Frailty and Sarcopenia in the Colorectal Patient

Frailty and sarcopenia are geriatric conditions, becoming more prevalent with the United Kingdom’s (UK) ageing population. More older patients are presenting for colorectal surgery, who may be frail or sarcopenic. Current literature suggests assessments for these conditions may have a predictive validity for adverse post-operative outcomes. There is confusion as to which measures are of true clinical value. Qualitative methodologies were employed to determine that whilst surgeons wish for frailty to be routinely identified at St James’ hospital, Leeds, UK, pre-assessment staff would require an intervention to also be available before identification is implemented. Initial pilot studies investigate prevalence of frailty and sarcopenia, identifying that there is a substantial variance between prevalence rates of either condition, depending on the assessment methodology. Initial analyses indicate these measures may not be predictive of post-operative outcomes. Development of Frailty and Sarcopenia Trial (FAST) identified that whilst prevalence of frailty by different measures varied, predictive validity was poor. FAST also determined that sarcopenia, as measured by the European Working Group of Sarcopenia in Older People criteria, identifies patients who are more likely to require increased care in-hospital, post-operatively. This may support the identification of patients who may fare worse as a result of their operation, and interventions put into place to optimise patient’s clinical conditions pre-operatively. An eccentric exercise program, lasting 4 weeks, can improve strength in older adults. It is hoped that developments from this study can inform physiotherapy interventions for frail or sarcopenic in-patients in the peri-operative window. This work highlights the possibility that there may be publication bias regarding frailty and sarcopenia, and that whilst these conditions may be prevalent in a clinical setting, caution is required when considering which assessment should be adopted to be clinically informative in a colorectal surgical pathway

The use of simulation in medical student education on the topic of breaking bad news : a systematic review

Background: Simulated patients (SPs) are widely used, but the most effective way of utilising them in undergraduate breaking bad news (BBN) medical education is unknown. Objectives: To conduct a systematic review into SP’s use in developing BBN skills in medical students. Methods 14 databases searched with the terms “Medical education”, “Patient simulation”, “Bad news”. Data was systematically extracted, and thematic analysis undertaken. Results: Of 2117 articles screened, 29 publications met the inclusion criteria. These demonstrated a variety of SP models, including actors as patients (65.5%), peers (7.0%), and cancer survivors (3.5%). with delivery at varying times in the curricula. SPs are uniformly reported as having positive impact, but there is a lack of high-quality evidence comparing the use of differing forms of training. There was some evidence that virtual SPs were as useful as in-person SPs. Conclusions: SPs allow students to practise vital BBN communication skills without risking detriment to patient care. Despite the heterogeneity of ways in which SPs have been used, the benefits of different approaches and when and how these should be delivered remains unclear. Practice implications Further educational development and research is needed about the use of SPs to support undergraduate BBN communication skills development

Abstracts of the 3rd Annual Graduate Entry Research in Medicine Conference

This book contains the abstracts of the papers presented at The 3rd Annual Graduate Entry Research in Medicine Conference (GERMCON 2020) Organized by Warwick Medical School, University of Warwick in collaboration with Swansea University Medical School, Swansea University, Wales, UK held on 12–18 October 2020. This was especially important for Graduate Entry Medical (GEM) students, who have less opportunity and time to engage in research due to their accelerated medical degree. Conference Title: 3rd Annual Graduate Entry Research in Medicine ConferenceConference Acronym: GERMCON 2020Conference Date: 12–18 October 2020Conference Location: Online (Virtual Mode)Conference Organizer: Warwick Medical School, University of Warwick, UKCo-organizer: Swansea University Medical School, Swansea University, Wales, UK Other Abstract Book of GERMCON: Abstracts of the 4th Annual Graduate Entry Research in Medicine Conferenc