‘It would not be tolerated in any other profession except medicine’: survey reporting on undergraduates’ exposure to bullying and harassment in their first placement year

OBJECTIVES: To determine the extent to which undergraduate medical students experience (and/or witness) bullying and harassment during their first year on full-time placements and to compare with new General Medical Council (GMC) evidence on bullying and harassment of doctors in training.SETTING: A UK university offering medical and nursing undergraduate programmes.PARTICIPANTS: 309 medical and nursing undergraduate students with 30-33?weeks' placement experience (123 medical students and 186 nursing students); overall response rate: 47%.PRIMARY AND SECONDARY OUTCOME MEASURES: (A) students' experience of bullying and harassment; (B) witnessing bullying and harassment; (C) actions taken by students; (D) comparison of medical and nursing students' data.RESULTS: Within 8?months of starting clinical placements, a fifth of medical and a quarter of nursing students reported experiencing bullying and harassment. Cohorts differ in the type of exposure reported and in their responses. Whereas some nursing students follow incidences with query and challenge, most medical students acquiesce.CONCLUSIONS: Bullying and harassment of medical (and nursing) students-as well as witnessing of such incidents-occurs as soon as students enter the clinical environment. This augments evidence published by the GMC in its first report on undermining of doctors in training (December 2013). The data suggest differences between nursing and medical students in how they respond to such incidents.<br/

Catching them early? Using a pre-arrival task to encourage first year students’ engagement with professionalism

BackgroundMedical professionalism includes aspects of professional governance, professional patient care and personal and professional development (Owen, Hill &amp; Stephens, 2009). There is growing interest in what medical professionalism is and how we teach it. In the UK, the GMC specifically emphasised the doctor as a professional in Tomorrow’s Doctors (2009). While there is agreement that it is important to include medical professionalism in the undergraduate curriculum, there is still no clear model for doing so (Passi, Doug, Peile, Thistlethwaithe &amp; Johnson, 2010). That said, there is a strong argument for teaching the cognitive basis of professionalism and then building upon this through experiential learning (Cruess &amp; Cruess, 2006). Following a curriculum re-design in 2013/14 Southampton medical school began to teach explicit professionalism in the early years through a combination of lectures, symposia, student presentations and tutorials. The introduction was accompanied by an evaluation (using quantitative and qualitative data), which indicated that the majority of students were struggling to see the relevance. In addition to reconsidering content, format and delivery, a pre-arrival task was introduced in 2014/15. Pre-arrival tasks are increasingly used within higher education more broadly. They are intended to build student engagement and seek to mobilise students’ prior learning and experiences in order to connect them with a new course and/or institution. This, to our knowledge is the first time that a pre-arrival task has been used in a UK medical school context. The presentation will outline what we did, how students responded and will offer key learning points (for staff and students). ReferencesCruess, R. L., &amp; Cruess, S. R. (2006). Teaching professionalism: general principles. Medical teacher, 28(3), 205-208.Owen, D., Hill, F. &amp; Stephens, C. (2009). Medical professionalism: more than fitness to practise. The Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine Newsletter, 01, (18), 16-19.Passi, V., Doug, M., Peile, E., Thistlethwaite, J., &amp; Johnson, N. (2010). Developing medical professionalism in future doctors: a systematic review.International Journal of Medical Education, 1, 19–29. doi:10.5116/ijme.4bda.ca2aRiley, S., &amp; Kumar, N. (2012). Teaching medical professionalism. Clinical Medicine, 12(1), 9-11.Tomorrow's doctors. General Medical Council. Education Committee, 2009.<br/

An exploration of students’ experiences of the PPD pre-arrival task: Its feasibility and impact

Background and purpose: firm guidelines have been put forward on professional outcomes and standards in medical education1, yet there is no agreed model for teaching professionalism2. Following a curriculum re-design in 2013/14, Southampton medical school introduced a programme of personal and professional development (PPD) in the early years. A pre-arrival task was introduced in 2014/15 to encourage students to research and document what kind of doctor they would like to be and what they think it means to be a medical professional. Pre-arrival tasks are increasingly used in Higher Education to help students prepare for the transition to university3,4, although to our knowledge this was the first time that a pre-arrival task has been used in a UK medical school. The early feedback from students in 2014/15 was positive and the PAT was re-run in 2015/16. This research explores the student experience of the PAT, looking at whether completing the PAT was feasible, the task itself, how participants approached the task and any impact it had.Methodology: all first year students on the BM5 programme at Southampton University were eligible to participate. A total of 22 students participated, with a mix of graduate entrants (GE, n=9) and undergraduate entrants (UE, n=13). Four focus groups were conducted, ranging in length from 42-77 minutes. With participants’ consent, the focus groups were audio-recorded and transcribed. The data was analysed thematically. Results: the task was feasible for most students, with the exception of 2 participants who had issues with timing. Many participants were unsure about what was expected of them, although GEs were less worried than the UEs. GEs tended to approach researching for the PAT with articles and material from the GMC, whereas UEs sought advice from family and the University website and often struggled to meet the required length. The impact of the task was more prominent for UEs: helping them to re-focus on studying, gain greater understanding into professionalism and the importance of it as future doctors. Ultimately, the PAT was considered more helpful for UEs. Discussion and conclusions: there appear to be differences in how UE and GE students understood what was expected of them, how they approached the task, and what they took away from it. This suggests that there may be some important differences in how UE and GE students engage with professionalism teaching when they arrive at medical school<br/

How do medical school applicants respond to the requirement for 'work experience'? An exploration of 'going abroad'

Background and PurposeArranging work experience prior to medical school can for many potential applicants prove extremely difficult,with access to clinical settings often considered the ideal type. Potential applicants struggle to interpret theofficial guidance from medical schools1, making the application process intensely unsettling. Anecdotalevidence suggests that some UK-based candidates have been responding to these perceived requirementsby paying to undertake commercially-mediated international work experience (i-WEX)2,3.A recent Medical Schools Council announcement highlights that overseas work experience prior to studyingmedicine is problematic.4 However, there is no literature that would tell us anything about why it is beingundertaken, by whom or about the potential consequences for participants and hosts. This project addressesthis gap and offers insights into applicants’ mind-sets and the commercial environment that appears to providea potential solution to their dilemma. It draws on parallels with existing debates around the benefits anddrawbacks of volunteer tourism pertaining to medical electives and gap year volunteer projects.MethodologyThis is an exploratory interview-based study with UK undergraduate medical students (n=15). Followingcompletion of the individual interviews, each one will be transcribed, before a thematic analysis is performed.ResultsTo date some seven interviews have been conducted already and we expect the final analysis and writing upto conclude in May 2015.Discussion and ConclusionsPreliminary analysis suggests that the seemingly conflicting guidance regarding work experiencerequirements has left applicants susceptible to panic when observing the apparent opportunities enjoyed bypeers encountered at school and on online forums. As previously suggested in the literature, networks (intothe healthcare professions) are invaluable for organising work experience, though many applicants do nothave such contacts. Apparently, this leads some applicants to undertake i-WEX, which promises exotic andexciting experiences to elaborate on in personal statements and interviews.1- Timm A. The Hopes and Fears of new medical students: An exploration of students’ perspectives of applying to medical school. MedicalEducation Development Unit, University of Southampton; 2013: 7.2- Gap Medics. About Us. http://www.gapmedics.co.uk/about (accessed 2nd January 2015).3- Projects Abroad UK. About Projects Abroad: Projects Abroad Today. http://www.projects-abroad.co.uk/about-us/ (accessed 2nd January2015).4- Medical Schools Council. Selecting for Excellence - Work experience guidelines for applicants to medicine. December 2014

Exploring the nature of undergraduate clinical placements in Germany in the context of developing a collaborative European undergraduate medical programme

Fragestellung/Zielsetzung*In 2013 the University of Southampton (UoS) established a new medical degree programme, the BM(EU), together with a German healthcare provider, Gesundheit Nordhessen. After two years in the UK, the first cohort will move to Kassel in the Autumn 2015. The entire programme is subject to the UK regulator’s requirements and quality control – and, coincidentally, meets the Wissenschaftsrat’s recommendations.As is typical for medical education in the UK, the BM(EU) students will spend the majority of their programme on clinical placements. Through ongoing collaboration, intensive staff development and quality assurance visits, we are ensuring that our German colleagues are equipped to deliver the Southampton curriculum. From our reading of the literature, we understand that the BM(EU) differs significantly from the majority of programmes delivered in Germany.To better understand our colleagues’ perspectives of clinical placements, we conducted an exploratory applied medical education research project in Kassel. Our research questions were:1. What happens during clinical placements in the medical education system in Germany?2. What is the nature of apprenticeship learning in the medical education system in Germany?Theoretically, the study was informed by the Communities of Practice model developed by Lave and Wenger.MethodenWe conducted semi-structured interviews with senior clinical teachers who will be involved in the delivery of the BM(EU); n=13. All interviews were transcribed and a thematic analysis was conducted.ErgebnisseThe German medical education system differentiates between four different types of clinical placements. However, it seems that only the Blockpraktika are organised by and form part of university teaching. The other three placement types are mandatory and signed off at the end, they seem to be organised by the students themselves, without any medical school involvement. As such, this clinical experience appears not to be subject to regulatory guidance and supervision and is without minimum staff training requirements. The lack of external quality control does not necessarily impede opportunities for apprenticeship learning but means the experience is quite variable. Participants provided examples of both good and bad learning opportunities.Diskussion/SchlussfolgerungGiven the experiences reported by the clinical teachers in Kassel, the Southampton approach, is likely to be new (and potentially challenging). The key differences, as we see them, are the UK emphasis on clear learning outcomes and assessments for all clinical placements, ongoing teacher training and the evaluation by an external regulator.It is important that we discuss and examine our definitions and underlying assumptions about the nature of clinical placements. In fact, we consider it an essential starting point for providing effective staff development and support for our clinical teachers in Germany.Literaturhinweise:[1] Chenot JF. Undergraduate medical education in Germany. German Medical Science 2009; Doc02.[2] Nikendei C, Weyrich P, Jünger J, Schrauth M. Medical education in Germany. Medical Teacher 2009; 31: 591-600.[3] Lave J, Wenger E. Situated Learning. Legitimate peripheral participation, Cambridge: University of Cambridge Press. (1991)<br/

Exploring the nature of undergraduate clinical placements in Germany in the context of developing a collaborative European undergraduate medical programme

Fragestellung/Zielsetzung*In 2013 the University of Southampton (UoS) established a new medical degree programme, the BM(EU), together with a German healthcare provider, Gesundheit Nordhessen. After two years in the UK, the first cohort will move to Kassel in the Autumn 2015. The entire programme is subject to the UK regulator’s requirements and quality control – and, coincidentally, meets the Wissenschaftsrat’s recommendations.As is typical for medical education in the UK, the BM(EU) students will spend the majority of their programme on clinical placements. Through ongoing collaboration, intensive staff development and quality assurance visits, we are ensuring that our German colleagues are equipped to deliver the Southampton curriculum. From our reading of the literature, we understand that the BM(EU) differs significantly from the majority of programmes delivered in Germany.To better understand our colleagues’ perspectives of clinical placements, we conducted an exploratory applied medical education research project in Kassel. Our research questions were:1. What happens during clinical placements in the medical education system in Germany?2. What is the nature of apprenticeship learning in the medical education system in Germany?Theoretically, the study was informed by the Communities of Practice model developed by Lave and Wenger.MethodenWe conducted semi-structured interviews with senior clinical teachers who will be involved in the delivery of the BM(EU); n=13. All interviews were transcribed and a thematic analysis was conducted.ErgebnisseThe German medical education system differentiates between four different types of clinical placements. However, it seems that only the Blockpraktika are organised by and form part of university teaching. The other three placement types are mandatory and signed off at the end, they seem to be organised by the students themselves, without any medical school involvement. As such, this clinical experience appears not to be subject to regulatory guidance and supervision and is without minimum staff training requirements. The lack of external quality control does not necessarily impede opportunities for apprenticeship learning but means the experience is quite variable. Participants provided examples of both good and bad learning opportunities.Diskussion/SchlussfolgerungGiven the experiences reported by the clinical teachers in Kassel, the Southampton approach, is likely to be new (and potentially challenging). The key differences, as we see them, are the UK emphasis on clear learning outcomes and assessments for all clinical placements, ongoing teacher training and the evaluation by an external regulator.It is important that we discuss and examine our definitions and underlying assumptions about the nature of clinical placements. In fact, we consider it an essential starting point for providing effective staff development and support for our clinical teachers in Germany.Literaturhinweise:[1] Chenot JF. Undergraduate medical education in Germany. German Medical Science 2009; Doc02.[2] Nikendei C, Weyrich P, Jünger J, Schrauth M. Medical education in Germany. Medical Teacher 2009; 31: 591-600.[3] Lave J, Wenger E. Situated Learning. Legitimate peripheral participation, Cambridge: University of Cambridge Press. (1991)<br/

Auditory stimulation in-phase with slow oscillations to enhance overnight memory consolidation in patients with schizophrenia?

Sleep-dependent memory consolidation is disturbed in patients with schizophrenia, who furthermore show reductions in sleep spindles and probably also in delta power during sleep. The memory dysfunction in these patients is one of the strongest markers for worse long-term functional outcome. However, therapeutic interventions to normalise memory functions, e.g., with medication, still do not exist. Against this backdrop, we investigated to what extent a non-invasive approach enhancing sleep with real-time auditory stimulation in-phase with slow oscillations might affect overnight memory consolidation in patients with schizophrenia. To this end, we examined 18 patients with stably medicated schizophrenia in a double-blinded sham-controlled design. Memory performance was assessed by a verbal (word list) and a non-verbal (complex figure) declarative memory task. In comparison to a sham condition without auditory stimuli, we found that in patients with schizophrenia, auditory stimulation evokes an electrophysiological response similar to that in healthy participants leading to an increase in slow wave and temporally coupled sleep spindle activity during stimulation. Despite this finding, patients did not show any beneficial effect on the overnight change in memory performance by stimulation. Although the stimulation in our study did not improve the patient&#39;s memory, the electrophysiological response gives hope that auditory stimulation could enable us to provide better treatment for sleep-related detriments in these patients in the future

DeepSurveyCam — A Deep Ocean Optical Mapping System

Underwater photogrammetry and in particular systematic visual surveys of the deep sea are by far less developed than similar techniques on land or in space. The main challenges are the rough conditions with extremely high pressure, the accessibility of target areas (container and ship deployment of robust sensors, then diving for hours to the ocean floor), and the limitations of localization technologies (no GPS). The absence of natural light complicates energy budget considerations for deep diving flash-equipped drones. Refraction effects influence geometric image formation considerations with respect to field of view and focus, while attenuation and scattering degrade the radiometric image quality and limit the effective visibility. As an improvement on the stated issues, we present an AUV-based optical system intended for autonomous visual mapping of large areas of the seafloor (square kilometers) in up to 6000 m water depth. We compare it to existing systems and discuss tradeoffs such as resolution vs. mapped area and show results from a recent deployment with 90,000 mapped square meters of deep ocean floor