Starting university is exciting but it can also be nerve-wracking. There are so many new experiences to navigate and new things to learn – and while some things are new for everyone, each new student will have their own questions and concerns. Making sure all students feel welcome, and helping them find the answers to their questions, is vital to their smooth transition to university life and study. We caught up with Dr Nandini Hayes, Reader in Medical Education from IHSE, to learn about Stepping Stones, a four-week summer programme designed to help all students successfully transition to medical and dental school.
Nandini launched Stepping Stones with some colleagues, including Dr Jen Randall from the Wolfson Institute of Population Health in 2021. Their aim was to ease students’ transition to university – and specifically to medicine and dentistry – and reduce students’ anxiety, by helping them connect with each other, develop the skills and obtain the initial information they would need to thrive. “If your parents are clinicians, you will know what an OSCE is”, said Nandini – and for about 40 percent of our students, that is the case. But for the others, “if your parents are not clinicians you won’t know that it’s a clinical examination. I think having that sort of knowledge before you start, gives people confidence.”
The increase in online learning during lockdowns, and the recognition that some learning at least could happen online, provided the opportunity to launch Stepping Stones. “Prior to the pandemic, it possibly wouldn’t have worked because people would not have seen it as being normal to access a course online”, Nandini reflected. She created a QMPlus site with some asynchronous learning materials, Jen set up a book club and they collaborated with colleagues in the Library to offer study skills sessions. “We chose a book – the Immortal Life of Henrietta Lacks – that brings up a lot of the issues that we think would be quite helpful for these students going into dentistry and medicine, to think about racism and to think about access to healthcare and confidentiality and patient consent.
Stepping Stones runs for four weeks before the academic year begins. All students commencing Medicine or Dentistry – in London and in Malta - are invited to take part – Nandini emphasised the importance of including all students in Stepping Stones, pointing out that just because students might not seem to sit within the Widening Participation grouping, “it doesn’t mean you’re not feeling vulnerable, that you’re not feeling insecure, that you don’t feel anxious about starting.” Around 150 students engage with the synchronous activities and over 200 students access the online content each year, with about 20 students taking part in recently-introduced in-person sessions focused on mindfulness, wellbeing and flourishing activities.
Nandini emphasises that the programme is not an ‘academic adjunct’, the focus is on supporting students’ transition. Sample lectures on medical topics ‘help people switch their academic brains on again – it is a long time between the end of A-levels and when you start in September’ and allow students to practice their note-taking skills. Students who may not have studied A-level Biology or who don’t feel confident with their maths and calculation skills can brush up, thanks to interactive courses designed by Keely Kulesza-Smith, Graham Weston and Ronan McDonald. Nandini shared that she had been very surprised that some students had not studied A-level Biology, highlighting the importance of “going back to basics and not making assumptions that people know things that we feel that they ought to know”.
The programme runs during the summer break so it can be difficult to involve more senior students. Nandini has addressed this by creating videos of students showing off different parts of campus – “where you eat, where things happen, the Perrin and that sort of thing”. These insights into student life, and the opportunity to hear from students, are really popular so Nandini and her colleague Alasdair Robertson are looking for ways to involve more senior students.
Nandini emphasised throughout our conversation the importance of not making assumptions about what students know based on their background. However she believes that for Widening Participation students, the two most important things are to help them build their confidence and to feel that they have a voice. This will be particularly beneficial in helping students get the most out of their PBL and TBL sessions. With this in mind, she is considering introducing debates to next year’s Stepping Stones programme, as a forum for people to discuss and form arguments about some of the complex and less tangible aspects of medicine, including ethics.
Asked how we might better support students’ transition to university, Nandini highlighted that transition is about more than just induction week: “I think transition to university can take at least a year”. She recommended incorporating more opportunities for students to connect and talk to each other, form a community, develop their academic skills and engage in flourishing activities at an early stage, with these activities embedded within the curriculum. She also pointed out that the transition between years, particularly between MBBS Years 2 and 3 when students start their hospital placements, can be challenging, and that we need to help prepare students with the skills and confidence they need to thrive in these new environments.
To close, Nandini emphasised the importance of listening to our students, but also of demonstrating that we have listened: “We can learn a lot from our students, as much as they learn from us, and we need to listen to them because they’re often quite perceptive. They often know what they need. [We need to create] an environment in which they feel that they can actually tell us what they need. I think on the whole we’re pretty good at the Medical School at listening to our students but I think what we’re not necessarily good at is telling them that we’ve listened to the feedback and that we’ve made the change.”
Dr Nandini Hayes,Reader in Medical Education