Meducate Academy

Meducate Academy’s First National Online ACE Conference

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Meducate Academy’s First National Online ACE Conference

Meducate Academy are pleased to announce their First National Online Conference on The role of the Associate Clinical Educator in Medical Education.

As I have said repeatedly, Simulation with an ACE plays a very important role in helping Medical Students, Physician Associates, Pharmacists and other health professionals in the application of their skills. This coupled with the use of other tools such as the Sim Man, anatomical models and volunteer patients integrate the teaching so that the students practical development is maximised. It prepares them to work with real life patients.

More often than not students only get to practice these skills on volunteer patients and mannequins. Neither of these can replace the type of feedback given by a human being in real time.

A few years ago this problem was addressed by Prof Jim Parle at The University of Birmingham on the Physician associate Course. He realised the importance of high quality feedback and created the role of the Associate Clinical Educator (ACE). The ACE, as we have previously said, is a highly experienced medical roleplayer who has been trained by clinicians to understand “how” the Systems examinations should be carried out. The ACE will then guide the student, allowing them to develop their skills in a safe and controlled environment.

It is also important to realise that as well as aiding the student in passing their OSCEs, the ACE role is there to help the student develop safe practice. This is a topic that is often not mentioned and this too will be discussed during the conference.

At the present moment ACEs are only being used by three institutions in the UK.

Birmingham University (In house through the ISU)
Chester University (Meducate Academy)
Wolverhampton University (Meducate Academy)

We are inviting clinical leads as well as those involved in simulation in the health professions to attend free of charge.

You will have a chance to listen to 5 key speakers who currently use ACEs alongside traditional methods of simulation and also get to see a brief example of how an ACE works with a student. This will be followed by a Q & A session with the speakers themselves.

The Line Up:
Professor Jim ParleProfessor Jim Parle

Professor Jim Parle will be speaking about the history of the role of associate clinical educator and his part in its development and what the future holds for simulation.

Jim Parle was Professor of Primary Care and was Course director for the Physician Assistant PGDip programme at The University of Birmingham. Although retired he continues to work tirelessly on a variety of projects.

Jim entered General Practice in 1982 and was Senior Partner from 1983 to 2000, continuing part-time General Practice alongside academia since then.  Jim’s main activity in his 20 years as an academic has been in education, leading on the introduction of a major community based teaching strand within the MBChB course; championing the place of non bio-sciences such as ethics and law and behavioral science in the medical curriculum; establishing the PA PGDip; and leading innovative educational approaches such as using lay women to teach medical students how to perform female pelvic examinations. His research interests have been predominantly in thyroid epidemiology and in education. He has received grants from, among others, the RCGP, PPP (now the Health Foundation) and the NIHR.

Jim had also led the development of community based experience for medical students, initiated (with Dr Sheila Greenfield), the innovative and successful intercalated degree in non-bioscience subjects; led the development of various types of simulation as enjoyable and effective learning methodologies for clinical skills and set up one of the first, and by most measures the most successful, postgraduate diploma in Physician Assistant studies in the UK. He was also chair of the UK and Ireland Board for PA Studies. He has been on the Steering Committee for the Biennial International Clinical Skills Conference series held in Tuscany, and chaired the Scientific Committee for that conference.

He is well known in the fields of thyroid epidemiology and, in education, particularly in the development of innovative approaches to learning clinical skills. He has spoken at numerous conferences on these issues (e.g. quinquennial thyroid conference, Buenos Aires, Ottawa conference on assessment, Toronto).

He recently stepped down as Chief Senior Examiner of the RCP Faculty of Physician Associate National Exam board.

James Ennis Course Director University of ChesterJames Ennis

James has worked in a number of clinical fields across the UK including general surgery, trauma and orthopaedics, acute medicine and general practice. He has worked in educational institutes across England and is currently research active. His research interest is in the PA role in the UK and the use of simulation in medical education. Recent publications include:

Effectiveness of technology-enhanced simulation in teaching digital rectal examination: a systematic review narrative synthesis.

Physician associates: the challenge facing general practice.

Physician associates working in secondary care teams in England: interprofessional implications from a national survey.

James is currently the Course Director of the MSc Physician Associate studies at the University of Chester.

Kate Straughton President FPAKate Straughton

President of the Faculty of Physician Associates and Senior Lecturer at The University of Birmingham Physician Associate Programme.

Kate is a qualified PA, graduating from the University of Birmingham in 2009 and completing her MsC in 2017 from the University of Worcester. She has over ten years experience including working in acute medicine and neurosurgery. She has been working in PA education since 2014, with a focus on work-based learning and clinical placements. Kate is currently the placement lead for the University of Birmingham PA course, and also oversees the MsC ‘top up’ for PAs who wish to carry out some further research.

Uzo Ehiogu Uzo Ehiogu

Uzo is a Clinical Specialist Physiotherapist who led the Spinal Therapy Unit at London Bridge Hospital in London, England. In that role he was responsible for the specialist spinal rehabilitation of post surgical patients referred by orthopaedic, upper limb and neuro surgeons. He also acted a source of clinical expertise for lower quadrant related dysfunction within the department. He now heads up the training of 4th year Medical students in Musculo Skeletal Examinations at the Royal Orthopedic Hospital in Birmingham as well as working in a busy clinical role.

Uzo is a retired British Army Physiotherapy Officer of the Royal Army Medical Corps. He spent several years in the Royal Marines Commandos and qualified as a Parachutist before being selected for a Commission in the Army as an Officer. During his service in the Army he has worked in secondary care, primary care and occupational health environments.

One his most recent appointment was as the Rehabilitation Officer at the Royal Military Academy Sandhurst providing clinical and administrative leadership for a high performance musculoskeletal service. He was the clinical lead responsible for the delivery of a high class service in a premier military training establishment for injured soldiers. He led the  accelerated return to military training and work of patients with career threatening injuries requiring ongoing care and extended rehabilitation for periods of 4-8 months.

Uzo deployed to Afghanistan twice during his Army service years in support of British Special Forces personnel. He conducted specialist musculoskeletal clinics. This role required independent decision making regarding the clinical diagnosis and future management of high value personnel.  He has also worked as a Specialist Physiotherapist at Defence Medical  Rehabilitation Centre Headley Court.

Uzo has worked in the National Health Service as a Senior Physiotherapist where he developed a Pilates and Spinal Stability retraining service in East London England. He has worked for several football teams in Northeast London, England, most notably at West Ham Professional Football Club as the Youth Team Physiotherapist.

Uzo is a Bachelor of Applied Sports Science, and an accredited Strength and Conditioning Specialist with the National Strength and Conditioning Association USA. He is also a Bachelor of Physiotherapy and is in his final year of a Clinical Masters of Science Degree in Manipulative and Manual Physiotherapy. He is a keen researcher and reader and is currently involved in a year long prospective research project investigating lower limb injury risk profiling in British Army Officer Cadets.

Mark Reynolds Mark Reynolds (Host) Mark has been working as an ACE since 2008 having trained as a medical role player two years previously. Aside from teaching cardiovascular, respiratory and gastrointestinal examinations, his special interests in the ACE role include clinical communication, orthopaedic examinations and Mark is a leading educator in the male intimate examinations. Outside of the ACE role Mark is currently involved with various narration projects for the BBC Doctor Who franchise.

We look forward to you joining us on the 4th September 2021 at 12 noon and engage with our experienced clinicians who will talk about their experience of simulation in teaching practice and how the ACE has helped their students develop important clinical and communication skills.

Click here to register for Meducate Academy’s First National Online ACE Conference

Training A New Generation Of Associate Clinical Educators

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Group image of ACEs at Meducate Academy's first training day
All of the ACEs at Meducate Academy’s training day in Birmingham on 19th June 2021

Meducate Academy have been working tirelessly with a view to creating more high quality ACEs, to help with the growing interest in the role we play. There seems to be a shortage of high quality ACEs and as our workload seems to be increasing, we conducted our first training programme on the weekend of the 19th June in Birmingham.

We have recently been busy over the past three weeks with the buildup to the OSCEs and of course the ongoing work with Chester and Wolverhampton Universities. It has been a successful time  for all involved and our ACEs have had their work cut out for them.

Working alongside clinicians, we have been assisting in the teaching of physician associates in:

  • MSK
  • Cranial Nerves
  • Gastro Intestinal
  • Respiratory
  • Cardio Vascular
  • Blood Pressure Measurement,
  • Peripheral Pulses and Nerves

We have also roleplayed a variety of exceptionally challenging scenarios, assisting the physician associate with a methodology of history taking, which enables them to become empathetic and safe clinicians.

We support and have continued to work closely with Matrix Education on their programme of weekend training courses.

Meducate Academy recently conducted our first training programme on the weekend of the 19th June in Birmingham.

The session was led by ACEs with the curriculum for the day previously scrutinised by two senior clinicians. Once they were satisfied with the content we gathered the delegates together in central Birmingham for the big day. There were 13 potential ACEs who had committed themselves to the training, who all turned up on time, ready for a very intense but enjoyable day.

The delegates were provided with a comprehensive manual/Aide-mémoire outlining the Gastro intestinal, Cardiovascular and Respiratory systems examinations.

It was important that we paid particular attention to the expectations of the role of the ACE, as none of the delegates had ever worked in this way before.

Medical mannequin
Whilst medical mannequins are useful, they can’t give structured feedback

It was explained that the ACE is not simply a body to practice on, but a high-quality expert patient capable of giving quality feedback about the process of the examination to the Physician Associate Student. We stressed this throughout the day because if the ACE can’t deliver this type of information correctly the student may well as have a mannequin to practice on!

The ACE is essentially an ‘expert’ patient who knows how a student should perform several of the primary systems examinations. It is our role as an ACE to guide the student from start to finish, creating a safe and effective clinician in a supportive and friendly learning environment.

The ACE does not get involved in diagnosis, or the theory behind the examination. We leave that to the clinician, who is usually present throughout the lessons. 

We are there to teach the physician associate student HOW an examination is carried out, and not WHY…

The delegates had traveled from all over the UK and the course was provided free to all those attending. It was satisfying to see how motivated and engaged they all were as we took them through basic jargon and vocabulary, peripheral pulses, blood pressure measurement and of course the main body systems.

Obviously, a day is not enough to encapsulate everything that is required of an ACE, so it was made clear that this was the first step on the road to becoming an Associate Clinical Educator.

Regarding attendance on future Meducate Academy courses (which will also be monitored by experienced clinicians and ACEs) we explained to the group that they will also be expected to shadow the more experienced ACEs before moving onto working autonomously. The new ACEs would also have an informal evaluation conducted by a clinician before being allowed to work as an ACE with Meducate Academy.

Clinical Lead Pete Gorman and Dr Banu Deniziri with newly qualified Physician Asscoiates Zaki and Asim
Clinical Lead Pete Gorman and Dr Banu Deniziri (Wolverhampton University) with newly qualified Physician Asscoiates Zaki and Asim

We want to ensure that our clients get the very best from Meducate Academy. I feel training programmes like ours go someway to developing a model that will provide the client with consistently high quality ACEs.

As has been mentioned on previous posts we are still endeavouring to get some sort of accreditation for the role of the ACE. This may take some time, but we are working on validation of the role with a couple of our university partners.

On another note, I have just had news that one of our partners, The University of Wolverhampton, has just repeated last years success at the National Exams and their last cohort achieved 100% in the written and 88% pass rate in the OSCEs.

It’s nice to know that our ACEs played a small part in that success and I would like to thank them for the hard work and dedication over the past 12 months.

Following up on this, Clinical Lead Peter Gorman has offered to take part in a podcast for Meducate Academy to talk about his innovative approach to preparing Physician Associates for their National Exams. Bookmark this blog and look out for the podcast video which will be posted in the near future.

Meducate Academy ACE Recruitment & Training Programme

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Meducate Academy ACE recruitment and training programme online

Meducate Academy recently embarked upon a continuing ACE recruitment and training programme with candidates who had expressed an interest in our ACE training schedules. We emphasised that the role we play is vital in ensuring a clinician is safe to practice with an actual patient and how much commitment is required to fulfill the role of an ACE.

Saturday 15th May 2021 was a very busy day at ‘Meducate Towers’ as we embarked upon our continuing ACE recruitment and training programme. After an initial online webinar a few weeks ago we set Saturday as the date to bring in those candidates who had expressed an interest in our ACE training schedules.

After an initial conversation, in which Mark and I outlined our background and history, we then went on to explain the role of the ACE in medical training. We went onto describe the body systems and how the student clinician would examine a patient. What then followed was a typical ACE hands-on session, with Mark playing the Physician Associate Student, and I as the ACE/simulated patient giving feedback.

This was a great opportunity for the candidates to see how much knowledge is required in order for them to fulfill their role with Meducate Academy. I think it surprised those watching just how much skill and knowledge is necessary to perform the task. Though we did explain that we have been in the role for twelve years, emphasising that this was not our expectation of them at the moment. ACE Training is an ongoing process and even Mark and I are still learning and developing our roles as ACEs.

As you can see from the heavily edited video above, Mark was playing a poorly prepared student. This was an extreme example which gave us the opportunity to show how the ACE needs to be alert when working in a situation with a below standard student.

We explained that the student does not expect us to give feedback on the students’ medical knowledge, or on their diagnosis, but on their technique when performing the examination. Of course, we would also comment on the students’ communication skills if we had any concerns.

Our role is to ensure that the student is safe to practice with a real patient and make a valuable contribution to their profession.

After the demonstration was over, we then went into an Q & A session, which included questions on the duration of training and how their assessment will be carried out. We explained that although the initial training is quite short, we will expect them to shadow an experienced ACE until we feel they are ready to take on the role. We emphasised that the part we play is vital in ensuring a clinician is safe to practice with an actual patient, and so stress was placed on the role and how much commitment is required to fulfill the role of an ACE.

Our customers are highly skilled professional educators and we expect the same high standard from our ACEs.

We are currently working on educational materials for the ACEs, and this is being done in conjunction with senior clinicians who are overseeing the development of this information. These instructional materials include training videos, handbooks and regular telephone or internet support along the way.

Meducate Academy has also been working recently with PAs at Wolverhampton and Chester Universities, and we received welcome news that many of our students had passed their National exams. Good news indeed.

Last weekend Mark and I worked with Matrix Education, again helping student Physician Associates get ready for their upcoming exams. It was great to touch base with students from every part of the UK and a pleasure to work with the team at Matrix, as always. I recently did a podcast with founder of Matrix Education Sofia Hiramatsu and we will be posting a video of the podcast next week on this blog.

I have also spent some time with Wolverhampton University developing their Golden 2 sessions on a weekday evening. If you have ever taken part in OSCEs, you’ll know that one of the vital parts of an OSCE station is the 2 minutes that the students have to read the question.

Sometimes, students find this really difficult and often miss the obvious. With this in mind, Peter Gorman of the Wolverhampton PA Program has put together sessions based purely on “how to read the question”. His approach has been really successful. Helping the student get to grips with being able to answer the question effectively, and I can’t believe someone has not attempted this before. Maybe they have!

It has been an honour to be involved in these sessions and I have seen this approach help struggling students turn a corner in their development. I intend to write something with Pete about this in the next few weeks.

The month ahead looks busy, so I would like to thank all those who attended the Webinar on Saturday. We are currently putting dates together for the initial 2 day training course.

If you are a role player who wishes to take your medical roleplay to the next level, we are always on the lookout for new people, so get in touch.

The Physician Associates Program And The Role Of The ACE

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Bob Spour working with Clinical Lead Pete Gorman at The University of Wolverhampton
Working alongside Clinical Lead Pete Gorman at The University of Wolverhampton

Congratulations are in order to all of those Physician Associates who were successful in passing their recent National Exams.

The Physician Associates Program is a very intensive 2 year Post-Graduate course and requires great dedication, focus, resilience and determination to complete. It takes many hours of reading, studying and practicing hands on skills training to produce a competent and safe PA.

Image of the University of Wolverhampton from the PA Skills suite
The University of Wolverhampton from the PA Skills suite

Working in close partnership with The University of Chester and The University of Wolverhampton has shown me how demanding the course can be. I see it as my duty as an ACE to ensure that the PA student gets the support and the skills they need to progress in the profession

As an ACE it is also important to keep up to date with any changes that might be happening in the curriculum. Whilst this sometimes is a challenge, I am always grateful to the tutors for their continued support.

Just as the students work and study hard, I am conscious that Meducate Academy’s ACEs put in the same effort. We will therefore continue to work closely with Chester University and Wolverhampton University to produce high quality training programmes for both communication skills and systems examinations this year.

We are about to start producing video and online resources materials for our ACE training programme over the summer months. In less than a month our ACE Aide Memoire will be available to all of our staff here at Meducate Academy.

It's always fun working with ACEs at The University of Chester
Bob & Mark enjoy working at The University of Chester

Academy continue to invest in our ACEs and we are still working on gaining some type of accreditation for the role. Although we are seen as lay educators our ability to provide high fidelity simulations and clinical skills is well documented by the institutions we work with. It is about time this was rewarded with some type of recognised qualification. It also means that our partners know that they are getting the highest quality ACEs working alongside their clinical staff.

We have always been passionate about continued professional ACE training and we want the quality of that work to be second to none.

We will be rolling out a regular annual training camp for the ACEs. This means we have control over the quality of the people we provide to our customers. This of course will be dependent on social distancing rules being relaxed in the coming months.

If you want to work as an ACE and be part of the team at Meducate Academy enter your details in the landing page here and we will get in touch.

Incidentally we will also be hosting an Annual Conference in July 2021. The panel will consist of five speakers all senior clinicians in their own right who have an impressive track record on the UK PA programme. The topic will be the role of simulation in medical training, specifically focusing on the role of the associate clinical educator.

 

Meducate Academy: Building Lasting Partnerships

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Bache Hall, University of Chester
Bache Hall was the venue for this years Summative OSCEs for the 2nd year physician associates

What a great week we have had this week.

We started the week with a mixture of Summative OSCEs for The University of Chester and ended the week with a long day of filming MSK examination procedures for The University of Wolverhampton.

The University of Chester Physician Associate Programme, under the guidance of Course Director James Ennis, were running a series of online and in person Summative OSCEs for their 2nd year students.

We had seven ACEs working on a variety of stations. I was personally responsible for being in Chester taking two days out to work alongside senior clinicians working on Suicide Assessment and Breaking Bad news scenarios.

Preparing for a days filming with Wolverhampton University
Setting up the scene and preparing for filming at the Meducate Offices

The team of ACEs from Meducate Academy gave a great account of themselves and all received glowing testimonials from the Clinicians they were working with. We had no problems with the technology and Chester University has mastered the art of working on Microsoft Teams to great effect. Even the students commented on how well organised the two days went.

Running OSCEs is always a challenge for both Meducate Academy and the universities involved. Our extensive experience working in this fields for over ten years ensures that we always deliver the best service.

Our close working relationship with Chester University means no matter what happens we all work together as a team to ensure the students have the best possible educational experience. I always know that things are going well when individual students remember the names of our ACEs and ask for them by name. It’s also important to build relationships with the students.

Friday morning saw Meducate Academy back in our offices in Birmingham, filming a whole range of Musculoskeletal Examinations for The University of Wolverhampton in preparation for their 2021 teaching modules and the start of their new cohort in February.

Course Lead Pete Gorman and myself filmed Hip, Knee, Shoulder, Spine, Wrist and Foot exams in great detail with explanations of how they can be adapted when demonstrating them on an OSCE station. Safe practice was always the main focus of the sessions, and we made mention of the importance of accurate communication with the patient.

Clinical lead Pete Gorman prepares to preform a hip examination
Clinical lead Pete Gorman prepares to preform a hip examination on the ACE at Meducate Academy

Although the day was long it was made easier by the shared sense of humour of both Professor Kenny Langlands (Course Director), Pete Gorman (Course Clinical Lead) and the team from Meducate Academy.

We also managed to film a short interview with Kenny and Pete as to how they see their close relationship with us and how important the ACE role is with regard to the development of the student Physician Associate.

The films are now in the film edit process and I shall work on this all week.

I’d like to take this opportunity to thank all of our friends and colleagues at both The University of Wolverhampton and the University of Chester for making 2020 a significant year for us, despite the restrictions placed on us by a series of Lockdowns.

2021 could be our best year yet.

Why not join us!

If you are a roleplayer, actor or clinician and wish to be part of the Meducate Team contact us by sending your name and email in the box below.

Meducate Academy Is Moving

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Clinical training room at Wolverhampton University

Meducate Academy is moving, in many senses of the word…

Almost three years in the business and despite the impact that Covid-19 has created, Meducate Academy seem to be leading the way in the education of health-care professionals by Lay Clinical Educators and Simulated Patients.

The past week has seen us providing our services to one of our partners, The University of Wolverhampton. Under the direction of Pete Gorman Clinical Lead we supplied Associate Clinical Educators on their Physician Associate Programme. Working with three experienced ACEs we covered scenarios including the management of Mental Health issues, dealing with an anxious patient presenting with STEMI and a session on how to examine a patient with thyroid problems

These scenarios were designed to challenge the students both in their ability to take a focused history and a perform a focused cardiovascular and thyroid examination, including testing them on their ability to read an ECG correctly.

We ran the sessions as a mock OSCE over ten minutes, but unlike an OSCE we were able to give feedback to the students for twenty minutes each. The days were long but productive and very rewarding, plus the feedback given by the students was also excellent.

The students had worked with us previously, so they were not surprised by the level of challenge and the way we approach the delivery of Clinical Examinations. They were all PA students in their second year, so the pressure was put on them to perform at the highest level. Most of them didn’t let us down, and they thanked us for the work we had done last year.

Unlike volunteers and real patients, an ACE working alongside an experienced clinician can make a significant difference to the development of a PA student.

It is sessions like this that allow the students to make their mistakes in a safe and supportive environment. The ACE always gives feedback in a structured way, including information on the students ability to build rapport with the patient.

We will be following these sessions up next week with Mock OSCEs under actual exam conditions using seven of our most experienced ACEs. It should be an enjoyable week!

Next month we will also work with The University of Chester on their PA programme, but this time we will work online using Microsoft Teams. This is a different type of teaching and requires good camera skills. More of that in another post.

Working online presents us all with a variety of communication challenges. Lousy cameras, dodgy Wi-Fi and misunderstandings about how to use the system. The Internet can seem to have a life of its own at times. We have contingency plans for events like this.

We have even run online sessions to help students and our ACEs use the technology more effectively. Most of the online work we do focuses more on History Taking as it’s virtually impossible to do physical exams online.

Working online presents its challenges, but we have been working online since the start of the first lockdown back in March earlier this year. We more or less have it sorted!

Embracing the new technology meant we had to invest in state-of-the-art cameras, lighting and sound equipment to ensure that our customers get the very best experience.

It also means we can film training material and create Podcasts for use by our clients for future use when the Covid-19 pandemic is all over.

Those of you with a keen eye will see that our address has also changed.

We have now moved our offices from Shenstone in Staffordshire to a Birmingham city center location, situated at Grosvenor House in the Jewellery Quarter in St Paul’s Square. Having a central location makes it easier to train upcoming ACEs and meet potential clients. We are near to Central Station and on the major route into Birmingham from the M6.

All this and more to come. Including a proposed webinar where we invite senior Clinicians and Associate Clinical Educators together with students to talk about how to approach OSCEs. We are also currently filming and building a library of systems exams so students can have access to the latest examination methods being used in the OSCEs.

Thanks to everyone who has helped us make this journey.

Answer the Question: Common Errors When Sitting The OSCEs

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Image of man writing on exam paper

As a roleplayer and ACE for more than ten years one of the most common errors I see students make when taking part in their OSCEs is failure to read the questions correctly.

It is more common than you may imagine and not enough time is spent on this aspect of their education. Pete Gorman, course lead of Wolverhampton University, spends one evening of the week working online with his PA students looking at what he calls the “Golden 2 Minutes”. Meducate Academy are currently working as partners with him on this aspect of their training.

That’s how important it is.

At the start of OSCEs we have stations and on each one of them there is a question. The students have two minutes to read this question before they enter the station.

A nail biting two minutes for unprepared students!

What students do in that two minutes is crucial to their success when they sit down with the “patient’ they are about to see.

It is often the case that a student, who feels they have performed badly on a previous station, carry this negative state onto the next question. When they arrive at the next station this inevitably clouds their judgement and therefore their ability to read the question correctly is compromised. Their heads are filled full of ideas about how they might have done better on that last station and this attitude has a definite influence on their state of mind when they sit down and look at the new question. This is the time to let that last experience go, to draw a line under it and clear their mind.

I often tell students to have a delete button in their head so that no matter what they did on the last station, positive or negative, is erased.

Deleted. They don’t need it.

They need clarity of mind to enable them to read the next question now placed in front of them, to take a couple of deep breaths and relax. Then read the question.

So the first thing they need to do is to read the question carefully. Ask themselves what type of question it is. Quickly skim through it to pick out it’s main features.

Is it a procedure, an examination or a history? How much detail do they have?

Quickly make a few relevant notes. Look at the patient information of which there may not be much, but if they concentrate and read the question there may be clues.

Age of patient, gender, ethnicity, marital status and their occupation?

Is there any information about previous medical history, or the medications they are currently on?

I know all of this may seem obvious, but when the red mist of fear comes down and clouds judgement it’s easy to lose sight of the basics.

Think about your strategy for diagnosing the likely outcome. What are the red flags and if this is a mental health problem remember to do a suicide assessment.

All of these things are basic to good structure and in the heat of the moment it’s so easy to skim through the question and think you have it right. Read the question carefully. It is that simple.

I remember one student who hadn’t read the question carefully after a perfect introduction and performed a respiratory exam on me when she was supposed to be performing a cardio vascular exam! Ooooops! Needless to say she failed that station.

Check out some of our videos on our YouTube channel to give more guidance. I will be posting more later in the month.

In Conversation With Senior Associate Clinical Educator Mark Reynolds

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Interview with Associate Clinical Educator Mark Reynolds
Associate Clinical Educator Mark Reynolds giving feedback to a PA student on a recent course

A few subscribers have asked me to expand further on the role of the ACE, and this is a transcript of an interview I did with fellow ACE Mark Reynolds a few years ago. It still has relevance today and should answer any questions I have received over the past few months.

Meducate: What can you tell me about the difference between a Role Player and an ACE (Associate Clinical Educator)?

Mark: A role player is involved in clinical communication, in that they play opposite a medical student as a patient or colleague in order to to improve their learning in terms of their technique of clinical communication.  The associate clinical educator is also trained as a role player but is also trained in the body system examination so they are a hand on resource for the student to work on. The ACE then feeds back how well the student carries out that examination.

Meducate: You mentioned the term “body systems” what do you mean by that?

Mark: The basic body systems, from the point of view of the  medical world, would be  the cardiovascular, respiratory, gastrointestinal, neurological and musculoskeletal systems. We are trained to give feedback on their examination technique. Techniques such as percussion, auscultation and palpation.  We  never teach pathology, that’s up to an academic tutor who normally works alongside us.

Meducate: So the academic tutor teaches the pathologies and the theory, and you are the resource? A bit like a living mannequin?

Mark: Yes, we are a living resource able to give feedback on the technique as well as our extensive knowledge of the OSCEs and what is required in those academic exams. At first Techniques like Percussion and Palpation are often a problem for new students, and we can guide them in the correct technique as well as ensuring they’re in the correct position on the body.

Meducate: And because you’re also a communications expert, you can give feedback on their ability to communicate effectively and build rapport with the patient.

Mark: Absolutely yes. Communication is a vital part of the examination process and it would be remiss of me to allow a student to carry on if they couldn’t build rapport with the patient.

Meducate: So can you describe a typical session with an ACE?

Mark: So normally a body system is picked for the day and the ACE will be working with four to six students. Sometimes the clinician may do a live demonstration using the ACE as the model, and then the students will be taken through the various pathologies they may come across on a typical patient. The students would then be left to work with the ACE, and they would then give feedback about how well they are doing. Having a “Talk the Walk” approach works very well, as we can direct the student toward the correct method right from the start. Sometimes we may run a scenario alongside the physical examination and thereby making it more realistic. With the help of the clinician present, we will also include a management plan and how to explain that to the patient in layman’s terms. We can also present various pathologies to the student such as asymmetrical breathing, antalgic gait, Shortness of breath and many more. We even have a member of the team who can create ulcers, bruising, and other physical signs using moulage.

Meducate: I have heard students say that they feel more relaxed when working with an ACE can you expand on that?

Mark: Yes, when a student has a clinician in the room they feel that they are being judged. Which of course is true. We are there as a resource, a tool, if you will to help them develop without judgement. It is true that we assess them, but not professionally. We are not qualified Medics!

 Meducate: ACEs are often used in OSCEs to great effect. How does that work?

Mark: During an OSCE it is not possible for the examiner to feel what is going on such as palpation, and that’s where we can give our feedback about how well the palpation went. Whether it was painful or too light. Because of our intensive hands on training, we know what a good technique is. This ensures that the PA is safe to practice once qualified. It should be remembered too that we have probably been involved in thousands of OSCEs, so we have an extensive experience, often much more than the examiners themselves. Examiners often remark on how extensive our knowledge is!

Meducate: Better than a real patient?

Mark: Yes, very different. A patient will not be qualified to give feedback. Of course, working with real patients is also valuable to the learning process.

Meducate: Thanks for taking time out to chat with us, Mark.