What clinical skills can the students learn?

The programme is designed to be a systems-based, basic science focussed a curriculum. The students are taught communication skills based on the Calgary–Cambridge Framework. They are taught clinical skills, covering cardiovascular, respiratory and abdominal system examination. The clinical skills areas covered are below. Please note there have been some changes so this is an updated list on previous academic years. By the time of the placements, students should be able to: Prove an understanding of the principles of infection control. Show the skill of hand washing. Show awareness of the correct procedure for the safe disposal of sharps. Show awareness of the correct procedure to be taken in the event of a needle stick injury. Measure and record the following: Radial pulse rate Blood pressure Body temperatured. Height and weight and calculate BMI. Perform and analyse the following investigations: Urinalysis ECG.

If a student is unable to attend placement what should the student do?

If a student is unable to attend, they are expected to: Email their phase one or two officer Email the Medicine Placements team Telephone the practice before the start time of their scheduled activities

If a student does not attend placement as planned - what should the practice do?

If your student doesn't turn up and and you have not been informed of their absence inform the Medicine Placements team as soon as possible so we can make sure that they are safe.

What should the practice do prior to placement?

Please send out an email to the student introducing them to the practice and include a timetable if possible. Set out the expectations for the first day including expected time of arrival and the practice address (this is especially important if the practice has more than one site). Perhaps include some travel hints if necessary.

Phase 1 medicine placements supervisor information

In this phase, the focus is on exposure to primary care and the multidisciplinary team. During the placements, students will expect some face-to-face teaching and shadowing opportunities.

These do not need to be delivered on every occasion by the named educator. To broaden students' experience, we encourage other members of the primary care team to deliver these. For example, this could be the nurse practitioner or practice manager.

Along with medical students, this cohort includes learners on the undergraduate Physician Associate course. These students learn alongside the Phase 1 medical students for the first two years of the course, before joining the postgraduate PA Students for their final two years to complete the learning outcomes for Physician Associates. During their time with you in phase one their learning outcomes are the same as the Medical Students. There should be no difference in activity opportunities offered. The Physician Associate learners will present in a maroon uniform which distinguishes them from the Medical Students.

Introduction into practice

To orientate students to the practice team and practice areas. This includes student safety and clarifying learning outcomes for the placement.

Below are expectations for students on their clinical placements in years one and two of the MBBS and MPAS courses. These are mapped against those identified by the General Medical Council in ‘Promoting Excellence’ (2015).

Apply knowledge of basic medical science, psychology and sociology to clinical placement experiences.
Undertake enough preparation to be able to outline the organisation of general practice/community placement. Be familiar with activities of each placement.
Understand working patterns and different working arrangements within the GP practice or community placement to deliver patient care.
Explain and understand the protocols, rules and procedures specific to that placement. Treating staff with courtesy and respect.
Complete induction activities and show safe working practices: hand- washing; infection control; health and safety in the workplace.
Where appropriate and under appropriate supervision, apply in practice the skills learned during the clinical and communication skills teaching components to support the development of competences and progression.
Show appropriate professionalism, good conduct and behaviour by observing dress codes and good time keeping. Treating patients and visitors with respect.
Reflect on patient narratives. Treating patients with courtesy and respect and maintaining patient confidentiality.
Understand multi-disciplinary team working, local NHS structures, career patterns and pathways.
Think about your placement activities to complete your portfolio tasks.
Communicate sensitively and effectively with patients.

By the end of the induction, students should be able to:

Describe the aims of the placement and be conversant with the placement’s risk management and health and safety policies.
Interview a member of staff about their role and responsibilities within the community or primary care team.
Reflect upon what their observations tell them about the area and the community using any external data available.

In preparation for their first placement day, students should have:

Made sure they know how to reach the Trust or Practice in good time.
Become familiar with the practice website.
Considered and written questions to ask a team member. This should focus on:
finding out about their training
role and responsibilities within the Primary Health Care Team
reasons for working in Primary Health Care / the Community / voluntary sector.

Staff induction and review of handbook together
Interview with a member of the Community / Primary Care Team about their role
Sit in the waiting room, observe and reflect on patient experience at reception
Observe and, if workable, undertake simple tasks in reception area under observation
Writing up notes, students should attempt to generate hypotheses about:
- possible health problems
- other problems
- opportunities for the practice
Debrief with GP /Practice Manager

Practicing phase 1 clinical skills during placement

Please see the table below.

Category A Can be practiced without direct supervision

Category B Can be practiced under direct supervision only

Category C Can be practiced under direct supervision only and only after the teaching session has been completed and the student has passed their Directly Observed Practical Skills (DOPS) assessment in the lab.

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Skill	Category A	Category B	Category C
Infection control	✓
Manual handling			✓
Basic life support*	✓		✓
First Aid*			✓
Basic observations		✓
Early warning score		✓
BMI measurement	✓
Urine dipstick testing		✓
Cardiovascular examination	✓
ECG recording		✓
Respiratory examination	✓
ECG recording		✓
Respiratory examination	✓
Abdominal examination	✓
Neurological examination (cranial nerves, central nervous system, cerebellum)	✓
Neck examination	✓
Peripheral vascular system examination	✓
Diabetes mellitus examination	✓
Examination of lumps, bumps and herniae		✓
Examination of the rectum and testes			✓
Examination of the musculoskeletal system (GALS)	✓
Examination of the ears, nose and throat	✓
Examination of the eyes	✓
Venepuncture			✓
Introduction to management of the deteriorating patient (ABCDE approach)*			✓

* In emergency situations only

Frequently asked questions

The programme is designed to be a systems-based, basic science focussed a curriculum.

The students are taught communication skills based on the Calgary–Cambridge Framework. They are taught clinical skills, covering cardiovascular, respiratory and abdominal system examination.

The clinical skills areas covered are below. Please note there have been some changes so this is an updated list on previous academic years.

By the time of the placements, students should be able to:

Prove an understanding of the principles of infection control.
Show the skill of hand washing.
Show awareness of the correct procedure for the safe disposal of sharps.
Show awareness of the correct procedure to be taken in the event of a needle stick injury.
Measure and record the following:
- Radial pulse rate
- Blood pressure
- Body temperatured. Height and weight and calculate BMI.
Perform and analyse the following investigations:
- Urinalysis
- ECG.

Portfolio ‘Pebble Pad’

All students have an e-portfolio using a software platform called Pebble Pad. This can be accessed via their tablets or on any PC with access to the web. Students go out on primary care placement, in the second semester of year one. At this point they are already conversant with the portfolio system and its contents.

Each student has a designated portfolio tutor for the year. The tutor will regularly read their entries and provides constructive feedback. The portfolio is part of the formal assessment of the course and is assessed both formatively at mid-year and summatively at year end.

Students are encouraged to share their portfolio with you as their GP Tutor, although this is not mandatory. GP Tutors do not have direct access into the portfolio system. If a student wishes to share theirs with you the best way is to sit down together and to show you round their portfolio.

There are several phase one portfolio inclusions relevant to the Primary Care elements of the course which are detailed below. It is not the responsibility of the GP Tutor to assess or provide feedback on portfolio pieces created during placements. But informal advice and constructive criticism is always welcomed.

Placement completion e-Form

You should fill out the e-form when the student has completed their placement to a satisfactory standard. For example, related to attendance, punctuality and engagement.

The student will complete a brief reflective element about their time on placement. They will, ideally, complete this on their pebble pad with you on their final day of placement. Or if this is not possible, send you the form to finalise.

You will get an email with a link:

Click on ‘Finalise’ (bottom right of the e-form).
‘Complete’ (follow the prompts of the pop-up window).

Please make sure you complete this within 1-2 weeks. The student is unable to progress into the following year without it.

Overview of topics covered in phase one

Clinical skills

Consent and use of simulated spaces
Infection control including hand washing
Fundamental healthcare skills (vital signs, moving and handling, BMI, urinalysis)
Basic Life Support, First Aid
Examination of the cardiac, respiratory and gastrointestinal systems
Examination of the cranial and peripheral
Nervous systems
Examination of the neck
Imaging of the cardiorespiratory and GI systems (basic interpretation of x-rays mostly)

Communication skills

Introduction to clinical communication skills
Non-verbal communication
Gathering information techniques (open v closed questions, signposting and summarising
Cardiovascular, respiratory, GI and pain histories
Other elements of the medical history (e.g.PMH, PSH, social history, FH)
Closing the consultation

Portfolio requirements

Clinical cases learning logs

Students are encouraged to complete two clinical cases learning logs. This will be carried out during Year one May/June placement from patients they see during their time with you.

This is not mandatory, as it lies outside their assessment period. If they do, they will get feedback from their year two Portfolio Tutor later.

They have a template to prompt them to think about the medical/clinical learning they can derive from seeing patients. It would encourage them to use this as a learning tool if you asked about it or suggest suitable cases.

Reflective practice

Students complete one reflective piece in year one, this is on the theme of ‘Talking to a patient [simulated]’.

Clinical cases learning logs

Students are required to complete three clinical case logs in Year 2. One can be observation of another HCP, at least two must be performed by the student themselves.

They are encouraged to see more, as it is a very useful learning tool, that focuses their placement experiences. It helps them to learn to think like a doctor and PA.

Students have a template (Excel Spreadsheet). This will prompt them to think about the medical/clinical learning they can derive from seeing patients. Please encourage them to use this as a learning tool and suggest any suitable cases. You don’t need to assess them. This is done by their Portfolio Tutors.

Reflective practice

The students are expected to write one mandatory reflective piece based on “communication with a patient”. This will be assessed by their portfolio tutor.

Workbooks

Prescribing workbook

The students have a mandatory prescribing workbook to completed whilst they are on placement.

The aim of this workbook is to help the student begin the journey of developing their role of a prescriber. Also to build on their pharmacology teaching from earlier in the year.

We hope that the challenges within the work book will bring the drugs they have studied ‘to life’.

This workbook does not need marking or assessing by the GP supervisor. A completed workbook will be given to the students to compare theirs to at the end of the placement period. It will also form basis of their supervisor review. They will need to show you that they have engaged with the process and we ask you tick the box on the placement e-form.

Primary care workbook

The students have a mandatory workbook to complete whilst on placement. The aim of this workbook is to help their learning throughout the module and to improve their understanding of primary care. We hope the workbook will help structure their learning about the important role of each member of the primary care team. Also how we serve the community we look after.

The workbook will ask the student to reflect on the different patient interactions they observe. They will be asked to focus some of these reflections on the different consultation styles that they experience. They will also be introduced to chronic disease management in primary care. This will include some focussed learning on some conditions.

This workbook does not need to be assessed or marked by the GP supervisor. We do ask that the supervisor ensure that they have engaged with the workbook and tick the box on the placement e-form.

Example timetables

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Year one timetable
	Day 1	Day 2	Day 3	Day 4
9am - 10:30am	Welcome and induction	Observe admin team	Observe GP clinic	Observe Practice Nurse clinic
10:30am - 12 noon	Spend time in reception	Observe HCA/Phlebotomy clinic	Structured history taking with patient	Spend time with practice management team
12 noon - 1pm	Lunch	Lunch	Lunch	Lunch
1pm - 2:30pm	Home visits with visiting clinician	Spend time with Clinical Pharmacist (or other allied health care professional)	Spend time with prescription team and discuss recall system	Home visits with visiting clinician
2:30pm-5pm	Observe GP clinic	Observe Practice Nurse clinic and time to ask questions	Spend time with other allied health care professional if available e.g. midwife/mental health	Observe GP clinic and then time with GP Supervisor to complete end of placement form

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	Day 1	Day 2	Day 3	Day 4
Morning	Welcome and induction	Spend time in reception	Observe GP clinic	Observe GP clinic
	Spend time in waiting room. Sit in with Practice Manager.	Spend time with admin/prescription team	GP Clinic/home visits	GP clinic/home visits
	Lunch	Lunch	Lunch	Lunch
Afternoon	Observe a clinic with ARRS team member (Ideally clinical pharmacist)	Observe clinic with practice nurse for chronic disease management (eg Asthma clinic)	Observe HCA Clinic	Observe clinic with ARRS team member or practice nurse
Other suggestions	Talk to ARRS team members to find out about their role	Invite to any practice meetings eg GSF meetings	Spend time with expert patient	Day 4 placement form completion (can be completed remotely if necessary)

These are examples of timetables. Each placement should develop their own timetable based on the make-up of their practice team.

We would like the students to spend time with a variety of members of the primary care team. So they can start to develop an understanding of the importance of patient care. If appropriate, please include students in any practice/multi-disciplinary team meetings.

The precise length of the student day is somewhat flexible. Not least because it may be constrained by travel requirements. But, it is intended to be eight hours with time for breaks (for example, 9am to 5pm). Students are required to attend every day and this needs to be signed off by the practice in the students’ portfolio.

Medicine placement FAQs

If you have concerns about a student’s attendance, please issue a Professionalism Development Opportunity via completion of an Event Form. The Event Form system has options for Wellbeing and Safety, and Professionalism Lapses.

Choose whichever one you feel is most appropriate for the situation as you understand it. This will then be dealt with by the Professionalism, Wellbeing and Safety Tutor or Lead for Professionalism who will take appropriate action.

Please be assured that all students will have had a DBS (Disclosure and Barring Service) check by the University prior to being allowed to attend placement. The student will have a copy of this, and we ask they have this available if you need to check.

The students also must complete the E-Learning for Health module for their year group. This includes safeguarding adults and children level 2 and resuscitation.

Student feedback is essential as it enables us to monitor and improve what we do. We are also required to submit such data to our regulatory body, the General Medical Council.

In phase 2, student feedback gets collected via four methods:

Clinical Module Evaluation Form – students will get asked to complete this at the end of every clinical module or sub-module. Questions will cover all aspects of the module including campus day and placements (including GP).
Module evaluation questionnaire – these get administered at the end of the academic year. The questionnaire covers all aspects of the programme over the entire year.
Staff Student Liaison Committee – this meets each term and issues are brought to the meeting by the student representatives.
Unitu – this is an online platform that allows students to raise issues and propose solutions for the school to consider.

All feedback can be anonymous if desired.

Feedback is part of students’ professional responsibilities and is not an optional activity. Students are encouraged to give constructive feedback rather than just critical.

Students will be informed about any actions taken based on feedback via the Staff Student Liaison Committee and through the twice yearly “You Said, We Did” sessions.

If there is any important feedback relating to a GP placement, a GP Tutor from the Work-Based Learning Team will discuss this with the practice involved.

You will receive a copy of the feedback from the students after each placement which should be useful for planning of future placements.

Phase 1 medicine placements supervisor information

Introduction into practice

Practicing phase 1 clinical skills during placement

Frequently asked questions

What clinical skills can the students learn?

How do the students record their learning?

What do I need to record?

Overview of topics covered in phase one

Clinical skills

Communication skills

Portfolio requirements

Clinical cases learning logs

Reflective practice

Workbooks

Prescribing workbook

Example timetables

Medicine placement FAQs

If a student is unable to attend placement what should the student do?

If a student does not attend placement as planned - what should the practice do?

What do I do if I have concerns about a student's attendance?

What do students need to do prior to placement?

What should the practice do prior to placement?

Students with a disability

Influenza and Coronavirus vaccinations

Student feedback