Response to ‘Does tandem clerking improve training?’ David Ahearn, Department of the Elderly, Wythenshawe Hospital, Manchester, UK Paul Baker, Foundation School, North Western Deanery, Manchester, UK Salil Singh, Department of Medicine and Gastroenterology, Royal Bolton Hospital, Bolton, UK
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any thanks for the opportunity to respond to the comments by Arshad and Steshenko.1 We perceive ‘tandem clerking’ as an educational tool (with additional service and patient quality benefits) that can be used in a clinical environment, without the need for lengthy training or financial investment. We note the comment that assessment should occur both before and after the clerking. Although we have no objection to this concept, in practice it is not possible to subject most educational interventions to such scrutiny, and we believe our approach to be valid but pragmatic. Professional guidance is now clear that acute admissions should be reviewed by a
consultant within 14 hours or less,2 and as such we feel confident that a combined review by a junior and senior trainee is unlikely to have a detrimental effect on patient care. Indeed, ensuring earlier access to a more senior trainee, in addition, is likely to be considerably safer. As discussed, colleagues have a variety of learning styles and this approach may not appeal to all. Even in those who find this a useful learning tool it will not be the only educational method used during acute care sessions, and thus should be considered ‘complementary’ to other approaches, such as the debriefing session recommended by Arshad and Steshenko.1 We acknowledge the concern raised about higher specialty
trainees still being in training themselves; however, all postgraduate curricula in the UK require such trainees to be actively involved in medical education. Tandem clerking acts as a conduit for this, as well as providing a dedicated opportunity for seniors directly observing junior trainees for workplacebased assessments. REFERENCES 1.
Arshad I, Steshenko A. Does tandem clerking improve training? Clin Teach 2014;11:237.
2.
Royal College of Physicians. Acute care toolkit 4: Delivering a 12-hour, 7-day consultant presence on the acute medical unit. London: Royal College of Physicians; 2011. Available at http://www.rcplondon. ac.uk/resources/acute-care-toolkit4-delivering-12-hour-7-day-consultant-presence-acute-medical-unit. Accessed on 18 February 2014.
Corresponding author’s contact details: Dr David Ahearn, Elderly Medicine, Wythenshawe Hospital, Manchester, UK. E-mail: davidjahearn@ gmail.com doi: 10.1111/tct.12230
238 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 237–239
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M
any thanks for the opportunity to respond to the comments by Arshad and Steshenko.1 We perceive ‘tandem clerking’ as an educational tool (with additional service and patient quality benefits) that can be used in a clinical environment, without the need for lengthy training or financial investment. We note the comment that assessment should occur both before and after the clerking. Although we have no objection to this concept, in practice it is not possible to subject most educational interventions to such scrutiny, and we believe our approach to be valid but pragmatic. Professional guidance is now clear that acute admissions should be reviewed by a
consultant within 14 hours or less,2 and as such we feel confident that a combined review by a junior and senior trainee is unlikely to have a detrimental effect on patient care. Indeed, ensuring earlier access to a more senior trainee, in addition, is likely to be considerably safer. As discussed, colleagues have a variety of learning styles and this approach may not appeal to all. Even in those who find this a useful learning tool it will not be the only educational method used during acute care sessions, and thus should be considered ‘complementary’ to other approaches, such as the debriefing session recommended by Arshad and Steshenko.1 We acknowledge the concern raised about higher specialty
trainees still being in training themselves; however, all postgraduate curricula in the UK require such trainees to be actively involved in medical education. Tandem clerking acts as a conduit for this, as well as providing a dedicated opportunity for seniors directly observing junior trainees for workplacebased assessments. REFERENCES 1.
Arshad I, Steshenko A. Does tandem clerking improve training? Clin Teach 2014;11:237.
2.
Royal College of Physicians. Acute care toolkit 4: Delivering a 12-hour, 7-day consultant presence on the acute medical unit. London: Royal College of Physicians; 2011. Available at http://www.rcplondon. ac.uk/resources/acute-care-toolkit4-delivering-12-hour-7-day-consultant-presence-acute-medical-unit. Accessed on 18 February 2014.
Corresponding author’s contact details: Dr David Ahearn, Elderly Medicine, Wythenshawe Hospital, Manchester, UK. E-mail: davidjahearn@ gmail.com doi: 10.1111/tct.12230
238 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 237–239
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4/29/2014 7:44:56 AM
