Alan R. Denison

Tracking genomic cancer evolution for precision medicine: the lung TRACERx study.

TRACERx, a prospective study of patients with primary non-small cell lung cancer, aims to map the genomic landscape of lung cancer by tracking clonal heterogeneity and tumour evolution from diagnosis to relapse.

A survey of clinical teaching fellowships in UK medical schools

Context  Undergraduate medical education in the UK has changed considerably over the last decade. One development has involved the creation of teaching‐specific posts for junior doctors by medical schools. These posts are generally termed ‘clinical teaching fellowships’, but it is not known how many of them exist, or whether they are similar in terms of educational activities, professional development, and research and clinical experience opportunities.

Good for them or good for us? The role of academic guidance interviews

Context  Weak students may pass unnoticed through their undergraduate programme until they fail a summative assessment. Early recognition and support of struggling students is crucial if they are to avoid subsequent failure at high stakes assessments.

Tablet versus paper marking in assessment: feedback matters

BackgroundThe Objective Structured Clinical Examination (OSCE) is a cornerstone in healthcare assessment. As a potential tool for providing learner-centred feedback on a large scale, the use of tablet devices has been proposed for the recording of OSCE marks, moving away from the traditional, paper-based checklist.MethodsExaminer-recorded comments were collated from successive first year formative and summative OSCE examinations, with paper-based checklists used in 2012 and iPad-based checklists used in 2013. A total of 558 and 498 examiner-candidate interactions took place in the January OSCE examinations, and 1402 and 1344 for the May OSCE examination for 2012 and 2013 respectively. Examiner comments were analyzed for quantity and quality. A tool was developed and validated to assess the quality of the comments left by examiners for use as feedback (Kappa = 0.625).ResultsA direct comparison of paper-based checklists and iPad-recorded examinations showed an increase in the quantity of comments left from 41 to 51 % (+ 10 %). Furthermore, there was an increase in the number of comments left for students deemed ‘borderline’: + 22 %. In terms of the quality of the comments for feedback, there was a significant improvement (p < 0.001) between comments left in written-recorded and iPad-recorded examinations.ConclusionsiPad-marked examinations resulted in a greater quantity and quality of examiner comment for use as feedback, particularly for students performing less well, enabling tutors to direct further learning for these students.

Cardiac sarcoid or arrhythmogenic right ventricular cardiomyopathy: A role for positron emission tomography (PET)?

We present a case of cardiac sarcoidosis of insidious onset mimicking arrhythmogenic right ventricular cardiomyopathy. Our patient initially presented with systemic sarcoidosis but later developed palpitations. The similarity in clinical presentation and cardiac magnetic resonance findings in both conditions posed a challenge in differentiating between the two in the absence of histological diagnosis. We highlighted the role of positron emission tomography in aiding a diagnosis.

Twelve tips for enhancing anatomy teaching and learning using radiology.

Abstract Anatomy is a keystone of many healthcare curricula and its understanding fundamental to patient care. The close relationship between clinical radiology and anatomy is well recognised and expanding. Imaging resources can be effectively integrated alongside traditional methods for learning anatomy in a resource efficient manner in order to enhance anatomy teaching. The following 12 tips have been divided into imaging tips, clinical tips and educational tips and offer practical advice and suggestions for designing and integrating radiological resources across the curriculum.

Using mobile technology to enhance medical student assessment

Given the value we place on ‘human’ qualities such as empathy, it is difficult to imagine a future where doctors are fully replaced by ‘Medibots’ as predicted by some. However, the integration of technology into the education domain is ubiquitous; innovations include EEG monitored high fidelity simulation,1 free open access medical education (FOAMED) and Google glass facilitated patient encounters.2 It is this increase in technologies, along with a deeper appreciation of educational psychology and pedagogy that has led to a significant change in the way medical learners are taught. In this article, we describe our experience of using one example of technology, the mobile device, for the assessment of both students and our practice, as we strive as medical educators to keep abreast of technological advances. This drives innovation in our curriculum and …

Incorporating patient partner scores into high stakes assessment : an observational study into opinions and attitudes

BackgroundVolunteer patients (also known as patient partners (PPs)) play a vital role in undergraduate healthcare curricula. They frequently take part in objective structured clinical examinations (OSCE) and rate aspects of students’ performance. However, the inclusion and weighting of PP marks varies, while attitudes and opinions regarding how (and if) they should contribute towards the pass/fail outcome are uncertain.MethodsA prospective observational study was conducted to explore beliefs of PPs regarding inclusion of their scores in a high stakes undergraduate OSCE in a single UK medical school. All PPs delivering components of the local MBChB curriculum were asked to participate in the questionnaire study. Quantitative and qualitative data were analysed using descriptive statistics and framework analysis respectively.ResultsFifty out of 160 (31% response rate) PPs completed the questionnaire; 70% had participated in a final year OSCE. Thirty (60%) felt their marks should be incorporated into a student’s overall score, while 28% were uncertain. The main reasons for inclusion were recognition of the patient perspective (31%) and their ability to assess attitudes and professionalism (27%), while reasons against inclusion included lack of PP qualification/training (18%) and concerns relating to consistency (14%). The majority of PPs were uncertain what proportion of the total mark they should contribute, although many felt that 5-10% of the total score was reasonable. Most respondents (70%) felt that globally low PP scores should not result in an automatic fail and many (62%) acknowledged that prior to mark inclusion, further training was required.ConclusionThese data show that most respondents considered it reasonable to “formalise their expertise” by contributing marks in the overall assessment of students in a high stakes OSCE, although what proportion they believe this should represent was variable. Some expressed concerns that using marks towards progress decisions may alter PP response patterns. It would therefore seem reasonable to compare outcomes (i.e. pass/fail status) using historical data both incorporating and not incorporating PP marks to evaluate the effects of doing so. Further attention to existing PP training programmes is also required in order to provide clear instruction on how to globally rate students to ensure validity and consistency.