Medical students in the pre-hospital environment – An untapped resource for undergraduate acute care and interprofessional education

Abstract

Background

The King’s College London Pre-hospital Care Programme (KCL PCP) is a student-run programme that provides undergraduate medical students with the opportunity to attend observer shifts with the local ambulance service. This study evaluates the contribution of pre-hospital exposure to medical students’ clinical and professional development.

Methods

Students were asked to complete a Likert-scale based survey on self-reported exposure and confidence in various aspects of acute patient assessment, communication and interprofessional education, both before and after the programme; additional qualitative questions querying their experience were asked post-programme. Pre and post-programme Likert-scale responses were matched and statistically analysed, alongside a thematic analysis of qualitative responses.

Results

Exposure to ambulance service clinicians, confidence assessing acutely unwell patients, and confidence making clinical handovers all increased with statistical significance. Key areas of learning identified from the thematic analysis include increased confidence communicating with patients and families, and an enriched understanding of the work done by pre-hospital clinicians.

Conclusions

Time spent in the pre-hospital environment shadowing ambulance service clinicians positively contributes to acute care knowledge, inter-personal skills and interprofessional understanding. Rotating medical students through the pre-hospital environment could bridge education gaps in these areas in a manner that complements traditional pre-clinical and clinical teaching.

Keywords:

• Multiprofessional: undergraduate
• medicine
• communication skills
• clinical skills

Acknowledgements

We would like to thank all the students that partook in the KCL PCP this year, and were kind enough to share their experiences with us. We would also like to thank all the LAS paramedics who volunteered their time to mentor our students, and in particular, to our lead paramedics Richard Kingham & Phil Guthrie for the immense amount of work they did to recruit mentors and support the running of the programme. Thank you also to Dr Shayan Shah and Dr Priyanka Iyer for their feedback on the manuscript. Lastly, thank you to all past members of the LAS and KCLEMS committees who have set up and run the KCL PCP over the years, and to the current members who continue to do an excellent job in challenging circumstances.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Pre-hospital care: Provision of care to ill or injured individuals outside of the hospital or medical environment.

Additional information

Notes on contributors

Aditi Nijhawan

Dr. Aditi Nijhawan, MBBS, BSc (Hons), AFHEA, is an Academic Foundation Doctor at Bart’s Health NHS Trust, Lead Student KCL PCP (2019–2020).

Joyce Kam

Joyce Kam, BSc (Hons), is a final year Medical Student at King’s College London, KCL PCP Officer (2019–present).

Jonathan Martin

Jonathan Martin, BSc (Hons), is a final year Medical Student at King’s College London, Lead Student KCL PCP (2020-2021).

Lewis Forrester

Lewis Forrester, MBBS, BSc (Hons), is a Foundation Doctor at Worcestershire Acute Hospitals NHS Trust, President of KCLEMS (2019–2020).

Sam Thenabadu

Dr. Sam Thenabadu, MBBS, MRCP, DRCOG, DCH MA Clin Ed, FRCEM, MSc (Paed), FHEA, FAcadMEd, is the Deputy Dean of GKT School of Medical Education, Consultant in Adult & Paediatric Emergency Medicine at King’s College Hospital NHS Foundation Trust.

Shadman Aziz

Dr. Shadman Aziz, MBBS, BSc (Hons), AFHEA, MAcadMed, DMCC is an Emergency Medicine Specialty Trainee Doctor at Bart’s Health NHS Trust, Lead Student KCL PCP (2017–2018).