1. Establishing Learning-Centred Advising
Dr Maggie Bunting
Dr Katie Ellis
Norwich Medical School

2. Introduction to how research based proactive advising system is carried out within the Norwich medical school
Introduction on How local research into resilience has supported the senior advising Team to develop a consultation framework for students with low level concerns.
Exploring the student meeting framework

3. Senior adviser goals
Create an atmosphere of support and provide expert information
Promote SHARED decision making and independent thinking by assisting students in their exploration of personal, academic and career goals
Develop practices that support success
Recently research is finding that mental health issues are on the rise yet also underreported. Research undertaken within York medical school found many student reporting sleeping disturbances, changed/controlled eating habits/ mood disturbances and also reliance on unhealthy coping mechanisms. I am sure this is across all faculties.
As a senior adviser our goals are:
Next slide- the solution

4. STAGES RECOGNISE EARLY
- EARLY WARNING TRIGGERS/ENCOURAGE DISCLOSURE/SUPPORT TRANSITION POINTS
RELATIONSHIP BUILDING
- GETTING TO THE HEART OF WHAT IS CAUSING THE DIFFICULTY
REFER EARLY
MAINTAIN CONTACT
MONITOR PROGRESS
1. Proactive – target the ‘at risk’ student.
Timely support of students through important transition points.
Can start at post offer day, induction week, blasts for declaring disability. FAQ on declaring a disability, attendance (reason and reporting behaviour). Motivating students to seek help early.
2. Get to the heart of what is causing the difficulty (workshop – consultation skills) CARA as a framework.
Health, academic, attendance – culture (1st generation of HE/medicine), professionalism (faculty expectations v students understanding), extenuating circumstances.
3. Refer early – All students want to be successful – but some don’t know what to do when life gets in the way of their education. Many not aware of the resources until they are in need of them. Have their own barriers to accessing support - your encouragement may help.
4. s, contact if another early alert occurs. Consider the degree as a marathon and not a sprint -
5. follow up on mid year /end of year exam grades, attendance.

5. GET TO THE HEART OF WHAT IS CAUSING THE DIFFICULTY
Supported by Local research: ‘Medical educators concepts of resilience and coping in medical students’ Dr Dominique Hubble Norwich Medical School
A colleague of mine presented data following her research on the perspective of medical educators concepts of resilience and coping in medical education. She interviewed GP tutors who see tutor MBBS students in small group (X10) session for the duration of a year. So these educators are seeing MBBS students regularly, over a period of time and were experienced tutors. Their GP observational skills were being added to their experience of supporting student learning.

6. C context A aspirations R resources A ability Four Themes
These themes around resilience, resonated with my experience and I proposed that my team tried these as a framework for questioning students who we have either requested to meet or who have asked to meet us.

7. EXPLORING THE STUDENT MEETING FRAMEWORK
In my experience and that of my colleagues using an approach used by doctors in their consultations with patients a useful way to have effective meetings with students – very much a student adviser partnership – common goal – reach full potential in studies just like in the dr pt partnership – common goal – patient health and wellbeing

8. Initiating the Meeting Gathering Information Explanation and Planning
Building the relationship
Preparation
Identifying the reason for the meeting/setting the agenda
Establishing initial rapport
Providing Structure
Gathering Information
ICE – IDEAS, CONCERNS AND EXPECTATIONS
CARA – CONTEXT, ABILITY, RESOURCES, ASPIRATIONS
Explanation and Planning
Providing the correct type and amount of information
Aiding accurate recall and understanding
shared decision making
Setting the agenda – what do the student and adviser want to get out of the meeting?timing
ICE - Ideas, concerns Expectations
Ideas – most students know the cause of any trigger/difficulty – gp/friend/themselves – have you had any thoughts as to what might have caused your absences? How do you think things have been going for you this year?
Concerns – about the meeting itself? About their situation? About their course/progress?
Expectations – Out of the meeting, their situation, the course itself e.g. do they want to pass or be top of the class?
Benefits –
More efficient  prevents ‘hand on door comments’
Promotes the student-adviser partnership
Increases engagement
Enpowers the student
Increases satisfaction for both parties -
Closing the meeting
Screening (is there something else?)
Summary
Next steps +/- Plan next meeting

9. IDEAS, CONCERNS, EXPECTATIONS
Benefits –
More efficient  prevents ‘hand on door’ comments
Promotes partnership
Increases engagement
Increases satisfaction

10. SUPPORTING OUR GOALS
Creating an atmosphere of support by Demonstrating a genuine interest
provide expert information – that is relevant and individualised
Promote shared decision making and independent thinking by assisting students in their exploration of personal (context, resources), academic (ability, resources) and career goals (aspirations, resources)
Develop practices that support success (informed SHARED decision making)
individualised plan

11. REFERENCES
J.Matthys, G.Elwyn, M.Van nuland et al (2009) Patients' ideas, concerns, and expectations (ICE) in general practice: impact on prescribing. Br J gen pract; 59 (558): Doi: /bjgp09x394833
Kravitz RL (2001) Measuring patients' expectations and requests. Ann Int Med 134(9 pt 2):881– 888.
Hubble D, ‘Medical educators concepts of resilience and coping in medical students’ MAHEP Dissertation