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A&E Consultant leads medical students back from the wilderness

A group of medical students is returning from the wilderness after completing a novel teaching course designed to develop their skills and experience in delivering clinical care to casualties in remote settings.

The six week course 'Wilderness Medicine' is delivered as part of the penultimate year of study for medical students at Newcastle University. It was developed by Dr Richard Hardern, an Emergency Medicine consultant at the University Hospital of North Durham and was the first of its kind to be running in the UK.
Dr Hardern explains: "This is a novel approach to enhancing the students' capability to provide clinical care in a remote or expedition environment, using a structured approach to respond to emergencies. The students also benefit from learning enhanced generic skills and knowledge to increase their ability to respond effectively to clinical and non-clinical situations, whatever the environment. This includes teamwork, leadership, communication, teaching, risk management and time management. They also get used to dealing with stressful and demanding situations.

"The vast majority of the course content is relevant to 'standard' practice. Although students do learn about, for example, snake bites, they spend most of their time learning how to assess and treat an acutely ill or injured patient. This knowledge and the associated skills are directly relevant in any specialty with 'acute' patients.

"We usually only spend about five days of the course in the classroom and the rest is 'scenario-based teaching'. We use this extensively on the course and it is extremely effective for good learning outcomes and maintaining motivation.

"For example, a student might find it is one thing to be able to carry out a primary survey indoors, with good lighting, but it is very different outdoors in the dark, cold and wet. So, as well as helping to maintain motivation, the settings have proved to be a good in terms of focusing students on high-quality physical examinations - there are no monitors, X-rays or blood tests to help them with their diagnosis or monitoring."

The course first ran in 2007 and has since been repeated in 2008, 2010 and this year. It is a "student selected component" which is a part of the undergraduate course for medical students. It is not compulsory but is chosen by the students and it is proving to be so popular that capacity on the course was increased this year to accommodate 12 students rather than eight.

Dr Hardern said: "The students are selected through a formal application process, including a selection centre, as the course is oversubscribed. They are selected on the basis of motivation, experience and personality.  I deliver a lot of teaching personally but we use external instructors too: as well as other clinicians with an interest in the wilderness they include members of Teesdale & Weardale Search & Mountain Rescue Team, the leader of a recent Everest expedition, and ex-military personnel."

Published: 14 April 2011

'Care received was fantastic and I was very well looked after and very impressed.'

Patient, Day Surgery, Darlington Memorial Hospital