To Fall at the Final Hurdle? Unpacking Experiences of Ophthalmology Trainees Undertaking Final Summative Examinations in Australia and New Zealand

How colleges should lead on climate

Medical specialist trainees report dissatisfaction with both the usefulness and timing of feedback provided following summative examinations. This study aimed to explore ophthalmology trainee and supervisor experiences of feedback following final summative examination (the Royal Australian and New Zealand College of Ophthalmologists Advanced Clinical Examination (RACE)). Semi-structured interviews were undertaken with ophthalmology trainees who had recently sat RACE (2017-2021) (n = 19) and supervising ophthalmologists who support trainees to prepare for RACE (n = 10). Interview data were thematically analyzed. Two themes were identified. Inadequate feedback related to trainee experiences receiving feedback relating to examination performance that was insufficient and unhelpful in identifying gaps in learning, explaining the reasons for failure and supporting preparation for resitting. Inability to contextualize feedback encompassed trainee and supervisor concerns regarding the inability to review examination manuscripts after sitting the examination, the absence of marking criteria, rubrics and model answers to understand the passing standard and the lack of opportunity to discuss performance with examiners. Detailed, individualized task-level and process-level feedback on examination performance is needed for all trainees. Opportunities to view examination manuscripts, marking criteria and model answers, as well as speak with examiners, would improve transparency of the assessment process, enhance feedback and improve trainee success.

To provide guidance for the optimal administration of electroconvulsive therapy, in particular maintaining the high efficacy of electroconvulsive therapy while minimising cognitive side-effects, based on scientific evidence and supplemented by expert clinical consensus. Articles and information were sourced from existing guidelines and the published literature. Information was revised and discussed by members of the working group of the Royal Australian and New Zealand College of Psychiatrists' Section for Electroconvulsive Therapy and Neurostimulation, and findings were then formulated into consensus-based recommendations and guidance. The guidelines were subjected to rigorous successive consultation and external review within the Royal Australian and New Zealand College of Psychiatrists, involving the full Section for Electroconvulsive Therapy and Neurostimulation membership, and expert and clinical advisors and professional bodies with an interest in electroconvulsive therapy administration. The Royal Australian and New Zealand College of Psychiatrists' professional practice guidelines for the administration of electroconvulsive therapy provide up-to-date advice regarding the use of electroconvulsive therapy in clinical practice and are informed by evidence and clinical experience. The guidelines are intended for use by psychiatrists and also others with an interest in the administration of electroconvulsive therapy. The guidelines are not intended as a directive about clinical practice or instructions as to what must be done for a given patient, but provide guidance to facilitate best practice to help optimise outcomes for patients. The outcome is guidelines that strive to find the appropriate balance between promoting best evidence-based practice and acknowledging that electroconvulsive therapy is a continually evolving practice. The guidelines provide up-to-date advice for psychiatrists to promote optimal standards of electroconvulsive therapy practice.

Australia and New Zealand

Competency-based medical education (CBME) is increasingly employed by postgraduate training programs worldwide, including obstetrics and gynaecology. Focusing on assessment of outcomes rather than time-in-training, and utilising a well-defined curricular framework, CBME aims to train doctors capable of meeting the needs of modern society. When this study was undertaken, in 2019, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) had a time-based curriculum and was due to undergo a curriculum review starting in 2020. To explore Victorian RANZCOG Integrated Training Program (ITP) coordinators' understanding of the concept of competency and how it is taught and assessed within RANZCOG training. A qualitative, grounded theory design using semi-structured interviews was employed. Victorian RANZCOG ITP coordinators from inner and outer metropolitan, and regional sites, were approached to participate. Transcripts were coded and analysed using thematic analysis. Themes identified were: Competence, Vision and Innovation, Structures, ITP Coordinator Role and Teaching and Learning. Competence was defined as a combination of independent practice and understanding of ones' own limits, in addition to required clinical skills and knowledge. Enablers and barriers to achieving competency were identified and associated with structures, human and logistical factors. Victorian ITP coordinators believed the current training program has positive elements but could be further improved. Several areas for future research were identified regarding understanding of competency, relevant if RANZCOG is to introduce a CBME framework. Replicating this research across all RANZCOG jurisdictions in Australia and New Zealand would be prudent to determine if the themes are universal.

BackgroundFailure rates on medical specialist final summative examinations in Australia are high, regardless of speciality. Examination failure can have detrimental psycho-social, financial and job security effects on the trainee, while delays in completion of training adversely impacts workforce growth and health outcomes for the community. The study aimed to explore the preparation factors that contribute to ophthalmology trainee success in their final summative examination.MethodsSemi-structured in-depth interviews were conducted with 29 participants via telephone or Zoom with ophthalmology trainees and Fellows. To be eligible, interviewees had to have sat the Royal Australian and New Zealand College of Ophthalmologists Advanced Clinical Examination (RACE) within the past five years or were providing supervision to trainees preparing for RACE. Interviews were audio-recorded, transcribed and thematically analysed.ResultsExamination success was underpinned by six themes relating to preparation: (i) ‘Those who fail to plan, plan to fail’, which related to development and adherence to a study plan; (ii) ‘It takes a village’ encompassed trainees establishing and activating personal and professional supports; (iii) ‘Get to know your opponent’, which encompassed developing an understanding of the examination construct, format and requirements; (iv) ‘There is no substitute for hard work’, which related to intensive study over a period of 12–18 months; (v) ‘Keep pace with the herd’, which referred to benchmarking preparation efforts and progress against peers; and (vi) ‘Don’t jump the gun’, which related to ensuring readiness to sit.ConclusionsMaximising medical specialist examination pass rates is in the best interest of trainees, training Colleges, health care systems and communities. Recognising and facilitating preparation approaches that foster success in final summative examinations are the collective responsibility of trainees, specialist training Colleges, training networks and health systems. Trainees need to plan for examination success, be self-determined to commit to intensive study over an extended time period and be realistic about their readiness to sit.

The international health workforce crisis had led to an increasing shortage of nurses, which has substantial implications for the quality of patient care. This shortage potentially results in nurse-perceived time pressure, which can be particularly challenging for nurses who provide care for older persons. This study aimed to show how geriatric nurses experience working under time pressure, perceive its impact on care and deal with time pressure in daily care. A qualitative descriptive interview design was used. Purposive sampling led to the inclusion of 11 nurses from three geriatric nursing wards in two general hospitals in Flanders (Belgium). Data were collected using semi-structured in-depth interviews and analysed using the QUAGOL (Qualitative Analysis Guide of Leuven). The study protocol was approved by the Ethics Committee of the University Hospitals Leuven (Ethics committee of the University Hospitals Leuven). In all interviews, time pressure was described as ubiquitous in the daily care of older persons. A sense of failure in providing care was the common thread in many interviews. Nurses felt compelled to 'reduce' good-quality care to basic care by focusing on the physical and visible aspects of care. Nevertheless, personal experiences with time pressure and strategies to cope with it differed among the interviewees. These variations were related to the working environment and the nurses themselves. They underscored the importance of nurses' perspectives for a good understanding of the phenomenon of time pressure. Working under time pressure in the care of older persons leads to various important challenges for nursing ethics. The findings show that providing care that promotes the human dignity of older persons in busy working environments in which care is rationed is an important ethical challenge. As such, our study offers a baseline for further research and discussion on how to support nurses working under time pressure.

A new subsection within JMIRO: Acknowledging the importance of Interventional Radiology and Interventional Neuroradiology research in Australia and New Zealand.

Journal of Medical Imaging and Radiation OncologyVolume 56, Issue S1 p. 78-162 RANZCR and AOCR Scientific ExhibitsFree Access Asian Oceanian Congress of Radiology 2012 and The Royal Australian and New Zealand College of Radiologists 63rd Annual Scientific Meeting First published: 23 July 2012 https://doi.org/10.1111/j.1754-9485.2012.02420.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume56, IssueS1Supplement: The Royal Australian and New Zealand College of Radiologists (RANZCR) 63rd Annual Scientific Meeting, and Asian Oceanian Congress of Radiology (AOCR), 30 August-2 September 2012, Sydney, Australia and the Faculty of Radiation Oncology Scientific Meeting 26-28 July 2012, Queensland, AustraliaAugust 2012Pages 78-162 RelatedInformation

Editorial introductions

Clinical & Experimental OphthalmologyVolume 49, Issue 8 p. 783-783 COMMITTEES The Royal Australian and New Zealand College of Ophthalmologists 52nd Annual Scientific Congress First published: 23 November 2021 https://doi.org/10.1111/ceo.14005Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume49, Issue8The Royal Australian and New Zealand College of Ophthalmologists 52nd Annual Scientific Congress 25 February – 1 March 2022November 2021Pages 783-783 RelatedInformation

Journal of Medical Imaging and Radiation OncologyVolume 56, Issue S1 p. 163-225 RANZCR and AOCR Educational ExhibitsFree Access Asian Oceanian Congress of Radiology 2012 and The Royal Australian and New Zealand College of Radiologists 63rd Annual Scientific Meeting First published: 23 July 2012 https://doi.org/10.1111/j.1754-9485.2012.02417.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume56, IssueS1Supplement: The Royal Australian and New Zealand College of Radiologists (RANZCR) 63rd Annual Scientific Meeting, and Asian Oceanian Congress of Radiology (AOCR), 30 August-2 September 2012, Sydney, Australia and the Faculty of Radiation Oncology Scientific Meeting 26-28 July 2012, Queensland, AustraliaAugust 2012Pages 163-225 RelatedInformation

Professional practice guidelines for the use of ketamine in psychiatric practice have been developed by the Royal Australian and New Zealand College of Psychiatrists to provide guidance on the use of ketamine in clinical practice in Australia and Aotearoa New Zealand, based on scientific evidence and supplemented by expert clinical consensus. Articles and information were sourced from existing guidelines and published literature. The findings were then formulated into consensus-based recommendations and guidance by the authors. The guidelines were subjected to rigorous successive consultation within the Royal Australian and New Zealand College of Psychiatrists, involving the Section of Electroconvulsive Therapy and Neurostimulation Committee, its broader membership and expert committees. The guidelines are intended for psychiatrists and clinicians engaged in the use of ketamine therapy to facilitate best practice to optimise outcomes for patients. They strive to find the appropriate balance between promoting best evidence-based practice and acknowledging that evidence for ketamine use is continually evolving.

To explore common barriers medical students perceive to choosing psychiatry as a medical specialty as reflected in existing literature and the authors' own experiences and whether funding student attendance of a Royal Australian and New Zealand College of Psychiatrists Congress serves to overcome some of these perceptions. Common barriers to selecting psychiatry as a career include stigma due primarily to lack of information about this specialty; concerns about personal safety; concerns about losing clinical skills and fear of burn-out. Bursaries funding student attendance to the Royal Australian and New Zealand College of Psychiatrists 2013 Congress were an excellent initiative that gave students a panoramic view of the variety of fields within the specialty and exposure to current debates and research, as well as the chance to discuss various subspecialties with keynote speakers and other professionals working in these areas. Undertaking more outreach activities and on-campus information sessions targeting final year students may help to further combat misperceptions and improve recruitment.

Introducing Australia's clinical care standard for low back pain.