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Sreedhar's design narrative: Teaching medical students how to take blood

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Sreedhar Krishna
21 March 2013

Title

Teaching medical students how to take blood.

Narrator

I oversaw the session and provided technical assistance as necessary. 

Situation

During my last post in rheumatology, I was assigned a group of four medical students to teach on Friday afternoons. Students have previously intimated that much of the teaching they receive is not perceived as clinically-relevant. Therefore, after consulting with the students, I decided to teach basic clinical skills which they will need to master prior to qualification.

Thus, I invited a group of students to meet on the rheumatology ward since I needed to be in relative proximity to the patients in case of deterioration. The ward was somewhat cramped which meant that we needed to be mindful of the space we were taking up (e.g. patients and nurses need to be able to pass by unhindered).

Students have completed two years of pre-medical science and therefore have a basic understanding of anatomy and physiology. There is a general lack of confidence in clinical skills owing to the fact that they simply have not practiced the task sufficiently, and there is the fear of having to take theory-to-practice on a real patient. Students who attend the session may be different in terms of prior experience with taking blood, which can make the less experienced members reticent to participate for fear of being ‘exposed’.

Students recognise the importance of mastering blood taking in their future clinical practice and are therefore keen to learn/attend the session.

Task

The aim was to produce medical students who can take blood from patients using a Vacutainer blood collection system. Students who could successfully take blood from a patient without causing undue distress would be deemed to have passed the session.

 Actions

  1. Students were contacted in advance and advised to consult clinical skills textbooks (and YouTube) to learn how this task is performed.
  2. I demonstrated taking blood from a banana. Students found this highly entertaining, especially when I carefully took consent for blood taking from the banana.
  3. Students were advised that by the end of the session, they would be offered the opportunity to practice on a real patient. Students were not coerced to take blood if they did not feel confident, but the offer of a remedial session was made. This helped reduce panic amongst those students who may feel out of their depth.
  4. Students took turns taking blood from the banana with feedback provided by their clinical partner (and myself).
  5. Students took blood from one another (and myself if any participant is reluctant to participate). I made it clear to the students that there is no pressure to allow another student to take blood from them.
  6. Students were offered the chance to take blood from an inpatient on the ward. They were supervised solely by myself in order to reduce the panic associated with having three more students watching.

Results

All four students were able to take blood from patients. Patients appreciated the opportunity to participate in the training of medical students. Students felt more comfortable with patient-interactions as evidenced by their greater willingness to participate in all aspects of patient care. For example, one student who was almost silent on the ward soon became very genial as she felt that was ‘able to do some good’ rather than passively observe activities on the ward.

Reflections

I learned that it is key to make students feel relaxed during the session. For the majority, this is the first time that they have taken blood and they may feel unprepared. It is also important to find patients who are happy to have blood taken by students in advance, to avoid any uncomfortable refusals which may affect the student’s confidence.

Extra content

Embedded Content

YouTube - How to take blood

YouTube - How to take blood

added by Sreedhar Krishna

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