Author: Nina Dutta

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.

WATCCH – A Student Perspective

by Nida Hafiz

WATCCH (Widening Access To Community Careers in Healthcare), run by the Undergraduate Primary Care Education Team at Imperial College is now in its fourth year of running. The programme aims to support Year 13 students from widening participation backgrounds to pursue a career in healthcare, providing information on a range of careers and guiding them through admissions processes. Mentors, recruited by Vision Society, facilitate the small group sessions within workshops and were first introduced to the scheme last year.

I was delighted to be accepted as a mentor last year, and this year am honoured to be student lead. I decided to apply to become a WATCCH mentor for many reasons. Knowing how difficult and stressful the university application process can be even with support around, I wanted to help provide guidance for those students who do not have access support elsewhere. As someone who would once shy away from mentoring, I really wanted to work on my interpersonal skills and confidence and felt that WATCCH was a great opportunity to do that whilst making a difference. In the past I have volunteered at one-day university application workshops but what drew me to WATCCH was its longitudinal approach, meeting with the same students at each workshop, allowing rapport to be built and maintained, creating a familiar environment for students to seek the guidance they would like.

The workshops are typically held monthly, this year online, covering different aspects of the application process. Following the central delivery of the main content, mentors work with students in breakout rooms on the topic pertaining to the workshop. For example, in the opening workshop in August, mentors and students discussed different healthcare professions’ roles and learnt about each student, their career goals and challenges they anticipated facing this year. September’s workshop was on personal statement writing, and students were able to have their personal statements reviewed in small groups. There is also now the online Brightside platform, new to WATCCH, meaning that mentoring can continue safely outside of the workshops.

Being a WATCCH mentor provides constant opportunities to build on mentoring and communication skills alike. During the training session, Dr Arti Maini ran through key skills for mentoring and coaching, including the GROW model, a personal favourite which involves asking a series of questions to help one think about a difficult situation more objectively. I have learnt what it is to mentor and guide someone rather than handing them the answer, something I have mistakenly done in the past but have been able to work on during the mentoring sessions. I have also learnt to become more adaptable and comfortable not knowing the answer to every question and to take on that mentoring approach and find ways to enable students to reach a solution themselves. These skills, whilst useful as part of WATCCH, could also provide a good foundation to build on later as doctors teaching medical students or doctors mentoring junior colleagues.

Mentoring with WATCCH has made me more appreciative of inequities that exist in accessing places at university and obstacles students can face when applying. To help better support students applying for non-medicine courses we have built up information resources for a range of different healthcare courses for mentors and students to access and we hope this can be carried forwards for years to come. It is incredibly rewarding to be able to help provide the WATCCH students with support to help them achieve their potential and get into their desired healthcare course.

Imperial College Union Student Choice Awards Success

Congratulations to several members of the Undergraduate Primary Care Education team who were nominated by students for the 2020 Imperial College Union Student Choice Awards.

Dr Arti Maini, Deputy Director of the Undergraduate Primary Care Education Team, received the Award for Outstanding Student Partnership. This award is given to an individual with a student-centred mindset who embraces all aspects of student-staff collaboration from co-creation to co-evaluation. The students who nominated Arti commented that she demonstrates ‘a true understanding of the student perspective and goes above and beyond to create space for them to express their opinions. She is able to create a symbiosis between staff and students.’ Arti is an inspiration for all who she works with and this award is appropriate recognition of her hard work and dedication to students and faculty.

Dr Camille Gajria, Teaching Fellow within the Undergraduate Primary Care Education Team, was shortlisted for the Award for ‘Outstanding Professional Support Staff’. The panel were impressed with how Camille was able to apply her knowledge as a GP to help her students. She was recognised particularly for her engagement and student-centred approach with the Imperial GP Society.

Dr Nichola Hawkins and Dr Nina Dutta were nominated for Student Choice Awards for Outstanding Teaching. Nichola is an out of programme GP trainee in the department and Dr Nina Dutta leads the Year 3 MICA course.

Bethany Golding, community collaborations lead, was nominated for an award for Outstanding Student Partnership. This is particularly impressive as Beth joined the department in January. In the few months she has been here, she has been able to forge important collaborative relationships with students and community to develop our undergraduate courses such that they are better able to target the assets and needs of our local community.

Thank you to all of our students for their nominations and we look forward to continuing these hugely valuable collaborative relationships.

WATCCH: Widening Access to Community Careers in Healthcare 2019/20

by Dr Nicky Hawkins and Dr Nina Dutta

Since 2017, the Widening Access to Community Careers in Healthcare (WATCCH) programme has hosted over 100 individuals from diverse and disadvantaged backgrounds who are interested in a career in healthcare. The programme aims to support young people in making informed career choices, raise their aspirations and facilitate access to healthcare careers. Previous participants having gone on to take up offers on a wide range of healthcare-related degrees; amongst others, these include Dentistry, Nursing, Audiology, Biomedical Sciences, Pharmacy, Psychology, Radiography, Neuroscience and Medicine.

The 2019/20 WATCH programme has supported 40 students with primary care work experience and educational workshops, including multi-professional healthcare panel question and answer sessions and admissions workshops including personal statements and mock Multiple Mini Interview (MMI) circuits. This year’s programme has also included a mentoring scheme, whereby WATCCH participants are linked to current Imperial College School of Medicine (ICSM) student volunteers that have received training in coaching and mentoring.  As the 2019/20 WATCCH programme comes to an end, our online closing event will focus on preparing students for the transition to life in higher education via a practical introduction to coaching, led by Dr Arti Maini, and talks spanning mentors’ ‘top tips’ on finances, accommodation, study skills and student welfare.

Looking ahead to 2020/21, we are committed to delivering a valuable WP programme despite the challenges posed by the COVID-19 pandemic.  Applications are now open (until 27/06/2020) to eligible students as we begin to plan an innovative series of interactive online workshops accompanied by remote student mentoring. Using technology to our advantage we hope to expand the online programme to accommodate a higher number of students across the UK and also collaborate with a wider range of healthcare professionals. Evaluation of the programme also continues via the Higher Education Access Tracker (HEAT) and the Medical Education and Research Innovation Centre (MEdIC) based within Undergraduate Primary Care Education Team in the School of Public Health. As well as evaluating the programme from the perspective of student participants, we are also interested in the impact of near-peer WATCCH mentoring on the personal and professional development of mentors themselves.

Once again, we would like to thank all of the student participants, schools, teachers, and our Imperial WATCCH mentors for the enthusiasm and dedication that they bring to the programme.

Quote from student in the current WATCCH 2019/20 cohort:

“The WATCCH programme was fantastic in helping me secure medical school offers by firstly providing a week of general practice work experience. This was a valuable opportunity to shadow healthcare staff that could be included in my personal statement and discussed in the interview. There was a focus on reflective learning following the GP placement and then there was helpful support in the personal statement as well as practice MMI mock interviews. These sessions overall strengthened my medical school application by improving my confidence at every stage of the UCAS application process.”

For further information on WATCCH, please go to https://www.imperial.ac.uk/school-public-health/primary-care-and-public-health/teaching/widening-access-to-careers-in-community-healthcare/

Digital learning: lessons learned during the COVID-19 pandemic

by Dr Nicky Hawkins, Dr Nina Dutta, Dr Neepa Thacker and Dr Arti Maini

The Undergraduate Primary Care Education Team leads on the delivery of a wide range of courses across the six years of the Imperial MBBS programme. On March 14th 2020, the medical school announced the suspension of all face-to-face undergraduate clinical placements in light of the COVID-19 pandemic. With major implications for two of our key primary care courses – Year 3 Medicine In the Community Apprenticeship (MICA) and Year 5 General Practice and Primary Healthcare (GPPHC) – we were tasked with the rapid conversion of these face-to-face clinical attachments into courses that could be developed and delivered entirely remotely.

Traditionally, both MICA and GPPHC are centred around medical students observing and assisting doctors in an authentic clinical environment, regularly engaging in meaningful interactions with patients themselves. The team therefore sought to capture the complexities of this learning environment, ensuring that we were adequately addressing the educational needs of our students. Here we describe and reflect on selected key components of the digital MICA and GPPHC courses, sharing some of the lessons learned from our students along the way.

Large group live webinars. Alongside other webinars, both MICA and GPPHC digital courses incorporated weekly live ‘Case Rounds’; webinars centred around clinical cases and questions, circulated to students in advance. Attended by up to 140 students, interactivity was integral to these webinars and maintained by actively encouraging students to submit questions and answers via the ‘chat’ and utilising real-time voting applications such as Mentimeter. Student feedback on live webinars in general was overwhelmingly positive. It was interesting to hear them repeatedly describe feeling liberated to interact more freely, due to the anonymity of the online format; it appeared to create a more inclusive environment for students whilst retaining engagement and learning value.

“I like this format because I feel more comfortable to engage and interact compared to face to face. Makes it feel safe knowing that we can contribute without other students knowing it’s me giving that answer…I felt more engaged and switched off less. I think it’s a good idea which should be incorporated more for future years.” Year 3 MICA student

Small-group history taking sessions. Recognising the need for peer-peer interaction, and a platform to actively promote development of students’ consultation skills, both MICA and GPPHC held history taking sessions using Zoom’s breakout room function to facilitate interactive small-group work. This enabled role-play of a range of primary care scenarios. Students rated the session highly, commenting on the value of real-time personalised feedback from both tutors and their peers.

 “It was a good opportunity to socially connect with colleagues remotely and undertake some peer-to-peer learning.” Year 5 GPPHC student

Self-study e-learning resources. Alongside timetables of live sessions, an online package of learning materials mapped to core curriculum content was made available to both MICA and GPPHC cohorts, combining internally created resources and external resources that had been quality assured by the team. Well received by students, this was available to access remotely in their own time, at their own pace, promoting asynchronous online learning.

As a team, we have rapidly upskilled in our digital capabilities to deliver innovative online learning across a range of formats.  It is exciting to pause and reflect on what has been achieved in such a short space of time. We have also had the opportunity to collaborate with colleagues in Melbourne University who have been leading a similar radical change to digital delivery of medical education. This collaboration has led to shared learning and innovation, which has led to a acceptance of a joint publication in The Clinical Teacher.

Drawing on the valuable lessons learned, we are looking to develop these digital course components further as we approach the start of the new academic year. Although students will be returning to clinical placements, it is clear there will remain an important role for digital learning strategies alongside more traditional placement teaching.

WATCCH 2019 (Widening Access to Careers in Community Healthcare)

This summer the Undergraduate Primary Care Education Team are delighted to welcome students to the third year of our innovative widening access programme, WATCCH (widening access to careers in community healthcare). WATCCH supports young people from diverse and deprived backgrounds who are keen to pursue a career in healthcare. Our WATCCH students are enjoying learning about a diverse range of healthcare careers via campus-based education days and work experience in the primary care setting. This year, we have partnered with the student society Vision who are offering mentoring for our WATCCH students, following bespoke coaching and mentoring training from our in-house coaching lead. We will be running a series of student-led mentoring workshops throughout the year on topics including admissions tips, finances and personal skill development.

This popular programme supported by HEE NWL, has hosted one hundred students over the last three years and has sparked interest in universities nationally.  Our evaluation to date shows that WATCCH increased students’ awareness of the range of healthcare careers available and has generated new thinking about career options. The programme also increased participants’ self- confidence in their ability to pursue their career choice, and importantly has given students access to relatable healthcare professional role models increasing their drive and motivation to join the healthcare workforce.

We look forward to expanding WATCCH further in upcoming years and would like to thank all the schools, teachers, Imperial College students, and our WATCCH students for the enthusiasm and dedication they bring to the scheme.

WATCCH sits within the Diversity and Inclusion theme of the newly-established Medical Education and Research Innovation Centre (MEdIC) based within Undergraduate Primary care Education Team in the School of Public Health. MEdIC aims to translate the medical education evidence-base into robust educational innovations and research which strengthen our medical workforce and have a sustainable, equitable and transformational impact on society.

For further information on WATCCH, please contact n.dutta@imperial.ac.uk

Our experience of the RCGP conference

by Ashleigh Sahota, Undergraduate Medical Student

We attended the RCGP (Royal College of General Practitioners) annual conference in Liverpool, during the 3 days we learnt about not only being a GP but about patient communication and social health more widely. We submitted our project from the Year 3 Community Action Project and were so pleased that it got accepted for display at the conference. Our Community Action Project aimed to encourage patients to take more ownership of their medications and allergies. As well as talking about our project and answering spectators’ questions, we also attended a variety of talks about patient-centred communication, social inequalities of health and working effectively in groups. These talks gave me lots to think about in terms of medical school but also in my career and being a trustworthy Doctor. Also, it enabled me to think about General Practice in a new way as I met so many GPs who were doing such a wide range of things as part of their job for example: working in the military, working with a sports team, have a special interest in a particular field and being a Partner. This variety of choices has made me consider General Practice as something I would want to do in the future as well as GPs being directly involved with the community. A particular highlight for Sarah and I was the talk given by Professor Michael Marmot about his research into the inequalities of health in our society, this was very eye opening and made us reflect on things we haven’t thought about during medical school so far.

WATCCH – Widening Access to Community Careers in Healthcare

This summer the Department of Primary Care and Public Health ran the second year of the Widening Access to Community Careers in Healthcare (WATCCH) programme. This is a programme for 16-17 year olds from diverse and deprived backgrounds who have an interest in careers in community healthcare.  The programme gives pupils an opportunity to get vital work experience in healthcare and provides support with the application process. This is needed, now more than ever, when OFFA data shows that in 2016 entry rate to “higher tariff universities” for 18 year olds from the most disadvantaged backgrounds was just 3.6%. The WATCCH programme doubled in numbers this year to accommodate 40 pupils and was once again oversubscribed with high calibre applicants.

The programme starts with a Welcome Day at Imperial College London’s Charing Cross campus. Here, the school pupils heard from a multiprofessional healthcare panel including GPs, a pharmacist, physiotherapist, midwife, nurse and occupational therapist.  The panel shared their career journeys and then took part in a Q&A session with an honest discussion on the pros and cons of a career in healthcare. The pupils then got the opportunity to get some hands-on experience practicing blood taking and blood pressure taking. The day ended with a creative session where the pupils created mindmaps, reflecting on their future aspirations and the steps they could take to achieve their goals (see picture).

Following the welcome day, the pupils took part in a 3 day work experience attachment in a local GP practice, where they had the opportunity to shadow a range of healthcare professionals. The pupils then came back together for a Closing Day where they reflected on their work experience and also received teaching on how to maximise their chance of successful application to their chosen career.

Our WATCCH pupils told us about the struggles they had had getting any work experience, and how valuable it had been to gain insight into what a healthcare career might involve. They also learnt about new potential healthcare career options, such as physician associates, which most had not previously encountered. In an era where the NHS workforce is facing a recruitment crisis, this scheme supports applicants from underrepresented backgrounds in their journey to careers in healthcare. Supporting these students is vital in order to create a diverse workforce which better reflects the patients we care for.