Strengthening Your Surgical Hand: Strengths-Based Profiling and Coaching of Surgical Trainees

Introduction As scientific and professional disciplines, medicine and surgery have a tendency to focus on deficiencies, namely what trainees do not know or are not good at doing. The philosophy of Positive Psychology and the notion of “Strengths” takes a different stance. It is an inherently positive process, seeing each trainee as an individual bringing a unique set of strengths to every situation. There is clear evidence from the commercial sector regarding improved performance and well-being when focusing on one's strengths. We were therefore keen to investigate its potential role in the global development of trainee surgeons. Methods Surgical trainees from Core Training 1 to Specialty Training 8 in one training region of the United Kingdom were invited to voluntarily undertake the online Strengthscope™ assessment tool. The computer-generated report was reviewed by an Occupational Psychologist and trainees were then invited to have a strengths-focused feedback discussion on that report, either face-to-face or via telephone. Results Thirty four surgical trainees ranging from CT1 to ST6 completed the tool and 28 undertook the voluntary feedback sessions. Decisiveness, self-improvement, efficiency, emotional control and critical thinking were common strengths identified. Less commonly represented were leading, creativity and developing others. Trainees found that the tool and feedback helped them identify their strengths and embrace them, rather than fitting the surgical mould. It further aided the recognition of strengths in-overdrive and for some trainees it helped explain difficulties they had experienced in previous jobs. It provided insight into individual motivations and character whilst also highlighting how others in the workplace might perceive them. Trainees liked the emphasis on the building up of positive attributes and utilizing innate skills and strengths. The feedback consultation from an accredited coach trained in the Strengthscope™ tool was judged by trainees to be crucial to a full understanding of the report and its potential implications. Conclusions Surgical trainees have a wide range of strengths which, if identified and focused upon, could help them to fulfil their greatest potential at work. Strengthscope™ has provided new insights into the range of skills and talents of surgical trainees and has a potential role in providing more advanced educational supervision and mentorship. For these trainees, the assessment and feedback discussion aided their personal and professional development, highlighting where their most significant strengths lay with a view to making their daily working lives more fulfilling and, hopefully, helping them excel.

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Email Consultations Between Patients and Doctors in Primary Care: Content Analysis

Journal of Medical Internet Research ◽

10.2196/18218 ◽

2020 ◽

Vol 22 (11) ◽

pp. e18218

Author(s):

Helen Atherton ◽

Anne-Marie Boylan ◽

Abi Eccles ◽

Joanna Fleming ◽

Clare R Goyder ◽

...

Keyword(s):

Primary Care ◽

General Practice ◽

Content Analysis ◽

Communication Technologies ◽

Face To Face ◽

The United Kingdom ◽

Wide Range ◽

The Face ◽

And Function

Background Increasingly, consultations in health care settings are conducted remotely using a range of communication technologies. Email allows for 2-way text-based communication, occurring asynchronously. Studies have explored the content and nature of email consultations to understand the use, structure, and function of email consultations. Most previous content analyses of email consultations in primary care settings have been conducted in North America, and these have shown that concerns and assumptions about how email consultations work have not been realized. There has not been a UK-based content analysis of email consultations. Objective This study aims to explore and delineate the content of consultations conducted via email in English general practice by conducting a content analysis of email consultations between general practitioners (GPs) and patients. Methods We conducted a content analysis of anonymized email consultations between GPs and patients in 2 general practices in the United Kingdom. We examined the descriptive elements of the correspondence to ascertain when the emails were sent, the number of emails in an email consultation, and the nature of the content. We used a normative approach to analyze the content of the email consultations to explore the use and function of email consultation. Results We obtained 100 email consultations from 85 patients, which totaled 262 individual emails. Most email users were older than 40 years, and over half of the users were male. The email consultations were mostly short and completed in a few days. Emails were mostly sent and received during the day. The emails were mostly clinical in content rather than administrative and covered a wide range of clinical presentations. There were 3 key themes to the use and function of the email consultations: the role of the GP and email consultation, the transactional nature of an email consultation, and the operationalization of an email consultation. Conclusions Most cases where emails are used to have a consultation with a patient in general practice have a shorter consultation, are clinical in nature, and are resolved quickly. GPs approach email consultations using key elements similar to that of the face-to-face consultation; however, using email consultations has the potential to alter the role of the GP, leading them to engage in more administrative tasks than usual. Email consultations were not a replacement for face-to-face consultations.

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What is meant by adaptability in buildings?

Facilities ◽

10.1108/f-07-2015-0053 ◽

2017 ◽

Vol 35 (1/2) ◽

pp. 2-20 ◽

Cited By ~ 6

Author(s):

James A. Pinder ◽

Rob Schmidt ◽

Simon A. Austin ◽

Alistair Gibb ◽

Jim Saker

Keyword(s):

Built Environment ◽

Construction Industry ◽

Design Methodology ◽

Qualitative Data ◽

Content Type ◽

Face To Face ◽

Wide Range ◽

Common Term ◽

Professional Disciplines ◽

Practical Implications

Purpose Despite being a common term in the literature, there is little agreement about what the word “adaptability” means in the context of the built environment and very little evidence regarding practitioners’ understanding of adaptability. This paper aims to examine what practitioners in the building industry mean when they talk about “adaptability”. Design/methodology/approach This study adopted a qualitative approach, involving 82 unstructured face-to-face interviews with practitioners from a range of professional disciplines in the construction industry, including architects, engineers, facilities managers, property agents and planners. The interview transcripts were coded inductively to identify themes in the qualitative data. Findings The interview data revealed a wide range of perspectives on adaptability, particularly regarding terminology, the meanings practitioners associate with adaptability and the way in which these meanings are communicated to others in the industry. The applied meaning of adaptability varied depending on context. Practical implications Conflicting language, and different interpretations of adaptability, is a potential barrier to the development of adaptable buildings. A clearer articulation of the meaning of adaptability (particularly by clients) during briefing and design could give rise to a more appropriate level of adaptability in the built environment. Originality/value This study has addressed a gap in the existing literature by foregrounding the voices of industry practitioners and exploring their (sometimes very different) interpretations of adaptability in buildings.

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370 Evaluating Knowledge of Common Surgical Instruments During Early Surgical Training in the United Kingdom: A Call for Formalised Training?

British Journal of Surgery ◽

10.1093/bjs/znab259.850 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

C Chang ◽

S Munro

Keyword(s):

Surgical Instruments ◽

Formal Training ◽

Surgical Instrument ◽

Multiple Choice Questions ◽

Barriers To Learning ◽

The United Kingdom ◽

Surgical Trainees ◽

Short Course ◽

Level Of Knowledge ◽

Improved Performance

Abstract Aim Knowledge of surgical instruments and their use is essential to effective surgical practice, enabling efficient task-specific utilisation and promoting clear intraoperative communication; thus, reducing the risk of error. However, variations in surgical instruments across different specialities and eponymous names can pose barriers to learning for early surgical trainees. There is a paucity of data on surgical instrument knowledge among early surgical trainees, and their knowledge acquisition route. Method questionnaire was distributed among early surgical trainees (ST3 and below) between 18 August 2020 and 18 November 2020 across various UK regions. Respondents were asked to answer ten multiple-choice questions to assess their surgical instrument knowledge levels. Respondents were also asked about their training level, experience, and opinion regarding formal surgical instrument teaching. Results Thirty-seven trainees responded to the questionnaire. The majority (81%) received no formal surgical instrument training. Most respondents (96%) feel they would benefit from formal training. The average test score was 50%. There was no evidence of improved performance with formal training, though the formal training received averaged less than one hour. Higher scores were associated with increased seniority and training years, indicating most trainees are learning ‘on-the-job‘. Conclusions There is generally an unsatisfactory level of knowledge in surgical instruments in early surgical trainees. Trainees have also overwhelmingly indicated a desire for formalised training on surgical instruments. The authors believe the lack of formal training may contribute to this knowledge gap and intend to design a new short course to address this.

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Aging Equally? Employing Active Aging Policy in the United Kingdom

Innovation in Aging ◽

10.1093/geroni/igab046.1662 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 430-430

Author(s):

Liam Foster

Keyword(s):

Comprehensive Approach ◽

Individual Responsibility ◽

Active Ageing ◽

Aging Policy ◽

The United Kingdom ◽

Working Lives ◽

Wide Range ◽

Pension Costs ◽

The Uk ◽

Pension Benefits

Abstract The UK’s responses to the challenges of ageing have largely focused on productivist notions of active ageing, with more comprehensive responses tending to be reactive and largely remedial. This presentation will show that productivist policies, often characterised by individual responsibility, including raising the retirement age, restricting access to early retirement, and providing a stronger link between pension benefits and contributions, have incentivised remaining in the labour market. These strategies have been justified in the context of ageing populations and increasing pension costs. However, opportunities to extend working lives have not been experienced equally. In practice most policies are gender blind. Furthermore, a more comprehensive approach to active ageing in the UK needs a collective emphasis to mobilise a wide range of societal resources, underpinned by a commitment to public welfare, which is highly problematic under neo-liberalism. Therefore, a comprehensive approach to ageing in the UK requires a substantial ideological shift.

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“My little piece of the planet”: the multiplicity of well-being benefits from allotment gardening

British Food Journal ◽

10.1108/bfj-07-2020-0593 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Miriam Clare Dobson ◽

Christian Reynolds ◽

Philip H. Warren ◽

Jill L. Edmondson

Keyword(s):

Social Capital ◽

United Kingdom ◽

Knowledge Exchange ◽

Well Being ◽

Natural World ◽

Environmental Benefits ◽

Content Type ◽

Community Activities ◽

The United Kingdom ◽

Wide Range

PurposeParticipation in urban horticulture (UH) is increasing in popularity, and evidence is emerging about the wide range of social and environmental benefits “grow your own” can also provide. UH can increase mental and physical well-being, as well as improve nature connectedness, social capital and community cohesion.Design/methodology/approachThis study focusses on allotments, which is one of the dominant forms of UH that takes place in the United Kingdom. 163 volunteers in England and Wales participated in keeping a year-long allotment diary as part of a citizen science project investigating activities on allotment gardens. This study examines the unprompted comments that 96 of these gardeners offered as observations when visiting their allotment plots.FindingsParticipants recorded high levels of social and community activities including the sharing of surplus food produce, knowledge exchange, awareness and interaction with wildlife, emotional connection to their allotment, appreciation of time spent outside and aesthetic delight in the natural world around them.Originality/valueAt a time when waiting lists for allotment plots in the United Kingdom are on the rise, and allotment land is subject to multiple pressures from other forms of development, this study demonstrates that these spaces are important sites not only for food production but also health, social capital and environmental engagement.

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Host–microbiome coevolution can promote cooperation in a rock–paper–scissors dynamics

Proceedings of The Royal Society B Biological Sciences ◽

10.1098/rspb.2019.2754 ◽

2020 ◽

Vol 287 (1920) ◽

pp. 20192754 ◽

Cited By ~ 4

Author(s):

Ohad Lewin-Epstein ◽

Lilach Hadany

Keyword(s):

Potential Role ◽

Computational Modelling ◽

Well Being ◽

Evolution Of Cooperation ◽

Wide Range ◽

Forms Of Life ◽

New Perspective ◽

Almost All

Cooperation is a fundamental behaviour observed in all forms of life. The evolution of cooperation has been widely studied, but almost all theories focused on the cooperating individual and its genes. We suggest a different approach, taking into account the microbes carried by the interacting individuals. Accumulating evidence reveals that microbes can affect their host's well-being and behaviour, yet hosts can evolve mechanisms to resist the manipulations of their microbes. We thus propose that coevolution of microbes with their hosts may favour microbes that induce their host to cooperate. Using computational modelling, we show that microbe-induced cooperation can evolve and be maintained in a wide range of conditions, including when facing hosts' resistance to the microbial effect. We find that host–microbe coevolution leads the population to a rock–paper–scissors dynamics that enables maintenance of cooperation in a polymorphic state. Our results suggest a mechanism for the evolution and maintenance of cooperation that may be relevant to a wide variety of organisms, including cases that are difficult to explain by current theories. This study provides a new perspective on the coevolution of hosts and their microbiome, emphasizing the potential role of microbes in shaping their host's behaviour.

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Suitability and acceptability of the Carer Support Needs Assessment Tool (CSNAT) for the assessment of carers of people with MND: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-039031 ◽

2020 ◽

Vol 10 (12) ◽

pp. e039031

Author(s):

Gail Ewing ◽

Sarah Croke ◽

Christine Rowland ◽

Gunn Grande

Keyword(s):

Needs Assessment ◽

Assessment Tool ◽

Well Being ◽

Support Needs ◽

Routine Practice ◽

Wide Range ◽

Carer Support ◽

Qualitative Focus Groups ◽

Supportive Interventions ◽

Stage 1

ObjectivesMotor neurone disease (MND) is a progressive, life-limiting illness. Caregiving impacts greatly on family carers with few supportive interventions for carers. We report Stages 1 and 2 of a study to: (1) explore experiences of MND caregiving and use carer-identified support needs to determine suitability and acceptability of the Carer Support Needs Assessment Tool (CSNAT), (2) adapt the CSNAT as necessary for comprehensive assessment and support of MND carers, prior to (Stage 3) feasibility testing.DesignQualitative: focus groups, interviews and carer workshops.SettingThree UK MND specialist centres serving a wide range of areas.ParticipantsStage 1: 33 carers, 11 from each site: 19 current carers, 14 bereaved. Stage 2: 19 carer advisors: 10 bereaved, 9 current carers. Majority were spouses/partners ranging in age from under 45 years to over 75 years. Duration of caring: 4 months to 12.5 years.ResultsCarers described challenges of a disease that was terminal from the outset, of ‘chasing’ progressive deterioration, trying to balance normality and patient independence against growing dependence, and intensive involvement in caregiving. Carers had extensive support needs which could be mapped to existing CSNAT domains: both ‘enabling’ domains which identify carers’ needs as co-workers as well as carers’ ‘direct’ needs as clients in relation to their own health and well-being. Only one aspect of their caregiving experience went beyond existing domains: a new domain on support needs with relationship changes was identified to tailor the CSNAT better to MND carers.ConclusionsCarers of people with MND found the adapted CSNAT to be an appropriate and relevant tool for assessment of their support needs. The revised version has potential for assessment of carers in other longer-term caring contexts. A further paper will report the Stage 3 study on feasibility of using the adapted CSNAT in routine practice.

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Email Consultations Between Patients and Doctors in Primary Care: Content Analysis (Preprint)

10.2196/preprints.18218 ◽

2020 ◽

Author(s):

Helen Atherton ◽

Anne-Marie Boylan ◽

Abi Eccles ◽

Joanna Fleming ◽

Clare R Goyder ◽

...

Keyword(s):

Primary Care ◽

General Practice ◽

Content Analysis ◽

Communication Technologies ◽

Face To Face ◽

The United Kingdom ◽

Wide Range ◽

The Face ◽

And Function

BACKGROUND Increasingly, consultations in health care settings are conducted remotely using a range of communication technologies. Email allows for 2-way text-based communication, occurring asynchronously. Studies have explored the content and nature of email consultations to understand the use, structure, and function of email consultations. Most previous content analyses of email consultations in primary care settings have been conducted in North America, and these have shown that concerns and assumptions about how email consultations work have not been realized. There has not been a UK-based content analysis of email consultations. OBJECTIVE This study aims to explore and delineate the content of consultations conducted via email in English general practice by conducting a content analysis of email consultations between general practitioners (GPs) and patients. METHODS We conducted a content analysis of anonymized email consultations between GPs and patients in 2 general practices in the United Kingdom. We examined the descriptive elements of the correspondence to ascertain when the emails were sent, the number of emails in an email consultation, and the nature of the content. We used a normative approach to analyze the content of the email consultations to explore the use and function of email consultation. RESULTS We obtained 100 email consultations from 85 patients, which totaled 262 individual emails. Most email users were older than 40 years, and over half of the users were male. The email consultations were mostly short and completed in a few days. Emails were mostly sent and received during the day. The emails were mostly clinical in content rather than administrative and covered a wide range of clinical presentations. There were 3 key themes to the use and function of the email consultations: the role of the GP and email consultation, the transactional nature of an email consultation, and the operationalization of an email consultation. CONCLUSIONS Most cases where emails are used to have a consultation with a patient in general practice have a shorter consultation, are clinical in nature, and are resolved quickly. GPs approach email consultations using key elements similar to that of the face-to-face consultation; however, using email consultations has the potential to alter the role of the GP, leading them to engage in more administrative tasks than usual. Email consultations were not a replacement for face-to-face consultations.

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Video hospice consultation in COVID-19: professional and patient evaluations

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002861 ◽

2021 ◽

pp. bmjspcare-2020-002861

Author(s):

Shannon Milne ◽

Jennifer Palfrey ◽

Jane Berg ◽

Jennifer Todd

Keyword(s):

Healthcare Professional ◽

Family Member ◽

Well Being ◽

Service Evaluation ◽

Face To Face ◽

Multiple Group ◽

Wide Range ◽

To Receive ◽

Improve Access ◽

Rapid Shift

BackgroundProviding care for our patients during the COVID-19 pandemic required a rapid shift to video consultations (VCs). A service evaluation was performed to capture hospice professionals’ (HPs) and patients’ experiences of VC.MethodsOnline or postal surveys were sent to HPs and patients, who had participated in VC between March and July 2020, focusing on their experience and satisfaction with the service.Results31 responses from HPs were received. 19 (61.3%) rated their experience of VC as good, despite 29 (93.5%) having no prior VC experience. One-third of HPs had undertaken potentially sensitive consultations, including resuscitation discussions. 23 (74.2%) undertook a VC that included a family member and 18 (58.1%) had included an external healthcare professional. 25 (80.6%) wanted to offer VC as an option going forward. Well-being staff successfully provided multiple group support sessions via video. 26 responses from patients (23) and carers (3) were received. 22 (84.6%) had access to a smartphone. 8 (30.8%) included a family member in their consultation. All patients/carers reported satisfaction with their VC, although 10 (38.5%) expressed a preference for face-to-face consultations. 22 (84.6%) patients would be happy to receive care via VC going forward and 21 (80.8%) stated they would recommend the use of VC to others.ConclusionPatients reported VC to be an acceptable way to receive support from a hospice service and HPs would like to continue to offer VC in the future. VC can be offered as an alternative to face-to-face consultations with the potential to continue and improve access to a wide range of hospice services.

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CODEM Instrument

GeroPsych ◽

10.1024/1662-9647/a000100 ◽

2014 ◽

Vol 27 (1) ◽

pp. 23-31 ◽

Cited By ~ 4

Author(s):

Anne Kuemmel (This author contributed eq ◽

Julia Haberstroh (This author contributed ◽

Johannes Pantel

Keyword(s):

Convergent Validity ◽

Interrater Reliability ◽

Discriminant Validity ◽

Assessment Tool ◽

Intraclass Correlation ◽

Well Being ◽

Communication Behavior ◽

People With Dementia ◽

Pearson's R ◽

Pearson’S R

Communication and communication behaviors in situational contexts are essential conditions for well-being and quality of life in people with dementia. Measuring methods, however, are limited. The CODEM instrument, a standardized observational communication behavior assessment tool, was developed and evaluated on the basis of the current state of research in dementia care and social-communicative behavior. Initially, interrater reliability was examined by means of videoratings (N = 10 people with dementia). Thereupon, six caregivers in six German nursing homes observed 69 residents suffering from dementia and used CODEM to rate their communication behavior. The interrater reliability of CODEM was excellent (mean κ = .79; intraclass correlation = .91). Statistical analysis indicated that CODEM had excellent internal consistency (Cronbach’s α = .95). CODEM also showed excellent convergent validity (Pearson’s R = .88) as well as discriminant validity (Pearson’s R = .63). Confirmatory factor analysis verified the two-factor solution of verbal/content aspects and nonverbal/relationship aspects. With regard to the severity of the disease, the content and relational aspects of communication exhibited different trends. CODEM proved to be a reliable, valid, and sensitive assessment tool for examining communication behavior in the field of dementia. CODEM also provides researchers a feasible examination tool for measuring effects of psychosocial intervention studies that strive to improve communication behavior and well-being in dementia.

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