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In the United Kingdom (UK) the government has increased the number of places at university to study medicine in England to meet workforce demands. In parallel, there have been growing student numbers in other healthcare professions and new professions whose roles overlap with doctors, such as advanced nurse practitioners and physician associates, have been introduced. These increasing numbers of medical students and other healthcare professions training in the same clinical setting have led to questions about the effect on the student experience. We aimed to investigate the impact of student-student encounters on the learning experience during clinical placements before student numbers increase further. In this investigation medical student perceptions were collected retrospectively at Norwich Medical School, University of East Anglia in the UK, during the 2018/19 academic year following two clinical placements in secondary care settings. Through mandatory online course evaluations, all medical students were asked if their learning had been positively or negatively affected by other students, and how frequently they had certain student-student experiences. Responses from 786 (of 844) medical students (93% response rate) demonstrated that most students felt their learning had been affected in some way by the presence of others while on their secondary care placements. Students experienced both positive and negative impacts of encounters with other students. Final year students tended to report more negative experiences, with first year students reporting more positive. while some students had experienced competition for learning opportunities and lower quality interactions with patients and doctors due to "overcrowding," more students reported benefits from learning from and with other students. However, it also was found that any negative encounters with other students, even if accompanied by positive experiences, detrimentally affected student satisfaction with the placement. This investigation indicates that student-student interactions influence the clinical learning experience of medical students both positively and negatively. Given the overriding influence of negative encounters, the findings suggest a need to maximize the beneficial effects of encountering other students on clinical placements; while protecting against missed or poor-quality learning opportunities due to competition between students, particularly for more senior students. Medical educators need to consider where their clinical attachments are at risk from multiple students being present at the same time and work to alleviate the negative impacts of such student-student encounters, while actively encouraging peer learning experiences between the medical students and collaborative activities between students of different healthcare professions. This is likely to become increasingly important as student numbers in medicine and other healthcare professions continue to grow. [ABSTRACT FROM AUTHOR]

Background: Research evidence over the past 20 years has established that doctors' ability to empathize with their patients is a crucial component of effective health care. Consequently, teaching and reinforcing empathy has entered undergraduate medical education curricula; however, there have been mixed results in terms of its effectiveness. While there is evidence that empathy fluctuates during undergraduate medical training, there has been very little longitudinal research looking at medical students' empathy levels over their full course of study. The aim of the current study was to investigate whether medical students' empathy changed during their 5-year MBBS degree. Methods: Students completed the medical student version of the Jefferson Scale of Physician Empathy (JSPE) at the start of Year 1 and then near the end of Years 2, 3, 4, and 5 during 2009–2015. Total empathy score for students who had completed the JSPE in all 5 years of medical training was compared over time using nonparametrical statistical analysis. Results: Results indicated that medical students' empathy varies with empathy being highest at the start of the medical course in Year 1, declining to a low in Year 3 and then rising again in Years 4 and 5. There was a tendency for female students to have higher empathy scores compared to male students in each of the 5 years, with scores significantly different in Years 2, 3, and 4. However, there were no differences in empathy scores according to the students' age. Discussion: The decline in empathy in the early years of undergraduate medical training is a concern. Medical educators should teach and reinforce empathy during early years of undergraduate medical training in a sustainable way to guard against declining empathy levels. Specific interventions targeted at increasing empathy in male students might be warranted in the future. [ABSTRACT FROM AUTHOR]

Background: It is well established that trainee doctors struggle with the transition from medical school to starting work and feel unprepared for many aspects of their new role. There is evidence that suitable induction experiences improve competence and confidence, but available data indicate that trainee doctors on the UK Foundation Programme are commonly not experiencing useful inductions. The aim of the reported research was to explore trainee doctors' experiences with induction during their first year of the Foundation Programme to identify the most useful characteristics. Methods: A questionnaire was designed to explore trainee doctors' experiences with induction at two points during their first Foundation year, during the first and third of three rotations, to enable all induction experiences on offer during the year to be surveyed. Data were collected using an anonymous questionnaire distributed during a teaching session, with an online version available for those trainees not present. Questions gathered information about characteristics of the inductions, usefulness of components of the inductions and what gaps exist. Results: 192 Foundation trainee doctors completed the questionnaire during Rotation 1 and 165 during Rotation 3. The findings indicated that induction experiences at the beginning of the year, including the local Preparation for Professional Practice week, were more useful than those received for later rotations. Longer inductions were more useful than shorter. Departmental inductions were generally only moderately helpful and they missed many important characteristics. Gaps in their inductions identified by many trainees matched those aspects judged to be most useful by those trainees who had experienced these characteristics. Conclusions: Many Foundation trainee doctors are experiencing inadequate inductions, notably at the department level. Trainees are starting rotations in new departments without rudimentary knowledge about their role and responsibilities in that department, where to find equipment and documentation, who to contact and how to contact them, local preferences, policies and procedures. Unsurprisingly, trainees who do receive such information in their inductions regard it as highly useful. Action is urgently needed to improve departmental inductions so that all trainees have the information they require to work confidently and competently in each new department they rotate into. [ABSTRACT FROM AUTHOR]

Portfolios need to be evaluated to determine whether they encourage students to develop in capabilities such as reflective practice and ethical judgment. The aims of this study were (i) to determine whether preparing a portfolio helps promote students' development in a range of capabilities including understanding ethical and legal principles, reflective practice and effective communication, and (ii) to determine to what extent the format of the portfolio affected the outcome by comparing the experiences of students at two different medical schools. A questionnaire was designed to evaluate undergraduate medical students' experiences of completing a portfolio at two medical schools. A total of 526 (45%% response rate) students answered the on-line questionnaire. Students from both medical schools gave the highest ranking for the portfolio as a trigger for reflective practice. 63%% of students agreed their portfolio helped them develop reflective practice skills ( p < 0.001), whereas only 22%% disagreed. 48%% of students agreed portfolios helped them understand ethical and legal principles whereas 29%% disagreed ( p < 0.001). In contrast, only 34%% of students thought the portfolio helped them to develop effective communication. Students perceive portfolio preparation as an effective learning tool for the development of capabilities such as understanding ethical and legal principles and reflective practice, whereas other capabilities such as effective communication require complementary techniques and other modes of assessment. [ABSTRACT FROM AUTHOR]

Objective: The aim was to examine the utility of the laddering interview technique to investigate complex issues in medical education, such as professionalism. Method: The laddering technique was used to identify examples of professional behaviour associated with the ideal medical doctor, and to explain why participants thought these behaviours were important. Three groups were interviewed: doctors ( n = 30), first-year medical students ( n = 31) and patients ( n = 33). Results: All groups identified characteristics associated with a ‘communication and interpersonal skills’ theme. Data suggested the essence of the doctor–patient interaction was shared by the groups, with varying later emphases due to their different perspectives. Additionally, Doctors and Students generated characteristics associated with ‘team-working’ and ‘competence’ themes; Doctors’ conceptualisation of each theme was more detailed. Positive and negative impacts of Doctor's professional behaviour on the patient, doctor and the wider medical arena were also identified. Conclusion: Use of laddering resulted in data-rich results for each of the three stakeholder groups, illustrating shared and divergent preferences as to the preferred characteristics of a medical doctor and effects of successful and less-successful doctor–patient interactions. The identified characteristics are relevant to the area under investigation and salient to these key stakeholders. [ABSTRACT FROM AUTHOR]

Background: The General Medical Council expects UK medical graduates to gain some statistical knowledge during their undergraduate education; but provides no specific guidance as to amount, content or teaching method. Published work on statistics teaching for medical undergraduates has been dominated by medical statisticians, with little input from the doctors who will actually be using this knowledge and these skills after graduation. Furthermore, doctor's statistical training needs may have changed due to advances in information technology and the increasing importance of evidence-based medicine. Thus there exists a need to investigate the views of practising medical doctors as to the statistical training required for undergraduate medical students, based on their own use of these skills in daily practice. Methods: A questionnaire was designed to investigate doctors' views about undergraduate training in statistics and the need for these skills in daily practice, with a view to informing future teaching. The questionnaire was emailed to all clinicians with a link to the University of East Anglia Medical School. Open ended questions were included to elicit doctors' opinions about both their own undergraduate training in statistics and recommendations for the training of current medical students. Content analysis was performed by two of the authors to systematically categorise and describe all the responses provided by participants. Results: 130 doctors responded, including both hospital consultants and general practitioners. The findings indicated that most had not recognised the value of their undergraduate teaching in statistics and probability at the time, but had subsequently found the skills relevant to their career. Suggestions for improving undergraduate teaching in these areas included referring to actual research and ensuring relevance to, and integration with, clinical practice. Conclusions: Grounding the teaching of statistics in the context of real research studies and including examples of typical clinical work may better prepare medical students for their subsequent career. [ABSTRACT FROM AUTHOR]

Aim: The aim was to compare staff and student perceptions of student experience with the UEA MB/BS educational environment. Methods: All MB/BS students were asked to complete a standard course evaluation at the end of the 2005/06 academic year, which included the Dundee Ready Education Environment Measure (DREEM). MB/BS teaching staff were asked to complete a revised version of the DREEM. Results: Data from 403 students and 73 teaching staff were compared. The overall DREEM was 144/200 for staff and 141/200 for students. Initial analysis suggested that staff believed that students' were experiencing more positive learning and teaching environments than students actually were, and they viewed the students' social experience as more negative than it actually was. However, staff were unable to comment on number of aspects of the educational environment and scored these as 'unsure'. This distorted the mean values for the subscales. When this was adjudged for, the differences disappeared. Conclusions: Staff did not believe that students were experiencing a perfect educational environment; in most cases their views were closely aligned. But staff 's unfamiliarity with aspects of the educational environment suggests a continuing need to provide feedback to staff about students' actual experiences, to enable provision of a better environment for students. [ABSTRACT FROM AUTHOR]

Objective To compare Year 1 medical students' perceptions of their educational environment at the end of Year 1, with their expectations at the beginning of the year using the Dundee Ready Education Environment Measure (DREEM). Methods Year 1 students ( n = 130) at the University of East Anglia Medical School were asked to complete the DREEM during their induction week at the beginning of Year 1, thinking about the educational environment they expected to encounter (Expected DREEM), and again as part of a compulsory evaluation at the end of Year 1, thinking about the educational environment they had actually experienced (Actual DREEM). A total of 87 students (66.92% of the starting cohort) completed the DREEM on both occasions and gave permission for their data to be published. Results The Expected DREEM score was 153 out of a maximum of 200, and the Actual DREEM score was 143. Student's expected perceptions of learning and teachers, and their expected academic self- and social self-perceptions were all more positive than their actual perceptions. There was no difference between expected and actual perceptions of atmosphere. Specific aspects of the educational environment showing dissonance were identified. In some areas students' low expectations had been matched by their actual experience. Conclusions Medical students had started Year 1 with expectations about the educational environment that had not been met. However, areas showing dissonance received low item scores on the Actual DREEM and as such would be picked up for remediation, even without information about student expectations. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine student views of peer feedback on their student-selected study (SSS) module. Methods: A questionnaire was developed to study perceptions of three groups of medical students (N = 42) towards feedback received from peers about their anatomy SSS presentation. Results: Most students felt comfortable receiving and giving feedback. They also felt that received feedback was fair, adequate and helpful, and that receiving feedback made them reflect. Slightly more students reported inadequate feedback from their peers about the presentations' content, compared to other aspects, due to their peers' relative lack of knowledge about their 'specialized' subject. Students would be reluctant to give feedback if anonymity was removed. Conclusion: The attitudes of medical students towards peer feedback were largely positive. We advocate further studies to evaluate quality of feedback, and the role of anonymity in peer feedback, and its effect on group dynamics and cohesion. [ABSTRACT FROM AUTHOR]