Emotional intelligence and perceived stress in healthcare students: a multi-institutional, multi-professional survey

<p>Abstract</p> <p>Background</p> <p>Emotional intelligence (EI) is increasingly discussed as having a potential role in medicine, nursing, and other healthcare disciplines, both for personal mental health and professional practice. Stress has been identified as being high for students in healthcare courses. This study investigated whether EI and stress differed among students in four health professions (dental, nursing, graduate mental health workers, medical) and whether there was evidence that EI might serve as a buffer for stress.</p> <p>Method</p> <p>The Schutte Emotional Intelligence and the Perceived Stress scale instruments were administered to four groups of healthcare students in their first year of study in both the autumn and summer terms of the 2005-6 academic year. The groups were undergraduate dental, nursing and medical students, and postgraduate mental health workers.</p> <p>Results</p> <p>No significant differences were found between males and females nor among professional groups for the EI measure. Dental students reported significantly higher stress than medical students. EI was found to be only moderately stable in test-retest scores. Some evidence was found for EI as a possible factor in mediating stress. Students in different health profession courses did not show significant differences in Emotional Intelligence.</p> <p>Conclusion</p> <p>While stress and EI showed a moderate relationship, results of this study do not allow the direction of relationship to be determined. The limitations and further research questions raised in this study are discussed along with the need for refinement of the EI construct and measures, particularly if Emotional Intelligence were to be considered as a possible selection criterion, as has been suggested by some authors.</p

Interprofessional training for final year healthcare students: a mixed methods evaluation of the impact on ward staff and students of a two-week placement and of factors affecting sustainability

BACKGROUND: Multiple care failings in hospitals have led to calls for increased interprofessional training in medical education to improve multi-disciplinary teamwork. Providing practical interprofessional training has many challenges and remains uncommon in medical schools in the UK. Unlike most previous research, this evaluation of an interprofessional training placement takes a multi-faceted approach focusing not only on the impact on students, but also on clinical staff delivering the training and on outcomes for patients. METHODS: We used mixed methods to examine the impact of a two-week interprofessional training placement undertaken on a medical rehabilitation ward by three cohorts of final year medical, nursing and therapy students. We determined the effects on staff, ward functioning and participating students. Impact on staff was evaluated using the Questionnaire for Psychological and Social factors at work (QPSNordic) and focus groups. Ward functioning was inferred from standard measures of care including length of stay, complaints, and adverse events. Impact on students was evaluated using the Readiness for Interprofessional Learning Survey (RIPLS) among all students plus a placement survey among medical students. RESULTS: Between 2007 and 2010, 362 medical students and 26 nursing and therapy students completed placements working alongside the ward staff to deliver patient care. Staff identified benefits including skills recognition and expertise sharing. Ward functioning was stable. Students showed significant improvements in the RIPLS measures of Teamwork, Professional Identity and Patient-Centred Care. Despite small numbers of students from other professions, medical students’ rated the placement highly. Increasing student numbers and budgetary constraints led to the cessation of the placement after three years. CONCLUSIONS: Interprofessional training placements can be delivered in a clinical setting without detriment to care and with benefits for all participants. While financial support is a necessity, it appears that having students from multiple professions is not critical for a valuable training experience; staff from different professions and students from a single profession can work successfully together. Difficulty in aligning the schedules of different student professions is commonly cited as a barrier to interprofessional training. Our experience challenges this and should encourage provision of authentic interprofessional training experience

Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenya

Background: Although one billion people live in informal (slum) settlements, the consequences for respiratory health of living in these settlements remain largely unknown. This study investigated whether children living in an informal settlement in Nairobi, Kenya are at increased risk of asthma symptoms. Methods: Children attending schools in Mukuru (an informal settlement in Nairobi) and a more affluent area (Buruburu) were compared. Questionnaires quantified respiratory symptoms and environmental exposures; spirometry was performed; personal exposure to particulate matter (PM2.5) was estimated. Results: 2373 children participated, 1277 in Mukuru (median age, interquartile range, 11, 9-13 years, 53% girls), and 1096 in Buruburu (10, 8-12 years, 52% girls). Mukuru schoolchildren were from less affluent homes, had greater exposure to pollution sources and PM2.5. When compared with Buruburu schoolchildren, Mukuru schoolchildren had a greater prevalence of symptoms, ‘current wheeze’ (9.5% vs 6.4%, p=0.007) and ‘trouble breathing’ (16.3% vs 12.6%, p=0.01), and these symptoms were more severe and problematic. Diagnosed asthma was more common in Buruburu (2.8% vs 1.2%, p=0.004). Spirometry did not differ between Mukuru and Buruburu. Regardless of community, significant adverse associations were observed with self-reported exposure to ‘vapours, dusts, gases, fumes’, mosquito coil burning, adult smoker(s) in the home, refuse burning near homes, and residential proximity to roads. Conclusion: Children living in informal settlements are more likely to develop wheezing symptoms consistent with asthma that are more severe but less likely to be diagnosed as asthma. Self-reported but not objectively measured air pollution exposure was associated with increased risk of asthma symptoms

Bottlenecks to glass return and refill in the United Kingdom: User Journeys to explore industry perspectives

Deposit return schemes primarily are aimed at increasing recycling rates, ideally for circular reuse. However, only 36% of collected glass in the UK is remelted for creating new bottles. This study used User Journey interviews with four senior representatives of key UK industrial stakeholders to explore manufacturers’ and value chain perceptions about a national refill scheme and to identify barriers and solutions. There was consensus that local refill may hold promise but that investment in colour-separated collection processes and raising recycling rates to over 90% could be a cheaper, faster and more sustainable approach to achieving Net Zero goals

A final clinical examination using a sequential design to improve cost-effectiveness

Context  Good examinations have a number of characteristics, including validity, reliable scores, educational impact, practicability and acceptability. Scores from the objective structured clinical examination (OSCE) are more reliable than the single long case examination, but concerns about its validity have led to modifications and the development of other models, such as the mini-clinical evaluation exercise (mini-CEX) and the objective structured long examination record (OSLER). These retain some of the characteristics of the long case, but feature repeated encounters and more structure. Nevertheless, the practical considerations and costs associated with mounting large-scale examinations remain significant. The lack of metrics handicaps progress. This paper reports a system whereby a sequential design concentrates limited resources where they are most needed in order to maintain the reliability of scores and practicability at the pass/fail interface. Methods  We analysed data pertaining to the final examination administered in 2009. In the complete final examination, candidates see eight real patients (the OSLER) and encounter 12 OSCE stations. Candidates whose performance is judged as entirely satisfactory after the first four patients and six OSCE stations are not examined further. The others – about a third of candidates – see the remaining patients and stations and are judged on the complete examination. Reliability was calculated from the scores of all candidates on the first part of the examination using generalisability theory and practicability in terms of financial resources. The functioning of the sequential system was assessed by the ability of the first part of the examination to predict the final result for the cohort. Results  Generalisability for the OSLER was 0.63 after four patients and 0.77 after eight patients. The OSCE was less reliable (0.38 after six stations and 0.55 after 12). There was only a weak correlation between the OSLER and the OSCE. The first stage was highly predictive of the results of the second stage. Savings facilitated by the sequential design amounted to approximately GBP30 000. Conclusions  The overall utility of examinations involves compromise. The system described provides good perceived validity with reasonably reliable scores; a sequential design can concentrate resources where they are most needed and still allow wide sampling of tasks

Identifying attributes required by Foundation Year 1 doctors in multidisciplinary teams : a tool for performance evaluation

Background: Effective working in multi-disciplinary teams (MDTs) is promoted as essential in ensuring good healthcare outcomes, suggesting that an understanding exists of the relationship between outcomes and the attributes needed by individuals to function effectively in the MDT. While the characteristics of effective teamwork have been described, the attributes needed by individual MDT members have not been investigated. To address this, the study focuses on newly qualified Foundation Year 1 (FY1) doctors, creating and testing a tool to evaluate their performance in the MDT. Methods: Repertory grid technique was used to elicit attributes needed by FY1 doctors to function effectively in the MDT. Study participants (all experienced MDT members) used these to evaluate MDT working by FY1 doctor colleagues. Data on 57 FY1 doctors were collected from 95 MDT members working in five hospitals. Participants also ranked the attributes in terms of importance for effective team functioning and rated an ‘Ideal’ FY1 doctor. Results: The repertory grid permitted differentiation between groups of FY1 doctors’ MDT performance. FY1 doctors who undertook interprofessional training were rated no differently than UK-trained graduates without such training. UK-trained graduates were rated significantly higher on all attributes than non-UK-trained graduates. Overall, FY1 doctors were rated lower than the ‘Ideal’. Factor analysis and rankings suggested tensions between clinical attributes needed for goodteam functioning and more ‘social’ attributes. Conclusions: This study demonstrates the potential of repertory grid methodology in eliciting attributes that are important for effective teamworking and using these to evaluate MDT working by FY1 doctors.Peer reviewe