Dr Sarah Greenwood, Lecturer, Physician Associate Programme, School of Chemistry, Food and Pharmacy, s.l.greenwood@reading.ac.uk
Physician Associate (PA) students are talented life-sciences postgraduates who must quickly develop critical thinking skills in relation to medicine. Our PA programme focuses on the core skill of applying bioscientific and medical theory to skills of history taking, clinical examination, investigation diagnosis and treatment in order to produce safe, competent practitioners within two years.
Our student numbers have doubled in the five years since the programme began, and so as we strive to accommodate higher numbers, we witness greater diversity in learning styles. We recognised the need to promote advanced critical thinking amongst all our students in creative ways.
Firstly, funding secured access for all our students to McGraw Hill’s ‘Connect Online’, (which included an anatomy and physiology e-book, histology slides, media files, assessment tests and a cadaver dissection) for students to work though system by system. This online package proved very popular with the students whereby the overall average grade over 18 assignments was 94.47%. Students’ engagement could be regularly monitored by the lead lecturer and areas of difficulty were successfully addressed.
Secondly, funding enabled us to develop in-house ‘PA workshop investigation packs’ – which were used by groups of PA students in our clinical skills suite, and online. The packs were themed according to body systems, and consisted of series of work stations containing instructions and various learning materials. Our PA students worked together to tackle core practical and theoretical concepts, working out solutions together in a systematic manner – hence using a ‘Sherlock’ detective approach to their learning! The funding covered the cost of all our workshop materials, in particular laminated displays/charts, questions and visual guides; these are particularly valued because they are reusable for future cohorts of PA students.
The learning processes aimed to mirror the role of the Physician Associate in practice. As such, the learning packs provided engaging, challenging and motivational learning to develop essential skills safely and effectively.
The effectiveness of the workshops became apparent early on – as evidenced by the number of students passing their formative practical examinations at first attempt (shown below).
Formative results without workshops Formative results with workshops
In the summative end-of-year objective structured clinical examinations (OSCEs): 28% of our workshop students achieved > 80% in these practical exams, with 5 students achieving 90% or above – this exceeded the previous cohort’s results where only 8% of students scored over 80% and none scored 90% or above. There was an overall improvement in mean performance from 66% to 70%.
The student evaluations were very positive; all students were able to articulate what they had gained from the experience:
“Examination station was useful because I was able to practice examination skills in an -almost- clinical environment, with the help of teachers. Another station I found useful was the BNF station. It gave me an understanding of how to use the BNF in a given time frame, and find what I am looking for. The BNF station also helped me identify a lot of drugs for certain conditions, which I would not have known otherwise”
“The upper and lower neurological examinations were very useful. This is because I found the overlap and structure similar and reinforce the other. I also found the breast examination very useful because I am less likely to get patient experience with this as a male student”.
“Listening to the heart murmurs station with questions on hypertension – allowed us to work through different case examples”
The lecturers and students all recognised the value of the workshops, and this fun, interactive and relaxed teaching approach has now been formally integrated into the curriculum. We are most grateful for the support of the University’s teaching and learning enhancement scheme which funded this intervention.