Findings from a public engagement programme for school children aged 13–15 years about endocrinology

Introduction

There are established differences in the number and severity of obstacles faced by students from areas of lower socioeconomic status (SES) in comparison to more affluent students when applying to medical school (1). A study by Gore et al. identified early secondary school years, high cultural capital, non-English language backgrounds, female gender, and self-perceived academic superiority as predictors of students expressing interest in the medical profession (2). While SES initially correlated with medical interest, it lost significance in the comprehensive regression model. The study underscores the nuanced interplay of SES with other factors in shaping occupational aspirations. It advocates for medical schools to adopt recruitment strategies that acknowledge the interplay between excellence and social accountability, emphasising early and sustained outreach initiatives to reshape perceptions of prospective medical students.

It has been argued that factors contributing to these disadvantages exist as early as preschool. Therefore, early interventions are essential to increase diversity among medical school applicants and provide equal opportunities. This is especially important as attempts made in recent years to increase applicant diversity by universities have made only minimal improvements (3). One way to close this gap is by increasing public engagement with medicine among secondary school-age students. Therefore, we designed our school outreach programme for students aged 13–18 studying science, benefitting from direct interactions with medical and science professionals that would facilitate learning about the medical sciences and expose them to various relevant careers, including healthcare workers, researchers, and current medical students from diverse backgrounds. While delivering this educational intervention, we aimed to:

1. Measure the change in students’ attitudes towards science-related careers following a medicine-centred enrichment activity.

2. Measure the change in students’ knowledge regarding diabetes mellitus, polycystic ovary syndrome (PCOS), health technology, and obesity following our intervention.

Methods

Our outreach sessions were conducted between February and July 2022. In February 2022, secondary schools in Birmingham with high indices of deprivation (4) were contacted by email regarding their interest in participating in our engagement activity. Two schools expressed interest in participating: King Edward Handsworth Wood Girls Academy (KEGWHA) and Perryfields Academy (PA). At KEGWHA, a cohort of 92 year nine girls (aged 13–14) took part in the event, while at PA, 51 year ten students (aged 14–15) from a mixed-gender cohort participated. Both events took place in June 2022 during the school day. Professionals invited to aid with the delivery of the sessions included senior lecturers from the University of Birmingham in cellular metabolism and endocrine biochemistry, doctors, and medical students who helped to facilitate the running of the sessions. The outline of the outreach programme is detailed in Table 1.

In each school, students completed a baseline survey (Supplementary 1, see section on supplementary materials given at the end of this article) to capture pre-session perceptions of healthcare careers and common endocrine conditions, including diabetes, PCOS, and obesity. A short general knowledge quiz followed to build rapport and engage the students. Following this, three pre-recorded 10-min talks on obesity and diabetes, PCOS, and Health Technology by experts in these subjects were presented to the students. The students were then allocated one of these three topics to make a poster showcasing their learning. The students then voted for their favourite poster in the three topics, excluding their own. The next session was a careers panel, in which professionals in different science-related careers joined virtually to talk to the students about their jobs and answer questions students had. The panel members included a research fellow in biomedical innovation, an associate professor in cellular metabolism, a science presenter, and a lecturer in endocrine biochemistry. In the penultimate session, the students with the winning posters (i.e. the ones with the most votes in each category) presented their posters to the rest of the cohort. Finally, the students completed the post-session evaluation survey (Supplementary 2).

Results

Pre- and post-session survey results (level 2a of Kirkpatrick’s framework)

Participants demonstrated a 24.5% increase in self-reported comprehension of diabetes following the event (pre- vs post: 61.5% (118/192) vs 86.0% (123/143), χ² (2, n = 335) = 25.349, P < 0.001). Similar gains were noted for emotional well-being (65.1% (125/192) vs 81.8% (117/143), χ² (2, n = 335) = 11.545, P = 0.003) and obesity (68.2% (131/192) vs 83.2% (119/143), χ² (2, n = 335) = 9.983, P = 0.007). However, the most significant change was noted for PCOS, with a 65.3% increase post-event (13.0% (25/192) vs 78.3% (112/143), χ² (2, n = 335) = 155.965, P < 0.001) (Fig. 1). These findings underscore the efficacy of the educational intervention in enhancing students’ understanding of various health-related topics.

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Pre- and post-session survey results.

Citation: Endocrine Connections 13, 12; 10.1530/EC-24-0232

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We found a significant improvement in students’ understanding of the career of a scientist (52.6% (101/192) vs 75.5% (108/143), χ²(2, n = 335) = 18.351, P < 0.001) and what being a lecturer entailed (42.2% (81/192) vs 70.6% (101/143), χ² (2, n = 335) = 28.711, P < 0.001). There was an improved understanding of what being a doctor entails post-event (78.1% (150/192) vs 79.7% (114/143), χ² (2, n = 335) = 0.201, P = 0.904). Similar results were noted for the nursing career (73.4% (141/192) vs 81.1% (116/143), χ² (2, n = 335) = 2.791, P = 0.248).

Discussion

Our findings highlight the potential utility and effectiveness of school outreach programmes in enhancing the understanding of common medical topics and the medical profession among secondary school students. The contextual factors, including the interactive nature of the outreach sessions and the opportunity for direct interaction with healthcare professionals, likely facilitated participants’ comprehension and retention of information. Theoretical frameworks such as experiential learning and social cognitive theory provide a lens to understand how professional hands-on activities and role modelling influence learning outcomes. The detailed representation of medical topics such as diabetes, obesity, health technology, and PCOS, as evident in the thematic analysis, suggests that participants actively engaged with the material and synthesised their knowledge effectively. Interestingly, the content on the posters matched the content of the lectures given in all cases, including the types of images drawn on the posters, suggesting the importance of accurate and reliable information dissemination within this age group.

Our thematic analysis’s findings align with previous studies highlighting the importance of interactive and experiential learning in promoting deeper understanding and retention of complex topics among students (5, 6, 7). Comparing the findings with existing literature reveals consistent patterns regarding the effectiveness of interactive educational interventions in improving students’ understanding of medical topics. Studies have shown that experiential learning activities, such as poster challenges and interactive sessions with professionals, enhance students’ engagement and comprehension of complex concepts (8, 9). The combination of different elements within the outreach day, such as pre-recorded videos, team-based activities, and poster presentations, contributed to the engagement and learning process. The video format allowed students to access information in a structured and visually appealing manner. This is further evidenced by the effective use of flipped classroom learning, which incorporates video-based material in medical education (10).

Practising team-based learning at an early stage encourages students to recognise the strengths of others and collaborate on ideas whilst working towards a shared goal. This is a key learning tool fostered by medical schools now integrating team and problem-based learning instead of entirely lecture-based traditional methods (11, 12). The opportunity for selected groups to present their posters in front of peers added an element of competition and promoted communication and public speaking skills.

Our finding has implications for theory, practice, and policy in medical education and outreach initiatives. From a theoretical standpoint, the results support the efficacy of experiential learning approaches in enhancing students’ understanding of medical topics and fostering interest in healthcare careers. Practically, the insights gained from our programme can inform the design of future outreach programmes, emphasising the importance of interactive and hands-on learning activities. Policymakers may consider allocating resources to support and expand school outreach initiatives, particularly in underserved communities, to promote diversity and inclusion in the healthcare workforce. Additionally, our findings underscore the need for continued research to evaluate the long-term impact of outreach programmes and identify strategies for enhancing their effectiveness. By improving awareness and knowledge of medical topics among secondary school students, outreach programmes can influence career aspirations and decisions. This is particularly significant for students from lower socioeconomic backgrounds who may have limited exposure to medical careers (13). By demystifying the medical profession and highlighting its various facets, outreach programmes can help students make more informed decisions about their educational and career pathways. We also highlight the need to increase awareness about PCOS and other women’s health diseases as it may help to reduce societal stigma and improve quality of life. However, it is important to recognise that changes in knowledge and attitudes following outreach efforts are not limited to the field of medicine; they can be applied across various disciplines to raise awareness and spark interest amongst school children (14, 15).

Early career awareness and increasing reach to widen participation may help to increase the number of medical school applicants from widening participation backgrounds (16). Additionally, even if students did not express interest in a health-related career at the time, they might reconsider this with further exploration. This highlights the significant impact that educational interventions can have immediately and in the long term, as demonstrated in initiatives encouraging medical students to pursue research opportunities (17).

However, it is important to acknowledge the limitations of our outreach programme, including its reliance on self-reported measures and the limited scope of the outreach programme. Future educational interventions should incorporate objective outcome measures and expand the reach of outreach initiatives to encompass a broader range of schools and communities. Future research could explore additional factors influencing students’ career aspirations, such as socioeconomic background and access to educational resources. Limitations of assessing impact include difficulty in measuring long-term effects, such as students pursuing medicine or STEM fields. Longitudinal studies with ongoing school partnerships could address this. Future research should consider feedback from session facilitators, as their positive experience is crucial for sustainability and mutual benefit.

Conclusions

We highlight encouraging evidence for the effectiveness of outreach programmes in engaging and educating secondary school students from lower socioeconomic backgrounds about medical topics and careers. Integrating qualitative insights from the posters with quantitative data from the surveys contributes to a well-rounded discussion of the programme’s outcomes. The findings suggest that such initiatives can serve as a practical approach to bridge knowledge gaps and inspire students to consider healthcare careers. By employing a combination of educational strategies, including videos, collaborative activities, and presentations, outreach programmes offer a multifaceted learning experience that resonates with students. Further research is warranted to assess the long-term impact of these programmes on career choices and to refine their design for optimal efficacy.

Supplementary materials:

This is linked to the online version of the paper at https://doi.org/10.1530/EC-24-0232.:

Declaration of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding

The outreach activity was funded by the Society for Endocrinology’s Public Engagement Grant in 2022.

Availability of data and materials

Data will be made available upon request.

Ethics Statement

Ethics approval was not required as recommended by the Institutional Review Board (ERN_2022-0206). No patients were involved.

Author contribution statement

SB and KM are joint-first authors. MK, JB, FR, AA, and CG made substantial contributions to the delivery of this educational intervention. PK conceptualised and supervised the delivery of all aspects and critically reviewed the manuscript. All authors contributed substantially to drafting and approving the final draft of the manuscript. The final version has been reviewed and approved by all the authors.