The power of animation: encouraging doctors to access support for psychological wellbeing.

The COVID-19 pandemic has exacerbated already high rates of poor psychological wellbeing in doctors. Many doctors perceive a stigma associated with acknowledging psychological wellbeing concerns, resulting in a reluctance to seek support for those concerns. The aim of this study was to develop a theoretically-informed and evidence-based composite narrative animation (CNA) to encourage doctors to access support for psychological wellbeing, and to evaluate the acceptability of the CNA.

'The word that comes to mind is polymath': medical students' perceptions of rural postgraduate careers.

Introduction: Medical education is essential in strengthening the rural medical workforce globally. Immersive medical education in rural communities guided by good role models and rural-specific curricula promotes rural recruitment of recent graduates. While curricula can be rurally oriented, the mechanism of action is unclear.

The status and outcomes of interprofessional health education in sub-Saharan Africa: A systematic review.

The increasing burden of chronic diseases, and shortage of health care workers especially in Low and Middle Income countries (LMICs) requires greater collaborative working between health professions. There is a growing body of evidence that interprofessional education (IPE) and interprofessional continuous education (IPCE) can improve collaborative practice thus strengthening health care delivery in low resource settings. The World Health Organization (WHO) promotes this educational strategy in these regions as part of wider programs to improve health care.

The Challenges of Visualisation During Delivery and Assessment of Clinical Teaching Under COVID-19: A Reflective Account of Problem Solving.

Whilst the in-person clinical immersion of students in their final years of medical programmes was relatively protected from the impact of COVID-19, the ability to deliver in-person clinical teaching was restricted or heavily altered for early-year students. Our challenge as a 3-year BSc (Hons) in Medicine programme at the University of St Andrew's School of Medicine was to continue to immerse and engage students in their clinical training when in-person access to the authentic environment was impossible, restricted, or completely altered from the original image held by students.In this chapter, we aim to discuss the problems faced, the solutions considered within the contextual restraints and then reflect on the successes and failures of the approaches we took in aiding students to visualise themselves in the clinical environment, or when using altered delivery modes that introduced radically different optics on the learning experience.

Heard, valued, supported? Doctors' wellbeing during transitions triggered by COVID-19.

Introduction: Supporting doctors' wellbeing is crucial for medical education to help minimise negative long-term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains.

Medical Curriculum: How Do We Manage Incidental Findings in Educational Settings?

Medical curricula encompass two practical-based teaching categories with likelihood of identifying incidental findings (unexpected and previously undiagnosed findings with potential health implications) in live models for demonstration purposes. One relates to clinical skills involving peers and simulated or volunteer patients. The other involves laboratory sessions, with live models, for the purposes of demonstrating scientific principles.

Supporting doctors' well-being and resilience during COVID-19: A framework for rapid and rigorous intervention development.

This paper aims to outline the development of a theoretically informed and evidence-based intervention strategy to underpin interventions to support the well-being of doctors during COVID-19 and beyond; delineate new ways of working were employed to ensure a rapid and rigorous process of intervention development and present the resulting novel framework for intervention development. The research comprised four workstreams: literature review (WS1), qualitative study (WS2), intervention development and implementation (WS3) and evaluation (WS4). Due to time constraints, we employed a parallel design for WS1-3 with the findings of WS1-2 informing WS3 on a continual basis.

'The word that comes to mind is polymath': medical students' perceptions of rural postgraduate careers.

Introduction: Physician shortages in rural and remote areas challenge accessibility and delivery of care to rural and remote communities, including within Scotland. Medical education is a reform priority to establish a sustainable medical workforce. Although there is evidence to support aspects of medical education that enhance the likelihood of practising rurally, the mechanism by which these educational initiatives work is not clearly understood.

Interventions for the well-being of healthcare workers during a pandemic or other crisis: scoping review.

Objectives: The aim of this scoping review was to identify pre-existing interventions to support the well-being of healthcare workers during a pandemic or other crisis and to assess the quality of these interventions.

Design: Arksey and O'Malley's five-stage scoping review framework was used to identify the types of evidence available in the field of well-being interventions for healthcare workers during a pandemic. PubMed, PsycINFO, Embase, Scopus, Web of Science, CINAHL and ERIC databases were searched to find interventions for the well-being of doctors during pandemics.

Predictors of weight discussion in primary care consultations: A multilevel modeling approach.

Objective: To understand how primary care weight-related communication processes are influenced by individual differences in primary care practitioner (PCP) and patient characteristics and communication use.

Methods: Two multilevel logistic regression models were calculated to predict the occurrence of 1) weight-related discussion and 2) weight-related consultation outcomes. Coded communication data (Roter Interaction Analysis System) from 218 video-recorded consultations between PCPs and patients with overweight and obesity in Scottish primary care practices were combined with their demographic data to develop the multilevel models.

Empathy maps in communication skills training.

Background: Empathy is a cornerstone of patient-centred care. However, empathy levels among health care professionals and medical students are currently suboptimal. An empathy map is a tool which aids in understanding another person's perspective.

'Having come to university my care was very much in my hands': exploration of university students' perceptions of health care needs and services using the common-sense model of self-regulation.

The health care needs and service experiences of higher education students require more research attention, given the increase in students who have a long-term illness, medical condition, or disability ("condition"). It is also important to consider the experiences of rising numbers of international students. This exploratory qualitative study used face-to-face interviews and the common-sense model of self-regulation to investigate students' perceptions and coping behaviours, in a higher education institution in the UK.

Primary care patient and practitioner views of weight and weight-related discussion: a mixed-methods study.

Objective: To understand the beliefs that primary care practitioners (PCPs) and patients with overweight and obesity have about obesity and primary care weight management in Scotland.

Setting: Seven National Health Service (NHS) Scotland primary care centres.

Participants: A total of 305 patients and 14 PCPs (12 general practitioners; two practice nurses) participated.

An analysis of directly observed weight communication processes between primary care practitioners and overweight patients.

Objective: To analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations.

Methods: Consultations between 14 PCPs and 218 overweight patients (BMI ≥ 25 kg/m) were video recorded. Weight communication was coded using the Roter Interaction Analysis System (RIAS) and the novel St Andrews Issue Response Analysis System (SAIRAS).

Foundation Year 2 doctors' reasons for leaving UK medicine: an in-depth analysis of decision-making using semistructured interviews.

Objectives: To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts.

Setting: All four regions of Scotland.

Participants: Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis.

Direct observation of weight-related communication in primary care: a systematic review.

Background: Primary care is ideally placed to play an effective role in patient weight management; however, patient weight is seldom discussed in this context. A synthesis of studies that directly observe weight discussion in primary care is required to more comprehensively understand and improve primary care weight-related communication.

Objective: To systematically identify and examine primary care observational research that investigates weight-related communication and its relationship to patient weight outcomes.

The application of the Practitioners in Applied Practice Model during breaking bad news communication training for medical students: a case study.

Background And Aims: Breaking bad news is a key skill within clinical communication and one which can impact outcomes for both the patient and practitioner. The evidence base for effective clinical communication training in breaking bad news is scarce. Frameworks have been found to assist the practitioner, such as SPIKES; however, the pedagogical approach used alongside such frameworks can vary.

Behaviour and burnout in medical students.

Background: Burnout is prevalent in doctors and can impact on job dissatisfaction and patient care. In medical students, burnout is associated with poorer self-rated health; however, it is unclear what factors influence its development. This study investigated whether health behaviours predict burnout in medical students.

Talk weight: an observational study of communication about patient weight in primary care consultations.

Background: Obesity is a major public health issue and primary care practitioners are well placed to opportunistically raise the issue of overweight or obesity with their patients.

Aim And Methods: This study investigated the prevalence of weight discussion in primary care consultations with overweight and obese patients, in a practice in Fife, Scotland, and described weight-related communication using video analysis.

Findings: Weight was raised in 25% of consultations with overweight and obese patients.

Anxiety and self-awareness in video feedback.

Background: Doctor-patient communication is an integral part of good medical practice and medical education throughout the UK. Innovative methods of clinical communication training make use of technology, including video feedback, within undergraduate learning; however, medical students may encounter barriers such as social anxiety and self-awareness that could prevent them from fully benefiting from training sessions. This study investigated the extent to which medical student anxiety and self-awareness impacted on their learning experience in video feedback workshops.

National survey of clinical communication assessment in medical education in the United Kingdom (UK).

Background: All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools.

Perceptions of postnatal care: factors associated with primiparous mothers perceptions of postnatal communication and care.

Background: The aim of this study was to determine whether personality and/or psychological functioning affect mothers' perceptions of postnatal communication and their level of satisfaction with their postnatal care. Mothers' perceptions of the communication with health professionals prenatally and during birth may be affected by their personality traits and psychological functioning and are linked to the level of satisfaction they have in their healthcare. Little is known about factors that are associated with perceptions of communication within postnatal care and the impact this may have on satisfaction with care.

How Do medical students respond to emotional cues and concerns expressed by simulated patients during OSCE consultations?--a multilevel study.

Objectives: How medical students handle negative emotions expressed by simulated patients during Objective Structured Clinical Examinations (OSCE) has not been fully investigated. We aim to explore (i) whether medical students respond differently to different types of patients' emotional cues; and (2) possible effects of patients' progressive disclosure of emotional cues on students' responses.

Methods: Forty OSCE consultations were video recorded and coded for patients' expressions of emotional distress and students' responses using a validated behavioural coding scheme (the Verona Coding Definitions of Emotional Sequence).

How do United Kingdom (UK) medical schools identify and support undergraduate medical students who 'fail' communication assessments? A national survey.

Background: The doctor's ability to communicate effectively (with patients, relatives, advocates and healthcare colleagues) relates directly to health outcomes, and so is core to clinical practice. The remediation of medical students' clinical communication ability is rarely addressed in medical education literature. There is nothing in the current literature reporting a contemporary national picture of how communication difficulties are managed, and the level of consequence (progression implications) for students of performing poorly.

Anxiety about anxiety in medical undergraduates.

Background: Effective communication with patients is a vital ability for a doctor, and therefore training in communication skills forms an important component of the undergraduate medical curriculum. However, some medical undergraduates experience anxiety in communicating with patients and this makes it difficult for them to communicate with patients effectively. We developed workshops to equip students with skills to reduce communication-related anxiety, but turnout was low and only female students participated.