Practice based small group learning during a pandemic: an evaluation from Defence Primary Healthcare.

The educational benefits of Practice-Based Small Group Learning (PBSGL) are well known. The Ministry of Defence in the United Kingdom employs a salaried healthcare workforce across the globe with staff frequently moving. Given the success of PBSGL in Canada and Scotland, PBSGL was introduced as a large pilot to assess it as a continuous professional development (CPD) resource. A survey gathering quantitative and qualitative was distributed to the pilot population after using PBSGL for 12 months. This showed the favoured types of CPD were PBSGL and taught CPD update courses. Themes identified from free-text comments were: developing professional educational networks during Covid; evolving themes of CPD; applying learning to practice; practical aspects of delivering CPD to Defence promoting a positive learning environment; human interaction is therapeutic. These were similar to educational and non-educational benefits found in previous evaluations, but with the added benefit of providing a professional educational network during the COVID pandemic. Benefits were preserved when the sessions were run remotely using video-conferencing, although some of the human interaction was lost. As CPD, it was highly valued. For Defence, who need to consider the CPD requirements of their workforce, provision of PBSGL alongside taught CPD updates may satisfy the learning needs of the majority of the workforce.

Implicit bias in healthcare: clinical practice, research and decision making.

Bias is the evaluation of something or someone that can be positive or negative, and implicit or unconscious bias is when the person is unaware of their evaluation. This is particularly relevant to policymaking during the coronavirus pandemic and racial inequality highlighted during the support for the Black Lives Matter movement. A literature review was performed to define bias, identify the impact of bias on clinical practice and research as well as clinical decision making (cognitive bias). Bias training could bridge the gap from the lack of awareness of bias to the ability to recognise bias in others and within ourselves. However, there are no effective debiasing strategies. Awareness of implicit bias must not deflect from wider socio-economic, political and structural barriers as well ignore explicit bias such as prejudice.

Individual Attributes, Values, and Goals of an All-Military Women Antarctic Expedition.

BACKGROUND: While participation of women in the military has increased, research on performance of female teams engaged in arduous physical activity in isolated, confined, and extreme (ICE) environments remains sparse.METHODS: A team of six British military women completed the Multidimensional Personality Questionnaire-Brief Form, Triarchic Psychopathy Measure, and Personal Values Questionnaire (PVQ) prior to embarking on an expedition that traversed the Antarctic continent. Questionnaires were completed weekly on the ice; repeat of the PVQ and individual semistructured debriefing interviews were carried out within 9 d post-expedition.RESULTS: Personality findings indicated a generally well-adjusted group with notable individual differences in personality and personal values. Positive affect and camaraderie among teammates was evident throughout, although pace vs. distance in the strategy of the daily trek was a continuing point of tension. Honesty in communication was viewed as key to team effectiveness. A significant post-expedition decline in the tradition value (Pre M = -0.55, SD = 0.99; Post M = -0.82, SD = 1.12) and an increase in the conformity value (Pre M = -0.26, SD = 0.46; Post M = 0.18, SD = 0.27) was found.DISCUSSION: Congruence in personal and team goals among group members engaged in highly challenging activities is crucial for optimal team performance. Presence of two highly dominant individuals has a negative effect on team dynamics. Application of study findings to space exploration is considered.Blackadder-Weinstein J, Leon GR, Norris RC, Venables NC, Smith M. Individual attributes, values, and goals of an all-military women Antarctic expedition. Aerosp Med Hum Perform. 2019; 90(1):18-25.

Female Reproductive, Adrenal, and Metabolic Changes during an Antarctic Traverse.

PURPOSE: To explore the effects of the first all-female transantarctic expedition on hormonal axes pertinent to reproductive and metabolic function. METHODS: Six females (age, 28-36 yr; body mass index, 24.2 ± 0.97 kg·m) hauled 80-kg sledges 1700 km in 61 d. Estimated average energy intake was 20.8 ± 0.1 MJ·d (4970 ± 25 kcal·d). Whole and regional body composition was measured by dual-energy x-ray absorptiometry 1 and 2 months before and 15 d after, the expedition. Body fat was also estimated by skinfold and bioimpedance immediately before and after the expedition. Basal metabolic and endocrine blood markers and, after 0.25 mg dexamethasone suppression, 1-h 10-µg gonadorelin and 1.0 µg adrenocortiocotrophin-(1-24) tests were completed, 39-38 d preexpedition and 4 to 5 d and 15 to 16 d postexpedition. Cortisol was assessed in hair (monthly average concentrations) and saliva (five-point day curves and two-point diurnal sampling). RESULTS: Average body mass loss was 9.37 ± 2.31 kg (P < 0.0001), comprising fat mass only; total lean mass was maintained. Basal sex steroids, corticosteroids, and metabolic markers were largely unaffected by the expedition except leptin, which decreased during the expedition and recovered after 15 d, a proportionately greater change than body fat. Luteinizing hormone reactivity was suppressed before and during the expedition, but recovered after 15 d, whereas follicle-stimulating hormone did not change during or after the expedition. Cortisol reactivity did not change during or after the expedition. Basal (suppressed) cortisol was 73.25 ± 45.23 mmol·L before, 61.66 ± 33.11 mmol·L 5 d postexpedition and 54.43 ± 28.60 mmol·L 16 d postexpedition (P = 0.7). Hair cortisol was elevated during the expedition. CONCLUSIONS: Maintenance of reproductive and hypothalamic-pituitary-adrenal axis function in women after an extreme physical endeavor, despite energy deficiency, suggests high female biological capacity for extreme endurance exercise.