Trial of new Integrated Clinical Apprenticeship to run alongside 5th Year teaching

A group of senior clinicians and teaching staff for the 5thyear have put together a plan for a new course, the Integrated Clinical Apprenticeship, designed to be trialled next year for 24 students who will spend 1 day a week in the new course and the rest of the time on their Year 5 firms.

Read more about the new course in this interview with Dr Arabella Simpkin, a SpR in Paediatrics who is currently doing her Masters in Medical Education at Harvard, and who will be leading the course next year.

Please could you give us a broad overview of the course?

The Integrated Clinical Apprenticeship is really a re-design of 5thyear. As one of the 24 students taking part next year you will still have your rotational firms but within that you will have your own cohort of about 12 patients who span the different disciplines in 5thyear.  These patients will be drawn out of primary care, and you will have the opportunity to follow their progress across the year, for example in going to their appointments with them.  Every Thursday you and another student would spend the morning with a dedicated GP mentor and the afternoon in tutorials with the rest of the course group.  These tutorials will be facilitated by experienced, enthusiastic clinicians and will involve debriefing on your experiences with presentations on clinical tutorials that you will give to your fellow students. This is very much driven by and for you, and we hope that having these Thursday sessions will create continuity with your fellow students and clinician tutors.

Where did the idea for a change come from?

There has been a lot of interest in medical education and whether we’re preparing doctors for tomorrow.  In particular shorter hospital stays have meant that students are often only seeing a snapshot of the disease process.  Additionally in medical education there’s often been a loss of the relational continuity that existed in the past, and we’ve been thinking about how to bring in some of the apprenticeship model that has been lost. Internationally there has been a huge amount of interest in this, we’ve taken lessons from America, Australia and South Africa and designed a course which is tailored to ICSM students.  By following your own patients and sticking with your GP mentor we hope you will get back some of that continuity and in a sense you would have some responsibility and become an advocate for your patients, perhaps acting as a translator of medical jargon after their appointments, and bridging primary and secondary care for them.

What do you think are the main benefits of the course for students?

This is a unique opportunity for students to part of an inaugural class, to really learn through experience and develop relational continuity not only with patients but also with clinician mentors and also with each other.

A key theme is to help prepare you for life as a doctor as much as possible, and so we hope you would develop many skills from the apprenticeship.  For example through this Thursday tutorial we hope that students will develop self-directed learning and teaching skills, and think about professional identity formation through reflection and discussion of patient journeys and clinical experiences they’ve had, as well as nurturing patient-centredness, empathy, resilience and other key attributes needed to thrive in the medical environment.

How much extra work would be involved?

There shouldn’t be much extra work involved at all.  You will be asked to give tutorials to the rest of your group 3-4 times during the year, and the rest of the tutorials will be based around debriefing and reflection on your experiences with teaching from experienced clinician teachers.  We are hoping that you can develop your sense of the cross-disciplinary nature of medicine. You would also have to keep track of your patients within your pair of students on the course. We hope this will enable you to see the whole spectrum of disease process, gaining a rich understanding of your patients’ journey through the healthcare system.

Is there a set curriculum for the tutorials?

These sessions will have a structure that ensures disciplines covered in the 5thyear are continuously re-visited, and that learning across specialities is brought together to emphasise the complex, cross-disciplinary nature of medicine. These sessions are not designed to be didactic, and we hope you will be able to reflect on the patient experience, with the opportunity for you to be able to lead those sessions in a meaningful way.  We have designed these tutorials to meet the demands of the students in a flexible way, building the course around that. Different students will be on different firms at different times so we hope to have rich discussions, overseen and facilitated by experienced teachers with expertise in the fields. We hope this structure will ensure students gain knowledge of, and are introduced to, the firms they won’t have until late in the year.

What if you need to be in firms one Thursday?

All of your firms will be with consultants who are aware and happy about the apprenticeship, and so although the Thursday sessions will all be compulsory we don’t envisage that this will cause a problem.

What happens if you can’t attend one of your patient’s appointments?

We hope that this will help to build your prioritisation skills, a key skill in being a doctor.  You would have the option to decide what will be most meaningful for you and to discuss with your current firm lead.

How will you select students for the programme?

We will ask students who are interested in taking part to write short answers to the two questions: what do you hope to gain from the apprenticeship; and what you think you could contribute to the apprenticeship.  This is to really ensure you have thought the opportunity through.  From those who apply we’ll then run a random lottery to select the students to be part of the inaugural class.

The deadline for applications will be on 12thFebruary at 5pm.

Watch out for an email with more information and the link to apply.

We will be evaluating the course to check we’re meeting the key goals, so we hope that those students who apply but who aren’t successful may also help us by answering some questions at the beginning and end of the year.

How do you hope the integrated clinical apprenticeship will develop?

Moving forwards we may scale the apprenticeship up to a degree. I don’t think it would ever be for the whole year group.  Whilst I think this is an incredible opportunity for some students, everyone learns in different ways and it probably isn’t how every student would want to learn.

What can students do to find out more?

For more information on the course and to meet the Faculty involved please come to the Q&A session on Tue 26thJanuary in the Reynolds building, from 5-7pm – pizza will be served, and there’ll be a chance to meet with Course Directors and Senior Faculty.  

If you’re not able to make that or can and would still have questions then please contact myself, Dr Arabella Simpkin at a.simpkin@imperial.ac.uk;  or Dr Andy McKeown, the GP lead at andrew.mckeown@imperial.ac.uk

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