reveals that students in NHS Lanarkshire value bedside teaching, with one student describing it as “informative, comprehensive and relevant for upcoming exams and clinical practice”.There are a number of potential barriers to consider when delivering bedside teaching in psychiatry. These include issues identifying suitable patients who can provide informed consent to participate and the ethical concerns regarding exploring difficult subjects such as suicide risk assessment with patients for purely educational purposes.These issues can be overcome; in inpatient units, there is usually a small cohort of patients who are able to consent and engage in student teaching, and difficult subjects can alternatively be addressed during role-play or simulation sessions.ConclusionDespite its challenges, bedside teaching can be an enjoyable and rewarding approach in undergraduate medical education, with feedback revealing it is positively received in NHS Lanarkshire. By utilising Cox's model and focussing on specific aspects of MSE and history-taking, bedside teaching is more accessible and an invaluable tool for psychiatric teaching. Clinicians and educators are encouraged to keep the patient at the centre of student learning.

The challenges of delivering addictions psychiatry teaching in the COVID era

AimsDuring the pandemic, addiction psychiatry moved from face-to-face lectures (delivered by Addictions Psychiatrists) to bitesize pre-recorded lectures (delivered by clinical teaching fellows) alongside interactive tutorials (delivered by Addictions Psychiatrists). The Addictions Team developed an online tutorial (delivered via Blackboard Collaborate) containing a combination of information slides, case studies, interactive quizzes, and short videos. These were delivered ‘live’ to small groups of students in up to four simultaneous virtual classrooms on a 6-weekly rolling basis. We aimed to assess student and tutor feedback regarding the move to interactive online tutorials in addiction psychiatry.MethodTwo questionnaires sought feedback from students and tutors, focussing on the change from face-to-face to virtual teaching during a 20-week period.Result21 (of 161) students completed the questionnaire. •100% ‘strongly agreed’ or ‘agreed’ that the content of the tutorial was relevant to learning outcomes.•52% felt ‘somewhat comfortable’ unmuting their microphones to contribute verbally, contrasting to 24% feeling ‘not very’ or ‘extremely uncomfortable’. In practice, only 30% of students contributed verbally.•57% felt most comfortable contributing via the written ‘chat’ function (rather than audio or camera).•65% felt either ‘somewhat’ or ‘very comfortable’ turning their cameras on, but only 1 student turned their camera on across all tutorials.•48% felt the tutorial was more accessible virtually than face-to-face; 5% considered it less so.•When COVID restrictions are lifted, 14% would prefer the tutorial to remain virtual, 53% would rather it returned face-to-face, and 33% had no preference.7 (of 7) tutors completed the questionnaire. •100% felt that students having their camera on would make their experience of delivering teaching ‘much better’ or ‘better’.•71% of tutors felt that students contributed ‘slightly’ or ‘significantly’ less in the virtual classroom.•Only 29% of tutors found the experience of virtual teaching ‘very’ or ‘somewhat’ enjoyable, contrasting 43% finding it ‘somewhat’ or ‘very’ unenjoyable.•Several white space tutor comments suggested the lack of audio-visual engagement made teaching less rewarding, whilst also preventing them from adapting content, pace, and teaching style to suit the group's needs. Tutors felt that the ease of delivering teaching from any location was beneficial.ConclusionVirtual teaching has become embedded in medical education and will likely remain so post-pandemic. For it to be an effective and enjoyable experience, for both students and teachers, there needs to be adaptation of content, technology, etiquette and culture.