scholarly journals Simulation past, present and future—a decade of progress in simulation-based education in the UK

2020 ◽  
pp. bmjstel-2020-000601
Author(s):  
Helen Higham

This review will present developments in simulation-based education (SBE) over the past decade with a focus on activity in the UK’s National Health Service and the role of the national society (the Association for Simulation Practice in Healthcare). The article covers the evolution of strategic changes for the use of SBE in the UK and the operational challenges faced by clinicians and other faculty in SBE. The expansion of the evidence base to support SBE in healthcare both in technical skills and, more broadly, in interprofessional team training is explored. Finally, the wider role of simulation in patient safety and healthcare systems, including testing pathways and the development of cognitive aids and involvement of patients in SBE is considered.

2018 ◽  
Vol 52 (3) ◽  
pp. 1800504 ◽  
Author(s):  
Zuelma A. Contreras ◽  
Zhanghua Chen ◽  
Theano Roumeliotaki ◽  
Isabella Annesi-Maesano ◽  
Nour Baïz ◽  
...  

The parallel epidemics of childhood asthma and obesity over the past few decades have spurred research into obesity as a risk factor for asthma. However, little is known regarding the role of asthma in obesity incidence. We examined whether early-onset asthma and related phenotypes are associated with the risk of developing obesity in childhood.This study includes 21 130 children born from 1990 to 2008 in Denmark, France, Germany, Greece, Italy, The Netherlands, Spain, Sweden and the UK. We followed non-obese children at 3–4 years of age for incident obesity up to 8 years of age. Physician-diagnosed asthma, wheezing and allergic rhinitis were assessed up to 3–4 years of age.Children with physician-diagnosed asthma had a higher risk for incident obesity than those without asthma (adjusted hazard ratio (aHR) 1.66, 95% CI 1.18–2.33). Children with active asthma (wheeze in the last 12 months and physician-diagnosed asthma) exhibited a higher risk for obesity (aHR 1.98, 95% CI 1.31–3.00) than those without wheeze and asthma. Persistent wheezing was associated with increased risk for incident obesity compared to never wheezers (aHR 1.51, 95% CI 1.08–2.09).Early-onset asthma and wheezing may contribute to an increased risk of developing obesity in later childhood.


2019 ◽  
Vol 71 (2) ◽  
pp. 137-158
Author(s):  
Ognjen Pribicevic

Leaving the EU is one of the major political decisions made in the UK over the past half-century. Brexit brought about a virtual political earthquake not only in EU-UK relations but also in terms of UK future place and role on the international scene. Immediately after the decision of UK citizens to leave the EU at a referendum held on 23 June 2016, the question arose as to whether the UK will lose some of its international influence, whether Scotland will remain part of the Union, whether the UK will retain its privileged relations and special status with the USA, and what its future relations with the EU will be. The purpose of this article is to point to the basic priorities of the contemporary British foreign policy as well as to place and role of the UK on the contemporary international scene particularly in view of its decision to leave the EU. We shall first try to define the status of present-day Britain in international relations. Second, we shall address the traditional dilemma of the UK foreign policy - what should be given priority - relations with the USA, Europe or the Commonwealth? After that, we shall discuss in more detail the phases the UK foreign policy went through following the end of the cold war. In the third phase, we shall analyze the British contemporary foreign and economic policy towards Gulf countries and China. In the fourth part of the article, we shall discuss relations with the USA. It should be pointed out that the article does not seek to analyze all aspects of British foreign policy, even if we wanted to, due to a shortage of time. Of course, the topic of Brexit will be present in all chapters and especially in the last one and conclusion remarks. By its decision to leave the EU, the UK appears to have given priority to its relations with the USA, China, Gulf countries as well as Commonwealth countries instead of the EU which has been economically and politically dominant over the past few decades. This decision taken by UK citizens will no doubt have a great impact not only on their personal lives and standard of living but on the UK role in international relations. Despite its military, political, economic and cultural capacities, it is highly unlikely that the UK will manage to overcome the consequences of an exit from the single market, currently generating 18 trillion dollars on an annual basis as well as the loss of a privileged partner role with the USA within the Union. We are, therefore, more likely to believe that in the foreseeable future, the role of the UK on the international scene will continue to decline and be increasingly focused on its economic and financial interests. Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III 47010: Drustvene transformacije u procesu evropskih integracija - multidisciplinarni pristup]


2016 ◽  
Vol 11 (11) ◽  
pp. 81 ◽  
Author(s):  
Vishanth Weerakkody ◽  
Mohamad Osmani ◽  
Paul Waller ◽  
Nitham Hindi ◽  
Rajab Al-Esmail

<p>Continued professional development (CPD) has been at the centre of capacity building in most successful organisations in western countries over the past few decades. Specialised professions in fields such as Accounting, Finance and ICT, to name but a few, are continuously evolving, which is necessitating certain standards to be followed through registration and certification by a designated authority (e.g. ACCA). Whilst most developed countries such as the UK and the US have well established frameworks for CPD for these professions, several developing nations, including Qatar (the chosen context for this article) are only just beginning to adopt these frameworks into their local contexts. However, the unique socio-cultural settings in such countries require these frameworks to be appropriately modified before they are adopted within the respective national context. The purpose of this paper is to examine the role of CPD in Qatar through comparing the UK as a benchmark and drawing corresponding and contrasting observations to formulate a roadmap towards developing a high level framework.</p>


2020 ◽  
pp. bmjmilitary-2020-001448 ◽  
Author(s):  
Leanne Jane Eveson ◽  
W Nevin ◽  
N Cordingley ◽  
M Almond

IntroductionAeromedical Evacuation (AE) is a vital role of the Defence Medical Services (DMS). With a far-reaching defence global footprint, an AE capability is crucial to enable movement of patients in the fastest, safest and least stressful way that meets or exceeds the level of care an injured or ill person may expect to receive in the UK. Operation (Op) TRENTON is a UK military humanitarian operation in support of the United Nations (UN) Mission in South Sudan.MethodsA retrospective analysis was carried out of all patients who underwent AE from the UK level 2 hospital at Bentiu during Op TRENTON over a 17-month period from June 2017 to October 2018.Results14 patients underwent AE. The median age was 36 (22–64) years and all patients were male. 21% of AEs were for UK personnel and 79% were for UN personnel. 29% of AEs were due to non-battle injury with the remainder due to disease. Musculoskeletal was the largest diagnostic group (n=4) followed by respiratory (n=3), cardiovascular (n=2), undifferentiated febrile illness (n=2), neurology (n=1), renal medicine (n=1) and psychiatry (n=1).ConclusionsPatients requiring AE from the level 2 hospital at Bentiu mostly had musculoskeletal and medical pathology, a stark contrast to the trauma patient cohort from operations in the past. The majority of patients had definitive care under the medical team highlighting the requirement for DMS physicians and the AE team, to be trained in acute, general and aviation medicine. The majority of AE moves were for UN personnel and on UN airframes, highlighting the importance of a sound understanding of the nations we are working with.


2019 ◽  
Vol 104 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Ameenat Lola Solebo ◽  
Jugnoo S Rahi ◽  
Andrew D Dick ◽  
Athimalaipet V Ramanan ◽  
Jane Ashworth ◽  
...  

Background/aimsThere is a paucity of high-level evidence to support the management of childhood uveitis, particularly for those children without juvenile idiopathic arthritis uveitis (JIA). We undertook a modified Delphi consensus exercise to identify agreement in the management of chronic anterior uveitis (CAU), the most common manifestation of childhood disease.MethodsA four-round, two-panel process was undertaken between June and December 2017. Paediatric uveitis specialists identified through multiple sources, including a multicentre network (the Paediatric Ocular Inflammation Group), were invited to participate. They were asked whether they agreed with items derived from existing guidelines on the management of JIA-U when extrapolated to the population of all children with CAU. Consensus was defined as agreement greater than or equal to 75% of respondents.Results26 of the 38 (68%) invited specialists participated with the exercise, and response rates were 100% for rounds one to three, and 92% for round four. Consensus was reached on 23 of the 44 items. Items for which consensus was not reached included management at presentation, use of systemic and periocular steroids for children with severe disease and the role of conventional steroid sparing immunosuppressants beyond methotrexate.ConclusionThe areas of management uncertainty at the level of the group, as indicated by absence of consensus, reflect the areas where the evidence base is particularly poor. Our findings identify the key areas for the future research needed to ensure better outcomes for this blinding childhood ocular inflammatory disorders.


2017 ◽  
Vol 4 (3) ◽  
pp. 117-125 ◽  
Author(s):  
Makani Purva ◽  
Jane Nicklin

There is widespread enthusiasm and emerging evidence of the efficacy of simulation-based education (SBE) but the full potential of SBE has not been explored. The Association for Simulated Practice in Healthcare (ASPiH) is a not-for-profit membership association with members from healthcare, education and patient safety background. ASPiH’s National Simulation Development Project in 2012 identified the lack of standardisation in the approach to SBE with failure to adopt best practice in design and delivery of SBE programmes. ASPiH created a standards project team in 2015 to address this need. The article describes the iterative process modelled on implementation science framework, spread over six stages and 2 years that resulted in the creation of the standards. The consultation process supported by Health Education England resulted in a unique document that was driven by front line providers while also having strong foundations in evidence base. The final ASPiH document consisting of 21 standards for SBE has been extensively mapped to regulatory and professional bodies in the UK and abroad ensuring that the document is relevant to a wide healthcare audience. Underpinning the standards is a detailed guidance document that summarises the key literature evidence to support the standard statements. It is envisaged the standards will be widely used by the simulation community for quality assurance and improving the standard of SBE delivered.


2011 ◽  
Vol 26 (1) ◽  
pp. 49-64 ◽  
Author(s):  
Michael G. Millin ◽  
Lawrence H. Brown ◽  
Catherine K. Craven ◽  
Seth C. Hawkins ◽  
David K. Tan ◽  
...  

AbstractPurpose: The 2007 Institute of Medicine report entitled Emergency Medical Services at the Crossroads identified a need for the establishment of physician subspecialty certification in emergency medical services (EMS). The purpose of this study was to identify and explore the evolution of publications that define the role of the physician in EMS systems in the United States.Methods: Three comprehensive searches were undertaken to identify articles that define the physician's role in the leadership, clinical development, and practice of EMS. Independent reviewers then evaluated these articles to further determine whether the articles identified the physician's role in EMS. Then, identified articles were classified by the type of publication in order to evaluate the transition from a non-peer reviewed to peer-reviewed literature base and an analysis was performed on the differences in the growth between these two groups. In addition, for the peer-reviewed articles, an analysis was performed to identify the proportion of articles that were quantitative versus qualitative in nature.Results: The comprehensive review identified 1,504 articles. Ninety articles were excluded due to lack of relevance to the US. The remaining 1,414 articles were reviewed, and 194 papers that address the physician's role within EMS systems were identified; 72 additional articles were identified by hand search of references for a total of 266 articles. The percentage of peer-reviewed articles has increased steadily over the past three decades. In addition, the percentage of quantitative articles increased from the first decade to the second and third decades.Conclusions: This comprehensive review demonstrates that over the past 30 years an evidence base addressing the role of the physician in EMS has developed. This evidence base has steadily evolved to include a greater proportion of peer-reviewed, quantitative literature.


2003 ◽  
Vol 62 (2) ◽  
pp. 553-562 ◽  
Author(s):  
Roger Shrimpton

The need for an evidence base for human nutrition action is analysed in the context of human rights. Over the last 50 years the twin tracks of development, economical needs based and normative rights based, have come progressively closer in terms of goals and objectives, even if they do maintain different orientations and origins. The international human rights machinery is described, together with those parts that are of relevance to the right to food and nutrition. The role of the State in respecting, protecting and facilitating these rights is further described. The evidence base for the benefit of nutrition interventions during the fetal and infant period to the health and well-being of populations throughout life's course is briefly reviewed, and reasons why such a large body of evidence has not been acted upon are discussed. The power of nutrition is in prevention more than cure, and the prevention of nutritional deficiency is best suited to radical population-wide strategies rather than high-risk strategies targeted at individuals. The population-wide distribution of benefits of nutrition is in congruence with universality of human rights. In the UK much remains to be done to ensure that food and nutrition rights are realised, especially during the critical period of fetal and infant growth. What role the Nutrition Society might play in the realisation of these rights, including the creation of a robust evidence base for nutrition action, is further discussed.


Author(s):  
Paul V. Knight

Key points• Major advances in medicine, policy, and services for older people have been made over the past fifty years.• The numbers of older people in the UK and elsewhere are increasing and will continue to do so.• This increase has concomitant sociological, medical, and economic challenges that need to be met because they affect the provision of services at all levels.• These challenges are occurring at a time when resources are becoming scarcer and budgets shrinking.• Governments are faced with orchestrating infrastructure and policy in this demanding and complex scenario.• Managers are attempting to do more with less.• Clinicians and other medical professionals are trying to base treatments on sound evidence-based strategies.• There is recognition of the need to include older people and the general public in these processes.• Research may provide us with information that can help resolve these problems.


Race & Class ◽  
2019 ◽  
Vol 61 (2) ◽  
pp. 96-104 ◽  
Author(s):  
Sophia Siddiqui

Two landmark books, originally published during the same era of struggle in the UK, have been republished in 2018: Finding a Voice: Asian women in Britain and Heart of the Race: Black women’s lives in Britain. These books make the history of anti-racism in the UK – and the role of black and Asian women within this that is so often overlooked – accessible to a broad audience and give context to the gendered racism and racialised patriarchies that persist today. Reviewing these reissued texts, the author argues that the UK’s radical history is a powerful tool that can reactivate anti-racist feminism both locally and internationally, pointing to the continued fight to retain BAME domestic violence refuges in the face of austerity cuts in the UK and the unique global solidarity that is coming to the fore as an emboldened far Right attacks women’s rights internationally.


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