There are four defined mandatory teaching sessions which will be formally monitored for attendance. These are:

1. Themed Case Discussions (on Fridays);
2. Secondary Component Teaching (on Fridays);
3. Clinical Debrief (within your placement);
4. Procedural Skills in the Classroom (included in this is the Anaesthetic Tutorial).

Failure to attend or provide a valid reason for non-attendance will result in your exclusion from the end of year examinations. This will mean you will be unable to progress to Year 4.  Please refer to absence for Year 3 for further information.

Although all planned teaching activities are face-to-face, there may be rare and exceptional circumstances where some activity is delivered online. All students should therefore refer to the Programme’s guidance: Student ‘Netiquette’ for remotely-delivered teaching sessions in order to ensure they get the best out of these sessions.

Themed Case Discussions (TCD)

During TCDs, you will work through key topics in General Medicine and General Surgery, applying the knowledge acquired after completing that week’s self-directed online learning. You will evolve from problem-based learning to clinical reasoning to enable you to ‘think like a doctor’.

Each week, a new theme will “open” on the preceding Friday at 13:00 with online material on 1Medlearn. The online material will contain a list of Medical Licencing Assessment (MLA) conditions and clinical presentations that you will be expected to learn about by working through the cases and sign-posted resources, reading materials, and working through the questions and exercises. They will also remind you about your Year 1 and 2 knowledge and help you apply this knowledge to the clinical scenarios. You will be expected to work through this material in preparation for your Friday TCD session.

The Friday TCD sessions will be delivered by an Expert (in the subject area of the week), tutor and a TCD facilitator. You will be presented with previously unseen clinical scenarios and apply the principles and knowledge of what you have already learned in the online material. These will be realistic and designed to help you to also apply the theoretical and practical knowledge you have gained during your clinical placements. Each case will focus on areas that are critical for you to understand and reason, to debate and apply. It is important to understand that TCD sessions are not teaching sessions and will not cover all of the material you have learned but instead focus on the translation of the theoretical knowledge into clinical practice by giving you the challenge of a new case.

The sessions are for your benefit. Please take part, help your fellow students and engage with the tutors. The more you engage, the more interesting and stimulating each session will be. It is a wonderful opportunity for you to learn how to think like a clinician and to develop your clinical reasoning skills as well as developing a knowledge of real-life clinical practice. You won’t just be asked for answers, but you will be expected to explain how you have reached the conclusions that you or your group have formed.

Each session will last 90 minutes, and all students across the year will cover the same topics synchronously.

10 Key Steps in Working through Weekly Themes:

• Use the MLA conditions and clinical presentations as a guide to what you need to learn about that week, and ensure you have met the session objectives of the week.
• Use the Illness Script as a framework for your learning of the MLA conditions and to develop your clinical reasoning by contrasting the clinical presentations.
• Work through the online content in 1Medlearn PRIOR to your TCD session. Do not skim read and do not use other students’ notes as your source of prep (e.g. from the year above).
• Spend time answering the interactive elements of the online case to get the most out of it and test your knowledge and understanding.
• Make use of other learning materials such as books or digital media to enhance your knowledge. The support provided centrally is not “the be all and end all” of what you need to know, you will in fact never cover everything in relation to each subject.
• Gain clinical experience, and link what you are learning with what you see in wards and the clinical environment.
• Before your TCD, you are expected to complete a formative assessment at the end of your case online via 1MedLearn. This will cue you to knowledge expected during the tutor-facilitated session.
• Actively participate in the discussion during each TCD. Your tutors will expect you to have completed the required reading beforehand.
• Interact with your peers and clinicians to clarify any areas of uncertainty.
• Assist your peers in assimilating knowledge and help them grasp concepts, which will be of benefit for both them and yourself. Remember each week some of you may have more clinical experience than others in relation to that week. Share that knowledge.
• Use the expertise of the lead tutors and facilitators to ensure you fully understand the concepts that you are being taught.

Your tutors will know what you have covered previously during the year in any subject area. They may well refer back to the knowledge you already have. We will ensure that concepts are not repeated but sometimes you may require more clarification and it is perfectly reasonable to ask for help from the tutor or facilitator.

Secondary Component Teaching (SCT)

SCT will integrate learning around key components that run through the academic year. It will cover essential areas of the curriculum: Clinical Communication, Prescribing and Medicines Safety, Ethics & Law, Clinical Reasoning and Behaviour Change.

Sessions will be in small groups and may include simulated patients. Each will last approximately 90 minutes.

Clinical Debrief (CD)

There are weekly CD sessions for 24 weeks. CD sessions are 2 ¼ hours long and are undertaken face to face in small groups, usually consisting of 6-8 students, and facilitated by a GP who will remain as your CD tutor for the duration of each semester.

The sessions provide a forum for students to share their experiences in clinical practice, both good and bad, in a safe space and allow the emotional and psychological aspects of your clinical experiences to be discussed in a supportive and non-threatening environment. CD sessions also allow for more in-depth reflection on cases that students have seen in the clinical setting, allowing the exploration of the thought processes behind how a history was taken and how differential diagnoses were arrived at. This process aims to improve students’ clinical reasoning and clinical decision-making skills. You will be expected to bring cases to consider and with additional resources provided by the tutors to promote and develop discussion. CD sessions are flexible to allow the specific learning needs of each group to be met and can focus on topics as wide-ranging as personal and professional identity, ethical issues and social determinants of health.

Procedural Skills in the Classroom and Undergraduate Procedural Skills Assessment (UPSAs)

You will be taught skills in the classroom to allow you to complete the UPSAs in the clinical environment in Years 3 to 5. You must attend all these sessions.

The GMC require that the assessment includes a professional judgement of your level of competence as outlined below:

1) Requires further simulation-based practice.

2) Requires further directly supervised practice.

3) Is safe to continue performing with only indirect (distant) supervision.

This will require you to complete multiple forms for each skill over the 3 clinical years to track your progress. It is important to seek feedback and sign-off for an UPSA skill at every opportunity you perform that skill. This will allow you to reflect on your learning needs throughout the years.

The assessor can be any clinician or allied health professional who is themselves competent at performing the skill independently themselves. Assessors must be a permanent member of staff. Assessors can include FY1 doctors who are independently competent at the skill themselves. The assessor cannot be a fellow student, even if they have another qualification which makes them competent at the skill.

In addition, the competence must not be under a Patient Group Direction (PGD) and it must be an independent prescribing practitioner that assesses you. A PGD allows certain healthcare professionals to administer medications to a defined group of patients under planned circumstances, such as vaccinations or contraception. A nurse, for example, administering an intramuscular injection under a PGD could not supervise a student doing this as an UPSA.

In Year 3 the minimum requirement for UPSAs is a level 2 (requires further directly supervised practise), however students can attain level 3 (is safe to continue performing with only indirect supervision) for some skills. Most skills require you to attain higher levels of competence over the clinical years and so it is important to repeat skills and get them assessed at every opportunity, so that we can monitor your progress until you are deemed competent to practice by graduation with only distant supervision. Please see: Year 3 UPSAs and PMS

 Anaesthetic Tutorials

At the start of your surgical block, you will have an anaesthetic tutorial. This will help you understand the role of the anaesthetist when a patient undergoes surgery and you will also learn how to undertake a pain assessment. These are part of your mandatory teaching sessions.

Prescribing Safety Assessments (PSA)

The PSA must be completed and signed off by someone who is competent in completion and/ or professional review of prescribing. This includes qualified pharmacists and allied healthcare professionals who are qualified to prescribe independently. The independent prescriber must be familiar with the medicine prescribed by the student as part of their independent prescribing practice.

The groups able to sign off students will include doctors, pharmacists and specialist nurses or advanced nurse practitioners who prescribe independently.

FY1 doctors can sign off student prescriptions, provided the FY1 themself has passed the PSA.