22 results found
Parekh R, Jones MM, Singh S, et al., 2021, Medical students’ experience of the hidden curriculum around primary care careers: a qualitative exploration of reflective diaries, BMJ Open, ISSN: 2044-6055
Dutta N, Maini A, Afolabi F, et al., 2021, Promoting cultural diversity and inclusion in undergraduate primary care education, EDUCATION FOR PRIMARY CARE, Vol: 32, Pages: 192-197, ISSN: 1473-9879
Alboksmaty A, Kumar S, Parekh R, et al., 2021, Management and patient safety of complex elderly patients in primary care during the COVID-19 pandemic in the UK—Qualitative assessment, PLoS One, Vol: 16, Pages: 1-17, ISSN: 1932-6203
ObjectivesThe study aims to investigate GPs’ experiences of how UK COVID-19 policies have affected the management and safety of complex elderly patients, who suffer from multimorbidity, at the primary care level in North West London (NWL).DesignThis is a service evaluation adopting a qualitative approach.SettingIndividual semi-structured interviews were conducted between 6 and 22 May 2020, 2 months after the introduction of the UK COVID-19 Action Plan, allowing GPs to adapt to the new changes and reflect on their impact.ParticipantsFourteen GPs working in NWL were interviewed, until data saturation was reached.Outcome measuresThe impact of COVID-19 policies on the management and safety of complex elderly patients in primary care from the GPs’ perspective.ResultsParticipants’ average experience was fourteen years working in primary care for the NHS. They stated that COVID-19 policies have affected primary care at three levels, patients’ behaviour, work conditions, and clinical practice. GPs reflected on the impact through five major themes; four of which have been adapted from the Safety Attitudes Questionnaire (SAQ) framework, changes in primary care (at the three levels mentioned above), involvement of GPs in policy making, communication and coordination (with patients and in between medical teams), stressors and worries; in addition to a fifth theme to conclude the GPs’ suggestions for improvement (either proposed mitigation strategies, or existing actions that showed relative success). A participant used an expression of “infodemic” to describe the GPs’ everyday pressure of receiving new policy updates with their subsequent changes in practice.ConclusionThe COVID-19 pandemic has affected all levels of the health system in the UK, particularly primary care. Based on the GPs’ perspective in NWL, changes to practice have offered opportunities to maintain safe healthcare as well as possible drawbacks that should b
Lalloo F, Hawkins N, Lindley R, et al., 2021, Medical students as service learners: opportunities, risks and recommendations, EDUCATION FOR PRIMARY CARE, Vol: 32, Pages: 135-139, ISSN: 1473-9879
Neve G, Fyfe M, Hayhoe B, et al., 2020, Digital health in primary care: risks and recommendations., British Journal of General Practice, Vol: 70, Pages: 609-610, ISSN: 0960-1643
Growing demand for access to NHS primary care means services are under increasing pressure. Many GP providers are using digital technologies (video/email/other online consultations) to try to improve access and efficiency. Alongside this is rapid growth in health technologies, which collect, measure, or interpret health data, and provide health information or advice. Many technologies have positive potential; however, the speed with which they are becoming available, increasingly blurred boundaries between health and lifestyle technologies and traditional healthcare provision, and the confidence and skills GPs have in using digital health technologies, bring new complexities and concerns.
Maini A, Fyfe M, Kumar S, 2020, Medical students as health coaches: adding value for patients and students, BMC Medical Education, Vol: 20, Pages: 1-8, ISSN: 1472-6920
BackgroundUnderlying the global burden of chronic disease are common and modifiable risk factors such as unhealthy diet, physical inactivity and tobacco use. Health coaching is being introduced into healthcare as an effective tool in facilitating behaviour change and addressing lifestyle risk factors in patients. Although some medical schools are training students in health coaching, there is little research on this emerging practice. This qualitative study explores the experience and application of health coaching approaches by third year medical students that have been trained in health coaching.MethodsSix focus groups were conducted with medical students (n = 39) who had participated in an experiential health coaching training module and practiced their health coaching skills in primary care settings. Interactive facilitated discussions between students aimed to explore experiences of health coaching, how this related to their ongoing practice, and their perceived impacts of engagement with patients. Data was thematically analysed.ResultsThemes emerged around ‘mindset’, ‘skills’, ‘application of skills’, ‘perceived value’ and ‘context’. Training in health coaching prompted a shift towards a non-judgemental, solution-oriented mindset in which students increasingly accepted the ability of each person to define their needs and identify individually appropriate solutions. Mindset change supported skill development in person-centred communication, active listening, and self-refection. Mindset and skills related to changes in how students conducted patient consultations, their practice of self-refection, and their personal relationships. Perceived value of coaching approaches reinforced mindset. Students described facilitators to their coaching practice, and also tensions due to misalignment between their coaching mindset and ongoing practices in medical education and service delivery.Conclusions
Tanna S, Fyfe M, Kumar S, 2020, Learning through service: a qualitative study of a community-based placement in general practice., Education for Primary Care, Pages: 1-6, ISSN: 1367-8523
Undergraduate students often lack opportunities for active, authentic roles with subsequent transitions to post-graduate training presenting abrupt changes in responsibilities. Service learning, where students contribute in their workplace, can facilitate assumption of active roles earlier in training. We aimed to identify features supporting service learning on primary care clinical placements. We undertook focus groups with third-year medical students participating in primary care placements designed around the concept of service learning. Participants discussed experiences; team roles; responsibilities, and resultant learning impacts of these. Data was thematically analysed. Four themes emerged as features related to effective service learning: (1) responsibility; (2) supervision; (3) working with uncertainty; (4) service learning barriers. Supervised student led clinics were effective in providing opportunities for service and learning simultaneously. Students felt they contributed to patient care through authentic interactions, and this sense of responsibility drove learning. Barriers included setting unrealistic student expectations, inadequate supervision and practice logistics such as constrained room space. This study concludes that authentic clinical experience integrated with responsibility are key features when designing service-led clinical placements, with resultant impacts on motivation, building resilience, managing uncertainty, and developing communication skills. Service learning in general practice settings may help support effective transitions to postgraduate training.
Lawson E, Kumar S, 2020, The Wass report: moving forward 3 years on., Br J Gen Pract, Vol: 70, Pages: 164-165
Houbby N, Abdelwahed A, Kumar S, 2020, A reflection on Imperial College London’s Community Action Project, Education for Primary Care, Pages: 1-2, ISSN: 1473-9879
The diverse and versatile roles that doctors today hold highlight the importance of encouraging personal and professional development within medical students enabling them to become confident leaders and innovators. The introduction of core curriculum projects such as the Community Action Project (CAP) endorses the development of skills required to prepare all students for their future role as doctors. The aim of this report is to reflect on our experiences having taken part in the CAP during our third year at medical school. The CAP at Imperial College London provides all medical undergraduates in their third year of medical school with an opportunity to undertake a quality improvement project. The CAP required students to engage with the local community and members of staff at the general practice to identify a need and deliver an appropriate intervention which was then evaluated. The CAP enabled us to deliver an intervention in the form of a creative stop-motion video created with patients at the practice. The project encouraged students to find creative ways to tackle prominent health-care issues within local communities and also acted as a stepping-stone for students to consider how to tackle larger healthcare issues on a national scale.
Fyfe MV, Maini A, Horsburgh J, et al., 2020, Racism in medical school Widening participation: moving from diversity to inclusion, BMJ: British Medical Journal, Vol: 368, Pages: 1-1, ISSN: 0959-535X
Kumar S, Lawson E, 2019, The Wass report: moving forward three years on, British Journal of General Practice, ISSN: 0960-1643
Craddock P, Maini A, Horsburgh J, et al., 2019, Lifetimes of the clinical consultation: the current situation of healthcare consultations, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 69, Pages: 506-507, ISSN: 0960-1643
Maini A, Neusy A-J, Palsdottir B, et al., 2019, Developing socially accountable UK medical schools, CLINICAL TEACHER, Vol: 17, Pages: 320-322, ISSN: 1743-4971
McKeown A, Mollaney J, Ahuja N, et al., 2019, UK longitudinal integrated clerkships: where are we now?, Education for Primary Care, Pages: 1-5, ISSN: 1473-9879
In this article, we discuss whether it is possible for UK institutions to influence the international longitudinal integrated clerkship (LIC) narrative, in the context of supplying future clinicians to a fragmented health service that is battling a General Practice recruitment crisis. Perhaps more importantly, we will discuss whether the ‘LIC model’ fits the UK undergraduate framework. We intend to present some emerging evidence of LICs in the UK, informed by a UK-wide survey and observations from a 2019 UK LIC think tank and then discuss whether the global CLIC definition applies to the UK context with possible ways forward.
Simpkin A, McKeown A, Parekh R, et al., 2019, Identifying central tenets needed in our education systems: results from a pilot integrated clinical apprenticeship, Medical Teacher, ISSN: 0142-159X
Purpose:The ability of healthcare systems to deliver world-class compassionate care depends on the quality of training and education of staff. Matching student-centered learning with patient-centered care is the focus for much curricula reform. This study explores the effect a novel longitudinal curriculum had on medical students’attitudes and experiences to better identify central tenets needed in our education system. Methods:Single-center, qualitative focus-group study conducted in 2017 of medical students in a longitudinally integrated clinical apprenticeship at a large UK medical school. Students were randomly assigned to focus groups to describe their educational journey and explore how longitudinal learning prepared them for a medical career, valuing their unique pos- ition as student participants in the healthcare system. Results:Four themes emerged from students’experiences: navigating the patient journey, their professional development, their learning journey, and the healthcare system. Conclusions:Listening to student voices lends insights for educators refining educational models to produce doctors of tomorrow. This project identified the educational value of students having authentic roles in helping patients navigate the healthcare system and the benefits of consistent mentorship and greater autonomy. The gulf between gaining skills as a future doctor and gaining skills to pass summative exams calls into question assessment methods.
Wilkinson E, 2018, GP recruitment: could an undergraduate apprenticeship create the generalists the NHS needs?, BMJ, Vol: 363, ISSN: 0959-8138
Tanna S, Ryan N, Kumar S, 2018, The IMPACT Q framework: teaching medical students how to gather a psychosocial history, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 68, Pages: 41-42, ISSN: 0960-1643
Heyhoe B, Verma A, Kumar S, 2017, Shared medical appointments, BMJ, Vol: 358, ISSN: 0959-8138
Majeed A, Kumar S, 2017, Commentary on "Changes in the Roles of Health Care Professionals in Primary Care in England's National Health Service", Journal of Ambulatory Care Management, Vol: 40, Pages: 189-192, ISSN: 0148-9917
Simpkin AL, McKeown AM, Parekh R, et al., 2017, A novel Integrated Clinical Apprenticeship: transforming medical students into student doctors, EDUCATION FOR PRIMARY CARE, Vol: 28, Pages: 288-290, ISSN: 1473-9879
Ahluwalia S, de Silva D, Kumar S, et al., 2013, Teaching GP trainees to use health coaching in consultations with patients: evaluation of a pilot study., Educ Prim Care, Vol: 24, Pages: 418-426, ISSN: 1473-9879
PURPOSE: The purpose of this paper is to describe the results of an evaluation of teaching health coaching to GP trainees for use in consultations with patients. DESIGN: Fourteen GP trainees were invited to attend a coaching skills training course. Each trainee was asked to apply coaching skills to up to four patients with long-term conditions. The evaluation used observation, surveys, review of trainee portfolios, and interviews with GP trainees, patients, and other stakeholders. FINDINGS: This evaluation found that it is feasible and useful to train GPs in health coaching. It had positive benefits for GP trainees, their patients, and the wider system. Lessons were also learned about the timing of the training, the style and content, the challenges of practising coaching skills within clinical practice, and selecting the most appropriate patients for coaching. LIMITATIONS: This is a small pilot with a keen group of GP trainees. Further research is needed to determine if such an approach provides meaningful changes to patient outcomes and whether such approaches are cost-effective.
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