Tracey Collett

The transition from medical student to junior doctor: today's experiences of Tomorrow's Doctors.

Medical Education 2010: 44: 449–458

Living Alone: Its Place in Household Formation and Change

In recent decades there has been a significant rise in the numbers of people who live alone and it was predicted that by 2002 that a third of all households will be single-person households. The predicted increase has occurred with indications of continued growth in this type of living arrangement. Furthermore, although living alone remains common among older age groups, the largest growth has been within younger populations. This demographic trend has attracted speculation about the numbers of people who will experience solo living, the stability of living alone in peoples biography, and the impact of gender differences in the likelihood and stability of living alone. To answers these questions, this paper uses longitudinally linked Census data from England and Wales to explore the household origins and household destinations of working age people who live alone. This longitudinal data derives from the 1971, 1981 and 1991 Censuses. The data from this analysis confirms other research demonstrating the increasingly numbers of non-retired people who live alone. Furthermore it demonstrates that once a person lives alone, they are more likely to continue to live in that household arrangement than any other and that the tendency to live alone and to continue to live alone is more likely amongst younger cohorts of people. It also demonstrates that the largest increase in living alone in amongst men, but that once women live alone they are more likely to continue to live alone. These findings have an important bearing on current debates about ‘individualisation’, the contemporary experience of family life, life course trajectories and the emergent life styles of younger populations.

Students’ views on the impact of peer physical examination and palpation as a pedagogic tool for teaching and learning living human anatomy

Background: Modern medical education teaching and learning approaches now lay emphasis on students acquiring knowledge, skills and attitudes relevant to medical practice. Aims: To explore students’ perceived impacts of using hands-on approaches involving peer/life model physical examination and palpation in teaching and learning living human anatomy on their practice of physical examination of real patients. Methods: This study used exploratory focus groups and a questionnaire survey of years 3–5 medical students. Results: The focus group discussions revealed new insights into the positive impacts of the hands-on approaches on students’ clinical skills and professional attitudes when dealing with patients. Students’ exposure to the hands-on approaches helped them to feel comfortable with therapeutically touching unclothed patients’ bodies and physically examining them in the clinical environment. At least 60% of the questionnaire survey respondents agreed with the focus group participants on this view. Over 75% also agreed that the hands-on experiences helped them develop good professional attitudes in their encounter with patients. Conclusions: This study highlights the perceived educational value of the hands-on approaches as a pedagogic tool with a positive impact on students’ clinical skills and professional attitudes that helps in easing their transition into clinical practice.

Evaluating a poetry workshop in medical education

This study aimed at evaluating how doing poetry could affect students’ understanding of medical practice and at assessing the effectiveness of the evaluation method used. Qualitative research was carried out on the experiences of medical students participating in a poetry workshop, followed by some quantitative analysis. The study was conducted at Peninsula Medical School and St Ives, Cornwall, UK, with three medical students, a poet and a pathologist as participants. Data were collected by interviews, observation and web access. “Doing poetry” with a professional poet was found to assist communication between doctors and patients as it enhanced skills of observation, heightened awareness of the effect of language and fostered deep reflection. Poetry was also found to offer an outlet for medics and patients. The voluntary workshop attracted three participants; however, it might have had an effect on the wider student community because the poetry website received 493 hits in four months. Qualitative methods worked well as a tool for evaluation. “Doing poetry for poetry’s sake” seemed to foster the development of skills related to empathy. The opportunity to do poetry should be made available to medical students as part of a wider arts and humanities programme.

The role of living models in the teaching of surface anatomy: some experiences from a UK Medical School.

Background: Despite recommendations stemming from the 1930s espousing the value of a living anatomy component in undergraduate medical education, living anatomy remains relatively under described. Aim: In this article, we explore the role of the living anatomy model in living anatomy teaching. Method: Our report is based on a larger ethnographic study of living anatomy classes, undertaken at Peninsula Medical School between 2002 and 2004. A Research Fellow participated as an observer in 24 Year One and Year Two anatomy classes in which living anatomy models were employed. The findings are based on field notes and conversations with models, students and tutors. Results and conclusions: Within the supervised context of the anatomy class the living models assisted students in the learning of structure, function, surface anatomy and body variation. Far from being ‘passive sites’ for the students to practice their anatomical knowledge, the living models were active participants in class, assisting students with their communication skills, sharing anatomical knowledge, offering guidance to staff and sharing their past medical history and experiences. Living anatomy models can foster an additional dimension of humanitarian thinking within the anatomy class; however, further research needs to focus on the power messages implicit in the organization of sessions.

What are threshold concepts and how can they inform medical education

Abstract The notion of “threshold concepts” is being widely applied and researched in many disciplines but is rarely discussed within medical education. This article is written by three medical educators who regularly draw on threshold concept theory in their work. They explore here the nature of threshold concepts and describe how the theory can offer medical educators new perspectives in terms of how they design curricula, approach teaching and support learners.

Understanding students’ experiences of professionalism learning: a ‘threshold’ approach

ABSTRACT Professionalism is a core element of curricula in many disciplines but can be difficult to teach and learn. This study used audio-diary methodology to identify professionalism threshold concepts in a small group learning setting in undergraduate medicine and to understand factors that might facilitate students to ‘get’ such concepts. Fifteen students and seven tutors kept audio-diaries over two terms. Data were analysed qualitatively for content. The key themes were then cross referenced to threshold concept criteria (e.g. where language indicated that learning was troublesome, integrative or transformative). Seven potential threshold concepts were identified which centred on students’ developing professional identities including working with uncertainty, considering the bigger picture, not needing to know everything and professional culture. Reflection on workplace experiences within a small group helped students ‘get’ these concepts. The study concludes that threshold concepts and audio-diaries are useful tools for understanding lived experiences of professionalism learning.

Empowering students with the hidden curriculum

The hidden curriculum (HC) refers to unscripted, ad hoc learning that occurs outside the formal, taught curriculum and can have a powerful influence on the professional development of students. While this learning may be positive, it may conflict with that taught in the formal curriculum. Medical schools take a range of steps to address these negative effects; however, the existence and nature of the concept tends to be hidden from students.

The value and challenges of collegiality in practice

Collegiality can be defined as the relationship between individuals working towards a common purpose within an organisation. The concept has its origins in the roman practice of sharing responsibility equally between government officials of the same rank in order to prevent a single individual from gaining too much power. In contrast, managerialism does not provide opportunities for exploring democratic consensus because it promotes being responsive and obedient to implementing the wishes of authority (Dearlove, 1997, King, 2004). Collegiality emphasises trust, independent thinking and sharing between co-workers. This encourages both autonomy and mutual respect and can impact on organisational efficacy (Donohoo, 2017). In modern day practice, the focus is less on sharing responsibility between officials of the same rank and more on ensuring that all employees within an organisation are treated with equal respect as individual people (Lorenzen, 2006).

The transition from medical student to junior doctor: today's experiences of Tomorrow's Doctors

Medical Education 2010: 44: 449–458