A Single-center Exploration of Attitudes to Deceased Organ Donation Over Time Among Healthcare Staff in Intensive Care.

Background: Changes to deceased organ donation in the United Kingdom, including establishment of the specialist nurse for organ donation (SNOD) role, have resulted in increased numbers of donations. Have increasing numbers of donations altered attitudes among intensive care unit (ICU) healthcare professionals (ICU staff) to organ donation over time? Methods: A written survey of ICU staff at Nottingham University Hospitals National Health Service Trust was conducted across 2 wk in 2015, 2018, and 2020 (pre-COVID-19). Participants were asked to submit descriptors (words/phrases) they associated with 3 aspects of donation: donation after brain death (DBD), donation after circulatory death (DCD), and SNOD role. Three independent and blinded assessors categorized the descriptors as positive or negative in favorability. Thematic analysis was used to identify trends within each group of descriptors. Results: Across the 3 surveys, 281 responses were returned, containing a total of 2095 descriptors. Positive descriptors were found in 65% of DBD responses, 46% of DCD responses, and 92% of SNOD role. Over time, there was some evidence of increased polarization of opinion for DCD and to a smaller degree DBD. Attitude toward the SNOD role remained consistently highly favorable over time. Thematic analysis was correlated with the assessor favorability ratings to identify specific factors for positive or negative attitudes; this demonstrated the themes that were the most common causes of positive or negative attributions for each aspect of organ donation. Conclusions: ICU staff were found to be highly favorably positive toward the SNOD role, positive toward DBD, and negative toward DCD. Although we found broadly positive perceptions of the benefits of deceased organ donation, negative attitudes toward DCD centered on timescale and complexity of the donation process. Measurement of staff attitudes to organ donation may allow targeted interventions that support staff and improve patient and family care through the organ donation process.

Academic ability and teamworking in medical students.

BACKGROUND: Teamworking is an essential skill for a doctor to develop in order to work effectively, and is required in the UK as part of the General Medical Council (GMC) Good Medical Practice guidance. Assessment of teamwork may be difficult, however, with medical school assessments being more commonly focused on knowledge and individual skills. We aim to explore the link between academic ability as measured at final medical examinations and teamworking. METHODS: All final-year medical students were asked to attend a simulation session in an immersive 22-bed simulated ward, which used a combination of patient simulators and high-fidelity manikin simulators, with nursing and telephone support. Students were split into separate groups stratified by performance in final-year assessments or in groups with mixed performance. Students were observed in real time by faculty staff and assessed with the individual Teamwork Observation and Feedback Tool (iTOFT), around which the debriefing was centred. Assessment of teamwork may be difficult RESULTS: The performance of 119 students in simulation was assessed, and groups with a mix of academic performance showed significantly greater teamworking ability as measured with the iTOFT as compared with those stratified by performance (p = 0.045). Final assessment at medical school was shown to be a poor predictor of teamworking ability: those who performed best at assessment seemed to underperform in teamworking. DISCUSSION: The simulated-ward learning activity received positive feedback, although the mix of patient simulators and high-fidelity manikins proved a challenge to some students. Medical school assessments appear to be inadequate in the assessment of teamworking ability, with change needed in future to ensure that this and other non-technical skills are assessed.