Student Selected Component Research Articles

Why do students choose to do an extended GP placement?

ABSTRACT The drivers for medical students’ decision making when considering which Student Selected Component (SSC) to undertake is poorly understood. Furthermore, it is unclear why students undertake a specific SSC allowing them to have an extended placement in GP in their final year. It is known that high quality GP placements encourage students to subsequently choose GP as their career, therefore if the decision-making process of students in this area can be better understood, then this may help inform medical school actions to encourage a greater uptake of these extended placements. Semi-structured interviews were conducted with final year medical students at a Scottish University. Students were selected to provide a mixture of those who had and had not chosen to undertake the extended placement. The data was transcribed and analysed using thematic analysis to generate themes which represented the data. This showed that career intention was a major factor driving SSC choice. Additionally, students sought peer feedback and tended to avoid specific SSCs if they felt a lack of internal motivation. Considering the choice for the extended placement, students tended, again, to choose based on career intentions, and they also based their decision on previous experiences of GP. Career intention and prior experience are key factors in student choice of SSC and whether to undertake an extended GP. In order to address the national shortage of GPs medical schools need to consider how they might influence these drivers.

Medical students' and GP tutors' experiences of near peer teaching in primary care: a qualitative study.

There exists a significant body of literature on the benefits of Peer Assisted Learning (PAL). Near-peer (NP) teaching can be defined as teaching delivered by senior students to younger year students. There are numerous examples in the literature of PAL projects in a non-clinical setting but little research in a clinical setting and even less in primary care. Postgraduate literature suggests that potential benefits include promotion of general practice as a career as well as increasing teaching capacity.A successful pilot led to the development of a new undergraduate NP teaching Student Selected Component (SSC) in a primary care setting. To explore the experiences of medical students and GP tutors who participated in this SSC. Semi-structured interviews were carried out with year 5 NP student teachers, GP tutors, and year 3 students. Thematic analysis was used to analyse the qualitative data generated. As well as increasing teaching capacity and consolidating their own knowledge, the findings suggest an impact on the professional identity formation of NP student teachers helping them to prepare to be future doctors. The NP teaching fostered an environment of psychological safety for all students, although there was an additional element of risk management and supervision when teaching with patients. Undergraduate NP teaching has advantages for student learners, NP student teachers, GP tutors, and practices. The increased teaching capacity has implications for recruitment of practices for teaching and may promote general practice as a future career.

Meeting the Shared Goals of a Student-Selected Component: Pilot Evaluation of a Collaborative Systematic Review.

Research methodology is insufficiently featured in undergraduate medical curricula. Student-selected components are designed to offer some research opportunities but frequently fail to meet student or supervisor expectations, such as completion or publication. We hypothesized that a collaborative, educational approach to a systematic review (SR), whereby medical students worked together, may improve student experience and increase success. This study aimed to establish whether offering a small team of students the opportunity to take part in the screening phase of SRs led by an experienced postgraduate team could enhance the learning experience of students, overcome the barriers to successful research engagement, and deliver published output. Postgraduate researchers from the University of Cambridge led a team of 14 medical students to work on 2 neurosurgical SRs. One student was appointed as the lead for each SR. All students were provided with training on SR methodology and participated in title and abstract screening using Rayyan software. Students completed prepilot, midscreening, and postscreening questionnaires on their research background, perceptions, knowledge, confidence, and experience. Questions were scored on a Likert scale of 1 (strongly disagree) to 10 (strongly agree). Of the 14 students involved, 29% (n=4) reported that they had received sufficient training in research methodology at medical school. Positive trends in student knowledge, confidence, and experience of SR methodology were noted across the 3 questionnaire time points. Mean responses to "I am satisfied with the level of guidance I am receiving," "I am enjoying being involved in the SR process," and "I could not gain this understanding of research from passive learning e.g., textbook or lecture" were greater than 8.0 at all time points. Students reported "being involved in this research has made me more likely to do research in the future" (mean 8.57, SD 1.50) and that "this collaborative SR improved my research experience" (mean 8.50, SD 1.56). This collaborative approach appears to be a potentially useful method of providing students with research experience; however, it requires further evaluation.

A student selected component (SSC) in applied forensic medicine and pathology: 'the language of trauma'

Summary Forensic medicine and forensic pathology are rarely taught at undergraduate level in medical schools in the UK. Student Selected Components (SSCs) offer a means by which subjects that are ‘beyond the core’ can be explored, and this article describes one such SSC in forensic pathology in which students explored ‘the language of trauma’ relevant to safeguarding vulnerable patients. Relevance Medical students will be exposed to injured patients in whichever setting they practice medicine, be it in the community or in secondary care settings. Being able to identify and assess wounds and injuries, and their distribution on their patients, is essential not only for patient management purposes, but also for meeting safeguarding needs. Take home messages Although most medical students will not become forensic physicians or forensic pathologists, all doctors have an important safeguarding role, requiring them to be able to identify and assess wounds and injuries suggestive of assault. An SSC that emphasises the forensic assessment of wounds and injuries provides a useful way in which medical students can learn ‘the language of trauma’ relevant to their future clinical practice.

Optimising undergraduate medico-legal and professionalism teaching through a student-selected component

PurposeWe sought to understand how best to teach medico-ethics, law and professionalism to undergraduate medical students using a student selected component.Materials and methodsStudents received small-group, seminar-based teaching from the module...

Training tomorrow's doctors: the impact of a Student Selected Component in Global Health during medical school.

This article was migrated. The article was marked as recommended. Introduction:Several reports highlight the importance of global health education (GHE) for training tomorrow's doctors. In 2006, Newcastle University Medical School developed a Student Selected Component (SSC) in Global Health. We followed up students who completed the SSC to assess the impact on their experience as practising clinicians and postgraduate career development. Methods:We developed an electronic survey including questions about speciality choice, postgraduate qualifications, extracurricular activity and international work. Surveys were sent to 72 SSC participants identified between 2006-2017 through the Newcastle University Alumni and Supporters network and social media. Results: Surveys were returned by 37 (51%) SSC participants; 25 (71%) and 16 (46%) believed the SSC had influenced their clinical practice and career choice, respectively. Twenty-two (59%) obtained an intercalated degree programme, of whom nine (24%) did a Masters programme specifically in Global Health and four (11%), and two (5%) completed a Masters degree in Epidemiology and Control of Infectious Diseases respectively, both key themes within GHE. Four (11%) undertook, and 10 (29%) were considering postgraduate study related to global health, of whom three (9%) specified undertaking a Diploma in Tropical Medicine and Hygiene (DTM&H) and one (3%) studying a Masters degree in Public Health. Five (14%) had, and 19 (54%) were planning to work abroad, most referring to work in humanitarian or low resource settings and GHE programmes. Discussion and Conclusion:Participation in an SSC in Global Health may affect positive change in students' clinical practice and help inform academic and clinical career choice. Whilst a causative relationship cannot be inferred, the experience may support or increase the pursuit of additional global health-related qualifications, research and international health work. Medical schools that endeavour to produce graduates motivated to tackle our society's global health challenges should champion comprehensive global health modules for students.

Art & anatomy: an everlasting relationship creating new insights in teaching surface anatomy.

This article was migrated. The article was marked as recommended. The purpose of this study is to briefly present the unique relationship between art and anatomy and propose the use of art in teaching surface anatomy, evaluating its effectiveness through a randomized control study. The use of art paintings in teaching surface anatomy to undergraduate medical students was investigated. In the "Surface Anatomy" student selected component (SSC), art paintings instead of classic anatomical images were used as an intervention (art group, n=30; control group, n=15) during six hours of revision lectures. Perceptions of students and impact of art paintings on performance were investigated. The vast majority of students considered the use of art paintings as an interesting approach, which made lectures more interesting and improved understanding. No impact on performance was observed since mean examination scores did not differ significantly (Control group:73.9±9.4; Art group:78.8±8.6, p=0.10). Students also stated that the use of art paintings moderately improved their level of art knowledge and proposed a visit to a museum for a live anatomy lesson using paintings and sculptures. In conclusion, the use for art paintings in teaching and learning surface anatomy is highly appreciated by students, seems to improve understanding and makes the educational process more interesting. It should be furtherly investigated to be considered for inclusion in future curricula.

Equal Opportunities? Examining Global Health teaching at UK medical schools

This article was migrated. The article was not marked as recommended. IntroductionIn an increasingly international and interdependent world, the need for global health teaching is becoming more recognized, both for current and prospective medical students. In this study, we looked to assess available information about global health teaching provision at UK medical schools in the context of the new GMC guidance.MethodsWe collected data about global health teaching in medical schools using three methodologies: 1. Information advertised on medical school websites; 2. Emailing medical school admissions offices; 3. Circulating a survey to medical students through Students for Global Health (then Medsin). We then assessed each university in 5 domains: Student-selected components, intercalated degrees, clearly defined teaching provision within the curriculum, extracurricular activity and dedicated institutes of global health. ResultsThe most common provision was extracurricular activities, the least a dedicated Institute of Global Health. Over half of all UK medical schools offered a Student Selected Component (SSC) option or Masters degree in global health. Only 11 of 33 UK medical schools had specific evidence of global health teaching within the core curriculum. When compared to previous literature regarding professional guidelines, global health teaching provision and information regarding it falls short of the required standards.ConclusionsInformation about global health teaching, both on the curriculum and extra-curricula, at UK medical schools is not universally available for prospective medical students. Although increased teaching within the core curriculum at every medical school may be impractical due to time restrictions, a global health SSC should be available to all students to provide the opportunity of further in-depth study for those who wish to further their knowledge and skills in the area.

Exploring Creativity in Medical Students: Themes and Media in a Compulsory Humanities Student Selected Component

Background: Humanities/arts modules are employed in medical education programmes with the aim of promoting reflection and creativity. The aim of this study was to examine media and themes chosen by students in a novel, compulsory, humanities Student Selected Component (SSC) with the aim of better understanding what influences students’ project choice at this point in their training. Methods: We studied 430 SSC projects (weighting equivalent to 2.5 ECTS credits) undertaken by students who had completed the first two years of a 4 year graduate entry medical degree program. Students’ work was qualitatively analysed, focusing on a number of themes and subthemes. Students have the option of a critique or producing an original work.Results: 99% of students produced original works (of which 85% were visual media, 10% written, 5% performing arts) while 1% were critiques. Descriptive analysis of the reflections identified six overarching themes as to why students chose particular projects: Biological (25.6%), Mental Health (11.9%), Life of the Student(14.4%), Life of the Doctor (15.8%), the Patient Experience/Perspective (12.6%) and Culture and Society(19.8%). There was a significant association between gender and choice of theme (p < 0.001) with female students more likely to choose the Patient Experience/Perspective and Culture and Society as a basis for their project than male students. Conclusion: The study demonstrates that students chose creative expression over critiques in self-selected media and themes related to medicine when motivated by a compulsory credited module. Gender rather than educational background influences themes chosen.

Humanities in Medicine: A Qualitative Study of Graduate and Student Experiences of Completing a Student Selected Component

Background: As a relatively recent addition to medical education, evidence for the medical humanities is still being gathered. This study aims to explore qualitatively medical students and graduates’ perceptions of completing humanities Student Selected Component (SSC) and the potential longitudinal impact of such a module. Methods: A qualitative approach was adopted; one focus group took place with current 3rd year medical students (n = 6) and two with medical school graduates (n = 11). Thematic analysis was completed on the three focus group sessions. Results: Three main themes were highlighted including 1) evolution, 2) rewards, and 3) difficulties of the humanities project. A number of sub-themes were also reported. Findings highlight the importance of completing the humanities project in regards to promoting self-reflection, development of new skills and impact on clinical practice. Perceived lack of artistic skills, time-management and perfectionism were highlighted as challenging areas. Conclusion: The importance of medical student and graduates’ experiences of completing a humanities SSC should be recognised and valued, particularly amongst curriculum developers in medical schools.

Blending MOOCs into Medical Education

This article was migrated. The article was marked as recommended. The importance of student choice and diversity of opportunities within the undergraduate medical curriculum is clear. However, space for additional content is limited, requiring novel ways to provide opportunities for students. Massive open online courses (MOOCs) are a recent educational development education which have attracted much attention, both positive and negative. As medical educators involved in MOOC development, we investigated how MOOCs can be used to increase variety in the medical curriculum. We developed a 2nd year MBChB Student Selected Component (SSC) that uses an existing MOOC, and describe our evaluation of this blended learning experience.

Student-selected component in the medical curriculum: investigations and psychiatric referral for paracetamol overdose in an accident and emergency department.

BackgroundA student-selected component (SSC) of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit.Materials and methodsAn audit approach was applied. The aim of the project study was to investigate the level of compliance with best-practice guidelines for investigations and psychiatric referral in paracetamol overdose.ResultsA total of 40 cases meeting the inclusion criteria were randomly selected. The sample had a mean age of 27 years, of whom 70.5% were female, and the ingested dose of paracetamol ranged from 0.864 to 80 g. Paracetamol abuse may present as intentional and unintentional overdose. In our study, 85% of cases were identified as intentional overdose and 76% had a history of psychiatric illness. Generally, medical management was compliant with guidelines, with some minor irregularities. The international normalized ratio was the most underperformed test.ConclusionOur choice of topic, paracetamol overdose, contributed to our understanding of the breadth of factors to be considered in the emergency medical management of a patient. In this regard, we had the benefit of understanding how the diagnostic and therapeutic factors, when applied in accordance with best-practice guidelines, work very effectively. The SSC impacted positively on our cognitive, personal, and professional development. In facilitating the student with choice, the SSC encouraged self-direction and proactivity. We gained experience in the discipline of research and acquired some skills in independent thinking and analysis.

Palliative care education for medical students: Differences in course evolution, organisation, evaluation and funding: A survey of all UK medical schools

Background: A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. Aims: To investigate the evolution and structure of palliative care teaching at UK medical schools. Design: Anonymised, web-based questionnaire. Settings/participants: Results were obtained from palliative care course organisers at all 30 UK medical schools. Results: The palliative care course was established through active planning (13/30, 43%), ad hoc development (10, 33%) or combination of approaches (7, 23%). The place of palliative care teaching within the curriculum varied. A student-selected palliative care component was offered by 29/30 (97%). All medical schools sought student feedback. The course was reviewed in 26/30 (87%) but not in 4. Similarly, a course organiser was responsible for the palliative care programme in 26/30 but not in 4. A total of 22 respondents spent a mean of 3.9 h (median 2.5)/week in supporting/delivering palliative care education (<1–16 h). In all, 17/29 (59%) had attended a teaching course or shared duties with a colleague who had done so. Course organisers received titular recognition in 18/27 (67%; no title 9 (33%); unknown 3 (11%)). An academic department of Palliative Medicine existed in 12/30 (40%) medical schools. Funding was not universally transparent. Palliative care teaching was associated with some form of funding in 20/30 (66%). Conclusion: Development, organisation, course evaluation and funding for palliative care teaching at UK medical schools are variable. This may have implications for delivery of effective palliative care education for medical students.

Engaging medical students in leadership and quality improvement through a formal educational programme

This article was migrated. The article was not marked as recommended. Background: Undergraduate medical training in medical leadership is limited, and there is a general negative perception among medical professionals towards leadership and management. Aims: To improve perceptions of leadership training and encourage leadership activity amongst medical students. Method: A leadership student-selected component (SSC) was designed offering formal leadership education and engagement of students onto leadership and quality improvement projects. The initial cohort consisted of 8 third year medical students. Students were given questionnaires exploring their attitudes and perceptions towards leadership before and after the SSC. Results: The students had no previous formal undergraduate education in leadership. Engagement in the SSC considerably enhanced the perception of leadership and management among students. The students also reported having more confidence in engaging with leadership projects and reported feeling more likely to be involved with leadership projects in future. Conclusions: A formal leadership educational programme which engages students in real leadership and quality improvement work enhances the perception of leadership and inspires students to undertake leadership roles in future.

Medical Students’ Attitudes towards the Addictions

This article was migrated. The article was not marked as recommended. Background: The need for medical students to engage with patients with addictive problems is projected to increase in coming years. There will also be a concomitant greater emphasis on community-based learning. The present study assessed the impact of a community based teaching initiative, the Student Selected Component (SSC) Lay and Professional Perspectives on the Addictions, on students' attitudes to these groups. Summary of Work: The SSC is assessed by a final student report which includes a self-reflective section. The free text data from this section of 28 qualitative reports over 7 years was analysed using content analysis. Summary of Results: Students were clear they believed the experience of the SSC had increased their understanding of both the psychological and social complexity related to the addictions and the role of medicine within this. Conclusions: We discovered that the SSC Lay and Professional Perspectives on the Addictions not only gave students first-hand experience of those suffering from and treating addictive problems, but also had a positive effect on their attitude towards this group.

Enhancing medical students’ leadership skills through student-selected components

Historical context: The importance of effective leadership in the healthcare setting has become increasingly apparent through such high-profile NHS enquiries as the Francis Report into failings at Mid Staffordshire hospitals (Mid Staffordshire NHS Foundation Trust Public Enquiry, 2013). These examples of failings in patient safety and care have brought about numerous attempts to improve healthcare quality through leadership and management initiatives.The authors, a team of four medical students under the guidance of an academic tutor, aimed to design additional leadership and management learning resources to complement their university’s current undergraduate medical curriculum as part of this drive to improve patient care and safety.Specifications of Project: A two-year Student Selected Component (SSC), spanning years 4 and 5 of the undergraduate medical course, was created to provide students with the opportunity to develop their medical leadership and management skills.Discussion of Pedagogy/Practice: An action learning approach was employed to enable the authors to take control of their learning and to aid professional development. The flexibility of the university’s SSC model allowed for a variety of activities to be undertaken.Implementation: Self-directed study combined with a seminar series, external speaker events, industry placements and self-development courses formed the basis of the SSC.Evaluation: The authors judged the project’s success through continuation and increased recruitment to the SSC this academic year, and through the positive personal reflections of students having completed the pilot.Lessons Learnt: The six key lessons identified related to: planning, communication, sustainability, pursuing opportunities, self-directed learning and ambition.

Integrating global health with medical education.

Globalisation has implications for the next generation of doctors, and thus for medical education. Increasingly, global health is being taught in medical schools, although its incorporation into an already full curriculum presents challenges. Global health was introduced into the MBChB curriculum at the University of Aberdeen through a student-selected component (SSC) as part of an existing medical humanities block. The Global Health and Humanities (GHH) module was first delivered in the autumn of 2013 and will shortly enter its third year. This student-led study used quantitative and qualitative methods to assess the module's appropriateness and effectiveness for strengthening learning on global health, consisting of online surveys for course participants and semi-structured interviews with faculty members. Integrating global health into the undergraduate medical curriculum by way of an SSC was regarded by teaching staff as an effective and realistic approach. A recognised strength of delivering global health as part of the medical humanities block was the opportunity to expose students to the social determinants of health through interdisciplinary teaching. Participating students all agreed that the learning approach strengthened both their knowledge of global health and a range of generic skills. SSCs are, by definition, self-selecting, and will have a tendency to attract students already with an interest in a topic - here global health. A wide range of learning opportunities is needed to integrate global health throughout medical curricula, and to reach all students.

A model for teaching occupational medicine

Despite its relevance to medical practice, occupational medicine has been poorly represented in undergraduate training. This article describes a model for the teaching of occupational medicine to student doctors. The model comprises two didactic lectures, a student-selected component (SSC) of five interactive two-hour sessions and one occupational medicine objective structured clinical examination (OSCE) station in the final MB ChB clinical exam. Interested final-year students are invited to join the SSC. In session 1, students discuss the scope of occupational medicine practice, which includes a job title-occupational illness quiz, the use of environmental measurements and audiovisual recordings of selected workplaces. Sessions 2-4 involve visits to workplaces such as a laundry, a foundry and a bakery, during which students are asked to record relevant hazards to health, their controls, health effects and how occupational causality might be determined. The final session allows students to present their findings and gain feedback from the occupational physicians and their peers. Occupational medicine has been poorly represented in undergraduate training Twenty-seven student doctors chose to undertake the SSC in three cycles. Students appreciated the relevance of the specialty and the opportunity to systematically evaluate workplaces. Eighty percent of all final-year medical students (n=250) passed the occupational medicine station in the OSCE in 2014. This model for the teaching of occupational medicine links work and medical practice at three stages of undergraduate training and could be adopted by all medical schools. The SSC gave students skills for undertaking illness prevention, workplace evaluation and risk assessment that they had not previously encountered.

Clinical realism: a new literary genre and a potential tool for encouraging empathy in medical students.

BackgroundEmpathy has been re-discovered as a desirable quality in doctors. A number of approaches using the medical humanities have been advocated to teach empathy to medical students. This paper describes a new approach using the medium of creative writing and a new narrative genre: clinical realism.MethodsThird year students were offered a four week long Student Selected Component (SSC) in Narrative Medicine and Creative Writing. The creative writing element included researching and creating a character with a life-changing physical disorder without making the disorder the focus of the writing. The age, gender, social circumstances and physical disorder of a character were randomly allocated to each student. The students wrote repeated assignments in the first person, writing as their character and including details of living with the disorder in all of their narratives. This article is based on the work produced by the 2013 cohort of students taking the course, and on their reflections on the process of creating their characters. Their output was analysed thematically using a constructivist approach to meaning making.ResultsThis preliminary analysis suggests that the students created convincing and detailed narratives which included rich information about living with a chronic disorder. Although the writing assignments were generic, they introduced a number of themes relating to illness, including stigma, personal identity and narrative wreckage. Some students reported that they found it difficult to relate to “their” character initially, but their empathy for the character increased as the SSC progressed.ConclusionClinical realism combined with repeated writing exercises about the same character is a potential tool for helping to develop empathy in medical students and merits further investigation.

G498(P) Are we failing our children and our future? introducing medical students to child health inequalities

Background and aims Huge inequalities exist in child health globally. Current under five mortality rates vary significantly between countries from 2.3 per 1000 live births in Singapore to 152.5 per 1000 live births in Guinea-Bissau. In the UK, children from poorer socio-economic backgrounds are more likely to be born small, die during their first year of life and die from an accident in childhood. We aimed to develop and evaluate a student-selected component (SSC) introducing medical students to inequalities in child health. Methods The student-selected component (SSC) ran one afternoon a week for eight weeks. Students participated in four interactive workshops on topics around child inequality and attended a relevant paediatric clinic or service. Students completed a self-directed project exploring an area of possible inequality for children, produced a poster and gave a short presentation at the end of the SSC, which was assessed. We evaluated the SSC by e-mailing a structured questionnaire to all participants and analysed responses thematically. Results Twelve second year students undertook the SSC. All 12 completed the post-programme questionnaire. Medical students gained the following from participating in the SSC: An increased understanding of the inequalities that exist in child health. “I was quite shocked at how large the differences were especially within the UK. Research and presentation skills. An awareness of the need for effective interventions to reduce inequality and improve children’s health. “ It’s not just a matter of throwing money towards services for children but preventing the inequalities from happening in the first place.” An increased motivation to see the situation improve. “ This has fired me up to want to do something about this in the future.” Seven out of 12 students (58%) reported that doing the SSC had either confirmed or increased their desire to pursue paediatrics as a career. Three further students reported they had wanted to do paediatrics before doing the SSC. Conclusions Introducing medical students to child health inequalities early on in their undergraduate training can have significant benefits, particularly in helping students to understand the broader social determinants of health, and encouraging more medical students to take up careers in child health.