Lundqvistrouse2785

Background International medical graduates (IMGs) contribute significantly towards the NHS care provision. No standardised clinical orientation programme (COP) for IMGs new to the NHS exists. Objective Our objective was to describe recruitment and retention strategies for junior doctors (JDs) in general medicine and develop a framework to anticipate outcomes of these interventions using the realist evaluation methodology. Methods We performed quality improvement interventions of recruitment and COP for new entrant IMGs in our organisation employed between December 2017 and April 2019. Results Twenty-three IMGs were recruited, 96% successfully completed the COP with a mean contract duration of 13±5 months. From the academic year 2017/18 to 2018/19, mean JD post occupancy increased from 54±3 to 73±4 JDs (p less then 0.001) and JD locum spend fell by £1.9 million. Conclusion Our structured COP provides a stable, trained and financially sustainable JD workforce. Application in broader NHS settings is recommended.Physicians take time out of training for a variety of reasons and, on their return, they often lack confidence and feel 'out of touch'. These trainees require enhanced support and concerns have been raised about trainers' lack of skills and knowledge in this area. A standardised workshop was developed and delivered to address this with a mixed-methods evaluation approach used to analyse data from participants before and after training. Quantitative analysis showed significant pre- to post-course improvements in trainers' ability to understand, explain and manage issues pertaining to trainees taking time out of training. Qualitative analysis yielded three 'learning' themes surrounding knowledge, understanding and awareness of support needed for returning trainees and three 'action' themes surrounding disseminating information, providing resources and actively supporting returning trainees. Framework analysis of follow-up interviews demonstrated not only retention of topics learned but also positive changes in behaviour.In preparation for the internal medicine training (IMT) programme introduced in 2019, the core medical training (CMT) programme in London was made 'IMT-ready' in 2018 by creating new rotations that reflected the compulsory requirements of the first 2 years of the IMT curriculum, including provision of the requisite number of critical care placements. Core medical trainees completed posts within the 'IMT-ready' programme between August 2018 and August 2019, during which time the trainee experience was evaluated. A total of 497 responses were received. Of these, 96% of trainees were on an 'acute unselected take' on-call rota, 79% were able to attend outpatient clinics, 80% had the opportunity to practise procedural skills and 88% had the opportunity to apply palliative care skills. Clear areas for improvement were identified that predominantly focused on the need to optimise trainee attendance of outpatient clinics and the number of patients seen during an acute take. With respect to future career intentions, only 63% of trainees planned on applying to a group 1 (with general medicine) higher medical specialty. Thematic analysis of trainees in critical care placements highlighted an appreciation of the level of senior support, feeling well integrated into the team, a positive experience of induction and excellent opportunities for performing procedures.Medical education has changed focus to a more learner-centred model, placing learners at the centre of innovations in training. The escape room is one such innovative learner-focused activity, in which a team of players cooperatively discover clues, solve puzzles and complete tasks in order to progress through the challenge to achieve a specific goal. Escape rooms can be used in medical education as a tool for team building, an entertaining way of delivering technical and non-technical skills, to read and acquire or refresh knowledge, as well as for educational research. Despite appearing to be a superficial form of entertainment, escape rooms can be grounded in sound educational theory and, when used effectively, act as a low-cost, high-impact resource for a variety of learners. While escape rooms may well be an example of yet another educational 'fad' demonstrating the rising influence of 'Millennial MedEd', it signals a promising shift to more learner-centred, team-based methods which are essential to the practice of safe modern healthcare during the current COVID-19 pandemic and beyond.The impact of incivility in terms of individual and team performance in clinical environments is increasingly acknowledged and supported by a growing evidence base. However, clinical environments are not just areas where patient care is delivered, they are also rich, key learning arenas for healthcare professionals. To date, the potential impact of incivility in clinical environments on healthcare professional learning and development has not been comprehensively explored. This article provides an overview of the physiological mechanisms that inhibit learning and memory recall in individuals experiencing or observing incivility and social stress. It establishes a clear need for focus on the impact of incivility on clinical learners and educators and further evidence for the need for clinical environments in which civility is firmly rooted into the pervading culture.Introduction With increasing demand on general practitioners (GPs) and emergency departments (EDs), patient empowerment for appropriate self-care and inspiring medical careers is vital to sustaining the NHS. Dr. Me trains doctors and medical students to teach primary school children how to self-care for common self-limiting illnesses. Niacinamide Sirtuin inhibitor Methods Volunteers delivered 1-hour Dr. Me sessions in schools, covering workshops on vomiting and diarrhoea; sore throat and fever; and minor and head injuries. Six case scenarios were asked at the beginning and end of the session, and children decided whether to stay home, visit the GP or attend the ED. Responses before and after were compared. A feedback questionnaire gauged confidence in self-care and interest in medical careers. Results Dr. Me taught 216 children. Correct responses after the sessions improved by 16.3% (p less then 0.00001). Vomiting scenarios improved from 48.1% to 68.8%, sore throat from 63.9% to 87.5%, and minor injuries from 84.7% to 89.4%. Feedback showed 93.