Over the past decade, the role of anatomical teaching in the undergraduate medical curriculum has changed considerably. At some medical schools, active dissection of cadaveric specimens is gradually being replaced by prosection-based methods and other resources such as e-learning. Warwick Medical School has recently obtained a large collection of plastinated prosections, which replace wet cadaveric specimens in undergraduate anatomy teaching. The aim of this study was to examine students' views on the use of plastinated prosections for their anatomical learning. A mixed method approach was employed using a questionnaire and focus group for data collection. The questionnaire was completed by 125 first-year medical students (response rate 68%). The majority of students (94%) rated plastinated prosections as a valuable resource for their anatomical learning. Various features of the specimens were highlighted, such as the detailed view of relevant anatomy, appreciation of relations between structures, and visualization of anatomy in real life. However, learning on plastinated prosections was perceived to be compromised because of limitations in terms of tactile and emotional experience. We conclude that plastinated prosections are an adequate resource for the early stages of undergraduate training, but that the learning experience may be further enhanced by providing opportunity for the study of wet cadaveric material.

Background Institutional injustice refers to structures that create disparities in resources, opportunities and representation. Marginalised people experience institutional injustice, inequalities and discrimination through intersecting personal characteristics and social circumstances. This study aimed to investigate sources of institutional injustice and their effects on marginalised people with experience of mental health problems. Methods Semi-structured interviews were conducted with 77 individuals from marginalised groups with experience of mental health problems, including psychosis, Black, Asian and minority ethnic (BAME) populations, complex needs and lived experience as a work requirement. These were analysed inductively enabling sensitising concepts to emerge. Findings Three processes of institutional injustice were identified: not being believed because of social status and personal backgrounds; not being heard where narratives did not align with dominant discourses, and not being acknowledged where aspects of identity were disregarded. Harmful outcomes included disengagement from formal institutions through fear and mistrust, tensions and reduced affiliation with informal institutions when trying to consolidate new ways of being, and damaging impacts on mental health and wellbeing through multiple oppression. Conclusions Institutional injustice perpetuates health inequalities and marginalised status. Master status, arising from dominant discourses and heuristic bias, overshadow the narratives and experiences of marginalised people. Cultural competency has the potential to improve heuristic availability through social understandings of narrative and experience, whilst coproduction and narrative development through approaches such as communities of practice might offer meaningful avenues for authentic expression.

Community pharmacy as a profession, is striving to provide better support for people experiencing mental health problems such as depression 1 . Depression is the fifth leading cause of global disability accounting for 4.2% of global years lived with a disability 2 . It can worsen treatment outcomes for co-morbid conditions 3 and is a risk factor for heart disease 4, 5 , suicide 6 and alcohol abuse 7 .Men with depression have worse mortality outcomes compared to women with depression 8,9 . This is somewhat explained by differences in their navigation of depression. Some men mask symptoms 10 and engage in recovery hindering behaviors such as delayed help-seeking [11][12][13] and alcohol abuse 14 . Many men have poorer socialsupport networks, which has been linked to hindered mental health recovery 15 . Hegemonic masculinity is a concept that can partially explain these findings. It is a pattern of practices, mainly enacted by men, to demonstrate or protect one's masculine status 16 . In western societies stoicism, strength, control, and restricted emotionality are traits typically characteristic of hegemonic masculinity 17 , and though men should not be seen as a homogenous group, the concept of hegemonic masculinity might help orientate healthcare professionals to relevant mental health phenomena such as self-stigmatisation in response to a threat to gender status 13,18,19 . For some men, reconstruction of one's masculinity is part of depression recovery 20 . However, hegemonic masculinity has nuanced meanings across different individuals, cultures, and contexts 21,22 . Community pharmacists can support men treating depression, particularly those taking antidepressants. They routinely interact with these patients, have expertise to address medicine related issues and have good mental health literacy [23][24][25] . Optimally utilising community pharmacists could also alleviate pressures elsewhere in the healthcare system 1 . Yet men underutilise these professionals 26,27 , and there is little knowledge about what men taking antidepressants see as the role of the community pharmacist in their treatment journey, or how community pharmacists can best support them.From non-gender specific knowledge it is known that antidepressant consultations by community pharmacists predominantly focus upon medication counselling, as opposed to psychosocial discussions 28 . Both community

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1330 responses out of a possible 1452 for all six course evaluation questions were achieved, for a response rate of 91.6%. The difference in response rates between the historical controls and the ARS was statistically significant (P < 0.00000001). Evaluation of results and impactThe results show a statistically significant difference in the response rates achieved using the ARS compared with those of historical controls. Achieving a higher response rate would conceivably make the feedback more accurate and the evaluations more representative of the entire group, rather than of a motivated few. As honest evaluation is a hallmark of the academic process, mechanisms which allow more complete and timely evaluation of feedback should be encouraged. The ARS collects feedback in real time and allows for further analysis of the evaluations.This study demonstrates a method of capturing a high percentage of course evaluations in real time, using a modality that allows for further statistical evaluation. Use of the ARS should be pursued as an option for feedback on lectures. Paediatric cardiac auscultation teaching based on digital phonocardiography Ioannis Germanakis & Maria KalmantiContext and setting The clinical skills of medical students and junior doctors in cardiac auscultation have been described as rather suboptimal. Although echocardiographic evaluation can almost always effectively rule out the presence of congenital heart disease in children, the initial paediatric cardiac evaluation is still based on cardiac auscultation. The purpose of this pilot study was to evaluate the usefulness of a digital phonocardiography-based teaching course in improving the clinical skills of medical students in paediatric cardiac auscultation. Why the idea was necessary Bedside teaching of paediatric cardiac auscultation is a challenging task because of the increased heart rate, breathing and movement in children and the reduced tolerance and increased fear of young children to prolonged evaluation by consecutive medical students. Furthermore, the rarity of academically active paediatric cardiologists and the low prevalence of congenital heart disease among paediatric patients increase the need for alternative methods of paediatric cardiac auscultation teaching. What was done Twelve medical students participated in a 16-hour digital phonocardiography course during their last year of medical training. Following a brief introduction to the classification of heart murmurs of childhood, students were able to listen to a large series (n = 125) of digitally stored phonocardiograms, corresponding to a wide spectrum of congenital heart disease and innocent murmurs. Each phonocardiogram included four discrete recordings from standard auscultation sites, obtained from paediatric cardiology patients (neonates to adolescents) with the consent of their parents. Participants were able to listen to selected recording intervals (using high-quality earphones) and simultaneously view the graphic display of the corresponding spectrum of sound freque...