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AnteayerBMJ Open

Effectiveness of a centrally designed, large-scale, multisite undergraduate medical simulation programme: student-reported confidence across eight London hospitals in a UK medical school setting

Por: Fung · C. Y. · Wraith · C. · Houghton · N. · Woods · B. · Brown · C. · Dharmarajah · A. · Sam · A. H.
Objectives

Simulation is well established in medical education. However, with rising numbers of medical students globally, provision of high-quality, equitable simulation teaching on a large, multisite scale is increasingly challenging. We sought to explore whether a centrally designed, multisite simulation programme could enhance student confidence equitably across multiple clinical sites with differing resources.

Design

An evaluative study on the changes in medical student confidence on defined intended learning outcomes (ILOs) in 3 undergraduate year groups across 11 simulation sessions delivered at eight different clinical sites with variable resources and facilitators.

Setting

Eight hospitals affiliated with Imperial College School of Medicine.

Outcomes

Students’ self-reported confidence in achieving the ILOs via a questionnaire at the end of each session. Changes in confidence following each session were analysed and compared across sites.

Results

522 students responded to the survey over 3 academic years. Students’ mean confidence in achieving ILOs increased in all sessions. Nine out of 10 sessions showed no statistically significant difference in the confidence increases between sites.

Conclusion

Our study suggests it is possible to deliver an equitable, centrally designed, large-scale simulation teaching programme to medical students across multiple clinical sites with different facilitator teams. The programme is sustainable, easily facilitated by new teaching fellows each year and is likely adaptable to other healthcare professions and settings.

Promoting smoking cessation and preventing relapse to tobacco use following a smoke-free mental health inpatient stay (SCEPTRE feasibility study): a multicentre randomised controlled feasibility study protocol

Por: Petersen Williams · P. · Huddlestone · L. · Shoesmith · E. · Brady · S. · Mitchell · A. · Exley · V. · Wiggins · F. · Sinclair · L. · Pervin · J. · Horspool · M. · Leahy · M. · Paul · C. · Colley · L. · Shahab · L. · Watson · J. · Hewitt · C. · Hough · S. · Britton · J. · Coleman · T. · Gilb
Introduction

Thousands of patients with mental illness are admitted to acute adult mental health wards every year in England, where local guidance recommends that all mental health settings be entirely smokefree. Mental health Trusts presently invest substantial effort and resources to implement smoke-free policies and to deliver tobacco dependence treatment to patients. Providing adequate support can help those who smoke remain abstinent or quit smoking during their smoke-free inpatient stay and beyond. At present, little is known about how best to support patients to prevent their return to pre-admission smoking behaviours after discharge from a smoke-free mental health inpatient stay. We have developed an intervention which includes targeted resources to support smoking-related behaviour change in patients following discharge from a smoke-free mental health setting. The aim of this trial is to determine the feasibility of a large-scale clinical trial to test the effectiveness and cost-effectiveness of the SCEPTRE intervention, compared with usual care.

Methods and analysis

This feasibility study will be an individually randomised, controlled trial in eight National Health Service mental health Trusts recruiting adults (≥18 years) admitted to an acute adult mental health inpatient setting who smoke tobacco on admission, or at any point during their inpatient stay. Consenting participants will be randomised to receive a 12-week intervention consisting of components aimed at promoting or maintaining positive smoking-related behaviour change following discharge from a smoke-free mental health inpatient setting or usual care. Data will be collected at baseline, 3 months and a second timepoint between 4 and 6 months post-randomisation. With 64 participants (32 in each group), the trial will allow a participation rate of 15% and completion rate of 80% to be estimated within a 95% CI of ±3% and ±10%, respectively. The analysis will be descriptive and follow a prespecified plan.

Ethics and dissemination

Ethics approval was obtained from the North West—Greater Manchester West Research Ethics Committee. We will share results widely through local, national and international academic, clinical and patient and public involvement networks. The results will be disseminated through conference presentations, peer-reviewed journals and will be published on the trial website: https://sceptreresearch.com/.

Trial registration number

ISRCTN77855199.

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