really good stuff two community-based groups – one for persons diagnosed with young-onset dementia and one for their caregivers – as part of a required month-long geriatric medicine rotation. Groups were run by trained facilitators, lasted 1.5 hours, and took place every other week in a local hospital. The impact on students was captured via anonymous 24-item surveys administered immediately following the sessions (example items: ‘To what degree can support groups be therapeutic?’ ‘How relevant is preserving dignity to treatment?’ ‘How well are participants coping?’) and semi-structured reflective essays collected 1–2 days later (example questions: ‘What themes were discussed?’ ‘What did you learn?’). What lessons were learned? The study confirmed our hypothesis that support group exposure can fill a long standing gap in training by sensitising future physicians to the psychosocial needs of chronic disease patients and their caregivers. However, we were quite surprised by students’ willingness to recognise and challenge their own stereotypes because this was not required. For many learners, this was their first-ever support group exposure. They often described it as ‘eye opening’. Overall, 99% recognised the therapeutic value of support groups, 86% reported that the experience taught them about living with dementia, and 83% recommended that it should become a required component in future curricula. Many ranked it as the best experience of the rotation and some extended this to their entire medical training. Students differentiated between didactic and experiential learning and appreciated the capacity of support groups to facilitate understanding of the interaction between biomedical and ‘human’ elements of illness. By reaching students on both cognitive and affective levels, this format enabled discussion of dignity, a somewhat abstract concept, to occur in a compelling manner difficult to simulate in the classroom. Students acknowledged the unique value of learning directly from patients and caregivers about chronic disease-related needs, the medical community’s ability to meet these needs, and related strategies they can implement in their practice. Most discussions targeted communication. Students reported being ‘shocked’, ‘surprised’ and ‘saddened’ when hearing of instances in which a diagnosis was disclosed by telephone or letter rather than in person, but they empathised and felt empowered to do better. Taken together, results suggest medical students want to learn more about non-biomedical aspects of care, their attitudes are modifiable, and the erosion of empathy is not inevitable, even among Year 4 trainees.

REFERENCE 1 Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med 2003;26 (1):1–7. Correspondence: Benjamin Bensadon, Department of Integrated Medical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, USA. Tel: 00 1 561 297 2578; E-mail: [email protected] doi: 10.1111/medu.12464

Undergraduate interprofessional paediatric simulation in a district general hospital Ahmed Osman What problems were addressed? Undergraduate interprofessional simulation-based education (IPSE) is relatively new, but its use is growing worldwide.1 The literature shows an almost universally positive response, and IPSE has been used for teaching teamwork, leadership and communication skills, as well as practical clinical skills. However, although a large proportion of undergraduate education takes place in district general hospitals (DGHs), most reported undergraduate IPSE interventions have occurred in teaching hospitals or university-based simulation laboratories. This means that a potentially valuable educational tool is not being utilised for a significant part of the undergraduate course. In order to address this educational gap, an interprofessional simulationbased teaching half-day was piloted in our DGH, based around the assessment and initial management of a sick child. What was tried? Four final-year nursing (NS) and two final-year medical students (MS) took part in the pilot programme, which comprised three smallgroup sessions. The first session was an interactive tutorial on assessment and initial management of sick children, followed by an interprofessional communication tutorial, including videos of good and bad communication. A real-time, high-fidelity simulation session followed, in which groups of medical and nursing students managed a simulated patient as a team, using the assessment and communication skills developed in the previous sessions. Students played the roles of newly qualified professionals, with a junior doctor present to allow them to contact a senior for support. Each scenario lasted 15 minutes and was followed by up to 15 minutes of feedback.

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really good stuff A paediatric registrar and a nurse educator were involved in the course design and implementation. Educational outcomes and expected standards were agreed by both faculty members in line with each undergraduate curriculum. Reusable lesson plans and scenarios were developed to enable future implementation. What lessons were learned? All students attended a focus group following the pilot programme. The programme was well received, with students finding it ‘helpful’ [MS1] and ‘worthwhile’ [NS1]. The simulation session was perceived to be of great educational benefit, both for the group undertaking the simulation and for the group observing. The formative nature of the sessions and provision of feedback helped to alleviate the potentially stressful nature of the simulation. One student commented: ‘. . .the more mistakes you do, the more you can be aware of what to do.’ The interprofessional nature of the programme was welcomed and strong desires for further realistic interprofessional experiences were expressed. Students described previously being aware of ‘tension between the two professions’ [MS2], and feelings of ‘a hierarchy’ [NS3]. They also felt that the two groups work in ‘different system[s]’ [MS2], resulting in communication difficulties. It was suggested that interprofessional education throughout undergraduate training might eliminate these problems, and help professionals ‘all know what each other are doing’ [MS2]. Overall, the pilot programme was felt to be a success by all involved, and has shown that not only is it feasible to provide undergraduate IPSE in a DGH, but that it is greatly appreciated by students. REFERENCE 1 Gough S, Hellaby M, Jones N, MacKinnon R. A review of undergraduate interprofessional simulation-based education (IPSE). Collegian 2012;19:153–70. Correspondence: Ahmed Osman, Department of Paediatrics, University Hospitals of Leicester, Leicester LE1 5WW, UK. Tel: 00 44 7930 571972; E-mail: [email protected] doi: 10.1111/medu.12452

Practice interviews for final-year medical students Anna T Ryan,1 Hamish P Ewing & Richard C O’Brien What problem was addressed? Australian medical students are interviewed as part of the internship

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(postgraduate year 1) recruitment process. For many, this high-stakes occasion is their first interview experience. The challenge was to provide practice interviews for students which allowed for the provision of individual feedback whilst being timeefficient within an already busy curriculum. What was tried? Final-year students at two clinical school sites were given an e-mail outline of likely interview structure, some general information about common clinical questions and a list of recommended resources for interview preparation. All students were then invited to participate in practice interviews prior to the beginning of the formal interview period. Fourteen medical staff volunteered to participate as interviewers and 80 of the entire cohort of 101 students requested to participate. Students were allocated into groups of four and booked into 1hour blocks with each interviewer. Each student spent 15 minutes as the interviewee (for both interview and brief feedback) and the other three students acted as observers until their turns. Students were encouraged to bring their curriculum vitae and a cover letter to help direct the interview. They were asked five questions in total, which included three general questions, one question about the curriculum vitae and one clinical question. Students were also invited to bring their smartphone or tablet device to record the interview. Interviewers were directed to look for a safe, organised and structured approach in students’ answers and for evidence of their understanding of the junior doctor’s role in the treating team. At the conclusion of the interview, they were requested to ask students to give an impression of their own performance, and then to provide brief verbal and written feedback (within a template) with a focus on specific plans to assist in preparation for students’ forthcoming interviews. What lessons were learned? A SurveyMonkey link was sent to all of the students who participated, 62 (78%) of whom completed the anonymous questionnaire. Using a 5-point Likert scale, 98% of students agreed or strongly agreed that the practice interview session was helpful as preparation for internship interviews, and 92% agreed or strongly agreed that they felt more confident about the real interviews after this practice session. There was initial concern that students would not appreciate the format of the session (given that most internship interviews are not conducted in a group), but this was allayed by the finding that 85% of students agreed or strongly agreed that the format of the session was appropriate. A number of students made comments on the helpfulness of

ª 2014 John Wiley & Sons Ltd. MEDICAL EDUCATION 2014; 48: 522–548

Undergraduate interprofessional paediatric simulation in a district general hospital.

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