Blog posts

Integrating sustainable healthcare into the undergraduate medical curriculum

by Dr Rene Ewe

Climate change is widely recognised as a health emergency. The GMC, NHS and WHO have emphasised the importance of teaching sustainable healthcare principles to medical students. The Planetary Health Report Card, a student-led review of sustainable healthcare education in the United Kingdom demonstrated huge variability in the level of integration into the core curriculum. At Imperial College London, we are making changes to our primary care curriculum to better equip our future doctors with the skills they will need to meet the NHS’s Net Zero initiative and to meet the changing healthcare demands of the global population. Tutors have reported that lack of familiarity with the principles of sustainable healthcare as a core barrier to teaching.

As part of this workshop, we will hear from our own students about the work they have been doing to drive changes in the curriculum. They will discuss the reasons why sustainable healthcare is so important, including the concept of the triple bottom line which highlights the economic, health and environmental benefits of greener health initiatives. We will then explore the challenges we face with integrating sustainability within the curriculum, and will invite an open discussion from attendees to help us further understand how we can support teaching of sustainable healthcare. We will discuss some of the successes the Department of Undergraduate Primary Care have had so far to galvanise our tutor community to push this further. We will round off this workshop with an open dialogue on your experiences of sustainable healthcare.

Society of Primary Care (SAPC) Madingley Conference 2022

By Dr Angelica Sharma (Academic Foundation Trainee, FY2, Imperial College London)

The Society of Primary Care (SAPC) Madingley Conference was held virtually between 20-21st January 2022 attracting over 200 attendees.

The theme was centred around ‘Primary Care – Building Back Better’. The sessions provided key knowledge updates, lessons learnt during the pandemic and ideas for change to help shape the future of primary care. The 2-day event focussed on areas such as health inequality and change including digital methods and innovative tools to address disparities in health care.

Panel discussions on ‘Digital Health: What’s Next?’ brainstormed ideas on how to integrate digital health tools within General Practice. Use of digital technologies in healthcare has progressed rapidly, especially in the face of COVID. In the next 20 years, approximately 90% of NHS jobs will require digital skills (Topol, 2019). However, there is a lack of formal integration of digital health within the medical curriculum and it is often an element that is not assessed within medical school.

Digital health initiatives included:

  1. ‘Live Well with Parkinson’s’ – a mobile application where patients living with Parkinson’s disease are able to track their symptoms on a day-to-day basis with clinicians receiving this data in live time.
  2. ‘Living with COVID Recovery Programme’ – formulating a clinical pathway to support individuals with long COVID with use of a patient-facing application delivering advice and offering a messaging service to contact health professionals.

I showcased our initiative to develop a primary care longitudinal digital health curriculum (DHC) for undergraduate medical students at Imperial College London. We compiled and reviewed learning objectives across all year groups and the learning objectives which had scope to integrate a digital health component were selected. As medical students are taught in a diverse range of settings, we explored appropriate formats of delivery of these learning objectives, including tutorial/lecture-based settings, and within written or clinical examinations. Finally, to align these curriculum changes with medical student assessments, we also carried out digital health exam question writing workshops. In these workshops, primary care clinicians were supported in implementing a digital health theme to proposed learning objectives. Key themes included patient generated data (i.e., wearables, mobile phone applications), remote consultations and electronic medical records. We were awarded the ‘Early Career Research’ Prize – with special thanks to Dr Renee Ewe, Dr Viral Thakerar and Dr Ravi Parekh.

We also presented medical education initiatives from the Primary Care Department at Imperial College including:

  1. Sense of belonging, authenticity, and wellbeing: A mixed-methods study – Dr Zoe Moula.

Medical students experience poorer wellbeing as compared to other students. Subject to the outcome of a funding application, this mixed-methods study will aim to understand how the sense of authenticity and belonging impacts medical students’ wellbeing. It will also aim to examine differences when adjusting for previous experiences of discrimination; pre-existing mental health conditions; protected characteristics; and year of study. The main objective of this study will be to identify and implement strategies that promote medical students’ sense of authenticity, belonging and wellbeing.

  1. Coaching skills for pupils from widening participation backgrounds considering healthcare careers – Hamza Ikhlaq (Medical Student).

A coaching skills workshop was developed and evaluated for sixth form pupils from widening participation backgrounds to support access to healthcare careers. Coaching offered students a greater sense of awareness and improved communication skills.

  1. Exploring the impact of a series of novel medical education masterclasses – Dr Nick Sylvan.

The masterclass series delivered in summer 2021 to UK medical students, included guest speakers, interactive workshops, and discussion panels on topic including diversity and inclusion, digital health, professional identity, preparation for practice and coaching skills. The masterclasses broadened students’ perspectives, agency, personal development, and inclusivity.

  1. Evaluation of the remote delivery of a community careers widening participation programme – Nida Hafiz (Medical Student). Widening Access to Careers in Community Healthcare (WATCCH) programme for Year 12 students who were from widening participation backgrounds. Due to the pandemic, the WATCCH programme was delivered online. Feedback from students suggested that although online sessions increased accessibility, face-to-face interaction would have helped build better relationships with peers and mentors.

Bethany Golding (Community Collaborations Lead) competed in a ‘Dragon’s Den’ style session on ‘What would you do with £1 million worth of funding?’. The talk focused on the importance of community engagement, especially in reaching out to communities and people with physical or mental health related disabilities. Examples of previous projects included tackling food poverty in local communities. She highlighted the importance of community small grants programmes to bring communities together around health and wellbeing in a way that is led by them.

The next SAPC Annual meeting will be held in Preston in July 2022, later this year.

WATCCH 2021/22: First Two Workshops Complete

by Dr Nikul Kotecha

Widening Access to Careers in Community Healthcare (WATCCH) is a widening participation initiative aimed at Year 12 students from state schools interested in a career in healthcare. WATCCH provides work experience, near-peer mentoring, and a programme of workshops on a range of healthcare careers and admissions help. The work experience and first two workshops have now been completed.

The first Imperial student-led workshop was on ‘Reflection and Coaching’ in which students engaged with mentors to reflect on their recent GP-based work experience as well as discuss their thoughts on matters such as the importance of reflection within the general/healthcare setting. Students then delved into the world of coaching. They were introduced to reflection and coaching frameworks and went on to apply their learning and skills in smaller groups. The workshop was really interactive and enjoyable and received really positive feedback from the students.

The second workshop was on ‘Personal Statements and Where should I apply’ where current medical students gave advice and tips on personal statement writing followed by a collaborative session reviewing personal statement drafts. The second workshop built on the first workshop where student used the reflection frameworks from the first workshop to probe further thinking regarding their personal statements in this conducive learning environment. Once again, the workshop received very positive feedback.

Preparation is already underway for the next useful workshop – ‘Interview Skills’.

For more about Widening Access to Careers in Community Healthcare, please see our website https://www.imperial.ac.uk/school-public-health/primary-care-and-public-health/teaching/watcch/

MEdIC Medical Education Masterclasses

by Sukhi Ubhi

During the summer, the Medical Education Research and Innovation Centre (MEdIC) delivered a series of free, virtual medical education masterclasses aimed particularly at UK medical students from under-represented backgrounds. Sessions covered topical areas in medical education including: coaching, preparation for practice, diversity & inclusion, digital health and professional identity.

The sessions were attended by 250 students from several UK universities including Imperial, Cardiff, Dundee, Leeds and Nottingham.

The feedback was overwhelmingly positive; students commented on how inspiring the sessions were and the enjoyment of meeting other medical students.

“Overall, the masterclasses provided a broad and insightful overview of medical education. I particularly enjoyed the opportunity to meet other like-minded students from different medical schools and the chance to listen to presentations and panel discussions by experts who shared their experience and passion for medical education”

Students felt the masterclasses had helped to increase their interests in pursing future careers in medical education:

“This experience has definitely made me consider medical education as a career choice”
“Prior to attending the masterclasses, I was uncertain about what medical education truly entails. However, now I have a deeper understanding of not only what it’s really about but also how to take the first steps to be involved”
“Overall the masterclasses have encouraged me to look at medical education with an inquisitive eye, always asking the questions: how well does current medical education translate into well-prepared doctors, and what changes are still needed? So, by giving me an insight into where the gaps may still lie, my interest in a career in medical education, as a means of being an instrument of change, has increased”

As part of the masterclasses, MEdIC ran a competition for students to submit medical education research project proposals. The shortlisted entries will be presented to a panel in November and the winning submission will be provided with supervision and funding by MEdIC to complete the project.

Annual Teachers Conference: Year 6 GPSA Photography Prize 2021

We asked our year 6 students on their General Practice Student Assistantship to submit photographs that they had taken while on their placements. In year 6 students go on placements all over the United Kingdom, you can see a selection of the photos below:

by Jehna Devraj
Here is a photo from my placement in Belfast. The surgery is located just by the top of the famous Shankill Road separating the loyalist and republican areas of the city. This is a photo of the adjacent peace wall (viewed from the Protestant side) that was built to quell some of the conflict during The Troubles. My GP was quite Protestant/loyalist skewed but I have also included a photo of a practice on the other side of the wall which is very Catholic/republican. It says family doctor in Irish.

 

by Febi Sidiku
“Different patients, different landscapes”

 

by Jinpo Xiang
On the way to a home visit, Loch Eriboll

 

by Jinpo Xiang
Monday morning waiting room

 

by Jinpo Xiang
Seal spotting with Dr Herfurt and Jean the retired district nurse

 

by Jinpo Xiang
The owner of Armadale house where I stayed for the placement

 

by George Stuart-Mullin
I took the first one on my last day of placement since it was the last day of placements ever, and the 2nd and 3rd are from an idea I had to help Dr Kim’s covid vaccine project by using a Bristol Drugs Project needle exchange van as a mobile vaccine clinic to reach vaccine hesitant areas!

 

by Hasan Khan

Annual Teachers Conference 2021: Navigating Future Pathways

The Undergraduate Primary Care Education Team held its Annual Teachers Conference on Wednesday 15 September. This was the first time the conference has been held online. The conference was open to everyone who has contributed to teaching our medical students or plans to get involved in teaching and we were pleased to be able to welcome more than 100 delegates from all over the United Kingdom.

We were delighted to have Dr Farzana Hussain as our keynote speaker. Dr Hussain is GP principal at The Project Surgery and Primary Care Network Clinical Director for Newham Central and was named as the Pulse GP of the Year in 2019. She gave an inspiring and insightful talk on the challenges of balancing work with our communities, so we have happier doctors and healthcare staff and happier communities, at a time when the NHS is shifting to becoming a well-being rather than a “treating sickness” service and our workforce is stretched.

Source: Dominic Lipinski/PA via the BMJ https://www.bmj.com/content/370/bmj.m2711

The presentations from our medical students have always proved one of the highlights of the conference in the past and despite the change of platform, this year was no different. Shahmeer Mohammad presented his experiences on the new I-Explore module and student shaper Kinan Wihba gave his perspective on Shaping An Inclusive Primary Care Curriculum.

Three pairs of Community Action Project students, winners from each term, presented their interventions. The delegates were asked to vote on which they thought was the best project overall and this was awarded to Thivyaa Gangatharan and Ellen Wrathall for their intervention aiding parents, carers and GPs in accessing Child Mental Health Services in Greenwich.

The delegates then broke out into workshops. This year these took on a variety of topics: creating an inclusive learning environment, make live online teaching great again, coaching skills, balancing clinical and teaching responsibilities, professional identity formation and graphic medicine.

After a break, students from across all years of teaching were awarded prizes and this was followed by our tutor awards. Many congratulations to Dr Tamara Joffe and Church End Medical Centre (Practice Award) who won Teaching Excellence Awards, Dr Adnan Saad and Dr Akbar Khan for their Supporting the Student Experience Awards and Dr Heather Molyneux who received the Outstanding Contribution to Teaching Award.

We also ran, as every year, a photography competition for final year students on their GP placements outside of London. You may see a selection of entries in the following post: https://blogs.imperial.ac.uk/gp-teaching/2021/10/01/annual-teachers-conference-year-6-gpsa-photography-prize-2021/

Widening Access to Careers in Community Healthcare (WATCCH) 2020/21

by Dr Dominique Forrest and Dr Katie Scott

The 2020/21 Widening Access To Careers in Community Healthcare (WATCCH) programme came to a close in February. WATCCH is a widening participation initiative for Year 13 students interested in pursuing a healthcare career. The 2020/21 programme consisted of a series of remote workshops, developed and run by Imperial medical students on the WATCCH committee, and the primary care team. The workshops are supported by medical student mentors recruited by Vision society.

The programme covers varied topics including interview skills, personal statement writing and reflection and coaching. The WATCCH students also have the opportunity to participate in a question and answer workshop with multi-disciplinary healthcare professionals and attend mock interviews. For the final workshop students were given the opportunity to suggest topics they would like to cover. In response to their suggestions the WATCCH team developed a ‘Higher Education Tips’ session covering key concerns such as finances, academic study tips, university support services, and the effect of the COVID-19 pandemic on university life. The workshop consisted of large and small group sessions, as well as a truly insightful talk from a first year Imperial medical student on her experience of starting university during the COVID-19 pandemic.

Over the next few months, whilst students are awaiting interviews and university offers, they can continue to access support from their Imperial medical student mentors via Brightside, an online mentoring platform. The WATCCH team are currently planning for the programme in 2021/22 where we hope to be able to re-introduce primary care work experience opportunities.

Inspiring the future generation: I-Explore Social Accountability in action

by Dr Josh Gaon

In January 2021, building on our relationships with local schools, Undergraduate Primary Care Education launched an exciting and innovative new module for year 2 Imperial Medical and Biomedical science students called I-Explore: Social Accountability in Action. This module was developed by our Community Collaboration Lead, Bethany Golding, together with Josh Gaon, Neha Ahuja, Arti Maini and Imperial StudentShapers Huriye Korkmazhan, Nadia Zaman & Ray Wang, with input from with local schools and community partners.

Imperial students explore the concepts of social accountability, power and privilege through a real-world project developing and delivering after-school STEMM-based sessions for local secondary school pupils in partnership with schoolteachers. STEMM topics have included a focus on the COVID-19 pandemic context, including topical issues relating to vaccine hesitancy and equitable distribution of the vaccine.

Imperial students have worked closely with the participating schools in Hammersmith and Fulham (Fulham Cross Academy, Phoenix Academy and Hammersmith Academy) to ensure the sessions are engaging, inclusive and relatable for the pupils. Through this real-life project work, our Imperial students are gaining invaluable experience of working in partnership with schools and with young people from a wide range of backgrounds and abilities as well as applying critical enquiry, creative thinking and using problem solving skills.

To support this experience, we provided central sessions where Imperial students learnt core inclusive teaching skills and were supported to explore concepts of social accountability, including consideration of power and privilege, and reflect on how these principles relate to their future professional career and their role in society. These sessions were built using inclusive material developed in collaboration with the three participating schools, and with Hammersmith and Fulham Youth Council, Mosaic Trust and Young Hammersmith and Fulham Foundation. We have been grateful to receive valuable input throughout from Matthew Chisambi, a TeachFirst Ambassador and the Innovation Lead at Imperial College Health Partners.

A key challenge this year has been the need to run the entire module, including delivery of after-school sessions, virtually. As many will know, running an interactive session virtually can be tricky even for the most experienced of teachers. Our Imperial students rose to this challenge, creating engaging and inclusive material that brought their sessions to life.

The feedback from schools has been fantastic so far.

Feedback from a teacher at Hammersmith Academy:
“I just wanted to pass on my gratitude on behalf of our pupils for the sessions yesterday, and my praise for the Imperial College students who led them so well. They were both fantastic sessions and flowed very well, stimulating sophisticated, thought-provoking conversation. The information shared was relevant and accessible to our students and the guidance they gave in regards to higher education was most definitely inspiring. I have no doubt that our pupils left the calls, considering their potential and excited for the future.”

The culmination of the project will be a presentation event in March where the students will be showcasing their work as well as reflections and lessons learnt from their teaching experience.

The pandemic has presented us with many unforeseeable challenges. We have been encouraged and heartened by the ability of our students, faculty team, schools and pupils to navigate rapidly changing circumstances, and by the feedback we have received.

We hope that I-Explore: Social Accountability in Action provides an exciting example of how our faculty and students can work in partnership-with local schools and communities to inspire our future generation, and we very much look forward to building on this work.

Support, supervision and service: Training medical students during the pandemic

At the beginning of December, the Undergraduate Primary Care Education Team at Imperial College ran a webinar for our GP Tutors on how best to support and train our medical students during the pandemic.

General practice has been transformed by the COVID pandemic, with majority of patient interactions continuing still remotely via telephone or digital means. This transition has been a steep learning curve for all clinicians. Our medical students have had their own challenges, learning in this changing landscape with reduced face to face contact, increased uncertainty and risk. Questions have been raised about how we can best support and supervise medical students safely as they develop their skills and experience in primary care.

The webinar was designed to address these questions, and to help support our GP Tutors with guidance. It covered how to organise a placement with safe learning activities, tips on supervision of students conducting consultations remotely and how to provide learning opportunities that also enhance service. The webinar also detailed Imperial College’s new guidance on how best to support students that are taking part in clinical and learning activity ‘off-site’, including those self-isolating.

Dr Nina Dutta (Year 3 MICA, Faculty development) and Dr Neepa Thacker (Year 5 GPPHC) led the webinar which was informed by the latest evidence and discussions with our GP tutors and students. We heard from Alexandra Cardoso Pinto (Year 3 Medical Student) on her experiences of being a student in a GP placement during the pandemic. She highlighted her key challenges, including having to isolate for a large part of her GP placement and how she overcame these, giving us all food for thought for our future students.

It was great to be joined by so many tutors with pertinent questions making for a really engaging session. We are glad to say, it was all recorded! If you missed it, you can catch up on link below:

National Diversity and Inclusion in Primary Care Education Working Group

At the end of August, the Medical Education Innovation and Research Centre (MEdIC) held a workshop bringing together leading undergraduate primary care educators across the UK to discuss diversity and inclusion within undergraduate primary care education. The workshop also included representation from the Imperial medical student body, to ensure that our focus remained firmly on those elements of diversity and inclusion which matter most from a student’s perspective. All medical students should feel they belong in their learning environment and are able to be their authentic selves. There is, however, a large literature which demonstrates that a significant proportion of students from under-represented groups continue to feel excluded, unsupported and have been subject to racial harassment. These issues affect learning and contribute to the ethnic attainment gap that emerges through medical education.  This topic has perhaps been never more pertinent in light of the Black Lives Matter movement, and widening health inequities including the disproportionate impact of COVID-19 on BAME populations.

The lens of race and ethnicity was used to examine diversity within primary care education. There was, however, recognition of the importance of approaching the work with an intersectional mindset, acknowledging that when understanding experience of discrimination and oppression all aspects of a person’s social and political identity must be considered including (though not limited to) gender, class, and sexual orientation. Discussion centred on three key areas of undergraduate primary care: curriculum and assessment, promoting diversity and inclusion in the student community and institutional culture. Delegates were candid about experiences within their own institutions many of which had shared themes. Following on from the workshop, key priority areas were identified to take forward including exploring faculty development needs, sharing resources on curriculum development and fostering belonging within the undergraduate student learning environment including development of a diverse personal tutor system.

The group will meet on a regular basis to continue discussions and develop new research with the aim of leading change for undergraduate primary care education, creating an environment where all students feel included and are able to advocate for marginalised groups. This workshop is one of several initiatives that MEdIC are undertaking in their Diversity and Inclusion Theme. Further details can be found on the MEdIC website.

For those interested in finding out more about this work, please email Dr Nina Dutta (Diversity and Inclusion Theme Lead for MEdIC) on n.dutta@imperial.ac.uk.