The disruption of medical education due to SARS-CoV-2 pandemic greatly affected clinical skills teaching, causing a shift to re-imagine the delivery of face-to-face components. Keele University adopted a Flipped Classroom (FC) approach (1) to clinical skills teaching, to adapt to the restrictions for smaller student groups and limited in-class contact. This study aimed to explore the opinions of undergraduate medical students regarding the developed pre-learning material for clinical skills teaching, in the context of FC theory.

An online asynchronous pre-learning platform was created using Microsoft Sways for every clinical skills session taught across the curriculum, including communication, procedural and examination. Student feedback was gathered with the aim of establishing what is valued in FC learning materials. Textual responses were subjected to thematic analysis (2) with a mixed deductive and inductive approach employed.

Results/Discussion

The 31 clinical Sways honed 341 evaluation comments, identifying four beneficial themes and two main problems. Students alluded that pre-learning was beneficial in enhancing engagement, improving preparedness, with the added benefit of reviewing the material at their own pace. Issues highlighted were the added burden of pre-work and challenges faced by students in need of clarification.

This study demonstrates the use of online pre-learning material in a novel FC approach using a versatile and interactive tool allowing students to become self-directed and independent learners. Further offering insights into the development of medical education and what students’ value.

Background: Social prescribing (SP) is now a key aspect of 21st century healthcare delivery and NHS Long term plan, yet it is missing from the core undergraduate curriculum in UK medical schools. We explored how to introduce this new content to ensure early years students understand what social prescribing is, how it works and why it is beneficial.

Summary of Work: In devising the curriculum delivery format for a new UK medical school, sessions on SP were embedded at each early years academic stage as a pilot project to raise awareness of the topic. Content was devised in partnership with the student SP champion, academic staff and partner stakeholders from the voluntary sector, making use of the skills and resources available locally. A focus was given to incremental learning that was stage appropriate: first year content focussing on introducing SP, second year content discussing patient experiences and third year focus on interactive simulated MDT based on SP.

Summary of Results: Results from the first two years of this pilot project show that the programme delivery has been well received by the cohort, with survey data showing that students have increased awareness (60%), interest in the subject (100%), and 63% were more likely to identify opportunities for SP on placement.

Discussion and Conclusions: We found that taking an integrated, structured approach which builds on the content and delivery year on year, first established a core knowledge base and secondly led to increased engagement from students in the topic. Having implemented SP into the curriculum, it will now be retained in the core timetable. Flexibility afforded by the timetabling of activities in a new medical school allowed these activities to be included as part of core learning time. This improved engagement during the sessions and subsequently improved follow up enquiries towards the SP lead and academic staff. The pilot has also led to the creation of a novel link worker 'shadowing' scheme for medical students as part of an optional module to be rolled out next academic year, in association with regional SP stakeholders.

Take-Home Messages: Embedding SP into the early years curriculum in a structured, interactive manner is feasible and is an important addition to 21st century medical education.

Due to the COVID-19 pandemic, the medical school had to rapidly convert their MMI into an online format which had to be reliable and secure, as well as provide a rigorous assessment of the candidates, all within the confines of what was technically and practically possible. A huge amount of work went into ensuring that potential problems which could disrupt the assessment had minimum impact. The result was an online objective structured panel based interview that was successfully used to select students for 2021 entry to the University of Nottingham Medicine courses.

Aim: To investigate the insights and experiences of interviewers and current medical students involved in the online and in person interviews, and allow comparison between the two types of interviews in order to assess factors which were perceived to have impacted the fairness and reliability of the assessment, caused by the online format. This will enable changes to be considered to future online admissions assessments.

Method: Qualitative data was obtained from 10 participants through online semi-structured interviews. Purposive sampling was used to recruit participants from a range of backgrounds who were involved in both the in-person and online assessments. Thematic analysis was conducted.

Results: Themes identified showed that participants perceived potential advantages and disadvantages of the online format, including the impact of technical issues, lack of familiarity with the online platform, the potential for fewer variables to be controlled leading to an increased impact of unconscious bias, potential for less effective candidate recovery between scenarios, and assessors own confidence in providing a reliable assessment. Several participants commented on the increased convenience and accessibility for candidates as well as suggesting that face validity remained adequate.

Broadly, the themes identified 3 sources of potential differences in the assessment: those mainly affecting the candidate, those affecting the interviewer, and those intrinsic to the new assessment method. 

Most participants felt that differences were unlikely to significantly affect the selection of the new medical student cohort, though may have had significant positive or adverse impacts for some individual candidates.

Conclusion: The online assessment method was perceived to provide an adequate assessment of candidates to allow for selection for entry to the University of Nottingham Medicine courses. The experiences of the participants can be used to inform the development of future admissions assessments to maximise the fairness and reliability of the assessment for future cohorts.

Methods: Ethics approval was gained, and a survey was sent to first- and third- year medical students. Analysis was descriptive and non-parametric tests (Mann-Whitney U, Kruskal-Wallis and Chi Squared tests) as well as independent samples T tests were used to explore associations.

Results: The response rate was 37.5%. The results supported the null hypothesis that knowledge or confidence in oral health were not associated with intent to integrate oral health into medical practice. For some statements, those with a previous qualification were more confident in their background knowledge of oral health than those without (p<0.05). Those in their third year were more likely to report higher confidence levels for some assessments for oral health than those in their first year (p<0.05). Those without a previous qualification appears more likely to integrate oral health into their medical practice once qualified (p<0.05).

Conclusions: Knowledge nor confidence in oral health is not associated with the intent to integrate oral health into medical practice once qualified

Brief Description of Content
The First Cut programme was developed in 2020 as part of a student-staff initiative in an effort to address the underrepresentation seen among surgeons in the NHS – most notably women, persons from a BME background and those with visible and hidden disabilities. The pilot project took the form of a 6-month one-to-one mentorship scheme offered to 30 students from a BME background with an interest in pursuing surgery. Each student was paired with a consultant surgeon from a similar background to their own, undertaking a range of clinical, academic and educational activities tailored to their mutual interests while receiving career support and guidance from their assigned mentors. Feedback regarding the programme was sought from mentors and mentees at the mid-point and close of the mentorship period to evaluate the effect of participation in the programme on mentors and mentees. The poster submitted will summarise the process involved and lessons learned by the mentors, mentees and committee members who oversaw the project.

Objectives: The aims of this study were to compare how effective a three-dimensional printed model of the head and neck is in improving a medical student’s knowledge, compared to a cadaveric prosection of the head and neck.

Methods: A three-dimensional model of the head and neck displaying the external carotid artery and its branches was designed and printed from computed tomography images. A prosection of the head and neck was prepared, displaying the external carotid arteries and its branches. Two methods were used to evaluate the effectiveness of the two modalities of learning. A quantitative pre/post-test to assess changes in students’ knowledge after usage of the learning modalities in a self-study session. A survey containing quantitative and qualitative elements to assess student attitudes to the two learning modalities.

Results: Pre-test scores were not significantly different (p = 0.692), nor were post-test scores (p = 0.895). 3D printed model users showed a significant increase in score (p = 0.003) as did prosection users (p = 0.008). Multiple prosection users stated that “they would prefer to use the 3D printed model to learn and then apply that knowledge to the prosection”.

Conclusion: The 3D printed model of an anatomical structure was statistically significantly as effective as the prosection of the same structure in improving a student’s knowledge. While it was not more effective than the prosection, the 3D printed model has benefits that the prosection does not and could potentially be an efficient supplement to cadaveric prosections in the teaching of anatomy.

Anatomy, in medicine, is the study of the form and gross structure of the human body. Historically, it has involved face-to-face teaching sessions and cadaveric exposure. The COVID-19 pandemic has profoundly affected the delivery of medical education worldwide. Lincoln Medical School (LMS), like most institutions globally, was compelled to adapt promptly in response to the pandemic, forcing them to adapt their existent teaching style (pre-COVID) to adhere to government and university guidelines. This resulted in the development of a new teaching style (COVID-safe).

To evaluate the impacts of COVID-19 on anatomy education at LMS in the academic years 2019/20 and 2020/21.

This mixed-methods study employed concurrent-triangulation design to simultaneously collect quantitate and qualitative data from students and staff at LMS.

104 Year 2 and 3 medical students completed the surveys provided via Microsoft Forms; the data was analysed by creating graphs and using non-parametric tests. Out of 104, 25 students volunteered to be part of focus groups. Of the 7 lecturers who taught at LMS, before and during the COVID-19 pandemic, 4 lecturers were available to take part in semi-structured interviews. The focus groups and interviews were conducted on Microsoft Teams and analysed by thematic analysis.

All students and staff were satisfied with the COVID-safe teaching style in 2020/21. However, staff members claimed that the lack of non-verbal communication due to the personal protective equipment (PPE) worn in anatomy lab sessions hindered their teaching. Having experienced both the pre-COVID and COVID-safe teaching styles, 77% of the third-year survey respondents preferred the pre-COVID style. When posed with a hypothetical question on how they would deliver anatomy in an era where there are no COVID-19 restrictions to consider, third-year students expressed an interest in reverting to a system resembling the pre-COVID style. Contrastingly, second-year students who have never experienced the pre-COVID teaching style favoured the retention of the COVID-safe style with minor amendments.

Overall, the results show a net-negative impact on the anatomy learning and teaching at LMS.

Brief Description
 We created a revision Board Game, called Differentiate, for use by final year medical students to improve recognition of differential diagnosis. This was a team-based board game where students worked in their firms of 3-4 students to race around a board. We created a set of 80 cards with each card having conditions from our 5 categories. Categories were different specialities and the conditions ranged from very common to rare. On their go they landed on a colour which dictated which speciality they would be describing. They would take the cards and describe as many conditions from their category as possible in 30 seconds. This game served as a revision tool to remind the students of conditions they haven’t come across in a while, and by making them think quickly about how to describe the condition they needed to have a good understanding of the key features of that condition. We found the students engaged very well in this activity and were intrinsically motivated to participate and learn.

Brief Description
 We developed WISE as a tool to aid final year medical students in the preparation of life as a new Foundation Year 1 doctor. The specific aspect of this we focus on is that of the independently led/supervised ward round. We felt that there is little in the way of preparation in a safe simulated environment for students to practice the intricacies of a ward round. It is usually a skill learnt on the job, which is an incredibly stressful experience on top of all the other new learning experiences happening simultaneously. Our WISE sessions encompassed a group of 4 final year medical students completing an independent ward round. They reviewed 4 patients and made their own management plans before presenting the patients they saw at the ward board round. In reviewing the four patients, they were required to do some of the following activities: - Assess an acutely unwell patient having an acute PE - Discuss DNAR discussion with a patient and their relative - Prescribe fluids for a patient post operatively - Prescribe antibiotics for a patient with likely sepsis The most valuable part of the session for most students was the practice of presenting patients at a board round and understanding their role

within the MDT. They also found the debrief afterwards invaluable as it helped them to have any questions and uncertainties addressed before taking a more active part in ward ro

Brief Description
Trends of recruitment and retention suggest the medical registrar role is under threat; fewer foundation doctors are transitioning straight into further training and the competition ratio for internal medical training has declined. This project aimed to see if implementing brief motivational educational interventions to foundation doctors training within Sandwell and West Birmingham NHS Trust would change their opinions towards different aspects of the medical registrar role, thereby encouraging junior doctors to train in internal medicine. Two different interventions were undertaken on three occasions; titled ‘The Medical Emergency Debrief’ and ‘Heroes of Tomorrow’. Both interventions focused on motivational content to educate and empower junior doctors, providing skills to build resilience and establish coping mechanisms during difficult situations. Pre and post intervention questionnaires were undertaken and analysed. Results were encouraging and showed positive improvements in attitude towards working as a medical registrar, belief in good work-life balance, decreased perceived anxiety and understanding of the role and duty of medical registrar. Further use of this intervention is planned and further research is required to ascertain whether this change in opinion can be sustained over time or most importantly, whether when applied more consistently on a larger scale, whether this could translate into improved medical registrar staffing levels.

Karen Argyle, Coventry MultiDisciplinary Safeguarding Hub

Zoe O’Connor, Safeguarding Nurse at University Hospital Coventry and Warwickshire

Rachel Cooper, Designated Safeguarding Lead, Centre for Teacher Education, University of Warwick

Mark Axon, Consultant Social Worker, West Midlands Teaching Partnership