Medical Education - Research Publications

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http://hdl.handle.net/11343/190

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More than another pair of hands? The impact of medical student placements on the healthcare service

Molloy, E ; Woodward-Kron, R ; Lew, S ; Delany, C ; Lavercombe, M ; Dodds, A (AMEE, 2018)

Background: Clinical placements are key to developing work-ready graduates. To date, the literature on workplace learning has focussed on learner-as-consumer, rather than learner-as-contributor. This study aimed to identify the impact of medical student clinical placements for multiple stakeholders in healthcare services. Method: This study was conducted at a large outer metropolitan healthcare service. Qualitative data collection included: observation of students on placement; activity profiling of supervisors and students; student and supervisor focus groups; and interviews with clinicians, academic and hospital leaders, and patient advocates. The data were analysed using Braun and Clarke’s (2006) thematic analysis. Results: The effects of medical students on the healthcare service were categorised into two higher order themes: ‘impact on workflow’; and ‘student presence amplifying quality of care’. In terms of affecting workflow, students in their earlier years reportedly absorbed clinicians’ time on account of direct teaching, task selection, and supervision of activities. As they approached graduation, students began to take on tasks independently (e.g. history taking, data entry, and coordinating patient discharge). Amplifying quality of care was observed through students’ prompting clinicians to reflect on their own practice. Students attended to different aspects of care, often responding to patient or family questions in the specialist’s absence. As one supervisor reported, “students often form an important, informed, but lay, connection between the patient and the medical staff so they can identify a mismatch of expectations.” Discussion: The results suggest that although students require an upfront investment of supervisor energy on clinical placement, they add value along a number of dimensions, particularly in the final year of their program. These contributions are beyond being “another set of hands”. The presence of students encouraged clinicians to reflect on their practice. Conclusion: The presence of students prompted clinicians to adopt a more critical gaze on their own work, and students focussed on humanistic elements of care – elements that can be missed or deprioritised when there is an attending expert only. The role of students as a bridge between patients and experienced staff, and how this can be optimised, warrants further exploration,
Gathering evidence for medical students’ contribution to health services: A communities of practice informed methodology

Molloy, E ; Woodward-Kron, R ; Hughson, J-A ; Delany, C ; Lew, S ; Dodds, A ; Lavercombe, M (Australian & New Zealand Association for Health Professional Educators, 2018)

Introduction: Immersion in clinical environments is key to developing work-ready graduates. Workplace learning literature has focused on the benefits of clinical placements for students and the burden for health services, such as the cost of supervisor time away from patient care. There has been little focus on mapping the benefits (obvious and hidden) of clinical placements to multiple stakeholders. Aim: To develop a methodology for capturing the benefits of clinical placements for multiple stakeholders. Methods: Using ethnographic methods of observation and interviews, as well as surveys, and drawing from the concept of legitimate peripheral participation within a Community of Practice, we charted student activities on clinical placements at an outer metropolitan health service. Results: The multiple data collection methods helped to identify how students learn through work as their expertise develops. The activity logs, survey and interviews prior to the observation phase, helped sensitise researchers to the less visible student contributions. Students in their final year contributed like a junior team member: taking patient histories, completing discharge planning and taking on ‘busy jobs’ that freed up senior team members. Discussion: The multiple data collection methods and variety of stakeholder participants allowed for triangulation of the findings, and the phased approach sharpened the focus for the student observations. Capturing the patient perspective presents challenges, as does taking into account differences in student year levels, and different levels of student engagement. Conclusions: A multi-phased, mixed methods approach can identify bi-directional benefits, mapping student contributions along a number of dimensions.
Community engagement programs and socially accountable medical education

Jones, R ; Lavercombe, M ; Schwarz, J ; Lew, S ; Toussaint, J (The Australian & New Zealand Association for Health Professional Educators, 2016)
Investigating the relationship between diabetes and surgical site infection following coronary artery bypass graft surgery

Cheuk, N ; Fourlanos, S ; Barmanray, R ; Worth, L ; Bull, A ; Kyi, M (Australian Diabetes Society, 2019)
Ectopic Acromegaly due to a Growth Hormone Releasing Hormone-Secreting Bronchial Carcinoid Tumour

Ho, W ; Harding, A ; Barmanray, R ; King, J ; WONG, R ; Yates, C ; Kevat, D (Australian and New Zealand Society of Nuclear Medicine (ANZSNM), 2018)
Not a typical case of atypical femoral fractures

Xu, S ; Barmanray, R ; HENDRICH, E (Australian and New Zealand Bone and Mineral Society, 2018)
Hypo-aged Hypovolaemic Hyponatraemia

Barmanray, R ; Yates, C ; Hamblin, P ; Rodda, C (Endocrine Society of Australia (ESA), 2018)
Optimising adrenal vein sampling: assessing the influence of ACTH stimulation

Disler, J ; Barmanray, R ; Chiang, C ; Fourlanos, S ; Dowling, R ; Rhodes, A ; Yates, C (Endocrine Society of Australia (ESA), 2018)
Follow-up of incidental thyroid nodules detected on CT angiography of the head and neck

Koome, M ; Barmanray, R ; Ho, W ; Yan, B ; Pace, M (Endocrine Society of Australia (ESA), 2018)
Inadequate Assessment of Glycaemia and Diabetes Medication Optimisation in Type 2 Diabetes Inpatients

Barmanray, R ; Foskey, R ; Kyi, M ; Colman, P ; Fourlanos, S (Royal Melbourne Hospital, 2018)

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