Professional learning needs in using video calls identified through workshops

BACKGROUND: Most people want to die at home but only half do. Supporting patients in rural locations is challenging. Video calls such as Skype, might help but are not routinely used; we should consider learning needs to increase uptake and ensure effective use. We aimed to identify learning needs of healthcare professionals (HCPs) in using video calls to support patients (and their carers) to die at home. METHODS: Face-to-face workshops were held in five Southwest England locations. Participants discussed advantages, disadvantages, scenarios for use, and the learning needs of video call users. Ideas were documented on flipcharts and discussions audio-recorded. The 116 participants included nurses, allied HCPs, doctors and previously bereaved volunteers. Lists of advantages, disadvantages, scenarios and learning needs were compiled and circulated to participants. In a subsequent online workshop, 21 participants ranked seven groups of learning needs in priority order. RESULTS: Most participants thought video calls could be used to advantage in many end-of-life scenarios, especially in rural areas. Seven themes, covering 59 learning needs for HCPs, were identified (in priority order): (i) confidence and technical ability in using video calls; (ii) being aware of how video calls fit into clinical practice; (iii) managing video calls; (iv) communication skills on ‘camera’; (v) understanding how patients and families may be affected by video call use; (vi) presenting video calls as an option to patients and families to assess their readiness; (vii) normal professional skills that become essential for effective video calls. CONCLUSIONS: Although almost ubiquitous, video call software is not routinely and effectively used in British clinical practice. Supporting patients and families at end-of-life is one example where it could be used to advantage, but clinicians need to plan and practise before using it in real situations. Learning needs were identified that could be developed into learning modules and/or courses. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-016-0657-6) contains supplementary material, which is available to authorized users

The Stoic paradox: freedom of determined action

The work deals with the problem of freedom in the theory of the early Stoics (3. c. BC) which has been a controversial issue since antiquity up to this very day. In its three parts the author examines basic aspects of this problem in order to offer his own interpretation. The first part tackles the question of action and responsibility being thus an introduction to the whole problem which in this light reveals its paradoxical form: on the one hand, the Stoics teach "fatal" determination of all motion, on the other, they defend human responsibility pointing at the specific faculty of human soul - the assent. In the second part, the author offers an analysis of the Stoic notion of reason in the full scope of its different characterizations as collection of concepts, as inner language and as specific structure of the motion of human soul. On the basis of an attempt to bring these definition together as complementary perspectives, the interpretation of the Stoic assent is proposed showing that it is to be understood as reflective turn of the reason towards itself. This claim aims also at solving the paradox of the assent - determined and autonomous in the same time: the assent is autonomous only insofar as it represents reason giving approval to its own interpretation of the world; it is however not autonomous..