How do United Kingdom (UK) medical schools identify and support undergraduate medical students who 'fail' communication assessments? : A national survey.

Acknowledgements Thanks go to Kirsty Boyd for discussion of early versions of the results of this survey. Grateful thanks to the UK Council for Clinical Communication in Undergraduate Medical Eduction for support of and contribution to this work.Peer reviewedPublisher PD

How do United Kingdom (UK) medical schools identify and support undergraduate medical students who ‘fail’ communication assessments? : A national survey

Background The doctor’s ability to communicate effectively (with patients, relatives, advocates and healthcare colleagues) relates directly to health outcomes, and so is core to clinical practice. The remediation of medical students’ clinical communication ability is rarely addressed in medical education literature. There is nothing in the current literature reporting a contemporary national picture of how communication difficulties are managed, and the level of consequence (progression implications) for students of performing poorly. This survey aimed to consolidate practices for identifying and processes for managing students who ‘fail’ communication assessments across all UK medical schools. Methods Data were collected via an email survey to all leads for clinical communication in all UK Medical Schools for the UK Council for Clinical Communication in Undergraduate Medical Education. Results All but two participating Schools reported some means of support and/or remediation in communication. There was diversity of approach, and variance in the level of systemisation adopted. Variables such as individuality of curricula, resourcing issues, student cohort size and methodological preferences were implicated as explaining diversity. Support is relatively ad hoc, and often in the hands of a particular dedicated individual or team with an interest in communication delivery with few Schools reporting robust, centralised, school level processes. Conclusions This survey has demonstrated that few Medical Schools have no identifiable system of managing their students’ clinical communication difficulties. However, some Schools reported ad hoc approaches and only a small number had a centralised programme. There is scope for discussion and benchmarking of best practice across all Schools with allocation of appropriate resources to support this.Publisher PDFPeer reviewe

General practice based teaching exchanges in Europe. Experiences from the EU Socrates programme 'Primary Health Care'

This paper reviews the experience of international exchange of medical students for general practice. The experience is based on the EU Socrates programme 'Primary Health Care' that offers, since 1992, clinical attachments and research electives in primary care. This programme involves 11 university departments of general practice/primary care in eight countries: Austria - Vienna; Belgium - Gent; Germany - D\ufcsseldorf; Italy - Monza, Udine; Netherlands - Nijmegen; Slovenia - Ljubljana; Sweden - G\uf6teborg; and the UK - Edinburgh, Imperial College London and Nottingham. More than 150 students have taken part in the programme, most in the last four years. For clinical attachment communication to patients is essential, and students should be able to speak the language of the host university. A research elective in primary care is less demanding and requires students' ability to communicate in English. Despite marked differences in health care structure in the countries involved, it is quite possible to provide a valuable teaching environment in general practice, and the experience gained by students in the exchanges more than equals that what they would gain at home. The added value is in experiencing the influence of another health care system and of working in another academic primary care centre. A substantial number of research electives have been published in international peer reviewed scientific journals with the student as first (occasionally second) author and staff members of the student's host and home university as co-authors. A further benefit of the exchange programme lies in the transfer teaching innovations between universities

Enhanced chemical weathering as a geoengineering strategy to reduce atmospheric carbon dioxide, supply nutrients, and mitigate ocean acidification

Chemical weathering is an integral part of both the rock and carbon cycles and is being affected by changes in land use, particularly as a result of agricultural practices such as tilling, mineral fertilization, or liming to adjust soil pH. These human activities have already altered the chemical terrestrial cycles and land-ocean flux of major elements, although the extent remains difficult to quantify. When deployed on a grand scale, Enhanced Weathering (a form of mineral fertilization), the application of finely ground minerals over the land surface, could be used to remove CO2 from the atmosphere. The release of cations during the dissolution of such silicate minerals would convert dissolved CO2 to bicarbonate, increasing the alkalinity and pH of natural waters. Some products of mineral dissolution would precipitate in soils or taken up by ecosystems, but a significant portion would be transported to the coastal zone and the open ocean, where the increase in alkalinity would partially counteract “ocean acidification” associated with the current marked increase in atmospheric CO2. Other elements released during this mineral dissolution, like Si, P or K, could stimulate biological productivity, further helping to remove CO2 from the atmosphere. On land, the terrestrial carbon-pool would likely increase in response to Enhanced Weathering in areas where ecosystem growth rates are currently limited by one of the nutrients that would be released during mineral dissolution. In the ocean, the biological carbon pumps (which export organic matter and CaCO3 to the deep ocean) may be altered by the resulting influx of nutrients and alkalinity to the ocean. This review merges current interdisciplinary knowledge about Enhanced Weathering, the processes involved, and the applicability as well as some of the consequences and risks of applying the method