Support and guidance for students by teachers

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The term 'support' is often used in relation to the wider aspects of learner support, which may include study skills, IT skills and library services, but here we are focusing on the provision of academic or personal support given to individual students, trainees or groups by clinical teachers. Support and guidance often involves giving advice, offering supervision, acting as an advocate or mentor and employing counseling skills, but we are not looking here at professional counseling services. The provision of effective support systems for learners at all stages is necessary, not just to create a good environment for learning but because the provision of effective and timely guidance and support can help in the retention of students, junior doctors and other health professionals. Many of the reasons that people leave university and the health professions are not simply academic, they feel unsupported, isolated and under stress. This is particularly important at times of transition: such as the first year at medical school, starting the PRHO year, the first year after graduating in the health professions, when changing jobs or having been promoted

GMC recommendations on undergraduate student support, guidance and feedback (Tomorrow's Doctors, GMC, 2002)

• Students must have appropriate support for their academic and general welfare needs at all stages. Medical schools must produce clear information about the support networks available, including named contacts for students with problems. Students taking special study courses that are taught in other departments or by other medical schools, and those on clinical attachments at sites that are not close to the medical school, must have access to adequate support.

• Medical schools must stress to students the importance of looking after their own health, and encourage them to register with a GP. They must tell students about the occupational health services, including counseling, that are available to them.

• Medicals schools must give guidance about the core curriculum, SSCs and how their performance will be assessed. This should include information about practical arrangements for assessments and the medical school's policy on students who cheat in examinations. Students must be able to get academic advice and guidance from identified members of staff if they need it in a particular subject.

• Students must receive regular and consistent information about their development and progress. Clinical logbooks and personal portfolios, which allow students to identify strengths and weaknesses and to focus their learning appropriately, can provide such information. Using these will emphasise the importance of maintaining a portfolio of evidence and achievement which will be necessary once they have become doctors and their licence to practise is regularly revalidated. Feedback about performance in assessments helps to identify strengths and weaknesses, both in students and in the curriculum, that allow changes to be mad

In all aspects of medical education, the provision of guidance and support by teachers helps students and trainees to take control of their lives and gives them the skills to:

- reflect on their own objectives

- set goals

- adopt appropriate learning strategies

- cope with crises

- review and manage their personal and professional development.

But if learners are to do this it means that teachers themselves have to have the skills and knowledge required to provide effective support

1. Think about the support systems for students, trainees and staff in your place of work.

2. What written materials are available, eg staff handbook?

3. What types of support systems are available and do you know how to access them?

4. Do students/trainees know how to access them?

5. Do you think the support systems are understood by all concerned?

6. Do you think that the support system works effectively?

7. Does the support system match needs?

8. How is careers advice dealt with?

9. How do you ensure that your students/trainees are aware of the support systems in plac

Apart from your face-to-face teaching activities, can you list the other roles you play or have played when interacting with students or trainees?

Personal tutors or academic supervisors may have a variety of roles. They may be purely for academic support, to guide the student through a course or curriculum. This may entail acting as a guide, as an advisor or as a supervisor. Most have an administrative or resource-provision role; guiding students to information and resources they may need, again partly advisory. Teachers may also have a professional or career guidance role advising on professional behaviours and attitudes, job opportunities or career pathways. Here we might have to act as a critical friend, or as an advocate or mentor to help the leaner identify strengths, weaknesses and self-assessment skills. Whether they are supposed to or not, most will also develop a personal support role. This can be comfortable and beneficial to the student but sometimes puts a tutor in a difficult position. Some basic counselling skills might be needed. Serious personal or professional issues will probably need to be referred onto other support services.

Typical problems or issues students might want to discuss which are not associated directly with the course may be concerned with:

• Finance

• Accommodation

• Health

• Personal relationships

• Career advice

• Harassment or bullying

• Illness or death of a family member

• Worries about other learners

• Drug taking, alcohol abuse

• Complaints about other doctors •

'Fitting in' and cultural issues

F

or each of these:

• how might you be able to help the learner yourself?

Who supports the teacher? Seeking help and when to refer

In many instances, the clinical teacher is able to deal with supporting and advising students and trainees through a combination of common sense, local knowledge and experience. Sometimes though, in cases where the teacher does not have the specific skills or knowledge or where he or she thinks that the student or trainee needs specific help, referral to other sources of help may be appropriate. Referral should always be with the agreement of the student or trainees unless the learner is at risk to him/herself or to others or where there has been serious professional misconduct.

Supporting medical students

For clinical teachers who are involved in teaching and supporting medical students, the medical school should be your main source of help and advice. All Universities have central services for students which typically include:

• Occupational health

• Counseling

• Psychotherapists

• Study skills support (including helping with examination issues)

• Senior personal tutors

• Student Union advisors and Nightline listening and practical information services (the SU usually has an officer who deals specifically with welfare issues)

• Chaplains (for all religious groups)

• Disabilities officers

• Equal opportunities officers

• Hall/residence wardens • International/overseas stud

ents' officer • Registry who can advise on financial aspect

s, legal issues, accommodation and information on charities that help students Central policies and procedures (usually av

• ailable on the University website) which should include a policy on harassment, an equal opportunities statement, complaintsand grievance procedures, etc.

M

of students to a named personal tutor, these personal tutors are overseen by a senior tutor or other senior member of the medical school staff. For example the personal tutor system at St George's Hospital Medical School

"a

ims to provide students with a reliable point of contact with the School and a source of pastoral and academic support and guidance. Students can use it:

• To seek advice concerning academic matters

• To obtain references for jobs, other courses or

charitable foundations) To raise issues relating to academic or other matters that the

known to the School (in addition to other channels of communication set up fothis purpose)

Who supports the teacher? Seeking help and when to refer

Supporting medical students

For clinical teachers who are involved in teaching and supporting medical students, the medical school should be your main source of help and advice. All Universities have central services for students which typically include:

• Occupational health

• Counseling

• Psychotherapists

• Study skills support (including helping with examination issues)

• Senior personal tutors

• Student Union advisors and Nightline listening and practical information services (the SU usually has an officer who deals specifically with welfare issues)

• Chaplains (for all religious groups)

• Disabilities officers

• Equal opportunities officers

• Hall/residence wardens • International/overseas stud

ents' officer • Registry who can advise on financial aspect

s, legal issues, accommodation and information on charities that help students Central policies and procedures (usually av

• ailable on the University website) which should include a policy on harassment, an equal opportunities statement, complaintsand grievance procedures, etc.

M

of students to a named personal tutor, these personal tutors are overseen by a senior tutor or other senior member of the medical school staff. For example the personal tutor system at St George's Hospital Medical School