8/12/2019 Sex, Drugs and Alcohol: bringing communities to life in the MBBCh programme

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To create great doctors, who understand

patients and the world in which we all live

- C21 Mission Statement

Sex, Drugs and Alcohol;bringing communities to life in the

MBBCh programmeProfessor Kamila Hawthorne, Cardiff University

Dr Lucy Jones, Cwm Taf Health Board

Dr Alan Stone, Cardiff University

Many routine patient presentations have their

roots in social factors that affect lifestyle

choices and health outcomes(1). Medical

Students (and their teachers) value the bio-

medical perspective and often forget

the social and psychological determinants

of health(2). This results in a misalignment of expectations and

objectives with their patients(3). Tomorrows Doctors 2009(4)

requires medical curricula to include significant psycho-social

scholarly content, so graduates can understand the factors

underlying many common medical presentations to doctors.

The problem for medical educators is how to link this to

clinically relevant examples that enable students to recognise

its importance(5). Experience in other institutions shows that

this type of learning can be highly effective(6)(7).

The C21 Community Clinical Learning programme

is making that linkage from the first year of the

MBBCh course. The challenge has been to enable

students to appreciate the importance of thesesocial and psychological perspectives in the

development and experience of illness. We also

tackled the important risk behaviours associated

with sex, drugs and alcohol. Obstacles included the

logistics of finding quality clinical learning

opportunities for 300 students over a 2 week case

window. We used a multitude of placements across

rural and urban South Wales and engaged with

Local Health Boards (LHBs) and busy clinicians in

delivering these learning seminars. With their help,

and contribution from colleagues in the Schools of

Psychology and Social Sciences, we have

designed course content that relevantly links these

clinical placements with concurrent on campusbiomedical science.

Students learn their biomedical science content in Years 1

and 2 via a series of virtual clinical case scenarios. These

caseshave been selected so that the aligned offcampus

learning can include role play on sexual health issues,

seminars on raising awareness of domestic violence and

visits to a variety of drug and alcohol services across South

Wales (including Cardiff Prison). Visits to patients homes,

amongst many other learning opportunities, has also

enabled students to appreciate the social context of illness

and disability. Engagement with local service providers has

been enthusiastic and highly productive. Formal evaluation

of the student experience is ongoing which will inform future

development of the programme. Initial feedback has been

positive indicating that students appreciate linking their bio-

medical learning with real the patient contexts.

The CBL, clinical situations, anatomy and lectures fit one another wonderfully. Learning has been g reatly enhanced and helpful to put into longterm memory - Year 1 Medical Student

http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdfhttp://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asphttp://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asphttp://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asphttp://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asphttp://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asphttp://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdfhttp://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf