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Across the United Kingdom, medical schools are acknowledging the need to respond to inequalities experienced by minority groups, racism within healthcare, and the need to decolonise medical curricula. Understanding the impact of structural racism is increasingly recognised as part of health professionals' training. In this paper we report the delivery of a new lecture and workshop on racism to first year medical students at Hull York Medical School, aimed to teach students about structural racism and the impact it has on health and healthcare services. Whereas comparable training programmes focus on personal values of inclusivity and diversity, these sessions encourage students to consider the reality of racism as part of health and healthcare experiences. The session includes conceptual content alongside applied examples of microaggression experienced by a healthcare professional. We report the results of student feedback attained through surveys using Likert scales and free text. We conclude by discussing the benefits of teaching medical students about racism, and its impact on patients and staff, rather than just inclusive practice.

— Alcohol misuse constitutes a major problem in our modern society and both physical and mental alcohol-related harm result in a large number of Accident and Emergency (A&E) attendances, thus imposing a significant burden on the workload and financial resources of the department. The current management of problem drinking by most A&E departments could be further improved. The introduction of a holistic approach that includes efficient screening instruments and effective brief, anti-alcoholic interventions, for the management of these patients must be considered. This should strengthen the preventive role of A&E departments, and, in the long term, may result in a decrease in the number of cases of alcohol misuse and in alcohol-related attendances. [ABSTRACT FROM PUBLISHER]

This paper reports on the findings from a study undertaken to explore students' perceptions of the timeliness, accessibility, consistency, and quality of feedback and grading received electronically. The system used was GradeMark®, an electronic tool available through the plagiarism software provider, Turnitin®. 296 students from the Schools of Nursing and Midwifery, Medicine, and Dentistry at Cardiff University were included in the study. Data collection included an online survey and a focus group for each discipline. Findings revealed that the use of GradeMark® improved the timeliness and accessibility of feedback due to its immediate availability via any personal computer with internet access. The use of annotation was proven to be valuable; however consistency and quality of feedback were affected by markers' individual comments, issues which GradeMark® may not necessarily address. Findings provide insight into what quality feed-back could look like from the students' perspective, which can help improve academic practice. Overall the study outcomes suggest there are benefits to using innovative technology such as GradeMark® to enhance learning. The paper provides valuable lessons that could assist others in adopting a pragmatic and planned approach to the introduction of electronic feedback using a system such as GradeMark®.

Despite the burgeoning rhetoric from political, social and educational commentators regarding creativity and learning and teaching, there is a paucity of scalable and measurable examples of creativity-centric pedagogical practice. This paper makes an argument for the application of social network visualisations to inform and support creativity-enabling pedagogical practice. This paper first describes social networks and how they relate to creative capacities and learning as a social process. It then provides an initial case study of how social network analysis may be meaningfully applied to evaluate students' learning networks and creative capacities, and elaborates on how such an evaluative resource can allow educators to design and implement creativity-enabling pedagogical practice. In so doing, this paper contributes conceptual, methodological and empirical advances that can take learning and teaching for creativity, particularly in higher education, beyond rhetoric towards more observable and measurable mainstream pedagogical practice. (Contains 1 figure and 5 tables.)

Doctoral research considered whether healthcare students were able to develop characteristics of Communities of Practice when engaged in an interprofessional online module. Using a case study approach the research included two phases. Within phase one a questionnaire was administered to the group of 109 healthcare students. These were analysed to gain information on which to base sampling for the subsequent phase. Phase two employed three strands of data collection; five students completed an online diary, the online interaction of seven students was captured on a discussion board and three students were interviewed. Data were analysed using a form of pattern matching. The results suggested students were able to develop the essential elements of Communities of Practice. This was not uniformly seen however, and particular issues emerged for the online community. This paper focuses on discussing the contribution of the research to the development of the Communities of Practice framework for online learning. The discussion will review the main findings of the research, showing how these have led to the development of the theory. It offers an augmented framework, in which the elements of mutual engagement, joint enterprise and shared repertoire are enhanced to include those facets necessary to support an online learning community. Finally, it is suggested that the augmented framework may have applicability to other professional groups engaging in online learning and working, with consideration given to how it might support e-based communities.

Background: Students must be proficient in surgical skills according to General Medical Council and Royal College of Surgeons of England guidelines. If these skills are not appropriately taught, there is a risk of an incoming junior workforce with inadequate surgical skills. This paper aimed to review the literature relating to undergraduate teaching of surgical skills in the UK and summarize future suggested training methods. Methods: The databases MEDLINE, Embase and SCOPUS were searched, and the existing literature relating to methodology of undergraduate teaching of surgical skills in the UK over the past 10 years was summarized. The Medical Education Research Quality Instrument was used to assess research quality. Results: A total of 19 papers were included. Cross-sectional evaluations and survey-based studies highlight a clear deficit in surgical skills teaching in the UK. Medical students are currently unable to fulfil their own learning needs and meet requirements set out by the General Medical Council. This lack of surgical teaching appears to negatively affect student desire to pursue a surgical career. The three main themes for improvement are extracurricular surgical skills days, near-peer teaching and simulation. Each method appeared to improve learning, although no studies utilized medium- to long-term follow-up to demonstrate efficacy and there lacks a clear consensus as to the 'standard' of undergraduate surgical skill education. There was also potential for selection bias and response shift bias in many of the studies assessing pre- and postintervention confidence and opinions. Conclusion: There is a concerning lack of surgical skills teaching that has resulted in medical students and junior doctors not having the necessary surgical skills as per General Medical Council guidance and students feel that their own learning needs are not met. This failure to address the learning deficit may be responsible for the fall in surgical competition ratios. While surgical skills teaching must be improved urgently, more robust evidence is required to evaluate the optimal ways of approaching this issue. Undergraduate medical students must be proficient in certain surgical skills as set out by General Medical Council and Royal College regulations. There appears a deficit in such teaching which we have discussed and attempted to address in terms of alternative methodology reported in the literature that can be used to teach these basic surgical skills. [ABSTRACT FROM AUTHOR]

Aims Newly graduated doctors write a large proportion of prescriptions in UK hospitals but recent studies have shown that they frequently make prescribing errors. The prescribing safety assessment (PSA) has been developed as an assessment of competence in relation to prescribing and supervising the use of medicines. This report describes the delivery of the PSA to all UK final-year medical students in 2016 (PSA2016). Methods The PSA is a 2-hour online assessment comprising eight sections which cover various aspects of prescribing defined within the outcomes of undergraduate education identified by the UK General Medical Council. Students sat one of four PSA 'papers', which had been standard-set using a modified Angoff process. Results A total of 7343 final-year medical students in all 31 UK medical schools sat the PSA. The overall pass rate was 95% with the pass rates for the individual papers ranging from 93 to 97%. The PSA was re-sat by 261 students who had failed and 80% of those candidates passed. The internal consistency (Cronbach's alpha) of the four papers ranged from 0.74 to 0.77 (standard error of measurement 4.13-4.24%). There was a statistically significant variation in performance between medical school cohorts (F = 32.6, P < 0.001) and a strongly positive correlation in performance for individual schools between PSA2015 and PSA2016 ( r = 0.79, 95% CI 0.61-0.90; P < 0.01). Conclusions PSA2016 demonstrated the feasibility of delivering a standardized national prescribing assessment online. The vast majority of UK final-year medical students were able to meet a prespecified standard of prescribing competence. [ABSTRACT FROM AUTHOR]

For decades, debates over medical curriculum reform have centred on the role of science in medical education, but the meaning of "science" in this domain is vague and the persistence of the debate has not been explained. Following Bourdieu, this paper examines struggles over legitimate knowledge and the forms of capital associated with science in contemporary UK medical education. Data are presented from a study of two UK medical schools, one with a traditional, science-oriented curriculum, another with an integrated curriculum. Constructions of legitimate knowledge were explored at both schools through six months participant observation, interviews with faculty members (n = 15) and students (n = 37) and documentary analysis. Findings show that medical schools compete for both scientific and clinical capital, but ultimately science has greater legitimacy. "Science" is defined in accordance with the structure of the traditional curriculum and has become a symbolic resource--a mark of distinction for both medical schools and medical students--which is equated with clinical competence. The significance of science is circumscribed by the medical education field, yet the struggles for scientific capital there have ramifications beyond medical education itself. It is argued that Bourdieu's concepts are particularly useful tools for studying the meanings that science takes on outside of the scientific field.

The article focuses on the need for reform in the selection procedure of medical students in Great Britain. Information on the selection procedure of medical students in the country is presented. Failures of medical schools in adopting a changing society and applying cumulative experience of other professions in selection techniques have been mentioned. However, some opportunities have been offered by the current alterations in the school examination system for change and experimentation.

This letter summarises the perspectives of medical students in the United Kingdom (UK) on the research paper conducted by Wang and colleagues (2023) titled 'Achievement Emotions of Medical Students: Do They Predict Self-Regulated Learning and Burnout in an Online Learning Environment?'. Overall, we find this paper a positive contribution to the literature surrounding medical education. However, we have highlighted some weaknesses in the study design and proposed additional points for exploration in further iterations of this study. We hope the readership takes the time to read our letter and consider the points we have raised. [ABSTRACT FROM AUTHOR]

Background: Otolaryngology (ENT), plastic surgery, ophthalmology and dermatology are medical specialties which tend to receive less coverage in UK medical school curricula compared to larger, generalist specialties. As a result, there are fewer opportunities for medical students to learn and to cultivate an interest. There are numerous papers that report concerns about junior doctors' ability to manage conditions within these specialties, which may jeopardise patient safety. The aim of our pilot project was to increase medical students' interest and knowledge of ENT, plastic surgery, ophthalmology and dermatology. In addition to describing our project, we present and discuss literature on UK undergraduate education in these specialties and its impact on preparedness of junior doctors and future career choices. Methods: One hundred twelve final year medical students at Newcastle University were invited to take part in a voluntary two-part (written and clinical) exam, in which prizes could be won and all participants would receive a certificate of participation. We distributed two online surveys to the students, one administered before the exam and one afterwards. Data was collected regarding the students' motivation for entering the prize exam and the students' baseline interest and knowledge in these specialties before and after the prize exam. Free-text responses were collected about the students' opinion of the project and whether participation was beneficial. Results: Sixteen students participated in the exam. There was a statistically significant increase in the students' knowledge in ENT (p < 0.000), plastic surgery (p < 0.000), ophthalmology (p < 0.028) and dermatology (p < 0.012) after participation in the exam, but not in their interest levels. ENT was the preferred specialty of our cohort. The students reported that they found participation beneficial to their learning, particularly receiving exam feedback and explanations to exam questions. Conclusions: This pilot project was a useful intervention in increasing medical students' knowledge in these specialties, but not in their levels of interest. It also demonstrates that medical students are willing to participate in voluntary initiatives (in their spare time) to gain more learning opportunities and that medical students value timely exam feedback to guide their revision. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease 2019 (COVID-19) restrictions resulted in an increased emphasis on virtual communication in medical education. This study assessed the acceptability of virtual teaching in an online objective structured clinical examination (OSCE) series and its role in future education. Methods: Six surgical OSCE stations were designed, covering common surgical topics, with specific tasks testing data interpretation, clinical knowledge, and communication skills. These were delivered via Zoom to students who participated in student/patient/examiner role-play. Feedback was collected by asking students to compare online teaching with previous experiences of in-person teaching. Descriptive statistics were used for Likert response data, and thematic analysis for free-text items. Results: Sixty-two students provided feedback, with 81% of respondents finding online instructions preferable to paper equivalents. Furthermore, 65% and 68% found online teaching more efficient and accessible, respectively, than in-person teaching. Only 34% found communication with each other easier online; Forty percent preferred online OSCE teaching to in-person teaching. Students also expressed feedback in positive and negative free-text comments. Conclusion: The data suggested that generally students were unwilling for online teaching to completely replace in-person teaching. The success of online teaching was dependent on the clinical skill being addressed; some were less amenable to a virtual setting. However, online OSCE teaching could play a role alongside in-person teaching. [ABSTRACT FROM AUTHOR]

The article offers information on the consensus statement and changes to the medical ethics and law for medical students in Great Britain. It features the changes to the improved consensus statement, curriculum components, ethics and law. Moreover, it unveils the ways on how the periodical handles the papers published in the periodical.

In 2022 a new curriculum for medical students at universities in the U.K. was mandated which included teaching planetary health. In this paper the authors relate their experiences of introducing a sustainability agenda two years before this time, using planetary boundaries as a teaching tool at the Manor Hospital in Walsall, U.K. Planetary health is taught with constant relevance to how it can affect health and society. The content of the teaching material evolved over a few months until very positive feedback from students was received, who also suggested that more should be done to raise awareness of sustainability in their university. Finally challenges to this innovative venture are discussed. [ABSTRACT FROM AUTHOR]

Key concepts and theories that are taught in order to develop cultural competency skills are often introduced to medical students throughout behavioral and social science (BSS) learning content. BSS represents a core component of medical education in the United Kingdom. In this paper, we examine, through (auto)ethnographic data and reflections, the experiences of BSS in medical education. The empirical data and insights have been collected in two ways: (1) through long-term ethnographic fieldwork among medical students and (2) via autoethnographic reflexive practice undertaken by the co-authors who studied, worked, examined, and collaborated with colleagues at different UK medical schools. Our findings indicate that despite BSS constituting a mandatory, essential component of the medical curriculum, medical students did not always perceive BSS as useful for their future practice as doctors, nor did they find it to be clinically relevant, in comparison to the biomedical learning content. We suggest that it is paramount for all stakeholders to commit to cultivating and developing cultural competency skills in medical education, through robustly embedding BSS learning content across the undergraduate medical curriculum. We conclude with recommendations for a wide range of educational practices that would ensure a full integration of BSS in the medical curriculum. [ABSTRACT FROM AUTHOR]

The article presents an interview with Joshua Totty, Fania Pagnamenta, and Kate Williams. Topics include challenges for professionals while attempting in understanding bias and overcoming the barriers; and health professionals fully understanding the bias while reading studies due to a lack of in-depth knowledge.

Background: Over recent years there has been an increase in teaching of both palliative care and reflective practice in UK medical schools. The palliative care teaching at the University of Cambridge School of Clinical Medicine is multi-faceted and involves students writing reflective essays after individually meeting patients approaching the end of life during their final year general practice and hospital medicine placements. This paper draws on two studies examining this teaching element to analyse what the students found valuable about it and to comment on the practice of meeting patients and subsequent reflective writing. Methods: Two studies have explored students' perceptions of these course components. The first was a thematic analysis of 234 reflective essays from 123 students written in 2007-2008, including examining what students wrote about the exercise itself. The second project involved a semi-structured questionnaire that students completed anonymously; this paper reports on the free text elements of that study [sample size =107]. Since similar themes were found in both studies, the coding structures from each project were compared and combined, enabling triangulation of the findings around what the students found valuable from the palliative care teaching involving meeting patients and reflective writing. Results: Overall, students reported that these components of the palliative care teaching are valuable. Four main themes were identified as aspects that students valued: (1) dedicated time with patients, (2) learning about wider elements of treatment and holistic care, (3) practicing communication skills, and (4) learning about themselves through reflective writing. Some students expressed a dislike for having to formally write a reflective essay. Conclusion: It is possible to arrange for all of the medical students to individually meet at least two patients receiving palliative or end of life care. Students found these encounters valuable and many wrote about the benefit of formally writing about these experiences. Students reported finding this model useful in widening their skill-set and understanding of palliative care. [ABSTRACT FROM AUTHOR]

Background: Imperial College School of Medicine, London UK, introduced a new curriculum in 2019, with a focus on the GMC outcomes for graduates, and pedagogy best practice. The new curriculum included formative assessments, named engagement and feedback assessments (EFAs), to support learning, and attainment in the summative examinations. The aims of this study were to assess the validity of EFAs and to determine whether they have utility as a modified form of programmatic assessment to inform decision-making regarding possible interventions by measuring and analysing attendance at and performance in these formative events. Methods: Seven hundred and sixty-one students were included in the study and assessment results were included for academic years 2019/20 to 2020/21. Forty-one data points per student, (27 in Year 1 and 14 in Year 2) were used, to compare EFA scores with the summative performance. Attendance was monitored through engagement with the EFAs. Results: Cohort 1 (enrolled 2019): In year 1, EFAs were associated with summative exam scores (overall r = 0.63, p < 0.001). Year 2, EFA scores were also associated with summative scores (overall r = 0.57, p < 0.001), including the clinical practical assessment (r = 0.45, p < 0.001). Missing two or more EFAs was associated with a significant increase in the likelihood of failing one or more summative examinations in the first year (OR: 7.97, 95% CI 2.65–34.39) and second year (OR: 3.20, 95% CI 1.74–5.95). Missing more than two EFAs in their first year was also associated with a higher risk of failing a summative examination in the second year (OR: 2.47, 95% CI 1.33–4.71). Students who increased their attendance between year 1 and 2 fared better in summative assessment than those who maintained poor attendance, whereas those that reduced their attendance fared worse than those that maintained high attendance. Cohort 2 (enrolled 2020): Analysis of cohort 2 supported these findings and in this cohort missing two or more EFAs was again associated with an increased likelihood of failing a summative examination (OR = 4.00, 95% CI = 2.02–7.90). Conclusion: Our EFA model has validity in predicting performance in summative assessments and can inform prospective interventions to support students' learning. Enhancing attendance and engagement can improve outcomes. [ABSTRACT FROM AUTHOR]

Background: The healthcare sector is a major contributor to climate change and there are international calls to mitigate environmental degradation through more sustainable forms of clinical care. The UK healthcare sector has committed to net zero carbon by 2040 and sustainable healthcare is a nationally mandated outcome for all UK graduating doctors who must demonstrate their ability to address social, economic, and environmental challenges. Bristol Medical School piloted successful Sustainability in Quality Improvement (SusQI) workshop, but identified challenges translating classroom learning into clinical practice. This paper aims to identify and address those challenges. Methods: We conducted five focus groups that identified and iteratively explored barriers and facilitators to practice among medical students, comparing a range of experiences to generate a conceptual model. We then combined our findings with behaviour change theory to generate educational recommendations. Results: Students that applied their learning to the clinical workplace were internally motivated and self-determined but needed time and opportunity to complete projects. Other students were cautious of disrupting established hierarchies and practices or frustrated by institutional inertia. These barriers impacted on their confidence in suggesting or achieving change. A minority saw sustainable healthcare as beyond their professional role. Conclusions: We present a series of theoretically informed recommendations. These include wider curricular engagement with concepts of sustainable clinical practice; supportive workplace enablement strategies such as workplace champions and co-creation of improvement goals; and time and headspace for students to engage through structured opportunities for credit-bearing project work. [ABSTRACT FROM AUTHOR]

Background: Educating doctors is expensive and poor performance by future graduates can literally cost lives. Whilst the practice of medicine is highly evidence based, medical education is much less so. Research on medical school selection, undergraduate progression, Fitness to Practise (FtP) and postgraduate careers has been hampered across the globe by the challenges of uniting the data required. This paper describes the creation, structure and access arrangements for the first UK-wide attempt to do so. Overview: A collaborative approach has created a research database commencing with all entrants to UK medical schools in 2007 and 2008 (UKMED Phase 1). Here the content is outlined, governance arrangements considered, system access explained, and the potential implications of this new resource discussed. The data currently include achievements prior to medical school entry, admissions tests, graduation point information and also all subsequent data collected by the General Medical Council, including FtP, career progression, annual National Training Survey (NTS) responses, career choice and postgraduate exam performance data. UKMED has grown since the pilot phase with additional datasets; all subsequent years of students/trainees and stronger governance processes. The inclusion of future cohorts and additional information such as admissions scores or bespoke surveys or assessments is now being piloted. Thus, for instance, new scrutiny can be applied to selection techniques and the effectiveness of educational interventions. Data are available free of charge for approved studies from suitable research groups worldwide. Conclusion: It is anticipated that UKMED will continue on a rolling basis. This has the potential to radically change the volume and types of research that can be envisaged and, therefore, to improve standards, facilitate workforce planning and support the regulation of medical education and training. This paper aspires to encourage proposals to utilise this exciting resource. [ABSTRACT FROM AUTHOR]

In this paper we present the current state of cultural diversity education for undergraduate medical students in three English-speaking countries: the United Kingdom (U.K.), United States (U.S.) and Canada. We review key documents that have shaped cultural diversity education in each country and compare and contrast current issues. It is beyond the scope of this paper to discuss the varied terminology that is immediately evident. Suffice it to say that there are many terms (e.g. cultural awareness, competence, sensitivity, sensibility, diversity and critical cultural diversity) used in different contexts with different meanings. The major issues that all three countries face include a lack of conceptual clarity, and fragmented and variable programs to teach cultural diversity. Faculty and staff support and development, and ambivalence from both staff and students continue to be a challenge. We suggest that greater international collaboration may help provide some solutions. [ABSTRACT FROM AUTHOR]

The Medical School at Bristol University is noted for offering, and in some instances requiring, its students to work creatively with medical themes. Students, artists, educationalists and a web designer have worked to create an on-line exhibition of the resulting creative output. This can be viewed at www.outofourheads.net. This site is a themed repository of poetry, prose, drawings, paintings, cartoons, films, music, dance and rap. Most works come with commentaries that can be as illuminating as the works they describe. The site invites comment and welcomes new postings from anyone connected to medicine. As an alternative to the conventional pedagogical report, and in keeping with the subject matter, in this paper we tell the story of this unique educational enterprise through the narratives of four of its principle architects. The 'Teacher's Tale', the 'Designer's Tale', the 'Curator's Tale' and the 'Artist's Tale' offer different, personal, tellings of how the site came to be. Each tale contains hypertext links to notable works on the site some of which have become teaching resources within the institution. This paper is of relevance to anyone who seeks to explore and champion the human insights of this privileged community. [ABSTRACT FROM AUTHOR]

Background: The outcome of assessments is determined by the standard-setting method used. There is a wide range of standard - setting methods and the two used most extensively in undergraduate medical education in the UK are the norm-reference and the criterion-reference methods. The aims of the study were to compare these two standard-setting methods for a multiple-choice question examination and to estimate the test-retest and inter-rater reliability of the modified Angoff method. Methods: The norm - reference method of standard -setting (mean minus 1 SD) was applied to the 'raw' scores of 78 4th-year medical students on a multiple-choice examination (MCQ). Two panels of raters also set the standard using the modified Angoff method for the same multiplechoice question paper on two occasions (6 months apart). We compared the pass/fail rates derived from the norm reference and the Angoff methods and also assessed the test-retest and inter-rater reliability of the modified Angoff method. Results: The pass rate with the norm-reference method was 85% (66/78) and that by the Angoff method was 100% (78 out of 78). The percentage agreement between Angoff method and normreference was 78% (95% CI 69% - 87%). The modified Angoff method had an inter-rater reliability of 0.81 - 0.82 and a test-retest reliability of 0.59-0.74. Conclusion: There were significant differences in the outcomes of these two standard-setting methods, as shown by the difference in the proportion of candidates that passed and failed the assessment. The modified Angoff method was found to have good inter-rater reliability and moderate test-retest reliability. [ABSTRACT FROM AUTHOR]

BACKGROUND: Healthcare professionals have a duty to maintain basic life support (BLS) skills. This study aims to evaluate medical students' factual knowledge of BLS and the training they receive. METHODS: A cross-sectional, closed-response questionnaire was distributed to the first- and fourth-year students studying at institutions in the United Kingdom. The paper questionnaire sought to quantify respondent's previous BLS training, factual knowledge of the BLS algorithm using five multiple choice questions (MCQs), and valuate their desire for further BLS training. Students received 1 point for each correctly identified answer to the 5 MCQ's. RESULTS: A total of 3,732 complete responses were received from 21 medical schools. Eighty percent (n=2,999) of students completed a BLS course as part of their undergraduate medical studies. There was a significant difference (P<0.001) in the percentage of the fourth-year students selecting the correct answer in all the MCQ's compared to the fi rst-year students except in identifying the correct depth of compressions required during CPR (P=0.095). Overall 10.3% (95% CI 9.9% to 10.7%) of respondents correctly identified the answer to 5 MCQ's on BLS: 9% of the first-year students (n=194) and 12% of the fourth-year students (n=190). On an institutional level the proportion of students answering all MCQ's correctly ranged from 2% to 54% at different universities. Eighty-one percent of students (n=3,031) wished for more BLS training in their curriculum. CONCLUSION: Factual knowledge of BLS is poor among medical students in the UK. There is a disparity in standards of knowledge across institutions and respondents indicating that they would like more training. [ABSTRACT FROM AUTHOR]

Objective: This paper concerns the continued use of the Hippocratic Oath in United Kingdom (UK) medical schools. A survey of all UK medical schools looked at which schools use the Oath, which variants they use, and what they perceive to be the benefits of using the Oath. 27 schools participated in the study. Results: Although some authors have deemed the Oath as out of date for the purposes of modern medicine [1], new variants of the Oath have been embraced and 19/27 (70%) of schools use an Oath, with some Universities asking student doctors to acknowledge this Oath on entry to and graduation from medical school. There is a renewed interest in use of the Oath, with use in some Schools on admission and graduation. Reasons for adopting the Oath include a desire to enhance good practice and to prevent unwanted behaviour. Variants of the Oath used were analysed according to which bioethical principles are contained within them and some do not accord with all principles. A new variant of the Oath is proposed which encompasses all four bioethical principles. [ABSTRACT FROM AUTHOR]

Patient consent has been formulated in terms of radical individualism rather than shared benefits. Medical education relies on the provision of patient consent to provide medical students with the training and experience to become competent doctors. Pelvic examination represents an extreme case in which patients may legitimately seek to avoid contact with inexperienced medical students particularly where these are male. However, using this extreme case, this paper will examine practices of framing and obtaining consent as perceived by medical students. This paper reports findings of an exploratory qualitative study of medical students and junior doctors. Participants described a number of barriers to obtaining informed consent. These related to misunderstandings concerning student roles and experiences and insufficient information on the nature of the examination. Participants reported perceptions of the negative framing of decisions on consent by nursing staff where the student was male. Potentially coercive practices of framing of the decision by senior doctors were also reported. Participants outlined strategies they adopted to circumvent patients' reasons for refusal. Practices of framing the information used by students, nurses and senior doctors to enable patients to decide about consent are discussed in the context of good ethical practice. In the absence of a clear ethical model, coercion appears likely. We argue for an expanded model of autonomy in which the potential tension between respecting patients' autonomy and ensuring the societal benefit of well-trained doctors is recognised. Practical recommendations are made concerning information provision and clear delineations of student and patient roles and expectations. [ABSTRACT FROM AUTHOR]

With the global challenge of antimicrobial resistance (AMR), interest in the development of antibiotic alternatives has surged worldwide. While phage therapy is not a new phenomenon, technological and socio-economic factors have limited its implementation in the Western world. There is now a resurged effort, especially in the UK, to address these challenges. In this study, we collect survey data on UK general practitioners (n = 131) and other healthcare professionals (n = 103), as well as interviews with medical professionals (n = 4) and a focus group with medical students (n = 6) to explore factors associated with their willingness to prescribe phage therapy to patients. The interviews with medical professionals show support for the expansion of bacteriophage clinical trials and highlight their role as a viable alternative to antibiotics. A conjoint experiment reveals that success rate, side effect rate, and patient attitude to treatment are the decisive factors when it comes to phage therapy prescription; in contrast, the effects of administration route, type of treatment, and severity of infection were not statistically significant. Moreover, we show that general practitioners overall are more likely to recommend phage treatment to patients, compared to other healthcare professionals. The results of the study suggest that phage therapy has a potential to be widely accepted and used by healthcare workers in the UK. [ABSTRACT FROM AUTHOR]

Aim: To offer a practical way in which the status of healthcare assistants (HCAs) can be increased by drawing on their experience, knowledge and skillset, whilst mentoring medical students during an HCA project. Design: Qualitative, reflexive thematic analysis. Methods: One‐to‐one semi‐structured interviews were conducted between April and June 2019, with 13 participants. Participants included five healthcare assistants; three practice development nurses, two of whom were former HCAs; one registered general nurse and four clinical educators. Results: Two themes were identified: HCAs as silent, invisible caregivers (theme 1) and the formation of an HCA identity through mentoring (theme 2). HCAs are often silent performers of complex patient care with limited opportunity to engage in the interprofessional team dialogue. Social perceptions of HCAs describe them as a marginalised, poorly understood, 'unqualified' group with 'lowly status'. Mentoring medical students allows HCAs to draw on their experience, knowledge and skillset by actively contributing to the learning and development of future doctors. Conclusion: The mentoring of medical students gave HCAs an active voice within the interprofessional team, instilling their confidence and self‐worth. Mentoring allowed HCAs to move from a homogenous, group‐based social identity to a role‐based one that enabled HCAs to reveal the true extent of their work whilst negotiating their place and identity within the interprofessional team. Impact: Leaders in healthcare will see that a re‐evaluation of HCAs as performers of basic, hands‐on patient care is needed to breakdown ingrained beliefs, eliminating a 'us and them' mentality. Involving HCAs in the mentoring of medical students will impact on the personal development of both HCAs and medical students in the cultivation of a future, person‐centred, inclusive and collaborative workforce. Reporting Method: COREQ guidelines to enhance methodological rigour were strictly adhered to. Patient and Public Involvement: There is no patient or public involvement. [ABSTRACT FROM AUTHOR]

The General Medical Council (GMC) provides a core curriculum for all medical degrees in the UK. However, these guidelines do not provide in-depth, specific learning outcomes for the various medical specialties. Recognising our ageing population, the British Geriatrics Society in 2013 published their own supplementary guidelines to encourage and further direct teaching on Gerontology and Geriatric Medicine in medical school curricula. Although teaching on Geriatric Medicine, a sub-discipline of Gerontology, has reassuringly increased in UK medical schools, there are convincing arguments for greater emphasis to be placed on the teaching of another sub-discipline: Social Gerontology. Considering the skills and knowledge likely to be gained from the teaching of Social Gerontology, in this paper we argue for the greater universal adoption of its teaching. This would help ensure that the doctors of tomorrow are better equipped to manage more successfully and holistically the growing cohort of older patients. [ABSTRACT FROM AUTHOR]

Background: Understanding professionalism is an essential component of becoming a doctor in order to ensure the trust of patients and wider society. Integrally linked to the concept of professionalism is the importance of identifying and raising concerns to ensure high quality, safe patient care. It is recognised that medical students are uniquely placed to identify and report concerns given their frequent rotations through multiple clinical placements and their peer relationships and, in so doing, develop and enact their own medical professionalism. Although there is existing literature exploring medical students' willingness to raise concerns about observed professionalism lapses, this has largely been in the context of clinical interactions. Medical students will however undoubtedly encounter concerning behaviours or attitudes in their fellow students, an area that has not specifically been reported upon. This study therefore set out to explore medical students' willingness to report professionalism concerns they encounter both within and away from the clinical setting, particularly focusing on peer-related concerns. Methods: 10 medical students, in later clinical years of a large UK medical school, volunteered to take part in in-depth semi-structured interviews. Interviews were recorded, transcribed and then analysed thematically to generate themes and subthemes to represent central organising concepts. Results: Three broad themes were generated from the data. Hidden curricular effects including role models, hierarchical structures and the operational systems in place to raise concerns subconsciously influenced students' decisions to raise concerns. Secondly, students offered a range of justifications to defend not taking action, including considering their own vulnerabilities and values alongside demonstrating empathy for perceived mitigating circumstances. The third theme highlighted the complex interplay of influencing factors that students considered when encountering professionalism issues in their peers including wider peer cohort effects and a desire to maintain individual peer-relationships. Conclusions: Medical students will inevitably encounter situations where the professionalism of others is brought into question. However, despite clear curricular expectations to report such concerns, these findings demonstrate that students undergo a complex decision-making process in determining the threshold for reporting a concern through navigating a range of identified influencing factors. This study highlights the important role medical schools play in helping reduce the inner conflict experienced by medical students when raising concerns and in ensuring they provide supportive processes to empower their students to raise concerns as part their own developing professionalism. Practice Points: Understanding professionalism is an essential component of becoming a doctor. Identifying and raising concerns is vital to ensure high quality safe patient care. There are many barriers to medical students raising concerns. Medical students navigate a complex decision-making process in determining if the threshold for reporting a concern has been reached. Medical students balance their own vulnerabilities and values, and the advantages and disadvantages of taking action when deciding whether or not to report a concern. Medical students will additionally encounter professionalism lapses from their peers outside the clinical setting. Their willingness to subsequently raise concerns about their fellow students is considered in the light of their peer group dynamics and potential impacts on peer-relationships. [ABSTRACT FROM AUTHOR]

Objective: Clinician-scientists are critical to medical innovation and research. However, the number of clinician scientists in the UK has been declining steadily over the last decade. One of the cited reasons is poor student recruitment to academic training pathways. The SMART study aims to assess current student perceptions on research and identify key factors influencing whether a student is interested in research. Design: We conducted a cross-sectional survey study between January and May 2022. Setting: This was a multi-centre national study with data collected across 40 universities offering medical courses in the UK. Participants: Participants were UK medical students enrolled in medicine for 21/22 academic year. Main outcome and measure: The main outcomes were related to participant perceptions on research and whether they were interested in engaging with research in their future career. These measures were correlated with demographic and non-demographic details using regression analyses. Results: One thousand seven hundred seventy-four individuals participated in the SMART survey from 40 medical schools. Nearly half the participants felt there were barriers preventing them from doing research (46.67%) and almost three-quarters felt it was at least somewhat difficult to combine research with medical school (73.49%). Of the options available, most commonly students did not want to pursue an academic career (43.11%) or training pathway (42.49%). However, most participants felt it was useful to do research at medical school (59.54%) and were also interested in doing more research in the future (69.16%). Regression analysis identified many factors influencing student's perceptions of research including year of study, gender, socioeconomic status, family background, research exposure at medical school, ethnicity, and country of pre-university education. Conclusions: The SMART study is the first of its kind in the UK, shedding light on medical student perceptions. While some express strong interest in academic careers, a larger proportion show a broader interest in research. Demographic factors like gender, parental occupation, and socioeconomic status play a role. Further exploration is needed for specific groups to address barriers, promote research, and boost academic pathway recruitment. [ABSTRACT FROM AUTHOR]

Background: Over two-thirds of UK medical schools are augmenting their selection procedures for medical students by using the United Kingdom Clinical Aptitude Test (UKCAT), which employs tests of cognitive and non-cognitive personal qualities, but clear evidence of the tests' predictive validity is lacking. This study explores whether academic performance and professional behaviours that are important in a health professional context can be predicted by these measures, when taken before or very early in the medical course.Methods: This prospective cohort study follows the progress of the entire student cohort who entered Hull York Medical School in September 2007, having taken the UKCAT cognitive tests in 2006 and the non-cognitive tests a year later. This paper reports on the students' first and second academic years of study. The main outcome measures were regular, repeated tutor assessment of individual students' interpersonal skills and professionalbehaviour, and annual examination performance in the three domains of recall and application of knowledge,evaluation of data, and communication and practical clinical skills. The relationships between non-cognitive test scores,cognitive test scores, tutor assessments and examination results were explored using the Pearson product-moment correlations for each group of data; the data for students obtaining the top and bottom 20% of the summative examination results were compared using Analysis of Variance.Results: Personal qualities measured by non-cognitive tests showed a number of statistically significant relationships with ratings of behaviour made by tutors, with performance in each year's objective structured clinical examinations (OSCEs),and with themed written summative examination marks in each year. Cognitive ability scores were also significantly related to each year's examination results, but seldom to professional behaviours. The top 20% of examination achievers could be differentiated from the bottom 20% on both non-cognitive and cognitive measures.Conclusions: This study shows numerous significant relationships between both cognitive and non-cognitive test scores,academic examination scores and indicators of professional behaviours in medical students. This suggests that measurement of non-cognitive personal qualities in applicants to medical school could make a useful contribution to selection and admission decisions. Further research is required in larger representative groups, and with more refined predictor measures and behavioural assessment methods, to establish beyond doubt the incremental validity of such measures over conventional cognitive assessments. [ABSTRACT FROM AUTHOR]

Health and social care students spend up to 50% of their course in practice. Placements are distributed across a wide geographical area and have varying degrees of IT access and support. Consequently, students may feel isolated from peers, academic staff, and resources required for effective learning. Mobile technology has considerable potential to enhance the learning of these students. This paper presents the development and implementation of the Centre for Excellence in Professional Placement Learning's mobile learning project and the principles that both drove and emerged from this work. Handheld devices were matched to students' pedagogic need. Principles covered areas such as pedagogy, partnership working, technology, inclusivity, evaluation, and research. Collaboration across sectors and institutions and an understanding of professional cultures and contexts were seen as key in instigating and embedding mobile learning to support students on placement. [ABSTRACT FROM AUTHOR]

Simple Summary: People are more likely to develop cancer as they become older, and as people live longer, the number of older adults with cancer is steadily increasing. Managing cancer in older adults is challenging because they often have long-term conditions and wider needs that complicate treatment decisions and outcomes. However, the care of older adults with cancer is not formally taught during undergraduate medical education or postgraduate training in the United Kingdom. In this review, we provide an overview of the current education that medical students and training trainee doctors receive to prepare them for caring for older adults with cancer and highlight where challenges exist. We summarise the research conducted and strategies implemented internationally and use this knowledge to provide recommendations which may improve the education and training of doctors to meet the needs of older adults with cancer. Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and the increasing complexity of treating older adults with cancer, the geriatric oncology field must be a priority for healthcare systems in education, research, and clinical practice. However, geriatric oncology is currently not formally taught in undergraduate education or postgraduate training programmes in the United Kingdom (UK). In this commentary, we outline the landscape of geriatric oncology undergraduate education and postgraduate training for UK doctors. We highlight current challenges and opportunities and provide practical recommendations for better preparing the medical workforce to meet the needs of the growing population of older adults with cancer. This includes key outcomes to be considered for inclusion within undergraduate and postgraduate curricula. [ABSTRACT FROM AUTHOR]

Objectives. Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment. Methods. We conducted usability testing with paramedic students and a Delphi panel of qualified paramedics. Participants studied the app and paper-based algorithm from which the app was developed. The potential use for the app was discussed. Usability testing focus groups were recorded, transcribed verbatim, and analyzed using a thematic approach. Proposed recommendations were disseminated to the Delphi panel that reviewed and confirmed them. Results. Twenty-four paramedic students from two UK ambulance services participated in the focus groups. Usability of the app and its potential were viewed positively. Four major themes were identified: 1) overall opinion of the app for use in paramedic services; 2) incorporating technological applications into the health care setting; 3) improving knowledge and governance; and 4) alternative uses for the app. Subthemes were identified and are presented. Discussion. Our results indicate that the pain assessment app constitutes a potentially useful tool in the prehospital setting. By providing access to a tool specifically developed to help identify/assess pain in a user-friendly format, paramedics are likely to have increased knowledge and confidence in assessing pain in patients with dementia. [ABSTRACT FROM AUTHOR]

Gender bias and sexism in the health profession in the UK has been highlighted as a major problem. Efforts to reduce this must include medical training and examinations. The Situational Judgment Test (SJT) is an examination that must be passed to work as a foundation doctor in the UK; and is taken by all UK medical students. We analysed gender balance in all 215 scenarios included in the official practice papers for the SJT. We found that senior doctors were more than twice as likely to be men than women, while there was no significant gender difference in representation of foundation year-1 doctors, other health professionals or patients/relatives. This inequality has the potential to reinforce gender biases in healthcare. Medical examinations can, instead, represent an opportunity for prejudices to be challenged. [ABSTRACT FROM AUTHOR]

Background: Learning tools using virtual patients can be used to teach clinical reasoning (CR) skills and overcome limitations of using face-to-face methods. However, the adoption of new tools is often challenging. The aim of this study was to explore UK medical educators' perspectives of what influences the adoption of virtual patient learning tools to teach CR. Methods: A qualitative research study using semi-structured telephone interviews with medical educators in the UK with control over teaching materials of CR was conducted. The Consolidated Framework for Implementation Research (CFIR), commonly used in healthcare services implementation research was adapted to inform the analysis. Thematic analysis was used to analyse the data. Results: Thirteen medical educators participated in the study. Three themes were identified from the data that influenced adoption: the wider context (outer setting); perceptions about the innovation; and the medical school (inner context). Participants' recognition of situations as opportunities or barriers related to their prior experiences of implementing online learning tools. For example, participants with experience of teaching using online tools viewed limited face-to-face placements as opportunities to introduce innovations using virtual patients. Beliefs that virtual patients may not mirror real-life consultations and perceptions of a lack of evidence for them could be barriers to adoption. Adoption was also influenced by the implementation climate of the setting, including positioning of CR in curricula; relationships between faculty, particularly where faculty were dispersed. Conclusions: By adapting an implementation framework for health services, we were able to identify features of educators, teaching processes and medical schools that may determine the adoption of teaching innovations using virtual patients. These include access to face-to-face teaching opportunities, positioning of clinical reasoning in the curriculum, relationship between educators and institutions and decision-making processes. Framing virtual patient learning tools as additional rather than as a replacement for face-to-face teaching could reduce resistance. Our adapted framework from healthcare implementation science may be useful in future studies of implementation in medical education. [ABSTRACT FROM AUTHOR]

Background: The number of academic clinicians in the UK is declining and there are demographic inequalities in the clinical-academic workforce. Increased research productivity by medical students is believed to reduce future attrition in the clinical-academic workforce. Thus, this study investigated the association between student demographics and research productivity amongst UK medical students. Methods: This is a national multicentre cross-sectional study of UK medical students in the 2020/21 academic year. We appointed one student representative per medical school, and they disseminated a 42-item online questionnaire over nine weeks, through departmental emails and social media advertisements. The outcome measures were: (i) publications (yes/no) (ii) number of publications (iii) number of first-authored publications (iv) abstract presentation (yes/no). We utilised multiple logistic and zero-inflated Poisson regression analyses to test for associations between the outcome measures and predictor variables at a 5% significance level. Results: There are 41 medical schools in the UK. We received 1573 responses from 36 UK medical schools. We failed to recruit student representatives from three newly formed medical schools, whilst two medical schools prohibited us from sending the survey to their students. Women had lower odds of having a publication (OR: 0.53, 95% CI: 0.33–0.85) and on average had fewer first-author publications than men (IRR: 0.57, 95% CI: 0.37–0.89). Compared to white students, mixed-ethnicity students had greater odds of having a publication (OR: 3.06, 95% CI: 1.67–5.59), an abstract presentation (OR: 2.12, 95% CI: 1.37–3.26), and on average had a greater number of publications (IRR: 1.87, 95% CI: 1.02–3.43). On average, students who attended independent UK secondary schools had a higher rate of first-author publications compared to those that attended state secondary schools (IRR: 1.97, 95% CI: 1.23–3.15). Conclusion: Our data suggest that there are gender, ethnic and socioeconomic inequalities in research productivity among UK medical students. To tackle this, and potentially improve diversity in clinical academia, we recommend that medical schools should facilitate targeted high quality research mentorship, funding and training, especially for under-represented-in-medicine students. [ABSTRACT FROM AUTHOR]

Recruitment into psychiatry is perceived as problematic in the UK but the paper by Goldacre and colleagues in this issue of the Journal shows that recruitment of new UK graduates has altered little over 35 years. Sources of psychiatry's malaise should be sought in its changing focus and the quality, rather than quantity, of its recruits. [ABSTRACT FROM AUTHOR]

Background: In recent years, higher education institutions have been moving teaching online, accelerated by the pandemic. The Remote Learning Project (RLP), based at the Norwich Medical School (NMS) in the United Kingdom (U.K.), was a peer-to-peer teaching program developed to supplement medical school teaching during the pandemic. The teaching was delivered through Facebook using peer-to-peer teaching. Tutors were final year medical students, teaching medical student learners in lower years. Tutors and learners perception of peer-to-peer online learning delivered through the Facebook Social Media (SoMe) platform was investigated. Methods: This qualitative study recruited tutor and learner participants from NMS by email, participation in the study was voluntary. Online semi-structured interviews of both tutors and learners in the remote learning project were conducted. The data was analysed using thematic analysis. Results: Seven participants were interviewed. Five themes were identified; education (learning/teaching), productivity, data security, professionalism, and usability of the platform. Learners enjoyed the asynchronous nature of the platform and both learners and tutors enjoyed the peer-to-peer nature of the RLP, including the ability to immediately and easily answer on Facebook comments. Some learners felt distracted on Facebook, whilst others enjoyed the reminders. The mix of social and professional on the platform was met with caution from tutors. Both learners and tutors enjoyed the familiarity of the platform. Conclusions: The study found that SoMe may be a credible platform to deliver online peer-to-peer teaching. Educators should consider the ergonomics of SoMe platforms when designing online curriculums. Guidelines for educators should be developed to better guide educators on the effective and safe use of SoMe as a learning tool. [ABSTRACT FROM AUTHOR]

In the UK, more women are studying medicine than men, most of whom have experienced sexism, yet these experiences are under-researched. This qualitative study explores female medical students' experiences of sexism on placement, impacts sustained, barriers and facilitators encountered upon reporting. A total of 17 semi-structured interviews were conducted, employing purposive sampling, snowball sampling and an inductive thematic analysis. A qualitative methodology was underpinned by the feminist social constructionist theory. Four themes were identified: 1—experiences of sexism, comprising physical and verbal harassment and microaggressions; 2—negative impacts of sexist encounters ranged from psychosocial to repercussions on learning and development; 3—systemic and attitudinal barriers to reporting; 4—recommendations to tackle sexism shaped by the views and experiences of female medical student participants. Female medical students experienced wide-ranging sexism which negatively impacted their wellbeing with negative repercussions for their training and development. The barriers to reporting need to be urgently addressed, and systems, policies and processes need to be over-hauled to sensitively, effectively and equitably manage and provide justice to students who experience and report sexism. Students need to be empowered to respond, report and be offered psychological safety in doing so. Attitudes and practices which are complicit in sustaining sexism need to be challenged and changed. [ABSTRACT FROM AUTHOR]

Background: The UK academic foundation programme (AFP) is a competitive programme for medical graduates and forms the initial stage of the integrated clinical academic pathway. The application is complex and targeted education is beneficial. As online technologies improve, virtual medical education is becoming more common. Currently, webinar education, particularly that of webinar series, are poorly evidenced. An online course was created to investigate the acceptability and effectiveness of webinars for medical education. Methods: A six-part, one-hour sessional webinar course was developed following a focus group with academic foundation doctors. A pre- and post-course cross-sectional questionnaire study evaluated participant demographics, webinar opinion and self-rated understanding of the AFP via Google Form (Google, USA). Where applicable a five-point Likert scale (1-Strongly disagree to 5-strongly agree) was utilised and analysis using non-parametric paired statistical analysis. Results: Medical students (n=303) from 35 UK universities completed the pre-course questionnaire. Most students had not received targeted education on the AFP. They rated webinars useful for education (mean=4.2 s.d. 0.7). After the course, participants (n=66) expressed it was significantly convenient (mean=4.7), effective (mean=4.7) and suitably interactive (mean=4.4) (p<0.001 compared to neutral). Participants preferred short sessions over multiple days to the concept of a full-day event (mean=4.6 vs 3.1, p<0.001). Paired analysis of participants completing both forms (n=47) demonstrates a significant increase in self-rated understanding of AFP content, portfolio building, application process, acute clinical scenarios, interview technique and overall confidence in acquiring an AFP post (p<0.001). Follow-up identified 43 participants who completed the course were successful in their AFP application. This represents 7.8% of all successful AFP applicants in 2021. Conclusions: This study evidences an accessible and effective webinar series for AFP education. Comprehensive webinar courses for similar topics and demographics may provide valuable utility in the provision of future medical education. Trial registration: Ethics requirements were waived for this study by Bristol University Ethics Committee. All participants in this study consented for anonymous use of their data. As such the trial is not registered. [ABSTRACT FROM AUTHOR]

Background: COVID-19 posed many challenges to medical education in the United Kingdom (UK). This includes implementing assessments during 4 months of national lockdowns within a 2-year period, where in-person education was prohibited. This study aimed to identify medical school assessment formats emerging during COVID-19 restrictions, investigate medical students' perspectives on these and identify influencing factors. Methods: The study consisted of two phases: a questionnaire asking medical students about assessment changes they experienced, satisfaction with these changes and preference regarding different assessments that emerged. The second phase involved semi-structured interviews with medical students across the UK to provide a deeper contextualized understanding of the complex factors influencing their perspectives. Results: In the questionnaire responses, open-book assessments had the highest satisfaction, and were the preferred option indicated. Furthermore, in the case of assessment cancellation, an increase in weighting of future assessments was preferred over increase in weighting of past assessments. Students were also satisfied with formative or pass-fail assessments. Interview analyses indicate that although cancellation or replacement of summative assessments with formative assessments reduced heightened anxiety from additional COVID-19 stressors, students worried about possible future knowledge gaps resulting from reduced motivation for assessment-related study. Students' satisfaction level was also affected by timeliness of communication from universities regarding changes, and student involvement in the decision-making processes. Perceived fairness and standardisation of test-taking conditions were ranked as the most important factors influencing student satisfaction, followed closely by familiarity with the format. In contrast, technical issues, lack of transparency about changes, perceived unfairness around invigilation, and uncertainty around changes in assessment format and weighting contributed to dissatisfaction. Conclusions: Online open-book assessments were seen as the most ideal amongst all participants, and students who experienced these were the most satisfied with their assessment change. They were perceived as most fair and authentic compared to real-life medical training. We seek to inform educators about student perceptions of successful assessment strategies under COVID-19 restrictions and provide evidence to allow debate on ongoing assessment reform and innovation. While this work looks specifically at assessment changes during COVID-19, understanding factors affecting student perception of assessment is applicable to examinations beyond COVID-19. [ABSTRACT FROM AUTHOR]

Students from lower socio-economic backgrounds who were educated in state funded schools are underrepresented in medicine in the UK. Widening access to medical students from these backgrounds has become a key political and research priority. It is known that medical schools vary in the number of applicants attracted and accepted from non-traditional backgrounds but the reasons for this are poorly understood. This study aims to explore what applicants value when choosing medical schools to apply to and how this relates to their socioeconomic background. We conducted a multicentre qualitative interview study, purposively sampling applicants and recent entrants based on socioeconomic background, stage of application and medical school of application. We recruited participants from eight UK medical schools. Participants attended semi-structured interviews. We performed a framework analysis, identifying codes inductively from the data. Sixty-six individuals participated: 35 applicants and 31 first year medical students. Seven main themes were identified; course style, proximity to home, prestige, medical school culture, geographical area, university resources, and fitting in. These were prioritised differently depending on participants' background. Participants from lower socioeconomic backgrounds described proximity to home as a higher priority. This was typically as they intended to be living at home for at least part of the course. Those from higher socioeconomic backgrounds were more concerned with the perceived prestige of medical schools. Since medicine is a highly selective course, only offered at a minority of UK higher education institutions, these differences in priorities may help explain observed differential patterns of medical school applications and success rates by applicant social background. [ABSTRACT FROM AUTHOR]

Background: It is now a General Medical Council requirement to incorporate education for sustainable healthcare (ESH) into medical curricula. To date, research has focussed on the perspectives of educators and which sustainable healthcare topics to include in teaching. Therefore, due to this gap in the literature, we have investigated the perspectives of medical students in the UK regarding current and future incorporation of ESH in medical education. Methods: A survey was circulated to 851 clinical year medical students and students intercalating after completing at least one clinical year in a London University. The anonymous survey consisted of sections on the environmental impact, current teaching and future teaching of ESH. Results: One hundred sixty-three students completed the survey. 93% of participants believed that climate change is a concern in current society, and only 1.8% thought they have been formally taught what sustainable healthcare is. No participants strongly agreed, and only 5 participants (3.1%) agreed, that they would feel confident in answering exam questions on this topic, with 89% agreeing that more ESH is needed. 60% believe that future teaching should be incorporated in both preclinical and clinical years, with 31% of participants preferring online modules as the method of teaching. Conclusion: Our study has stressed the lack of current sustainable healthcare teaching in the medical curriculum. There is student demand for ESH, however, uncertainty remains regarding who is best placed to facilitate ESH, how it should be delivered, and whether there is a gender discrepancy regarding sustainable healthcare importance, emphasising the need to close the gap between educational rhetoric and action. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic UK medical schools facilitated the early graduation of their final-year medical students to 'Foundation interim Year 1 (FiY1) doctors' through amendments made to curricula and final assessment. Such changes gave opportunity for evaluation. This study therefore aimed to explore 1) graduate perspective on the implementation of FiY1 and 2) how changes to course structures have affected self-reported preparedness for work. Methods: Questionnaire surveys using Likert scale and free-text responses (n = 45), and semi-structured interviews (n = 7) were conducted with FiY1s from two UK medical schools contrasting in the amendments made to course structures. Data were analysed using quantitative methods and thematic analysis; 44% (n = 20) of respondents believed that governing health bodies had not communicated sufficiently prior to starting work. Results: Graduates who had sat modified practical and written examinations reported 'legitimacy' and feeling more prepared compared to having not sat examinations (practical 100%, n = 17; written 88.3%, n = 15). Graduates from both schools agreed that carrying out assistantships as originally scheduled would have made them feel more prepared (91.1%, n = 41). Conclusions: The implementation of FiY1 was largely well received by graduates yet assistantship programmes may fulfil a similar role in normal times. Medical schools and governing bodies must ensure effective communication channels exist with students in order to better prepare them for their first posts, especially in times of crisis. Additionally, final examinations contribute to feelings of preparedness for work and instil a sense of legitimacy, a finding which is relevant to working within the current programmatic assessment structure. [ABSTRACT FROM AUTHOR]

Background: Many prominent UK medical organisations have identified a need for more generalist clinicians to address the complex requirements of an aging society. We sought to clarify attitudes towards "Specialists" and "Generalists" amongst medical students and junior doctors at Imperial College School of Medicine. Methods: A survey exploring medical students' beliefs was followed up by qualitative analysis of focus groups of medical students and Imperial-graduate foundation year doctors. Results: First year medical students associated specialists with academia and higher income, and generalists with ease of training and job availability. Senior (Years 5/6) medical students associated specialists even more firmly with broader influence and academic work, whilst generalists were assigned lower prestige but the same workload as specialists. The medical student focus group discussed concepts of Generalism pertaining only to Primary Care. In contrast, the foundation year doctor focus group revealed that Generalism was now seen to include some hospital care, and the perception that generalists sat lower in a knowledge hierarchy had been challenged. Conclusion: Perceptions that Generalism is associated with lower prestige in the medical profession are already present at the very start of medical school and seem to be reinforced during undergraduate training. In early postgraduate clinical practice, the perceived knowledge and prestige hierarchy lessens. These findings can help inform curriculum redesign and the promotion of Generalism as a rewarding career aspiration. [ABSTRACT FROM AUTHOR]

Planetary health is a field that looks at human-caused disruptions to the environment and the effect that these disruptions have on human health. We are living in a world where experts have declared a 'code red' for both the planet and human health - hence, planetary health is an area of increasing and urgent importance. Health professionals of all levels need to be aware of the relationship between climate change and health. Education on this should begin at the medical student level, ideally building on first and second level education for all. Medical students around the world have been calling for teaching in this area, and in many cases are leading the movement. Globally, there is a shift amongst third level educators to provide education on planetary health. In their 2018 Outcomes for Graduates, the General Medical Council in the United Kingdom (UK) introduced a new learning outcome on sustainable healthcare, which has served as leverage for educators in the UK to implement new planetary health teaching. Current teaching on planetary health at the university level in Ireland is inconsistent and inadequate. There are no defined learning outcomes for medical students in Ireland as seen in the UK. In the absence of same, groups such as Irish Doctors for the Environment and the Climate and Health in Medical Education (CHIME) network have been making efforts to develop a framework for planetary health teaching which could be implemented at both a national and international level. This article will discuss the work of these groups so far. It will outline how we can overcome some of the barriers and facilitators to integration, and will also provide examples of learning outcomes that can be incorporated easily into current curricula without requiring significant change. A changing climate requires a changing curriculum, and educators must build on the global momentum with the urgency that this crisis requires. [ABSTRACT FROM AUTHOR]

In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula. [ABSTRACT FROM AUTHOR]