How are the principles of integration currently taught to Scottish medical students? Sharing ideas and building connections in undergraduate education

Abstract

An introduction: (comprising background and problem statement) In April 2016, legislation came into force in Scotland implementing Health and Social Care integration. This project looks at teaching and promoting integrated care to medical students who will be involved in its future delivery. Description of policy context and objective: To explore how integration is currently taught to medical students with an aim to highlight and share innovation, and explore relevant incorporation into the undergraduate curriculum. Targeted population: This project looks at the medical undergraduate population in Scotland. Highlights: (innovation, Impact and outcomes) Staff involved in curriculum design from all five Scottish Medical Schools were interviewed, exploring healthcare system structure, health and social care integration, person-centred care and inter-professional teaching. Overall they demonstrated, to differing extents, these principles with specific teaching on professionalism, teamwork, communication, self-reflection etc. One university has introduced managing uncertainty at an early stage, another has introduced a module which focuses on the operation of a ward. Medical students work closely with nurses and allied health professionals (as well as families), giving insight into the healthcare system and holistic care. Some had strong inter-professional teaching with one university using clinical scenario/simulation teaching and group reflection with good feedback. Positive rolemodelling of community facing specialities, joint teaching from doctors and other healthcare professionals, clinical skills taught by nurses etc. is displaying professional behaviour required for working within integrated services. These projects have received positive feedback from students, staff and patients involved. It has also encouraged use of new technology to encourage engagement of students. Comments on transferability: Each university's curriculum is different and changes recommended need to be general to allow appropriate and relevant adaptation. A focus on the themes of integration - including empowering patients, families and communities; social determinants, managing risk, health inequalities, complexity, multimorbidity - rather than detailed teaching on specifics of the Scottish healthcare system will make the teaching more relevant and transferrable to international students, those who move after graduation etc. Conclusions: (comprising key findings, discussion and lessons learned) There is already a lot of teaching on integration principles. There is understandable caution regarding adding material to an already full curriculum but the importance of integration is acknowledged with a willingness to explore this.