5 results
Improving Trainee Knowledge of Raising Concerns: A Trainee-Led Session at Induction for Postgraduate Doctors in Training
- Sian Davies, Vicki Ibbett, Katherine Hubbard, Ella Kulman, Shay-Anne Pantall, Ruth Scally
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S17-S18
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Aims
As part of a wider Quality Improvement Project aiming to improve trainees’ experiences with ‘Raising Concerns’ in a large mental health trust, we sought to improve induction processes to make information on raising concerns more accessible when starting a new post. Based on change ideas generated from our driver diagram, peer-delivered information was identified as a useful tool, so a trainee-led session was introduced to the induction programme.
MethodsA 60-minute trainee-led session was integrated into the induction programme for Postgraduate Doctors in Training in August 2022. The session included sections on raising concerns, on-call advice and rota information. Following the induction, as part of our “Plan, Do, Study, Act” (PDSA) cycle, we sent a questionnaire to gather data from trainees, which covered quantitative measures, including overall helpfulness of the session and effectiveness of information on ‘raising concerns’, and qualitative feedback for how to improve the session. The session was replicated at both the December 2022 and February 2023 inductions, incorporating the feedback from each previous session.
ResultsOn a 1-5 scale (5 = strongly agree), the average response for how helpful the trainee-led induction session was 4.5 from both the August and December 2022 inductions. 4 out of 6 responders from the August 2022 induction specifically mentioned the information on raising concerns as being particularly helpful. There was also feedback on improvements that could be introduced, such as increasing the amount of time for the session to allow for more questions. When asked to rate the helpfulness of the ‘raising concerns’ section, the average response was 4.83 and 4.50 for August and December 2022 inductions, respectively. Following the feedback from August 2022, we implemented changes to increase the duration to 90 minutes and include trainee reps in a separate ‘Question and Answer’ session. Unfortunately, there were only 2 responders to the December 2022 questionnaire due to a small intake, so we will evaluate data from February 2023 induction to analyse the effectiveness of changes made to the session and assess the need for further improvements.
ConclusionOverall, the response to our trainee-led induction session has been positive, with good feedback both for the whole session and specifically relating to ‘raising concerns’. It has highlighted trainees’ appreciation for peer-delivered information and the need for more time in this session. The questionnaire from February 2023 induction will give more data on whether our improvements have been effective and provide ideas for future PDSA cycles.
Understanding Trainees’ Current Likelihood of Raising Concerns
- Vicki Ibbett, Manjinder Padda, Katie Thomas, Rajendra Harsh, Sian Davies, Tabassum Mirza, Katherine Hubbard, Ainy Gul, Khadija Kulman, Marium Fatima, Amy Shaw, Ella Kulman, Razan Saeed, Shay-Anne Pantall, Ruth Scally
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S96
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Aims
Raising concerns is a duty for all doctors. However, a scoping exercise within a large mental health Trust demonstrated that trainees experience difficulties in raising both patient safety and training concerns. As part of a trainee-led quality improvement (QI) project within this Trust, our aim was to develop a pulse survey to capture the current likelihood of trainees raising concerns and factors influencing this.
MethodsAn online survey was developed using ‘plan do study act’ (PDSA) methodology. The initial draft was informed by data from the Autumn 2021 scoping exercise. The survey was refined using a collaborative trainee-led approach. It was tested by trainees involved in the QI project followed by two other trainees and was revised accordingly.
Trainees across all training grades were invited to complete the survey through various communication channels. The pulse survey will be repeated monthly with a two-week response window.
ResultsTen trainees out of 103 responded to the first pulse survey open from 18th to 31st January 2023 (response rate 9.7%). Seven respondents were core trainees and three were higher trainees.
Respondents were more likely to raise patient safety concerns than training concerns (average score of 3.8 out of 5, where 5 equals ‘very likely’, versus 3.4 out of 5 respectively). Of the three respondents who had experienced a patient safety concern in the past 2 weeks, only two had used any existing process to raise it. These data were replicated for training concerns.
No respondents were confident that effective action would be taken if they raised a training concern, while less than half of respondents were confident that effective action would be taken if it were a patient safety concern.
The reasons for the low response rate are likely varied. However, there may be some similar underlying reasons for low engagement in surveys and low engagement in raising concerns. Given this, a more negative picture of trainees’ likelihood of raising concerns may have been portrayed if more trainees engaged in the survey.
ConclusionEngaging trainees to provide insight into their likelihood of raising concerns is challenging. Despite the low response rate, this initial pulse survey demonstrated that trainees continue to experience barriers to raising concerns. PDSA methodology will continue to be used to optimise the monthly pulse survey response rate. The key QI outcome measures will also be integrated into pre and post intervention surveys as a pragmatic approach to evaluate specific change ideas.
Visuospatial Functioning in the Primary Progressive Aphasias
- Christa L. Watson, Katherine Possin, I. Elaine Allen, H. Isabel Hubbard, Marita Meyer, Ariane E. Welch, Gil D. Rabinovici, Howard Rosen, Katherine P. Rankin, Zachary Miller, Miguel A. Santos-Santos, Joel H. Kramer, Bruce L. Miller, Maria Luisa Gorno-Tempini
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- Journal:
- Journal of the International Neuropsychological Society / Volume 24 / Issue 3 / March 2018
- Published online by Cambridge University Press:
- 17 October 2017, pp. 259-268
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Objectives: The aim of this study was to identify whether the three main primary progressive aphasia (PPA) variants would show differential profiles on measures of visuospatial cognition. We hypothesized that the logopenic variant would have the most difficulty across tasks requiring visuospatial and visual memory abilities. Methods: PPA patients (n=156), diagnosed using current criteria, and controls were tested on a battery of tests tapping different aspects of visuospatial cognition. We compared the groups on an overall visuospatial factor; construction, immediate recall, delayed recall, and executive functioning composites; and on individual tests. Cross-sectional and longitudinal comparisons were made, adjusted for disease severity, age, and education. Results: The logopenic variant had significantly lower scores on the visuospatial factor and the most impaired scores on all composites. The nonfluent variant had significant difficulty on all visuospatial composites except the delayed recall, which differentiated them from the logopenic variant. In contrast, the semantic variants performed poorly only on delayed recall of visual information. The logopenic and nonfluent variants showed decline in figure copying performance over time, whereas in the semantic variant, this skill was remarkably preserved. Conclusions: This extensive examination of performance on visuospatial tasks in the PPA variants solidifies some previous findings, for example, delayed recall of visual stimuli adds value in differential diagnosis between logopenic variant PPA and nonfluent variant PPA variants, and illuminates the possibility of common mechanisms that underlie both linguistic and non-linguistic deficits in the variants. Furthermore, this is the first study that has investigated visuospatial functioning over time in the PPA variants. (JINS, 2018, 24, 259–268)
Standard X-Ray Diffraction Powder Patterns of Sixteen Ceramic Phases
- Winnie Wong-Ng, Howard F. McMurdie, Boris Paretzkin, Yuming Zhang, Katherine L. Davis, Camden R. Hubbard, Alan L. Dragoo, James M. Stewart
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- Journal:
- Powder Diffraction / Volume 2 / Issue 3 / September 1987
- Published online by Cambridge University Press:
- 10 January 2013, pp. 191-202
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The following sixteen reference patterns of boride, silicide, nitride and oxide ceramics represent the second group of reference patterns measured at the National Bureau of Standards under the project “High Quality Reference Patterns and Total Digital Powder Patterns of Technologically Important Ceramic Phases”. Included in the sixteen reference patterns are data for two high Tc superconducting oxide phases (CuSr0.2La1.8O4 and Ba2Cu3YO7) plus one related phase (BaCuY2O5). In addition to these new phases, five other patterns represent phases previously not contained in the PDF and eight represent major corrections to data in the file. The general methods of producing these X-ray powder diffraction reference patterns are described in this journal, Vol. 1, No. 1, pg. 40 (1986).
Reference X-Ray Diffraction Powder Patterns of Fifteen Ceramic Phases
- Winnie Wong-Ng, Howard F. McMurdie, Boris Paretzkin, Yuming Zhang, Katherine L. Davis, Camden R. Hubbard, Alan L. Dragoo, James M. Stewart
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- Journal:
- Powder Diffraction / Volume 2 / Issue 4 / December 1987
- Published online by Cambridge University Press:
- 10 January 2013, pp. 257-265
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Fifteen reference patterns of boride, silicide, selenide, telluride and oxide ceramics are reported. Included in the 15 reference patterns are data for three oxide phases which are related to high critical temperature (Tc) superconducting materials: BaCuO2, BaCuSm2O5 and BaCuYb2O5. Four other patterns are included which represent phases previously not contained in the PDF. The remaining six are major corrections of data already included in the file. Reference data for phases Ba2CuY3O6.8 and Ba2Y3CuO6 appeared in the special July superconductor issue of the Advanced Ceramic Materials, 1987. The general methods of producing these X-ray powder diffraction reference patterns are described in this journal, Vol. 1(1), 40 (1986).
Samples were mixed with one or two internal standards: silicon (SRM640a), silver, tungsten, or fluorophlogopite (SRM675). Expected 2θ values for these internal standards are specified in the methods described (ibid.). Data were measured with a computer controlled diffractometer. The POWDER-PATTERN system of computer programs was used to locate peak positions, to calibrate the patterns, and to perform variable indexing and least-squares cell refinement. A check on the overall internal consistency of the data was also provided by a computer program.
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