Future Sessions Research Articles

Developing Water Leaders as Catalysts for Change: The Nebraska Water Leaders Academy

AbstractManaging water resources is increasingly complex and dynamic. Sustaining freshwater ecosystem services in the face of increasing challenges and emerging threats is a supreme leadership challenge. Leadership development program designers should look to social science theories and methods to prepare leaders to catalyze the change necessary to meet future challenges. This paper provides evidence that a new generation of water leaders is needed; and correspondingly, there is a need for new leadership development programs. The Nebraska Water Leaders Academy and its evaluation is presented as a case study of a successful program training leaders in social science‐based skills in order to produce catalysts of change. The Academy is theoretically grounded in transformational leadership, champions of innovation, civic capacity, and entrepreneurial leadership. The Academy employs a process‐based curriculum with developmental experiences that includes key components of assessment, challenge, and support. Formative assessment provides constructive feedback from participants and guides the development of future sessions and curriculum. Summative assessment is used to gauge participants’ leadership knowledge, skills, and behaviors, and evaluate the instructional methods used in the Academy. Results of pre‐ and post‐Academy assessments of participants from both the participants’ and raters’ perspectives indicate statistically significant increases in transformational leadership behaviors, champion of innovation behaviors, civic capacity, entrepreneurial leadership behavior, awareness of Nebraska water issues, and engagement with Nebraska water issues.

76. IMPLEMENTATION AND EVALUATION OF A COORDINATOR-LED, PEDIATRIC PROGRAM COORDINATOR MONTHLY EDUCATIONAL SERIES

BackgroundWith ever expanding requirements from the Accreditation Council of Graduate Medical Education (ACGME), the role of the program coordinator has grown, necessitating updated onboarding materials for new coordinators and continuing education for experienced coordinators. While the need for coordinator education and professional development is well-established, there remains the question of who should provide such education. A needs assessment at a single institution of coordinators representing 177 programs (111 ACGME accredited residencies and fellowships, 66 non-ACGME accredited fellowships) found that although monthly meetings were provided by the Graduate Medical Education Office, gaps still existed in the knowledge and engagement of coordinators across-the-board. 86% of coordinators surveyed indicated that coordinator professional development is very important and needed.ObjectiveTo create and assess the impact and feasibility of a coordinator-led educational series for pediatric program coordinators.MethodsThe Department of Pediatrics at Stanford University School of Medicine instituted a monthly, coordinator-led educational series. Three coordinators organized the series, with a total of nine coordinators collaborating on presentation of topics. Over a period of 18 months, 20 distinct topics were delivered, with some topics being repeated (Figure 1). Participants were asked to rate the entire series as a whole at the end of the 18-month period. Descriptive statistics were used to analyze the results.ResultsOf 19 pediatric coordinators, 18 completed the final survey (95%). Coordinators reported they were satisfied with the series (94%), likely to recommend to new coordinators (100%), and likely to recommend to experienced coordinators (82%). C-TAGME and opportunities for national participation were identified as topics that would be useful for future sessions. Comments underscored that rolling topics were necessary for new coordinators but would be repetitive for experienced coordinators. The time spent in organization and preparation of the series was estimated at eight hours a month.ConclusionThe implementation of a program coordinator-led educational series was found to be feasible and satisfactory, with coordinators likely to recommend the series to others. More work needs to be done to determine the best format, frequency, and topics for a coordinator-led series. With ever expanding requirements from the Accreditation Council of Graduate Medical Education (ACGME), the role of the program coordinator has grown, necessitating updated onboarding materials for new coordinators and continuing education for experienced coordinators. While the need for coordinator education and professional development is well-established, there remains the question of who should provide such education. A needs assessment at a single institution of coordinators representing 177 programs (111 ACGME accredited residencies and fellowships, 66 non-ACGME accredited fellowships) found that although monthly meetings were provided by the Graduate Medical Education Office, gaps still existed in the knowledge and engagement of coordinators across-the-board. 86% of coordinators surveyed indicated that coordinator professional development is very important and needed. To create and assess the impact and feasibility of a coordinator-led educational series for pediatric program coordinators. The Department of Pediatrics at Stanford University School of Medicine instituted a monthly, coordinator-led educational series. Three coordinators organized the series, with a total of nine coordinators collaborating on presentation of topics. Over a period of 18 months, 20 distinct topics were delivered, with some topics being repeated (Figure 1). Participants were asked to rate the entire series as a whole at the end of the 18-month period. Descriptive statistics were used to analyze the results. Of 19 pediatric coordinators, 18 completed the final survey (95%). Coordinators reported they were satisfied with the series (94%), likely to recommend to new coordinators (100%), and likely to recommend to experienced coordinators (82%). C-TAGME and opportunities for national participation were identified as topics that would be useful for future sessions. Comments underscored that rolling topics were necessary for new coordinators but would be repetitive for experienced coordinators. The time spent in organization and preparation of the series was estimated at eight hours a month. The implementation of a program coordinator-led educational series was found to be feasible and satisfactory, with coordinators likely to recommend the series to others. More work needs to be done to determine the best format, frequency, and topics for a coordinator-led series.

From Paris to Katowice: cop-24 Tackles the Paris Rulebook

The adoption of the “Paris rulebook” at Katowice in late 2018 marks the most significant milestone in international climate policy making since the adoption of the Paris Agreement in 2015. Through a package of decisions, Parties to the Paris Agreement fulfilled almost all of the Paris mandate and moved towards the full implementation of the treaty. With the exception of the discussion on the future of carbon markets, negotiators managed to find common ground across negotiation items ranging from mitigation action to ensuring transparency and follow-up, including through “global stocktakes”, climate finance and technology transfer. Most obligations will apply to all countries, replacing the “bifurcation” of the Kyoto Protocol with a common set of rules for all Parties. Developing countries can make the case for additional time and assistance to comply with the full set of requirements. Several matters are left for future sessions – concerning, in particular, the harmonization of the timeframes of mitigation goals, markets and finance mobilization– and structural challenges – not least concerning the integration of non-state actors – remain. However, in building on accountability, trust, and compliance through facilitation, the new Paris rules may ultimately prove decidedly more robust and sustainable than those of the Kyoto Protocol.

Twelve tips for assessing medical knowledge with open-ended questions: Designing constructed response examinations in medical education

Medical knowledge examinations employing open-ended (constructed response) items can be useful to assess medical students’ factual and conceptual understanding. Modern day curricula that emphasize active learning in small groups and other interactive formats lend themselves to an assessment format that prompts students to share conceptual understanding, explain, and elaborate. The open-ended question examination format can provide faculty with insights into learners’ abilities to apply information to clinical or scientific problems, and reveal learners’ misunderstandings about essential content. To implement formative or summative assessments with open-ended questions in a rigorous manner, educators must design systems for exam creation and scoring. This includes systems for constructing exam blueprints, items and scoring rubrics, and procedures for scoring and standard setting. Information gained through review of students’ responses can guide future educational sessions and curricular changes in a cycle of continuous improvement.

Procuring Spontaneous Session-Level Resource Guarantees for Real-Time Applications: An Auction Approach

Real-time multimedia applications, such as interactive gaming, live video streaming, and augmented reality, have strict latency and bitrate requirements. However, unpredictable network conditions, such as congestion and link quality, can severely degrade the quality of experience (QoE). While buffer-based mitigations cannot be applied to real-time applications due to their immediate resource needs, recent innovations in network slicing have demonstrated the feasibility of dedicating specified amounts of network resources to individual sessions in the radio access network. Encouraged by this, we propose to reserve network resources for multimedia sessions in real time according to their declared needs, thereby providing ad hoc session-level performance guarantees . Through Wi-Fi experiments and trace-driven LTE simulations, we show that such session-level resource provisioning is robust to real-time channel fluctuations and congestion externalities over the lifetime of a session. This approach, however, raises challenges: how can the network ensure that users are honest about their resource needs and optimally allocate its limited resources to users under uncertainty in future sessions’ resource needs ? We derive a novel multi-unit combinatorial auction (MUCA) model with a unique structure that can be exploited for fast winner determination, and yet incentivize truthful bidding, properties not simultaneously achieved in a generic MUCA but essential to making real-time session guarantees. Furthermore, since dynamic bidding in real time is challenging for end-users who are budget-constrained, we develop a reinforcement learning-based utility-maximizing strategy to distribute their budget across sessions and show that it yields high user utility.

Utility of 3D Printed Cardiac Models for Medical Student Education in Congenital Heart Disease: Across a Spectrum of Disease Severity.

The most common modes of medical education for congenital heart disease (CHD) rely heavily on 2-dimensional imaging. Three-dimensional (3D) printing technology allows for the creation of physical cardiac models that can be used for teaching trainees. 3D printed cardiac models were created for the following lesions: pulmonic stenosis, atrial septal defect, tetralogy of Fallot, d-transposition of the great arteries, coarctation of the aorta, and hypoplastic left heart syndrome. Medical students participated in a workshop consisting of different teaching stations. At the 3D printed station, students completed a pre- and post-intervention survey assessing their knowledge of each cardiac lesion on a Likert scale. Students were asked to rank the educational benefit of each modality. Linear regression was utilized to assess the correlation of the mean increase in knowledge with increasing complexity of CHD based on the Aristotle Basic Complexity Level. 45 medical students attended the CHD workshop. Students' knowledge significantly improved for every lesion (p < 0.001). A strong positive correlation was found between mean increase in knowledge and increasing complexity of CHD (R2 = 0.73, p < 0.05). The 3D printed models, pathology specimens and spoken explanation were found to be the most helpful modalities. Students "strongly agreed" the 3D printed models made them more confident in explaining congenital cardiac anatomy to others (mean = 4.23, ± 0.69), and that they recommend the use of 3D models for future educational sessions (mean = 4.40, ± 0.69). 3D printed cardiac models should be included in medical student education particularly for lesions that require a complex understanding of spatial relationships.

Predicting the results of evaluation procedures of academics.

BackgroundThe 2010 reform of the Italian university system introduced the National Scientific Habilitation (ASN) as a requirement for applying to permanent professor positions. Since the CVs of the 59,149 candidates and the results of their assessments have been made publicly available, the ASN constitutes an opportunity to perform analyses about a nation-wide evaluation process.ObjectiveThe main goals of this paper are: (i) predicting the ASN results using the information contained in the candidates’ CVs; (ii) identifying a small set of quantitative indicators that can be used to perform accurate predictions.ApproachSemantic technologies are used to extract, systematize and enrich the information contained in the applicants’ CVs, and machine learning methods are used to predict the ASN results and to identify a subset of relevant predictors.ResultsFor predicting the success in the role of associate professor, our best models using all and the top 15 predictors make accurate predictions (F-measure values higher than 0.6) in 88% and 88.6% of the cases, respectively. Similar results have been achieved for the role of full professor.EvaluationThe proposed approach outperforms the other models developed to predict the results of researchers’ evaluation procedures.ConclusionsSuch results allow the development of an automated system for supporting both candidates and committees in the future ASN sessions and other scholars’ evaluation procedures.

An evaluation of large group cognitive behaviour therapy with mindfulness (CBTm) classes

BackgroundEnsuring equitable and timely access to Cognitive Behaviour Therapy (CBT) is challenging within Canada’s service delivery model. The current study aims to determine acceptability and effectiveness of 4-session, large, Cognitive Behaviour Therapy with Mindfulness (CBTm) classes.MethodsA retrospective chart review of adult outpatients (n = 523) who attended CBTm classes from 2015 to 2016. Classes were administered in a tertiary mental health clinic in Winnipeg, Canada and averaged 24 clients per session. Primary outcomes were (a) acceptability of the classes and retention rates and (b) changes in anxiety and depressive symptoms using Generalized Anxiety Disorder 7-item (GAD-7) and Patient Health Questionnaire 9-item (PHQ-9) scales.ResultsClients found classes useful and > 90% expressed a desire to attend future sessions. The dropout rate was 37.5%. A mixed-effects linear regression demonstrated classes improved anxiety symptoms (GAD-7 score change per class = − 0.52 [95%CI, − 0.74 to − 0.30], P < 0.001) and depressive symptoms (PHQ-9 score change per class = − 0.65 [95%CI, − 0.89 to − 0.40], P < 0.001). Secondary analysis found reduction in scores between baseline and follow-up to be 2.40 and 1.98 for the GAD-7 and PHQ-9, respectively. Effect sizes were small for all analyses.ConclusionsThis study offers preliminary evidence suggesting CBTm classes are an acceptable strategy to facilitate access and to engage and maintain clients’ interest in pursuing CBT. Clients attending CBTm classes experienced improvements in anxiety and depressive symptoms. Symptom improvement was not clinically significant. Study limitations, such as a lack of control group, should be addressed in future research.

The Weight of Pain: What Does a 10 on the Pain Scale Mean? An Innovative Use of Art in Medical Education to Enhance Pain Management

ContextArt and museum spaces offer a novel educational platform for exploring the subjective elements inherent to the understanding and treatment of pain. Physicians and museum educators collaborated on an educational model using art to explore the metacognitive dimensions of pain management. ObjectivesSessions used inquiry-based strategies to increase clinician awareness of implicit biases and build clinically applicable metacognitive skills that might influence how clinicians respond to patients in pain. MethodsTwo sessions led by museum educators and physician facilitators were held at the Museum of Art, Rhode Island School of Design. Through exercises that used works of art as the basis for guided discussions rooted in constructivist learning theory, participants explored how personal experiences, communication, and tolerance for uncertainty shape their interpretations. These sessions created unique, nonjudgmental opportunities for clinicians to make connections between their experience and how they perceive, interpret, and respond to the subjective experiences of patients in pain. Optional surveys were distributed. ResultsParticipants at both sessions noted the event impacted how they think about making observations and communication—elements of practice inherent to pain management. The majority reported the experience could lead to a change in their practice. At the first session, 100% were interested in future sessions and 100% at the second would recommend it. ConclusionsFacilitated, reflective experiences with works of art have the capacity to challenge clinicians to become aware of their implicit biases, thought processes, and communication with potential importance for improving pain management and providing more compassionate care.

The Clinical Reasoning Mapping Exercise (CResME): anew tool for exploring clinical reasoning.

IntroductionNational organizations have identified a need for the creation of novel approaches to teach clinical reasoning throughout medical education. The aim of this project was to develop, implement and evaluate a novel clinical reasoning mapping exercise (CResME).MethodsParticipants included a convenience sample of first and second year medical students at two US medical schools: University of Central Florida (UCF) and Uniformed Services University of Health Sciences (USUHS). The authors describe the creation and implementation of the CResME. The CResME uses clinical information for multiple disease entities as nodes in different domains (history, physical exam, imaging, laboratory results, etc.), requiring learners to connect these nodes of information in an accurate and meaningful way to develop diagnostic and/or management plans in the process.ResultsThe majority of medical students at both institutions felt that the CResME promoted their understanding of the differential diagnosis and was a valuable tool to compare and contrast elements of a differential diagnosis. Students at both institutions recommended using the CResME for future sessions.DiscussionThe CResME is a promising tool to foster students’ clinical reasoning early in medical school. Research is needed on the implementation of the CResME as an instructional and assessment strategy for clinical reasoning throughout medical school training.Electronic supplementary materialThe online version of this article (10.1007/s40037-018-0493-y) contains supplementary material, which is available to authorized users.

Development of Bespoke and Sustainable 2-Day Cancer, Palliative, End of Life, and Bereavement Care Educational Workshops for Health Care Professionals in Nigeria

In Nigeria there is a consensus that in-country cancer services lack strategy, focus and coordination of care. This is magnified by poverty and by cultural and religious issues, resulting in the majority of patients presenting late and deemed palliative at the time of diagnosis. The Bricon Foundation, a Nigerian nongovernmental organization joined forces with Macmillan Cancer Support, a well-known established UK cancer charity to design an interactive teaching package for Nigerian health care professionals. The aim of the workshops was to share best practice in basic cancer, palliative and end of life care including bereavement support. The project concentrated on facilitating open discussions among Nigerian health care professionals about these topics including communication challenges and how to take care of themselves. The four two-day workshops were designed to identify challenges and obstacles health care professionals faced in delivering cancer and palliative care in Nigeria. They empowered participants to realize their own potential in improving the cancer experience for the patients and themselves. The cancer sessions were adapted from Macmillan cancer awareness materials that have been well evaluated in the UK. Additionally, the team developed a palliative, end of life and bereavement care study day as day two of the workshops to give participants a basic holistic overview. A team of Macmillan Alumni volunteers traveled to Nigeria to work with The Bricon Foundation team in delivering this training, which had sponsorship from NNPC, Total EPNL and partners. After each day participants completed an evaluation form. This enabled the team to adapt subsequent presentations to the Nigerian context using the feedback. The training was delivered to 91 participants from 26 government and private facilities with all 4 workshops evaluating positively. Attendees specifically valued the group work as it facilitated an exchange of ideas ensuring their voice was heard. Most expediently we were able to identify professionals drawn from different areas of healthcare who are interested in delivering future sessions on a regular basis keeping education at the forefront of cancer, palliative care and health care practice development. With further educational sessions anticipated in the near future, evaluation is on-going.

Pediatric Emergency Medicine Simulation Curriculum: Cardiac Tamponade.

Cardiac tamponade is an uncommon presentation to the pediatric emergency department and requires early recognition and emergent intervention. We developed this patient simulation case to simulate a low-frequency, high-acuity scenario for pediatric emergency medicine fellows and resident physicians in emergency medicine, pediatrics, and family medicine. We ran the case in a pediatric emergency department using a high-fidelity pediatric mannequin and equipment found in the clinical environment, including a bedside ultrasound machine. The case involved a 10-year-old patient with Hodgkin lymphoma who presented with fever, neutropenia, and shock and was found to have a pericardial effusion with tamponade after evaluation. The providers were expected to identify signs and symptoms of shock, as well as cardiac tamponade, and demonstrate appropriate emergent evaluation and management. Required personnel included a simulation technician, instructors, and a nurse. Debriefing tools tailored specifically for this scenario were created to facilitate a formal debriefing and formative learner assessment at the end of the simulation. This case has been implemented with 10 pediatric emergency medicine fellows during two 3-year cycles of fellow education. Session feedback reflected a high level of satisfaction with the case and an increased awareness of bedside ultrasound in the identification of cardiac tamponade. This resource for teaching the critical components for diagnosing and managing unstable cardiac tamponade in the pediatric patient, including use of bedside ultrasound, was well received by pediatric emergency medicine fellows.

Identifying and Resolving End of Session Cues in Substance Detection Canine Training

When training and working a substance detection canine, a trained final response should be performed immediately upon recognition of odor (Generally, a 1–3 s window is preferred within our detection practices). Typical canine training places much emphasis on planning and setting up training scenarios to achieve specific objectives but not much consideration is given to how to end a training session. When the canine fails to maintain criteria, trainers are left trying to determine the cause of poor performance. One consideration often overlooked is a phenomenon called End of Session Cueing that may exist in detection training whereby a previously trained canine no longer responds to odor because it has taken on aversive association. This may be due to several factors associated with motivation. The sequence of events at the end of a session can be as equally important to maintain motivation for the task of scent detection in future sessions. This paper will identify and examine multiple factors associated with “End of Session Cues” in working dogs, how they may be responsible for poor final response performance and discuss potential strategies to address them.

Daily dynamic assessment and modelling of intersession processes in ambulatory psychotherapy: A proof of concept study

Background: the typical mode of assessment in studies on intersession processes (ISP) in psychotherapy is using cross-sectional or weekly measurements. Daily dynamics of intersession processes have not yet been studied. Method: intersession process data from 22 ambulatory psychotherapy cases were collected in a naturalistic study with high temporal resolution, resulting in a total of 1026 daily measurements. Multilevel vector autoregressive (VAR) modelling was applied to discover the temporal course and causal influences among intersession processes. Centrality analysis was applied to discover unique functions of various intersession process variables. Results: a group-level network structure was discovered, offering first insights on the role of different intersession processes during psychotherapy. Centrality analysis revealed unique roles for various aspects of the intersession process. Temporal distance from the last session had only weak influence on the ISP. Conclusions: using short, daily measures, the unique role of various aspects of the ISP were uncovered. Some aspects of the ISP, like recalling session contents or reflection on future session contents, are facilitators of overall ISP intensity. Other aspects like thoughts on payment or appointments or negative treatment-related emotions are likely to suppress ISP.

Therapist turnover and client non-attendance

ObjectivesAlthough turnover, defined as when a therapist leaves his/her organization, occurs frequently in public mental health organizations, its impact on clients is understudied. This study examined the effects of turnover on client engagement among youth receiving services in one public mental health agency. MethodsData were abstracted through a retrospective chart review of 76 clients who initiated outpatient trauma-focused treatment with 30 therapists between June 2013 and January 2016 at one agency in Philadelphia. Client demographic information, client session attendance, and therapist for each session was abstracted from each chart. The dependent variable (i.e., client engagement) was operationalized as client attendance to scheduled sessions. Mixed-effects regression analyses were used. ResultsYouth who experienced therapist turnover were 86% more likely to miss a future scheduled therapy session. When exploring this effect by diagnosis, youth without a Post-Traumatic Stress Disorder (PTSD) diagnosis were more likely to miss a scheduled session following therapist turnover than those with a PTSD diagnosis (p < .05). ConclusionsTherapist turnover is a strong predictor of client engagement among youth receiving trauma-focused treatment, and a PTSD diagnosis may be a protective factor against missing sessions. Implications for treatment planning in the face of therapist turnover are discussed.

Virtual Education for Older Adults with Type 2 Diabetes during Transitions

Compared to older adults without type 2 diabetes (T2D) older adults with T2D have higher rates of hospital admission and readmission. Despite having a diagnosis of T2D, attendance of diabetes self-management education (DSME) classes by older adults is low. Hospitalizations are an opportune time to engage older adults with T2D, currently no interventions exist utilizing telehealth and DSME for this population during transitions. The purpose of this study is to demonstrate the feasibility of providing DSME through telehealth to older patients with T2D following a hospital admission. We conducted a qualitative study using semi-structured, face-to-face interviews with older adults with T2D engaged in a post-discharge DSME telehealth transitions intervention. Hospitalized older adults (≥ 55 years of age) with T2D were recruited. An advanced practice nurse certified diabetes educator provided one in-person home visit within 48 hours of discharge and weekly DSME sessions via electronic tablet for four additional weeks. After completion of the program, eight patients were asked to describe their experience using the tablet to receive DSME, describe any behavior changes, and if they would accept future education virtual visits. Interviews were audio-recorded, transcribed verbatim and content analyzed thematically. Participants (50% male, aged 57-73 years, 75% African American), cited inconvenience and lack of availability as the leading cause for prior DSME non-attendance. Participants described an increased awareness of dietary habits and more frequent monitoring of glucose. Seven out of 8 participants indicated they would participate in future virtual DSME sessions. Every participant indicated the technology was easy to use and would recommend sessions to others. Our findings support ADA recommendations to improve transitions and to evaluate DSME need at this critical time. Technology use is feasible to enhance availability and convenience for continued DSME in the home after a hospital admission. Disclosure C.R. Whitehouse: None. J.A. Long: None. L. McLeer Maloney: None. D.A. Horowitz: None. K. Bowles: None.

Student affairs assessment: Sharing results through poster sessions

At a private four-year university, two student life poster sessions were held in order to share student affairs assessment projects and their results with the larger university community. During the sessions, faculty members, administrators, staff, and students viewed eleven posters highlighting various assessment projects having to do with student development. Topics included 1) student learning in public deliberation initiatives, 2) findings from a campus food insecurity task force, 3) correlations between attendance at summer orientation programs and retention, and 4) an assessment of goals related to the faculty-in-residence program. The process involved in preparing for the poster sessions included securing a venue, soliciting posters, offering training on poster preparation, advertising the poster sessions, holding the sessions, and assessing the sessions. Insights from the sessions included the positive impact of the sessions as well as suggestions for ways future sessions could be improved. It was observed that training was needed on how to present a poster as well as the purpose of a poster session. The process involved in conducting the sessions and insights gained are shared for the benefit of those who may wish to utilize this simple and cost-effective method to encourage student affairs assessment at their institution.

Abstract P-088: HOW MANY NWTS DOES IT TAKE TO CHANGE A REGION? THE PROVISION OF A REGIONAL EDUCATION PROGRAMME BY A PAEDIATRIC TRANSPORT TEAM

Aims & Objectives: In addition to transporting critically ill children throughout the North West, The North West and North Wales Paediatric Transport Service (NWTS) offer education and outreach to 32 District General Hospitals, reaching over 1000 nurses, ODP, ANP’S and consultant and trainee anaesthetists, paediatricians, intensivists and emergency physicans annually. Methods The NWTS education team (led by a Consultant and Clinical Nurse Specialists, supported by educational Clinical Fellows and administrator) aim to engage as many colleagues as possible by utilising a variety of educational strategies such as outreach, Paediatric Critical Care Network medical and nurses sub group meetings, debriefs, conferences, and postgraduate teaching for both nursing and medical staff. Since the commencement of our outreach service in 2010, annual individualised outreach sessions are offered to each DGH in the region. Results Last year over 1000 professionals accessed our education programmes with up to 72 attendees per session. We have received excellent feedback - “Good to hear different experts and specialities offer their ideas / advice, improving thoughts on approach to sick child and managing this, understanding the best use of inotropes and airway problem solving” Conclusions Our main focus for future sessions is to encourage a wider variety of professionals to attend, as learning opportunities are enhanced when a number of teams come together. New technology such as teleconferencing will increase our capabilities both in the acute setting and for debrief and teaching opportunities. The forthcoming ‘Little Airways’ course aims to increase the clinical skills and confidence of DGH staff in managing the neonatal/infant airway.

Development and Evaluation of an Epidural Analgesia Workshop for Senior Nursing Students.

Most prelicensure nursing students receive little to no training in providing care for patients who receive epidural analgesia, despite exposure in clinical settings and the potential for devastating adverse effects. To develop and pilot an epidural workshop for senior nursing students using standardized patients (SPs), and to evaluate feasibility and learner outcomes. A 4-hour epidural workshop consisted of a large group lecture and demonstration, small-group practice scenarios, and individual learner evaluation with SPs. Learning outcomes were evaluated using a performance checklist and critical thinking rubric, and pre- and posttests. Participants scored well on the performance-based evaluation (mean score of 86% items performed correctly) and rated the workshop highly. However, learners and instructors made several recommendations for improving the learning module for future sessions. This pilot project demonstrated that an epidural analgesia workshop using SPs is feasible and results in positive learning outcomes and high satisfaction with senior nursing students. [J Nurs Educ. 2018;57(6):359-365.].

Perceived utility and relevance of intern well‐being sessions

We conducted a pilot project assessing the perceived utility and relevance of well-being sessions provided to interns at a large regional teaching hospital in Australia, with the aim of promoting intern well-being and fostering a nurturing and supportive learning and work hospital culture. Our intervention involved two separate 60-min lectures covering well-being topics and skills to approximately 50 interns within protected teaching time, along with emailed well-being resources. Participants were emailed an online survey asking questions about value and novelty of the sessions, and work satisfaction and stress, as well as open comments. A request for an additional interview to explore responses in more depth was included. Fifty interns attended at least one of the sessions and 35 participated in the survey, six to an additional interview. Survey and interview data showed that the majority of interns perceived the sessions as valuable, relevant and useful and felt that ongoing sessions would benefit junior medical officers in future years. Feedback highlighted the importance of providing future sessions in person, incorporating an interactive approach and emphasised that work site factors and medical culture play a large causative role in their stress. We conclude that well-being sessions are acceptable and useful to interns and should be incorporated into hospital teaching curricula, and evaluated. However, these programmes are unlikely to change the high stress experienced unless external and systemic stressors are addressed by all stakeholders.