CBME Newsletter Issue 12 by Queen Mary University of London

Community-Based Medical Education (CBME) Newsletter for General Practice www.gptutorbartsandthelondon.org

February 2012 â&#x20AC;˘ Issue 12

Welcome to the winter issue of the CBME newsletter and thank you to all of you who have contributed. This issue includes an update on Year 3 case-based discussions and news of the new CBME mentorship scheme. Inside this issue Introducing Dr Siobhan Cooke

Introducing Dr Dev Gadhvi

Quality Assurance - Self-Assessment

Year 4, a year of change

Year 3 Update: Case-based Discussions (CBDs)

Medicine, Death and Me: A study day with Bartâ&#x20AC;&#x2122;s students in Primary Care

Google Groups

Blind Date with a difference!

Mentorship Scheme

Business Meeting 2012

Finally...

Puzzle Corner

www.qmul.ac.uk

February 2012 Issue 12

Introducing Dr Dev Gadhvi I joined the CBME team in November 2011. I am working as Clinical Teaching Fellow covering Sian Stanley’s maternity locum delivering the Year 4 community teaching units alongside Mbang Ana and Siobhan Cooke. I am excited to have been appointed to this post and I am looking forward to working with the rest of the team to deliver high quality education for our medical students and supporting GP tutors in their roles. I am interested in medical education and completed the Introduction to Teaching in Primary Care in September 2011. I have enjoyed teaching Year 4 medical students, being a PBL facilitator and OSCE examiner at Barts and The London and Guy’s and St Thomas’. I have recently completed an Academic GP ST4 post at Barts and The London working on two main research projects. I was the lead for a qualitative project investigating attitudes to vitamin D insufficiency in different ethnic groups. I also worked on the London Low Emission Zone Study which is investigating the link between air pollution and children’s respiratory health. In my role as one of the Year 4 coordinators I will be the unit lead for the Brain & Behaviour unit and am pleased to say that we have had plenty of interest in teaching this exciting unit that was only introduced last year. We are keen to recruit GPs to teach in our Locomotor unit that is a mixture of MSK, Dermatology and Care of the Elderly. This is an exciting chance to teach on a broad range of core primary care topics and will be covered over 3 days in February and March. I am very much looking forward to working with you over the rest of the academic year and would encourage you to contact me if I can be of any assistance. My email address is d.h.gadhvi@qmul.ac.uk Dr Dev Gadhvi, CBME

Introducing Dr Siobhan Cooke I began working with CBME in September 2011 working as a Year 4 Clinical Teaching Fellow for three sessions a week providing maternity cover for Dr Sian Stanley. Prior to starting in CBME I have been a GP tutor at The Blithehale Medical Centre for 15 years and hope to bring this perspective to my work with CBME. Since starting work in CBME I have been taking the lead on the Human Development unit as well as supporting the other Year 4 units, Brain and Behaviour and the new Community Locomotor unit. Teaching dementia with a multidisciplinary team with a physiotherapist from the Falls team, occupational therapist and a social worker has been an exciting and innovative approach to medical student teaching. I have just started studying for a masters degree in Clinical Education and am looking forward to the opportunity to teach and develop specialities in the curriculum and also to develop as a medical educator. I continue to work as a salaried GP at Jubilee Street Practice and so have an understanding of local issues affecting GPs. I have really enjoyed my contact with GP tutors and students. It has been exciting to get the Salaried GP Tutor Scheme up and running following the work done by Dr Bruna Carnevale. Dr Siobhan Cooke, CBME

Quality Assurance Self-Assessment Following on from the development and agreement of the Quality Standards for teaching, I am proposing to send you a self-assessment sheet by email. This is designed to provide information about your perceptions of achievement of the standards to date, areas that need support and any issues that practices or teachers need to consider more fully. We wish to drive up further the quality of the learning and teaching experience for both students and tutors. I then propose to develop a dashboard of all teaching practices and the quality standards to help focus energies in the areas that need it most. I do hope you will be able to respond to the email and complete the electronic form as promptly as possible after receipt. We envisage that this information may also support the implementation of the Mentorship Scheme. Dr Ann O’Brien, CBME

Barts and The London School of Medicine and Dentistry, Academic Unit for Community-Based Medical Education, Garrod Building, Turner Street, Whitechapel , E1 2AD.

www.ihse.qmul.ac.uk/cbme

Year 4, a year of change The 2011-12 academic year has brought with it many changes to Year 4: 1. A new academic team line up. I am joined by Drs Dev Gadhvi and Siobhan Cooke. Dev and Siobhan are both local GPs and will be working as locum part-time clinical teaching fellows in Year 4. They are replacing Drs Sian Stanley and Bruna Carnevale respectively. Dev will be acting Year 4 lead until Sian returns from maternity leave. 2. A new arrival. I am pleased to inform you all that Sian Stanley had a baby girl, Alexandra, in November. Both mother and baby are doing very well. 3. New arrangements for Year 4 Student Selected Components (SSC). Student Selected Components are study units that are aimed to give students the opportunity to either study an area of medicine that is not covered in the core curriculum or to study a core area in greater depth. Students are offered SSCs in all five years of the course. In Year 4 they are expected to produce a 6-8000 word dissertation on a chosen subject. In previous years they were given two block weeks during the fourth year as dedicated SSC time, however this year in order to make room for the new Community Locomotor unit, the block weeks have been distributed as half days throughout the year. This is therefore reflected in the timetabling of our community units as follows (it is compulsory that the students are given this time): Community Teaching Unit

Total Time allocated to SSCs

Brain and Behaviour

4 sessions (2 half days each week)

Human Development

2 sessions (1 half day each week)

Locomotor

6 sessions (3 half days each week, already built into the timetable)

4. A Family Planning Pilot. As part of the Human Development teaching unit, we are piloting a half day placement at a family planning clinic. We are hoping that we can offer 25 students each semester (75 in total) the opportunity to attend family planning clinics run by Tower Hamlets Contraceptive and Sexual Health Service (TH-CASH) and Brook. We think this will help to increase student exposure to contraceptive counselling, examinations and procedures during their community Human Development placements. The plan is to role this out to the whole year in 2012/13 if the pilot is successful. Participating tutors would need to give the student(s) permission to attend the above mentioned clinics for one half day during their Human Development placement. The half day needs to be preagreed with Brook and TH-CASH. If you are interested in assisting CBME with this pilot please contact Barbara Sommers (b.e.sommers@qmul.ac.uk) for further information. 5. A new teaching unit. This is the inaugural academic year for the Community Locomotor teaching unit. This is a two week teaching unit comprising Orthopaedics and Rheumatology, Health Care of

the Elderly and Dermatology. The students are taught centrally at Barts during the first week of the unit and then spend three days in the general practice in the second week. The community days focus on Musculoskeletal Medicine (Monday), Dermatology (Tuesday) and Health Care of the Elderly (Thursday). We would like to thank all the central and community tutors who helped us to successfully implement the first rotation this term. We have a few dates remaining for interested community tutors in February, March and June 2012. We wish to thank all of our Year 4 tutors for your patience, cooperation and flexibility over the past few years. Your hard work and adaptability has made it possible for us to deliver high quality teaching which is greatly appreciated by our students. If you are interested in becoming a Year 4 tutor, please feel free to contact either Dev (d.h.gadhvi@qmul.ac.uk) Siobhan (s.d.cooke@qmul.ac.uk) or myself (m.ana@qmul.ac.uk). Dr Mbang Ana, CBME

Year 3 Update: Case-based Discussions (CBDs) You will have read about the new case-based discussions in our last newsletter. By way of summary these are structured group case discussions which are designed to be relevant to general practice. Students will be assessed on their contribution to group discussions within the final assessment. There will be no written assessment of the CBDs from January 2012. Although over the past (autumn) term we have been delivering CBDs for all three modules, from January 2012, there will be no GP CBDs for Met 3A. As this is a largely surgical module, it was felt more appropriate for the trusts to deliver PBL teaching on more acute surgical cases. You are still very welcome to discuss the cases provided in your support notes but the students will not be marked on these. So far the CBDs have been delivered really well and we are impressed by how quickly and smoothly our tutors have taken these on. We have yet to collate feedback from the students about how this has gone, but thus far there have been very few issues and we will keep you updated of the feedback. Dr Elora Baishnab, CBME

Issue 12, February 2012

February 2012 Issue 12

Medicine, Death and Me: A study day with Bart’s students in Primary Care Richford Gate Medical Practice It started with a collision of teaching commitments: “GI and Cancer” and “Brain and Behaviour” should – and could? - be taught at the same time. Is there also a theme where care of the dying meets mental health? It started with the effect dealing with death has on patients and their families and ended with the difficult conversations healthcare workers face with patients and their relatives. What changes, when a patient is categorised as dying? And what are the characteristics and boundaries of these categories? A visit to a funeral director; a talk by the Richford Gate Practice Manager about commissioning and service coordination for end-oflife care in Primary Care; a presentation on the practical and ethical aspects of delivering this service from a senior GP; and finally a session with a Richford Gate patient who nursed her husband through terminal cancer and, shortly after his death, was diagnosed with advanced cancer herself – this was the programme for the day. The main themes in the initial goal-setting session included difficult conversations around uncertainty about when death is likely to happen. Before that, in the first session Paul Bye, funeral director from Barnes and Sons, gave an overview about what happens to the body of the deceased and all the procedures and regulations that have to be followed. Students learned about time frames for forms to be filled out, about equipment to handle bodies, such as the Washington stretcher, and about the costs of a funeral. What is “bequeathal”, what is a “cremulator”? (Are they heavy metal bands…?) In fact the remaining bones after cremation are ground in a cremulator, while bequeathal is the process by which people donate their remains to science. Apparently it is even more difficult for human remains to be accepted in medical schools than it is for live human beings. Unblemished perfection is the norm. Human touch was mentioned several times and Mr Bye outlined its boundaries of this – a rub on the arm, nothing in the intimate spaces. In the next session, Renos Pittarides, the Richford Gate Practice Manager, felt the impact of the previous one. Students left the funeral parlour with strong emotions. Mr Pittarides happens to be a non-stipendary priest and he explained his experience of journeying with the dying. He also talked about organising care for the dying and their relatives across different organisations like Out-of-Hoursservices, palliative care, district nursing, hospital services and General Practice. The afternoon was dedicated to the doctor-patient relationship. Dr Sarah Jarvis gave the students insights derived from her long experience and pioneering work in the care of the dying. She talked about when to have a conversation with the patient about death, stressing that this would likely not be a one-off event. She positioned it in the ongoing relationship GPs have with their patients and their relatives. Dr Jarvis related her presentation to stories about actual patients. There was the patient with heart failure and renal failure

who was told that her remaining life expectancy was short, probably less than six months. That was three years ago and she is still alive. She mentioned “thingy” – the term a patient used for “the big C” in her body, a name for the unnameable, which still enabled her to talk about the untalkable. Dr Jarvis pointed out how psychological flexibility is a key virtue in dealing with dying people. On a broader level she talked about wills and advanced directives, decisions against, and decisions for, actions to take place when people lose the power over themselves. This tied in seamlessly with the story of Claire Walsh, a patient at the Richford Gate practice. Her partner was diagnosed with incurable cancer and eventually died. She talked about the experience of nursing him in the final part of his life, about the experience of hospital care and community care, about the extraordinary individuals who became Marie Curie nurses and the highly competent and empathetic Macmillan nurses. She spoke particularly about the difficulties some doctors in hospital medicine have in letting patients go home to die, a theme also touched on by Dr Jarvis. Shortly after the death of her partner Mrs Walsh herself was diagnosed with secondary breast cancer. She said she tried to think of herself as having a chronic condition, categorised as “living”, not “dying”. Many questions emerged during these sessions: How can you conduct a conversation with patients about their death when you don’t know when death will occur? How do you interact with a patient who remains to be in denial about their condition? Mrs Walsh was asked about her response to receiving the diagnosis of a incurable illness after her experience of “knowing” the environment of death. She said it was devastating. Students were shocked. They did not expect this answer. The final feedback session with the students revealed the richness of the day. Their statements included the importance of quality of life and most important the diversity of ways people deal with their death and the deaths of others, placing doctors in awkward situations at times. Not knowing what is right and what is wrong, having to have conversations with a lot of uncertainty remained to be an uncomfortable theme. The structure of the day was perceived as helpful towards getting more insight into caring for the dying. It started with a funeral director and ended with the story of an insightful person who experienced the death-behaviour of clinicians. It was a “full-on”-day. By looking at the care for the dying it highlighted the problems in care for the living: applying caution and care in conversations, treating every patient as an individual, allowing different truths for different people. Dr Jens Foell, Richford Gate Practice Acknowledgements to Renos Pittarides, Dr Sarah Jarvis, Paul Bye, Claire Walsh

Barts and The London School of Medicine and Dentistry, Academic Unit for Community-Based Medical Education, Garrod Building, Turner Street, Whitechapel , E1 2AD.

www.ihse.qmul.ac.uk/cbme

Feedback from Tutor Training for Medicine in Society and Extending Patient Contact on 6th October We at CBME organised a tutor training afternoon on 6th October for GP and community tutors teaching Medicine in Society and Extending Patient Contact. The afternoon was well attended and we would like to thank everyone who came for their contributions, which made the afternoon so successful. We started the afternoon with a session on setting ground rules. When meeting a new group of students, it is always worth starting with some negotiation with the students about what they expect from you, and what you expect from them, and thus help manage some of the students’ more unrealistic expectations. Therefore we discussed what had been the common problems tutors had encountered and thought about how to negotiate ground rules to head off any problems that might arise later. This is a précis of our discussion: Problem

Ground rule

Punctuality / absenteeism

Make the students aware they are assessed on attendance and professionalism, which includes punctuality. Discuss what works best for you (students & tutors) in terms of contacting each other if the student is running late or is sick (text, phone, e-mail?)

Poor attitude / Ask them what they think patients might expect from dress / a doctor. hygiene Expectations too high

Say what you will be able to provide in terms of patient examination etc, and what they won’t be able to do because it isn’t available or appropriate at their stage.

to these courses, so take time to go through their guide books and the requirements of the course (e.g. the log book) with them on the first day In the other parallel session for GP tutors, Louise Younie, Clinical Senior Lecturer in CBME, examined how to support and assess the students’ reflective writing and reviewed the student reflective writing assignments in Medsoc 1 and EPC. The aim of this session was to develop confidence in encouraging student reflection, marking student reflection and feeding back on student reflection. The session began by defining reflection and thinking about why we encourage student reflection. The group considered the reflective models in the tutor guide to see if or how they might apply in practice and then attempted to mark examples of student reflections from both courses. One of the challenges raised was the difficulty of applying some of the more complex reflection models in practice (see EPC tutor guide Appendix 9 or MedSoc 1 Appendix 10 ‘Guidance on reflection’). Pee et al’s (2002) model was thought to be more usable in the year 1 and 2 context of short student reflections. Johns (2000) model was noted to offer lots of questions that might help students to write reflectively (although they would need to choose a few pertinent areas to address within their limited word count). Another challenge was differentiating between merit and pass when marking student work. Marked examples as well as more explicit marking criteria were requested (these will be forthcoming as the marking approaches and will be available on the website). In terms of student learning, it was noted that GP feedback comments are far more developmental than any grades given. Finally, we had a plenary session highlighting news from CBME and asking for feedback on ways we can support our tutors. Some of the items discussed were: • The salaried GP tutor scheme(see last newsletter)

Confidentiality Again ask them what they think is acceptable in terms of talking and writing about patients they will see when on placements and work from there.

• The recruitment of new community tutors. We need new community tutors. If anyone is interested or knows anyone who may be interested, again please contact me.

Students not prepared

Ask the students if they want to choose 1 or 2 sessions each and prepare them so that they can lead the seminar that day – this will make it more interesting for them and they will learn more effectively.

• There are new online reading lists, [links available from main CBME website.] Incidentally, please e-mail p.j.washer@qmul.ac.uk any links or articles you have come across which you think might be useful additions to these for inclusion.

Very quiet or Ask the students how they want you to manage the group overconfident in terms of dealing with people who don’t contribute or if students one person is not letting others have a say.

• Due to copyright issues, the tutors do not currently have access to QMUL e-journal papers on the reading lists. If tutors want to be able to access the e-journals themselves, they need to contact IT services directly and ask for a QMUL IT account which will give access to ejournals: Please contact its-helpdesk@qmul.ac.uk. Tutors will need to e-mail them their full name, institute (which is the Institute of Health Sciences Education) and department (which is Community Based Medical Education), the full title of the course (e.g. Medsoc 1 or 2, EPC or GEP) and start and end date for teaching on this course.

We then ran two parallel sessions. The community tutors, shared best practice and their ‘top tips’. These are some of things we discussed: • Get the students out of the surgery and meeting people in their homes and in other situations as soon as possible • Get them to meet a range of people – as many as possible

Dr Peter Washer Lecturer in Medical Education

• Prepare the students beforehand so that they are aware of the information they want to find out, and phrase the actual questions they might ask to garner that information

References: JOHNS, C. 2004. Becoming a Reflective Practitioner, Oxford, Blackwell Publishing.

• There should be a debriefing after visits

PEE, B., WOODMAN, T., FRY, H. & DAVENPORT, E. 2002 Appraising and assessing reflection in studnets’ writing on a structured worksheet. Medical Education, 36 575-585

• Meet the students individually as well as in a group • Remember the students have only had a one hour introductory lecture

Issue 12, February 2012

February 2012 Issue 12

Google Groups

To this end we have started to set up new Google Groups, initially for the Years 1 and 2 (Medicine in Society and Extending Patient Contact) and Year 3 (Integrated Clinical Studies in Primary Care) tutors. To date we have 28 members for Years 1 and 2, 35 members for Year 3 and are still growing. We have been posting updates and news on this every week. We hope that it will grow to be used as a forum for tutors to share ideas and support each other. We sometimes don’t get the opportunity to meet other tutors except at training days and I hope that the Google Group will serve as a community for our tutors and a means to share best practice and to feedback any issues or concerns about teaching.

The nature of our teaching model in CBME is that we rely on GPs and others to teach our students in community and hospital settings ‘remotely’, so to speak. Unlike a team of teachers based in the same location, this model means that we lack opportunities to share best practice, troubleshoot common problems or just generally keep in touch. Thus many of our tutors have been asking for some sort of online forum that could facilitate communication between us in CBME and our teachers.

General Practice Student Selected Components (SSCs) SSCs are a wonderful opportunity for students to gain a deeper understanding of how General Practice works, or to experience an aspect of General Practice that they do not otherwise encounter in their community based placements. They are also a chance for GP Tutors to create your own, bespoke teaching unit, of either 2 weeks for Year 1 and 2, or 4-5 weeks for Year 5. If there is an area of General Practice that you feel is not well covered in the curriculum, or that you have a particular interest in, you can have the freedom to start from scratch and design and deliver your own teaching module. Students have told us that they very much enjoy SSCs that • Allow them to begin to experience working independently: “[The most enjoyable thing was] the... appointments we were able to run (practically) by ourselves”

“[The most enjoyable thing was] running mini consultations seeing patients”

“I was able to run my own consultations with patients”

If you are a tutor on Year 1 and 2 courses, you should have received an email from Peter p.j.washer@qmul.ac.uk or for Year 3 tutors from Elora e.baishnab@qmul.ac.uk inviting you to join the relevant group. Please do get in touch if you haven’t received that email, or if you are having any problems joining. Dr Peter Washer, CBME Dr Elora Baishnab, CBME

• Offer the chance to become more involved in patient care than is sometimes possible in hospital placements: “[The most enjoyable thing was] minor surgery, unlike all my surgery placements to date, I was able to do my first human suture which was amazing”

“[The most enjoyable thing was] having the opportunity to visit different paediatric sites and be enrolled onto study days”

• Offer the opportunity to see a variety of different medical problems, which can help with making future career choices: Some of the existing SSC titles currently on offer to students are: “SSCs are an incredible opportunity to gain insight into the various specialties, as medicine is such a diverse profession. I feel it is very important to familiarise ourselves with the specialties so we can make more informed career choices as it is very daunting to make such a life-changing decision after our foundation jobs. I have always had a keen interest in general practice and this placement has only made me more determined to pursue this as a career in the future!” • Auditing Chronic Disease Management • Paediatric care in the Community • Patient Pathway: Out of Hours

• Make them feel welcome and part of a friendly, hardworking team: “being in a welcoming environment and learning about my favourite subject – General Practice”

“[The most enjoyable thing was] the enthusiasm of the medical staff to teach me”

“the team were very friendly and it was easy to integrate within the practice”

• Cervical cytology and women’s health in the Community • Practising medicine through a different lens If you have an area you are enthusiastic about and enjoy teaching on, and you think it would make a good SSC, or if you would like any advice or further information on SSCs, please contact Dr Emma Ovink at e.ovink@qmul.ac.uk or Ms Barbara Sommers at b.e.sommers@qmul.ac.uk

Barts and The London School of Medicine and Dentistry, Academic Unit for Community-Based Medical Education, Garrod Building, Turner Street, Whitechapel , E1 2AD.

www.ihse.qmul.ac.uk/cbme

Mentorship Scheme As part of tutor training and developing a GP tutor ‘learning and teaching community’ we are setting up a mentorship scheme. This will initially be focussed on pairing up new(ish) GP tutors with those who have more experience, trying to link people who practice in the vicinity of each other. You may like to only have email contact or to occasionally meet up for a coffee and discuss the practicalities of delivering the course you have signed up to teach. Informal conversations and discussions around facilitation of student learning, sharing good ideas and practice should hopefully be of value and benefit to both parties. Mentor-mentee interactions can also be included in your NHS appraisal documentation both with the slant of reflection on, and development of your own educational practice. We would also hope that any key issues or great ideas would be fed back to us centrally to share or discuss with the wider teaching team. There will be opportunities for this at tutor training days*, through emailing myself m.l.a.younie@qmul.ac.uk and possibly through setting up a mentor-mentee google group – depending on enthusiasm and uptake.

When we send out the preference forms for the next academic year we will also be sending a form for tutors to complete if they wish to be part of the mentorship scheme. We will only ask mentors to have one mentee. In the mean time if you are keen to get involved please contact Lynne Magorrian l.c.magorrian@qmul.ac.uk if you are an experienced GP and would be happy to act as mentor, or if you are a new(ish) GP tutor seeking some mentorship. Please specify where your practice is, which unit(s) you are teaching and whether you are a prospective mentor or mentee. Dr Louise Younie, CBME * We will offer a small group session at Tutors Day 2012.

Blind Date with a difference! The Salaried GP Tutor (SGPT) Scheme is up and running! We have recently had a successful match for the scheme with a Salaried GP Tutor and host practice. Dr Jane Edmunds taught for a day on Musculoskeletal Medicine as part of the Community Locomotor unit at Bedford Square Medical Centre in Bloomsbury. They talked to me about their ‘blind date’.

JE: Fine, as long as there is a computer for case history and correspondence etc.

Dr Jane Edmunds, Salaried GP Tutor and Dr Dunia Al-Naemi, Host Practice

Any difficulties you experienced?

Did you get enough information about the scheme and what would be involved before the session? JE : Yes

JE: Obviously it would be easier to teach on your own patients as you know them and they know you, but I think Bedford Square were excellent at arranging everything with Siobhan’s guidance.

DA-N: Yes

DA-N: No. quite happy. Salaried doctor was very good and came in early.

What were you hoping for before the session?

Best thing about the sessions?

JE: To know what the conditions were of the patients and be able to look up their case histories on arrival at the practice before I started.

JE: Everything being organised before you arrive!

DA-N: I was not involved in organising as the salaried GP liased with Sheila (Practice Manager) and the organisation was quite straightforward. We had no problems recruiting patients.

JE: I thought very well. All the patients had interesting conditions and were very obliging. I did a home visit which also worked well and I was able to use public transport. DA-N: The sessions went well. What is it like to teach on patients you have not met before and do not know?

DA-N: Patients are happy to be seen. The patient seen on the home visit felt very well looked after by so many doctors. If you could change one thing what would it be?

First impressions

JE: Case histories before the teaching day to avoid having to turn up early to read up quickly before starting.

JE: It worked well and Sheila (Practice Manager) was very attentive and I arrived early and she set me up on the computer so I could look up all patient details and correspondence etc. I had a room for the day and felt very welcome and was able to ask for advice when I needed it.

JE: Yes, definitely. DA-N: Yes.

DA-N: It worked well. I was teaching medical students on the same day. I was upstairs teaching and the salaried GP was downstairs.

Thank you to Dr Edmunds and the team at Bedford Square for taking part in the scheme and describing such a positive experience.

How did the session go?

Dr Siobhan Cooke, CBME

Would you do it again?

Issue 12, February 2012

February 2012 Issue 12

Finally... the new website is here... Finally, the new website is here, having taken a little longer than expected...it seemed like such a simple task when I took this on, but there have been various unforeseen challenges. The idea for this website was that educational sessions with students might be better supported and developed if all the learning resources were there at a click or two of the mouse such that they might be accessed in those few minutes before the students arrive. I am grateful for all the support and contributions to the website which have come from across CBME (Community Based Medical Education) and beyond with the year leads contributing their tutor guides, assessment forms and learning resources (see under each year tab). Dr Simon Brownleader has contributed the substance of his ‘digital literacy’ workshop from the summer education day http://www.delicious.com/Londonmedical (under useful links). Also a number of short articles have been written in response to key areas of GP tutor development e.g. student-centred learning or managing small group teaching (look under the ‘GP tutor development tab’).

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Puzzle Corner Here’s something to keep those little grey cells active - enjoy!

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Contact the Editorial Team This is your newsletter. If you have any suggestions for future content, useful teaching tips, teaching resources or experiences you would like to share please send us your contribution. Lynne Magorrian l.c.magorrian@qmul.ac.uk

Dr Louise Younie, CBME

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The website is a work in progress and I am keen to see continued development of this electronic interface with you so if you have any thoughts or feedback, please email m.l.a.younie@qmul.ac.uk

I would like to thank Gary Schwartz in particular for all his hard work and employment of his technical and creative skills in designing and constructing this website. The baton is now being passed into the capable hands of Lynne Magorrian and Janet Johnstone to maintain and update the website.

Janet Johnstone j.r.johnstone@qmul.ac.uk

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Barts and The London School of Medicine and Dentistry, Academic Unit for Community-Based Medical Education, Garrod Building, Turner Street, Whitechapel , E1 2AD.

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