A Lifesaving Quality Improvement Project - Investigating the Practicality of the Emergency Medicine Bag in a Primary Care Setting

Although uncommon, emergencies in primary care must be adequately prepared for. The Care Quality Commission (CQC) has produced a resource of emergency medications GP practices are recommended to stock. This list is neither exhaustive nor mandatory, but practices should consider the necessity within their population (1). Many GP practices choose to have an emergency bag on site. Alnwick Medical Practice developed an emergency bag which contained all the medication and equipment required for medical emergencies in primary care. Successful treatment in a medical emergency requires staff to be confident in using the emergency bag under pressure and be familiar with its layout and contents. This QIP explored staff confidence in navigating the emergency bag before and after a QI intervention

Delivering Patient Centred Care; Advanced Communication Skills Teaching

No abstract available

Conversation café: lived experience in undergraduate addictions teaching

No abstract available

A creative case study: Enhancing student engagement with professionalism through graphic Medicine

As we are seeing the year out, we are delighted and excited to welcome you to the very first open Annual #creativeHE Collection of 30 diverse contributions from 60 authors, educators and students, across our wider community and practitioners from the United Kingdom, Slovenia, Nigeria, Canada, Italy and Germany that capture creative and resourceful practices during this pandemic year that show the inventiveness and commitment to creating stimulating learning and development opportunities and experiences

“I wouldn’t know what to do with the breasts”: the impact of patient gender on medical student confidence and comfort in clinical skills

Background: Previous research has found a relationship between students’ gender and attitudes surrounding peer physical examination, but relationship between patient gender and confidence/comfort is less clear. We explored whether patient gender affects medical students’ levels of confidence and comfort in clinical examination skills. Methods: An electronic survey and focus groups were conducted with medical students from one UK institution. Students reported levels of confidence/comfort when carrying out clinical examinations on men/women. An inductive thematic analysis was performed. Results:    Of a total of 1500 students provided with the opportunity to participate, ninety (6%) responded. For cardiovascular and respiratory examinations, confidence/comfort were higher when examining male-presenting patients. The opposite was true for mental state examinations. Barriers to confidence/comfort included perceiving males as a norm, difficulty navigating breasts, tutors’ internalised gendered attitudes and a wider sociocultural issue. Facilitators of confidence/comfort included students relating to patients, embodying a professional role, gender blindness, and authentic clinical environments. Fewer than 20% (n = 18) of students felt they had enough opportunity to practice clinical skills on women, versus 90% (n = 82) on men. Conclusion: Our study identified an area where students’ confidence and comfort in clinical examinations could be enhanced within medical education. Changes were implemented in the institution under study’s vocational skills teaching, which is rooted in general practice. Information on gender and clinical skills was provided within course handbooks, time was scheduled to discuss gender and clinical skills in small group settings, and equitable gender representation was ensured in clinical assessment

An observational analysis of frailty in combination with loneliness or social isolation and their association with socioeconomic deprivation, hospitalisation and mortality among UK Biobank participants

Frailty, social isolation, and loneliness have individually been associated with adverse health outcomes. This study examines how frailty in combination with loneliness or social isolation is associated with socioeconomic deprivation and with all-cause mortality and hospitalisation rate in a middle-aged and older population. Baseline data from 461,047 UK Biobank participants (aged 37–73) were used to assess frailty (frailty phenotype), social isolation, and loneliness. Weibull models assessed the association between frailty in combination with loneliness or social isolation and all-cause mortality adjusted for age/sex/smoking/alcohol/socioeconomic-status and number of long-term conditions. Negative binomial regression models assessed hospitalisation rate. Frailty prevalence was 3.38%, loneliness 4.75% and social isolation 9.04%. Frailty was present across all ages and increased with age. Loneliness and social isolation were more common in younger participants compared to older. Co-occurrence of frailty and loneliness or social isolation was most common in participants with high socioeconomic deprivation. Frailty was associated with increased mortality and hospitalisation regardless of social isolation/loneliness. Hazard ratios for mortality were 2.47 (2.27–2.69) with social isolation and 2.17 (2.05–2.29) without social isolation, 2.14 (1.92–2.38) with loneliness and 2.16 (2.05–2.27) without loneliness. Loneliness and social isolation were associated with mortality and hospitalisation in robust participants, but this was attenuated in the context of frailty. Frailty and loneliness/social isolation affect individuals across a wide age spectrum and disproportionately co-occur in areas of high deprivation. All were associated with adverse outcomes, but the association between loneliness and social isolation and adverse outcomes was attenuated in the context of frailty. Future interventions should target people living with frailty or loneliness/social isolation, regardless of age

General Practice - It's Just Sitting Down! Perceptions of a General Practice-focussed Curriculum: A Qualitative Study of First-year Medical Students

Reducing numbers of medical students are choosing GP as a career. To reverse the trend there has been extra funding for enhanced undergraduate GP curricula. The University of Glasgow Undergraduate Medical School developed an optional 4-year GP-focussed curriculum, the COMET (Community Orientated Medical Experience Track) programme which was promoted to students in 2019. A qualitative study of 1st year medical students, at University of Glasgow, conducted using two online focus groups with separate cohorts of students; those who applied to the COMET programme and those who did not. Discussions were structured using a topic theme guide and video-recorded using Zoom, with subsequent thematic analysis conducted following a constructivist grounded theory approach. The findings showed there were two main factors influencing the students’ decisions: perceptions of GP and impressions of the COMET programme. These two themes emerged from both groups of students. The prime factor was the students’ perceptions of GP, which revealed a consistent narrative of negative associations with GP. This influenced the non-COMET students in their decision not to apply, and this negativity was reiterated by the COMET students, who decided to apply despite these influences. Conclusion: There remains ingrained perceptions of GP, many of which are formed pre-medical school from multiple sources (media portrayal, public perceptions, personal experience)

Communication skills

No abstract available

Truth Told in Jest? Professional Value Confessions at the End of a Medical Curriculum

Introduction: During week 1 of medical school, we ask the first year students “What makes a good doctor?” Collectively they generate a list of attributes subsquently used in small group Professionalism teaching. In 2019, for the first time, we asked the 5th year students the same question to see how their recognition, and understanding, of professional values had changed. Methods: The list of attributes generated in 2015, when the students were in 1st year, was retrieved and a new list was collated in 2019, when the cohort were in final year. Analysis for similarities and differences, that may throw light on our professionalism teaching and impact of the medical curriculum was undertaken. Results/Discussion: We had been expecting a comprehensive list of professionalism attributes that more fully reflected key professionalism documents (1, 2). Conventional attributes did develop over the 5 years, however, analysis revealed many surprising “attributes” e.g. “a robust ovarian reserve” “cute placement clothes”,*. There was concordance with 31 values between 1st and 5th year but 17 attributes did not survive to final year. The manner of anonymous data collection used might encourage more freedom of expression than conventional methods.The findings may also be an expression of student stress or the impact of the ‘hidden’ curriculum? Further exploration through focus groups would be of interest. Conclusion: Were these uncoventional findings a one-off expression of student feelings in jest or do they reveal on-going tensions that require to be addressed? Why did imminent graduates not identify a full range of professional values