scholarly journals The Educational and Clinical Benefits of a “Consultant-Speciality Trainee” ENT Shared Clinic

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Yaser Najaf ◽  
Sam Fishpool ◽  
Harry Hunt ◽  
Steven Backhouse
Keyword(s):  
Clinical Outcomes ◽  
Outpatient Clinic ◽  
Medical Training ◽  
Junior Doctors ◽  
Positive Trend ◽  
Trainee Doctor ◽  
European Working ◽  
Clinical Benefits ◽  
One To One ◽  
The One

Introduction and Aims. The European Working Time Regulations (EWTR) of 48-hour working week limit have raised concerns regarding the quality of medical training for junior doctors. Our study has looked to improve junior doctors training without impairing patients’ care with the introduction of one-to-one “consultant with specialty trainee” doctor teaching in the outpatient clinic setting. Methodology. In this study, an ENT specialty trainee conducted a 3-month block of solo clinics seeing new patients. After that, the same specialty trainee shared the clinic with an ENT consultant for 3 months and subsequently the same trainee reconducted solo clinics. Outcomes of the specialty trainee performance were measured clinically by completed patient episodes (CPE) (i.e., patient discharged from clinic or placed on surgical operation waiting list) and ongoing patient episodes (OPE) (i.e., patient given follow-up appointment to ENT clinic) and educationally by workplace based assessments (WBA) completed in the trainee’s e-portfolio. Results. 271 patients were recruited in this research: 24% being in the preintervention group, 47% during the intervention, and 29% in the postintervention. The intervention of one-to-one outpatient clinic teaching increased the specialty trainees CPE rate (60% to 67.5%, p>0.1) and reduced their OPE rate (40% to 32.5%, p=0.001). Educationally these trainees completed with the consultant statistically significant WBA (17 assessments) during the one-to-one clinics compared to solo clinics (2.3 on average). Discussion and Conclusion. In this study, a positive trend in the clinical outcomes was obtained in terms of CPE, while a statistically significant reduction of the total OPE was achieved giving an indicator to consider this concept for further research in terms of patient’s clinical outcomes. Nevertheless, it showed a new way of supporting the trainee’s education supported by more WBA being filled.

Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

2021 ◽  
Vol 82 (3) ◽  
pp. 1-10
Author(s):  
Soumya Mukherjee ◽  
James Meacock ◽  
Eleanor Kissane ◽  
Debasish Pal
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Medical Training ◽  
Working Hours ◽  
Junior Doctors ◽  
Clinical Experiences ◽  
Postgraduate Medical Training ◽  
European Working ◽  
Working Time Directive ◽  
The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

scholarly journals Institutional Transference and Disengagement: A Study of an Outpatient Clinic

1971 ◽  
Vol 16 (3) ◽  
pp. 227-232 ◽  
Author(s):  
H. M. Sampath ◽  
E. Kingstone ◽  
B. Dhindsa
Keyword(s):  
Outpatient Clinic ◽  
The Other ◽  
Outpatient Department ◽  
Treatment Staff ◽  
One To One ◽  
Set Up ◽  
The One ◽  
Entire Treatment

This paper describes an outpatient clinic where many of the patients are chronic attenders who resist all attempts at discharge. Their dependency needs and the difficulty of one-to-one treatment are outlined. On the one hand there is the almost insatiable demand for magical medications, and on the other the frustration of the therapists trying to deal with this situation. To circumvent these difficulties, the concept of institutional transference was fostered by a policy of disengagement. As a result a flexible therapeutic set up was evolved allowing for the fulfillment of dependency needs and the maintenance of satisfactory morale, not only among the patients but also among the entire treatment staff. The clinic, instead of being viewed as merely a place for difficult and incurable patients, is now seen as a useful alternative in the treatment armamentarium of the outpatient department.

Influence of Rim Run-Out on the Nonuniformity of Tire-Wheel Assemblies

1994 ◽  
Vol 22 (2) ◽  
pp. 99-120 ◽  
Author(s):  
T. B. Rhyne ◽  
R. Gall ◽  
L. Y. Chang
Keyword(s):  
Finite Element ◽  
Radial Force ◽  
Membrane Model ◽  
Model Experiments ◽  
Force Variation ◽  
One To One ◽  
The One

Abstract An analytical membrane model is used to study how wheel imperfections are converted into radial force variation of the tire-wheel assembly. This model indicates that the radial run-out of the rim generates run-out of the tire-wheel assembly at slightly less than the one to one ratio that was expected. Lateral run-out of the rim is found to generate radial run-out of the tire-wheel assembly at a ratio that is dependent on the tire design and the wheel width. Finite element studies of a production tire validate and quantify the results of the membrane model. Experiments using a specially constructed precision wheel demonstrate the behavior predicted by the models. Finally, a population of production tires and wheels show that the lateral run-out of the rims contribute a significant portion to the assembly radial force variation. These findings might be used to improve match-mounting results by taking lateral rim run-out into account.

scholarly journals European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045635
Author(s):  
Erik Donker ◽  
David Brinkman ◽  
Milan Richir ◽  
Paraskevi Papaioannidou ◽  
Robert Likic ◽  
...  
Keyword(s):  
Medical Education ◽  
Delphi Study ◽  
Medical Training ◽  
Medical Center ◽  
European Countries ◽  
Essential Medicines ◽  
Ethical Review ◽  
Junior Doctors ◽  
Direct Supervision ◽  
Modified Delphi

IntroductionJunior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education.Methods and analysisThis modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision.Ethics and disseminationThe study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.

Tree Rewriting Systems, Combinatory Weak Reduction Systems and Type Free Languages1

1982 ◽  
Vol 5 (3-4) ◽  
pp. 279-299
Author(s):  
Alberto Pettorossi
Keyword(s):  
Combinatory Logic ◽  
Rewriting Systems ◽  
Tree Transducers ◽  
Tree Languages ◽  
One To One ◽  
The One ◽  
Weak Reduction

In this paper we consider combinators as tree transducers: this approach is based on the one-to-one correspondence between terms of Combinatory Logic and trees, and on the fact that combinators may be considered as transformers of terms. Since combinators are terms themselves, we will deal with trees as objects to be transformed and tree transformers as well. Methods for defining and studying tree rewriting systems inside Combinatory Weak Reduction Systems and Weak Combinatory Logic are also analyzed and particular attention is devoted to the problem of finiteness and infinity of the generated tree languages (here defined). This implies the study of the termination of the rewriting process (i.e. reduction) for combinators.

scholarly journals EWTD: maintaining the pressure

2009 ◽  
Vol 91 (8) ◽  
pp. 258-259 ◽  
Author(s):  
John Black
Keyword(s):  
Medical Association ◽  
Working Time ◽  
European Working Time Directive ◽  
News Item ◽  
Junior Doctors ◽  
Public Concern ◽  
European Working ◽  
Working Time Directive ◽  
First Time ◽  
Radio Programme

The ill-judged introduction of the 48-hour week demanded by the European Working Time Directive (EWTD) was the first news item on every television and radio programme on Saturday 1 August, indicating just how successful the College has been in raising public concern. It was encouraging that the British Medical Association (BMA) speakers were for the first time expressing serious anxiety, largely about the effects on training and about pressure being put on junior doctors to falsify their hours returns. All conversions to the cause are welcome, however late in the day. It is disappointing that the BMA is not yet stressing the dangers to patients, which they are surely hearing about from their members working in the acute specialties.

In search of the perfect orthography

2005 ◽  
Vol 7 (2) ◽  
pp. 139-163 ◽  
Author(s):  
Richard L. Venezky
Keyword(s):  
Writing System ◽  
Writing Systems ◽  
International Phonetic Alphabet ◽  
Experienced Reader ◽  
Cultural Considerations ◽  
Advanced Stages ◽  
One To One ◽  
The One ◽  
Psychological Processing ◽  
The Ideal

Philologists, linguists, and educators have insisted for several centuries that the ideal orthography has a one-to-one correspondence between grapheme and phoneme. Others, however, have suggested deviations for such functions as distinguishing homophones, displaying popular alternative spellings, and retaining morpheme identity. If, indeed, the one-to-one ideal were accepted, the International Phonetic Alphabet should become the orthographic standard for all enlightened nations, yet the failure of even a single country to adopt it for practical writing suggests that other factors besides phonology are considered important for a writing system. Whatever the ideal orthography might be, the practical writing systems adopted upon this earth reflect linguistic, psychological, and cultural considerations. Knowingly or unknowingly, countries have adopted orthographies that favour either the early stages of learning to read or the advanced stages, that is, the experienced reader. The more a system tends towards a one-to-one relationship between graphemes and phonemes, the more it assists the new reader and the non-speaker of the language while the more it marks etymology and morphology, the more it favours the experienced reader. The study of psychological processing in reading demonstrates that human capacities for processing print are so powerful that complex patterns and irregularities pose only a small challenge. Orthographic regularity is extracted from lexical input and used to recognise words during reading. To understand how such a system develops, researchers should draw on the general mechanisms of perceptual learning.

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