Spotlight on Provost's Teaching Award 2016 winner Dr Faye Gishen

What did your win highlight?

In my role as academic lead for Clinical and Professional Practice at UCL Medical School, I aim to promote a culture of reflection in students. I have introduced a novel tool to the curriculum: Schwartz Centre Rounds (SCRs). This is the second medical school in the world,a nd the first in the UK, to introduce dedicated rounds for students, so is highly innovative. This work was enabled by a Health Education England (HEE) grant.

SCRs recognise that the wellbeing of staff impacts upon the wellbeing of patient. They are forums where clinical and non-clinical staff share experiences on thought-provoking topics drawn from patient experience and so are used to enhance communication through empathy and reflection.

SCRs have been adopted in many hospitals in the UK, and were mentioned in the recent Francis Report as fostering compassion in healthcare. Medical students experience significant stress during their training. It is not yet known whether SCRs could enhance training for medical students by promoting reflection and empathy, thereby enhancing patient care. This model recognises that building resilience can have profound implications for future professional practice. A compassionate culture embedded during an ‘apprenticeship’ at medical school, can set the culture for subsequent attitudes in a career.

Two SCRs were piloted at UCL Medical School. Attendance was not compulsory. The first round ran with year 5 medical students. A panel of clinicians presented their stories of ‘A Patient I Will Never Forget’. Two trained facilitators then opened the confidential discussion up to the students: 265 students attended. We asked for feedback from all participants. The second SCR was entitled ‘In At The Deep End’ and was focused on transitioning to becoming a doctor and the associated emotions. A panel of clinicians presented on their experiences of assuming more senior roles and responsibilities. 180 final year medical students attended. We conducted a focus group with students to gather qualitative data

The result was a successful learning opportunity for participants. Data collected from almost 400 medical students showed widespread support for SCRs, with 79% saying they would attend a round again, and over 80% feeling that it had given them insight into emotions that patients can elicit in carers. Many said it was a uniquely valuable opportunity for reflection. A significant number admitted worrying about compassion fatigue and burnout.

Most felt that SCRs should be incorporated into the curriculum. The training of staff, and on-going costs present practical issues regarding embedding and sustaining such rounds into the medical school culture. However, due to the grant, this is sustainable for at least 5 years. Three further SCR are running in the 2015/16 session. UCLMS has taken part in a national evaluation of Schwartz Rounds.

I hope this demonstrates my enthusiasm for adopting innovative, evidence-based teaching techniques. SCRs can promote excellent role modelling for learners. Other medical schools have approached me for advice on how to implement this tool as part of their local ‘Resilience Training’.

What does this award mean to you?

I was delighted to receive this Provost Teaching Award.  This recognises the importance of an initiative focussing on the processing of complex cases by medical students. Addressing the emotional impact of cases on us as medics is vital.

What new ways of teaching are you looking into at the moment?

We are moving towards adopting more interaction and small group work in the medical undergraduate curriculum. There is also a drive to increase Computer Assisted Learning and Self-Paced Learning to reflect the increase in the role of technology and remote learning. Medicine however continues to be very patient-focussed in its teaching.

What advice would you give to a colleague who would like to be more innovative in their teaching?

Innovation is valuable! This should ideally be underpinned by research where possible. I would encourage my peers to apply for grants, and work with students regarding innovation whenever feasible.

Student perspective

‘There’s a lot of concern about the mental health of medical professionals and how they cope with stress. We’re in a highly pressurised career and I think that the issues that start to affect you, start when you’re in medical school.'

'To be able to say that patients affect you – to have a safe place to do this, is so positive. If you can incorporate it into your educational life it becomes so much more natural.’

‘The Schwartz Round was a completely different way of thinking that we’ve not had in the medical school before.’

Year 5 and 6, UCLMS students