Norwich Medical School Research Articles

Tackling discrimination in medicine head on: The impact of bystander intervention training

Purpose A mixed-methods study to evaluate Bystander Intervention Training (BiT), a simulation-based small-group training programme designed to teach skills to tackle discrimination. Materials and methods Norwich Medical School delivered the intervention online between January 2020 and June 2023 to medical students, physician associate trainees, and qualified doctors. A sample of 569 participants was used in the main analysis. Participants completed pre- and post-training and follow-up evaluations. Results Paired post-training scores were significantly different (all p < 0.001) from the pre-training scores for all 12 questions, in favour of the post-training scores. Of the 159 participants who completed follow-up questionnaires, 27 (17.9%) reported having the opportunity to be an active bystander; of those, 23 (85%) intervened. Scores in the follow-up questionnaire were significantly higher than those in the pre-training survey and significantly lower than those in the post-training questionnaire (p < 0.001). Participants had an increased sense of responsibility to be an active bystander and were empowered to challenge discrimination. Participants from marginalised groups expressed positive views about the training. Conclusions Interventions that allow open discussion and carefully supported personal disclosure in safe spaces, where difficult and uncomfortable discussions can occur, with an opportunity to change behaviour, must be developed to tackle discrimination.

Online medical education using a Facebook peer-to-peer learning platform during the COVID-19 pandemic: a qualitative study exploring learner and tutor acceptability of Facebook as a learning platform

BackgroundIn recent years, higher education institutions have been moving teaching online, accelerated by the pandemic. The Remote Learning Project (RLP), based at the Norwich Medical School (NMS) in the United Kingdom (U.K.), was a peer-to-peer teaching program developed to supplement medical school teaching during the pandemic. The teaching was delivered through Facebook using peer-to-peer teaching. Tutors were final year medical students, teaching medical student learners in lower years. Tutors and learners perception of peer-to-peer online learning delivered through the Facebook Social Media (SoMe) platform was investigated.MethodsThis qualitative study recruited tutor and learner participants from NMS by email, participation in the study was voluntary. Online semi-structured interviews of both tutors and learners in the remote learning project were conducted. The data was analysed using thematic analysis.ResultsSeven participants were interviewed. Five themes were identified; education (learning/teaching), productivity, data security, professionalism, and usability of the platform. Learners enjoyed the asynchronous nature of the platform and both learners and tutors enjoyed the peer-to-peer nature of the RLP, including the ability to immediately and easily answer on Facebook comments. Some learners felt distracted on Facebook, whilst others enjoyed the reminders. The mix of social and professional on the platform was met with caution from tutors. Both learners and tutors enjoyed the familiarity of the platform.ConclusionsThe study found that SoMe may be a credible platform to deliver online peer-to-peer teaching. Educators should consider the ergonomics of SoMe platforms when designing online curriculums. Guidelines for educators should be developed to better guide educators on the effective and safe use of SoMe as a learning tool.

How are medical schools supporting student’s mental wellbeing during the COVID-19 pandemic?

IntroductionThe COVID-19 pandemic has impacted medical students in many ways. They are not exempt from personal struggles caused by the health crisis, and many have faced similar challenges adapting to a new learning experience. The University of East Anglia (UEA) has initiatives in place to support medical students including the society Headucate UEA and the Wellbeing Champions scheme established by Norwich Medical School (NMS).ObjectivesHeaducate aims to improve mental wellbeing by educational online webinars and social events aimed at university students. NMS Wellbeing Champions offer support and signpost students to resources and the wider student support system at the UEA.MethodsHeaducate was established in 2012 by NMS students that began running workshops at local secondary schools. Their work has expanded to include wellbeing workshops, social events for students and mental health first aid training, so members can provide peer support. Wellbeing Champions are medical student representatives responsible for completing mental health first aid training, communication between students and faculty, providing resources and signposting, creating mental health bulletin newsletters, and running socials exclusively for medical students.Results100% of Headucate workshop attendees who completed anonymous feedback agreed that they enjoyed it and that it was useful. No feedback has been collected regarding the success of the Wellbeing Champions. This should be carried out to assess and enhance the project further.ConclusionsMore data is needed to establish the success of the initiatives at NMS and their impact on medical student’s wellbeing.DisclosureNo significant relationships.

Taking Mental Health into Schools: The work of Headucate Student Society

Headucate: University of East Anglia (UEA) is a student-led organisation aiming to raise awareness around Mental Health through their workshops and events. Events in the last year have included a 24-hour live stream TV fundraiser, UEA’s first Psychiatry and Mental Health conference, a mental health themed stand-up show, mental health assistance workshops, a suicide prevention evening and a variety of panels. Headucate has also collaborated with Beat, the UK’s leading eating disorder charity, to run training aimed at Norwich Medical School students, other healthcare students and Professionals. Headucate provides opportunities for their members, including research, education within the medical community, organising group projects, hosting poster competitions and by collaborating with likeminded initiatives. Workshops were designed to include common mental health conditions; wellbeing; advice regarding looking after yourself and others; ways to get for support and the impact of COVID-19 on our mental health. They are arranged and delivered by our members to school children and university students; they have been adapted to an online platform, which allowed us to reach a wider audience. Outcome measures demonstrating the impact of Headucate’s work were analysed via verbal, written and rated feedback, obtained from participants of workshops and events. Headucate workshops can help to improve mental health awareness and education in schools; however, it is only a local initiative. To educate schools outside of Norfolk, Headucate’s repeatable model can be used to create new branches of organisations that can spread nationwide; so mental health education in schools can be promoted across the UK.DisclosureNo significant relationships.

Commentaries on Viewpoint: Fragile bones of elite cyclists: to treat or not to treat?

Commentaries on Viewpoint: Fragile bones of elite cyclists: to treat or not to treat?

Placement Overlap with Other Students; Effects on Medical Student Learning Experience

Phenomenon In the United Kingdom (UK) the government has increased the number of places at university to study medicine in England to meet workforce demands. In parallel, there have been growing student numbers in other healthcare professions and new professions whose roles overlap with doctors, such as advanced nurse practitioners and physician associates, have been introduced. These increasing numbers of medical students and other healthcare professions training in the same clinical setting have led to questions about the effect on the student experience. We aimed to investigate the impact of student-student encounters on the learning experience during clinical placements before student numbers increase further. Approach In this investigation medical student perceptions were collected retrospectively at Norwich Medical School, University of East Anglia in the UK, during the 2018/19 academic year following two clinical placements in secondary care settings. Through mandatory online course evaluations, all medical students were asked if their learning had been positively or negatively affected by other students, and how frequently they had certain student-student experiences. Findings Responses from 786 (of 844) medical students (93% response rate) demonstrated that most students felt their learning had been affected in some way by the presence of others while on their secondary care placements. Students experienced both positive and negative impacts of encounters with other students. Final year students tended to report more negative experiences, with first year students reporting more positive. while some students had experienced competition for learning opportunities and lower quality interactions with patients and doctors due to “overcrowding,” more students reported benefits from learning from and with other students. However, it also was found that any negative encounters with other students, even if accompanied by positive experiences, detrimentally affected student satisfaction with the placement. Insights This investigation indicates that student-student interactions influence the clinical learning experience of medical students both positively and negatively. Given the overriding influence of negative encounters, the findings suggest a need to maximize the beneficial effects of encountering other students on clinical placements; while protecting against missed or poor-quality learning opportunities due to competition between students, particularly for more senior students. Medical educators need to consider where their clinical attachments are at risk from multiple students being present at the same time and work to alleviate the negative impacts of such student-student encounters, while actively encouraging peer learning experiences between the medical students and collaborative activities between students of different healthcare professions. This is likely to become increasingly important as student numbers in medicine and other healthcare professions continue to grow.

Journal Digest: Z-Drugs and Dementia; Methotrexate and Schizophrenia; Smartphones and Depression; Brexpiprazole and Sexual Function; E-Cigarettes and Youth; Opioids Deaths and Neighborhoods

Journal Digest: Z-Drugs and Dementia; Methotrexate and Schizophrenia; Smartphones and Depression; Brexpiprazole and Sexual Function; E-Cigarettes and Youth; Opioids Deaths and Neighborhoods

Humanising medicine: teaching on tri-morbidity using expert patient narratives in medical education

ABSTRACTExpert patients have recognised benefits for both students and patients in medical education. However, marginalised patients such as homeless patients are less likely to participate. Learning from such individuals is crucial for future doctors, who can, in turn, aid their inclusion in society and improve access to health care. A ‘humanising medicine’ lecture was delivered to Year Four medical students at Norwich Medical School. The lecture utilised narratives from patients with experience of homelessness and tri-morbidity (physical and mental health problems and substance abuse). We used a qualitative approach to evaluate this teaching and understand the experience of both students and patients. Students were asked to complete questionnaires, whereas expert patients were interviewed. We thematically analysed data using an inductive approach. Students reported an increased understanding, empathy and preparedness to consult with marginalised patients. Expert patients described positive feelings about their involvement, giving something back, and the therapeutic benefits of telling their story. We found that including marginalised patients in medical education had positive benefits for both students and patients. Our findings suggest that expert patient narratives are valuable in medical education particularly in teaching and learning about medical complexity and tri-morbidity.

Digital Problem-Based Learning: An Innovative and Efficient Method of Teaching Medicine.

Background:The breadth of knowledge assimilated by undergraduates is substantial. Time must be utilised to impart knowledge and skills to ensure optimal training. Dermatology comprises a large portion of work in primary care; yet UK undergraduate dermatology training is short. Digital problem-based learning (PBL) is an innovative teaching method incorporating clinical images into intense, interactive teaching sessions.Aim:To determine the efficacy of digital PBL sessions in teaching UK medical students during their dermatology module.Methods:In total, 59 second-year medical students at Norwich Medical School during their dermatology secondary care attachment completed two 2.5-h digital PBL sessions. One session was focused on lesions and the second on inflammatory diseases. During each session, students assessed 60 clinical cases each comprising an image with a brief history. In small groups, students discussed the cases, described the images, and agreed a diagnosis followed by a group discussion with the supervising clinician who provided feedback. Following each session, students completed a feedback questionnaire.Results:In total, 117 sets of feedback were received; 60% of students considered they learnt a great amount in a short time. The majority of students reported feeling more confident to make a dermatological diagnosis and more motivated in clinics as a result of the digital PBL; 64% of students found digital PBL more useful than real patient clinics. The most frequent negative comment was that 2.5 h was too long to concentrate.Conclusions:Digital PBL was a popular, effective, and efficient teaching method. Digital PBL sessions should be introduced alongside clinics and other teaching methods for undergraduates.

Medical Students\u2019 Views About Having Different Types of Problem-Based Learning Tutors

BackgroundAt Norwich Medical School, Year 3 or 4 medical students taking a year out of the 5-year undergraduate MBBS degree to do a master’s degree in clinical education worked as near-peer problem-based learning (PBL) tutors for students in Year 2. Peer-assisted learning has been shown to benefit both peer tutors and tutees; in this study, experiences of students with near-peer PBL tutors were compared to students with other types of PBL tutor.MethodsUsing existing student evaluation data, we compared student views about PBL tutor performance, PBL group functioning, and overall satisfaction with PBL learning experience according to whether their PBL tutor/s were (1) a single near-peer tutor (later-year MB BS student), (2) a single staff tutor, (3) multiple staff tutors, or (4) multiple newly qualified doctor tutors.ResultsResults indicated that students’ evaluation of tutor performance was more positive for near-peer PBL tutors compared to both groups of staff tutors for most areas evaluated. Additionally, students’ evaluation of overall satisfaction with PBL was more positive for near-peer PBL tutors compared to multiple staff tutors. Tutor performance for multiple staff tutors was evaluated less positively compared to both single staff and multiple newly qualified doctor groups. But there were no statistically significant differences between the four groups regarding PBL group functioning.ConclusionNear-peer PBL tutors perform comparably or better to staff PBL tutors in salient measures of tutor performance and group functioning. We conclude that medical students find near-peer PBL tutors to be an acceptable addition to the PBL tutor workforce.

Editorial introductions

Editorial introductions

Developing a new empathy-specific admissions test for applicants to medical schools: A discourse-pragmatic approach.

The ability to empathise with patients is an important professional skill for doctors. Medical students practise this skill as part of their medical education, and are tested on their use of empathy within their final examination. Evidence shows that appropriate training makes a difference but that natural aptitude also plays a role. Most medical schools, therefore, probe applicants' basic understanding of empathy at admissions interviews. The purpose of the project presented in this paper was to apply existing understanding of how empathy may be communicated in a clinical context (building on a literature review by Pounds [2011]) to develop a new empathy-specific medical admissions interview station, probing applicants' empathic communicative performance (not just theoretical knowledge) and fitting the widely used Multiple Mini Interview (MMI) format. The paper outlines how this tool was developed, trialled and implemented by: (1) conceptualising empathic communication in discourse-pragmatic terms - that is, as a set of specific but context-dependant empathic speech acts; and (2) formulating and trialling a written and two oral versions of a situational test, capable of probing the applicants' ability to communicate empathically in everyday conversation and suitable for use at Norwich Medical School and other similar educational institutions.

Improving outcomes for pregnant women with diabetes

Improving outcomes for pregnant women with diabetes

Editorial introductions

Editorial introductions

Releasing the GENIE and Other Tips for Life Sciences Teachers.

This article was migrated. The article was marked as recommended. This paper describes practical tips and tools for delivering life sciences teaching, it is based on the authors' experiences at Norwich Medical School (NMS), which opened in 2002 at the University of East Anglia. The inaugural medical curriculum, including its ethos and how it is perceived by staff and students, have all been described previously.⁽¹⁻³⁾ Our 5 year medical degree at NMS is a modular, systems-based programme that integrates theory and clinical practice from the beginning. We use problem based learning (PBL) but teaching is also delivered via clinical placement; structured and simulated patient teaching; and via formal lectures and workshops. Core social science themes and life science themes run longitudinally through the course and spiral delivery of learning outcomes allows students to re-visit our themes, and particular topics, with increasing complexity. We offer ten tips here, about delivering the curricula for genetics, pharmacology, and prescribing. One challenge that we face, with a modular degree programme, is that we meet our students intermittently and throughout their years of study, and our science curriculum has been developed in response to this.

Editorial introductions

Editorial introductions

Why, Oh Why, Are So Many Older Adults Not Drinking Enough Fluid?

The National Resident Assessment Instrument was introduced a quarter century ago, was fully operational by October 1991, and appeared to reduce the prevalence of dehydration from 2% to 1% in nursing home residents. 1 Fries B.E. Hawes C. Morris J.N. Phillips C.D. Mor V. Park P.S. Effect of the National Resident Assessment Instrument on selected health conditions and problems. J Am Geriatr Soc. 1997; 45: 994-1001 Crossref PubMed Scopus (126) Google Scholar Despite this, Marra and colleagues 2 Marra M.V. Simmons S.F. Shotwell M.S. et al. Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index. J Acad Nutr Diet. 2016; 116: 828-836 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar found that 38% of long-term-care residents are dehydrated (assessed using serum osmolality), and a further 30% have impending dehydration. The 132 long-term residents of eight long-term-care facilities in Nashville, TN, who were studied had a blood sample and a written order for caloric supplementation, but were not receiving hospice care, enteral nutrition, or parenteral nutrition. The mean age of the 247 adults included in the study (not all had a blood sample) was 83±11 years, mean body mass index (BMI) was 25±5, and 79% were women. 2 Marra M.V. Simmons S.F. Shotwell M.S. et al. Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index. J Acad Nutr Diet. 2016; 116: 828-836 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar Hydration status was measured using serum osmolality (directly measured by freezing point depression). A resident was determined to be dehydrated when serum osmolality was >300 mOsm/kg, impending dehydration was defined as serum osmolality between 295 and 300 mOsm/kg, and normal hydration was defined as serum osmolality below 295 mOsm/kg. 3 Thomas D.R. Cote T.R. Lawhorne L. et al. Understanding clinical dehydration and its treatment. J Am Med Dir Assoc. 2008; 9: 292-301 Abstract Full Text Full Text PDF PubMed Scopus (210) Google Scholar , 4 Institute of Medicine, Food and Nutrition BoardPanel on Dietary Reference Intakes for Electrolytes and Water. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. The National Academies Press, Washington, DC2004 Google Scholar L. Hooper is a reader in research synthesis, nutrition, and hydration, Norwich Medical School, University of East Anglia, Norwich, UK. Elevated Serum Osmolality and Total Water Deficit Indicate Impaired Hydration Status in Residents of Long-Term Care Facilities Regardless of Low or High Body Mass IndexJournal of the Academy of Nutrition and DieteticsVol. 116Issue 5PreviewDehydration is typically associated with underweight and malnutrition in long-term care (LTC) settings. Evidence is lacking regarding the influence of the rising prevalence of overweight and obesity on risk factors, prevalence, and presentation of dehydration. Full-Text PDF

The role of travel mode in engagement with a Radio Frequency ID chip based school physical activity intervention

The role of travel mode in engagement with a Radio Frequency ID chip based school physical activity intervention

040. Combining Lifestyle and Metabolic Predictors of Incident Inflammatory Polyarthritis in the Epic-2-Noar Study

Jamie C. Sergeant, Suzanne M. M. Verstappen, Catharine Morgan, Robert N. Luben, Amit Bhaniani, Serena Anuj, RA-MAP consortium, Alex J. MacGregor, Nick Wareham, Deborah P. M. Symmons, Kay-Tee Khaw and Ian N. Bruce Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester, NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge and Norwich Medical School, University of East Anglia, Norwich, UK

Comment on “Ebola Virus Persistence in the Environment: State of the Knowledge and Research Needs”

ADVERTISEMENT RETURN TO ISSUEPREVCorrespondenceNEXTComment on “Ebola Virus Persistence in the Environment: State of the Knowledge and Research Needs”Daniele S. Lantagne*† and Paul R. Hunter‡View Author Information† Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States‡ Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom*E-mail: [email protected]Cite this: Environ. Sci. Technol. Lett. 2015, 2, 2, 48–49Publication Date (Web):January 15, 2015Publication History Received29 December 2014Accepted15 January 2015Published online20 January 2015Published inissue 10 February 2015https://doi.org/10.1021/ez500410tCopyright © 2015 American Chemical SocietyRIGHTS & PERMISSIONSArticle Views1216Altmetric-Citations5LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InReddit PDF (173 KB) Get e-AlertsSUBJECTS:Antimicrobial activity,Chlorine,Liquids,Wastes Get e-Alerts