Medical Students in QI – an untapped resource

Megan Godfrey-Harris is a fourth-year medical student at Brighton and Sussex Medical School. She has recently undertaken a QI project in frailty on a general surgical ward. She also has an interest in neurodiversity in medical education.

When I started my quality improvement (QI) project over the summer, I had no idea about the steep learning curve I was about to climb. I had an aim to improve recognition of frailty on the general surgical ward in order to increase appropriate referrals to the Frailty Liaison Team. Approaching a QI project as a medical student was daunting, as I didn’t really understand QI or how to get stuff done!

I had lots of support from those around me with a wealth of QI knowledge, but for many medical students this can be inaccessible. I have reflected on what help was most useful, and what else may have been beneficial as a newbie to the QI world.

1: Having a key sponsor

The most helpful person would be someone that truly believes in the aims of the project, and ideally is based within the area in which the project is happening – such as the hospital ward. This is useful as it means they will be familiar with the people and systems which may be involved in the project. The sponsor should ensure they have enough time to commit to supporting the medical student. Lining up a medical student schedule with a consultant or registrar schedule can be complex!

2: Choosing a project that matters

The project must be important to the student. Time spent delivering a project could be allocated to other tasks including undertaking paid work, or studying. Although it may be an investment towards future CV points, this might not be enough in itself and should be something that the student values enough to spend the time on. On the other hand, if the project doesn’t matter to the organisation, or is unrealistic, then producing a sustainable positive change might be tricky. The reasons for a project being important to the student and organisation may be different, but they should be congruent. Project outcomes and goals don’t have to be mutually exclusive. For example, reducing polypharmacy in a general practice (GP) might mean that patients can take less tablets and experience fewer side effects. This might be viewed positively by many patients, and looking at satisfaction could be the main focus of interest for a medical student interested in holistic care – but this initiative could also reduce costs for the GP surgery, which is also of benefit as resources could then be reallocated.

3: Signposting to resources and QI tools

When you have no idea where to begin, or which direction to go in, a resource that has it all in front of you is invaluable. I used https://learn.nes.nhs.scot/1262/quality-improvement-zone/qi-tools

This website has the tools listed in order of when they are useful and explains the key terms. Approaching the QI methodology and tools felt like learning a new language. I found myself googling terms after talking to people and would ask that people don’t assume that medical students or other colleagues understand new and unfamiliar terms! It can also be helpful when starting any project to ascertain what experience different team members have already undertaken – sometimes junior colleagues can have unexpected skill sets that can be easy to overlook, including in QI.

4: Help integrate us into the team

When trying to make a positive and lasting change, you need involvement of many different people. As a medical student, we rarely know who these people are or how to contact them simply because we rotate so frequently between different teams. It is not uncommon that even on longer placements, no one has learned the names of the medical students and this can be difficult to navigate. Being introduced to the doctors, nurses, clerical staff, occupational therapists and discharge coordinators (or anyone else who might be useful) can make a huge difference not only with project work but also experiences on placement overall.

5: Check in with the medical student

As we frequently rotate around specialties and even hospitals, it can be difficult to stay in touch. This can make it difficult to keep the momentum going. We appreciate that consultants and registrars are often juggling multiple different tasks and have working pattern pressures at play, but really appreciate it when people check in and keep us on track. Reassurance can go a long way.  

Finally

If you have an idea for a project that would benefit from an enthusiastic medical student, and would like to get us involved – please reach out. This could be via individual department contacts, or via wider medical school channel. Keeping students who express interest in your specialty aware of opportunities is always so appreciated. There can be additional benefits to be gained as experience of supervision is also helpful for many trainees, as an additional bonus.