Understanding the ward environment: factors determining medical students’ ‘ward smarts’

Abstract

Background: Medical students are expected to know how to function on hospital wards and to be at ease within the ward environment. Such ward-based knowledge indicates that a student is 'ward smart'. However, formal teaching in this area seems to be somewhat neglected, with students being le to gather this knowledge through experience. Methods: Data were collected via an online questionnaire comprising both closed and open questions designed to assess students' ward smarts, focusing on knowledge of the ward environment (routines, equipment, and terminology used), relevant clinical knowledge, and communication/roles of other members of the multidisciplinary team. Multiple regression was used to identify factors in uencing students' scores (i.e. demographics, work experience). Thematic analysis was used to explore medical students' opinions on how their ward understanding could be improved. Results: In our sample of 53 medical students, 96% did not know how to turn on a hearing aid and only 30% knew what a Waterlow score was. Furthermore, 89% did not know how to read an oxygen owmeter, and only 55% knew where the CPR lever on the bed was situated. Multiple regression showed that ward smarts can be predicted by previous hospitalbased work and year group, both of which may represent time spent on wards. Thematic analysis suggested that students felt they would bene t from more ward time and shadowing healthcare professionals on the wards. Discussion: This suggests that students may not be prepared to work in a ward environment. We propose, based on training implemented in other medical schools, that a speci c ward-based interprofessional learning placement or experience should be added to the medical curriculum. As an initial step, speci c teaching and/or practical sessions for students centred around patient communication and understanding the ward environment would be bene cial.

Educational impact and recommendations from implementation of student-led clinical trial recruitment: a mixed-methods study

“…However, flexibility of opportunities and recognition of contributions also emerged as key motivating factors behind engagement. One of the key themes identified was that researchers should ensure medical students had sufficient theoretical and clinical knowledge to perform patient recruitment, and that common practical barriers were pre-emptively addressed (such as access to medical records28 or familiarity with the clinical environment) 29. Moreover, repeated emphasis was placed on the value of the research team providing an accessible and responsive support system to provide guidance, and address unforeseen questions or issues that arise during recruitment.…”