Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital

Objectives To identify the availability and variability of learning opportunities through patient presentations on an acute medical placement at a teaching hospital.Design A prospective study evaluating all acute admissions to the Acute Medical Unit over 14 days (336 hours). Clinical presentations a...

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Main Authors: Amir H Sam, Chee Yeen Fung, Emilia Peleva, Zhin Ming Tan, Adam Savage, Mahdi Rahim, Fatima Osman, Mohammed Adnan
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e040575.full
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author Amir H Sam
Chee Yeen Fung
Emilia Peleva
Zhin Ming Tan
Adam Savage
Mahdi Rahim
Fatima Osman
Mohammed Adnan
author_facet Amir H Sam
Chee Yeen Fung
Emilia Peleva
Zhin Ming Tan
Adam Savage
Mahdi Rahim
Fatima Osman
Mohammed Adnan
author_sort Amir H Sam
collection DOAJ
description Objectives To identify the availability and variability of learning opportunities through patient presentations on an acute medical placement at a teaching hospital.Design A prospective study evaluating all acute admissions to the Acute Medical Unit over 14 days (336 hours). Clinical presentations and the day and time of admission were recorded and compared with the learning outcomes specified in the medical school curriculum.Setting An Acute Medical Unit at a London teaching hospital.Outcomes (1) Number of clinical presentations to the Acute Medical Unit over 14 days and (2) differences between the availability and variation of admissions and presentations between in-hours and out-of-hours.Results There were 359 admissions, representing 1318 presentations. Of those presentations, 76.6% were admitted out-of-hours and 23.4% in-hours. Gastrointestinal bleeding, tachycardia, oedema and raised inflammatory markers were over three times more common per hour out-of-hours than in-hours. Hypoxia was only seen out-of-hours. Important clinical presentations in the curriculum such as chest pain and hemiparesis were not commonly seen.Conclusions There is greater availability of presentations seen out-of-hours and a changing landscape of presentations seen in-hours. The out-of-hours presentation profile may be due to expanded community and specialist services. Medical schools need to carefully consider the timing and location of their clinical placements to maximise undergraduate learning opportunities.
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spelling doaj-art-0c6ebcee9256456db6300628c3f5605d2025-08-20T02:33:08ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-040575Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospitalAmir H Sam0Chee Yeen Fung1Emilia Peleva2Zhin Ming Tan3Adam Savage4Mahdi Rahim5Fatima Osman6Mohammed Adnan7Imperial College London, London, UK5National Health ServiceImperial College School of Medicine, Imperial College London, London, UKImperial College School of Medicine, Imperial College London, London, UKImperial College School of Medicine, Imperial College London, London, UKImperial College School of Medicine, Imperial College London, London, UKImperial College School of Medicine, Imperial College London, London, UKImperial College School of Medicine, Imperial College London, London, UKObjectives To identify the availability and variability of learning opportunities through patient presentations on an acute medical placement at a teaching hospital.Design A prospective study evaluating all acute admissions to the Acute Medical Unit over 14 days (336 hours). Clinical presentations and the day and time of admission were recorded and compared with the learning outcomes specified in the medical school curriculum.Setting An Acute Medical Unit at a London teaching hospital.Outcomes (1) Number of clinical presentations to the Acute Medical Unit over 14 days and (2) differences between the availability and variation of admissions and presentations between in-hours and out-of-hours.Results There were 359 admissions, representing 1318 presentations. Of those presentations, 76.6% were admitted out-of-hours and 23.4% in-hours. Gastrointestinal bleeding, tachycardia, oedema and raised inflammatory markers were over three times more common per hour out-of-hours than in-hours. Hypoxia was only seen out-of-hours. Important clinical presentations in the curriculum such as chest pain and hemiparesis were not commonly seen.Conclusions There is greater availability of presentations seen out-of-hours and a changing landscape of presentations seen in-hours. The out-of-hours presentation profile may be due to expanded community and specialist services. Medical schools need to carefully consider the timing and location of their clinical placements to maximise undergraduate learning opportunities.https://bmjopen.bmj.com/content/10/11/e040575.full
spellingShingle Amir H Sam
Chee Yeen Fung
Emilia Peleva
Zhin Ming Tan
Adam Savage
Mahdi Rahim
Fatima Osman
Mohammed Adnan
Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital
BMJ Open
title Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital
title_full Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital
title_fullStr Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital
title_full_unstemmed Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital
title_short Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital
title_sort undergraduate exposure to patient presentations on the acute medical placement a prospective study in a london teaching hospital
url https://bmjopen.bmj.com/content/10/11/e040575.full
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