CARDIOPULMONARY RESUSCITATION TRAINING FOR MEDICAL STUDENTS IN ANESTHESIOLOGY ROTATION IN ARDABIL MEDICAL UNIVERSITY (IRAN)

Objectives : Cardiopulmonary resuscitation (CPR) training for undergraduate medical students has been noted to be poor in the past. Attempts have been made The aim of this study is to determine effect of CPR training in the anesthetic ward to improve knowledge and practice undergraduate medical student of CPR Methods : A 12 month Educational experimental study with self control was done on all undergraduate medical student (n=30) at the medical university of Ardabil in 2006-2007. During I month of program all this students have undergone CPR training including basic life support (BLS) , advanced cardiac life support (ACLS) and practical skills. Data were collected via questionnaire, demographic, pre/post knowledge and practice. Results : After training the acceptable score (good and very good) about knowledge of BLS, ACLS and practical skill significantly increased %6.7 to %50 (p=0.0001) , %13.3 to %53.4 (p=0.001) and %3.3 to %100 (p=0.001) respectively. A significant relationship between knowledge of ACLS and practical skills was shown (p=0.005). Conclusion : The CPR training course in anesthetic ward leads to a significant increased in skills and knowledge. Adding this course to undergraduate curriculum of medical students especially in operatically wards (e.g. Anesthetic ward) is essential

Cardiopulmonary Resuscitation Training for Medical Students in Anesthesiology Rotation in Ardabil Medical University (Iran)

Background and purpose: Cardiopulmonary resuscitation (CPR) training for undergraduate medical students has been noted to be poor in the past. Attempts have been made The aim of this study is to determine effect of CPR training in the anesthetic ward to improve knowledge and practice undergraduate medical student of CPR. Methods: A 12 month Educational experimental study with self control was done on all undergraduate medical student (n=30) at the medical university of Ardabil in 2006-2007. During I month of program all this students have undergone CPR training including basic life support (BLS) , advanced cardiac life support (ACLS) and practical skills. Data were collected via questionnaire, demographic, pre/post knowledge and practice. Results: After training the acceptable score (good and very good) about knowledge of BLS, ACLS and practical skill significantly increased %6.7 to %50 (p=0.0001) , %13.3 to %53.4 (p=0.001) and %3.3 to %100 (p=0.001) respectively. A significant relationship between knowledge of ACLS and practical skills was shown (p=0.005). Conclusion: The CPR training course in anesthetic ward leads to a significant increased in skills and knowledge. Adding this course to undergraduate curriculum of medical students especially in operatically wards (e.g. Anesthetic ward) is essential

Leadership in medical ward rounds

Leadership in Medical Ward Rounds: Abstract Medical ward rounds are an under researched area. The medical post take ward round has been cited as being a source of anxiety for new consultants. The non-technical skills involved may well be those that new consultants feel underprepared for in contrast to clinical skills. Ward rounds historically have been a principal vehicle for teaching junior doctors. There have been many changes in how junior doctors work which has potentially impacted their training and preparation towards being a consultant. The overarching aims of this thesis are firstly to expand our current understanding of the incorporation of training into medical ward rounds, and secondly to translate this understanding into an instrument that evaluates senior trainees or consultants skills in leading a ward round. Ultimately, improved training and assessment of the ward round process should enhance patient safety and effectiveness of care on medical wards. This thesis incorporates a narrative review on training and ward rounds. There is also a literature review on non-technical skills tools used in hospital medicine, how they were developed and their psychometric evaluation. The second review of non-technical skills tools leads to a choice of tool on which to base the development of a ward round leadership tool. The review on training and ward rounds, provides background to the thesis but also some of the findings are used for the instrument development. A post take ward round simulation was developed alongside the ward round leadership tool, which serves 2 purposes. One is to develop a training program by which to train senior medical registrars to lead post take ward rounds, and secondly, it is used to psychometrically evaluate the developed medical ward round leadership tool. There is also a chapter reporting an interview study of medical consultants and patients about training and post take ward rounds. The findings from this chapter feed directly into the tool and simulation development. The development of the simulation and tool are described and evaluated in detail. The tool is evaluated in terms of reliability and validity.Open Acces

Economic evaluation of a nursing-led intermediate care unit

Objectives: The aim of this paper is to examine the costs of introducing a nursing-led ward program together with examining the impact this may have on patients' outcomes. Methods; The study had a sample size of 177 patients with a mean age of 77, and randomized to either a treatment group (care on a nursing-led ward, n = 97) or a control group (standard care usually on a consultant-led acute ward, n = 80). Resource use data including length of stay, tests and investigations performed, and multidisciplinary involvement in care were collected. Results: There were no significant differences in outcome between the two groups. The inpatient costs for the treatment group were significantly higher, due to the longer length of stay in this group. However, the postdischarge costs were significantly lower for the treatment group. Conclusions: The provision of nursing-led intermediate care units has been proposed as a solution to inappropriate use of acute medical wards by patients who require additional nursing rather than medical care. Whether the treatment group is ultimately cost-additive is dependent on how long reductions in postdischarge resource use are maintained

Understanding the ward environment: factors determining medical students' 'ward smarts'

Background Medical students are expected to know how to function on hospital wards and to be at ease within the ward environment. Such ward-based knowledge indicates that a student is ‘ward smart’. However, formal teaching in this area seems to be somewhat neglected, with students being left to ‘pick up’ this knowledge as they go along. Methods Data were collected via an online questionnaire comprising both closed and open questions designed to assess students’ ward smarts, focusing on knowledge of the ward environment (routines, equipment, and terminology used), relevant clinical knowledge, and communication/roles of other members of the multi-disciplinary team. Multiple regression was used to identify factors influencing students’ scores (i.e. demographics, work experience). Thematic analysis was used to explore medical students’ opinions on how their ward understanding could be improved. Results In our sample of 53 medical students, 96% did not know how to turn on a hearing aid and only 30% knew what a Waterlow score was. Furthermore, 89% did not know how to read an oxygen flowmeter, and only 55% knew where the CPR lever on the bed was situated. Multiple regression showed that ward smarts can be predicted by previous hospital-based work and year group, both of which may represent time spent on wards. Thematic analysis suggested that students felt they would benefit from more ward time and shadowing healthcare professionals on the wards. Discussion This suggests that students may not be prepared to work in a ward environment. We propose, based on training implemented in other medical schools, that a specific ward-based interprofessional learning placement or experience should be added to the medical curriculum. As an initial step, specific teaching and/or practical sessions for students centred around patient communication and understanding the ward environment would be beneficial

Does doctors’ workload impact supervision and ward activities of final-year students? A prospective study

<p><b>Abstract</b></p> <p><b>Background</b></p> <p>Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students.</p> <p><b>Methods</b></p> <p>A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1) only watched, (2) assisted the ward resident, (3) performed the activity themselves under supervision of the ward resident, or (4) performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL), and the number of admissions and discharges. Both students and ward residents were blinded to the study question.</p> <p><b>Results</b></p> <p>A total of 32 diaries (59 %, 442 recorded working days) were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p < .0001). No relationship between the ward specific workload and number of medical activities could be shown.</p> <p><b>Conclusions</b></p> <p>There was a significant association between ward doctors’ supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.</p

The Sir Anthony Mamo Oncology Centre

In 2009, the development of a medical brief, effectively detailing the specifications for a purpose-built oncology hospital and including the medical equipment and human resources required, was commenced. Robust engagement by the relevant stakeholders, many of which hailed from the extant Sir Paul Boffa Hospital, ensured a very relevant proposal. The project (ERDF 196), led by the Foundation for Medical Sciences, was subsequently approved for partial funding through European Regional Development Funds. The new Sir Anthony Mamo Oncology Centre, as it came to be named, first opened its doors for service in December 2014 when the Out-patients Department received the first oncology patients. In April 2015, this was extended to include haematology and paediatric oncology patients. Full migration of services, including in-patient care, took place in September 2015. The distribution of services within the new Centre includes five clinical areas for in-patients made up of two oncology wards, one radioisotope unit, one haematology ward and one palliative care ward, with a total of 88 beds, an out-patient unit with 12 clinic rooms, a day area for day-treatment with a total of 21 couches and eight beds, a clinical support services unit and a radiotherapy department.peer-reviewe

Pain assessment and management in different wards of a tertiary care hospital

OBJECTIVE: To assess the pain management by medical team, emergency room (ER) team and Acute Pain team in a tertiary care hospital. METHODS: The cross-sectional study was done in Medical Ward, Surgical Ward and Emergency Room of Aga Khan University, Karachi, in March-April 2010. The assigned research medical officer visited the three locations every day and selected patients by way of convenient sampling. The study comprised 75 patients; 25 each in three groups. Information was collected on patient\u27s demographics, general characteristics, type of drugs and modalities used. Specific queries about pain were sorted out like adequacy of pain assessment done by primary physician, pain intensity, any intervention done and pain relief post-intervention. SPSS version 17, analysis of variance and Chi square test were used for statistical purpose. RESULTS: The mean current pain score on the visual analogue score (VAS) was lowest in the Surgical Ward which was being managed by the Acute Pain Management Service (APMS) team followed by the Medical Ward and then Emergency Rooms. The difference was found to be statistically significant. The mean of worst pain score was also the lowest in the Surgical Ward. There was significant difference between wards in terms of the use of pain medications. Proper documentation for pain was done for all patients in the Surgical Ward, followed by the Emergency Room and then the Medical Ward. CONCLUSION: Better pain assessment, re-assessment, documentation and patient satisfaction were observed in the Surgical Ward compared to the other two locations of the study

Becoming 'ward smart' medical students.

BACKGROUND: A small number of medical students elect to work as health care assistants (HCAs) during or prior to their undergraduate training. There is a significant body of evidence in the literature regarding the impact of HCA experience on student nurses; however, little research has examined the effects of such experience on medical students. METHODS: All fourth-year medical students with self-declared experience as HCAs from a single UK medical school were invited to participate in focus groups to explore their experiences and perceptions. Ten students from the year group took part. RESULTS: Participants felt that their experience as HCAs enhanced their learning in the workplace through becoming 'ward smart', helping them to become socialised into the world of health care, providing early meaningful and humanised patient interaction, and increasing their understanding of multidisciplinary team (MDT) members' roles. Little research has examined the effects of [HCA] experience on medical students DISCUSSION: Becoming 'ward smart' and developing a sense of belonging are central to maximising learning in, from and through work on the ward. Experience as a HCA provides a range of learning and social opportunities for medical students, and legitimises their participation within clinical communities. HCA experience also seems to benefit in the 'hard to reach' dimensions of medical training: empathy; humanisation of patient care; professional socialisation; and providing a sense of belonging within health care environments