scholarly journals How can we make renal medicine careers more appealing to UK trainees?

2019 ◽  
Vol 12 (5) ◽  
pp. 756-759
Author(s):  
Alvin H K Karangizi ◽  
Dimitrios Chanouzas ◽  
Amar Mahdi ◽  
Lukas Foggensteiner

Abstract Background There is a global decline in interest in careers in renal medicine. This is concerning given the increasing global burden of kidney disease. Previous studies in the USA and Australia have identified factors such as a poor work–life balance, lack of role models and the challenging nature of the speciality as possible reasons behind recruitment struggles. This study aimed to identify factors associated with declining interest among trainees in the UK. Methods We conducted a survey of 150 National Health Service Foundation trainees (interns) and Core Medical Trainees in Health Education West Midlands. Participants completed a 14-part paper-based questionnaire capturing data on trainee demographics, medical school and postgraduate exposure to renal medicine and perceptions of a career in renal medicine. Results There was limited early clinical exposure to renal medicine both in terms of time spent in the speciality and perceived exposure to the range of domains of the speciality. Trainees perceived the speciality as complex with a heavy workload. Very few trainees considered the speciality to be lifestyle oriented. There was also disinterest in taking on the associated general medicine commitments of the training programme. Job experience and identification of role models increased the likelihood of consideration of the speciality. Conclusion This survey has identified key areas to drive interest in the speciality, including early engagement, enthusiastic supervision and increased training flexibility. Urgent attention is required to address these areas and make renal medicine careers more appealing.

Author(s):  
Warren F. Smith ◽  
Michael Myers ◽  
Brenton Dansie

The Australian Government and industry groups have been discussing the projected “skills shortage” for a number of years. This concern for the future is mirrored in many countries including the USA and the UK where the risk is not having sufficient skilled people to realise the projects being proposed. Growing tertiary qualified practicing engineers takes time and commitment but without the excitement of the possibility of such a career being seeded in the youth of the world, school leavers won’t be attracted to engineering in sufficient numbers. In response, one successful model for exciting school children about engineering and science careers is the international F1inSchools Technology Challenge which was created in the UK in 2002 and implemented in Australia in 2003. It is now run in over 300 Australian Schools and 33 countries. In the Australian context, the program is managed and promoted by the Reengineering Australia Foundation. It is supported and fostered through a range of regional hubs, individual schools and some exceptional teachers. Presented in this paper are some perspectives drawn particularly from the Australian experience with the program over 10 years — which by any measure has been outstanding. The F1inSchools model has been designed specifically through its association with Formula One racing to attract the intrinsic interests of students. It is based on the fundamentals of action learning. Role models and industry involvement are utilised as motivation modifiers in students from Years 5 to 12. While immersing children in project based learning, the program explicitly encourages them to engage with practicing mentors taking them on a journey outside their normal classroom experience. In this program, students have the opportunity to use the design and analysis tools that are implemented in high technology industries. Their experience is one of reaching into industry and creative exploration rather than industry reaching down to them to play in a constrained and artificial school based environment. Anecdotally F1inSchools has been very successful in positively influencing career choices. With the aim of objectively assessing the impact of the program, doctoral research has been completed. Some key findings from this work are summarized and reported in this paper. The children involved truly become excited as they utilise a vehicle for integration of learning outcomes across a range of educational disciplines with a creative design focus. This enthusiasm flows to reflective thought and informed action in their career choice. As a result of F1inSchools, students are electing to follow engineering pathways and they will shape tomorrow’s world.


2020 ◽  
Vol 21 (3) ◽  
pp. 535-562
Author(s):  
Ali Uyar ◽  
Merve Kılıç ◽  
Mehmet Ali Köseoğlu

PurposeThe objective of this study is to explore the accounting research network among institutions and countries globally and to contribute to the knowledge development in accounting discipline across regions with a novel and original approach.Design/methodology/approachThis study has been conducted by manually collecting data from 10,863 papers published in 22 accounting journals indexed in the Web of Science (WoS) for the period 2000–2016. Analyses and visualizations of collaborative networks across institutions and regions were performed by using network analysis software packages, including Pajek, UCINET 6, NetDraw and VOSviewer.FindingsThe study finds that the most productive five universities are the University of New South Wales, University of Sydney, University of Texas, University of California and University of Manchester worldwide. In accordance with the institution ranking, the five most productive countries in all periods are the USA, the UK, Australia, Spain and Canada. However, in addition to these countries, it is important to note that some European and Asian countries and New Zealand from Oceania are among the most productive countries which host prolific institutions. Furthermore, network indicators show that the UK is the most influential actor in centrality and brokerage within the research network. We should note that Australia is also among the most influential nations with its influential institutions. In all research metrics, the dominance of Anglophone countries (e.g. the USA, the UK and Australia) is observable on which language advantage might play a role since most internationally accredited journals publish scientific articles in English.Research limitations/implicationsThe study is bounded with several main limitations. First, due to collecting the data manually, there might be some inherent limitations. Second, the study is constrained by the time frame between 2000 and 2016. The study does not answer why and how questions in investigating research productivity and effectiveness in the network. Our study might inspire new studies to complement ours by considering these constraints.Practical implicationsOur findings indicated the prominent institution-wide and country-wide actors; thus, the results provide a global perspective on the collaboration network. Second, our findings guide job seekers, who are particularly research-oriented, to potential recruiters around the world both at the institution level and country level. Third, the results might play an important role in forming institution-based and country-based research policies. The USA, among others, is a particularly important actor in productivity, whereas the UK, among others, is a remarkable country in centrality and brokerage in the research network. By examining the policies of these two countries, other nations might shape their research strategies, promotion policies and support and reward schemes. Fourth, cross-institution and in particular cross-country collaborations are imperative in the diversity of accounting research as they blend culturally diverse researchers. Fifth, prominent institutions highlighted in this study might be adopted as role models by other institutions in the same country and benefit their expertise in productivity and cooperation by scrutinizing their approaches. Sixth, our findings and metrics might be adopted as benchmarks for institutions and nations for performance evaluation. Considering our 5-year period indicators, institutions can set targets for their improvement and for measuring the progress. We provide other important implications in the conclusion section of the study.Originality/valueTo the best knowledge of the authors, no study yet investigated the collaboration across academic institutions, regions, and countries in accounting discipline to this extent. Therefore, our research provides a significant contribution to the literature by seeking a comprehensive network analysis of authorship patterns from an institutional and geographical perspective. Doing so, we contribute to knowledge development in accounting discipline with institutional and geographical network analyses.


Gut ◽  
1998 ◽  
Vol 43 (5) ◽  
pp. 711-714 ◽  
Author(s):  
G S Duthie ◽  
P J Drew ◽  
M A P Hughes ◽  
R Farouk ◽  
R Hodson ◽  
...  

Background—Flexible sigmoidoscopy is a technical skill that has been successfully performed by suitably trained colorectal nurse practitioners in the USA. However, no recognised training course exists for nurse practitioners in the UK.Aims—To design and evaluate a training programme for nurse endoscopists.Methods—A multidisciplinary committee of nurses and clinicians developed a structured programme of study and practice. This involved a staged process of observations, withdrawals, and ultimately, full procedures. Once training had been completed the nurse practitioner was permitted to practice independently. Patients with colorectal symptoms referred for flexible sigmoidoscopy were examined for the final stages of training and independent practice. A prospective evaluation of the training and practice of the first trained nurse flexible sigmoidoscopist was performed. Barium enema, video, clinical follow up, and histology were used to validate the results of the flexible sigmoidoscopies.Results—The training programme required that 35 observations, 35 withdrawals, and 35 supervised full procedures were performed prior to the development of independent practice. Subsequent to the completion of this programme 215 patients have been examined independently by the nurse practitioner. Ninety three per cent of the examinations were judged successful and pathology was identified in 51%. The nurse endoscopist successfully identified all “significant” pathology whereas barium enema failed to identify pathology in 12.5%. There were no complications.Conclusion—With suitable training nurse endosocopists are able to perform flexible sigmoidoscopy safely and effectively.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tanya Kane ◽  
Tawanda Chivese ◽  
Ayad Al-Moslih ◽  
Noora A. M. Al-Mutawa ◽  
Suhad Daher-Nashif ◽  
...  

Abstract Background Though common practice in Europe, few studies have described the efficacy of early clinical exposure (ECE) in the Middle East. The barriers to clinical learning experienced by these novice medical students have not been reported. This evaluation reports on introducing ECE in primary care, supported by Experiential Review (ER) debriefing sessions. The evaluation explores students’ experiences of their acquisition of clinical and non-technical skills, sociocultural issues commonly encountered but underreported and barriers to clinical learning experienced. Methods We conducted a cross-sectional study of three student cohorts in 2017–19: All second and third-year students at the new College of Medicine were invited to participate. The primary outcome was students’ perceptions of the aims of the Primary Health Centre Placement (PHCP) programme and how it facilitated learning. Secondary outcome measures were students’ perceptions of their learning in ER sessions and perceived barriers to learning during PHCPs. Student perceptions of the PHCPs were measured using a Likert scale-based questionnaire. Results One hundred and fifty-one students participated: 107 in year 2 and 44 in year 3; 72.3% were female. Overall, most students (> 70%) strongly agreed or agreed with the purposes of the PCHPs. Most students (71%) strongly agreed or agreed that the PCHPs allowed them to learn about patient care; 58% to observe doctors as role models and 55% to discuss managing common clinical problems with family physicians. Most students (year 2 = 62.5% and year 3 = 67%) strongly agreed/agreed that they were now confident taking histories and examining patients. Student barriers to clinical learning included: Unclear learning outcomes (48.3%); faculty too busy to teach (41.7%); lacking understanding of clinical medicine (29.1%); shyness (26.5%); and finding talking to patients difficult and embarrassing (25.8%). Over 70% reported that ER enabled them to discuss ethical and professional issues. Conclusions Overall, our Middle Eastern students regard ECE as beneficial to their clinical learning. PHCPs and ER sessions together provide useful educational experiences for novice learners. We recommend further exploration of the barriers to learning to explore whether these novice students’ perceptions are manifesting underlying cultural sensitivities or acculturation to their new environment.


2003 ◽  
Vol 53 (2) ◽  
pp. 195-213 ◽  
Author(s):  
K. Majoros

The study introduces a Hungarian economic thinker, István Varga*, whose valuable activity has remained unexplored up to now. He became an economic thinker during the 1920s, in a country that had not long before become independent of Austria. The role played by Austria in the modern economic thinking of that time was a form of competition with the thought adhered to by the UK and the USA. Hungarian economists mainly interpreted and commented on German and Austrian theories, reasons for this being that, for example, the majority of Hungarian economists had studied at German and Austrian universities, while at Hungarian universities principally German and Austrian economic theories were taught. István Varga was familiar not only with contemporary German economics but with the new ideas of Anglo-Saxon economics as well — and he introduced these ideas into Hungarian economic thinking. He lived and worked in turbulent times, and historians have only been able to appreciate his activity in a limited manner. The work of this excellent economist has all but been forgotten, although he was of international stature. After a brief summary of Varga’s profile the study will demonstrate the lasting influence he has had in four areas — namely, business cycle research and national income estimations, the 1946 Hungarian stabilisation program, corporate profit, and consumption economics — and will go on to summarise his most important achievements.


Author(s):  
Marco M. Fontanella ◽  
Giorgio Saraceno ◽  
Ting Lei ◽  
Joshua B. Bederson ◽  
Namkyu You ◽  
...  
Keyword(s):  
The Usa ◽  

Author(s):  
Vandana Daulatabad ◽  
Prafull K. ◽  
Dr. Surekha S. Kadadi-Patil ◽  
Ramesh S. Patil

Introduction: Medical Education is witnessing a significant transition and global shift towards competency based medical education (CBME) which includes early clinical exposure (ECE) program to help students apply and correlate principles of preclinical subjects with clinical scenarios, in various forms and in a variety of settings. One of the easy and feasible methods of ECE being Case Based Learning (CBL), our study aimed to design a case scenario and to evaluate impact of case base learning as a part of ECE module in first year undergraduate medical teaching program in nerve muscle physiology. Methods: The present study was conducted in 96 students at Ashwini Rural Medical College Hospital and Research Centre, Solapur after obtaining institutional ethics committee approval. 3 hrs session of CBL was conducted for a case scenario on myasthenia gravis in the nerve muscle physiology module. The students’ responses on pre-test, post-test and their insights regarding the CBL were taken through a pre validated questionnaire using 5-point Likert scale. Results: High impact of CBL was seen as significant improvement in student’s performance. Maximum students felt CBL to be easy method of learning and was highly appreciated through their feedback. Conclusion: CBL was found to have positive impact on understanding and perception of topic. CBL helped students to understand, evaluate, analyze, diagnose and interpret the case, paving them towards newer approach of self-directed and vertical integrated learning. CBL is easier, feasible an effective method among other early clinical exposure methods as it involves students in deeper and self-directed active learning, encouraging and promoting them to reach higher levels of cognitive domain of Bloom’s taxonomy. This method will be very useful in its practical implementation during online classes for ECE module in the threat of COVID 19 situation as well.


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