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Article ; Online: The impact of extracorporeal membrane oxygenation on mortality in patients with cardiogenic shock post-acute myocardial infarction: a systematic review and meta-analysis.

Paddock, Sophie / Meng, James / Johnson, Nicholas / Chattopadhyay, Rahul / Tsampasian, Vasiliki / Vassiliou, Vassilios

European heart journal open

2024 Volume 4, Issue 1, Page(s) oeae003

Abstract: Aims: Cardiogenic shock remains the leading cause of death in patients hospitalized with acute myocardial infarction. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used in the treatment of infarct-related cardiogenic shock. ...

Abstract	Aims: Cardiogenic shock remains the leading cause of death in patients hospitalized with acute myocardial infarction. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used in the treatment of infarct-related cardiogenic shock. However, there is limited evidence regarding its beneficial impact on mortality. The aim of this study was to systematically review studies reporting the impact of VA-ECMO on mortality in patients with acute myocardial infarction complicated by cardiogenic shock. Methods and results: A comprehensive search of medical databases (Cochrane Register and PubMed) was conducted. Studies that reported mortality outcomes in patients treated with VA-ECMO for infarct-related cardiogenic shock were included. The database search yielded 1194 results, of which 11 studies were included in the systematic review. Four of these studies, with a total of 586 patients, were randomized controlled trials and were included in the meta-analysis. This demonstrated that there was no significant difference in 30-day all-cause mortality with the use of VA-ECMO compared with standard medical therapy [odds ratio (OR) 0.91; 95% confidence interval (CI) 0.65-1.27]. Meta-analysis of two studies showed that VA-ECMO was associated with a significant reduction in 12-month all-cause mortality (OR 0.31; 95% CI 0.11-0.86). Qualitative synthesis of the observational studies showed that age, serum creatinine, serum lactate, and successful revascularization are independent predictors of mortality. Conclusion: Veno-arterial extracorporeal membrane oxygenation does not improve 30-day all-cause mortality in patients with cardiogenic shock following acute myocardial infarction; however, there may be significant reduction in all-cause mortality at 12 months. Further studies are needed to delineate the potential benefit of VA-ECMO in long-term outcomes. Registration: The protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42023461740).
Language	English
Publishing date	2024-01-18
Publishing country	England
Document type	Journal Article
ISSN	2752-4191
ISSN (online)	2752-4191
DOI	10.1093/ehjopen/oeae003
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Circumferential resection margin positivity due to direct or indirect tumour involvement in rectal cancer - a call for better stratification.

Sadien, Iannish D / Ari, Kaso / Fernandes, Megan / Paddock, Sophie / Sington, James / Kapur, Sandeep / Hernon, James / Stearns, Adam T / Shaikh, Irshad A

ANZ journal of surgery

2023

Abstract: Background: A positive circumferential resection margin (CRM) after rectal cancer surgery, which can be the result of direct or indirect tumour involvement, has consistently been associated with increased local recurrence and poorer survival. However, ... ...

Abstract	Background: A positive circumferential resection margin (CRM) after rectal cancer surgery, which can be the result of direct or indirect tumour involvement, has consistently been associated with increased local recurrence and poorer survival. However, little is known of the differential impact of the mode of tumour involvement on outcomes. Methods: 1460 consecutive patients undergoing rectal cancer resection between 2003 and 2018 were retrospectively assessed. Histopathology reports for patients with a positive CRM were reviewed to determine cases of direct (R1-tumour) or indirect tumour involvement (R1-other). Disease-free survival (DFS) and overall survival (OS) were assessed by Kaplan-Meier analysis. The role of the mode of CRM positivity was examined by univariate and multivariate Cox proportional hazards models. Results: Eighty-five patients had an R1 resection due to CRM involvement (5.8%). Of those, 69 were due to direct tumour involvement, while 16 were from indirect causes. Kaplan-Meier analysis revealed that R1-other was associated with increased OS (hazard ratio 0.40, log-rank P = 0.006) and DFS (P = 0.043). Multivariate regression confirmed that the mode of CRM positivity was an independent predictor of OS. More interestingly, the patterns of recurrence were different between the two groups, with R1-tumour leading to significantly more local recurrence (P = 0.04). Conclusions: Our data strongly suggests that direct tumour involvement of the CRM confers worse prognosis after rectal cancer surgery. Importantly, differences in the site and frequency of recurrences make a case for better stratification of patients with a positive CRM to guide treatment decisions.
Language	English
Publishing date	2023-12-29
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.18851
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Article ; Online: Drug coated balloons for coronary artery bifurcation lesions: A systematic review and focused meta-analysis.

Corballis, Natasha H / Paddock, Sophie / Gunawardena, Tharusha / Merinopoulos, Ioannis / Vassiliou, Vassilios S / Eccleshall, Simon C

PloS one

2021 Volume 16, Issue 7, Page(s) e0251986

Abstract: Objectives: We sought to systematically review the evidence supporting the role of drug coated balloons (DCBs) in the treatment of coronary bifurcation lesions.: Background: DCBs are emerging as an attractive alternative treatment strategy for ... ...

Abstract	Objectives: We sought to systematically review the evidence supporting the role of drug coated balloons (DCBs) in the treatment of coronary bifurcation lesions. Background: DCBs are emerging as an attractive alternative treatment strategy for treating coronary bifurcations due to simplifying the approach and reducing rates of stent related complications. We systematically reviewed the evidence for DCB use in coronary bifurcations and conducted a focused meta-analysis on late lumen loss in the side branch comparing DCB and plain old balloon angioplasty (POBA). Methods: This study was conducted in line with the PRISMA statement. All studies (including both RCTs and observational studies, excluding case reports) using DCB as part of a bifurcation strategy were included in this review. A literature search identified a total of ten studies for inclusion. A focused meta-analysis was undertaken for the use of DCB in side-branch compared with POBA. Mean late lumen loss was used with a random effects model due to heterogeneity. Results: DCB was found to be superior to POBA for side branch treatment in bifurcations (p = 0.01). There are four studies that investigated the use of DCB for main branch treatment in a bifurcation, with evidence supporting its safety in main branches of bifurcation lesions, while prospective observational studies have demonstrated favourable target lesion revascularisation rates. Conclusion: Although there is a lack of robust RCTs comparing DCBs with current generation DES, DCBs appear safe in main branch bifurcation lesions with improved side branch late lumen loss when compared with DES or POBA.
MeSH term(s)	Angioplasty, Balloon, Coronary ; Coronary Artery Disease/surgery ; Humans
Language	English
Publishing date	2021-07-09
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0251986
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Article ; Online: Effectiveness of Digital Education on Communication Skills Among Medical Students: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.

Kyaw, Bhone Myint / Posadzki, Pawel / Paddock, Sophie / Car, Josip / Campbell, James / Tudor Car, Lorainne

Journal of medical Internet research

2019 Volume 21, Issue 8, Page(s) e12967

Abstract: Background: Effective communication skills are essential in diagnosis and treatment processes and in building the doctor-patient relationship.: Objective: Our aim was to evaluate the effectiveness of digital education in medical students for ... ...

Abstract	Background: Effective communication skills are essential in diagnosis and treatment processes and in building the doctor-patient relationship. Objective: Our aim was to evaluate the effectiveness of digital education in medical students for communication skills development. Broadly, we assessed whether digital education could improve the quality of future doctors' communication skills. Methods: We performed a systematic review and searched seven electronic databases and two trial registries for randomized controlled trials (RCTs) and cluster RCTs (cRCTs) published between January 1990 and September 2018. Two reviewers independently screened the citations, extracted data from the included studies, and assessed the risk of bias. We also assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations assessment (GRADE). Results: We included 12 studies with 2101 medical students, of which 10 were RCTs and two were cRCTs. The digital education included online modules, virtual patient simulations, and video-assisted oral feedback. The control groups included didactic lectures, oral feedback, standard curriculum, role play, and no intervention as well as less interactive forms of digital education. The overall risk of bias was high, and the quality of evidence ranged from moderate to very low. For skills outcome, meta-analysis of three studies comparing digital education to traditional learning showed no statistically significant difference in postintervention skills scores between the groups (standardized mean difference [SMD]=-0.19; 95% CI -0.9 to 0.52; I Conclusions: We found low-quality evidence showing that digital education is as effective as traditional learning in medical students' communication skills training. Blended digital education seems to be at least as effective as and potentially more effective than traditional learning for communication skills and knowledge. We also found no difference in postintervention skills between more and less interactive forms of digital education. There is a need for further research to evaluate the effectiveness of other forms of digital education such as virtual reality, serious gaming, and mobile learning on medical students' attitude, satisfaction, and patient-related outcomes as well as the adverse effects and cost-effectiveness of digital education.
MeSH term(s)	Communication ; Education, Distance/methods ; Female ; Humans ; Male ; Students, Medical/statistics & numerical data ; Telemedicine/methods
Language	English
Publishing date	2019-08-27
Publishing country	Canada
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1439-4456
ISSN (online)	1438-8871
ISSN	1439-4456
DOI	10.2196/12967
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Article: Clinical Translation of Three-Dimensional Scar, Diffusion Tensor Imaging, Four-Dimensional Flow, and Quantitative Perfusion in Cardiac MRI: A Comprehensive Review.

Frontiers in cardiovascular medicine

2021 Volume 8, Page(s) 682027

Abstract: Cardiovascular magnetic resonance (CMR) imaging is a versatile tool that has established itself as the reference method for functional assessment and tissue characterisation. CMR helps to diagnose, monitor disease course and sub-phenotype disease states. ...

Abstract	Cardiovascular magnetic resonance (CMR) imaging is a versatile tool that has established itself as the reference method for functional assessment and tissue characterisation. CMR helps to diagnose, monitor disease course and sub-phenotype disease states. Several emerging CMR methods have the potential to offer a personalised medicine approach to treatment. CMR tissue characterisation is used to assess myocardial oedema, inflammation or thrombus in various disease conditions. CMR derived scar maps have the potential to inform ablation therapy-both in atrial and ventricular arrhythmias. Quantitative CMR is pushing boundaries with motion corrections in tissue characterisation and first-pass perfusion. Advanced tissue characterisation by imaging the myocardial fibre orientation using diffusion tensor imaging (DTI), has also demonstrated novel insights in patients with cardiomyopathies. Enhanced flow assessment using four-dimensional flow (4D flow) CMR, where time is the fourth dimension, allows quantification of transvalvular flow to a high degree of accuracy for all four-valves within the same cardiac cycle. This review discusses these emerging methods and others in detail and gives the reader a foresight of how CMR will evolve into a powerful clinical tool in offering a precision medicine approach to treatment, diagnosis, and detection of disease.
Language	English
Publishing date	2021-07-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2021.682027
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Article ; Online: Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise.

McManus, I C / Harborne, Andrew Christopher / Horsfall, Hugo Layard / Joseph, Tobin / Smith, Daniel T / Marshall-Andon, Tess / Samuels, Ryan / Kearsley, Joshua William / Abbas, Nadine / Baig, Hassan / Beecham, Joseph / Benons, Natasha / Caird, Charlie / Clark, Ryan / Cope, Thomas / Coultas, James / Debenham, Luke / Douglas, Sarah / Eldridge, Jack /

Hughes-Gooding, Thomas / Jakubowska, Agnieszka / Jones, Oliver / Lancaster, Eve / MacMillan, Calum / McAllister, Ross / Merzougui, Wassim / Phillips, Ben / Phillips, Simon / Risk, Omar / Sage, Adam / Sooltangos, Aisha / Spencer, Robert / Tajbakhsh, Roxanne / Adesalu, Oluseyi / Aganin, Ivan / Ahmed, Ammar / Aiken, Katherine / Akeredolu, Alimatu-Sadia / Alam, Ibrahim / Ali, Aamna / Anderson, Richard / Ang, Jia Jun / Anis, Fady Sameh / Aojula, Sonam / Arthur, Catherine / Ashby, Alena / Ashraf, Ahmed / Aspinall, Emma / Awad, Mark / Yahaya, Abdul-Muiz Azri / Badhrinarayanan, Shreya / Bandyopadhyay, Soham / Barnes, Sam / Bassey-Duke, Daisy / Boreham, Charlotte / Braine, Rebecca / Brandreth, Joseph / Carrington, Zoe / Cashin, Zoe / Chatterjee, Shaunak / Chawla, Mehar / Chean, Chung Shen / Clements, Chris / Clough, Richard / Coulthurst, Jessica / Curry, Liam / Daniels, Vinnie Christine / Davies, Simon / Davis, Rebecca / De Waal, Hanelie / Desai, Nasreen / Douglas, Hannah / Druce, James / Ejamike, Lady-Namera / Esere, Meron / Eyre, Alex / Fazmin, Ibrahim Talal / Fitzgerald-Smith, Sophia / Ford, Verity / Freeston, Sarah / Garnett, Katherine / General, Whitney / Gilbert, Helen / Gowie, Zein / Grafton-Clarke, Ciaran / Gudka, Keshni / Gumber, Leher / Gupta, Rishi / Harlow, Chris / Harrington, Amy / Heaney, Adele / Ho, Wing Hang Serene / Holloway, Lucy / Hood, Christina / Houghton, Eleanor / Houshangi, Saba / Howard, Emma / Human, Benjamin / Hunter, Harriet / Hussain, Ifrah / Hussain, Sami / Jackson-Taylor, Richard Thomas / Jacob-Ramsdale, Bronwen / Janjuha, Ryan / Jawad, Saleh / Jelani, Muzzamil / Johnston, David / Jones, Mike / Kalidindi, Sadhana / Kalsi, Savraj / Kalyanasundaram, Asanish / Kane, Anna / Kaur, Sahaj / Al-Othman, Othman Khaled / Khan, Qaisar / Khullar, Sajan / Kirkland, Priscilla / Lawrence-Smith, Hannah / Leeson, Charlotte / Lenaerts, Julius Elisabeth Richard / Long, Kerry / Lubbock, Simon / Burrell, Jamie Mac Donald / Maguire, Rachel / Mahendran, Praveen / Majeed, Saad / Malhotra, Prabhjot Singh / Mandagere, Vinay / Mantelakis, Angelos / McGovern, Sophie / Mosuro, Anjola / Moxley, Adam / Mustoe, Sophie / Myers, Sam / Nadeem, Kiran / Nasseri, Reza / Newman, Tom / Nzewi, Richard / Ogborne, Rosalie / Omatseye, Joyce / Paddock, Sophie / Parkin, James / Patel, Mohit / Pawar, Sohini / Pearce, Stuart / Penrice, Samuel / Purdy, Julian / Ramjan, Raisa / Randhawa, Ratan / Rasul, Usman / Raymond-Taggert, Elliot / Razey, Rebecca / Razzaghi, Carmel / Reel, Eimear / Revell, Elliot John / Rigbye, Joanna / Rotimi, Oloruntobi / Said, Abdelrahman / Sanders, Emma / Sangal, Pranoy / Grandal, Nora Sangvik / Shah, Aadam / Shah, Rahul Atul / Shotton, Oliver / Sims, Daniel / Smart, Katie / Smith, Martha Amy / Smith, Nick / Sopian, Aninditya Salma / South, Matthew / Speller, Jessica / Syer, Tom J / Ta, Ngan Hong / Tadross, Daniel / Thompson, Benjamin / Trevett, Jess / Tyler, Matthew / Ullah, Roshan / Utukuri, Mrudula / Vadera, Shree / Van Den Tooren, Harriet / Venturini, Sara / Vijayakumar, Aradhya / Vine, Melanie / Wellbelove, Zoe / Wittner, Liora / Yong, Geoffrey Hong Kiat / Ziyada, Farris / Devine, Oliver Patrick

BMC medicine

2020 Volume 18, Issue 1, Page(s) 136

Abstract: Background: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of ...

Abstract	Background: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. Method: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. Results: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. Conclusions: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.
MeSH term(s)	Female ; Humans ; Male ; Schools, Medical/standards ; Students, Medical/statistics & numerical data ; United Kingdom
Language	English
Publishing date	2020-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-020-01572-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning.

Devine, Oliver Patrick / Harborne, Andrew Christopher / Horsfall, Hugo Layard / Joseph, Tobin / Marshall-Andon, Tess / Samuels, Ryan / Kearsley, Joshua William / Abbas, Nadine / Baig, Hassan / Beecham, Joseph / Benons, Natasha / Caird, Charlie / Clark, Ryan / Cope, Thomas / Coultas, James / Debenham, Luke / Douglas, Sarah / Eldridge, Jack / Hughes-Gooding, Thomas /

Jakubowska, Agnieszka / Jones, Oliver / Lancaster, Eve / MacMillan, Calum / McAllister, Ross / Merzougui, Wassim / Phillips, Ben / Phillips, Simon / Risk, Omar / Sage, Adam / Sooltangos, Aisha / Spencer, Robert / Tajbakhsh, Roxanne / Adesalu, Oluseyi / Aganin, Ivan / Ahmed, Ammar / Aiken, Katherine / Akeredolu, Alimatu-Sadia / Alam, Ibrahim / Ali, Aamna / Anderson, Richard / Ang, Jia Jun / Anis, Fady Sameh / Aojula, Sonam / Arthur, Catherine / Ashby, Alena / Ashraf, Ahmed / Aspinall, Emma / Awad, Mark / Yahaya, Abdul-Muiz Azri / Badhrinarayanan, Shreya / Bandyopadhyay, Soham / Barnes, Sam / Bassey-Duke, Daisy / Boreham, Charlotte / Braine, Rebecca / Brandreth, Joseph / Carrington, Zoe / Cashin, Zoe / Chatterjee, Shaunak / Chawla, Mehar / Chean, Chung Shen / Clements, Chris / Clough, Richard / Coulthurst, Jessica / Curry, Liam / Daniels, Vinnie Christine / Davies, Simon / Davis, Rebecca / De Waal, Hanelie / Desai, Nasreen / Douglas, Hannah / Druce, James / Ejamike, Lady-Namera / Esere, Meron / Eyre, Alex / Fazmin, Ibrahim Talal / Fitzgerald-Smith, Sophia / Ford, Verity / Freeston, Sarah / Garnett, Katherine / General, Whitney / Gilbert, Helen / Gowie, Zein / Grafton-Clarke, Ciaran / Gudka, Keshni / Gumber, Leher / Gupta, Rishi / Harlow, Chris / Harrington, Amy / Heaney, Adele / Ho, Wing Hang Serene / Holloway, Lucy / Hood, Christina / Houghton, Eleanor / Houshangi, Saba / Howard, Emma / Human, Benjamin / Hunter, Harriet / Hussain, Ifrah / Hussain, Sami / Jackson-Taylor, Richard Thomas / Jacob-Ramsdale, Bronwen / Janjuha, Ryan / Jawad, Saleh / Jelani, Muzzamil / Johnston, David / Jones, Mike / Kalidindi, Sadhana / Kalsi, Savraj / Kalyanasundaram, Asanish / Kane, Anna / Kaur, Sahaj / Al-Othman, Othman Khaled / Khan, Qaisar / Khullar, Sajan / Kirkland, Priscilla / Lawrence-Smith, Hannah / Leeson, Charlotte / Lenaerts, Julius Elisabeth Richard / Long, Kerry / Lubbock, Simon / Burrell, Jamie Mac Donald / Maguire, Rachel / Mahendran, Praveen / Majeed, Saad / Malhotra, Prabhjot Singh / Mandagere, Vinay / Mantelakis, Angelos / McGovern, Sophie / Mosuro, Anjola / Moxley, Adam / Mustoe, Sophie / Myers, Sam / Nadeem, Kiran / Nasseri, Reza / Newman, Tom / Nzewi, Richard / Ogborne, Rosalie / Omatseye, Joyce / Paddock, Sophie / Parkin, James / Patel, Mohit / Pawar, Sohini / Pearce, Stuart / Penrice, Samuel / Purdy, Julian / Ramjan, Raisa / Randhawa, Ratan / Rasul, Usman / Raymond-Taggert, Elliot / Razey, Rebecca / Razzaghi, Carmel / Reel, Eimear / Revell, Elliot John / Rigbye, Joanna / Rotimi, Oloruntobi / Said, Abdelrahman / Sanders, Emma / Sangal, Pranoy / Grandal, Nora Sangvik / Shah, Aadam / Shah, Rahul Atul / Shotton, Oliver / Sims, Daniel / Smart, Katie / Smith, Martha Amy / Smith, Nick / Sopian, Aninditya Salma / South, Matthew / Speller, Jessica / Syer, Tom J / Ta, Ngan Hong / Tadross, Daniel / Thompson, Benjamin / Trevett, Jess / Tyler, Matthew / Ullah, Roshan / Utukuri, Mrudula / Vadera, Shree / Van Den Tooren, Harriet / Venturini, Sara / Vijayakumar, Aradhya / Vine, Melanie / Wellbelove, Zoe / Wittner, Liora / Yong, Geoffrey Hong Kiat / Ziyada, Farris / McManus, I C

BMC medicine

2020 Volume 18, Issue 1, Page(s) 126

Abstract: Background: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of ... ...

Abstract	Background: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). Method: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. Results: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. Discussion: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.
MeSH term(s)	Curriculum/standards ; Education, Medical, Undergraduate/organization & administration ; Female ; Humans ; Male ; Surveys and Questionnaires ; United Kingdom
Language	English
Publishing date	2020-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-020-01571-4
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The impact of extracorporeal membrane oxygenation on mortality in patients with cardiogenic shock post-acute myocardial infarction: a systematic review and meta-analysis.

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Article ; Online: Circumferential resection margin positivity due to direct or indirect tumour involvement in rectal cancer - a call for better stratification.

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Article ; Online: Drug coated balloons for coronary artery bifurcation lesions: A systematic review and focused meta-analysis.

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Article ; Online: Effectiveness of Digital Education on Communication Skills Among Medical Students: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.

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Article: Clinical Translation of Three-Dimensional Scar, Diffusion Tensor Imaging, Four-Dimensional Flow, and Quantitative Perfusion in Cardiac MRI: A Comprehensive Review.

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Article ; Online: Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise.

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Article ; Online: The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning.

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