OSCEs

Adapt, Improvise, Excel: How ACEs Deliver Effective Educational Content

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University of Newcastle Physician Associate 2nd year cohort
We were invited to teach MSK skills to University of Newcastle Physician Associate 2nd year cohort in preparation for their upcoming OSCEs.

Being an Associate Clinical Educator (ACE) is a rewarding and dynamic role that contributes to the education and growth of future healthcare professionals. The ACEs receive immense fulfilment from positive student feedback and witnessing their progress. The job brings excitement and unpredictability, requiring adaptability and improvisation to deliver effective educational content. ACEs gain valuable experience from working with diverse clinicians, undergo regular training and evaluation to stay updated, and ensure the quality of education. Recently, at Newcastle University Medical School, a four-person ACE team provided comprehensive MSK examination training and extended support in other areas of healthcare education. The students appreciated learning from experienced ACEs and requested guidance on various exams. Despite time constraints, consultation skills were briefly covered, and a group Q&A session concluded the day. Gratitude was expressed to the university staff for their collaboration in creating a valuable learning environment.

Experienced Associate Clinical Educator (ACE), Mark Reynolds, collaborates with experienced clinicians from the FRCS (Fellowship of the Royal College of Surgeons) at the prestigious Royal Orthopaedic Hospital
Experienced Associate Clinical Educator (ACE), Mark Reynolds, collaborates with experienced clinicians from the FRCS at the prestigious Royal Orthopaedic Hospital

Working as an Associate Clinical Educator (ACE) is an incredibly fulfilling and stimulating role. ACEs play a vital role in the education and development of future healthcare professionals, and the rewards of this position are often experienced on a personal and professional level. The positive feedback received from students after a job well done is a source of immense fulfilment. Knowing that your efforts have contributed to their growth and progress is a testament to the significance of the ACE role.

One aspect that makes this role exciting is the unpredictability it brings. The subject matter can change at a moment’s notice, from cranial nerves to a cardio examination with a roleplay element added spontaneously. These unexpected twists and turns add an element of excitement and keep the role fresh and invigorating. As ACEs, it is crucial to be adaptable and ready to improvise, as this flexibility ensures the effective delivery of educational content.

The ability to adapt and improvise stems from the wealth of experience ACEs gain from working with clinicians from diverse backgrounds. This experience equips them with the necessary skills and knowledge to handle various teaching scenarios. To ensure the continuous professional development of ACEs, regular training sessions and a rigorous evaluation process are implemented. These measures not only guarantee that ACEs are up to date with the latest advancements but also uphold the quality of education they provide.

Recently, at Newcastle University Medical School, we had the privilege of teaching MSK examinations to 2nd Year Physician Associate students. Musculoskeletal (MSK) is one of our specialties, and our expertise in this field is derived from training with renowned clinicians and collaborating with members of the FRCS. Our knowledge is cutting-edge, ensuring that students receive the most up-to-date information.

Experienced MSK ACE Howard takes the student through the details of a Spine examination at The University of Newcastle
At The University of Newcastle, experienced MSK Associate Clinical Educator (ACE), Howard, expertly guides students through the intricacies of a spine examination

The positive feedback we received from our previous visit to Newcastle prompted the university to invite us back for further training. While the students initially exhibited some reticence, having only practiced on each other, our four-person ACE team quickly alleviated their fears. The advantage of having a small student-to-ACE ratio allowed us to delve into details and answer their questions promptly and effectively. We covered a range of MSK examinations, including the hip, knee, shoulder, and spine. Additionally, we fulfilled requests for hand and ankle exams, ensuring a comprehensive learning experience. Our instruction included all the special tests for MSK, providing continuous feedback to aid their learning. The students greatly appreciated the opportunity to learn from experienced ACEs rather than relying solely on practicing with their peers. One student even humorously remarked that it was a case of the blind leading the blind!

Surprisingly, some students were amazed at our level of knowledge of other body systems. They requested that we check their cardio, GI, and respiratory exams ahead of their upcoming OSCEs (Objective Structured Clinical Examinations). As ACEs, our expertise extends beyond our specialization, allowing us to provide guidance and support in various areas of healthcare education.

Although time constraints prevented us from fully exploring consultation skills, we provided the students with a brief overview of the basics. We reassured them that their history-taking skills were up to par for their current stage of training.

As the day came to an end, we conducted a group Q&A session to address any remaining questions. We expressed our gratitude to the students for their active participation and made the journey back to Birmingham, reflecting on the meaningful interactions and knowledge shared.

We would like to extend our heartfelt thanks to Alice Fitzpatrick, Year 2 & EDI Lead for MSc Physician Associate Studies, and Emma McAllister, Degree Program Director, MSc Physician Associate Studies, for granting us the opportunity to teach at Newcastle University. Their support and collaboration have been instrumental in fostering a rich learning environment for the students.

In Other News…

Exciting times are ahead for Meducate Academy as we prepare to launch our latest offering: Pharma Pathways. This is a programme of training designed to support clinical pharmacists. In collaboration with experienced Clinical Lecturers in Clinical Pharmacy, we aim to assist pharmacists in meeting the new government directive regarding consultation and clinical skills training. Through our dedicated ACEs and Medical Roleplayers, who possess decades of experience working with healthcare professionals such as Physician Associates and Nurses, we are committed to delivering comprehensive support.

Currently, Meducate Academy supplies ACEs and Medical Roleplayers to pharmacy programs at both the University of Wolverhampton and Birmingham, further expanding our reach and impact in the field of healthcare education. Pharma Pathways has been created to offer educators access to ACEs and Medical Roleplayers.

In conclusion, the role of an Associate Clinical Educator is undeniably fulfilling, interesting, and exciting. It provides opportunities for personal growth and professional development while positively influencing the education and future careers of aspiring healthcare professionals.

 

If you’re a Pharmacy Clinical Lead and wish to discuss working with Meducate Academy Ltd., we would love to give you a demonstration and a workshop at your institution.

Please contact: bobspour@meducateacademy.com or on 07870 611850

Bootcamp For Physician Associate Students At Chester University

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The Meducate Team and some 2nd year PA students on their Bootcamp at The University of Chester

The Bootcamp for Physician Associate students at Chester University is an intensive training program designed to help students prepare for National Exams. It involves practising skills, receiving feedback from experienced trainers, and honing communication and consultation skills. The Bootcamp is structured over three days and covers a variety of conditions and scenarios, including multi-systems examinations. The program is designed to help students deal with stress and pressure in a simulated exam setting, and to conform to the standards required by OSCE assessors. The Bootcamp ends with the students having the opportunity to practice under exam conditions and receive feedback.

Who Dares Trains!

Putting the Physician Associate student through their paces.

I think it is essential to define what I mean by Bootcamp. The definition of a boot camp is an intensive way to obtain knowledge about a specialisation. In the case of the Physician Associate program, these are related to medicine.

A common practice is to take the students (usually 2nd years) through a whole range of skills working with ACEs, mannequins and clinicians to help them hone their skills and then receive focused feedback at the end of the process.

The idea of the Bootcamp comes from the military where soldiers are put under intense pressure and made to perform the skills they have learnt in their area of expertise. Unlike the military, we do not shout at students but guide them with structured feedback. They do feel pressured to perform which helps them deal with the stress of their upcoming OSCEs. This is also a valuable skill for a PA as they will inevitably find themselves outside of their comfort zone when out in the workplace. In particular Emergency Medicine and Breaking Bad news.

Bob works with students on the intensive bootcamp held at the University of ChesterThe ACE plays a very important part in this process, and because of their high level of knowledge and skill can replicate the patient journey in fine detail. This is what distinguishes us from volunteers or role-players, who give high-fidelity feedback on more than just communication skills. An Ace is trained to give feedback on the way a student handled the patient, and the efficacy of the techniques they are using. For example, the way the student auscultates and percusses the patient or the way the student used palpation.

Did the student perform the examination using the accepted methodology? Did they conform to the standards required by the OSCE assessors?

Each institution has its way of running the boot camps, but generally, the structure is something like this:

Day One: Introduction to the methodology and approach expected from the student. Consultation skills: History taking on a variety of conditions to be determined by the academic staff.

Challenging scenarios related to the workplace. It is not just patients that can be a challenge, but colleagues too, so it is important to learn how to have difficult conversations.

Day one usually ends with a group discussion about what they would like to cover over the remaining 2 days. At Chester University, the students worked with 4 experienced ACEs and we covered Cardio, Respiratory and GI. We practised them as stand-alone examinations and blended them, where a patient would present with a pathology that required a multi-systems approach. The students always find this a challenge but usually do well at this level of their training.

We also worked through MSK and Neurological examinations.

For a Physician Associate to prepare for National Exams it is always great for the team at Meducate Academy to get the feedback they deserve. We work hard to ensure the students get the best tuition and feedback.

The two years working with this cohort have flown by, as they say, and it has been a journey filled with surprises and detours. Plain sailing and a few rough patches, but when all is said and done we got there in the end!

PA Students sent a thank you letter to Meducate Academy teamBoot camps are a great way to help the students tie up any loose ends they may feel they have in their understanding, and I am pleased to say we and the academics were there to support them.

I got the sense that the students were more than ready for the nationals and we wish them all the luck for their future as Physician Associates.

As an aside, it was also great to get a ‘thank you’ card from the students, which was totally unexpected but very welcome. I look forward to being at their graduation.

So, it is onwards and upwards for the coming year and 2023 promises to be a good one with us working closely with our partners and also with Pharmacists at Wolverhampton University.

If you’re a Clinical Lead or Senior Lecturer and want to have a chat with us about how we can add value to what you already get in touch. We would love to give you a demonstration and a workshop at your institution. Please contact: bobspour@meducateacademy.com or on 07870 611850

 

How To Pass The OSCE On Purpose

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Associate Clinical Educator Bob of Meducate Academy and a cohort of PA Students
Associate Clinical Educator Bob working with a cohort of PA Students at Chester University

For many years I’ve worked with thousands of students in medical schools and institutions teaching specifically on the physician associate programme at Wolverhampton and Chester University. It’s been a highly satisfying job and allows me to do what I love more than anything and that is to teach students! One of the major concerns students have are about passing their OSCEs. From the day their course starts to the day of their exams the conversation inevitably centres around one topic: The dreaded OSCEs.

OSCE is an acronym that has become linked to insecurity and fear, most of which is unfounded. These fears and insecurities are prevalent with most PA students wherever I am teaching. The common questions I get asked are:

“What’s going to happen in the OSCE?”

“What happens if I fail the OSCE?”

“Are they going to try and catch me out in the OSCE?”

“I get really nervous before any exam and never do well.”

It’s all students think and talk about to colleagues and friends. It seems to be the main topic of conversation whenever I talk to students. I often tell the students, why not focus this emotional energy and time on the coursework itself. These negative types of conversations can only produce one outcome; that all involved in this unproductive dialogue will scare each other to death. Instead, I get them to imagine using that intensity of focus on doing what they need to do to pass the exams, rather than fretting, worrying and talking to other students who also feel the same way.

These negative thoughts and ideas about the OSCEs are after all just assumptions based on ignorance. Ignorance inevitably leads to the imagination running riot and before you know it you have prepared yourself to fail the exam. Talk of OSCE fears inevitably start in week one of the first term, two years before the actual national exams. What a waste of time and energy.

When I talk to these students (usually in their 1st year) I ask them,“What made them choose the PA Programme. What made them want to be a Physician Associate? What is it about the PA Programme that excites them? Does it excite them?” In other words, I ask them if they know their purpose in becoming a PA?

“Why are you doing this course?”

“What will you get out of becoming a physician associate?”

“What is your purpose?”

Their usual response when asked these questions is to get confused and talk about setting goals and passing the exams. A few will say it’s what they have always wanted to do. A minority will say that their purpose is to care for people and see themselves as a compassionate person. This is what drives them each day. Now that sounds like someone who understands their purpose in life.

I knew one PA many years ago who shared his thoughts with me after a session and he had just this mindset. He said when he was a student and thought about the OSCEs it got him excited, not afraid. He looked forward to the OSCEs because this meant he was getting nearer to his goal of fulfilling his purpose which was to help others. Incidentally, he passed all 14 stations in the National Exams later that year. He knew what his purpose was and kept that in mind every day. Yes, he was nervous before the exams, but he had developed a strategy for dealing with those emotions. More of that later.

Once you have defined your purpose, you now need to review it every day and get yourself excited about achieving the goal of becoming a PA. If you stay on purpose you will achieve your goals both short and long term. But remember a goal without purpose will be short-lived.

This is a strategy I have always used and it helps keep me focused. I know why I am doing what I am doing and I know I will reap the rewards. I have never been goal oriented only purpose driven and yet I seem to achieve my goals.

Another technique I encourage students to practice is to add a sensory component to their thoughts when they think about their approach to the PA course. For example:

“How will it look when you are working as a PA?” (Visual component)

“How will it feel when you are doing the job you were born too do?” (Kinesthetic component)

“Imagine how it will sound when you proudly tell people you are a Physician Associate”, (Auditory component)

Employing your imagination and thinking like this changes your mindset so that you stay focused on your purpose. You have already been doing this when you have spoken negatively about the OSCEs. You know how to do this, but have been using your imagination to work against you and not for you. Use your brain for a positive change, not a negative one!

When fellow students say things like:

“What happens if I fail the OSCEs?” I always re-frame it and say: “What happens if you pass the OSCEs? What would that look like and feel like in your minds eye?”

By staying focused on that feeling your energy will begin to change. You will approach each task with the knowledge that you are getting closer to living out your purpose.

Sometimes, it is true to say that you will encounter setbacks, when things don’t quite work out the way you wanted them. I call these badly formed outcomes. I don’t see them as a failure. These situations are often outside of your control and have been dictated by others. That’s OK. See these episodes as just feedback. That’s all. This approach allows you to stay focused on what’s important and not worry about being a failure. This just wastes emotional energy. Energy you can use in a more positive way.

A great way to re-programme your brain, so that you do more of the above, is to sit for 10-15 minutes a day in a quiet place. Focus on your purpose, imagining how you will feel when you finish the final station of the OSCEs and become a Physician Associate. You should timetable this in to your activity every day. It’s an OSCE meditation, if you like. It will be time well spent and as mindfulness is a big thing at the moment why not get in with the trend?

I’ve taught and used meditation long before it was fashionable, as well as taking part in physical exercise, both of which have helped me stay balanced and integrated and lead a pretty stress free life. So why not add those two beneficial activities to your diary every week to improve your mental and physical health. These activities will not only help you with work, but in all areas of you life.

I suggest you give both a try and 10-15 minutes of meditation every day will show you what state your mind is in. It will teach you how to ensure that you won’t be ambushed by the inevitable negative thoughts, internal dialogue and subsequent emotions when the acronym OSCE is mentioned!

When you sit in meditation for the first time, many thoughts will come into your awareness. Being a PA student you may encounter many negative reactions including thoughts about the OSCEs. Focus on those thoughts and then do the following:

  • Observe the emotion, the reaction and see it for what it is. Just a creation of your mind. Just a sensation in the body.
  • Then Let It Go. That’s right,just release it and watch it vanish. A student once said to me what happens when this train of thought arises? I said, “Do not get on the train”. “Let it Go. Let it leave the station”.  She said she waved it off, smiled and felt relief.
  • Once you have Let Go of the thought, any inevitable knee jerk reaction you would normally experience will stop. Allowing you time to …
  • Be in the moment and come back to focusing on your purpose. These techniques will help you to become more mindful of your mental states, and you can practice this awareness which will carry over into your daily life.

It is a great technique for improving your overall mental health too. It helps you remain balanced and integrated in the other aspects of your life. Do it for a week and see how you feel!

This doesn’t mean you wont be influenced by those around you though. They will still attempt to discuss their failings with you but this time stay focused and listen politely with out getting dragged into the  conversation. I have a technique to deal with that to and I’ll share it now.

When the negativity starts to flow from others around me and they don’t want to listen for an alternative, I have a delete button. Yes a delete button in my head. I use it quite a lot actually. Mainly if I listen to the news. But seriously, it can be a powerful tool and a great strategy that will help you stay on track. Just use it for a week and see what happens.

It turns out that this is what successful people seem to do most of the time. Some of the most successful people have not listened to the naysayers and the critics. They stay on purpose until they achieve what it is they are looking for. If you become one of them you become an optimist. Optimists always seem to get things done. They don’t always succeed on the first attempt, but optimism keeps them going. There is always a silver lining to every cloud and a light at the end of the tunnel for an optimist.

By putting yourself in this mindset you are as the saying goes, “living in the moment”, but with an optimistic eye on the future. The only alternative is of course to do what you are probably doing already:

Thinking about how tough the OSCE will be and how badly you are going to do.

Filling your head with self-doubt and negative internal chatter.

Deciding ahead of time how you are more than likely going to fail a station or two.

If you’re doing that, use the delete button or turn the volume down! Drown out the internal dialogue by reminding yourself of your purpose, and asking yourself every day as to just why you want the job of a Physician Associate.

If you want to learn more about some of these strategies and techniques Bob will be running an online seminar on 23rd July 2022 at 12pm until 2pm explaining in detail how to put these techniques into daily practice. Once you’ve signed up for the course you will receive a downloadable handbook on how to improve your mental health.

When you enroll on the course please send your questions to Bob in confidence and he will address those issues during the online seminar. The cost, including the manual, is only £9.99 paid via PayPal.

He is also available to do 121 coaching for any students who feel they need a little bit of personal help. Contact him on 07870 611850 to arrange private Zoom meeting.

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.

From Comedy to Clinical Education: My Journey As An Associate Clinical Educator

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Clinical Director James Ennis demonstrates an Elbow exam with ACE Mark Reynolds
Clinical Director James Ennis going through an Elbow exam with ACE Mark Reynolds

My journey as An Associate Clinical Educator started way back in 1984 when I enrolled on the Drama and Theatre Arts Degree course at The University of Birmingham. It was a massive departure from my previous life back in the North of England. I was a mature student and at least ten years older than my fellow students, and the real challenge was also having two small children in tow! The course was the best thing I could have done and has changed my life immeasurably.

I would never have imagined that many years later I would work as an associate clinical educator at the same university but this time in the Medical School and not the Drama department.

After qualification I was working as an actor in TV, Film, Theatre and Motion Capture. I served a fifteen year apprenticeship as a comedian on the alternative comedy circuit through the late 80s to the early noughties as part of a double act.

It was during my time as a comedian that I was able to develop skills as an performer and spent this time persuading the audience that we were funny. Working as a live comedian is the best place to learn to deal with an audience. If you don’t get your message across, you are told to “Get Off”. Not usually as politely as that!

In the background to this I was also building my skills as a corporate educator, motivational speaker, and a Trainer of NLP (Neuro Linguistic Programming). NLP is something I continue to be involved with to the present day.

Associate Clinical Educators Bob Spour, Greg Hobbes, Mark Reynolds at The University of Chester
Working with Clinical Director James Ennis, and ACEs Greg Hobbes and Mark Reynolds at The University of Chester

In 2009 I changed direction and applied to be a Medical Role Player with The Interactive Skills Unit (ISU) at The University of Birmingham. This required a different set of skills and as well as acting I was also expected to give feedback to the medical students after having role played various scenarios with them. A different way of working for me, and I enjoyed it immensely.

It was during a GPVTS roleplay session that the Manager of the ISU, Karen Reynolds, approached me and asked if I would be interested in working as an ACE. This was a role developed by Professor Jim Parle of The Physician Associate Programme at Birmingham. I jumped at the chance and embraced this new venture. It would shape the course of my future career working with health professionals.

With the help of Jim Parle I embarked upon my new career as an ACE. It meant I could combine my skills as a communicator alongside my new growing knowledge of body systems examinations. Giving feedback on the students technique as well as their communication skills. I could now help the student on two levels. Having been a trained engineer in the 70s I took to the role easily, as body systems are not dissimilar to mechanical systems. I also took this approach whilst studying anatomy and physiology.

Over the next six months I bought books on body system examinations and practiced the techniques with Mark, one of the other ACEs. Together we made a formidable team and worked with The Physician Associates and their Clinical staff. The clinicians were always supportive of our efforts and always made us feel part of the team. They gave us insight into the methodology of examining the CV, respiratory, GI, cranial nerves, upper and lower limb neurology. We also helped the students’ approach to sitting the OSCEs (Objective Structured Clinical Exams). We were learning on the job and I spent many hours pouring over medical textbooks to enhance my knowledge in my own time.

In 2011 I was offered a chance to learn examinations of the musculo-skeletal systems, working for The Royal Orthopaedic Hospital (ROH). Training was carried out by Consultant Surgeon Mr Edward Davis and Consultant Physiotherapist Andy Emms. These sessions were well structured, theoretical and practical, and they guided us through the hip, knee, shoulder, spine, hand and ankle examinations in great detail along with supporting materials. This would be another string to my bow.

University of Chester. Riverside Campus
University of Chester, Riverside Campus

As time went on, I was fortunate to work with some great clinicians who were always happy to help and answer my questions. Some have even become friends as well as colleagues.

I now have the pleasure of extending my knowledge to other universities and institutions and find myself able to offer employment and training to other role players and actors wishing to embark on this amazing career.

I am also in the process of creating a course with a view to ACEs gaining accreditation for the role through one of our partners. I believe this is vitally important in maintaining high standards of teaching to the medical students. Many of the clinicians I have worked with over the years have offered their help in teaching new ACEs to the very highest level.

Who would have thought it would have come this far? It’s thanks to the people who gave me the opportunity to reach out to students and help them on their journey to becoming great clinicians.

The recent pandemic saw a downturn with employment in the field for many role players, but I was able to take up this challenge and run with it. Working in conjunction with Peter Gorman at The University of Wolverhampton and James Ennis at Chester University, we were able to teach online and take OSCEs from March 2020 right up to the present date. Thus ensuring the students had as little disruption as possible to their studies. Sadly, some universities did not embrace this way of working until much later. We were therefore ahead of the curve in adapting to the changing working environment and I was able to offer employment to some of my friends and colleagues.

It is during tough times like this that I fully realise the significance of one of my lifelong maxims:

There is no Failure. Only Feedback.

If 2020-21 was anything to go by, 2022 promises to be an exceptional year for Meducate Academy. This is how I see the future.

If you, like me, fancy a real challenge, come work with Meducate Academy and join us on the journey.

My Top 10 Tips For Failing The OSCEs

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Image of long haired and unshaven medical student
Here are my top ten tips that will assure you fail the OSCEs

The idea for this post developed over the past ten years of my involvement in the training of Physician Associates, Medics, Pharmacists, Dentists and other health professionals. Ten years of working as an ACE and role-player observing those same students pass and fail their OSCEs every year.

I have also spent ten years mentoring and coaching students from all walks of life, at various levels of their education in order to help them become a success.

I have consequently developed strategies and models to help students become safe and competent health professionals. I have seen how successful many of them have become, time and time again.

Over that time, I have also made a careful study of underachievement. The students who fail. I have therefore reached a shocking conclusion that many of the students who fail, share the same strategies on a daily basis that leads to a state of total and absolute failure.

It takes an awful lot of work to fail this well. Often a lot more work than it takes to succeed.

Successful people always reveal that they never feel that they are working for a living.

They’re invariably optimists.

Failures are invariably pessimists.

They usually hate their work.

I have learned a lot from failures.

Failure is a choice… It takes conscious effort!

As I have said, I have studied success too and I know those strategies well. I guess if you know specific strategies for success and do the exact opposite, you’re well on your way to being a spectacular failure.

So, here are my top tips, my step-by-step approach to help you fail the OSCEs majestically.

Of course you could also do the exact opposite… But that would be crazy!!

So here we go:

STEP ONE

If you want to ensure that you fail the OSCE then you must definitely never ever think about what success could mean for you. Avoid, at all costs, positive role models and avoid successful people.

Never define your goals or find your purpose.

STEP TWO

DO NOT turn up early or even on time for lectures. In fact make sure you miss as many as possible. Forget to set your alarm and enjoy those extra minutes in your lovely warm bed. You deserve it after all. It’s been a tough week!

STEP THREE

If you insist on revising, remember to never revise in a structured way. Never plan you day around your study time.There are more important things to do. Tidying up your room, washing the dishes, the laundry or catching up on the a Netflix series that you missed first time around.

STEP FOUR

As the OSCE dates get closer never try to be optimistic about this approaching nightmare. Do anything but think about those exams.

Reaffirm on an hourly basis, that it’s going to be difficult. Maybe even impossible. OSCEs are difficult and scary.

STEP FIVE

Repeat Step Four the night before the OSCE and stay up late. Never get an early night and always panic. Lots of panicking!

“DO NOT REMAIN CALM.”

STEP SIX

You have somehow made it to the OSCEs and you are at your first station. Whatever you do… DO NOT READ THE QUESTION PROPERLY! Tell yourself that those two minutes are going to fly by, so only give it a quick scan.

STEP SEVEN

Never tidy up your appearance. Do not iron your clothes and always wear something inappropriate. You washed your hands earlier in the day, so do not use the hand gel when you enter the room.

STEP EIGHT

When you enter the room, lack confidence. This shouldn’t be difficult if you have followed the previous seven steps. If you look scared, you may win a sympathy vote. Mumble your name incomprehensibly and as fast as you can to save time.

STEP NINE

Forget to take notes. If you have been stupid enough to have wasted time making some outside the station… NEVER refer to them again. Remember to leave your stethoscope and watch at home. You can borrow them from the examiner, anyway!

STEP TEN

Have no structure when performing a systems exam. You’re a free spirit and want to show your improvisational skills to the examiner. When taking a history, DO NOT make eye contact. DO NOT listen for cues and always use jargon. Keep saying: “OK. OK. OK.”

Finally. Thanks for coming this far with the article. You have succeeded at something! Best that you forget everything I have said and now delete all the above from your memory. That would just take up valuable space.

This is by no means a complete guide for failing the OSCEs. That would take a book and you probably wouldn’t be bothered to read it, anyway. Avoid books, research papers and journals related to medicine. Hello magazine has more pictures in it, is more interesting and wastes a bit of time.

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.

An Interview With Matt Chapman Managing Director of Meducate

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Image of Matt Chapman Managing Director of Meducate Academy
Matt Chapman Managing Director of Meducate Academy

Matt Chapman is Managing Director of Meducate and is a founding member of the company. In this post, Matt talks about his vision for the company and how Meducate differs from other companies he has worked for over the years.

“I’ve been involved with Meducate from it’s inception over 2 years ago and the big thing that stood out for me was how engaged the students were with the ACEs and the methods we use. Feedback was always phenomenal  something I hadn’t experienced in any other business before. There’s always a grumpy customer that you have to deal with in any business, but with Meducate it was always positive feedback.

“Every time we engage with an institution and their students, they give us 5 stars across the board.

“When we first met and you talked about the concept of Meducate  you were already doing corporate training with me and when you told me about the potential of the ACE role in medical training, I suspended my judgement on how good you said the work was. I remember coming on the first session with one of our earliest customers at Wolverhampton and it was all true. Not only were you and the other ACE enjoying the day but so were the students. Id never seen that level of engagement with anyone in business before. 100% of the class were involved and craved more! That is when I knew we could make this work. In business we always want a win-win situation, and this seemed to be the right type of service to offer. That and the fact that we are almost the only people to be offering this service.

“The fact that this had never been picked up on before and was an open market surprised me. I know there are lots of role play companies out there offering medical role players, but the role of the ACE is unknown. My only concern was, would we have enough ACEs to cover the 40 + institutions that may need our services. Our answer came with the pandemic. This gave us time to regroup and begin training role players in the skills required for them to perform as an ACE. We did this with the help of some senior academic tutors and experienced clinicians who work in the health care sector. Again, this was another of Meducate’s strengths. Our ability to contact the right people is paramount and we are even in discussions to validate the role of the ACE with two Universities keen to promote what we do.

“I was asked recently what drives me in business and I remember we were talking about values and how you see the work we do at Meducate. One of the core values I have always had was with having the ability to measure and monitor every aspect of the customer experience. That would be at all levels. So how well do we handle incoming calls and meetings with potential clients? Feedback from students is something I have already talked about, but what do the clinicians think? How do they feel about utilising ACEs in the educational process and how valuable are they? The answers coming back so far have been outstanding.  I really believe in giving the customer what they want and will always work with them to achieve their goals.

“I have always believed in being transparent with the people who work for us and the customer. Keeping everyone in the loop on a regular basis makes for a happy and fruitful relationship.

“What has been difficult, but I have now adapted too, is the sudden changes a client might make at the last minute about the type of training they want delivered? I was surprised by how flexible our ACEs were. They were able to shift gear quickly and improvise, effectively delivering exactly what the customer wanted. This I believe is one of Meducate’s great strengths and is due to the intensity, passion and abilities of the people we have working with us.

“With regard to the abilities of the ACEs I would like to mention that we update the ACEs skill sets every 6 months and will run regular training days to help the ACE with any areas in which they might feel weak. We want everyone to feel like they’re part of a family and if we all look after each other, we will all prosper. It’s a continuing process that we can’t let slip. As times change, we must change, as we have all recently experienced, and we were quickly working online in March of this year. I don’t believe any other organisation reacted that quickly. We were already prepared to provide online trainings anyway, so it was simply a matter of contacting our customers and setting it up.

“In closing, I would just like to say that I feel we are a very under-used resource, but we have professional credibility with several universities using us and several ACEs with over 12 years’ experience. If you want to test us out, why not call us or email or call us for a 5 minute conversation?”

Click here to view the full video podcast of the Matt Chapman interview on the Meducate Academy Channel at YouTube