scholarly journals Improving the confidence and competence of junior doctors in conducting seclusion reviews

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S156-S157
Author(s):  
Mostafa Shalaby ◽  
Mehtab Rahman
Keyword(s):  
High Risk ◽  
Junior Doctor ◽  
Simulation Training ◽  
Junior Doctors ◽  
List Type ◽  
Confidence Levels ◽  
Effective Interventions ◽  
Before And After ◽  
Average Confidence ◽  
Quality Improvement Interventions

Aims•To improve the quality and consistency of medical seclusion reviews at St Charles Hospital and across the Trust.•To ensure at least 80% compliance with minimum standards for seclusion review documentation by the end of December 2020.•To increase doctors' mean perceived competence and confidence scores to 4.5/5 by the end of December 2020MethodSeclusion is commonly used to manage patients at high risk of aggression or violence, but is a high risk and very restrictive intervention. As such, it requires regular nursing and medical reviews. Work has been done recently at St Charles to improve the timeliness and effectiveness of nursing reviews including detailed guidance. Medical reviews are usually performed by junior doctors, many with limited experience in psychiatry. There is •A lack of consistent local or national guidance for junior doctors undertaking seclusion reviews•The quality and scope of these reviews is not consistent•There may be a need to ensure that there is more standardization and to improve junior doctors' confidence – and therefore patient safety and experience – overall.•The following interventions were used to improve the quality of seclusion reviews at the hospital:•Minimum standard guidelines•Presenting in Restrictive interventions meeting.•Feedback from PICU consultants for guidelines•Changing guidelinesFuture plans: •Guidelines teaching (Early November)•Re-audit and new survey (Early November)•Simulation training (Mid November)•Seclusion teaching video (Early December- to be ready for Induction)•Re-audit and new survey (Beginning of April)ResultSurveys were conducted before and after quality improvement interventions were put in place. The average confidence levels of junior doctors increased from 38.5% to 87% following these interventions.ConclusionRevision of seclusion guidelines, junior doctor teaching and simulation training are effective interventions to improve junior doctor confidence levels in conducting seclusion reviews.

scholarly journals Transurethral Catheterization in Early Training: The Impact of Peer-Led Mentorship

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mohamed Mubarak ◽  
Qasim Isa ◽  
Mahmood Alsaeed ◽  
Mohamed Alalawi
Keyword(s):  
Procedural Knowledge ◽  
Junior Doctors ◽  
Confidence Levels ◽  
Transurethral Catheterization ◽  
Before And After ◽  
Long Term Impact ◽  
The Impact ◽  
Average Domain ◽  
Early Training

Introduction. Transurethral catheterization (TUC) is a common hospital procedure. According to the literature, junior doctors contribute to the majority of TUC-related injuries. Our aim is to evaluate the immediate and long-term impact of a short procedure-centric TUC workshop on junior doctor’s confidence, procedural knowledge, and ability to identify potential complications of catheterization. Materials and Methods. Intern doctors were invited to attend a one-hour workshop on TUC. A questionnaire was completed before and after the workshop. Three months later, the questionnaire was readministered to assess the workshop’s long-term impact. The questionnaire consisted of three domains. A: experience, training, and confidence levels (using 5-point Likert scales), B: procedural knowledge (the highest possible score was 10 points), and C: identification of TUC-related complications (the highest possible score was 3 points). Results. 81 interns participated and reported a confidence level of 3.03 ± 1.05 in performing a straightforward TUC. Preworkshop domain B and domain C were 3.92 ± 1.63 and 1.75 ± 0.69 points, respectively. After the workshop, reported confidence levels improved to 3.71 + 1.02 ( p < 0.05 ). Likewise, the scores in domains B and C increased significantly to 8.85 ± 1.40 ( p < 0.005 ) and 2.65 ± 0.6 ( p < 0.005 ), respectively. Three months later, the same parameters were evaluated, and confidence levels were higher than those of the preworkshop levels at 3.83 ± 0.77 ( p < 0.05 ). The average domain B score was 7.85 ± 1.88 ( p < 0.005 ), and domain C score was 2.69 ± 0.53 ( p < 0.005 ). All scores reported after three months were significantly better than the preworkshop levels ( p < 0.005 ), but there were no statistically significant differences when compared to the immediate postworkshop scores ( p > 0.05 ). Conclusion. Short peer-led TUC workshops positively impact intern doctors’ confidence levels, procedural knowledge, and identifying complications.

scholarly journals Addiction peer recovery coach training pilot: assessment of confidence levels

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10783
Author(s):  
Nicholas Guenzel ◽  
Hongying Dai
Keyword(s):  
American Indians ◽  
Addiction Treatment ◽  
Initial Attempt ◽  
Self Assessment ◽  
Systematic Analysis ◽  
Confidence Levels ◽  
Before And After ◽  
Average Confidence ◽  
Self Assessments ◽  
The Impact

Background Peer recovery coaches (PRCs) have become a critical tool in addiction treatment in many areas of the world. Despite this fact, no identified research has examined the process or impact of PRC training. Furthermore, no scales were identified to measure trainee confidence in various PRC techniques. The goal of this article is to analyze the process and immediate impact of PRC training of twelve American Indians (AIs) in a culturally-specific program. We focus most specifically on trainee confidence levels. Methods No written consent was obtained and completion of the assessment was considered consent. Trainees completed self-assessments before and after the training. The self-assessment examined nine areas ranging from understanding the role of PRCs to knowledge of effective PRC techniques. Paired t-tests were used to assess for changes in individual trainee responses between the pre- and post-assessments. Results Pre-training responses ranged from moderate to high. Questions with the lowest average confidence levels address PRC activities or specific techniques to facilitate recovery. All nine questions showed statistically significant mean improvements in the post-training self-assessments. Questions regarding specific PRC activities and techniques showed the greatest improvement. Questions relating to helping people more generally showed the smallest improvement. Average post-training responses fell within a very narrow range indicating relatively consistent confidence levels across skills. Analysis indicates participants were possibly over-confident in certain areas (i.e., maintaining boundaries). This small pilot represents an initial attempt to measure confidence levels of PRC trainees. The findings may inform future training by identifying certain areas where emphasis might be most helpful for trainees. In addition, it is hoped that this work will encourage more systematic analysis of the impact of PRC training on individuals.

scholarly journals Trauma Simulation Training Increases Confidence Levels in Prehospital Personnel Performing Life-Saving Interventions in Trauma Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Christine M. Van Dillen ◽  
Matthew R. Tice ◽  
Archita D. Patel ◽  
David A. Meurer ◽  
Joseph A. Tyndall ◽  
...  
Keyword(s):  
Confidence Level ◽  
Simulation Training ◽  
Prehospital Care ◽  
Tension Pneumothorax ◽  
Trauma Patients ◽  
Care Providers ◽  
Confidence Levels ◽  
Life Saving ◽  
Before And After ◽  
Needle Decompression

Introduction. Limited evidence is available on simulation training of prehospital care providers, specifically the use of tourniquets and needle decompression. This study focused on whether the confidence level of prehospital personnel performing these skills improved through simulation training.Methods. Prehospital personnel from Alachua County Fire Rescue were enrolled in the study over a 2- to 3-week period based on their availability. Two scenarios were presented to them: a motorcycle crash resulting in a leg amputation requiring a tourniquet and an intoxicated patient with a stab wound, who experienced tension pneumothorax requiring needle decompression. Crews were asked to rate their confidence levels before and after exposure to the scenarios. Timing of the simulation interventions was compared with actual scene times to determine applicability of simulation in measuring the efficiency of prehospital personnel.Results. Results were collected from 129 participants. Pre- and postexposure scores increased by a mean of 1.15 (SD 1.32; 95% CI, 0.88–1.42;P<0.001). Comparison of actual scene times with simulated scene times yielded a 1.39-fold difference (95% CI, 1.25–1.55) for Scenario 1 and 1.59 times longer for Scenario 2 (95% CI, 1.43–1.77).Conclusion. Simulation training improved prehospital care providers’ confidence level in performing two life-saving procedures.

Distilling the core meaning of medical engagement to three junior doctor staff groups in a Welsh Health Board

BMJ Leader ◽  
2020 ◽  
pp. leader-2020-000339
Author(s):  
Thomas Cromarty ◽  
Rachel Rayment ◽  
Patti Mazelan ◽  
Fred Barwell ◽  
Peter Spurgeon ◽  
...  
Keyword(s):  
Cultural Change ◽  
Junior Doctor ◽  
Junior Doctors ◽  
Health Board ◽  
Research Approach ◽  
List Type ◽  
Job Roles ◽  
The Core ◽  
Core Concepts ◽  
Core Issues

BackgroundHealth systems demonstrate that levels of staff engagement correlate with a variety of performance indicators, including mortality, morbidity, staff sickness. The purpose of this paper is to help healthcare managers and clinical leaders gain greater clarity in understanding the core concepts which drive medical engagement for junior doctor staff groups.MethodsA total of 245 members of medical staff completed the Medical Engagement Survey (MES) with a local focus in a participating Welsh University Health Board in April 2018. In this paper a ‘mixed-methods’ research approach is described. Both quantitative and qualitative data have been collected and analysed as part of the MES and these are interpreted and integrated with the aim of highlighting insightful links between the various methodological perspectives (as described by Shorten and Smith).ResultsThe findings reported are the results of the first purposive sample from an application of the MES targeted specifically at junior doctors.Though improvements in medical engagement often require a cultural change over the longer term, trainees have highlighted to the organisation valuable opportunities for quick wins. These capture the essence of what medical engagement really means to Junior Doctor Staff groups.Being kept informed in a flexible and timely manner about any changes in systems, job roles and rotas.Having more time outside ward duties to develop and progress effectively through training.Being undervalued by senior management and poor communication with medical staffing.ConclusionThe systematic surfacing of these core issues may potentially help keep sight of fundamental staff priorities when attempting to enhance levels of medical engagement. Although these views are from one Health Board, they mirror findings elsewhere. Disengaged junior doctors may be part of continuing the wider problem of lack of engagement in senior staff as they themselves become more senior and influential.

scholarly journals Multidisciplinary Simulation Training for Surgical Tracheostomy in Patients Mechanically Ventilated Secondary to Severe Acute Respiratory Syndrome Coronavirus 2

2021 ◽  
pp. 014556132110421
Author(s):  
Rebecca Towning ◽  
Catherine Rennie ◽  
Mark Ferguson
Keyword(s):  
High Risk ◽  
Simulation Training ◽  
Training Experience ◽  
High Stakes ◽  
Surgical Tracheostomy ◽  
Roles And Responsibilities ◽  
Staff Members ◽  
Before And After ◽  
High Level ◽  
Multidisciplinary Simulation

Objective: A proportion of patients with coronavirus disease (COVID) and severe respiratory manifestations of disease will require admission to intensive care for intubation and ventilation. When anticipating prolonged ventilation, the patient may proceed to surgical tracheostomy to afford safe respiratory wean. As surgical tracheostomy is an aerosol-generating procedure, it poses a high risk of viral transmission and ultimately may prompt anxiety and caution in participating staff members. We aimed to mitigate these risks by providing staff with appropriate training and experience, to improve their confidence as well as practical ability. Methods: We developed a multidisciplinary simulation training experience and checklist in order to optimize team performance during the high-stakes procedure. We evaluated staff confidence before and after the training with questionnaires. Results: Post-simulation, surgeons were more confident with donning the high level personal protective equipment, and nurses were more confident in performing their role. Conclusions: Simulation allows the multidisciplinary team an opportunity to practice high-risk procedures and prompts the team to assess staff knowledge base, troubleshoot queries, and teach roles and responsibilities in a safe environment. In the context of COVID-19, simulation encourages staff sense of preparedness and protection for true participation during a high-risk procedure.

scholarly journals 187 Improving Awareness of Managing Post-Operative Haemorrhage in Patients Undergoing Thyroid and Parathyroid Surgery: The SCOOP Protocol

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Bhattacharya ◽  
J Jegadeeson ◽  
J Ramsingh ◽  
P Truran
Keyword(s):  
Nursing Staff ◽  
Simulation Training ◽  
Clinical Signs ◽  
Skin Wound ◽  
Junior Doctors ◽  
Parathyroid Surgery ◽  
Surgical Department ◽  
Life Threatening ◽  
Clinical Questions ◽  
Life Threatening Complication

Abstract Introduction Post-operative haemorrhage is a rare but potentially life-threatening complication of thyroid surgery and occurs in 1 in 100 patients. Our aim was to assess current levels of awareness of post-operative haemorrhage in the surgical department and to improve confidence in managing this. Method Questionnaires with a combination of clinical questions were distributed amongst nurses, foundation doctors, senior house officers and registrars in the surgical department. Results There was a clear gap in awareness in all grades. The British Association of Endocrine and Thyroid surgeons (BAETS) have guidance on the management of these patients and in particular the acronym SCOOP (Steristrips removed, Cut subcuticular sutures, Open skin wound, Open strap muscles, Pack wound). 18/24 of participants had not heard of the SCOOP protocol. Most nurses (6/12) all junior doctors (8/8) showed lack of confidence in managing patients with suspected bleeding. Conclusions An informative poster was created for relevant clinical areas as per the BAETS recommendation. These posters outlined the steps in the SCOOP acronymas well as the main clinical signs of haemorrhage. BAETS recommend that all first responders, including nursing staff, junior doctors and the crash team should be aware of the SCOOP protocol. Simulation training sessions are in progress for these members of staff.

scholarly journals Audio-guided self-hypnosis for reduction of claustrophobia during MR imaging: results of an observational 2-group study

2021 ◽  
Author(s):  
Adriane E. Napp ◽  
Torsten Diekhoff ◽  
Olf Stoiber ◽  
Judith Enders ◽  
Gerd Diederichs ◽  
...  
Keyword(s):  
High Risk ◽  
Mr Imaging ◽  
Odds Ratio ◽  
Control Group ◽  
Waiting Room ◽  
High Risk Patients ◽  
Imaging Results ◽  
Before And After ◽  
Risk Patients ◽  
And Coping

Abstract Objectives To evaluate the influence of audio-guided self-hypnosis on claustrophobia in a high-risk cohort undergoing magnetic resonance (MR) imaging. Methods In this prospective observational 2-group study, 55 patients (69% female, mean age 53.6 ± 13.9) used self-hypnosis directly before imaging. Claustrophobia included premature termination, sedation, and coping actions. The claustrophobia questionnaire (CLQ) was completed before self-hypnosis and after MR imaging. Results were compared to a control cohort of 89 patients examined on the same open MR scanner using logistic regression for multivariate analysis. Furthermore, patients were asked about their preferences for future imaging. Results There was significantly fewer claustrophobia in the self-hypnosis group (16%; 9/55), compared with the control group (43%; 38/89; odds ratio .14; p = .001). Self-hypnosis patients also needed less sedation (2% vs 16%; 1/55 vs 14/89; odds ratio .1; p = .008) and non-sedation coping actions (13% vs 28%; 7/55 vs 25/89; odds ratio .3; p = .02). Self-hypnosis did not influence the CLQ results measured before and after MR imaging (p = .79). Self-hypnosis reduced the frequency of claustrophobia in the subgroup of patients above an established CLQ cut-off of .33 from 47% (37/78) to 18% (9/49; p = .002). In the subgroup below the CLQ cut-off of 0.33, there were no significant differences (0% vs 9%, 0/6 vs 1/11; p = 1.0). Most patients (67%; 35/52) preferred self-hypnosis for future MR examinations. Conclusions Self-hypnosis reduced claustrophobia in high-risk patients undergoing imaging in an open MR scanner and might reduce the need for sedation and non-sedation coping actions. Key Points • Forty percent of the patients at high risk for claustrophobia may also experience a claustrophobic event in an open MR scanner. • Self-hypnosis while listening to an audio in the waiting room before the examination may reduce claustrophobic events in over 50% of patients with high risk for claustrophobia. • Self-hypnosis may also reduce the need for sedation and other time-consuming non-sedation coping actions and is preferred by high-risk patients for future examinations.

scholarly journals How does participation in a voluntary prize exam affect medical students’ knowledge and interest in ENT, plastic surgery, ophthalmology and dermatology?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Razan Nour ◽  
Kerry Jobling ◽  
Alasdair Mayer ◽  
Salma Babikir
Keyword(s):  
Medical Students ◽  
Plastic Surgery ◽  
Pilot Project ◽  
Junior Doctors ◽  
Free Text ◽  
Medical Specialties ◽  
Spare Time ◽  
Before And After ◽  
To Receive ◽  
Interest And Knowledge

Abstract Background Otolaryngology (ENT), plastic surgery, ophthalmology and dermatology are medical specialties which tend to receive less coverage in UK medical school curricula compared to larger, generalist specialties. As a result, there are fewer opportunities for medical students to learn and to cultivate an interest. There are numerous papers that report concerns about junior doctors’ ability to manage conditions within these specialties, which may jeopardise patient safety. The aim of our pilot project was to increase medical students’ interest and knowledge of ENT, plastic surgery, ophthalmology and dermatology. In addition to describing our project, we present and discuss literature on UK undergraduate education in these specialties and its impact on preparedness of junior doctors and future career choices. Methods One hundred twelve final year medical students at Newcastle University were invited to take part in a voluntary two-part (written and clinical) exam, in which prizes could be won and all participants would receive a certificate of participation. We distributed two online surveys to the students, one administered before the exam and one afterwards. Data was collected regarding the students’ motivation for entering the prize exam and the students’ baseline interest and knowledge in these specialties before and after the prize exam. Free-text responses were collected about the students’ opinion of the project and whether participation was beneficial. Results Sixteen students participated in the exam. There was a statistically significant increase in the students’ knowledge in ENT (p < 0.000), plastic surgery (p < 0.000), ophthalmology (p < 0.028) and dermatology (p < 0.012) after participation in the exam, but not in their interest levels. ENT was the preferred specialty of our cohort. The students reported that they found participation beneficial to their learning, particularly receiving exam feedback and explanations to exam questions. Conclusions This pilot project was a useful intervention in increasing medical students’ knowledge in these specialties, but not in their levels of interest. It also demonstrates that medical students are willing to participate in voluntary initiatives (in their spare time) to gain more learning opportunities and that medical students value timely exam feedback to guide their revision.

scholarly journals Simulation-based Training for Pelvic and Breast Physical Examination: Effect on the Anxiety and Self-confidence of Medical Students

2020 ◽  
Vol 42 (11) ◽  
pp. 739-745
Author(s):  
Talles Dias Orsi ◽  
Ana Lucia Ribeiro Valadares ◽  
Paula Miranda Esteves Orsi ◽  
Isabella Miranda Esteves Orsi ◽  
Alexandre Sampaio Moura
Keyword(s):  
Medical Students ◽  
Self Report ◽  
Student Anxiety ◽  
Factors Associated ◽  
Confidence Levels ◽  
Learning Satisfaction ◽  
Self Confidence ◽  
Breast Examination ◽  
Simulation Based ◽  
Before And After

Abstract Objective To evaluate factors associated with anxiety and the effect of simulation-based training (SBT) on student anxiety, self-confidence and learning satisfaction in relation to pelvic and breast examination. Methods A longitudinal study was conducted with 4th year medical students at the Universidade José do Rosário Vellano. A 12-item, self-report questionnaire on student anxiety at performing gynecological examinations was applied before and after SBT, with answers being given on a Likert-type scale. After training, the self-confidence levels and satisfaction of the students related to the learning process were also evaluated. Results Eighty students with a mean age of 24.1 ± 4.2 years were included in the study. Of these, 62.5% were women. Pre-SBT evaluation showed that students were more anxious at performing a pelvic examination than a breast examination (2.4 ± 1.0 versus 1.7 ± 0.8, respectively; p < 0.001). The primary reason for anxiety regarding both pelvic and breast examination was fear of hurting the patient. SBT significantly reduced student anxiety (2.0 ± 0.8 versus 1.5 ± 0.5, respectively; p < 0.001). The satisfaction and self-confidence of the students were found to be high (6.8 ± 0.3 and 6.0 ± 0.9, respectively), with no difference between genders. Conclusion The use of SBT in teaching students to perform pelvic and breast examinations resulted in reduced anxiety and increased self-confidence in a group of medical students of both genders, with high levels of satisfaction in relation to the training.

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