Peer teacher training (PTT) in action

BACKGROUND

The benefits of peer teaching for tutors, students and institutions are well documented. Skills in peer teaching, assessment and feedback are cited as important graduate attributes by international medical councils; however, the literature on preparation for this role, specifically peer teacher training (PTT), is sparse. This study evaluated the implementation of a PTT programme adopted from the Medical School at the University of Sydney in 2016. The programme was adopted to support the development of skills in UK medical undergraduates. The training was accessed by students studying at the University of Leicester in 2017 and 2018.

METHODS

The course was evaluated using mixed methods. Students completed pre- and post-course self-rated questionnaires. Semi-structured focus groups were conducted after each course to investigate students' perceptions.

RESULTS

Twenty fourth-year medical students attended the PTT. Students reported improvements in their understanding of educational principles, confidence in teaching and feedback skills, and an increased likelihood of volunteering to teach. Focus groups revealed potential benefits for future patient interaction and preparation for educator roles.

DISCUSSION

The PTT provided an effective approach for medical students to gain perceived competence and confidence in teaching and giving feedback. Students reported an increased propensity for teaching when qualified. Students with lower self-reported teaching ability reported greater improvements following the course. Students reported unanticipated perceived benefits for improving patient education and obtaining teaching accreditation for their portfolio and future clinical roles. They perceived potential value if the training were to be made interprofessional on future courses. Furthermore, this study demonstrates the transferability of the PTT programme across university settings.

Exploring junior doctor morale in a UK hospital

BACKGROUND

The importance of junior doctor morale is increasingly being recognised. We aimed to identify and explore the factors affecting junior doctor morale in a UK teaching hospital.

METHODS

We carried out an online survey asking junior doctors to rate their morale, rank the top five factors that positively affected morale and offer free-text comments.

RESULTS

Nine hundred and forty three junior doctors were approached, 402 (42.6%) responded. Overall morale was rated 6 [interquartile range (IQR): 5-8], and how valued 6 (IQR: 4-8), supported 7 (IQR: 6-9) and autonomous 7 (IQR: 6-8) they felt [median ratings using a scale of 0 (low)-10 (high)]. When comparing the four domains of feeling supported, feeling valued, having autonomy and overall morale, respondents felt most supported overall (n = 402, χ2 = 85.6, p < 0.0001). Key themes were identified: team working and relationships, feedback, training and education, resources, wellbeing and pastoral support, staffing and workload, senior clinician support, and autonomy. The most common factors positively affecting morale were 'feeling part of a team' (66.4%) and 'being recognised for good practice' (56.7%).

CONCLUSION

We identified a number of diverse themes affecting junior doctor morale. Doctors felt more supported than valued or autonomous, with complex relationships between these domains.

Improving uptake of HIV testing in patients with a confirmed STI

Up to 70% of GU clinic attendees with a sexually transmitted infection (STI) and undiagnosed HIV, remain HIV undiagnosed after their visit. STIs have been shown to facilitate HIV transmission. Therefore, patients with an STI should test for HIV. Our objective was to compare the uptake of HIV testing in GU clinic attendees with an STI (study group) with those receiving a negative GU screen (control group). This re-audit was performed after introduction of the following clinic changes: nurse-performed asymptomatic GU screening; 'opt-out' HIV testing policy; discontinuing routine pre-HIV test counselling; access to HIV results by post. The uptake of HIV testing overall, and in the study and control groups respectively was 53% (n = 573), 41% (n = 285) and 65%, showing significant improvement compared to the first audit in 1999 (18%, 14% and 33% respectively) (P < 0.01). The clinic interventions increased HIV testing rates which were in keeping with National Sexual Health strategy targets.

Regular partners and risky behaviour: why do gay men have unprotected intercourse?

Studies in both the UK and the USA continue to show that gay and bisexual men put themselves at risk of exposure to HIV through unprotected intercourse, most often with regular partners. As part of a larger study of homosexually active men, 310 men who had had unprotected anal intercourse with a man in the previous year were asked to describe the last occasion on which this had happened. The majority of men had had unprotected intercourse with a regular partner and did not perceived it as risky, although most did not know the HIV status of their partner. Regular and non-regular partners were perceived differently. Men were more likely to be emotionally involved in regular partners and to perceive unprotected penetrative sex with a regular partner as not risky. Future health education initiatives must take into account men's emotional involvement in regular partners and their perception of unprotected intercourse with such partners as not risky.