Newsletter 13

Community-Based MedicalEducation (CBME) Newsletter for General Practice December 2012 • Issue 13 www.gptutorbartsandthelondon.org

Welcome to our winter newsletter andthank you very much to all those whohave contributed to it, it is very muchappreciated. This edition includes anarticle on the ethical discussions thatare had throughout the EPCplacement, student reflections ofMedSoc and Ann O’Brien describesher trip to Sri-Lanka where QueenMary is linked with Jaffna UniversityMedical School.

www.qmul.ac.uk

Inside this issueInternational Links:

What is the challenge for community

based medical education? 02

Tutor Feedback 02

Students’ reflections on patient contact 03

Extending patient contact extends to ethical

parts that other teaching cannot reach 03

GP tutor induction training event, 19th Sept, 2012 04

Farewell to Dr Christopher Derrett 04

Dates for 2013 04

Changes at CBME 04

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December 2012 Issue 13

Barts and The London School of Medicine and Dentistry, Academic Unit for Community-Based Medical Education, Garrod Building, Turner Street, Whitechapel , E1 2AD.

TutorFeedbackThe project surgery had two students for their communityplacement in the fifth year, alongside second year med studentsand also GP trainees. For the fifth year teamwork project I setthem the subject of teamwork teaching in the project surgery.The students devised a questionnaire with no help from mewhich asked all staff members including non clinicians, abouttheir role as both learners and teachers. The students analysedthe results and presented them at a whole team meeting withrecommendations of how we could improve our teaching. Theresults of their project were absolutely fantastic and have led tothe surgery holding a whole team meeting and changing theentire way we teach.

It became apparent that we were enthusiastic but were workingmore parallel than integrated in our teaching and it also became

International Links:What is the challenge for community based medical education?

I was privileged to beinvited by Dr RajendiraSurenthirakumaranfrom Sri Lanka todeliver the ProfessorSivagnasundramMemorial Oration. Thistook place at theUniversity of Jaffna inAugust 2012. Professor

Sivagnasundram was the founder of the faculty of CommunityMedicine and worked tirelessly to promote the delivery of familymedicine close to home. This was, and remains, a limited servicefor the local Sri Lankan people. It is also a branch of medicinethat is poorly taught to undergraduate medical students. As aresult few graduates choose to follow a career in communitymedicine. Is there an opportunity that this is the start of a dooropening for students here to learn about primary care in differentsettings or for students from Sri Lanka experiencing communitybased medical education?

Primary care at present is delivered from privately owned andrun small centres with no continuity of care for patients who canattend any clinic at any time for any condition. There is noguarantee that the expertise required is available. The majority of

care is delivered through hospital settings which tend to beprivately owned.

I was also invited to the opening a new primary care centre atKondavil that has been developed by the Faculty of Medicine atJaffna University. This is the first of its kind to provide a settingfor undergraduate students the opportunity to see primary acredelivered by primary care physicians. They will be supported byallied health professionals, midwives and psychology services.The concept of a primary health care centre is born!

I was also pleased to visit another centre that is being developedby Dr Poologanathan, one of our GP tutors and DrSurenthirakumaran. This centre will be the first communitybased education centre linked to a general practice and willprovide the first Health Care Assistant Training programme. Theyhope to open in the very near future. This could be anopportunity for our educators to be involved in the delivery ofhealthcare education in Sri Lanka. Anybody interested?

Please see the link to the full speech delivered in Sri Lanka—http://www.gptutorbartsandthelondon.org/newsletter.html

Dr Ann O’BrienCBME

apparent that our non clinicians wanted to teach more. This hasbeen so useful for our practice and would never have happenedwithout the students’ hard, honest work. The practice has nowdone a rota so that our nurse and practice administrator aremore involved in teaching.

I feel proud that the students were able to give us such honestfeedback and feel that due to these two talented youngcolleagues the practice learned something very useful- wewonder who was the teacher and who was the learner here?

The whole practice wishes to extend its thanks to the "teaching"that our final years gave us and we wish them the very best intheir careers.

Dr Farzana Hussain, The Project Surgery


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www.gptutorbartsandthelondon.org

Issue 13, December 2012

My current second years on EPC unit, are keen to engage inethical debate about topics they are studying.

Under human development we had a lively discussion aboutwomen having the right to a caesarean section; this was reallybrought to life when we saw a patient who had a ventousedelivery and wishes that she had been given the chance to have acaesarean. In locomotor we discussed whether sports medicineshould be available on the NHS or whether it should be chargedfor privately if it were a "lifestyle choice" injury.

"Extending patient contact extends to ethical parts that other teaching cannot reach"

Students’ reflections on patient contactAs part of the assessment of the Medicine in Society and ExtendingPatient Contact (EPC) units (in year 1 and 2 of the MBBSprogramme) students are required to reflect on their experience.They have a brief introduction to reflective practice in a lecturebefore they start their placements, but they really learn aboutreflecting on their experience in the clinical setting from our expertGP tutors, and the community tutors that support the delivery of theMedicine in Society module in Year 1. Tutors and students haverequested examples of reflections, and samples of different stylesand depths of reflections, with some feedback are now available onour website. These are also available to students either via ourwebsite or via Blackboard.

Below are some of the reflections submitted by a Year 1 student toDr Jim Lawrie at Royal Docks Medical Practice. The student isreflecting on the child they met on the last day of their MedSocplacement - the Young Child day; and on their own professionaldevelopment.

This week when we visited Lily and her mother I was incrediblysurprised to see how much work having a young child involved andthis was made more apparent by the fact that Lily had Down’sSyndrome. She needed much more attention than normal childrenbecause she was less stable on her feet and would fall quite a lotand she was also more ‘reckless’ because she didn’t seem to learnas quickly as other children. Her mother explained that she wouldoften get the grater out of the cupboard and grate her hands andthis is why she felt she had to watch her all the time.

I found that Lily’s mother was very overprotective of her daughterand she felt that she needed to shield her from people who didn’tunderstand Down’s Syndrome and this was why she was veryreluctant to send her daughter to nursery. She also felt that herdaughter wasn’t quite ready to go to nursery because she hadn’t yetlearnt how to interact with other children and was very attached to

her mother and was not ready to leave her. I found it amazing athow much she did for her daughter and how much love she hadfor her even when her life had changed completely and wasmuch more difficult. She didn’t have any time for herself and yetwhat was amazing about her was that she didn’t sound annoyedor regretful but she loved her daughter and above anything, saidthat Lily was a joy to have.

I found it very shocking that some of the doctors were surprisedthat she was keeping the baby when she found out it has Down’ssyndrome and acted quite rudely towards her. I think that thisbehavior is really dreadful; especially from members of the healthprofession because a baby with Down’s syndrome is still able toenjoy a good quality life and I think it’s important to keepprejudices out of the situation when interacting with patients.

I think overall, MEDSOC has been really useful in being able tomeet patients and be able to talk to them about their experiences.I think as a future doctor, it is really useful to understand patientsand their individual stories, because there’s much more to adisease or condition than just the medical symptoms themselves.It is also really inspiring sometimes to see how hopeful andoptimistic the patients can be with their circumstances and I thinkit has helped me to develop much more empathy towardspatients and has been a very enriching experience.

For me this illustrates really well what I hope students will ‘get’from their MedSoc placements i.e. an ability to recognize thepatient as an individual rather than simply focusing on thepatient’s illness or their ‘problem’. I am very grateful to you, thetutors that model reflective practice and support our students tobecome reflective practitioners themselves,

Maria Hayfron-Benjamin,CBME

What is remarkable about my group is that they are happy tohold these ethical conversations which have no easy answer andrespect each other’s differing views but also speak their mind.

I am so pleased that my group are asking questions and remaincurious about issues rather than just rote learn facts.

Great debating and good luck to my young colleagues for theirfuture.

Dr Farzana Hussain, The Project Surgery


Farewell to Dr Christopher DerrettDr Christopher Derrett has retired after 18 years atBarton House Group Practice. We have had the pleasureof having Dr Derrett as one of our GP tutors for manyyears and we thank him for his massive contribution tosupporting undergraduate Education at Barts and TheLondon. All of us at CBME would like to wish him all thebest in his retirement.

About 30 GP tutors attended this neweducational event and engaged withenthusiasm and energy in the sessions.This course was for new GP tutors butwe welcomed any GP tutor seeking ageneral update in their teaching skills.We focussed on how to facilitate student-centred learning through a number oftopics including lesson planning, learningneeds analysis, setting group rules,considering a wide variety of educationaldelivery methods and when and how tofeedback to students. Other genericareas that we addressed includedevaluation and reflection, though giventhe time contraints we had to skim overthese somewhat. As well as the plenarysessions with opportunities for pairedand small group work, there were alsoyear specific workshops and of course

GP tutor induction training event, 19th Sept, 2012the coffee breaks for time to dialoguearound challenges, solutions, the joysand struggles that you face in facilitatingmedical student learning.

Using paper feedback at the end of thesession we managed to secure a 90%feedback rate. Most of the quantitativeratings on the organisation andeducational value of the day fell withinthe excellent and good categories(although a few of the attendees thoughtthe food was rather satisfactory).

Qualitatively some of the key pointsraised included:

• GP tutors liked the signposting toeducational resources, meeting andsharing knowledge with each other, smallgroup discussions and the broadoverview of educational topic areas. Not

so good was too much information, toolittle time, the didactic part, too muchbreaking into pairs.

• Future topics suggested byparticipants included ‘student-centredlearning’, managing the difficult student,lesson planning, assessment, learningresources including e-learning and howthe GP placement fits into theundergraduate student curriculum.

We will take forward some of these ideasinto our next Clinical training event (6thMarch 2013, 12.20-16.30) for GP tutorsteaching years 3, 4 and 5 and until thenI will leave you with my favouritefeedback quote from the day:

Your ‘reassuring smile’ was very helpful

Dr Louise Younie CBME

Dates for 2013ITTPC training course dates are:6th February 2013 - 7th February 2013.

CBME training dates are: Tutor training: 6th March 2013Business Meeting: 6th February 2013 Summer Education Meeting: 5th July 2013

Contact the Editorial TeamThis is your newsletter. If you have anysuggestions for future content, usefulteaching tips, teaching resources orexperiences you would like to share pleasesend us your contribution.

Lynne Magorrian [email protected]

Rosie [email protected]

Academic Unit for Community-Based MedicalEducation, Garrod Building, Turner Street,Whitechapel, London E1 2AD

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December 2012 Issue 13

Barts and The London School of Medicine and Dentistry, Academic Unit for Community-Based Medical Education, Garrod Building, Turner Street, Whitechapel , E1 2AD.

The new term hasbrought about a lot ofchanges to the staffhere at CBME.Barbara Summershas retired, and is offaround the world onher travels. HollyRiches has also left,but she’s not gonetoo far and has

started her new job in the Business School hereat Queen Mary. Both Barbara and Holly will bemissed and we wish them both the best of luckin all that they do. Janet Johnstone is currentlyon maternity leave and has recently given birthto a healthy baby boy called Alexander.

These departures meanthat new faces havejoined CBME;

Year 1 and 2 MedSoc:Rosie Murphy,[email protected]

Year 2 EPC and year 3:Paula Jones,[email protected]

Year 4 and SSC: KateScurr,[email protected]

Changes at CBME


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Newsletter 13