King’s Undergraduate Medical Education in the Community (KUMEC)
description
Transcript of King’s Undergraduate Medical Education in the Community (KUMEC)
MEDICAL STUDENTS – POTENTIAL CONTRIBUTORS TO SMOKING CESSATION PROVISION: THE ADDED BENEFITS OF THE ONLINE NCSCT TRAINING
King’s Undergraduate Medical Education in the Community (KUMEC)Department of Primary Care and Public Health Sciences
NCSCT London Friday 13th June 2014
Dr Ann Wylie Senior Teaching FellowKUMEC King’s undergraduate medical education in the community [email protected]
KUMEC - King's Undergraduate Medical Education in the Community
AIMSTo describe the background to our cessation
teaching and challenges
The opportunity NCSCT offered
The benefits and limitations
Future of cessation teaching in one medical school
Smoking cessation in medical curriculum
Basic skillsSchool and
NCSCT
Assessment School and
NCSCT
Certificates; School and
NCSCT
Apply in context Clinical
placements
Win win! Students skills and patient support
KUMEC - King's Undergraduate Medical Education in the Community
Doctors’ responsibilities for lifestyle modification – a norm!
Background
Behaviour change skills essential for medical education (GMC)
Specifically smoking cessation
Students need some theory and evidence base as well as technique
Been in KCL core curriculum for a decade, with assessment but various challenges
Challenges
Only recently seen as essential for clinical therapeutics
Limited number medical teachers with smoking cessation skills
Students getting “mixed messages”, not necessarily evidence based
Core teaching time only 90 mins in 3rd year!
KUMEC - King's Undergraduate Medical Education in the Community
The Stages of Change: students identify where the patient is on this journey
Action:Making
Changes
Maintenance:Maintaining
change
Relapse:Relapsing back
Contemplation:Thinking about
change
Commitment:Ready to change
Current teaching With scenarios and facilitators
Focused on applied techniques stages of change 5 As motivational interviewing brief interventionthe normality and response to relapseenabling students to see this as a treatment and
management
Small groupsCurrently groups of 20 clinical students
From 2014 moving to start of first clinical year to enable students to link this to their clinical placements and repeated learning opportunities
Smaller groups if possible - suitable facilitators and room availability can be problematic
NCSCT – a new opportunitySince 2011-12 senior medical students
completing online Stage 1 and /or 2 received a certificate
Students advised of the potential benefit of this training however this was not compulsory
Suggested they did it around their core teaching and respiratory training
Constant promotion was needed!
Complementary learningDuring the Behaviour Change teaching sessions
students with Stage 1 and or 2 displayed confidence, knowledge and skills
Prompted other students to do NCSCTSome students with Stage 1 and or 2 did GP
practice based cessation projects – helpful to GP practices
Some students did hospital based cessation project to prepare for NICE secondary care implementation
Current dataStudents from 3-5th year with Stage 1
N = 140 (12%)
Students from 3-5th year with Stage 2N = 46 (3%)
Graduating final year students with one or more certificate N = 116 (30%)
Disseminating Students have used their skills to design posters and presentations
for GP practices (46 students based at 13 practices)
for GP conferences (3)for presentations to policy makers (3)for research (2)for further academic workfor encouraging other students
Medical students – significant contributorsAbout 6000 medical students graduate each year
in UK – becoming FY1 doctors in Aug
At KCL about 400 graduates and currently about 120 have an NCSCT certificate
In their final 3 years medical students have substantive patient contact and opportunities to talk to patients
Potential problemsEarly evaluation qualitative research findings suggested:Students had limited opportunities to “apply &
practice” skills in clinical arena – danger of “atrophy”
The online process (now improved) was onerousNeeded to repeat the course for exam revisionLimited exposure to good clinical role modelling
KUMEC - King's Undergraduate Medical Education in the Community
2014 Graduating cohortWill be junior doctors in
Aug Assessing new patient
admissions for smoking status
Providing appropriate therapy including NRT
30% of KCL graduates have Stage 1
5% have Stage 2
FutureOnline learning/e-learning now the norm
Need to ensure students are given time to do this, at appropriate junctures in curriculum at linked to clinical contact/patient context
Integrate into wider curriculum and assessment
Other medical schools adopting NCSCT option
GP practices and NHS training hospitals can expect students to have competences and be contributors to cessation provision/policy
Smoking cessation in medical curriculum
Basic skillsSchool and
NCSCT
Assessment School and
NCSCT
Certificates; School and
NCSCT
Apply in context Clinical
placements
Win win! Students skills and patient support
Students as learners and contributors
KUMEC - King's Undergraduate Medical Education in the Community
It also enables us to critically assess the functioning of the GP practice …in terms of what smoking cessation services they provided and how efficient they were.”
It was beneficial to be able to put what we learn into context. We learnt about GP community practice and we learnt about smoking cessation