The Practice and the Pressure to Progress

As one of the most traditional professions, the practice of law has been slower than most to adapt to technological advances and recognize the impact on the changing nature of work for attorneys. Only two state bar associations currently require continuing legal education in technology. New York's bar association has recommended mandatory training in cybersecurity; however, it would comprise only 1 credit within the Ethics & Professionalism Continuing Legal Education (CLE) requirements. This chapter will explore the negative “domino effect” that disregarding or underestimating the power of technology in both legal education and practice can have on access, diversity, and ultimately justice. By presenting the evidence here, perhaps the profession through its many and varied institutions and organizations can finally turn against the tide of tradition. The profession and its oversight bodies must look farther back in the pathway to practice to re-imagine legal education and embrace that which is now possible through technology and innovative teaching and learning methods.

Basic Life Support Awareness in Pakistan: Still in Embryonic Phase

Objectives: To gauge/evaluate the knowledge and skill of BLS trained and untrained teaching faculty members at postgraduate tertiary care training institute Materials and Methods: A prevalidated questionnaire comprising of 44 questions was distributed among teaching faculty of three big tertiary care, post-graduate institutes. The questions were focused on evaluating the knowledge and awareness of the participants. Total number of the participants was 345 Statistical Analysis: Data was entered and analyzed by using SPSS (version 23.0). Results: The mean knowledge score related to basic life support was 4.57±1.81 out of total 12 points and the mean score for level of awareness regarding BLS was 34.5 %. Moreover, only 28.15% were aware of the current AHA guidelines Conclusion: The low level of knowledge and awareness regarding BLS in the health care workers depicts that regular BLS hands-on- workshops should be conducted and should be a part of mandatory training.

Lean Six Sigma Redesign of a Process for Healthcare Mandatory Education in Basic Life Support—A Pilot Study

Healthcare staff are required to undertake mandatory training programs to ensure they maintain key clinical competencies. This study was conducted in a private hospital in Ireland, where the processes for accessing mandatory training were found to be highly complex and non-user friendly, resulting in missed training opportunities, specific training license expiration, and underutilized training slots which resulted in lost time for both the trainers and trainees. A pilot study was undertaken to review the process for accessing mandatory training with a focus on the mandatory training program of Basic Life Support (BLS). This was chosen due to its importance in patient resuscitation and its requirement in the hospital achieving Joint Commission International (JCI) accreditation. A pre- and post-team-based intervention design was used with Lean Six Sigma (LSS) methodology employed to redesign the process of booking, scheduling, and delivery of BLS training leading to staff individual BLS certification for a period of two years. The redesign of the BLS training program resulted in a new blended delivery method, and the initiation of a pilot project led to a 50% increase in the volume of BLS classes and a time saving of 154 h 30 min for staff and 48 h 14 min for BLS instructors. The success of the BLS process access pilot has functioned as a platform for the redesign of other mandatory education programs and will be of interest to hospitals with mandatory training requirements that are already facing healthcare challenges and demands on staff time.

THE QUESTION OF THE MOTIVATIONAL COMPONENT IN SCIENTIFIC ACTIVITIES OF CADETS AT HIGHER EDUCATION INSTITUTIONS OF THE FEDERAL PENITENTIARY SERVICE OF RUSSIA: ANALYSIS OF PROBLEMS AND DEVELOPMENT PROSPECTS

В статье исследуются состояние и особенности мотивации курсантов вуза ФСИН России, оказывающие влияние на вовлеченность в научно-исследовательскую деятельность, затрудняющие активизацию познавательной активности. Рассматривается роль научно-исследовательской деятельности (дополняющей учебный процесс) в формировании инновационной образовательной среды в вузе. Именно в ней авторы усматривают весомый ресурс, позволяющий формировать необходимые компетенции для дальнейшей профессиональной деятельности. В статье приводятся результаты проведенного опроса курсантов Самарского юридического института ФСИН России с использованием разработанной авторами анкеты. С целью поиска путей активизации научно-исследовательской деятельности в стенах ведомственного вуза авторы исследовали некоторые аспекты ценностно-мотивационных установок курсантов 1-4 курсов, провели анализ основных факторов, определяющих значимость данного вида работы в среде обучаемых, тенденций и проблем на пути реализации поставленной цели. Авторы приходят к выводу, что привычные механизмы вовлечения обучающихся в исследовательскую деятельность недостаточно задействуют компонент личностной заинтересованности курсантов, а также обращают внимание на превалирование ситуативной мотивации у обучающихся в данном виде деятельности, нарастающую демотивированность к старшим курсам. Следовательно, для поддержания и повышения мотивации обучающихся заниматься научным творчеством необходимо привлекать дополнительные инновационные возможности. Одним из перспективных путей укрепления мотивационной составляющей научно-исследовательской деятельности обучающихся, активизирующим научный потенциал личности, по мнению авторов, может являться организация в вузе проектной деятельности. The article examines the state and features of the motivation of cadets of the Federal Penitentiary Service of Russia, which affect the involvement in scientific activities, making it difficult to activate cognitive activity. The role of scientific activities (in addition to the mandatory training program) in the formation of an innovative educational environment at the institute is considered. The authors see a significant resource that allows them to form the necessary competencies for further professional activity. The article presents the results of a survey of cadets of Samara Law Institute of the Federal Penitentiary Service of Russia using a questionnaire developed by the authors. In order to find ways to activate scientific activities within a departmental educational institution, the authors investigated some aspects of the value-motivational attitudes of cadets of the 1-4 year of education, analyzed the main factors determining the importance of this type of work among cadets, trends and problems on the way to achieving this goal. The authors come to the conclusion that the usual mechanisms of involving cadets in scientific activities do not sufficiently affect the component of personal interest of young scientists. They pay attention to the prevalence of situational motivation among cadets in this type of activity, increasing demotivation to senior years of education. One of the promising ways to strengthen the motivational component of cadets' scientific activities, which activates the scientific potential of the individual, according to the authors, can be the organization of systematic activities in the direction of project management at the institute.

1340 Is Displaying Mandated Information in Clinic Harming Patient and Society?

Aim The CQC has mandated certain pieces of information are displayed in a clinic and the staff know where to find them. This is in addition to the mandatory training that staff members undergo with increasing repetition. The UK Armed Forces is no exception to this, in addition wall space is often used as opportunistic education for patients. Method We counted the number of posters that were displayed in a CQC good, rated clinic, worked out the average cost to produce, produced a questionnaire of staff and patients to see how many times people engaged with the information and the carbon footprint of compliance. We looked timed how long it took for someone new to the clinic to spot the lifesaving information. Results 140 items of literature took on average 65 minutes ±240 to produce, with an average of 9 pages per item ±190. Average cost was 10 pence per page when lamination was included, totalling £126. At 6000kg CO2/paper page and 1500kg CO2/laminate page, the total carbon footprint was 9,450,000 Kg CO2. Staff members engaged zero times with the literature and only one patient engaged. The time to spot the critical information in a clean room was 0.8 second, in a normal clinic room was 4.3 seconds. Conclusions Distractions can be detrimental in emergency situations and with human factors interplay this can cost people their lives. A 3.5 second delay may seem inconsequential but compounded could be devastating. The cost and Carbon footprint is extraordinary for little benefit.

751 Improving Engagement with Home-Based Surgical Skills Simulation

Introduction Surgical simulation has been repeatedly shown to facilitate technical skill acquisition. However, trainee engagement with self-directed practice remains variable, despite access to resources. Understanding the motivators and barriers to participation is crucial to develop modules which can effectively meet the learning needs of current, and future, surgical trainees. The aim of this qualitative study was to examine factors which influence trainee engagement with home-based surgical skills simulation. Method A series of one-to-one semi-structured interviews were conducted remotely with ST3 vascular trainees who had previously consented to take part in a national programme of home-based technical skills simulation. Interview data was transcribed and thematically analysed. Results 12 trainees were interviewed during a 4-week period. Overall, trainees valued simulation but found it difficult to balance against clinical commitments and mandatory training requirements, particularly if there were limited opportunities for skill transfer to the real-world environment. Although simulation was acknowledged to be a safe environment for experiential learning, trainees alluded to an underlying culture of perfection which limited willingness to learn from mistakes, even within a simulated setting. In addition, traditional attitudes about the apprenticeship model of surgical training prevail, with simulation often viewed as inferior to learning “on the job” in theatre. Conclusions Trainee engagement with home-based surgical skills simulation may be influenced by a range of systemic factors. In future, formal certification of simulation modules, mandating simulated competencies and curricular integration may help improve participation, as well as supporting cultural shift towards recognition of simulation as a vital component of modern surgical training.

Hindrance and Benefits to Green Building Implementation: Evidence from Benin City, Nigeria

The clamor for sustainable development and reduction of greenhouse gases led to the green concept which, in recent times, has gained significant momentum. To encourage the widespread development of green buildings, an understanding of the awareness, benefits, and hindrances for their adoption is necessary. This is relevant now that concerns over climate change have led to an increasing global demand for sustainability within the built environment. While the discourse is still rather muted in Nigeria, this study will contribute to the ongoing effort to raise public awareness regarding green building development and the potential benefits by evaluating the opinion of professionals regarding the subject matter. Structured questionnaires were distributed among five different professions in the built environment and information sourced includes the level/mode of awareness, benefits and bottleneck, and support for its development. The survey results showed that 43.48% of the professionals advocated for the development of green construction in Nigeria. The benefits and bottlenecks were ranked according to their perceived importance. The study recommends public enlightenment on green education, enforcement of mandatory training, formulation and implementation of policies directed towards green building acceptability. This will help promote and protect the built environment, and reduce health hazards posed by conventional development.

Developing and piloting a simulated placement experience for students

COVID-19 and rising student numbers are affecting healthcare education, particularly access to clinical placements. As healthcare education is increasingly supported by technology and non-traditional teaching methods, educational experiences gained through clinical placement also require new approaches. This article explores and discusses the use of a simulated clinical placement for a dietetic student cohort. During this virtual placement, students were able to explore and experience a virtual clinical setting and immerse themselves in a placement experience. A vast range of virtual resources were linked to the online placement portal, including statutory and mandatory training, dietetic resources, patient journeys and interprofessional communication. Advantages of this approach include that all students experience a given situation, unlike in traditional placements where workloads, variety and engagement vary; there is also no risk to patient safety. The aim is to enhance the learning experience to create effective, efficient clinicians. This virtual placement for dietetics is part of a bigger project to develop and evaluate the use of a virtual placement framework in a range of professions. The concept of virtual placement may have been brought forward by the COVID-19 crisis but was inevitable with the move to more technology-enhanced learning tools.

Prospective oversight and approval of assisted dying cases in Victoria, Australia: a qualitative study of doctors’ perspectives

BackgroundAssisted dying (AD) is increasingly becoming lawful internationally. While all AD models have oversight mechanisms, Victoria, Australia is rare in requiring formal approval before AD is permitted. Other jurisdictions are now enacting or implementing prospective approval models yet little is known about their operation. This paper reports the first empirical research internationally analysing the operation of a prospective approval model.MethodsThis qualitative study recruited doctors involved in providing lawful AD during the first year of the Victorian AD system. Recruitment occurred through the mandatory training doctors providing AD must undertake. Semistructured interviews were undertaken predominantly through Zoom conferencing, transcribed and thematically analysed.Results32 doctors from diverse specialties (including general practice) and diverse AD experiences were interviewed. Six themes were identified: (1) The primary gatekeeping to AD in practice was by the administrative Secretariat of the oversight body, the Voluntary Assisted Dying Review Board, and not the government department who issues the final ‘permit’; this may not have been intended by parliament. (2) The prospective oversight and approval process was bureaucratic and (3) the mandatory online system to manage AD was a barrier. (4) These factors caused unnecessary delays which (5) impeded AD for very sick patients. (6) However, this prospective process protected doctors and ensured system safety.ConclusionsPotential barriers to accessing AD posed by prospective approval should be evaluated carefully by jurisdictions implementing or considering such a model. Attention is needed not only to law but to system design and how AD is implemented in practice.

Evaluating service user & carer experience of videoconferencing software during COVID-19 pandemic

AimsTo evaluate service user and carer experience of use of videoconferencing software (Microsoft Teams) during MDT meetings.To identify specific areas for improvementTo make changes based on these recommendationsMethod2 surveys were distributed to inpatients and their carers on a functional Older Adults inpatient ward (n = 21), including quantitative and qualitiative questions. The results from these were compiled, and on review, mutliple recommendations for improvement were made.Result90% of service users find it helpful to have family present over videoconferencing software during their MDT meetings, and 91% of carers feel involved and able to contribute when they do join in this way81% of carers have the technology available at home to use such software, but only 55% of them feel confident using it. 73% need more information on its use.60% of carers referenced poor staff skills with software as a barrier to its use, and 60% referenced poor organisation of meetings2 service users raised issue with the size of a small laptop screen not allowing them to see who was actually present over MS Teams, although none were concerned with issues around confidentiality and the use of such softwareSeveral service users, carers and members of community teams identified poor sound quality as an issue, both when joining over the software, and when present in the room.ConclusionWidespread use of videoconferencing software such as MS Teams is likely to continue beyond the end of the COVID-19 pandemic. Through discussion with the ward team, the IT department, the training department, and the local council, multiple changes were made to the service, as below. These form a recommended list of areas for improvement in other services.Availability of videoconferencing equipment (in addition to laptop)Dedicated videoconferencing microphone/speaker to improve sound qualityDisplay screenWebcamOrganisation of meetingsDesignating a chairperson to admit and introduce all participantsDesignating a meeting organiser to invite all necessary participantsStaff skillsLocal audit of staff familiarity with softwareIntroduction of mandatory training for staff on use of softwareCarer skills & access to equipmentInformation and support available from well-trained staffLiaison with other organisations including council and third sector about availablity of equipment loans and training for carers