Regaining creativity in science: insights from conversation.

The 'early modern' (Renaissance) workshop was predicated on the idea that informal, open-ended cooperation enables participants to experience difference and develop new insights, which can lead to new ways of thinking and doing. This paper presents the insights that emerged from a conversation event that brought wide-ranging voices together from different domains in science, and across the arts and industry, to consider science leadership as we look to the future in a time of interlocking crises. The core theme identified was a need to regain creativity in science; in the methods of scientific endeavours, in the way science is produced and communicated, and in how science is experienced in society. Three key challenges for re-establishing a culture of creativity in science emerged: (i) how scientists communicate what science is and what it is for, (ii) what scientists value, and (iii) how scientists create and co-create science with and for society. Furthermore, the value of open-ended and ongoing conversation between different perspectives as a means of achieving this culture was identified and demonstrated.

Surgical Performance Anxiety and Wellbeing Among Surgeons: A Cross-sectional Study in the United Kingdom.

OBJECTIVE: This national cross-sectional study aims to establish the prevalence and potential impact of performance anxiety among surgeons and investigate its association with psychological traits and wellbeing. SUMMARY AND BACKGROUND DATA: Despite a growing awareness that human factors, non-technical skills and wellbeing in healthcare affect patient outcomes, an area that has remained unexplored is surgical performance anxiety (SPA). METHODS: A prospectively registered, cross-sectional study using mixed methods was conducted across the United Kingdom. Data captured included demographics, surgical specialty, trait anxiety, trait perfectionism, SPA, and surgical perfectionism scores. Wellbeing was assessed using The Short Warwick-Edinburgh Mental Wellbeing Scale, whereas qualitative data were collected regarding surgeons' experiences of SPA. RESULTS: A total of 631 responses were collected. Mean age was 41·2 years and mean surgical experience 15·3 years. A total of 62% were male and 52% of consultant/attending grade. A total of 100% felt that SPA affected surgeons, with 87% having experienced it themselves. A total of 65% reported SPA negatively impacted surgical performance and 96% felt SPA negatively impacted surgeons' wellbeing. Male surgeons reported significantly better wellbeing than female surgeons. Surgeons with SPA reported significantly worse wellbeing compared with surgeons who did not experience SPA. Surgeons in general experienced significantly lower mental wellbeing compared with population norms. Thematic analysis highlighted a reticence to share SPA openly and need for cultural change. CONCLUSIONS: Surgical performance anxiety is a very common and significant challenge among surgeons across all specialties at all levels of experience in the United Kingdom. It is perceived by surgeons to affect surgical performance adversely and is associated with worse psychological wellbeing. A more open culture of sharing and acknowledgment has been identified to be beneficial.

Qualitative evaluation of asthma services for young people: a sequential simulation study.

Background: Asthma is the most common chronic disease of childhood and an important preventable cause of mortality in children and young people (CYP). Few studies have brought together CYP and health professionals to understand the patient perspective of routine asthma care. We sought to explore how young people engage with routine asthma care in North West London through sequential simulation. Method: We designed a sequential simulation focusing on routine asthma management in young people aged 12-18. A 20 min simulation was developed with four young people to depict typical interactions with school nurses and primary care services. This was performed to a mixed audience of young people, general practitioners (GPs), paediatricians, school nurses and commissioners. Young people were invited to attend by their GPs and through social media channels. Attendees participated in audio-recorded, facilitated discussions exploring the themes arising from the simulation. Recordings were transcribed and subjected to thematic analysis. Results: 37 people attended the sequential simulation. Themes arising from postsimulation discussions included recognition of chaotic family lifestyles as a key barrier to accessing care; the importance of strong communication between multidisciplinary team professionals and recognition of the role school nurses can play in delivering routine asthma care. Conclusion: Sequential simulation allows healthcare providers to understand routine asthma care for CYP from the patient perspective. We propose improved integration of school nurses into routine asthma care and regular multidisciplinary team meetings to reduce fragmentation, promote interprofessional education and address the widespread professional complacency towards this lethal condition.

Cross-disciplinary perspectives on the transition to remote education.

The COVID-19 pandemic has prompted the cancellation of clinical attachments and face-to-face teaching at medical schools across the world. Experiential learning-through simulation or direct patient contact-is essential for the development of clinical skills and procedural knowledge. Adapting this type of teaching for remote delivery is a major challenge for undergraduate medical education. It is also an opportunity for innovation in technology enhanced learning and prompts educators to embrace new ways of thinking. In this article, the authors explored how educators from different disciplines (medicine, music and performing arts) are using technology to enhance practical skills-based learning remotely. The authors, five experienced educators from different fields (surgery, medicine, music and magic), jointly documented the transition to technology enhanced remote teaching through a series of five structured conversations. Drawing from literature on distance learning in medicine and professional experience in education, the authors identified seven practice-enhancing recommendations for optimising teaching of procedural knowledge and skills. These are: (1) make a virtue out of necessity; (2) actively manage your environment; (3) make expectations clear; (4) embrace purposeful communication; (5) use digital resources; (6) be prepared for things to go wrong and (7) personalise the approach. The authors argue that widening the discourse in technology enhanced learning to include cross-disciplinary perspectives adds richness and depth to discussions. This article demonstrates a cross-disciplinary approach to addressing challenges in technology-enhanced medical education.

Taking the Pressure Off the Patient - Understanding Digital Rectal Examinations on a Real Subject.

Better understanding of palpation techniques during unsighted physical examinations has mostly been limited to qualitative and quantitative studies of performance of experts whilst conducting examinations on plastic benchtop models. However, little is known about their performance when conducting such examinations on real subjects. OBJECTIVE: The aim of this paper is to better understand palpation techniques of experts whilst conducting a Digital Rectal Examination on a real subject. METHODS: We recruited four consultants from relevant specialties and asked them to conduct two DREs on a Rectal Teaching Assistant whilst wearing small position and pressure sensors on their examining finger. We segmented the relevant anatomy from an MRI taken of the pelvic region, registered 3D models and analysed retrospectively performance in relation to executed tasks, supination/pronation, palpation convex hull and pressure applied. RESULTS: Primary care consultants examined the anatomy more holistically compared to secondary care experts, the maximum pressure applied across experiments is 3.3N, overall the pressure applied on the prostate is higher than that applied to rectal walls, and the urologist participant not only applied the highest pressure but also did so with the highest most prominent frequency (15.4 and 25.3 Hz). CONCLUSIONS: The results of our research allow for better understanding of experts' technical performance from relevant specialities when conducting a DRE, and suggest the range of pressure applied whilst palpating anatomy. SIGNIFICANCE: This research will be valuable in improving the design of haptics-based learning tools, as well as in encouraging reflection on palpation styles across different specialities to develop metrics of performance.