Ever feel like a spare part on placement?

Why do some medical students find it difficult to feel integrated as part of the clinical team? In busy hospital environments, students sometimes report feeling like a spare part which can reduce morale. At the same time, hospital staff work incredibly hard, but sometimes it can be difficult to stay positive. Even before the COVID-19 pandemic, NHS Staff Survey results suggest the workforce as a whole is experiencing low morale, in the face of challenging conditions.

There are lots of factors which affect the wellbeing of staff in the NHS. I strongly believe positivity breeds positivity. In my role as an education fellow at the Royal Free Hospital, I have been working to support the morale of medical students. I did this alongside the multi-disciplinary team (MDT) they are placed with through an initiative called Project Positivity. This project is focused on two critical issues – improving medical student integration in the clinical team, while also increasing the focus on positivity within the workplace for all members of the MDT. Ensuring medical students feel well integrated in the clinical team has the potential to shape their thinking as tomorrow’s doctors.

Creating positive sharing spaces

To kick off, I created a lunchtime event called Positivity in Paediatrics at the Royal Free Hospital in London, and encouraged all members of the wider MDT to attend, including medical students, trainees, administration staff and managers. This was a new event for the team and was designed to create an encouraging environment for discussion, sharing ideas and initiatives that could be implemented across the department collaboratively. The session enabled all staff and medical students to come together as a group, fuelled by a hearty team lunch and lots of baked goods! It really helped set the tone of a positive environment for our initiatives.

Our main aim was to find opportunities to integrate medical students within the MDT. Medical students had told us they sometimes felt like a “spare part” on placement and not part of the team. Although the MDT recognised the importance of integrating medical students, it was often challenging due to the busy nature of the job and stretched resources.

Uniting all members of staff at this event helped students understand the challenge and consider solutions to build more coalition. It also gave members of the MDT the chance to interact with students, understand their perspective and get behind the suggested initiatives. By involving both groups - medical students and the MDT - the initiative was set-up for success from the start with a shared purpose and ambition from the participants.

The session was extremely well received, with excellent and positive feedback from across the MDT. The feedback from the medical students was particularly glowing, with many students asking “Why is this session not used in more departments in the hospital or on more occasions throughout medical school?” Additional comments from the MDT included: “Such a fantastic example of how a department should be and the kind of positive environment every department should strive for”. 

Introducing InteGreat

As a result, we focused on medical student integration through the initiative – InteGreat! This is an acronym which encourages students to introduce themselves to the team, ask questions and take part in teamwork with the MDT.

InteGreat also highlighted ways the team could involve students, and emphasised the importance of this. The pointers are easy-to-do, but could be forgotten in busy and stressful environments. We created small laminated prompt cards for both medical students and MDT members (see above). The cards were distributed at medical student induction and in clinical teaching sessions.

Paving the way with positivity

We repeated two further similar sessions within the paediatric department, and then adapted a similar session in the haematology department. Feedback from one of the sessions showed 72% of people ‘strongly agreed’ the session was useful and 100% of participants ‘strongly agreed’ the session was enjoyable. There is current ongoing discussion about expanding into other clinical departments and even the medical school curriculum. 

Ultimately we believe this is an initiative everyone can benefit from. Positivity is like a boomerang – the more we put it out there, the more it comes back to us. We look forward to expanding the project further.

If you are a medical student, I hope the InteGreat tips will help you to become more integrated in the teams where you are currently working. InteGreat is a fantastic tool which can spark discussions about teamwork and contribute to a more positive and productive working environment, for both staff and patients!