Clinical Skills and T–DOCS

As medical students, we obviously spend a great deal of time learning how to be competent and effective clinicians. A lot of this involves learning about the human body, what can go wrong with it and how to treat that. We learn this, initially, through lectures and case-based learning, and then later during placements on the wards. But the development of another essential skillset, the hands-on, practical techniques that we actually use with patients – comes from more tactile and interactive forms of instruction.

In the first year, we were drilled on our “clinical skills”; this is the battery of basic examinations that every doctor knows by heart. They could be major-system based (abdominal, cardiac, respiratory), neurological or musculoskeletal – we had to know them all, and testing us on them formed a major part of our end-of-year-one summative OSCE exams. And a large part of our clinical days in the first year (and beyond) involved practicing our exams on very patient and willing patients, most of whom were resident on wards and had provided consent to letting us try our skills on them. These people, the uncountable thousands across the country, are absolutely invaluable resources to the NHS.

In the second year, our clinical skills (now renamed TDOCs) have taken on a very focused, very clinical approach. We have focused much more on basic tasks that doctors, especially junior doctors, are expected to carry out on a daily basis. We learn in great detail procedures such as cannulation, venepuncture (drawing blood from veins for laboratory tests, etc.), drawing arterial blood, inserting nasogastric tubes and so on. The list is long, and the instruction is very complete – we don’t just learn the basics of how to insert needles into veins, for instance. We also learn about the indications, contraindications, complications and risks of each of these procedures – all of these are extremely important, and I’m glad that the medical school goes to great lengths to ensure patient safety. For instance, I wouldn’t want someone to poke my arm or a relative's arm with a needle unless they’ve had this training, and I’m glad that we go through this process.

Once we have been assessed as competent by our clinical-skills instructor, then we are given permission to put our skills to use on our assigned wards – under supervision by qualified doctors, of course. And it is with practice that our competence and confidence grows. Not every encounter is perfect of course, because human bodies are complex, but this is the reality of medicine. Gaining experience is the best part of our education. By the time we qualify, we will have had a great deal of practice with all of our TDOC skills, and hopefully, at least in this aspect, transitioning to being junior doctors should not be so challenging. I’m sure it will be challenging in many other ways, though!

John

Catrin Davies : 02 Jun 2016 09:27 |  Tags: John Mbchb Patients Skills Student Warwick Wms |  Comments (0) |  Report a problem