ABSTRACT
New psychiatry residents must rapidly acquire new clinical skills and learn to work effectively with new colleagues. In medical and surgical specialties, high-fidelity simulation with structured debriefing is widely used, but so far this has not been applied to psychiatry. We have developed a one-day simulation-based training course for emergency psychiatry which incorporates clinical and team-working skills training. Five scenarios covering key psychiatric emergencies are delivered in a purpose-built simulation facility. Patients are played by an actor or a high-fidelity manikin. Each scenario is followed by a 45-minute group debrief. Evaluation of a pilot group found that the course was well received and improved participants' workplace confidence. We are now planning to expand the course, provide it to all new residents and conduct further evaluation.
Subject(s)
Emergencies , Internship and Residency/methods , Psychiatry/education , Clinical Competence , Communication , Humans , Interprofessional Relations , Manikins , Patient Simulation , Problem-Based Learning , Time FactorsABSTRACT
INTRODUCTION: This paper describes the evaluation of a 2-day simulation training programme for staff designed to improve teamwork and inpatient care and compassion in an older persons' unit. OBJECTIVE: The programme was designed to improve inpatient care for older people by using mixed modality simulation exercises to enhance teamwork and empathetic and compassionate care. METHODS: Healthcare professionals took part in: (a) a 1-day human patient simulation course with six scenarios and (b) a 1-day ward-based simulation course involving five 1-h exercises with integrated debriefing. A mixed methods evaluation included observations of the programme, precourse and postcourse confidence rating scales and follow-up interviews with staff at 7-9 weeks post-training. RESULTS: Observations showed enjoyment of the course but some anxiety and apprehension about the simulation environment. Staff self-confidence improved after human patient simulation (t=9; df=56; p<0.001) and ward-based exercises (t=9.3; df=76; p<0.001). Thematic analysis of interview data showed learning in teamwork and patient care. Participants thought that simulation had been beneficial for team practices such as calling for help and verbalising concerns and for improved interaction with patients. Areas to address in future include widening participation across multi-disciplinary teams, enhancing post-training support and exploring further which aspects of the programme enhance compassion and care of older persons. CONCLUSIONS: The study demonstrated that simulation is an effective method for encouraging dignified care and compassion for older persons by teaching team skills and empathetic and sensitive communication with patients and relatives.
Subject(s)
Computer Simulation , Health Personnel/education , Health Services for the Aged/standards , Interprofessional Relations , Patient Simulation , Quality Assurance, Health Care , Aged , Comprehensive Health Care/organization & administration , Hospital Units , Humans , Manikins , Models, Theoretical , Organizational Innovation , Outcome and Process Assessment, Health Care/methods , Patient Care Team/organization & administration , Patient-Centered Care , Professional-Patient Relations , Program Development , Program Evaluation , Surveys and Questionnaires , WorkforceABSTRACT
We report the successful exclusion of a ruptured left renal artery aneurysm as a first presentation of fibromuscular dysplasia in a haemodynamically unstable 57-year-old man. The aneurysm was repaired in an emergency setting by deployment of a covered stent with a satisfactory result. Follow-up computed tomography confirmed successful exclusion of the aneurysm. A renal artery branch originating from the aneurismal sac was sacrificed with subsequent regional infarction. Our experience shows that the use of a covered stent is an effective, quick and life saving procedure in a ruptured renal artery aneurysm.
Subject(s)
Aneurysm, Ruptured/etiology , Aneurysm, Ruptured/surgery , Fibromuscular Dysplasia/complications , Renal Artery , Stents , Acute Disease , Emergency Treatment , Humans , Male , Middle AgedABSTRACT
Genetically modified (or GM) plants have attracted a large amount of media attention in recent years and continue to do so. Despite this, the general public remains largely unaware of what a GM plant actually is or what advantages and disadvantages the technology has to offer, particularly with regard to the range of applications for which they can be used. From the first generation of GM crops, two main areas of concern have emerged, namely risk to the environment and risk to human health. As GM plants are gradually being introduced into the European Union there is likely to be increasing public concern regarding potential health issues. Although it is now commonplace for the press to adopt 'health campaigns', the information they publish is often unreliable and unrepresentative of the available scientific evidence. We consider it important that the medical profession should be aware of the state of the art, and, as they are often the first port of call for a concerned patient, be in a position to provide an informed opinion. This review will examine how GM plants may impact on human health both directly - through applications targeted at nutrition and enhancement of recombinant medicine production - but also indirectly, through potential effects on the environment. Finally, it will examine the most important opposition currently facing the worldwide adoption of this technology: public opinion.
