"I couldn't do this with opposition from my colleagues": A qualitative study of physicians' experiences as clinical tutors

<p>Abstract</p> <p>Background</p> <p>Clinical contact in the early curriculum and workplace learning with active tutorship are important parts of modern medical education. In a previously published study, we found that medical students' tutors experienced a heavier workload, less reasonable demands and less encouragement, than students. The aim of this interview study was to further illuminate physicians' experiences as clinical tutors.</p> <p>Methods</p> <p>Twelve tutors in the Early Professional Contact course were interviewed. In the explorative interviews, they were asked to reflect upon their experiences of working as tutors in this course. Systematic text condensation was used as the analysis method.</p> <p>Results</p> <p>In the analysis, five main themes of physicians' experiences as clinical tutors in the medical education emerged: <it>(a) Pleasure and stimulation</it>. Informants appreciated tutorship and meeting both students and fellow tutors, <it>(b) Disappointment and stagnation</it>. Occasionally, tutors were frustrated and expressed negative feelings, <it>(c) Demands and duty</it>. Informants articulated an ambition to give students their best; a desire to provide better medical education but also a duty to meet demands of the course management, <it>(d) Impact of workplace relations</it>. Tutoring was made easier when the clinic's management provided active support and colleagues accepted students at the clinic, and <it>(e) Multitasking difficulties</it>. Combining several duties with those of a tutorship was often reported as difficult.</p> <p>Conclusions</p> <p>It is important that tutors' tasks are given adequate time, support and preparation. Accordingly, it appears highly important to avoid multitasking and too heavy a workload among tutors in order to facilitate tutoring. A crucial factor is acceptance and active organizational support from the clinic's management. This implies that tutoring by workplace learning in medical education should play an integrated and accepted role in the healthcare system.</p

Communication as a non-technical skill in the operating room: A qualitative study

Aim: The aim of this study was to explore how operating room nurses (ORNs) experience operating room (OR) team communication concerning non-technical skills. Design: Based on the Scrub Practitioners List of Intraoperative Non-Technical Skill (SPLINTS), qualitative individual in-depth semi-structured interviews were conducted with 11 ORNs in a Norwegian university hospital. Braun and Clarke's six analytic phases for thematic data analysis were used. Results: Surgeons being unprepared or demanding different instruments than the preoperative information indicates, cause stress and frustration. So does noise and brusquely or poor communication. Ensuring good information flow within the entire team is important. When silence is required, the ORNs communicate with gestures, looks and nods. Creating a positive and secure team culture facilitates discussions, questions and information sharing. Conclusion: Inappropriate dynamics, inaccurate and/or disrespectful communication and noise may reduce patient safety. Interdisciplinary team training may bring attention to the value of communication as a non-technical skill.publishedVersio

Effects of maternal inhalation of carbon black nanoparticles on reproductive and fertility parameters in a four-generation study of male mice

Abstract Background Previous findings indicate that in utero exposure to nanoparticles may affect the reproductive system in male offspring. Effects such as decreased sperm counts and testicular structural changes in F1 males have been reported following maternal airway exposure to carbon black during gestation. In addition, a previous study in our laboratory suggested that the effects of in utero exposure of nanoparticles may span further than the first generation, as sperm content per gram of testis was significantly lowered in F2 males. In the present study we assessed male fertility parameters following in utero inhalation exposure to carbon black in four generations of mice. Results Filter measurements demonstrated that the time-mated females were exposed to a mean total suspended particle mass concentration of 4.79 ± 1.86 or 33.87 ± 14.77 mg/m3 for the low and high exposure, respectively. The control exposure was below the detection limit (LOD 0.08 mg/m3). Exposure did not affect gestation and litter parameters in any generation. No significant changes were observed in body and reproductive organ weights, epididymal sperm parameters, daily sperm production, plasma testosterone or fertility. Conclusion In utero exposure to carbon black nanoparticles, at occupationally relevant exposure levels, via maternal whole body inhalation did not affect male-specific reproductive, fertility and litter parameters in four generations of mice