The value of European exchange programs for early career family doctors.

The Hippokrates Exchange programme (HEP) is designed to give early career General Practitioners (Associates in Training (AITs)/First5s) first-hand experience into concepts of a primary healthcare system outside of their host country. The aim is to improve GP knowledge and skills, inspire professional development and promote a global approach to primary care. Although an increasing number are taking up this opportunity, their views and experiences of international exchanges are not well described. The aim of the study was to explore the experiences of AITs/First5s following their HEP exchanges. This qualitative study analysed 16 post-exchange reports of UK participants visiting 10 European countries via the HEP, using a thematic approach. Participants were unanimously positive about their exchange experiences. The themes that emerged were (1) Comparison of primary care practice (2) Infrastructure of host primary care (3) Motivation and experience of exchanges and (4) Learning and reflection. Participants displayed considerable benefits from these exchanges by broadening their experience in different primary care systems and identifying improvements to be incorporated into their UK practice.

Production improves recognition and reduces intrusions in between-subject designs: An updated meta-analysis.

The production effect refers to the finding that words read aloud are better remembered than those read silently. This pattern has most often been explained as arising from the incorporation of sensorimotor elements into the item representation at study, which could then be used to guide performance at later test. This theoretical framework views aloud items as being distinctive in relation to silent items, and thus the effect was thought to emerge only when production was manipulated within-subjects. This claim was later challenged, and a reliable (albeit smaller) between-subject production effect has since been shown in recognition memory. Across a series of meta-analyses, we extend this earlier work, replicating the between-subject production effect for recognition, and demonstrating no such effect for overall target recall. However, supporting recent theoretical claims, we further observed an interaction between the production effect and serial position within recall, such that a production effect was observed for late time points but not early time points (a similar, albeit smaller and noncredible trend was observed for recognition). Finally, we provide evidence that production reduces off-list intrusions. In summary, production has a reliable impact on recognition memory when manipulated between-subjects, but a more complex relationship with recall performance. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Should we involve terminally ill patients in teaching medical students? A systematic review of patient's views.

OBJECTIVE: To review available published research that has explored how terminally ill patients feel about being involved in undergraduate medical teaching. METHODS: A systematic review using narrative synthesis. Qualitative or quantitative publications were included if they directly explored the views of adult patients, with a terminal diagnosis, about their involvement in undergraduate clinical teaching. RESULTS: Seven publications met the inclusion criteria: one case report, one qualitative study and five questionnaire-based studies. A total of 269 patients were included across all studies. Patients were predominantly studied in a hospice or hospice day care setting. Both patients who had, and who had not, previously been involved in student teaching were captured by the included publications. In general, the views of patients were highly positive: overall 85%-100% were in favour of involvement in teaching. There were also some negative aspects, such as: concerns about being physically examined by a student; finding involvement in teaching tiring; feeling unable to decline consent to participate. CONCLUSIONS: An assumption that clinical undergraduate medical teaching involving terminally ill patients may be too burdensome is not reflected overall in studies that have sought the views of the patients themselves. Understanding the patient's perspective provides a number of practical points in relation to how clinical teaching should be adapted in this patient group; for example, using smaller student group sizes; direct supervision if physical examination performed; short encounters with multiple patients rather than a longer encounter with one patient; adequate informed consent beforehand and without the students automatically being present.

GP speciality trainees' knowledge, attitude and practice regarding risks associated with common radiological investigations.

BACKGROUND: Thirty-eight million radiological or radio-diagnostic tests were undertaken in England between August 2010 and August 2011. A systematic review of studies based in secondary care reports that risk is rarely discussed with patients undergoing radiological investigations and only a minority of hospital doctors are well informed about the dose and risk associated with common radiological procedures. There is little available evidence on knowledge, attitudes and practice of radiological risk in a primary care setting. OBJECTIVES: Explore knowledge, attitudes and practice of discussing risks associated with common radiological procedures amongst current general practice specialty trainees (GPSTs). DESIGN: cross-sectional questionnaire-based survey. SETTING: GPSTs in Wales. OUTCOMES MEASURED: trainees' current knowledge, attitude and practice with regard to risk communication about radiological procedures. Participants estimated the radiation dose of common radiological investigations, using a chest X-ray as one unit. Participants were also asked to estimate the lifetime cancer risk associated with common radiological procedures. RESULTS: One hundred and twenty-eight completed questionnaires were returned (response rate 32%). Only 28% of respondents had prior radiation training. Although most respondents felt it was the referrer's role to explain the risk of radiological procedures (85%), the vast majority underestimated the radiation doses associated with commonly requested investigations, including lumbar and thoracic spine X-rays. CONCLUSION: General practice specialty trainees underestimate the risk of common radiological procedures. Educational interventions are needed to address this issue, particularly in light of increasing open access to radiology in primary care.

Resuscitation on television: realistic or ridiculous? A quantitative observational analysis of the portrayal of cardiopulmonary resuscitation in television medical drama.

INTRODUCTION: Patients' preferences for cardiopulmonary resuscitation (CPR) relate to their perception about the likelihood of success of the procedure. There is evidence that the lay public largely base their perceptions about CPR on their experience of the portrayal of CPR in the media. The medical profession has generally been critical of the portrayal of CPR on medical drama programmes although there is no recent evidence to support such views. OBJECTIVE: To compare the patient characteristics, cause and success rates of cardiopulmonary resuscitation (CPR) on medical television drama with published resuscitation statistics. DESIGN: Observational study. METHOD: 88 episodes of television medical drama were reviewed (26 episodes of Casualty, Casualty, 25 episodes of Holby City, 23 episodes of Grey's Anatomy and 14 episodes of ER) screened between July 2008 and April 2009. The patient's age and sex, medical history, presumed cause of arrest, use of CPR and immediate and long term survival rate were recorded. MAIN OUTCOME MEASURES: Immediate survival and survival to discharge following CPR. RESULTS: There were a total of 76 cardio-respiratory arrests and 70 resuscitation attempts in the episodes reviewed. The immediate success rate (46%) did not differ significantly from published real life figures (p=0.48). The resuscitation process appeared to follow current guidelines. Survival (or not) to discharge was rarely shown. The average age of patients was 36 years and contrary to reality there was not an age related difference in likely success of CPR in patients less than 65 compared with those 65 and over (p=0.72). The most common cause of cardiac arrest was trauma with only a minor proportion of arrests due to cardio-respiratory causes such as myocardial infarction. CONCLUSIONS: Whilst the immediate success rate of CPR in medical television drama does not significantly differ from reality the lack of depiction of poorer medium to long term outcomes may give a falsely high expectation to the lay public. Equally the lay public may perceive that the incidence and likely success of CPR is equal across all age groups.