Year 4 Medical Students

Year 4 has two 17 week modules: “Mind and Movement” and “Families and Children”.
Each has 14 weeks of core and a 3-week PEP.
Year 4 ends with an 11-week period when every student is required to undertake the Project Option.

The Overall Objectives of Phase 2 PEP

The SSCs allow students to:

extend their education in depth and breadth from personally defined objectives
acquire in depth knowledge and skills about a specialty or aspect of medicine
relate in depth knowledge and skills to a specific medical issue or problem relating to a patient, a patient group, a family, a community or health care service
critically appraise published research and understand research methodology
constantly question and be self-critical
communicate clearly in writing
Focus on the long term intellectual and attitudinal demands of a professional life.

Students will complete a number of agreed Quality Improvement (QI) activities in this area alongside clinical experience.

For example, students might spend 3 days of the week gathering evidence for their QI project and gaining clinical skills and 2 days doing research for and writing up their project/s.
Students are not expectedto carry out a complete audit during the module. Instead QI activities might include looking at previous audits and evidence, or planning implementation of recommendations. Students might get involved with existing or previous QI work or use the experience to investigate theoretical proposals for audits (i.e. ‘what I would do if..’)
Students will be able to complete an Activity Log Book to plan and record the QI activities carried out during the placement.
Students will also be assessed on two written reports (one per 4 week block). One of these reports will be a Quality and Evidence Report of 4,200 words. The other will be the creation of a Lay Document accompanied by a 1,500-3,000 word Work Report on the Lay Document.
Expert Advisors – specialists in Audit, research, statistics etc will be available to supervisors and students to provide advice and guidance in their particular area of expertise. This will be facilitated through an online forum called Piazza.

Intended Learning Outcomes

At the end of the Year 3 Quality and Evidence PEP, the student will be able to:
Identify the mechanisms, barriers and facilitators to evidence adoption in healthcare locally;
Describe how clinical guidelines are developed and clinical governance is conducted with special reference to improving the quality, effectiveness and equity of clinical care;
Describe how to conduct an audit in relation to a criterion statement, and link this to the relevance and scope of the practice of evidence based medicine;
Describe the place of audit in clinical governance and quality improvements in terms of patient care and doctors performance
Interpret and appropriately analyse findings from an audit or quality improvement project;
Communicate effectively as a teacher by demonstrating that he/she can:

Summarise findings of an audit or quality improvement project
ii. Construct documentation that is understandable for a lay audience, which addresses a topic or area that he/she have been investigating;

Discuss the inter-relationship between applying best evidence in practice and the requirement to maintain good medical practice (keeping up to date);
Describe how commitment to self-regulation (and maintaining good medical practice) is demonstrated through active participation in clinical governance and requirements for appraisal and revalidation;
Demonstrate a structured approach to the critical appraisal of evidence in at least one of the settings of audit, quality improvement and clinical governance by:

Formulating a search strategy using specialist clinical library and information services
ii. Manipulating data gathering and search tools to access relevant literature
iii. Appraising relevant data from literature & critically evaluate data
iv. Evaluating the range and level of authority of different forms of scientific literature
v. Constructing a scientific written report (journal style article) addressing the topic under investigation.

At Brookhouse Medical Centre Personal Excellence Programme (PEP) medical students are offered the opportunity to suggest a topic based upon their own area of interest or choose from a pre-determined topic list. Once agreed the student will complete a four week project. Where appropriate the student will work to identify key issues around their chosen topic and will be encouraged to work with members of the practice team to develop action plans for improvement. The Student will present their project work to the Practice Team at the end of their placement.

New topics -This would include setting researching the subject, criteria, standard, first data collection, power-point/poster presentation.

Existing Topics -Re-visit and Re-audit – This would involve a second audit, comparing the results against the set standard and development of set of regulations for the clinicians to be put on protocols on intranet

Suggested Topics

Clinical audit-To be discussed with the tutor
Drug interactions, medication safety, equipment check, health and safety audits
Research Ethics in Primary Care

Organisational and educational

Structural-Health and safety audits
Hospital referral audit-timely?

Chronic disease Management

Home visit for bedbound patients with chronic diseases-satisfaction scores with scope for improvement.
Reduction of acute hospital admissions of patients with chronic diseases
Palliative care of patients -Symptom management and satisfaction scores