PG77 ‘Hazard to help’ – a quality improvement project for 4th year medical students

Introduction 100% of fourth year medical students on placement at New Cross Hospital felt consistently ‘lost’ or ‘in the way’ whilst on the wards: A feeling shared amongst many medical students during the early phases of clinical attachment. In turn, this negatively impacted on both the overall learning experience and general satisfaction of being on placement. The objective of this Quality Improvement Project was to equip students with the skills, knowledge & confidence to undertake a more ‘active’ role whilst on placement. Methods Based on survey results of the 4th year medical students, the following 5 aims were created. Each were simple, practical skills that the students felt would enable them to undertake a more active role on the ward. They were sub-categorised as follows: Skills for the ward round: Aim 1: To feel confident taking an active role during a ward round [to include writing in patient notes] Aim 2: To be able to accurately interpret an Early Warning Score & be able to appropriately act upon it. Communication Skills: Aim 3: To have confidently presented patients to a consultant in a comprehensive & efficient manner. Aim 4: To adequately have utilised the SBAR technique to hand-over to a colleague. Skills for being ‘on call’: Aim 5: To understand the role of a junior doctor when ‘on call’, to include the ‘clerking process’, responsibilities of a junior doctor and the importance of maintaining a patient list. A cohort of 8 students completed an interactive teaching programme comprising of 3 interventions/PDSA Cycles over a 1 month period with a weekly survey to identify their confidence in each of the 5 aims listed above. Their results were then compared with the control students, placed within the same hospital. All 3 interventions primarily utilised simulation, re-creating ‘real-world’ scenarios which simply could not be taught in a lecture theatre. Results Upon completion of this teaching programme, there were significant improvements in each of the 5 aims, with students feeling ‘3 times’ more ‘useful’ on the ward. Discussion By empowering medical students, enabled junior doctors and nursing staff to share the workload of daily jobs on the ward - creating a more inclusive work environment. Conclusion The results highlighted that this simple teaching programme could easily be replicated across other hospitals and would be amenable to further expansion with simulation.