Prescribing hormone replacement therapy: key considerations for primary care physicians

The last few years has seen a dramatic rise in the number of women seeking advice for the menopause and hormone replacement therapy (HRT).1 Navigating the complexities of HRT and being able to discuss the options available in primary care is, therefore, essential. The aim of this article is to provide key considerations for primary care physicians (PCPs) when considering HRT implementation and also the role of testosterone and vaginal estrogen for symptom management (Figure 1). It is beyond the scope of this article to discuss the role of tibolone, selective oestrogen receptor modulators (SERMs), and dehydroepiandrosterone (DHEA) for managing menopausal symptoms, and PCPs would be encouraged to seek specialist input prior to commencing these treatments

Medical student perceptions of reflective practice in the undergraduate curriculum [version 1; peer review: awaiting peer review]

INTRODUCTION: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. METHODS: This was a qualitative study based on the methodology of phenomenology. All penultimate year medical students at University College London Medical School (n=361) were approached for this study and altogether thirteen participants were recruited, with data collected through two focus group discussions. Thematic analysis was used to generate the coding framework. RESULTS: Five key themes emerged around student attitudes to RP, which were grouped into three domains: ‘value of RP’, ‘barriers to engagement’, and ‘strategies for enabling RP’. ‘Value of RP’ centred on the themes of humanising medicine and developing empathy, developing professionalism and RP as a tool for sense-making. ‘Barriers to engagement’ centred on the purpose and tokenism of RP and in the third domain, ‘strategies for enabling RP’, the theme of student agency in RP emerged strongly. CONCLUSION: Overall, the value of RP was not fully appreciated until students began their clinical placements. Potential strategies identified by participants for optimising engagement included student co-design and positioning RP within a broader pastoral role early in the undergraduate curriculum

Medical student perceptions of reflective practice in the undergraduate curriculum [version 3; peer review: 1 approved, 1 approved with reservations]

INTRODUCTION: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. METHODS: This was a qualitative study based on the methodology of phenomenology. All penultimate year medical students at University College London Medical School (n=361) were approached for this study and altogether thirteen participants were recruited, with data collected through two focus group discussions. Thematic analysis was used to generate the coding framework. RESULTS: Five key themes emerged around student attitudes to RP, which were grouped into three domains: ‘value of RP’, ‘barriers to engagement’, and ‘strategies for enabling RP’. ‘Value of RP’ centred on the themes of humanising medicine and developing empathy, developing professionalism and RP as a tool for sense-making. ‘Barriers to engagement’ centred on the purpose and tokenism of RP and in the third domain, ‘strategies for enabling RP’, the theme of student agency in RP emerged strongly. CONCLUSION: Overall, the value of RP was not fully appreciated until students began their clinical placements. Potential strategies identified by participants for optimising engagement included student co-design and positioning RP within a broader pastoral role early in the undergraduate curriculum