Eric Clarke

An international eDelphi study identifying the research and education priorities in wound management and tissue repair

AIM To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. BACKGROUND A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. DESIGN The study used a survey method. METHODS A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. RESULTS Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. conclusion: Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. RELEVANCE TO CLINICAL PRACTICE The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The determination of research and education priorities is therefore an absolute requirement in developing services.

Medical Students' Knowledge, Perceptions, and Interest in Complementary and Alternative Medicine

BACKGROUND Complementary and alternative medicine (CAM) is a growing industry in the health care system. In Ireland, to date there has not been a study that evaluates the knowledge of, interest in, and attitude of Irish medical students toward CAM. OBJECTIVES This research can serve as a pilot study to inform Irish medical schools on the need to introduce CAM into the medical curriculum. MATERIALS AND METHODS The survey instrument was a modified design based on previously published studies carried out in other geographical areas. All medical students within the undergraduate and graduate entry programs (GEP) at the Royal College of Surgeons in Ireland were invited to participate in the study. SPSS software was used to analyze the results of the questionnaires. RESULTS The survey completion rate was 20.1%. A majority of students (78.4%) thought that CAM knowledge is important for their future career as physicians. Approximately 65% of students reported that they have not acquired sufficient knowledge about CAM from medical school, and 50.2% of students believe CAM should be incorporated into the medical curriculum. Preclinical years (49.4%) were suggested as the most appropriate time to learn about CAM. Knowledge of CAM modalities was generally rated as minimal or none by students. Among the 15 CAM modalities incorporated in the survey, massage, acupuncture, and meditation received the highest interest from students. Students who believe in a religion had a higher interest in CAM (p<0.05). In terms of their personal view, massage, spirituality, and acupuncture received the highest positive responses. Attitudes toward CAM were positive from students. Lower willingness to use CAM was seen in clinical students (p<0.05). CONCLUSIONS It is important for the faculty of Irish medical schools to consider the possibility of integrating CAM education into the conventional medical curriculum in a systematic manner to better prepare students in their future career.

A descriptive survey study of violence management and priorities among psychiatric staff in mental health services, across seventeen european countries

BackgroundIn mental health services what is commonplace across international frontiers is that to prevent aggressive patients from harming themselves, other patients or staff, coercive measures and foremost, violence management strategies are required. There is no agreement, recommendations or direction from the EU on which measures of coercion should be practiced across EU countries, and there is no overall one best practice approach.MethodsThe project was conceived through an expert group, the European Violence in Psychiatry Research Group (EViPRG). The study aimed to incorporate an EU and multidisciplinary response in the determination of violence management practices and related research and education priorities across 17 European countries. From the EVIPRG members, one member from each country agreed to act as the national project coordinator for their country. Given the international spread of respondents, an eDelphi survey approach was selected for the study design and data collection. A survey instrument was developed, agreed and validated through members of EVIPRG.ResultsThe results included a total of 2809 respondents from 17 countries with 999 respondents who self-selected for round 2 eDelphi. The majority of respondents worked in acute psychiatry, 54% (n = 1511); outpatient departments, 10.5% (n = 295); and Forensic, 9.3% (n = 262). Other work areas of respondents include Rehabilitation, Primary Care and Emergency. It is of concern that 19.5% of respondents had not received training on violence management. The most commonly used interventions in the management of violent patients were physical restraint, seclusion and medications. The top priorities for education and research included: preventing violence; the influence of environment and staff on levels of violence; best practice in managing violence; risk assessment and the aetiology and triggers for violence and aggression.ConclusionIn many European countries there is an alarming lack of clarity on matters of procedure and policy pertaining to violence management in mental health services. Violence management practices in Europe appear to be fragmented with no identified ideological position or collaborative education and research. In Europe, language differences are a reality and may have contributed to insular thinking, however, it must not be seen as a barrier to sharing best practice.

Peer interviewing in medical education research: experiences and perceptions of student interviewers and interviewees.

AbstractBackgroundInterviewing is one of the main methods used for data collection in qualitative research. This paper explores the use of semi-structured interviews that were conducted by students with other students in a research study looking at cultural diversity in an international medical school. Specifically this paper documents and gives ‘voice’ to the opinions and experiences of interviewees and interviewers (the peers and the communities) on the value of peer interviewing in the study and outlines (1) the preparation made to address some of the foreseen challenges, (2) the challenges still faced, and (3) the benefits of using peer interviews with respect to the research study, the individual and the institution.MethodsPeer interviewing was used as part of a two-year phased-study, 2012–2013, which explored and then measured the impact of cultural diversity on undergraduate students in a medical higher education institution in Ireland. In phase one 16 peer interviewers were recruited to conduct 29 semi-structured interviews with fellow students. In order to evaluate the peer interviewing process two focus group discussions were he ld and an online survey conducted.ResultsKey findings were that substantial preparations in relation to training, informed consent processes and addressing positionality are needed if peer-interviewing is to be used. Challenges still faced included were related to power, familiarity, trust and practical problems. However many benefits accrued to the research, the individual interviewer and to the university.ConclusionsA more nuanced approach to peer interviewing, that recognises commonalities and differences across a range of attributes, is needed. While peer interviewing has many benefits and can help reduce power differentials it does not eliminate all challenges. As part of a larger research project and as a way in which to get ‘buy-in’ from the student body and improve a collaborative research partnership peer interviewing was extremely useful.

Young adults' preferred options for receiving chlamydia screening test results: a cross-sectional survey of 6085 young adults

Summary We investigated how young adults aged 18-29 years would like to be notified of chlamydia screening test results, and, when they test positive, their willingness and preferred mechanism for informing their partners. We conducted a cross-sectional survey of 6085 young adults and found that a call to their mobile phone was their preferred way of receiving positive test results (selected by 50%), followed by email. Text messages (short message service [SMS]) and calls to landline phones were unpopular options, selected by between 5 and 10%. Over 75% of respondents stated they would inform their current partner of a positive chlamydia diagnosis, and 50% would inform their previous partners. Most were willing to receive yearly reminders to go for a chlamydia test. Young adults preference for being informed of chlamydia test results by mobile phone call, rather than by email or SMS text, especially if they test positive, suggests they place high value on the security of the communication mechanism. Offering a range of mechanisms for receipt of test results may increase the acceptability and coverage of sexually transmitted infection (STI) control strategies.

Where do young adults want opportunistic chlamydia screening services to be located

BACKGROUND This study measured the acceptability of urine-based chlamydia screening to young adults, where young adults wanted opportunistic chlamydia screening services to be located, and by whom they wanted to be offered screening. METHODS A cross-sectional survey of 5685 university students and 400 young adult healthcares setting attendees (age: 18-29 years). RESULTS Ninety-six percent of males and 93% of females said that they would find it acceptable to be offered chlamydia screening. Seventy-six percent of males and 77% of females wanted to be offered screening by a doctor or nurse. Young women would prefer female staff. Most respondents preferred that screening be located in traditional healthcare settings such as General Practices, and offered by either doctors or nurses. More than 90% of respondents did not want screening services to be located in pharmacies and almost all rejected public non-health care screening settings. CONCLUSIONS Opportunistic chlamydia screening services should be located in traditional healthcare/medical settings, and screening should be offered by doctors and nurses.

Toward a wiki guide for obstetrics and gynecology trainees in Ireland.

The present paper describes the implementation of a novel, web‐based, comprehensive national information hub for trainees in obstetrics and gynecology in Ireland. This was a unique development in the context of an entire medical specialty and was aligned with the communication strategy of the governing professional body. To date, trainee doctors working in Ireland undergo an incoherent and inconsistent new‐staff induction and handover. In the healthcare setting, staff integration can have a major impact on the quality of patient care.

Determining the role of a national objective assessment of surgical skills in gynecological oncology: an e-Delphi methodology.

Objective The aim of this study is to determine a national consensus on the role of an objective assessment of technical surgical skills in gynecological oncology (GO). Methods After approval was obtained from Society of Gynecologic Oncology of Canada, A panel of 20 GO leaders was assembled, representing all GO fellowship programs, and was asked to participate in an anonymous group and respond to an online 49-item questionnaire using a modified Delphi methodology. Results Ninety-five percent (n = 19) of those invited to participate did so. Seventeen of the panelists (89.5%) believed there was no sufficiently standardized technical skills assessment for GO fellows, whereas 18 responders (95%) believed that fellows should be objectively assessed on more than 1 occasion during their training. Consensus was predefined as Cronbach &agr; greater than 0.8. The panel agreed on what procedures should be objectively assessed with a Cronbach &agr; of 0.967. An overall Cronbach &agr; of 0.993 was achieved after a single Delphi round. Conclusions We achieved consensus on the possible components and logistics of a skills assessment process among a group of highly experienced GO trainers in Canada. This study provides the basis for further investigation and debate on the potential value, necessity, and feasibility of an assessment of advanced surgical and nonsurgical skills of GO trainees.

Out of sight, out of mind: Do repeating students overlook online course components?

E‐Learning is becoming an integral part of undergraduate medicine, with many curricula incorporating a number of online activities and resources, in addition to more traditional teaching methods. This study examines physical attendance, online activity, and examination outcomes in a first‐year undergraduate medical program. All 358 students who completed the Alimentary System module within the first semester of the program were included, 30 of whom were repeating the year, and thus the module. This systems‐based, multidisciplinary module incorporated didactic lectures, cadaveric small group tutorials and additional e‐Learning resources such as online histology tutorials. Significant differences were demonstrated in physical attendance and utilization of online resources between repeating students and those participating in the module for the first time. Subsequent analyses confirmed that physical attendance, access of online lecture resources, and utilization of online histology tutorials were all significantly correlated. In addition, both physical attendance and utilization of online resources significantly correlated with summative examination performance. While nonattendance may be due to a variety of factors, our data confirm that significant differences exist in both physical attendance and online activity between new entrants and repeating students, such that all students repeating a module or academic year should be routinely interviewed and offered appropriate supports to ensure that they continue to engage with the program. While the development of complex algorithmic models may be resource intensive, using readily available indices from virtual learning environments is a straightforward, albeit less powerful, means to identify struggling students prior to summative examinations. Anat Sci Educ 9: 555–564.

Complementary and alternative medicine: knowledge, interest and attitudes of medical students

Complementary and alternative medicine (CAM) is a growing industry in the healthcare system. It has been reported that medical students across the globe have an interest in learning about CAM in addition to conventional medicine. In Ireland, to date there has not been a study that evaluates the knowledge of, interest in and attitude of Irish medical students towards CAM. This research can serve as a pilot study to inform Irish medical schools on the need to introduce CAM into the medical curriculum.