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I really appreciate that students with learning difficulties and/or mental illness are encouraged to speak up and offered assistance at the QMHA. This would not happen where I am from; even if a service were made available, students would be too afraid to speak out for fear that it could negatively impact their future careers. I think this goes a long way towards destigmatizing mental illness and learning difficulties in the medical community, which is critical. We have had at least one student come through our rotation with a previously diagnosed mental illness. Had I not known he was struggling, I would have thought he was disinterested and lazy in his patient care. Having known many people who struggle with depression, I was able to work with him, recognizing that he needed extra encouragement and may require more gentle reminders than certain colleagues. That added level of communication, without ever exchanging a word about his diagnosis between the two of us, allowed us to work together so much more effectively as a team. I really appreciate what the QMHA has done to advance student mental health awareness.

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Going through clinical exam technique with two students I felt they were disinterested and easily distracted, not really paying attention - in hindsight I think they may have been quite stressed, it was the first day of there rotation in the hospital and we were in the middle of a busy hospital corridor. There had also been a change to their rota for that day. This study unit has been very useful in raising my awareness of the challenges and difficulties students face which may negatively impact their learning.

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Going through clinical exam technique with two students I felt they were disinterested and easily distracted, not really paying attention - in hindsight I think they may have been quite stressed, it was the first day of there rotation in the hospital and we were in the middle of a busy hospital corridor. There had also been a change to their rota for that day. This study unit has been very useful in raising my awareness of the challenges and difficulties students face which may negatively impact their learning.

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I had a group of students that seemed uninterested because they weren't asking questions and only one or two in the group would answer questions. In retrospect, there are a number of reasons why the students might be concerned about asking or answering questions: fear of answering incorrectly or asking something "dumb" or silly, unfamiliar topic, feeling intimidated by senior staffmembers/residents, etc. A lot of these relate to mindsets fixated on their knowledge gaps, though there could have been individual learning challenges too.

We try to encourage students by telling them it's ok to not always know the answer to a question; we're more interested in knowing that they can talk us through their thought process and mentally work through a challenge.  But even this might be difficult for students when they're stressed and feel "on the spot" and under pressure from themselves to get to the final answer

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I once worked with a student who was always late to rounds in the morning, but appeared to know what his patient had done minute by minute overnight.  The clip on the autism was very useful in understanding where this derives from. It is easy, especially in a fast paced environment like the QMHA to get frustrated with students like this. However, being able to acknowledge the condition should make people more understanding. In this case, I came in early, helped the student with his patient care to improve time efficiency whilst addressing all his concerns and then promoting a more succinct rounds presentation. 

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I once worked with a student who was always late to rounds in the morning, but appeared to know what his patient had done minute by minute overnight.  The clip on the autism was very useful in understanding where this derives from. It is easy, especially in a fast paced environment like the QMHA to get frustrated with students like this. However, being able to acknowledge the condition should make people more understanding. In this case, I came in early, helped the student with his patient care to improve time efficiency whilst addressing all his concerns and then promoting a more succinct rounds presentation. 

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On another note, on our service we receive a confidential email about people with physical or mental health issues that are joining the rotation that week - I think this is very useful. Do all services have this?

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I had a student recently who refused to make eye contact during group or one-to-one discussions.  I took this as an indication the student wasn't interested in learning or engaging and often tried to force eye-contact by asking them direct questions.  Looking back (and after watching the video on Autism) I can actually appreciate the student did verbally communicate as much as other students, but that the lack of eye contact somehow made that communication seem less important.  

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I had a student recently who refused to make eye contact during group or one-to-one discussions.  I took this as an indication the student wasn't interested in learning or engaging and often tried to force eye-contact by asking them direct questions.  Looking back (and after watching the video on Autism) I can actually appreciate the student did verbally communicate as much as other students, but that the lack of eye contact somehow made that communication seem less important.  

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One student I remember had taken a case responsibility of a complicated case. Whilst it is natural to miss some problems or make mistakes in an overall assessments as a young budding clinician (that is why we are here), she found these quite difficult. After that I could see that she was taking simple cases and stop making mistakes. Reflecting to what I've learned from this module, I think she may have been a fixed-mindset learner at the time and maybe she was afraid of being judged. Perhaps I should have stimulated a discussion to stimulate a growth mindset.

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I recently had a student assigned to a case of mine. The student was clearly stressed from the outset and it became clear that this predominantly arose from a lack of self-confidence and a fear of being asked questions that they didn't know the answer to. On reflection, this student may well have had some kind of SpLD, as well as anxiety which was most apparent. This student was very good at distracting or changing the subject by being loud and generally chatting about anything that wasn't relevant to anything going on around them. When asked a question, the student would get very worked up and proceed to tell me that they don't know anything and that they don't know why they are in vet school as they got a grade 'B' in A-level chemistry! This was clearly affecting their day to day life and their happiness during rotations. I think that this student, having identified that they may have had a SpLD could be referred to a senior member of the team to further discuss this possibility. In the short term, we talked at length about managing expectations as they were often much higher than any of the people asking them the questions in the first place. We discussed taking time to think about questions and formulating an answer and with time, the knowledge started to come out! If we don't identify and help students with issues like this during university, life as a new grad vet will be hideous for them and can even have a negative impact on the profession as a whole

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We do mid-week feedback and I discussed with one student they fact that it had been noted that they were quite easily distracted to the extent it could appear rude. She said she was aware of this problem as she would catch herself staring out the window and have to bring herself back to focussing on the seminar. She also mentioned her dyslexia diagnosis in relation to needing to ask questions that others may already have asked.
We had been told in advance of her dyslexia but this hadn't been circulated to all teaching staff which I think we need to start doing more, maybe not just at the start of the week but before the first session each staff member has that student for. It provides some explanation for her level of distraction. I found it interesting that she was concerned about asking questions multiple times more than she was about the level of distraction. To me needing a student needing to repeat a question generally means it wasn't explained the right way -  a failing of the teacher not the student!
This student definitely copes better in the interactive sessions as the pace is generally slightly slower and her level of distraction is reduced due to her active engagement.

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We are very good at being told in advance of any health issues, mental health included, that a student you are about to teach may have. What I had not appreciated when teaching a student with known anxiety problems was that it would directly affect her learning. In retrospect, the fear and anxiety she had must have distracted her somewhat and affected her working memory - something which I had not considered before.

I really struggled to assess her prior knowledge because she would not speak up in a group setting and I did not want to force her to do so in case it set off her anxiety. In hind-sight I wish I had done more tasks like "think, pair, share" so that she could have a confidence boost by having her opinions backed up by other group members. Equally I wonder if either a) she learnt nothing at all by hiding behind her peers or b) she learnt a lot because she stayed within her emotional comfort zone. In her feedback she said she felt like she learnt a lot but students aren't rude enough (and she certainly wouldn't have been brave enough) to say they learnt nothing!