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Opening up the UCL Medical School through teaching and public engagement

Dr Anita Berlin (Senior Lecturer, UCL Medical School) shares how the academic department has encouraged collaboration between groups through teaching methods and public engagement.

Medical School

15 June 2016

The School first thought about public engagement, and how patients might inform the training of tomorrow’s doctors, in the context of establishing local links in the London community. Dr Berlin felt the academic department had an opportunity to be a cultural resource, in perhaps the same way that UCL museums are.

Asking patients about engagement

The project started by asking patients how they thought a Medical School should engage with them.

Both students and staff ran focus groups informally exploring the idea of “today’s patients helping tomorrow’s doctors”. The team heard from a diverse range of patients, including underrepresented groups. This included advocates for drug and alcohol users and those using mental health services. They also heard from staff working in public engagement within hospitals.

The response was surprising, Dr Berlin explains. There was a strong feeling that many patients did not know what the term ‘medical student’ meant.

“They asked questions like:

  • Did it mean they were qualified?
  • What were their roles as junior doctors within hospitals?
  • What did students learn during their medical education?

It’s clear medical students occupy a middle ground – they learn within the context of a university as students but also as professionals within a long established public service. Patients wanted to know what the boundaries were,” Dr Berlin says.

As a result, the Medical School now encourages medical students to explain to their patients what their role is as a medical student.

Universities not as 'open' with patients as hospitals are

The project, funded by a bursary from UCL Public Engagement, found that universities were not open in the same way that hospitals are – there is no dedicated ‘public and patient involvement’ (PPI).

Although some members of the public may get involved with the quality assurance of medical education through formal committees, there is often no public engagement or opportunities for students and patients to learn from one another, outside structured placements.

Many of those who took part in the focus group said they wanted to find out more about medical education because students were primarily seen as the doctors of future.

Many of the patients said that although they valued input through public representation on committees, in course design and through quality assurance, this did not allow them to understand how they could better interact with “tomorrow’s doctors”.

Developing a 'show and tell' for medical education

The team then set up a ‘public show & tell’ event for patients to hear about medical education and for students to learn more about what patients might want from them.

Some 15 members of the public and 15 students attended the session, which was split in two.

  • In the first half, students involved the public in hands-on objective structured clinical examination (OSCE) style demonstrations of how to take blood, suture, deliver babies and perform CPR, while the public shared their ideas and experiences of healthcare.
  • The second part involved award-winning comic strip artist Emily Haworth-Booth inviting all participants to reflect on their side of the medical consulting table and to devise collaborative artwork.

"It was successful for two reasons,” says Dr Berlin. “Firstly because anyone can tell a story, regardless of their role. Patient narratives are an important part of medicine and it was a positive activity to create a strip of their health experience from start to finish, where there are no right or wrong approaches.

Secondly, Emily was very connected and gave people a way of getting the skills very quickly. Both the students and patients spoke highly of how it really helped them to articulate their medical experience and some said it gave them closure.”

One of the student participants also commented on how it showed that there was a lot to learn from each other. It is hoped the comic strips may be compiled in to a book.

Activities that should not have a formal assessment

Dr Berlin thinks that these types of activities, “the accessible parts of medicine” which encourage reflection on personal experience as well as professional development, should stay out of the formal course structure.

By making them optional modules there is no risk of devaluing them through a marking structure.

“Many students would take the opportunity to improve their professional development without linking it to academic standards. We already teach on ethics and communication skills, but once assessment is factored in to these, there can be a change in the dynamic of undertaking those soft skills, for example the way they might interact with a patient.

Students are nervous about the volume of protocol and safety to adhere to with the profession so taking the pressure off with formative assessment is valuable.”

Future plans for student and public collaboration

There are now plans to seek further funding to carry out more events like this, possibly linking them with another art form – such as poetry or art.

Dr Berlin believes this approach to public and student collaboration shows what can happen when academic departments trust the people they are working for to contribute to their students’ education.

“It also provides an important lesson for students – showing them how learning from the public can empower them in a professional capacity and to fully help the patients they are serving. It’s a reminder that facts and knowledge are not everything and that exposure to professional development is vital.”