Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

my name's Helen. Salt free on Dime A GP in oxygen in the UK Um, Andi, I was for quite a long time the lead for communication skills teaching for our medical students. And also, um, I was in charge off a joint judge of the patient in public involvement program for our medical school. Um, that's what I want to talk about to you today. A little about patient involvement in medical education. I've just got a few slights. Um, and then I'll tell them off for just talking to people. Um, okay, so, uh, I'm just going to share my screen. If I can work out how to do that, just bear with me one second. You we go. So patient moment in medical education. Um, well, the first question is, why wipe over? It's a relatively recent thing that we're trying to do. This adult involve patients? Uh, there's also sort of very good reasons for doing this, which I will come to. But one of the first reasons for why bother was because we were told we have to s o in 2000 and nine. The General Medical Council, in a document called I'm Trying to get my, um, my slice Move on. And again. What bones? Just bear with me. Oh, in a, um, a supplement to introduction called tomorrow's doctors started asking us to involve patients in the public in all parts, Earth on gradient medical education. Um, on. They wanted us not just to think about patients as teachers, and that's mostly what I'm talking about today. But patients in all sorts of areas off medical education. So actually deciding what it is that medical students need to learn so some correct from setting, actually having a say in which people would choose to train those doctors. It's a big decision. You know who's gonna be suitable until Hatcher having patients on the interview panels when when students get admitted, Uh, it's also a very big role for patients in teaching students, and I took a little bit more about that on in. Under making assessments know, have do the students hands the required level of skills to proceed. Next day, you'll qualify completely on. Patients will soon have a role in governance of the whole institutions that training medical just actually seat up the top table to to work out how medical school should best run. Um, when this whole set first of I, there was a little bit of a positive the skepticism, some educators on basically a bit of a power struggle. Really. Possibly some duck in this. This the thing which might have seen ah, on various right earns and basically doctor really feeling saying to the patient, Don't confuse your Google search with my six years of medical studies. So it's the patient. Very, um, sensibly replies. Don't confuse your one hour lecture you want had in medical school in my condition, with my 20 years of living living with it, really showing that that actually patients all the experts in in their condition. So if you are going to be work with patients on, they were going to be involved in the teaching in your institution. What sort of things? What sort of ways might they be involved was quite of academic literature on this. This this next time is taken from work of something called Angela Towel, who's a Canadian, and she can't go through different levels at which people patients might be involved on. There is a sense in which you could say, well, patients are always involved. I mean, even if you doing pathology and looking down a microscope slide, there's a patient involved in this somewhere. But in terms of actually live patients being involved in the in the teaching, you could go from a bit where they're just a story, uh, through to whether you given assigned rolls to you. Maybe another step for on where the patient talks about, um, his or her own experience within a defined, um, part of the curriculum that on the back of his decided what they will talk about. And then you can move on to parts where patients and teachers are actually in folds in In the deciding what teaching years and evaluating students, you go through these various levels with curriculum where you get to patients being equal partners on down and teaching. Um, I think I mean, we we need to have some. None of these is intrinsically better than another on, you know, um, it don't matter. We will inevitably have a low these different things. Well, we'll have to be have the loans. That question is time. We moved to some of the higher ones. That's well, some some of those ways where patients can really add, uh, I think it's worth starting to think about in what ways, um, papers that what sort of teaching we're talking about. So I'm going to start showing my screen now because I've run out of slides and they weren't very interesting anyway, So let's stop doing that. Just look at me. So when I when I was in medical school, most of the teaching was on an apprenticeship model. So you kind of high around and you joined a team on Did you hope? But being there, you would learn enough pick up enough. And if you're really lucky, then you would find some, um, willing doctor to take you to a patient on Did show you what he to learn the patients themselves a passive in all of this. And if you wanted to learn cardiology, you really, really hope some some kind doctor would take you to see the patient. You have the murmur that you needed to listen to on. You would ask the patient very nicely, and you could see on the face that you were the 18 patient student that day that had asked, Um, but Nevertheless, you did get to tear it. Um, and things have changed quite a lot. I think there's a change partners, because patients are in hospital very much less time they used to be impacting stays are are much, much shorter on. Therefore, it's very possible that students just won't get a chance to hear and see on talk to all the patients they want that they need to, um, I think we can also just do it better. So instead of doing lots of old rounds and get some clinics and hoping that you will, that students will eventually have gathered all the information they need, why not from a clinic to start with where you invite, you are teaching session where you invite patients with a range of different conditions who are stable on you. Give them some training on. Then they, um, help teach the students they tell the story of their symptoms. They help the students learn how to examine them properly very rapidly. Get to say no. You need to put the stethoscope here, not there on. Do you want to listen to my lungs basis as well on the stoop that the patients become teachers on work collaboratively with you. There are lots of other ways you couldn't you couldn't do. This is well, you can have some. Sometimes we have. We have patients coming to work shops with us, where they talk about their own experience, this question of things in medicine that if you're a junior, it's difficult to work. How do you ask those questions? You really want a bit of help and actually having somebody with a condition who's very happy to sit and talk with you and answer questions on There's a student. You could get some of those questions wrong, and that's fine. And they'll explain to you why. What languages is more acceptable of the lovely patient that I worked with? Who, UH, AST Parkinson's and 11 of these sessions with the medical students on? I remember talking about how do you ask about whether somebody suffers from excessive salivation with Parkinson's? Actually, that's not a great question. Do you have excessive celebration? Would say, Do you dribble a lot? That's also not great. So she would have teach them t o ask patients about whether they work up in the morning with a very wet pillow, which is a very much nicer way of talking about things on we have. We have some patient lead workshops. We have a new allergy. Ones will have some in women's health, with subjects like menorrhagia on pregnancy loss, which can be difficult touch subjects to talk about that the students get a chance to talk with patients who, ah Prejean willing to talk about that some length and to answer questions and to give students a bit of guidance. Um, I think the there was there's more than one quickly. So I strongly believe that the students can learn more from patients and then from doctor. They could build a lot from other doctors, but they aren't other things from patients. So there's a really good factual information they learn on. They learn. How do you ask questions of patients on all of that is really, really useful. There's another better curriculum, too, though, which is about the relationship between students on patient on their four future doctor and patient. And there's something about having the patient in the teaching role to start with, which subtly alters that eventually relationship. And I think also is it towards something more collaborative. In the end, least that is, that is the aim. When, when students have started to value patients as people from whom they learn things rather than, um, merely the substrate of their learning, which is a phrase I have heard being used. Um, I I think I also just quickly like to talk about the role of of patients in assessment, because I think that's a very fundamental question that we should always ask is about what makes a good enough doctor on who gets to make that decision. Who decides what is good enough? Um, clearly unique conditions doing excessive to There's no for lots of technical stuff that needs to be judged when you're trying to side. Has the student met that standard? Do they know enough Do they reach the right conclusion is not sorts of things that actually the patients may probably not be able to judge. But then again, there are some things that are also really important that maybe the patient is the best judge, which is what it felt like to be in the patient's shoes in the in a clinical examination. Sometimes that's just the verbal that if the patient says that I found the manner of that candidate really be patronizing, or I know they have not to inflation. But actually, the way they spoke, I didn't understand what they were saying. Didn't work as communication May. That's really important. I'm very fundamental thing that the Examiner can't tell is what did it feel like to be examined? Why that candidate? But he is a purely subjective thing, but surely must be important. You know, in our institution, we we've made huge drive with this. I'm actually for a while we were able to you have our gynecological examination skills actually examined by trained lay women who were worked who were assesses the talk with students skills on the assess their skills. And actually, who could tell you whether a gynecologic examination is skilled? It's the person receiving it. Um, so that was a really interesting A project. I did. I didn't think it would ever work. I don't think we could do it all, but it did. Um, I think the other thing that we've done more recently during Kobrick lock down our students were really deprived off critical contact because the hospitals weren't allowing anybody in there wasn't 100% necessary. 30 media care. Um, so we set up some zoom interview. Some remote interviews with our with us are with willing patients on's students so that the babies are very junior students just to give them a chance to practice their history, taking skills, practice, talking to patients and also here It's a little bit longer length sometimes did in the hospital, the whole patient story, Um, on some of them found that really wouldn't helpful. I think, um, we still look quite a long way. Torno I think there were many medical schools that her head of us, um, on patient in involvement, um, to do it well, you you need a lot of good organization because it doesn't just happen by my magic. You need to recruit patients. You need to train them. You need to support thumb. You need to pay them, definitely need to pay them. They'll be doing the job of work and teaching. Written. There were different roles and different roles, mainly different levels of payment. We need some sort of structure to say this is how we're going to do with it to do it, but we feel that working with our patients A Z partners are the training. Cross Street has definitely improved, and they've learned not just about the disease, but about how that disease has affected patients. And that, I think improves the knowledge would also improves their empathy and makes them better doctors in. Thank you very much. Um, Hi, Doctor Salisbury. We've got a couple of questions that have come in. You're in the chat high on, but we've got time for one question, if that's okay. Our way. Okay, so I picked one at random. What patient Lead groups exist who seek to organize, have on have involvement in patient or healthcare education. Oh, that's a really interesting question. Um, I think there are. There are some There's a There's a very good group called the Lift Experience Network, which particularly looks after what's with, I think, with patient with disabilities. And they could be a really, really good resource for helping but for coming and talking with students and sharing their experience outside the actual clinic to just talk to students. But what it's like, what their what their experience is like. Okay, there are tons and tons of questions so if you can join in the chat and try to answer them as well. Okay. Thank you so much. Yeah. Thank you.