Completed Specialist Training Research Articles

Immersive virtual reality for interdisciplinary trauma management – initial evaluation of a training tool prototype

IntroductionEmergency care of critically ill patients in the trauma room is an integral part of interdisciplinary work in hospitals. Live threatening injuries require swift diagnosis, prioritization, and treatment; thus, different medical specialties need to work together closely for optimal patient care. Training is essential to facilitate smooth performance. This study presents a training tool for familiarization with trauma room algorithms in immersive virtual reality (VR), and a first qualitative assessment.Materials and methodsAn interdisciplinary team conceptualized two scenarios and filmed these in the trauma room of the University Medical Center Mainz, Germany in 3D-360°. This video content was used to create an immersive VR experience. Participants of the Department of Anesthesiology were included in the study, questionnaires were obtained and eye movement was recorded.Results31 volunteers participated in the study, of which 10 (32,2%) had completed specialist training in anesthesiology. Participants reported a high rate of immersion (immersion(mean) = 6 out of 7) and low Visually Induced Motion Sickness (VIMS(mean) = 1,74 out of 20). Participants agreed that VR is a useful tool for medical education (mean = 1,26; 1 very useful, 7 not useful at all). Residents felt significantly more secure in the matter after training (p < 0,05), specialist showed no significant difference.DiscussionThis study presents a novel tool for familiarization with trauma room procedures, which is especially helpful for less experienced residents. Training in VR was well accepted and may be a solution to enhance training in times of low resources for in person training.

Scientific approach and attitudes among clinically working physiotherapists in Sweden -a cross sectional survey

BackgroundEvidence based medicine (EBM) should be an endeavor within all healthcare professions. Knowledge and understanding of science are important prerequisites of EBM. ObjectiveThe aim was to examine and compare perspectives on science and perceived inhibiting and facilitating factors for the assimilation and implementation of scientific information among clinically working specialist- and non-specialist physiotherapists in Sweden.MethodsA cross-sectional survey study was conducted via a web-based questionnaire. Clinically active physiotherapists in Sweden were invited to participate. Attitudes and perspectives were compared between physiotherapists with completed or on-going specialist training, and non-specialists.ResultsIn total, 1165 physiotherapists responded to the survey (75.5%, (n = 870) women, mean age 44.8 (SD 12.1), whereof 25.5% (n = 319) with completed or ongoing specialist training). The majority of participants had a high interest in science but did not consider a general scientific approach to be applied within physiotherapy. The main perceived inhibiting factor for a clinical practice more based on scientific evidence was lack of time. Specialists had in general higher interest and ability to interpret and evaluate science, and prioritized scientific evidence to a higher extent.ConclusionAmong respondents, a scientific approach was considered valuable within physiotherapy but not considered fully applied in practice. The higher interest and perceived ability to interpret science among specialists indicates that further education and specialist training can increase both interest and understanding of science among physiotherapists.

Operating Room Nursing: Integration of Nurses into the Field

The operating room is a specific workplace that requires operating room nurses to possess key competencies in the areas of perioperative healthcare, ethics, legislation, communication, and organizational skills, with continuous professional development through education and research. This knowledge will be acquired through basic and specialized training, which will continue to be integrated into the process in the field of perioperative care in a targeted manner. The need for immediate and effective action by nurses in the operating room in unpredictable situations requires them to respond appropriately, which requires knowledge and practice only possible through structured formal training. These trainings have clear learning outcomes and competencies for knowledge assessment procedures. The current challenge is poorly designed processes for integrating inexperienced staff into perioperative care without explicit requirements to complete perioperative specialist training.

Current situation and influencing factors of the nursing practice environment in five tertiary general hospitals in Shenzhen: a cross-sectional study.

ObjectiveThis study investigates the current situation and influencing factors of the nursing practice environment in Shenzhen, China, and provides suggestions for improving it.BackgroundNursing shortage is an urgent global problem and also of concern in China. Studies have shown that better work environments are related to high job satisfaction and better patient outcomes.MethodsThe 37-item Practice Environment Scale was used to assess the nursing practice environment. Respondents were 1116 nurses from five general tertiary hospitals in Shenzhen.ResultsThe mean satisfaction score for the nursing practice environment was 3.63 ± 0.72 (where 5 is the highest possible score). Position, being a specialist nurse, choice of nursing major, educational attainment, and night shifts significantly affected nurses’ working environment satisfaction.ConclusionThe practice environment of nurses was satisfactory. We recommend reducing the workload and encouraging nurses to complete specialist training, and supporting nurses to expand their roles in hospitals and society to improve the nursing practice environment.

The leadership gap: is there a crisis of leadership in anaesthesiology?

Medical educators and specialist colleges have always had concerns about the effectiveness of training programmes to produce specialists with appropriate skills at the fore. Typically these concerns have centred on the ability to perform tasks, unerstand key concepts and having exposure to a sufficient number of cases to produce expertise by deliberate, repeated practice.1 However, other competencies of specialists are less well defined. How do we ensure that those who complete specialist training programmes are ready to support others, to communicate, advocate and lead the speciality? These skills have often been referred to as the ‘hidden curriculum’ – the skills, knowledge and attitudes expected of clinicians in a sociocultural sense, both by society and their own profession.2

The Impact of COVID-19 on Gastrointestinal Endoscopy Training in the United Kingdom

The Impact of COVID-19 on Gastrointestinal Endoscopy Training in the United Kingdom

New EUCAST definitions of S, I and R from 2019 - German physicians are largely not aware of the changes.

On January 1st 2019, the new EUCAST definitions of susceptibility testing categories S, I and R took effect. The changes in the I category have considerable clinical impact because they lead to major changes in the antibiogram, and misinterpretation may result in inappropriate selection and dosing of antibiotics hampering effective treatment of infectious diseases. We assessed if German physicians are aware of the new definitions and their consequences. We conducted a nationwide web-based survey to assess the knowledge on the new definitions of S, I and R. The survey was addressed to clinicians across all medical specialties working in Germany and was open from May 9th to July 30th 2019. The answers of 902 participants were included in the analysis. Most participants were employed at hospitals (79.3%) and had already completed specialist training (86.1%). The predominant specialty was internal medicine (50.6%). Of all participants, 45.7% did not know that there was a change in the definitions of S, I and R, and 65.4% did not feel well-informed about the changes. When the participants had to identify true and false statements regarding the new I, substantial knowledge gaps were apparent. Worst results were achieved by those physicians who are not employed in a hospital but work in their own practice. Our survey shows that German physicians are insufficiently informed about the new definitions of S, I and R. Further education is strongly needed to ensure optimal treatment of infectious diseases.

Mo1698 RESIDENCY TRAINING IN COLORECTAL ESD IN WESTERN PRACTICE: OUTCOMES OF INDEPENDENT RESIDENT PERFORMED ESD IN A TERTIARY UNIT

There are no published reports on resident training in colorectal Endoscopic Submucosal Dissection (ESD) or resident performed ESD in western practice. It is unclear if any such training takes place in western centres where uptake of colorectal ESD has been slow and training, where it exists, is confined to experienced endoscopists who have already completed specialist training. The challenges of ESD training in the west compared to Japan are well known, but if safe and effective colorectal ESD is to take place on a larger scale in western centres it is important to establish the feasibility and efficacy of resident training in ESD. We evaluated resident training in colorectal ESD in our centre and report outcomes from the first 10 cases completed by a resident unassisted by a trainer.

Peter J B Hubner

Peter Hubner was born in London in 1942, the third son of a Czech antiques dealer who emigrated to England after the first world war. Peter developed an interest in...

James Joseph O’Donnell

James Joseph O’Donnell (“Jim”) entered medical school after national service. After a brief period in general practice he rejoined the army and spent many years overseas. He completed specialist training...

Advances in immunotherapy for melanoma

Paolo A Ascierto obtained his MD from the University of Naples, Italy, where he earned board certification in oncology. He is currently Director at the Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, National Tumor Institute 'Fondazione G. Pascale', Naples, Italy. Before his present position, he served consecutive positions there as a postdoctoral fellow and then as Vice Director of the Department of Clinical Immunology. His major research interests have included genetics and proteomics research of melanoma, apoptosis and cell death in human cancer and the assessment of molecular markers for tumor progression in melanoma, as well as the management of targeted therapies for melanoma, vaccination treatments and biochemical and immunological monitoring. He has served as a principal investigator in numerous clinical trials and has been widely published in peer-reviewed journals on topics related to his interests. Ascierto has been an invited speaker at more than 200 national and international meetings and is an active member of the Italian Society of Medical Oncology (AIOM), the American Society of Clinical Oncology (ASCO), the European Society of Medical Oncology (ESMO), the European Organisation for Research and Treatment of Cancer (EORTC) and the International Society for Biological Therapy of Cancer (iSBTc). He is also the Editor-in-Chief of the Combination Strategies section of the Journal of Translational Medicine and serves as a scientific reviewer for several journals. James Larkin is a consultant medical oncologist specializing in the treatment of patients with cancer of the kidney and cancers of the skin, including melanoma. Larkin obtained a first-class degree in Natural Sciences from Cambridge University and undertook clinical training at Oxford University, qualifying in 1996. He underwent general medical training in London and, in 2001, won a Medical Research Council Fellowship for a Clinician, carrying out laboratory research at the Institute of Cancer Research (ICR), which led to the awarding of his PhD. He completed specialist training at The Royal Marsden Hospital and was appointed as a consultant in 2008. His research interests include the individualization of patient treatment in renal cancer and melanoma and the combination of novel targeted therapies for the treatment these diseases. He is the UK Chief Investigator for a number of clinical trials in melanoma and kidney cancer and has been awarded research grants from bodies including Cancer Research UK, the Wellcome Trust and the European Framework Programme 7. He is a member of the National Cancer Research Institute (NCRI) Melanoma Clinical Studies Group and Chair of both the NCRI Renal Cancer Clinical Studies Group and The Royal Marsden/ICR Committee for Clinical Research.

Advances in treating solid tumors

James Larkin speaks to Laura McGuiness, Managing Commissioning Editor: Dr James Larkin, FRCP, PhD, is a Consultant Medical Oncologist specializing in the treatment of patients with cancer of the kidney and cancers of the skin, including melanoma. His research interests include the individualization of patient treatment in renal cancer and melanoma, the identification of mechanisms of sensitivity and resistance to systemic therapies and the combination of novel targeted therapies to treat these diseases. Larkin received a first in Natural Sciences from Cambridge University and undertook clinical training at Oxford University, qualifying in 1996. He underwent general medical training in London and in 2001 won a Medical Research Council Fellowship for a Clinician, carrying out laboratory research at The Institute of Cancer Research. He completed specialist training at The Royal Marsden and was appointed a Consultant in 2008. He is UK Chief Investigator for a number of clinical trials in melanoma and kidney c...

THU0456 A comparatvie study of rheumatology training across three european countries

BackgroundFree circulation of medical specialists within the European Union was approved under the Treaty of Rome in 1993. To maintain standard of care and support easy flow of medical specialists...

A third of trainee diabetologists can’t secure consultant posts

Less than two thirds of the doctors (43 of 69) who completed specialist training in diabetes from January 2008 to September 2010 secured a substantive NHS consultant post, research in the Journal of the Royal College of Physicians has found.1 Of the 51 …

One-third of doctors completing specialist training in diabetes fail to secure a substantive consultant post: Young Diabetologists’ Forum survey 2010

Reports have highlighted a shortage of consultant diabetologist posts in the UK. The number of doctors completing specialist training in diabetes has increased in recent years, but little is known about their employment after they receive their certificate of completion of training. An online survey was sent to all doctors who completed specialist diabetes training from January 2008 to September 2010. Of the 95 eligible respondents, 69 (73%) completed the survey (61% men; median age 36 years). Forty-three (62%) respondents secured substantive NHS consultant posts, and of those who gave their job breakdown, 48/51 (94%) were contributing to specialist diabetes care. Five (7%) respondents held substantive academic positions, while 11 (16%) were locum consultants. Seven (9%) respondents worked abroad, with half of these attributing their emigration to lack of opportunities in the UK. When asked about alternative choices, 39% of respondents were likely to seek 'general physician' roles, which equalled the number who would consider emigrating. Overall, only two-thirds of doctors who complete specialist training in diabetes secure substantive NHS consultant positions, which suggests a failure in workforce planning and a lack of expansion of the number of consultant posts despite progression of the diabetes epidemic.

Doctors from some medical schools are more likely to pass specialist exam

Doctors who attended particular medical schools, such as Oxford, Cambridge, and Edinburgh, are more likely to pass their specialist training exams, says research published online in the Postgraduate Medical Journal (doi:10.1136/postgradmedj-2011-130479). The researchers looked at the first time pass rate for both parts of the Royal College of Obstetricians and Gynaecologists membership (MRCOG) examinations, a prerequisite for doctors who want to complete specialist training in obstetrics and gynaecology, and assessed the potential effects on pass rates of the medical school attended, sex, and overall academic performance at A level. Between 1998 and 2008 …

Postgraduate diploma in burn care

The two year programme aims to provide a core curriculum for established surgeons, surgical trainees, and physicians who wish to practise in the field of burn care after completing specialist training. Although primarily aimed at people working in plastic surgery units, it is invaluable to emergency medicine specialists and other specialists who encounter burn injuries in clinical practice. This year delegates have come from Ireland, Manchester, and London, and students in the Middle East are taking part online. Entry requirements for the course are the MBBS or equivalent. I started the course in 2009 while working as a senior house officer in emergency medicine. I am now a core surgical trainee in plastic surgery, which has made the diploma much more relevant to my clinical practice. The course fee …

Training to be a specialist – the prizes and pitfalls

Having obtained my Bachelor of Dental Surgery (BDS) in 2001, I was sure that my academic career had come to an end. The first and last thought I remember having as I embarked on vocational training was ‘finally an income and no more exams’. Nothing could have been further from the truth and, having completed my specialist training in fixed and removable prosthodontics, in this article I aim to highlight the journey I travelled, with perils and prizes, and give some insight into the self-funded mono-speciality training pathway for potential applicants.

Mary Louise Cameron

After qualifying, Mary Cameron came travelling to the United Kingdom, where she stayed for 20 years. She trained in psychiatry at St George's Medical School, staying there to complete higher...

Diagnosis of genital chlamydia in primary care: an explanation of reasons for variation in chlamydia testing

Objectives: To explore the reasons for the 40-fold variation in diagnostic testing for genital Chlamydia trachomatis by general practices. Methods: A qualitative study with focus groups. We randomly selected urban...