scholarly journals Dynamic Plus-Delta: an agile debriefing approach centred around variable participant, faculty and contextual factors

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ranjev Kainth
Keyword(s):  
Contextual Factors ◽  
Training Programme ◽  
Learning Needs ◽  
Clinical Environment ◽  
Healthcare Staff ◽  
Dynamic Nature ◽  
Core Component ◽  
New Approach ◽  
Core Features ◽  
Similar Simulation

AbstractThe current coronavirus pandemic has necessitated rapid intensive care infrastructure expansion with corresponding demand for training healthcare staff. At the NHS Nightingale Hospital, London, the staff underwent a training programme prior to entering the clinical environment with simulation being a core component. This paper describes the rationale for choosing an initial debriefing model which evolved overtime to consider multiple contextual factors: demands of the clinical environment, the diverse participants and their learning needs, the variable experience of faculty, and the dynamic nature of available debriefing time. The new approach, termed here as the Dynamic Plus-Delta model, blends the traditional Plus-Delta approach with specific dynamic elements which considers the unique demands of rapidly training large number of staff. We outline the core features of this model and detail specific considerations around psychological safety. This debriefing approach can be used in similar simulation intervention settings where rapid training of participants is required with multiple and varying contextual factors.

scholarly journals Making the invisible visible: New perspectives on the intersection of human-environment interactions of clinical teams in intensive care

2021 ◽  
Author(s):  
Sheena Visram ◽  
Laura Potts ◽  
Neil J Sebire ◽  
Yvonne Rogers ◽  
Emma Broughton ◽  
...  
Keyword(s):  
Intensive Care ◽  
Medical Devices ◽  
New Technologies ◽  
Clinical Team ◽  
Clinical Environment ◽  
Healthcare Staff ◽  
Human Environment ◽  
New Approach ◽  
Design Considerations ◽  
New Interactions

Understanding human behaviour is essential to the adoption practices for new technologies that promote safer care. This requires capturing the detail of clinical workflows to inform the design of new interactions including those with touchless technologies that decipher human-speech, gesture and motion and allow for interactions that are free of contact. Many environments in hospitals are sub-optimally designed, with a poor layout of work surfaces, cumbersome equipment that requires space and effort to manoeuvre, designs that require healthcare staff to reach awkwardly and medical devices that require extensive touch. This suggests there is a need to better understand how they can be designed. Here, we employ a new approach by installing a single 360 degree camera into a clinical environment to analyse touch patterns and human-environment interactions across a clinical team to recommend design considerations for new technologies with potential to reduce avoidable touch.

scholarly journals The discovery of biological subphenotypes in ARDS: a novel approach to targeted medicine?

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Karin Wildi ◽  
Samantha Livingstone ◽  
Chiara Palmieri ◽  
Gianluigi LiBassi ◽  
Jacky Suen ◽  
...  
Keyword(s):  
Age Groups ◽  
Geographical Location ◽  
High Morbidity ◽  
Shock State ◽  
Pharmacological Agents ◽  
New Approach ◽  
Novel Approach ◽  
Active Research ◽  
Targeted Medicine ◽  
Core Features

AbstractThe acute respiratory distress syndrome (ARDS) is a severe lung disorder with a high morbidity and mortality which affects all age groups. Despite active research with intense, ongoing attempts in developing pharmacological agents to treat ARDS, its mortality rate remains unaltered high and treatment is still only supportive. Over the years, there have been many attempts to identify meaningful subgroups likely to react differently to treatment among the heterogenous ARDS population, most of them unsuccessful. Only recently, analysis of large ARDS cohorts from randomized controlled trials have identified the presence of distinct biological subphenotypes among ARDS patients: a hypoinflammatory (or uninflamed; named P1) and a hyperinflammatory (or reactive; named P2) subphenotype have been proposed and corroborated with existing retrospective data. The hyperinflammatory subphenotyope was clearly associated with shock state, metabolic acidosis, and worse clinical outcomes. Core features of the respective subphenotypes were identified consistently in all assessed cohorts, independently of the studied population, the geographical location, the study design, or the analysis method. Additionally and clinically even more relevant treatment efficacies, as assessed retrospectively, appeared to be highly dependent on the respective subphenotype. This discovery launches a promising new approach to targeted medicine in ARDS. Even though it is now widely accepted that each ARDS subphenotype has distinct functional, biological, and mechanistic differences, there are crucial gaps in our knowledge, hindering the translation to bedside application. First of all, the underlying driving biological factors are still largely unknown, and secondly, there is currently no option for fast and easy identification of ARDS subphenotypes. This narrative review aims to summarize the evidence in biological subphenotyping in ARDS and tries to point out the current issues that will need addressing before translation of biological subohenotypes into clinical practice will be possible.

scholarly journals ‘I thought it would be a very clearly defined role and actually it wasn’t’: a qualitative study of transition training for pharmacists moving into general practice settings in Wales

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e051684
Author(s):  
Sophie Bartlett ◽  
Alison Bullock ◽  
Kate Spittle
Keyword(s):  
General Practice ◽  
Phase 1 ◽  
Qualitative Evaluation ◽  
Phenomenological Approach ◽  
Training Programme ◽  
Learning Needs ◽  
Telephone Interviews ◽  
Need Support ◽  
Interpretative Phenomenological Approach ◽  
Transition Training

ObjectivePharmacists are increasingly contributing to the skill mix of general practice surgeries to help alleviate pressures faced by UK doctors working in primary care. However, they need support in overcoming barriers to their integration. The purpose of this work was to evaluate a programme designed to support pharmacists’ transition to working in general practice settings. We explored the learning needs of pharmacists’, the barriers and enablers to their integration and provide recommendations based on our results.InterventionA qualitative evaluation of a 1-year transition programme in Wales starting in September 2018 to support pharmacists’ transition to working in general practice settings.Design and settingWe employed an interpretative phenomenological approach involving 10 pharmacists across Wales enrolled on the transition to general practice training programme, and their tutors. Data were collected across two sequential phases: in phase 1 telephone interviews were held with pharmacists midway through their training; in phase 2, focus groups were conducted with both pharmacists and tutors towards the end of the programme.ResultsPharmacists enter general practice settings with a variety of prior experience. The programme provided a framework that pharmacists found helpful to map their experience to but the programme needed to be flexible to individual learning needs. The tutor role was typically regarded as the most valuable component, but interaction with the wider general practice team was critical to ease the transition. Pharmacists encountered a lack of clarity about their role which impeded their integration into the workplace team.ConclusionsA formal programme with a designated tutor can support pharmacists’ transition into general practice settings. The programme’s competency framework facilitated reciprocal understanding of the pharmacist’s role in the team, helped to manage expectations and enhanced collaborative practice. Recommendations to facilitate pharmacist integration into general practice settings are provided.

scholarly journals The simulation coaching concept - A step towards expertise

2020 ◽  
Vol 10 (4) ◽  
pp. 83
Author(s):  
Mari Salminen-Tuomaala ◽  
Jaakko Hallila ◽  
Asta Niinimäki ◽  
Paula Paussu
Keyword(s):  
Healthcare Professionals ◽  
Professional Competence ◽  
Development Project ◽  
Educational Institutions ◽  
Learning Needs ◽  
Healthcare Staff ◽  
Learning Skills ◽  
Ongoing Research ◽  
Coaching Intervention ◽  
Simulation Based

Background and objective: This paper presents a sub-study of an ongoing research and development project (August 1, 2017-December 31, 2019), whose aim has been to use simulation-based coaching to meet social and healthcare staff’s self-reported learning needs in 20 small and medium-sized enterprises in Finland. Two regional educational institutions are responsible for the management of the project. The study aim was to examine the development of self-rated professional competence and expertise of social and healthcare staff, following a simulation coaching project.Methods: An electronic questionnaire was used to collect information about participants’ self-rated expertise, first in November 2017 and again in May 2019 following the simulation-based coaching intervention. IBM SPSS for Windows 25 was used to analyse the data.Results: The respondents appreciated simulation coaching as an effective way of developing expertise and the continuous learning skills of professionals. In this project, coaching was considered to be especially suitable for theoretical and practical management of acute situations; for keeping up with change in society; for anticipating development needs, and for promoting the attractiveness and competitiveness of the company where they worked.Conclusions: The simulation coaching concept, which involves action-based and concrete ways of developing theoretical and practical competence, is well suited for social and healthcare professionals undertaking continuing education. Using the companies’ own facilities facilitates participation and application of new knowledge and skills.

scholarly journals The challenge of clinical adoption—the insurmountable obstacle that will stop machine learning?

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180017
Author(s):  
Jonathan Taylor ◽  
John Fenner
Keyword(s):  
Machine Learning ◽  
Clinical Practice ◽  
Health Economics ◽  
Clinical Environment ◽  
New Approach ◽  
Representative Data ◽  
Potential Benefits ◽  
Insurmountable Obstacle ◽  
Learning Software ◽  
Clinical Adoption

Machine learning promises much in the field of radiology, both in terms of software that can directly analyse patient data and algorithms that can automatically perform other processes in the reporting pipeline. However, clinical practice remains largely untouched by such technology. This article highlights what we consider to be the major obstacles to widespread clinical adoption of machine learning software, namely: representative data and evidence, regulations, health economics, heterogeneity of the clinical environment and support and promotion. We argue that these issues are currently so substantial that machine learning will struggle to find acceptance beyond the narrow group of applications where the potential benefits are readily evident. In order that machine learning can fulfil its potential in radiology, a radical new approach is needed, where significant resources are directed at reducing impediments to translation rather than always being focused solely on development of the technology itself.

scholarly journals Competency based internship training programme in undergraduate dental education in Bangladesh: Clinical teachers and intern doctors' perception

2017 ◽  
Vol 8 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Md Immam Hossin ◽  
Mohammad Faruque ◽  
Md Humayun Kabir Talukder ◽  
Md Rasel Ahmad ◽  
Md Abdullah Al Harun ◽  
...  
Keyword(s):  
Patient Care ◽  
Dental Education ◽  
Training Programme ◽  
Dental Students ◽  
Clinical Environment ◽  
Cross Sectional ◽  
Clinical Teachers ◽  
Competency Based ◽  
Structured Questionnaire ◽  
Internship Training

Background: For the first 20 years or so after formal education in dentistry commenced at Glasgow in 1879, the manner of learning technical and clinical procedures was little different from what it had been since immemorial. In other words dental students learned by watching others until it was felt that they could be trusted to perform the procedure themselves.Rationale: The intern year is the first level of hands-on training in dentistry and is an essential step in every dental surgeon's career. Opportunity to apply, consolidate and expand one's clinical knowledge, skills and also progressively increase one's responsibility for providing safe, high-quality patient care. Opportunity to develop overall patient management skill especially for the general dental practitioner. The intern year should provide a balance between education, training and clinical responsibility, enabling interns to develop the professional and personal competencies that result in good patient care and provide a foundation for lifelong learning.Objectives: The present study was undertaken to identify the Competency based internship training programme in undergraduate dental education in Bangladesh: Clinical teachers and intern doctors' perceptionMethods: This descriptive type of cross sectional study was conducted in six public and private dental colleges of Bangladesh. A semi-structured questionnaire based on 5-point Likert scale was used to collect the clinical teachers and inter doctors' perceptions. The semi-structured questionnaire was prepared on the basis of logbook based internship training programme. Before administering the questionnaires to the respondents the investigator gave them an introductory idea about the purpose of the research.Results: competencies acquired by the intern doctors were satisfactory but some problematic areas such as less duration of training period, no community placement, availability of training aid, lack of supervision as well as feedback etc were highlighted which interfered in achieving their satisfaction on their competencies.Conclusion: To ensure excellence in all aspects of internship training programme, it can be concluded that intern doctors must need to acquire sufficient competencies in most of the clinical areas for their daily practice. There are many areas for further improvement through evaluating and developing the internship training programme as well as the logbook and strengthening the clinical environment in the institutes.Bangladesh Journal of Medical Education Vol.8(1) 2017: 9-13

Optimal level and order detection in wavelet decomposition for PCG signal denoising

2019 ◽  
Vol 64 (2) ◽  
pp. 163-176 ◽  
Author(s):  
Mohamed Rouis ◽  
Abdelkrim Ouafi ◽  
Salim Sbaa
Keyword(s):  
Signal To Noise Ratio ◽  
Optimal Level ◽  
Signal Denoising ◽  
Discrete Wavelet ◽  
Clinical Environment ◽  
Mother Wavelet ◽  
New Approach ◽  
The Mean ◽  
Pcg Signals ◽  
Selection Of

Abstract The recorded phonocardiogram (PCG) signal is often contaminated by different types of noises that can be seen in the frequency band of the PCG signal, which may change the characteristics of this signal. Discrete wavelet transform (DWT) has become one of the most important and powerful tools of signal representation, but its effectiveness is influenced by the issue of the selected mother wavelet and decomposition level (DL). The selection of the DL and the mother wavelet are the main challenges. This work proposes a new approach for finding an optimal DL and optimal mother wavelet for PCG signal denoising. Our approach consists of two algorithms designed to tackle the problems of noise and variability caused by PCG acquisition in a real clinical environment for different categories of patients. The results obtained are evaluated by examining the coherence analysie (Coh) correlation coefficient (Corr) and the mean square error (MSE) and signal-to-noise ratio (SNR) in simulated noisy PCG signals. The experimental results show that the proposed method can effectively reduce noise.

scholarly journals Acute Internal Medicine Trainee Survey 2015

2015 ◽  
Vol 14 (2) ◽  
pp. 78-82
Author(s):  
Nicholas Smallwood ◽  
◽  
Nerys Conway ◽  
Keyword(s):  
Internal Medicine ◽  
Social Media ◽  
Career Choice ◽  
Online Survey ◽  
Skill Training ◽  
Training Programme ◽  
Core Component ◽  
Acute Medicine ◽  
National Training ◽  
E Mail

Objectives: To ascertain current Acute Internal Medicine (AIM) trainees’ opinions on their training programme, practical procedures, specialist skills and AIM as a specialty. This can then be used to feedback to the national training committee to help shape training priorities. Methods: Online survey sent to all AIM Higher Specialty Trainees registered on the Society for Acute Medicine database, and advertised through e-mail communication and social media. Results: The majority of trainees (55.5%) were quite happy or very happy with their training currently, although significant difficulties were highlighted with time off for specialist skill training and difficulty achieving certain procedural skills. The majority of trainees believe ultrasound should form a core component of AIM training (82.3%). A high proportion of trainees would recommend AIM as a specialty despite these difficulties. Conclusions: A number of issues were highlighted causing difficulties within AIM training, despite which the vast majority of trainees would recommend AIM as a career choice. The results were fed back to the training committee in March.

Sign in / Sign up

Export Citation Format

Share Document