STUDENT ASSISTANTSHIPS (SAs) Academic Year 2011/2012

1. STUDENT ASSISTANTSHIPS (SAs)Academic Year 2011/2012 Professor Michael A Horan – Year 5 Lead Manchester Medical School Dr Marie Hanley – Year 5 Lead MRI Louise Turner – Year 5 Co-ordinator MRI

2. ORIGINS of SAs • Requirement of GMC • Tomorrow’s Doctors 2009 (TD 2009) • Supplementary Guidance • Curriculum mapped to TD 2009 • Required in Academic Year 2011/2012 • Pilot of SAs occurred in Academic Year 2010/2011 at all base hospitals

3. ‘In the final year, students must use practical and clinical skills, rehearsing their eventual responsibilities as an F1 doctor. This should take the form of one or more Student Assistantships in which a student, assisting a junior doctor and under supervision, undertakes most of the duties of an F1 doctor’

4. SA Duties Student assistants should: • Be fully integrated within a clinical team • Be on the rota for that team • Have a defined role with defined responsibilities within the team • Participate in activities similar to those of a newly qualified doctor wherever possible subject to patient safety and consent and legal requirements (Supplementary Guidance, para. 77)

5. SA Tasks (a) Clerking patients so that their notes, although checked by a doctor, can form the basis of the patient record (b) Carrying out practical procedures on real patients under supervision. These could include procedures from the list of practical procedures listed in Appendix 1 of Tomorrow’s Doctors (2009) (c) Managing acute patients under supervision (d) Prioritising patients and tasks

6. (e) Working shifts and out of hours (f) Managing patient paperwork under supervision (g) Making recommendations for the prescription of drugs to real patients. This could take the form of producing duplicate ‘dummy’ prescriptions on which the student is given feedback from a registered doctor or pharmacist (Supplementary Guidance Para. 78)

7. SA Learning Outcomes (a)  Develop complex communication skills, for example breaking bad news (b)  Learn how to priorise a complex workload (c) Learn how tounderstand and apply legal and ethical considerations (d)  Develop an understanding of the operation of the NHS (e)  Improve and develop their knowledge of prescribing

8. Supervision Medical students must: • Be supervised by a fully registered doctor • The supervising doctor may determine that an F1 doctor can oversee the student in certain contexts but the responsibility for the student and their supervision ultimately remains with the supervising doctor • Overall responsibility for supervising medical students be undertaken by the consultant or consultants to whom the student is attached

9. Levels of Supervision Consultant “Supervisor” – overall responsibility for the student and completes end of placement form Immediate “Coach” – middle grade staff who provide day to day supervision FY1 or 2 “Observer” – the person whose rota the student will follow

10. Key Features All students will experience: • One SA of four weeks duration • Most in blocks 5-8 (February – May) • EO Students in blocks 1-4, in Base Hospitals (September – December) • Any SA induction/governance requirements in week 1 • Student allowed to attend half day per week education/training time (may be at Base Hospital) • Assessment through Portfolio (Supervisor Forms A and B replaced by Student Assistantship Placement & Feedback record) • Feedback is a critical component and should be explicit • QA by placement form and on-site inspections (weeks 2 and 3) and student feedback • Students can fail to graduate because of an unsatisfactory SA • While on a SA placement, the requirements of the placement take precedence over all other activities other than a QA visit

11. Students Must Not: • Prescribe medicines • Sign any statutory forms (e.g. MCCD, Cremation, Sickness leave) • Perform invasive procedures (e.g. chest drain, liver biopsy, central venous cannulation) • Record written consent

12. Supervisors must: • Induct the student assistants to the ward • Introduce the students to the named coach and observer • Meet with the students regularly throughout the placement to ensure they are meeting their objectives • Ensure that the student is following the rota of the FY1 and that they complete at least 2 acute “on takes” • Validate the completed SA form which is the students responsibility to complete and submit on MedLea

13. Students Must: • Report any problems on SA placements, as soon as they arise to their supervisor and to Louise Turner • Ensure they can perform all practical procedures listed in TD 2009 • Meet WBA (work based assessment) requirements e.g. U-PSAs, U-CEXs, U-CMDs • Adhere to Faculty Dress Code • Engage fully in the activities of the “firm” • Complete the Student Assistantship Placement & Feedback from week 1 of the placement and the final version be submitted within 1 week of the end of the placement • Record and reflect on feedback • Complete a minimum of two “acute takes”

14. Placement & Feedback record • Must be completed from week 1 • Describes the location and content of the placement • Includes work plan and on-call requirements • Records the names of supervisor(s), coach(es) and observers • Requires a record of what is actually done during the SA placement • Records any and all time “off-placement” • Requires a record of feedback received • And the plans made in the light of such feedback

15. The form will be submitted under the student and supervisor name on MedLea As the Supervisor you will be signing the form off for Technical compliance only

16. The form is 9 pages long in total and a Medical School member of staff will have the final sign off

17. Quality Assurance • Will be assessed as part of the placement form • A proportion of SAs will have a QA visit • Usually in week 2 of the placement • 2 assessors (1 from QA team, 1 from Phase 3 team) • This visit will last 30 – 60 minutes • Visit to include meeting a patient • It takes precedence over all other activities

18. Quality Assurance Section on the Placement Form

19. Placement Feedback • We will be asking students to complete an end of block feedback form as we do for all blocks and we did in the pilot 2010/11 • It is also assessed through the placement form:

20. Feedback from the Pilot From the 49 people who took part in the pilot at the MRI: • 98% said that it has increased their readiness for FY1 • 2% felt ready for FY1 when they started their placement and therefore their readiness couldn't be improved • “You learn things about the job that only come with experience and not from books.” • “I felt that this is the best placement that I have ever had … My FY1/FY2 were very enthusiastic and supportive I cannot thank them enough.” • “Excellent preparation. FY1s allowed us to be part of the team and 'act' as Foundation doctors - without ever letting us feel out of our depth.”

21. Additional information: MedLea: https://www.medlea.manchester.ac.uk/files/year5/studentassistantships/ MRI Undergraduate Website: http://www.cmft.nhs.uk/undergrad/tutorarea.asp.html Tomorrow’s Doctors: http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asp Thank you for your time. Any questions?