Poster presentationsDE06 Incorporating the ‘clinical teacher’ role in job plans: a way to increase medical students’ hands-on experience?

Abstract Around 60% of dermatological conditions are managed by nondermatology specialist doctors (Lowell BA, Froelich CW, Federman DG, Kirsner RS. Dermatology in primary care: prevalence and patient disposition. J Am Acad Dermatol 2001; 45: 250–5). Despite this, a survey of junior doctors found that only 8% of doctors felt confident in initiating basic therapy for a skin complaint (Hussain W, Hafiji J, Stanley AG, Khan KM. Dermatology and junior doctors: an evaluation of education, perceptions and self-assessed competencies. Br J Dermatol 2008; 159: 505–6). This highlights that there is a need to evaluate and improve current ‘hands-on’ dermatology undergraduate training. A quality-improvement project was done looking at fourth-year medical students on clinical placement in dermatology at a UK university hospital. Previous feedback showed that while attending dermatology clinics, 50% of students reported they did not have the opportunity to take any histories, and only 41% received feedback from clinicians. Students were asked to rate their satisfaction of their placement on a scale of 1 to 5; the average student score was 2.6. Based on this feedback, we decided to commit more clinicians to have a specific educational role as part of their job plan. Only one out of the existing nine consultants expressed an interest. This led to us organizing for one existing and four new senior dermatology colleagues, who had recently joined the department, to be assigned as ‘clinical teachers’ in their job plans. They were allocated 1–2 h per week dedicated to education (0.25–0.5 SPA – supporting programmed activity). Funding was from the existing dermatology undergraduate teaching budget. The clinical teachers were assigned to tutor a couple of students a week and to give them personalized feedback. Students were asked to assess the quality of this feedback through their online platform ‘My Knowledge Map’. The students also logged the number of histories they were able to take in clinic and with which clinician; this allowed us to organize a prize for the most accommodating clinician per block. The clinical teachers were also expected to deliver dermatology teaching sessions in a 1/7 rota, and to be involved in assessments. Through these changes, the percentage of students who were able to take a history during their dermatology week increased to 77% and 91% of these students received feedback on their skills. Overall student satisfaction in clinics increased from 2.3 to 3.4 out of 5. Our findings show that assigning a specific ‘clinical teacher’ role in the job plans of dermatology clinicians increased students’ hands-on experience, the amount of personalized feedback they received and overall student satisfaction.