Community Based Learning
Download
1 / 20

Community Based Learning - PowerPoint PPT Presentation


  • 125 Views
  • Uploaded on

Community Based Learning. C21: Modernising Medical Education in Cardiff Annual Curriculum Away Day Friday 16 th September 2011, All Nations’ Centre. ‘To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all’.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Community Based Learning' - phuong


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Community Based Learning

C21: Modernising Medical Education in CardiffAnnual Curriculum Away DayFriday 16th September 2011, All Nations’ Centre


‘To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all’.

Sir William Osler


C21 strap line: sail an uncharted sea, while to study books without patients is not to go to sea at all’.

To produce excellent clinicians who understand their patients and the world in which we all live and work


Gmc requirements

GMC requirements sail an uncharted sea, while to study books without patients is not to go to sea at all’.

  • Prof Jim McKillop, Chair of Undergraduate Board, Education and Training Committee, GMC (AMEE conference, Glasgow 2010):

  • Early clinical contact

  • Professionalism stream throughout the course

  • Clinical and practical skills from early stage

  • Integration of scientific and clinical material

  • Room for innovation and individuality – both for students and the course


Rationale for clinical learning in the early years

Rationale for Clinical Learning in the early years sail an uncharted sea, while to study books without patients is not to go to sea at all’.

Integrate clinical, basic, behavioural and social sciences

Explore patients’ experiences of illness

Gain competence in history taking

Become proficient in conducting physical examinations

Develop a patient-centred approach to clinical practice

Develop professional attitudes

Learn clinical reasoning and decision making skills

Experience a wide range of specialties


Rationale for community based learning in early years

E sail an uncharted sea, while to study books without patients is not to go to sea at all’. xperience of a more personal relationship with patients in their own settings

Experience patient contact and continuity of care over a length of time and in appropriate settings – especially for long term conditions

More opportunities to sample and contribute to community projects and get involved

Contextualises learning - effect of social environment on health and healthcare, effects of diversity and disadvantage of different types

Patients are willing to participate

Students may be more likely to come back to work in these settings

Students will learn transferable skills and informed professional attitudes

Rationale for Community Based Learning in early years


Rationale for community based learning in early years1

Issues in ‘traditional’ training: sail an uncharted sea, while to study books without patients is not to go to sea at all’.

NHS greater emphasis on primary care and community services

Shorter inpatient stays reducing learning opportunities

Pressure to meet waiting list targets

Changes in junior Dr hours

Fragmentation of firms within hospitals

Competition with postgraduate training

Increased numbers of students

Increasing specialisation reduces the numbers of patients suitable for undergraduate training

Rationale for Community Based Learning in early years


So what s the evidence
So - what’s sail an uncharted sea, while to study books without patients is not to go to sea at all’. the evidence?

  • Systematic review 2006:

  • How can experience in clinical and community settings contribute to early medical education?

  • 6 electronic databases + 6 journals hand searched (1992 – 2001)

  • 73 studies – 25% comparative, 75% descriptive

  • 277 educational outcomes:


Systematic review findings
Systematic Review findings: sail an uncharted sea, while to study books without patients is not to go to sea at all’.

  • Fosters self-awareness and empathetic attitudes towards sick people

  • Boosts students’ confidence, motivates and satisfies

  • Helps develop professional identity, roles and responsibilities

  • Better understanding of underserved communities and their needs

  • Learn the context of medicine delivery better: communication, multi-disciplinary working, health care systems, population health needs

  • Gives relevance to medical biosciences and makes them easier to learn

  • Motivates teachers and patients

  • Increased recruitment to areas and specialties under-doctored, if clinical experience in those areas.

  • Entering FY1 less stressful – better interpersonal skills


Students comments from published literature

‘…we start our clinical placements early. We tend to get to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

‘teaches us things that cannot be learned from books’

‘value being able to explore social and psychological determinants of health and illness through contact with real patients’

Students’ comments from published literature:


How do we apply this to the cardiff curriculum

How do we apply this to the Cardiff curriculum? to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

  • Develop learning outcomes for community based learning

    • Primary Care

    • Aspects of

      • Public Health

      • Social sciences medicine

      • Psychology

  • Develop structures for community based learning

    • Phase 1

    • Phase 2

    • Phase 3

  • Identify placement capacity issues and funding capacity issues

  • Engage and involve stakeholders, incorporate ideas

  • Develop new learning sessions and link to curriculum and assessment programme via learning outcomes


C21: Phase 1 to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

The Mature Family

Old Age 1

Introduction

to Medicine in

Cardiff

The Young

Family

Conception Foetal Life

2

Old Age

2

Research Block

2

Infancy Childhood

2

Adolescence

Young

Adult

2

Maturity

2

  • Clinical Case Led Chronological Life Cycle – 20 weeks in year 1 and 26 weeks in year 2

  • Small Group Facilitated Sessions

  • Community based clinical placements – up to 20 half days Year 1 and 26 half days Year 2

  • Programme of lectures, seminars, practicals and clinical skills

  • Year 1:

    • Basic Science applied to medicine and basic clinical consulting

    • Normal Structure and Function

  • Year 2:

    • Consolidate knowledge and skills with application to more complex clinical presentations

    • Abnormal Structure and Function


Put yourself in their shoes... to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

The Mature Family

Old Age 1

Introduction

to Medicine in

Cardiff

Adolescence, young adulthood and the young family

Conception Foetal Life

2

Old Age

2

Research Block

2

Infancy Childhood

2

Adolescence

Young

Adult

2

Maturity

2

Oncology

Hospital Front Door

Chronic Disease

Women, Children and Family

Neuroscience and Mental Health

Complex Needs and Rehabilitation

Science

in

Practice

Elective

Senior Student Assistantship

Junior Student Assistantship

Primary Care Attachment


Mr pritchard a salesman with palpitations

  • 40 year old IT salesman from Newport to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

  • Attending an international conference in Paris

  • Several episodes of palpitations each lasting a few minutes

  • Lifestyle Information and Family History

  • Although he and his wife are worried, he hasn’t been to see a doctor yet

Mr Pritchard a salesman with palpitations


C21: Phase 1 Typical Week to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

Taught Hours:

Lectures - 3 hours

Practicals – 6 hours

Clinical Skills (incl demo) – 4 hours

Small Group Learning – 4.5 hours

Community based Learning – 3.5 hours

Self Directed Learning – 10.5 hours

Total – 31.5hours


Clinical learning

  • Clinical Skills Lab: to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

  • Measuring and assessing the pulse

  • Communication skills

    • Developing active listening skills

    • Meaning of patient centred consulting and background to the concept

    • How professional understanding of ‘palpitations’ might differ from lay perspectives

    • Focussed history taking for patients presenting like Mr Pritchard

  • Community Based Learning:

  • Visit facilitated by GP Tutor

  • Home visit in pairs to patient with history of palpitations

  • Experiential Learning: how patients present and psychosocial and lifestyle factors affecting that presentation

  • How patients would be assessed in a general practice setting, incorporating principles learnt from Clinical Skills Lab

Clinical Learning


Threats

  • Funding to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

  • Capacity

  • Organisation

  • ‘Students don’t get the same experience – eg if based in Biosciences Cathays Park versus Merthyr Health Park’

  • Rotate groups every few blocks

  • Aim for equivalence in content

  • Some of the block community learning will be about the community site

  • Merthyr – mining tradition/ closure of mines -effect on community/ unemployment and health/ how we bring about change and work with communities

  • Cardiff – comparisons between Butetown/ Grangetown and Vale of Glamorgan/ Barry. Effect of a port city/ minority groups/ why people settle here

Threats


Opportunities for the school the university and local communities

Working with partners in the NHS: to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

CwmTaf LHB and Merthyr Health Park

Bridgend Hospital teaching and learning facilities

Barry Community Hospital

Gwent hospitals

Opportunities for active patient involvement

Involving the Patients Association in planning

Expert patients as teachers

Involvement in curriculum development, lay representation – the patient perspective on chronic illness management, diversity and equality, ethical dilemmas or dr/Patient communication

Training in patient centredness, shared decision making

Developing a sense of ‘service’ to communities and social accountability

Opportunities for the School, the University and local communities


C21 Phase 2 + Phase 3 to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’.

(still fluid…)

Phase 2:

Patient pathways - Following patients out to their homes and communities

Longitudinal case studies in each block – similar in style to the current Oncology project

? Assessed by case based discussion with a panel of tutors

Reflective diaries, eportfolio logs

Phase 3:

Primary Care attachment – 8 weeks, 6.5 attached to GP.

Development of learning curriculumto deliver agreed Primary Care and other community learning outcomes

Oncology

Hospital Front Door

Chronic Disease

Women, Children and Family

Neuroscience and Mental Health

Complex Needs and Rehabilitation

Science

in

Practice

Elective

Senior Student Assistantship

Junior Student Assistantship

Primary Care Attachment


Community based learning next steps

Finalise to grips with communication skills, patient rapport quite quickly. I think this is a really good part of the curriculum because we have really early patient contact – which is why many of us want to be doctors in the first place! It certainly reinforces learning outcomes and revision, as we see in reality what we see in books’. Learning Outcomes from the submitted discipline groups

Develop a series of cases which reflect basic science learning linking to Community Based and other clinical learning outcomes

Establish community based placements – capacity and funding

Recruit and train small group facilitators

Draft handbooks for students and facilitators

Pilot case based learning and some community placements

Design the assessment and feedback programme

Develop academic and administrative structures to support and maintain teaching and learning

Ensure continuity of learning into Phases 2 and 3, keeping the core curriculum focussed

Community Based Learning: Next Steps


ad