A video book of ophthalmic skills for medical students

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UK Physician Associate primary care placements: staff and student experiences and perceptions

Objective To provide an insight into the experiences and perceptions of physician associate students and primary care staff involved in primary care educational placements in the United Kingdom. Methods A qualitative study was conducted. Data were collected from focus groups and semi-structured interviews with eight first year Physician Associate students and six primary care staff in two general practice surgeries in East Sussex, United Kingdom. Recruitment was via purposeful sampling. Thematic Analysis was used to develop common themes. Results Three themes were identified: 'Perceptions of the Physician Associate Role', 'Interprofessional Working', and 'The Physician Associate Course Structure and Placements'. Staff demonstrated a lack of familiarity with the physician associate programme and there was a risk of unrealistic expectations. Overall, staff and students were positive about their experiences. However, students expressed anxiety over a large amount of learning in a short timeframe, the perceptions of others, and the reluctance of staff to train them in phlebotomy skills. In addition, students were unsure about their career aspirations for the future. Conclusions Participants were positive about their experiences however students expressed a number of anxieties, with a scope to improve interprofessional education. Staff demonstrated an overall lack of knowledge of the curriculum and physician associates in general leading to a risk of unrealistic expectations. Further studies on these themes with a larger sample size across relevant training institutions in the United Kingdom is required to explore this further

Development On Automatic Vehicle Speed Control Using Radio Frequency Technology

Reducing the rate of occurrence of road accidents is a big challenge to traffic officials and road users in various parts of the world.  These accidents mainly result from the behavior of the driver in respect to speed control while driving.  Most drivers drive vehicles at high speed even in speed limited areas and under undesirable traffic conditions without considering the safety of the public. While it is not practical to monitor all parts of the road throughout the time, it is not also possible for the traffic police to control the drivers with full effect.  The advancement in wireless sensor technology has made it possible to develop autonomous in-vehicle systems capable of effectively restricting over speeding in various traffic and road conditions. Thus, in this project, a model was proposed and developed for the control of vehicle speed system using fuzzy logic inference system in conjunction with the radio frequency identification (RFID) technology. The application of the proposed model to various road conditions and speed limits were simulated and observed using Matlab simulink toolbox. The results from the simulation showed an improvement in the vehicle speed control by over 51.4% compared to a conventional PID based vehicle speed control system

Safe and Effective Prescribing with Dyslexia: A Collaborative Autoethnography

Prescribing medicines is the most common patient-level intervention made by doctors in the United Kingdom. However, this is associated with a potential for harm. Whilst dyslexia can bring many strengths, it also impacts reading and writing abilities and therefore has the potential to contribute to errors in the prescribing process if dyslexic doctors are unsupported. This paper explores the experiences of Seb – regarding prescribing and prescribing education – as a dyslexic medical student and doctor. We hope that this might spark more research on this overlooked issue. This is a collaborative, analytic, autoethnographic study within an interpretivist paradigm. Firstly, Seb wrote an autobiographical account; he was then interviewed by Mike. The interview audio-recording was transcribed verbatim and both data sources were thematically analysed. Emerging themes included: learning to prescribe, coping, struggling and support, errors, near misses and handwritten charts, and moving forward. Specific issues included a deficiency in active learning/assessment at an undergraduate level, a lack of support, and potential safety concerns regarding handwritten charts. Electronic prescribing was felt to be a positive step forwards for both safety and accessibility. Our findings suggest that further consideration of specific supports is needed to assist dyslexic trainee doctors in the prescribing of medicines, so as to prevent the clinical environment acting to disadvantage them. They also suggest that we may need to review the ways in which we teach and assess this vital skill at an undergraduate level

The education and training of medical students in electronic prescribing

Education and training in prescribing for medical student often relies on the use of paper drug charts. With the pending elimination of paper prescribing in UK hospitals we look to address how educators can introduce eprescribing into medical undergraduate teaching of prescribing skills

Safe and effective prescribing with dyslexia

Background: The term ‘dyslexia’ refers to a condition that impacts upon reading and writing abilities whilst not altering intelligence. Individuals with dyslexia may have difficulties with the speed and accuracy and their reading and writing, amongst other issues. Dyslexia is not automatically considered a disability but is a protected characteristic under the UK Equality Act (2010), and therefore employers and educational institutions are required to provide ‘reasonable adjustments’ in order to allow individuals to reach their full potential. There is a lack of research on this issue, but what little there is suggests that doctors feel as though any support they received ended when they graduated from medical school. Main body: A core distinction between medical school and medical practice is the requirement to prescribe medicines as registered medical practitioners. Junior doctors have to master this complex and potentially hazardous skill “on the job”, with a perceived lack of support. Here, we open up a debate about the potential impact of dyslexia on prescribing, and the need to find supports that may be effective in enabling doctors with dyslexia prescribe medicines safely and effectively – and thus reach their full potential as medical practitioners and promote patient safety. Conclusion: We argue that medical schools and hospitals could immediately provide dyslexia awareness training in both undergraduate and postgraduate settings. We discuss electronic prescribing systems, and conclude that research is required to identify effective supports for junior doctors with dyslexia

Safe and effective prescribing with dyslexia: a collaborative autoethnography

Prescribing medicines is the most common patient-level intervention made by doctors in the United Kingdom. However, this is associated with a potential for harm. Whilst dyslexia can bring many strengths, it also impacts reading and writing abilities and therefore has the potential to contribute to errors in the prescribing process if dyslexic doctors are unsupported. This paper explores the experiences of Seb – regarding prescribing and prescribing education – as a dyslexic medical student and doctor. We hope that this might spark more research on this overlooked issue. This is a collaborative, analytic, autoethnographic study within an interpretivist paradigm. Firstly, Seb wrote an autobiographical account; he was then interviewed by Mike. The interview audio-recording was transcribed verbatim and both data sources were thematically analysed. Emerging themes included: learning to prescribe, coping, struggling and support, errors, near misses and handwritten charts, and moving forward. Specific issues included a deficiency in active learning/assessment at an undergraduate level, a lack of support, and potential safety concerns regarding handwritten charts. Electronic prescribing was felt to be a positive step forwards for both safety and accessibility. Our findings suggest that further consideration of specific supports is needed to assist dyslexic trainee doctors in the prescribing of medicines, so as to prevent the clinical environment acting to disadvantage them. They also suggest that we may need to review the ways in which we teach and assess this vital skill at an undergraduate level

Current status of white coat hypertension: where are we?

White coat hypertension (WCH) is characterised by an elevated clinic blood pressure (BP) with normal ambulatory or home BP. It is well recognised in clinical practice and occurs in approximately one-third of untreated patients with elevated clinic BP. Current evidence suggests that WCH is associated with cardiovascular risk factors, including the development of sustained hypertension and the presence of target organ damage. However, its effects on cardiovascular outcomes remain a matter of debate. There is also insufficient evidence from randomised controlled trials to determine whether WCH warrants treatment. This narrative review aims to provide an update on the current understanding of WCH. It focuses on the clinical characteristics and potential implications of WCH, its relationship to cardiovascular risk and the evidence regarding treatment. Gaps in existing research are also highlighted

COVID-19 pandemic interim Foundation Year 1 post and confidence in core skills and competencies: a longitudinal survey

Objectives The interim Foundation Year 1 (FiY1) post was created in response to the COVID-19 pandemic to help bolster the workforce and manage increased clinical pressures. This study aimed to assess the impact of the FiY1 post on medical graduates’ self-reported confidence in common tasks, core skills, competencies and procedures prior to starting FY1, as a measure of increasing preparedness for practice. Setting A longitudinal survey was performed at a tertiary teaching hospital in the South East of England. FiY1 posts ran from June to July 2020. Participants Questionnaires were sent to 122 medical graduates from a single medical school (recipients included FiY1s and non-FiY1s) and to 69 FiY1s at a single Teaching Hospital NHS Trust, irrespective of medical school attended. Initial and follow-up questionnaires had 86 and 62 respondents, respectively. Of these, 39 graduates were matched; 26 were FiY1s and 13 non-FiY1s. The 39 matched results were analysed. Primary outcome measures Confidence levels in common FY1 tasks, core procedures and competencies were gathered before and after the FiY1 post through online questionnaires. Change in confidence comparing FiY1s and non-FiY1s was measured and analysed using linear regression. Results On a 5-point scale, the FiY1 post increased overall confidence in starting FY1 by 0.62 (95% CI 0.072 to 1.167, p=0.028). The FiY1 post increased confidence in performing venepuncture by 0.32 (95% CI 0.011 to 0.920, p=0.045), performing intravenous cannulation by 0.48 (95% CI 0.030 to 1.294, p=0.041) and recognising, assessing and initiating the management of the acutely ill patient by 0.32 (95% CI 0.030 to 1.301, p=0.041). Conclusions The COVID-19 pandemic FiY1 post improved confidence in core skills and competencies. These findings may help guide future educational interventions in conjunction with further larger scale studies, ultimately aiding to bridge the transition gap between being a medical student and a doctor