… at the …
Number 80
Monthly news
Emma Phillips (F2 trainee) writes:‘Not Quite Peer’- Assisted Learning : Foundation
Doctors Teaching Programme for Final Year
Students.
As a final year medical student I remember grumbling
with others about the well-intentioned but sometimes
seemingly rambling teaching we were receiving which
we (in our great wisdom!) thought ‘got in the way’ of our
other finals revision. In an attempt to counteract student
grumbles, across the Trust, foundation trainees have
been running a programme of organised teaching for 5th
year medical students. There are several advantages to
foundation doctors providing teaching for the final year
students – firstly, we have just crossed the same (or
similar) hurdles to those they are facing, secondly we
have a good idea of what they want and in addition
thirdly, we hopefully have a better idea than them of
what they actually need when it comes to teaching!
Fourteen trainees in Cheltenham and a similar number in
Gloucester came together at the start of the academic
year and under the initial guidance of Simon Atkinson
and Dr Peter Fletcher (UoB Academy Dean) agreed
upon a basic structure of teaching sessions. These
tutorials aimed to cover the 5th year syllabus in twentyfive weekly sessions from November, when the students
returned from elective, to May, when finals began in
earnest. After the preliminary meeting, all subsequent
management, planning and teaching has been carried
out by foundation trainees, with a little administration
assistance from the very helpful Academy team.
During the initial planning, we all intended to attend as
many sessions as possible both to learn from each
other’s teaching styles and to give a helping hand if it
was needed. Unfortunately due to pressures of service
provision this idea soon fell by the wayside and a single
foundation trainee ran most tutorials.
Topics covered included overviews of all basic medical
(respiratory, gastroenterology, renal, cardiology and
neurology) and surgical (colorectal, upper GI, vascular,
breast, ophthalmology, ENT) specialties as well as some
palliative care and oncology (a major part of the 5th year
syllabus in Bristol), acute and emergency medicine (ABC
approach to the patient, poisoning and alcohol). In
addition to this selection of largely didactically taught
topics, we included a couple of sessions on clinical
examination for the long-case examinations (OSLERS),
a DOSCE/OSCE expertly run by Dr James Fasham (F1
1st July 2010
trainee) and a final session on ‘top tips for finals’ run
by myself, in which I offered to cover whatever the
students wanted on the day as well as providing
them with all the things I wished I’d known before
sitting my final exams! Dr Tom Massey produced a
‘Google Calendar’ which the students could access,
telling them the topics and times of teaching
sessions.
Around half of the trainees running the programme
had attended Bristol University themselves, and
therefore had ‘insider’ knowledge on the structure
and standards required for finals examinations.
Alongside this, students benefitted from trainees who
had different experiences and teaching at other
universities. Discussing amongst ourselves, I was
surprised how much the final exams can vary
between different universities.
Bristol University has a strong tradition of peerassisted learning, with the PALS scheme proving a
very popular option for 5th year SSCs. To me,
however, this programme felt like it should be a little
different, with that hurdle of ‘finals’ separating
foundation trainees and final year students.
I have enthusiastically taught younger students,
peers and colleagues throughout my time at medical
school and my foundation training, but never had any
formal training. Most of the teaching I have done has
been of an ‘ad hoc’ nature, or at the bedside. In our
programme each session was scheduled to last
ninety minutes and I was certainly daunted by the
thought of having to stand up in front of students who
(let’s face it, with all the reading they’d hopefully
been doing by the end of the year) should have had
their brains stuffed with far more medical textbook
facts than mine is currently. Added to this the fact
that most foundation trainees are trying to fit the
teaching into a busy rota, and you have some idea of
the achievement it was to make the programme!
As I mentioned, I have no formal teaching training;
this was the case for most of the foundations doctors
who provided the tutorials. Despite this, talking to
colleagues and students, it was clear that we all did
our best to use a range of teaching styles and aids to
maximise the students’ learning. I myself spent some
time thinking about senior colleagues whose
teaching I have found inspirational in my training,
and what exactly it was they did which underpinned
their success as a tutor.
My sessions were all in the last couple of months
approaching finals, so I did my best to tailor the teaching
to what the students wanted to cover. For instance, in a
session on clinical neurology, I went with several
different aspects prepared – some examination
techniques, a short ‘PowerPoint’ presentation with
didactic teaching on the major topics of stoke and
epilepsy, and some case-based discussions. I then
offered the students a choice of what they wanted the
most; they picked cases. I ran the session as if I was
several different patients presenting with one of the topic
headings
(headache,
falls,
transient
loss
of
consciousness etc). The students had to work through
the cases out loud as if they were the admitting doctor. I
think that foundation doctors, perhaps more than senior
colleagues, have a greater awareness of the need for
students to prepare for life as a junior doctor, not just for
finals, and therefore slip some more practical scenes into
their teaching.
Slightly more bravely, in my last ‘top tips for finals’
session, I offered to cover anything the students wanted.
Taking a chance on them likely wanting the same things
as I remembered wanting to revise myself, I produced a
PowerPoint with a large selection of ECGs, X-rays and
CTs,
clinical
biochemistry
scenarios,
ABG
interpretations,
spirometry,
ophthalmology
and
dermatology pictures and some other bits and pieces.
Luckily my hunch was right and we had an enjoyable
session working through ways to approach these
different topics in the final exams!
Feedback from the students on the whole programme
was very positive and the other trainees I have spoken to
all felt that doing the teaching was a great experience.
Obviously, with the heavy focus on ‘portfolio’ and
revalidation, recording teaching and training experience
is an important aspect of progressing as a doctor, but
this is certainly not the only reason to get involved- I
myself felt I had gained confidence in my own ability to
do public speaking, answer difficult questions, and
communicate learning objectives over the sessions I
taught. I have been left with an enthusiasm to progress
further with teaching and hope to carry out some formal
training in the next few years. This is perhaps something
the Academy could look into for the junior doctors who
put their own free time and energy into running this
popular programme of teaching.
Thanks go to:
The other junior doctors involved At CGH: Dr Anna Paes, Dr Emily Darvill, Dr Isabelle
Cooper, Dr Helena Barton, Dr Georgina Hatton, Dr Frances
Seymour, Dr Tom Massey, Dr Joanna Lambert, Dr James
Fasham, Dr Joanne Gill, Dr Zara Edwards, Dr Nick Eastley
and Dr Sarah Lancaster.
At GRH: Dr Lawrence Bell, Dr Joanna Kyte, Dr Harry
Thangavel, Dr James McEwan, James Warbrick-Smith, Dr
Lara Gibbs, Dr Nicola Hannaway, Dr Emily Buckwell, Dr
Kate Greenhalgh, Dr Steven Bailey, Dr Simon Trotter, Dr
Ben Sieniewicz, Dr Michael Lacey, Dr Laura Beard, Dr
Matthew Govier, Dr Andrea Waldecker, Dr Sarah Oakley
and Dr Helen Green
And to Academy Team, most particularly Emily
Shingleton-Smith, for her very helpful administration of
the programme!
University of Bristol
Centre for Medical Education
David.Cahill@bristol.ac.uk (Director of Medical Education)
Tim.Lovell@bristol.ac.uk (Director of Student Affairs)
General Practice
debbie.sharp@bristol.ac.uk
Andrew.Blythe@bristol.ac.uk
Consultant Senior Lecturer General Practice (Glos)
Anne.Hampton@gp-l84077.nhs.uk
Teaching and Learning for Health Professionals Certificate course
http://www.medici.bris.ac.uk/tlhp
Stephen.Greenwood@bristol.ac.uk
Medical Dean University of Bristol at Gloucestershire
(GRH Ex 6230) [also enquiries re electives and preparing for
professional practice (PfPP)
Peter.Fletcher@glos.nhs.uk
Undergraduate Skills Lead (GRH 5667)
Hannah.Chant@glos.nhs.uk
Undergraduate Medical Education Coordinator (GRH Ext 6231)
Angie.Coulson@glos.nhs.uk
Undergraduate Administrator (GRH Ext 6233)
Emily.Shingleton-Smith@glos.nhs.uk
Leads for Curriculum Units within Gloucestershire NHS
Year 3 Junior Medicine and Surgery
Caroline.Rodd@glos.nhs.uk
Paul.Morrish@glos.nhs.uk
Year 3 Musculoskeletal Diseases, Emergency Medicine &
Ophthalmology ‘MDEMO’
Philip.Davies@glos.nhs.uk
Year 3 Psychiatry (2gether NHSFT)
Attila.Sipos@bristol.ac.uk
Year 3 Ethics
Royse.Murphy@nhs.net
Year 3 Ophthalmology
Richard.Caesar@glos.nhs.uk
James.Nairne@glos.nhs.uk
Year 4 O&G and neonates (‘RHCN’)
Philip.Kaloo@glos.nhs.uk
Isaac.Babarinsa2@glos.nhs.uk
Russell.Peek@glos.nhs.uk
Year 4 paediatrics (‘COMP1’)
Simon.Ackroyd@glos.nhs.uk
Alison.Rushforth@glos.nhs.uk
Year 4 CoE, GP& Dermatology (‘COMP2’)
Pauline.Morrow@glos.nhs.uk
Sangeeta.Kulkarni@glos.nhs.uk
Anne.Hampton@gp-l84077.nhs.uk
Tom.Millard@glos.nhs.uk
Year 4 Pathology
Rebecca.Frewin@glos.nhs.uk
Year 4 Anaesthesia
Mahesh.Parmar@glos.nhs.uk
Daniel.Evans@glos.nhs.uk
Year 5 Oncology and Palliative Care
Kim.Benstead@glos.nhs.uk
Year 5 Medicine
Tripti.Mahajan@glos.nhs.uk
Ian.Crossley@glos.nhs.uk
Year 5 Surgery
Mark.Vipond@glos.nhs.uk
James.Wheeler@glos.nhs.uk