Pathways to paediatric urology subspecialisation: a study of casemix, incumbent attitudes and opinions.

OBJECTIVE: To identify any self-reported differences or attitudes towards certification, publication, or practice patterns between adult urology and paediatric general surgery-trained paediatric urology providers. There are no known published differences in clinical/operative/research outcomes in either group. METHODS: An 18-item cross-sectional survey was compiled through the EAU Young Academic Urologists (YAU) office and disseminated to a trans-Atlantic convenience sample of current practising paediatric urologists. This was created using a mini-Delphi method to provide current semi-quantitative data relating to current opinions and attitudes of this cohort. RESULTS: A total of 228 respondents completed the survey, with female respondents representing 37% and 34% for urology and paediatric general surgery, respectively. Nearly 90% overall respondents felt that a full 2-year paediatric fellowship program was very important and 94% endorsed a collaborative dedicated paediatric urology on call service, with 92% supporting the joint development of transitional care. Urology managed higher numbers of bedwetting (p = 0.04), bladder bowel dysfunction (p = 0.02), endourological procedures (p = 0.04), and robotics (p = 0.04). Paediatric general surgery managed higher numbers of laparoscopic reconstruction (p = 0.03), and posterior urethral valve ablation (p = 0.002). CONCLUSION: This study represents the first time that a cross-sectional cohort of paediatric urologists from different training backgrounds were compared to assess their productivity, practice patterns and attitudes. Paediatric urology is in a unique position to have two contributing specialities, with the ability to provide optimal transitional and lifelong care. We believe that there should be a strong emphasis on collaboration and to remove any historically-created barriers under policies of equity, diversity and inclusivity.

What Does It Mean to Be an Interventional Radiologist? SIR and the Private Practice Initiative.

The new interventional radiology (IR) residency training pathways seek to graduate physicians who are not only experts at imaging and technically savvy but clinically oriented doctors capable of preprocedural workup and postprocedural care. The goal is for compassionate IRs who are holistic in their treatment of the patient and their disease, not just an expert at the procedure. However, much of this new envisioned approach for the modern IR is contradicted by the stark reality that most IRs in practice today (and most of the job market) are in private practice, where resources for clinical care in reality may not be prioritized as much in this idealistic scenario. The Society of Interventional Radiology (SIR) has recently made it a priority to represent the unique needs and frustrations of IRs in private practice and hopefully find a solution to the imminent reality that is facing most practicing IRs and future graduates.

Evolution of the general practice pharmacist's role in England: a longitudinal study.

BACKGROUND: To address the growing GP workforce crisis, NHS England (NHSE) launched the Clinical Pharmacists in General Practice scheme in 2015. The NHSE scheme promotes a newer, patient-facing role for pharmacists and, currently, there is little insight into the role and activities undertaken. All scheme pharmacists are enrolled on the general practice pharmacist training pathway (GPPTP). AIM: To investigate the role evolution and integration of clinical pharmacists in general practice in England. DESIGN AND SETTING: Longitudinal survey of all phase 1 GPPTP registrants working in general practice at start of (T1) and 6 months into (T2) training. METHOD: An online longitudinal survey was administered to all phase 1 GPPTP registrants (n = 457) at T1 and T2, measuring their perceived knowledge, skill, and confidence, activities performed, and perceptions of practice integration, environment, and support. Descriptive statistics and non-parametric tests were conducted. RESULTS: Response rates were 46% (T1) and 52% (T2); 158 participants completed both questionnaires. Perceived knowledge, skill, and confidence levels increased significantly from T1 to T2 for all areas, except for managing acute or common illness. Scope of practice increased significantly, particularly in patient-facing activities. Sharing office space with administrative staff was common and 13% of participants reported having no designated work area. Perceived integration at T2 was fairly high (median = 5 on a scale of 1-7) but GP clinical support was 'too little' according to one-third of participants. CONCLUSION: Findings show not only patient-facing role expansion, but also practice environment and support issues. Pharmacists may appreciate more GP time invested in their development. Practices need to be realistic about this support and not expect an immediate reduction in workload.

The Supply and Demand of the Cardiovascular Workforce: Striking the Right Balance.

As the burden of cardiovascular disease in the United States continues to increase, uncertainty remains on how well-equipped the cardiovascular workforce is to meet the challenges that lie ahead. In a time when health care is rapidly shifting, numerous factors affect the supply and demand of the cardiovascular workforce. This Council Commentary critically examines several factors that influence the cardiovascular workforce. These include current workforce demographics and projections, evolving health care and practice environments, and the increasing burden of cardiovascular disease. Finally, we propose 3 strategies to optimize the workforce. These focus on cardiovascular disease prevention, the effective utilization of the cardiovascular care team, and alterations to the training pathway for cardiologists.

Where did the acute medical trainees go? A review of the career pathways of acute care common stem acute medical trainees in London.

Acute care common stem acute medicine (ACCS AM) training was designed to develop competent multi-skilled acute physicians to manage patients with multimorbidity from 'door to discharge' in an era of increasing acute hospital admissions. Recent surveys by the Royal College of Physicians have suggested that acute medical specialties are proving less attractive to trainees. However, data on the career pathways taken by trainees completing core acute medical training has been lacking. Using London as a region with a 100% fill rate for its ACCS AM training programme, this study showed only 14% of trainees go on to higher specialty training in acute internal medicine and a further 10% to pursue higher medical specialty training with dual accreditation with internal medicine. 16% of trainees switched from ACCS AM to emergency medicine or anaesthetics during core ACCS training, and intensive care medicine proved to be the most popular career choice for ACCS AM trainees (21%). The ACCS AM training programme therefore does not appear to be providing what it was set out to do and this paper discusses the potential causes and effects.

Principios básicos para una ruta de formación en la cualificación de los docentes en el diseño y aplicación de recursos educativos digitales / Basic principles for a training pathway in the teaching qualification in terms of design and application of digital educational resources

Resumen La implementación de rutas de formación para los docentes orientados a la cualificación, diseño y aplicación de recursos educativos digitales son necesarios y prioritarios para que las instituciones avancen hacia la transformación cultural requerida en los procesos de enseñanza-aprendizaje con soporte en las TIC. Esto implica una revisión de la construcción de los conceptos de comunidades de aprendizaje, práctica, práctica virtual, zona de desarrollo próximo en la práctica pedagógica, las relaciones en los ambientes virtuales de aprendizaje y las competencias docentes en el uso de las TIC.

Abstract The implementation of teacher training pathways aiming at the qualifica tion, design, and application of digital educational resources are necessary and priority so that institutions move towards the required cultural transformation in the teaching and learning processes with ICT support. This involves a review of the construction of the concept of communities of learning, communities of practice, virtual practice, zone of proximal development in pedagogical practice, relationships in virtual learning environments, and educational expertise in the use of ICT.