Meducate Academy has been providing student centered educational services now for five years. Five exciting years of ups and downs but mostly ups!
When we established the Academy in 2017 the world was a very different place, pre-Covid, when every thing looked brighter. We had established ourselves with two growing University departments. Wolverhampton had only just recommenced their Physician Associate Programme under the leadership of Gill Conde and Pete Gorman. It was going from strength to strength.
Chester University was also using our Associate Clinical Educators across their programme under the guidance of their new Clinical Lead James Ennis. Things were going well and growing rapidly. Who could have guessed what would happen next.
The Pandemic came as something of a surprise to everyone and things started slowing down for most educational institutions. Some closed their doors and didn’t start up again until twelve months had passed and things for us looked bleak.
Simulation means being in front of students. Face to face interaction and hands on physical examinations which were the norm had all but ended for everyone.
Undaunted, we took the bull by the horns and started working online with history taking skills, and even had an attempt to run a pilot of online OSCEs. It was a creative time for us and our partners, and we learned a lot during that period. We adapted and improvised and came up with innovative new ways of teaching online and used a variety of different technologies to further our cause.
Once restrictions began to lift we were back to work but this time in full PPE, taking the students through the preparatory work on systems examinations in preparation for their OSCEs; and it worked. Students were keen to get back into the sessions and Chester and Wolverhampton Universities led the way. Whilst other Institutions were using mannequins, we were back at it. Cardio, respiratory, G.I. Cranial nerves, Neurological, and of course MSK examinations were being practiced almost as normal.
Teaching and support for the students was second to none and we were able to carry on almost as normal. It was for us a good time and now that the situations is getting back to normality we are being approached by a number of institutions to supply Associate Clinical Educators on their Programmes.
In the above video we listen to Bob (Founder and Director of Meducate Academy) and Senior ACE™ Mark Reynolds about what’s been happening and how Meducate Academy is shaping up for the next 5 years.
If you are a Clinical Educator and would like to take advantage of using ACEs as part of your clinical teaching, book now for a free consultation. Contact us via the form below or give us a call on 07870611850. Thanks again for reading this post.
Kate Straughton is one of the senior lecturers with the Physician Associate Programme at the University of Birmingham and is also currently the President of the Faculty of Physician Associates (FPA). Kate wanted to talk about how working with ACEs has helped in her educational role in training student Physician Associates.
“Thank you very much for inviting me to the conference. I’m a Physician Associate and have been qualified for several years now, working in a few different settings and in education itself for around seven years. I have also worked in a university that did not use role players, simulated patients or ACEs and instead relied on volunteers. Now, I find myself working on a different programme where we rely heavily on ACEs, simulated patients and role players. So, I just want to talk a little bit about my experiences from having been a student but also from working on the other side of the fence as an educator.
“A word that has come up on the conference today is consistency, which I have found personally when working with ACEs. When you have a scenario to work with, you know that that’s what the ACE is going to deliver. As an educator, you can then concentrate and talk to the student about the learning outcome. You don’t have to worry about whether the ACE is delivering the scenario in the correct way, consistently and accurately. That’s the beauty of having such highly trained people with that type of experience over several years; and who also have the ability to improvise when needed quickly, yet still work within the parameter you have set as a teacher. This means we can go down different routes depending on how the student interacts with the ACE.
“For me, the really useful thing is whilst teaching the students we are able to stop the scenario and if necessary, rewind and play it again. We give students time to reflect on the experience, they can then have a chat with their colleagues, re-calibrate and try it again to see how the response changes.
“It’s about identifying errors and being able to iron those out. I’ll give an example: I recently taught a Breaking Bad News session and here we had a scenario which we had used several times before. We knew that it worked very well: ‘One student said what if we adapt the scenario so the ACE and the scenario is one where the patient wasn’t expecting any bad news, so it was a complete surprise for her.’ The ACE we were working with was highly experienced and so I had a very quick chat with her and then she came back in and ran it in a completely different style. The student was then able to compare and re-calibrate some of the earlier statements they had made. A stupid statement made previously was changed and the learning outcome was remarkable.
“The students really appreciated being able to see those changes and, as we went through another example, their style of communication was demonstrably better. The other real strength, and what makes the ACE unique, is their ability to give feedback on examination technique.
“We’ve had students, fairly new first-year students, who had gone out on their first hospital placements. They returned to university and said that they were nervous about examining real patients. This is quite a common experience. So we explored why and the comment came back that they were afraid to examine patients in pain. They felt that although they had a good grasp of the examination routine, they were worried that they might hurt a patient. As a result they were stepping back and weren’t getting too involved with real patients. They didn’t want to cause any discomfort and consequently they were nervous.
“We were therefore able to incorporate that into our teaching and the ACE and I ran a session about examining a patient in severe pain. We had the student perform a GI examination on the ACE who presented with severe abdominal pain. What we found was that aside from being nervous they just weren’t palpating deeply enough because they were really worried about hurting the patient, and that’s obviously knowing that this is a simulated patient! Once two or three students had received the feedback from the ACE that they needed to palpate appropriately with good communication skills, they were able to allay any fears they had. Incidentally one student was was too forceful and would have hurt a real patient. We then had the ACE turn the pain on and off until the students got the message. You can’t do this with a volunteer or a real patient!
“Having the ability to turn the symptoms on and off is really useful and all the students walked away saying that was one of the best sessions they had had. They felt much more competent and confident in their abilities.
“The other thing I think that I wanted to raise at this conference is that what I like to do when I’m working with ACEs is to let them get on with it without me interfering. I’m still involved, but at a distance, so there is no undue pressure on the student from the academic. I’m there if they need to talk to me. They tend to share their worries with the ACEs more openly too, which is extremely useful. To be honest, the ACEs know the answers to a lot of the questions, especially when it comes to their experiences of being involved in OSCEs. The student tend talk to the academic about their academic performances, whereas they will admit things to the ACE about their lack of confidence or worries.
“I’m really confident and I do feel this quite strongly, that the little bit of time away from the academics really helps. With an experienced ACE, we know that the student is in safe hands. They are able to get more out of their experiences, which ultimately will help them in the long term too.
“I think simulation using mannequins also plays an important role. The more I talk to my fellow professionals about simulation in my role as FPA president, the more we discuss how you have to get the mix of skills just right. ACEs are not the answer to everything to be honest and the right answer is probably going to be that we should think in terms of a hybrid approach to simulation in teaching.
“However, the training that goes into producing ACEs and the confidence they engender in the student definitely improves the students skill sets quickly and effectively. They bring the human side to simulation and also provide standardisation. I’m just finally, quickly going to touch on that topic now as I feel this is important.
“With an ACE, you will get an expert patient who can repeat again and again a task, whether that be roleplay or physical examinations or a mixture of the two. In the past, I have used volunteer patients and the main problem was their lack of consistency and their inability to react in the same way every time, which is very important in an OSCE or training for the OSCEs. They would also get tired and sometimes give the student too much information too readily or even forget important details. In some cases, they would also add details that were not relevant. This can take a student off course quite dramatically.
“We’ve seen OSCEs where we’ve had students having wildly different experiences over the course of a day, and if it’s for something like an assessment, particularly high-stakes assessments, you need to be able to rely on consistency and standardisation. This sort of improvised information can be included of course, but needs to be done in a way that maintains consistency across the day.
“We have ACEs and role players who can improvise within a fixed scenario without losing track of what the key points are and what the desired outcome is. They will also make sure that this done within a specified timeframe. For me the important point is that I’ve had extensive experience from both sides, both as a student where I was really nervous and didn’t have any clinical background, then as a Practice Manager before I trained as a Physician Associate.
“When I was a student Physician Associate, having an ACE there was so reassuring. My colleagues, some of whom who are on this conference, who were responsible for training me were also incredibly intimidating. They knew so much about medicine and had so much experience, and actually just having someone who you could just have a chat to such as the ACE, was invaluable to me. It made real life much less scary! I also felt much more prepared to be able go into a hospital and have a chat with a real person because of my experiences with the ACEs. It also meant that I got stuck into the course as a PA student and it prepared me to be able to take an accurate history, to examine a real human being, and to be more practical rather than just observing clinicians on placement. That experience to me was the key to my success as a PA and educator.”
If you have enjoyed reading these posts and you are a student Physician Associate who wants to learn more about the work of the Associate Clinical Educator and how they can help you gain more insight into the OSCEs; why not join us on our workshop on January 8th 2022 at 12 noon on Zoom.
We will have two highly experienced Associate Clinical Educators along with President of the Faculty of Physician Associates Kate Straughton to answer any questions you might have about passing your OSCEs in 2022/23.
Our ACEs have over 12 years experience of being involved, not just in the teaching of Physician Associates but actually taking part in the exams, both as role players and ACEs. They have interesting things to say about:
The Golden 2 minutes that happen outside of the station
Taking a history
Building Rapport and knowing when you have it
The cues the role player will give you
How to structure for success
Of course we will be directed by your questions and will make sure we can answer most of them.
Why not join us on January 8th 2022 at 12 noon online on Zoom.