Daniele Carrieri

Background and Objectives Hospitals streamline treatment pathways to reduce the length of time older adults admitted for planned procedures spend in hospital. However patient perspectives have been poorly evaluated. This systematic review aimed to understand the experiences of older patients, carers, families and staff of multi‐component interventions intended to improve recovery following elective treatment. Research Design and Methods Bibliographic databases searched in June 2021 included MEDLINE ALL, HMIC, CENTRAL, CINAHL, AMED and ProQuest Dissertations and Theses. We conducted citation searching and examined reference lists of reviews. Two reviewers independently undertook screening and data extraction, resolving disagreements through discussion. We used an adapted Wallace checklist for quality appraisal and meta‐ethnography to synthesise data. Clinician, carer and patient views were incorporated throughout the review. Results Thirty‐five papers were included in the synthesis. Thirteen studies were conducted in the UK, with patient views the most frequently represented. We identified six overarching constructs: ‘Home as preferred environment for recovery’, ‘Feeling safe’, ‘Individualisation of structured programme’, ‘Taking responsibility’, ‘Essential care at home’ and ‘Outcomes’. Discussion and Implications Findings explore the support patients, families and carers need throughout hospital admission, and may inform commissioning of services to ensure patients and carers receive appropriate follow‐up support after hospital discharge. The findings may help hospital and community‐based health and social care staff provide person‐centred care based upon assessments of emotional and physical wellbeing of patients and family/carers. Research is needed to establish a core‐set of patient‐reported outcome measures which capture aspects of recovery which are meaningful to patients.

Background Social connections between medical students provide a key basis for learning and support. These connections, and associated social identity, may be patterned by ethnicity, and students often perform similarly academically to those they connect with. The mechanisms that underpin the formation of these connections and the role that they play are not fully understood. This study explored how medical students connect with each other, and the potential impact of this on their academic attainment and well‐being, with a focus on students with minoritised ethnic identities. Methods A mixed methods study combining (1) a survey to establish the number and strength of connections formed by Years 1 and 2 medical students with both minoritised and non‐minoritised ethnicities and (2) semi‐structured interviews to understand how connections were formed, whether this was shaped by ethnicity and the role of connections in supporting students with their learning and well‐being. Results One hundred fifty‐one students (15.5% response rate) completed the survey. Students connected regularly with three to four peers with the goal of supporting learning and 71.9% of students reported a sense of social identification with this group. There was no statistical difference between ethnically minoritised and White students on either of these measures ( t = 0.1, p = 0.92, χ 2 = 2.9, p = 0.56). Interviews with 19 students found that social connections were shaped by perceptions of their self‐identity and the need to find ‘equilibrium’ by forming relationships with compatible others. The education environment, including its ethnic diversity, impacted on the opportunities to make connections. Students who were ethnically minoritised reported encountering challenges, especially in the clinical environment, and described the burden of these for them. Discussion Curriculum designers should consider the time and space that is afforded to student interaction during course development, as finding compatible others with whom students can socially connect is important to balancing well‐being with academic performance.