A Quality Improvement Project presentation by Kate Kiln & Meng Wang “Wardcraft”: Equipping medical students with the procedural knowledge and skills to make them more confident junior doctors A Quality Improvement Project presentation by Kate Kiln & Meng Wang

Aims Identified gap in skills and knowledge: “wardcraft” Aims: Identify clinical topics commonly faced by junior doctors that medical students lack confidence in managing. Recruit junior doctors to design and deliver weekly sessions to final year medical students at Addenbrooke’s Hospital, teaching them the practical knowledge/skills used by junior doctors to tackle the identified clinical topics. Increase the subjective confidence of medical students in managing these clinical problems through our teaching course SMART

Planning Surveyed medical students to identify topics of interest/need Designed a teaching programme, based on team members previous experiences involving: ~ Short lecture followed by small group teaching ~ Scenario based tutorials ~ Inclusion of practical skills e.g. prescribing Recruited junior doctors to facilitate Designed written feedback forms Each tutorial divided and written by different team member. Quality assurance by peer review and use of local and national guidelines. Feedback to act as an outcome measure and guide changes to future cycles.

Implementation Prescribing and monitoring antibiotics. Interpreting full blood counts and prescribing blood products. Practical prescribing and symptom management. Practicalities of inpatient diabetes management and insulin prescription. Interpreting electrolyte derangements and prescribing IV fluids Practical and organizational skills to survive on-call shifts. Every Thursday 1830-2030 6 week blocks to cover each of 3 sets of students rotating through Addenbrookes Feedback after each cycle

Results and actions taken Feedback after Cycle 1: GOOD: Small groups, realisitc scenarios, interactive cases BAD: More time for cases, Diabetes, Food, More simulation Feedback after cycle 2: GOOD: Small groups, practical tips, simulation BAD: Handouts, eariler start in day, session too long

CYCLE 1 CYCLE 2 CYCLE 3 Student Attendance Sessions Overall Rating Self-rated Confidence Sessions CYCLE 1 CYCLE 2 CYCLE 3

Results and actions taken Student:Facilitator Ratio Sessions CYCLE 1 CYCLE 2 CYCLE 3

Lessons learnt and next steps Medical students particularly value teaching on practical activities that simulate the role of the junior doctor. Junior doctors are an under-utilized resource in medical student teaching, and are well placed to teach the appropriate skills and knowledge required for a new junior doctor Ongoing problems include: timing and length of session, recruitment of junior doctor facilitators, continuation of sessions once current committee leave Future: AMEE international conference Cambridge clinical school liaison Overall feedback was positive: lecture + small group format, tips from junior doctors, realisitc scenarios, practical skills + simulation Future work needed on session length, timing and recruitment.

Team members and thanks Simon Biddie Kate Kiln Bahar Mirshekar-Syahkal Edward Poynton Snigdha Reddy Russell Senanayake Meng Wang Ben Warne The Stage 3 Medical Students of Cambridge University Clinical School