Financial support is provided as an Educational Grant by Pfizer Limited to enable Patients Know Best to employ a full-time equivalent project manager for a 2-year post to support the deployment of the Patients Know Best (PKB) MedEd Programme Initiative for academic institutions.
In June of this year, we welcomed the University of Winchester’s Faculty of Health and Wellbeing as a new partner for our Education Programme.
The faculty considered digital health as a core part of their teaching curriculum for healthcare students, therefore, the decision to incorporate the use of Patients Know Best (PKB) in their projects and courses had been a natural evolution of their already enormous strides in this field.
It is a pleasure to start working with a new institution, whose mission “to build a digitally ready workforce” aligns completely with the one of our Education programme.
The Faculty believed that to do so, it was key to grow the skills and confidence of the healthcare workforce, and this starts with educating students utilising high quality technology- such as the one PKB provides.
As at July, PKB had been used by around 20 students in their school of nursing, and in September, by 120 from their school of physiotherapy. We were delighted as, while the use of PKB in clinical settings is widespread among nurses and physiotherapy teams, the University of Winchester was the first in which our platform was used by students of these subjects.
It is well known that there is currently a challenge associated with placement procurement for healthcare students, meaning that universities can't find enough placements for their students. Doing virtual and simulated placement is, therefore, even more important and recommended by the HEE (Health Education England). This challenge started before the hit of the Covid-19 pandemic, and exacerbated during and after that. Professional bodies such as HEE , are recommending education institutions explore the use of simulation to manage the overall demand on practice based learning placements.
Findings from different studies showed that simulated placements, as well as being an immediate and practical solution for the lack of available face-to-face clinical ones, can lead to even better competence than the latter, in a number of different professions (Watson et al, 2012; Blackstock et al, 2013).
Our platform, allowing for simulated interaction, with real patient volunteers, actors, or even fictitious case study patients, has shown to be the perfect ally to make these placements successful.
In their first use this summer, the School of Nursing utilised PKB for their simulated placement, while the School of Physiotherapy for their simulated placement preparation week. This was both complementing and in part substituting face-to-face placements for the students
Among the learning outcomes, the lecturers identified that using PKB in this setting can:
Around 120 BSc (Hon) Physiotherapy students, from 2nd and 3rd year, had the chance to use our platform during a simulated placement preparation week in September of this year.
Regarding learning outcomes of this experience, Louise Stanley, Senior Lecturer leading the week commented:
With this significant driver in the NHS for digital transformation, we felt that we wanted to better prepare our students for that digital transformation, by exposing them to remote consultations… also, we wanted to familiarise them with a simulated notes package to replicate practice, so I was keen to use an electronic Patient record system. When they go into the workplace they will be using different systems potentially, but I wanted them to be familiar with the concept of using electronic PHRs.
Using the platform as Professionals, the students were divided into 12 different teams, each looking at 2 case study patients created by the lecturers.
PKB was used for 2 scenarios they were running.
The first one was about a patient that the students were physically assessing using other simulation modalities: this was a patient admitted to A&E, whose PKB record included acute medical unit notes, an admission clerking sheet, a chest x-ray and more. For the first phase of the simulation an actor was involved. The main objective for the students at this stage was to gain subjective information, background information about past medical history, and write an initial assessment.
In the second stage of the simulation, the patient deteriorated and the scenario was moved into an intensive care environment, which was simulated using simulated manikins and high fidelity simulated ventilators. At this stage the students were asked to gather clinical information and make a clinical assessment. This involved gathering the hospital admission information, some of the patient’s medical history, and then individually editing the “Respiratory assessment” care plan on PKB, which was created by the team at the University of Winchester with the support of PKB.
Part of the “Respiratory Assessment” Care Plan used by students
In July 2022, 2nd year Nursing students had the opportunity to participate in an optional four-week virtual and simulated placement. This was part of a study called “digital literacy and clinical skills developed during a virtual nursing placement”, and included activities such as an acute medical ward simulation scenario, a service improvement hackathon, and culminated in a Digital Health conference on the topic of telehealth and the future digital workforce.
The nursing team at the University worked with PKB to set up the environment for the students, who were then invited to register to the platform with the role of professionals. Once the students logged in, they had the chance to look at 3 case study patients’ records, created by the lecturers: one PEG-fed child; one diabetic adult, with multiple diagnoses and test results; and one frail elderly with pressure wounds and affected by Parkinson’s disease.
The students were able to participate in MDT-style (Multi-Disciplinary Team) interprofessional working, based on these case studies.
Diagnoses section for the adult patient as seen by the students
In the first semester of this academic year, the physiotherapy students will go out into clinical placements, and the professors are confident that the virtual experience using PKB will provide them with a better platform to begin that placement opportunity.
The team at Winchester was pleased that this project also helped with placement provision for their 2nd year students. For them, the simulated placement week substituted one week of face-to-face, and this in turn reduced the crossover of students so the team was able to get more placement opportunities for them.
At the same time, even though the study on the nursing virtual placement is at its early stages, the first results revealed that the students are highly satisfied with it, and the school’s intention is to keep organising them, while increasingly embedding the use of PKB into more and more of their projects, of which the students were enthusiastic.
While face-to-face placements remain a cornerstone experience for all healthcare students, it is widely accepted that simulation-based ones can lead to a number of positive outcomes, such as the fact that they can promote student’s development of professionalism (Rogers et al, 2017), and prepare them better for clinical placements (Gibson et al, 2016; Miles et al, 2016). Moreover, it also allows to make sure all the students have experienced a certain situation, while this would be impossible in face-to-face placements.
The professors at the University of Winchester are very happy with how the students engaged with PKB during the simulated placements, and are already exploring how to embed the platform more and more in their teaching. As part of this, the team worked with PKB to create new care plans to be used by students - a NEWS care plan and a musculoskeletal one - and are willing to populate the PKB platform with an entire community of patients, to mimic what the students would encounter in clinical practice.
