In Part 1, we looked at the steps already taken to promote Liberating The Curriculum (LTC) themes in UCL Medical School teaching on Clinical and Professional Practice (CPP). In this post we will explore some of the ways in which there have been improvements, and some of the sessions that have been delivered to allow us as students to put our learning into practice.
Although there is a national curriculum for communication skills, and certain core sessions have been delivered in UCLMS for several years, one of the great things about the UCL CPP team is that they are receptive to ideas from their students about new sessions that could be included. Sometimes as a medical student, particularly in the pre-clinical years, it can be difficult to know what you don’t know. It might not be until you’re confronted with a challenging situation that you realise that it could have been covered in teaching. In the video below, Faye explains an example of a new session that is being developed based on student feedback.
Another way in which the UCLMS CPP teaching programme can be expanded is with teaching projects that have been given some of the UCL-wide LTC funding. A brilliant example of this is the teaching on LGBT+ issues that has been delivered to the 4th year students for the past 2 years. What is great about the video below is the feedback Jayne includes from the students that was taken before and after the session – it really shows the increase in confidence that the students had after the teaching, and being able to ask sensitive questions in a safe environment. Medical students are generally keen to do things ‘right’ and part of what makes people feel awkward about addressing people who are different from themselves is their lack of underlying knowledge and lack of vocabulary. Hopefully the students that have benefited from this teaching will be able to carry their experience from the teaching session into their clinical practice, and do their small part to help to decrease the health inequalities experienced by LGBT+ people.
As important as it is to learn about the theory of communication skills and the reasons behind health inequalities, it is also vital that we as students are able to apply our skills in real situations. This means not only being able to communicate effectively with our patients, but also appreciate the impact that someone’s social background, race, gender and many other factors may have had on their current health and future health risks. As clinicians, we only see snapshots of our patients’ lives and the interventions that we can advise or prescribe may only be a small factor in their overall health and wellbeing.
Through experiential learning, students can start to appreciate the context of patients’ presentations as well as the complex factors involved. The two clips below are a worthwhile watch to see how this kind of learning gets put into practice. Firstly, Ms Shirley Cupit talks about the opportunities provided at UCL for pre-clinical students to meet people living with disabilities, as well as elderly people.
In this video, Dr Naomi Gostelow discusses a teaching session for final years where they need to elicit the impact that social determinants of health have had on a simulated patient. I feel that you can really see the progression here that is expected from a medical student, from a more passive role in the first year to actively applying their skills in communication and knowledge of LTC themes to understand the patient’s experience by the time they are preparing to leave medical school.
It may be easier for the final years, rapidly approaching the beginning of their medical careers and anticipating daily patient interaction, to see the relevance of CPP teaching and LTC themes to them. However, one of the challenges of improving the curriculum is not only creating new sessions or adding new material, but engaging the students and making them keen to come to these sessions and learn. One of the questions that was raised by a UCL medical student, Kevin, queried whether we should be including more questions on these topics in end of year assessments. Unfortunately, due to the high pressure surrounding exam performance at medical school, students generally put the majority of their time and effort into material that they think will come up in the exams! See Kevin’s question and Faye’s response in the video below.
So as you can see, not only are these concepts and themes present in the curriculum already but there is a move not only to improve their teaching but also to make sure that these topics are examined and become part of the core curriculum.
By Gemma Wells with contributions from Maihma Lamba