Superhuman? Perceptions of accelerated students and graduates working in health care

Background: Accelerated university courses were developed in response to consumer demand and educational advances, yet a lack of research exists related to the impact of accelerated health care courses in the United Kingdom. Objectives: This study explored clinicians' perceptions of accelerated pre-registration courses in physiotherapy. Method: Senior clinicians were recruited by purposive sampling from several National Health Service hospitals across northeast England. Data from face-to-face semi-structured interviews were recorded, transcribed verbatim and analysed using Interpretive Phenomenological Analysis. Findings: Findings from fourteen participants indicated their admiration of accelerated students’ attributes to complete what they considered to be an intense and in-depth course. Such graduates were described as ‘superhuman.’ Participants noted that accelerated graduates were likely to ‘hit the ground running’ in clinical settings. However, concerns were raised that some accelerated graduates' over-confidence affected team dynamics and/or affected some aspects of clinical reasoning. Conclusions: Participants valued the varied routes to graduation while recognising their strengths and limitations. Findings from the study suggested the need for different types of clinical supervision to support each route

The effects of pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: protocol for a randomised controlled trial

BACKGROUND: Non-cystic fibrosis bronchiectasis is characterised by sputum production, exercise limitation and recurrent infections. Although pulmonary rehabilitation is advocated for this patient group, its effects are unclear. The aims of this study are to determine the short and long term effects of pulmonary rehabilitation on exercise capacity, cough, quality of life and the incidence of acute pulmonary exacerbations. METHODS/DESIGN: This randomised controlled trial aims to recruit 64 patients with bronchiectasis from three tertiary institutions. Participants will be randomly allocated to the intervention group (supervised, twice weekly exercise training with regular review of airway clearance therapy) or a control group (twice weekly telephone support). Measurements will be taken at baseline, immediately following the intervention and at six and 12 months following the intervention period by a blinded assessor. Exercise capacity will be measured using the incremental shuttle walk test and the six-minute walk test. Quality of life and health status will be measured using the Chronic Respiratory Questionnaire, Leicester Cough Questionnaire, Assessment of Quality of Life Questionnaire and the Hospital Anxiety and Depression Scale. The rate of hospitalisation will be captured as well as the incidence of acute pulmonary exacerbations using a daily symptom diary. DISCUSSION: Results from this study will help to determine the efficacy of supervised twice-weekly pulmonary rehabilitation upon exercise capacity and quality of life in patients with bronchiectasis and will contribute to clinical practice guidelines for physiotherapists in the management of this population. TRIAL REGISTRATION: This study protocol is registered with ClinicalTrials.gov (NCT00885521)

ECFS best practice guidelines: the 2018 revision

Developments in managing CF continue to drive dramatic improvements in survival. As newborn screening rolls-out across Europe, CF centres are increasingly caring for cohorts of patients who have minimal lung disease on diagnosis. With the introduction of mutation-specific therapies and the prospect of truly personalised medicine, patients have the potential to enjoy good quality of life in adulthood with ever-increasing life expectancy. The landmark Standards of Care published in 2005 set out what high quality CF care is and how it can be delivered throughout Europe. This underwent a fundamental re-write in 2014, resulting in three documents; center framework, quality management and best practice guidelines. This document is a revision of the latter, updating standards for best practice in key aspects of CF care, in the context of a fast-moving and dynamic field. In continuing to give a broad overview of the standards expected for newborn screening, diagnosis, preventative treatment of lung disease, nutrition, complications, transplant/end of life care and psychological support, this consensus on best practice is expected to prove useful to clinical teams both in countries where CF care is developing and those with established CF centres. The document is an ECFS product and endorsed by the CF Network in ERN LUNG and CF Europe

Occupational Therapy and Physiotherapy: Similar, but separate

Three articles were published in the 1998 volume of the British Journal of Occupational Therapy which dealt with the issue of professional boundaries and role overlap between occupational therapy and physiotherapy. There has also been some recent debate on the same topic in the USA and Canada. This paper discusses issues related to the perceived professional role overlap between occupational therapy and physiotherapy. The implications for occupational therapy are discussed and recommendations are made