The transition from medical student to junior doctor: today's experiences of Tomorrow's Doctors.

CONTEXT Medical education in the UK has recently undergone radical reform. Tomorrow's Doctors has prescribed undergraduate curriculum change and the Foundation Programme has overhauled postgraduate education. OBJECTIVES This study explored the experiences of junior doctors during their first year of clinical practice. In particular, the study sought to gain an understanding of how junior doctors experienced the transition from the role of student to that of practising doctor and how well their medical school education had prepared them for this. METHODS The study used qualitative methods comprising of semi-structured interviews and audio diary recordings with newly qualified doctors based at the Peninsula Foundation School in the UK. Purposive sampling was used and 31 of 186 newly qualified doctors self-selected from five hospital sites. All 31 participants were interviewed once and 17 were interviewed twice during the year. Ten of the participants also kept audio diaries. Interview and audio diary data were transcribed verbatim and thematically analysed with the aid of a qualitative data analysis software package. RESULTS The findings show that, despite recent curriculum reforms, most participants still found the transition stressful. Dealing with their newly gained responsibility, managing uncertainty, working in multi-professional teams, experiencing the sudden death of patients and feeling unsupported were important themes. However, the stress of transition was reduced by the level of clinical experience gained in the undergraduate years. CONCLUSIONS Medical schools need to ensure that students are provided with early exposure to clinical environments which allow for continuing 'meaningful' contact with patients and increasing opportunities to 'act up' to the role of junior doctor, even as students. Patient safety guidelines present a major challenge to achieving this, although with adequate supervision the two aims are not mutually exclusive. Further support and supervision should be made available to junior doctors in situations where they are dealing with the death of a patient and on surgical placements

Pengukuran Tingkat Kepuasan Wisatawan terhadap Fasilitas Wisata di Pantai Lasiana

Penelitian ini dilakukan untuk mengetahui kepuasan pengunjung terhadap fasilitas wisata di Pantai Lasiana. Penelitian ini termasuk jenis penelitian deskriptif. Metode penelitian yang digunakan dalam penelitian ini yaitu metode pendekatan kuantitatif dan kualitatif. Teknik sampel yang digunakan adalah accidential sampling. Sampel yang diambil sebanyak 100 responden yaitu wistawan yang berkunjung ke Pantai Lasiana. Pengumpulan data menggunakan kuisioner (angket), observasi dan studi kepustakaan. Analisis data menggunakan Importance Performance Analysis (IPA). Hasil penelitian menunjukkan tingkat kepuasan konsumen senyatanya lebih rendah dibandingkan dengan tingkat harapan. Hal ini berarti secara keseluruhan pengunjung belum sepenuhnya merasa puas dengan fasilitas wisata yang ada di Pantai Lasiana. Berdasarkan analisis diagram kartesius, fasilitas wisata yang masuk dalam prioritas utama dan memiliki kinerja yang rendah terdiri dari kondisi fisik lopo, kondisi fisik tempat sampah, ketersediaan jumlah tempat sampah dan pemisahan jenis tempat sampah organik dan non organik perlu diperbaiki agar dapat meningkatkan kepuasan wisatawan di masa mendatang

Pengaruh Pemberian Pupuk Bokashi Padat yang difermentasi dengan Waktu Berbeda terhadap Pertumbuhan dan Produksi Rumput Benggala

The purpose of this study was to determine the growth and production of Bengal grass treated with solid bokashi fertilizer fermented at different times. The experimental design used was a randomized block design with 4 treatments and 4 replications. The treatment consists of R0 = Control (without bokashi). R1 = Bokashi fertilizer with 14 days fermentation time. R2 = Bokashi fertilizer with 28 days fermentation time. R3 = Bokashi fertilizer with 28 days fermentation time. The variables measured in this study were shoot height, number of leaves, leaf fresh weight and leaf dry weight. The results of the analysis of variance showed that the duration of bokashi fertilizer fermentation significantly (P <0.05) on the growth of Bengal grass shoots, number of Bengal grass leaves, fresh weight of Bengal grass leaves, dry weight of Bengal grass leaves. It was concluded that the fermented bokashi 28 days (R3) produced a plant height of 100.28 cm, a leaf number of 13.94 cm, and a fresh leaf weight of 3525.00 gr, the dry weight of the leaf was 833 gr so that it was better than the fermentation treatment of 14 days, 21 day and Control.Tujuan dari penelitian ini adalah untuk mengetahui pertumbuhan dan produksi rumput benggala (Panicum Maximum) yang diberi perlakuan pupuk bokashi padat yang difermentasi dengan waktu berbeda. Rancangan percobaan yang digunakan adalah Rancangan acak kelompok (RAK) dengan 4 perlakuan dan 4 ulangan. Perlakuannya terdiri dari R0 = Kontrol (tanpa bokashi). R1 = Pupuk bokashi dengan lama fermentasi 14 hari. R2 = Pupuk bokashi dengan lama fermentasi 28 hari. R3 = Pupuk bokashi dengan lama fermentasi 28 hari. Variabel yang diukur dalam penelitian ini adalah tinggi tunas, jumlah daun, berat segar daun dan berat kering daun. Hasil analisis ragam menunjukkan bahwa lama fermentasi pupuk bokashi berpengaruh nyata (P<0,05) terhadap pertumbuhan tinggi tunas rumput benggala, jumlah daun rumput benggala, berat segar daun rumput benggala, berat kering daun rumput benggala. Disimpulkan bahwa bokashi yang di fermentasi 28 hari (R3) menghasilkan tinggi tanaman 100,28 cm, jumlah daun 13,94 cm, dan berat segar daun 3525,00 g, berat kering daun 833 g sehingga lebih baik dibanding perlakuan fermentasi 14 hari, 21 hari dan Kontrol

Comparing psychiatric care experiences shared online with validated questionnaires; do they include the same content?

Patient feedback is considered integral to patient safety and quality of care. However, limited research has compared the content of validated questionnaires with subjective patient experiences shared online. The aim of this study was to therefore identify and compare the content of psychiatric care experiences shared online with validated questionnaires. All research was conducted in co-production with a volunteer mental-health-patient-research-partner. We analysed all reviews published on the United Kingdom’s leading health and social care feedback platform Care Opinion, between 2005-2017 that discussed adult psychiatric care and compared findings with two validated questionnaires (ACP360 and General Medical Council patient feedback questionnaire). Our research findings show that patients describe some different measures of psychiatric care quality online and use different terminology to those used in validated questionnaires. Psychiatric care was also rarely discussed in relation to an individual psychiatrist alone. Multiple interactions affect patient experience and perceived care quality. Further work is needed to incorporate patient perceptions and terminology of care quality into patient feedback questionnaires and surveys. This may best be achieved through co-design although exploration of this approach is required. The current focus of patient feedback in revalidation is of limited value as patients do not typically disaggregate the care provided by an individual clinician from the wider healthcare team, system or environment. Although focused on psychiatry, research findings have clear implications for those looking to facilitate quality improvement and professional development